• 제목/요약/키워드: Clinical Nursing Performance

검색결과 597건 처리시간 0.023초

관절염 환자의 운동행위 결정요인 (Determinant factors of Exercise behaviors in Patients with Arthritis)

  • 서길희;임난영
    • 근관절건강학회지
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    • 제7권1호
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    • pp.102-130
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    • 2000
  • The aims of this study were to understand and to predict the determinant factors affecting the exercise behaviors and physical fitness by testing the Ponder's health promotion model, and to help the patients with rheumatoid arthritis and osteoarthritis perform the continuous exercise program, and to help them maximize the physical effect such as muscle strength. endurance, and fuctional status and mental effects including self efficacy and quality of life, and improve the physical and mental wellbeing, and to provide a basis for the nursing intervention strategies. We analyzed the clinical records of 208 patients with rheumatoid arthritis and degenerative arthritis who visited the outpatient clinics at H university hospital in Seoul between October 5, 1999 and October 24, 1999. Data were composed of self reported questionnaire and good of fitness score which were obtained by pedalling the ergometer of bicycle for 9 minutes. SPSS Win 8.0 and Window LISREL 8.12a were used for statistical analysis. 24 Of 54 hypothetical paths were supported in modified model, which was considered as a proper model with improved fit index. The physical fitness was directly influenced by exercise participation behavior and education level, and indirectly by physical fitness, while fatigue, physical disability, pastexercise behavior, life-style, self-efficacy, which explained 20% of physical fitness. The exercise participation were directly influenced by perceived benefits and self-efficacy, and indirectly influenced by life-style, fatigue and physical disability, and directly and indirectly by past exercise behavior, which explained 53% of exercise participation. Exercise score were directly affected by perceived health status, perceived benefits, self efficacy, and past exercise behavior, and were indirectly affected by fatigue, physical disability, and life-style, which explained 50%. Perceived health status were directly influeced by level of education, depression, sleep disorder, and physical disability, which explained 34% of perceived health status. Perceived benefit was directly influenced by fatigue, sleep disorder, physical disability, and life-style, which explained 45%. Perceived barriers was directly influenced by fatigue, sleep disorder, and lifestyle, which explained 9%. Self- efficacy was directly influenced by fatigue, physical disability, past exercise behavior, and level of education, which explained 61%. In conclusion, important variables for physical fitness were exercise participation and level of education, and variables affecting exercise participation were perceived self-efficacy, benefits, and past exercise behavior. Perceived self-efficacy of exercise was a significant predictor of exercise participation. Life-style, fatigue, and physical disability showed direct effects on perceived benefit, perceived barriers, and self-efficacy, and indirect effects on exercise behavior. Therefore, disease related factor should be minimized for physical performance and well being in nursing intervention for patients with rheumatoid arthritis, and plans to promote and continue exercise should be soaked to reduce disability. In addition, Exercise program should be planned and performed by the exact evaluation of exercise according to the ability of the patients and the contents to improve the importance of exercise and self efficacy in self control program, dedicated educational program should be involved.

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COVID-19 팬데믹 상황에서 응급실 간호사의 소진에 영향을 미치는 융합적 요인 (Convergence factors Affecting Burnout of Emergency Room Nurses During the COVID-19 Pandemic)

  • 노승애;양승애
    • 사물인터넷융복합논문지
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    • 제8권6호
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    • pp.99-113
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    • 2022
  • 본 연구는 응급실 간호사를 대상으로 COVID-19 대유행 상황에서 COVID-19 스트레스, 대인관계(보호자-환자) 스트레스, 감정노동이 소진에 미치는 영향을 파악하기 위한 서술적 조사 연구이다. 자료수집은 H 의료원 산하기관 5개 상급종합병원과 종합병원 응급실 간호사를 대상으로 2021년 12월 9일부터 12월 23일까지 시행되었다. 대상자의 일반적 특성과 직무 관련 특성, COVID-19 스트레스, 대인관계(보호자-환자) 스트레스, 감정노동, 소진을 측정하기 위해 자기기입식 설문지로 진행하였다. 수집된 자료는 SPSS/WIN 25.0 통계 프로그램을 이용하여 빈도 분석, 기술통계분석, Independent sample t-test, One-way ANOVA, Scheffé test, Correlation analysis, 다중회귀분석을 실시하였다. 응급실 간호사의 COVID-19 스트레스의 평균은 3.64점, 대인관계(보호자-환자) 스트레스 4.35점, 감정노동 3.38점, 소진 3.44점이었다. 일반적 특성 및 직무 관련 특성에 따른 간호사의 소진은 성별, 결혼상태, 총 임상 경력, 근무 기관 형태에 따라 유의한 차이를 보였다. 소진은 COVID-19 스트레스, 대인관계 스트레스, 감정노동과 모두 유의한 정적 상관관계를 보였다. COVID-19 팬데믹 상황에서 응급실 간호사의 소진에 영향을 미치는 융합적 요인으로는 근무 기관 형태 중 권역 응급의료센터, 지역응급의료센터, 대인관계 스트레스, COVID-19 스트레스, 성별로 나타났고 설명력은 28.6%로 나타났다. 이와 같은 결과를 통해 신종감염병 대유행 시점에서 응급실 간호사의 소진을 예방하고 간호업무성과를 높이기 위한 중재프로그램 개발을 위한 기초자료를 제공하고자 한다.

보건진료원 및 보건진료보조원의 근무시간활용에 대한 조사연구 (Time and Motion Study of Community Health Practitioners and Community Health Aids in Ocku Area)

  • 황인담;기노석
    • 한국인구학
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    • 제3권1호
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    • pp.42-51
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    • 1979
  • A study on analysis of daily activities and time allocations of Community health Practitioners(CHP) and Community Health Aids(CHA) who assigned to Ocku Demonstration Health Project of the Korean Health Development Institute was conducted for one week from 3rd through 8th December 1979. The purpose of this study was to determine the efficacy including productivity of the community Health Workers developed by KHDI for rural areas. Five Community Health Practitioners and eight Community Health Aids were selected for the studies and their activities and time allocations were measured by designed format for one week. The following are the summary of the findings. 1. The mean age of the CHPs was 34.4 years with standard deviation 4.8 years, while that of CHAs was 26.9 years with standard deviation 3.1 years. 2. On educational background, all of the CHPs were graduated from Junior Nursing College, six CHAs were from high school and the rest of them from middle school. 3. On marital status, all CHPs were married, meanwhile four CHAs were married and the rest of them were single. 4. On service duration in public health fields, all of the CHPs have worked for less than three years, meanwhile five CHAs for 5 to 9 years and one CHA for more than 10 years. 5. Only one CHP lives in the myon where she works, and the rest of them live in other areas. Three CHAs live in the same myon where they work, and five live in other areas. 6. On types of work, the CHPs have worked on technical areas for 3.6 hours per day and on supportive and administrative activities for 2.7 hours and other activities for 1.8 hours on average. 7. The CHAs have spent 2.9 hours a day on technical activities, 4.2 hours on supportive and administrative activities and 1.6 hours on other activities in terms of time spent on average. 8. The average hours per day spent by CHPs on functional areas were 2.2 hours for clinic activities, 13.7 minutes for maternal health, 30.1 minutes for infant and child health, 13.4 minutes for family planning, 1.1 hours for supporting activities and 1.7 hours for administrative affairs. 9. The average hours per day spent by CHAs on functional areas were 4.1 hours for administrative affairs, 2.6 hours for supportive activities and only 2.9 for maternal health, infant and child health an family planning, and other technical works. 10. The average time spent by CHPs on clinical works were 1.0 minutes for history takings on disease, 2.6 minutes for physical examinations, 1.1 minutes for measurements, 3.8 minutes for administration of medications, 1.5 minutes for educations and 0.9 minutes for others. 11. On the average 92.8 percent of whole working hours of CHPs were spent in the substations, meanwhile 70.4 percent of CHAs were spent in the substations. 12. 17.8 percent of field working hours of CHAs were spent on the roal for their transportations. 13. The average time for unit service performance by CHPs were 10.9 minutes on clinical case, 18.1 minutes on maternal health, 14.8 minutes on infant and child health, 20.5 minutes on family planning and 29.9 minutes on tuberculosis control. 14. The average time for unit service performance by CHAs were 19.4 minutes on clinical work, 19.9 minutes on maternal health, 20.1 minutes on infant and child health, 17.2 minutes on family planning, 22.2 minutes on tuberculosis control.

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Protein target identification of ginsenosides in skeletal muscle tissues: discovery of natural small-molecule activators of muscle-type creatine kinase

  • Chen, Feiyan;Zhu, Kexuan;Chen, Lin;Ouyang, Liufeng;Chen, Cuihua;Gu, Ling;Jiang, Yucui;Wang, Zhongli;Lin, Zixuan;Zhang, Qiang;Shao, Xiao;Dai, Jianguo;Zhao, Yunan
    • Journal of Ginseng Research
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    • 제44권3호
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    • pp.461-474
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    • 2020
  • Background: Ginseng effectively reduces fatigue in both animal models and clinical trials. However, the mechanism of action is not completely understood, and its molecular targets remain largely unknown. Methods: By screening for proteins that interact with the primary components of ginseng (ginsenosides) in an affinity chromatography assay, we have identified muscle-type creatine kinase (CK-MM) as a potential target in skeletal muscle tissues. Results: Biolayer interferometry analysis showed that ginsenoside metabolites, instead of parent ginsenosides, had direct interaction with recombinant human CK-MM. Subsequently, 20(S)-protopanaxadiol (PPD), which is a ginsenoside metabolite and displayed the strongest interaction with CK-MM in the study, was selected as a representative to confirm direct binding and its biological importance. Biolayer interferometry kinetics analysis and isothermal titration calorimetry assay demonstrated that PPD specifically bound to human CK-MM. Moreover, the mutation of key amino acids predicted by molecular docking decreased the affinity between PPD and CK-MM. The direct binding activated CK-MM activity in vitro and in vivo, which increased the levels of tissue phosphocreatine and strengthened the function of the creatine kinase/phosphocreatine system in skeletal muscle, thus buffering cellular ATP, delaying exercise-induced lactate accumulation, and improving exercise performance in mice. Conclusion: Our results suggest a cellular target and an initiating molecular event by which ginseng reduces fatigue. All these findings indicate PPD as a small molecular activator of CK-MM, which can help in further developing better CK-MM activators based on the dammarane-type triterpenoid structure.

Clinical application of RapidArc volumetric modulated arc therapy as a component in whole brain radiation therapy for poor prognostic, four or more multiple brain metastases

  • Lee, Seung-Heon;Lee, Kyu-Chan;Choi, Jin-Ho;Kim, Hye-Young;Lee, Seok-Ho;Sung, Ki-Hoon;Kim, Yun-Mi
    • Radiation Oncology Journal
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    • 제30권2호
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    • pp.53-61
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    • 2012
  • Purpose: To determine feasibility of RapidArc in sequential or simultaneous integrated tumor boost in whole brain radiation therapy (WBRT) for poor prognostic patients with four or more brain metastases. Materials and Methods: Nine patients with multiple (${\geq}4$) brain metastases were analyzed. Three patients were classified as class II in recursive partitioning analysis and 6 were class III. The class III patients presented with hemiparesis, cognitive deficit, or apraxia. The ratio of tumor to whole brain volume was 0.8-7.9%. Six patients received 2-dimensional bilateral WBRT, (30 Gy/10-12 fractions), followed by sequential RapidArc tumor boost (15-30 Gy/4-10 fractions). Three patients received RapidArc WBRT with simultaneous integrated boost to tumors (48-50 Gy) in 10-20 fractions. Results: The median biologically effective dose to metastatic tumors was 68.1 $Gy_{10}$ and 67.2 $Gy_{10}$ and the median brain volume irradiated more than 100 $Gy_3$ were 1.9% (24 $cm^3$) and 0.8% (13 $cm^3$) for each group. With less than 3 minutes of treatment time, RapidArc was easily applied to the patients with poor performance status. The follow-up period was 0.3-16.5 months. Tumor responses among the 6 patients who underwent follow-up magnetic resonance imaging were partial and stable in 3 and 3, respectively. Overall survival at 6 and 12 months were 66.7% and 41.7%, respectively. The local progression-free survival at 6 and 12 months were 100% and 62.5%, respectively. Conclusion: RapidArc as a component in whole brain radiation therapy for poor prognostic, multiple brain metastases is an effective and safe modality with easy application.

암 환자의 삶의 질에 영향을 미치는 재정 관련 어려움 요인 (Financial Hardship Factors affecting the Cancer Patient's Quality of Life)

  • 이영선;김수연;박정환
    • 한국산학기술학회논문지
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    • 제21권10호
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    • pp.299-307
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    • 2020
  • 연구목적: 본 연구는 암 환자의 삶의 질에 영향을 미치는 재정 관련 어려움 요인을 찾고자 수행하였다. 방법: 연구대상은 항암, 방사선 치료 경험이 있는 암 환자이며, 종속변수는 삶의 질, 독립변인은 인구사회학적 요소, 의료적 상황, 재정관련 어려움(암 치료비로 인한 물질적 상황, 심리적 반응, 대처행동)을 변인으로 하여 모형을 구성하였다. 자료수집은 자기기입식 설문지를 활용, 5개 요양병원에서 수집하였으며, 422부의 설문지를 분석에 사용하였다. 분석방법은 인구사회학적, 의료적 변인과 함께, 세 유형으로 분류한 재정관련 어려움 변인을 각각 단계적으로 투입하여 5단계로 위계적 다중 회귀분석 하였다. 결과: 삶의 질에 가장 영향력이 큰 요인은 평소처럼 일할 수 없거나, 가계에 도움이 될 수 없다는 좌절감이었으며, 신체활동수행정도가 나쁠수록, 동반질환이 있는 경우, 여자인 경우, 암 치료비에 대한 심리적 부담감이 클 경우, 치료비용에 대한 의료진과 의사소통 만족도가 낮을 경우, 경제적 상황에 대해 잘 관리되고 있다고 느끼지 못하는 경우, 삶의 질이 나쁜 것으로 나타났다. 결론: 본 연구결과가 암 환자 삶의 질 향상을 위한 실천 현장의 중재 프로그램 개발, 임상적 개입방안 및 관련 정책 방안 마련을 위한 근거로 활용되길 기대한다.

성별에 따른 암환자의 통증 차이 (Gender Differences in Pain in Cancer Patients)

  • 김현숙;이소우;윤영호;유수정;허대석
    • Journal of Hospice and Palliative Care
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    • 제4권1호
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    • pp.14-25
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    • 2001
  • 목적 : 통증에 있어서의 성별차이에 대한 연구결과에 있어서 일치하지 않고 있다. 이에 암환자를 대상으로 성별에 따른 통증정도를 살펴보고, 통증과 우울 및 활동도의 상호작용에 있어서도 성별에 따른 차이가 있는 지를 규명하기 위함이다. 방법 : 1999년 2월부터 6월까지 서울소재 S대학교 병원 혈액종양내과에 입원 또는 외래치료중인 암환자 140명(남성 78명, 여성 62명)을 대상으로 하였으며, 통증정도는 한국판 간이 통증 평가도구(BPI-K), 우울은 한국판 Beck Depression Inventory를 이용한 설문지를 통하여 수집되었고, 기타 인구학적 및 임상학적 자료는 의무기록 열람 및 주치의의 의견을 참조하여 수집되었다. 대상자를 서술하기위해 빈도, 평균, 표준편차를 구하였으며, 집단간 비교에서 불연속척도는chi-square test를 하였고, 연속척도는 t-test를 하였으며, 변인간 상관관계는 Pearson 상관계수를 구하였다. 결과 : 1) 통증의 중증도의 경우 통증정도가 24시간 동안 가장 심했을 때 통증 평균은 남성이 5.77점, 여성이 6.45점이었다. 통증으로 인한 지장정도는 남성의 경우 기분(5.49점), 인생을 즐김(5.36점), 통상적인 일(5.00점)이 순이었으나, 여성의 경우는 통상적인 일(7.48점), 인생을 즐김(7.16점), 기분6.53점) 순이었다. 2) 통증의 중증도의 경우 24시간 동안 평균 통증정도(t=-2.130, P=.035)에서 남성과 여성간에 유의한 차이가 나타났으며, 통증으로 인한 장애정도에서는 활동(t=-2.450, P=.015), 기분(t=-2,321, P=.022), 보행 능력(t=-2.762, P=.007), 통상적인 일(t=-4.946, P=.000), 대인관계(t=-2.595, P=.010), 수면(t=-2.071, P=.040), 인생을 즐김(t=-3.198, P=.001)에서 남성과 여성간에 통계적으로 유의한 차이가 나타났다. 3) 통증과 우울과의 상관관계 분석결과, 통증의 중증도에서 남성의 경우 24시간동안 가장 심했을 때 통증정도와 우울(r=0.323, P<.05), 평균 통증정도와 우울(r=.236, P<.05) 및 조사당시 바로 지금 느끼는 통증정도와 우울(r=0.248, P<.05)이 통계적으로 유의한 정적 상관관계가 나타난 반만 여성에서는 조사당시 바로 지금 느끼는 통증정도와 우울(r=.250, P<.05)만이 유의한 정적상관관계가 나타났다. 통증으로 인한 지장정도의 경우 남성은 모든 항목과 우울간 유의한 정적상관관계가 나타난 반만 여성에서는 전 항목과 우울간에 유의한 관계가 나타나지 않았다. 통증과 활동성 정도와의 상관관계 분석결과, 통증의 중증도에서 남성의 경우 24시간동안 가장 심했을 때 통증정도와 활동성 정도(r=0.378, P<.05), 평균 통증정도와 활동성 정도가(r=.330, P<.05)가 유의한 정적상관관계가 나타난 반면, 여성에서는 활동성 정도와 통증의 중증도는 유의한 관계가 없는 것으로 나타났다. 남성은 관계를 제외한 모든 항목의 통증으로 인한 지장정도와 활동성 정도가 유의한 정적상관관계가 나타난 반만 여성에서는 보행 능력, 통상적인 일, 인생을 즐김 항목과 활동성 정도간 유의한 정적 상관관계가 있었다. 결론 : 암환자의 통증정도 및 지장정도는 여성이 남성보다 높았으며, 통증과 우울 및 활동도와의 상관관계에서 차이를 보였다. 앞으로 암성통증 관리 대책 수립시 여성과 남성의 이러한 차이를 고려하여야 한다.

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