• 제목/요약/키워드: Clinical Nursing Practice Research

검색결과 638건 처리시간 0.034초

말기 암환자의 체험에 관한 현상학적 연구 (Lived Experience of patients with Terminal Cancer : Parses Human Becoming Methodology)

  • 이옥자
    • 대한간호학회지
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    • 제25권3호
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    • pp.510-537
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    • 1995
  • Human health is an integral part of experience in the process of Human Becoming. Through continual interaction with the environment human beings freely choose experience and develop as responsible beings. The process of the health experience of patient with terminal cancer is a unique. he objective of this study is to understand the lived experience of patients with terminal cancer in order to provide basic information for nursing care in the clinical setting and to develop a theoretical background for clinical practice. This study is to de-scribe and define the lived experience of patients with terminal cancer in order to provide a foundation for nursing research and education. Data collection has been done between December 1993 and November 1994. The subjects included five persons -four females and one male : one who was in her sixties, one in his fifties, two in their forties, and one who was in her thirties. The researcher has met with these patients 35 times, but at eight times the patient was in a stuporous condition and not able to participate, so these were not included in the data analysis. Parse's "Human Becoming Methodology", an existential phenomenological research methodology is used for this study. Data has been collected using he dialogical engagement process of "I and You", the participant researcher and the participant subject. Dialogical engagement was discontinued when the data was theoretically saturated. Data was analyzed using the extraction - synthesis and heuristic interpretation. The criteria of Guba and Lincoln(1985). and Sandelo wski(1986) : credibility, auditability, fitness and objectivity were used to test the validity and reliability of the data. The following is a description of the structure of the lived experience of patients with terminal cancer as defined by this study : 1. Structure : 1) Suffering through the reminiscence of past experience 2) The appearance of complex emotions related to life and connectedness 3) The increasing importance of significant people and of the Absolute Being 4) The increasing realization of the importance of health and belief 5) Desire for a return to health and a peaceful life or for acceptance of dying and a comfortable death In summary the structure of the lived experience of these patients can be said to be : suffering comes through reminiscence of past experience, and there are complex emotions related to life and connectedness. Significant people and the Absolute Being become increasingly important along with a realization of the importance of health and faith. And finally there is a desire for either a return to health and a peaceful life or for the acceptance of dying and a comfortable death. 2. Heuristic Interpretation : Using Parse's Human Becoming Methodology, the structure of the lived experience of patients with terminal cancer identified in this research is interpreted as. The lived experience of patients with terminal cancer involves the solving of past conflicts, and the experience of the healing and valuing of sorrow and pain. Through the relation of life and health, and the complex emotions that arise, the lived experience of revealing - concealing is of paradoxical emotions. The increasing importance of significant others and of the Absolute Being shows Connecting and Separating an on- going process of nearness and farness. Revision of thoughts about health and faith is interpreted as transforming and desire for restoration to health and a peaceful life or acceptance of dying and a cowfortable death, as powering. In summary, it is possible to see, in the lived experience of patients with terminal cancer, the relationship of the five concepts of Parse's theory : valuing, revealing -concealing, connecting-separating, transforming, and powering. From Parse's theory, the results of this study show that meaning is related to valuing, rhythmicity to revealing-concealing and connect-ing-separating, and cotranscendence to transforming and powering.

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발 반사마사지가 유방암 환자의 수술 후 통증 및 기분에 미치는 효과 (Effect of Foot Reflexology on Patient's Pain and Mood Following a Mastectomy)

  • 장화경
    • 종양간호연구
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    • 제1권2호
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    • pp.204-216
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    • 2001
  • The purpose of this study was to test the effects of foot reflexology on pain and mood in patients who have just had a mastectomy. The research design was a nonequivalent control group, non-synchronized design. The participants for this study were 28 patients with breast cancer on first or second day after mastectomy surgery. The first 12 patients were assigned to the control group and the second 16 to the experimental group. The study was conducted from October 28, 2001 to December 22, 2001 on a surgical unit of Y Medical Center in Seoul, Korea. Pain intensity, blood pressure, pulse rate and mood were measured as dependent variables. The instrument used for pain intensity and mood was a 10 cm visual analogue scale. Cronbach alpha for this study was .70. For the experimental group pre and post tests were done immediately before and 15 minutes after completion of foot reflexology. Foot reflexology was performed once for 20 minutes. After the pretest, patients in the control group were instructed to have a quiet time for a 35 minute period and then the post-test was done. The number of participants was small so the data were analyzed by Mann-Whitney U test, and Wilcoxon signed ranks test. The results of this study are as follow : 1. In the experimental group there were significant decreases between the pre and post tests for pain intensity (z=-3.47, p<.001), diastolic blood pressure (z=-2.67, p<.01) and pulse rate (z=-3.44, p<.001) but there was no difference between the two groups on the post test. 2. The systolic blood pressure, diastolic blood pressure and pulse rate were also not significantly different between the experimental group and the control group on the post test. 3. The mood score was significantly improved after foot reflexology(z=-3.52, p=.000) and the difference between the two groups was also significant (u=49.0, p=.03). In conclusion, there was a statistically significant difference in mood between the two groups, but no difference for pain intensity, blood pressure, or pulse rate. However, there were significant differences between the pretest and post-test for pain intensity, diastolic blood pressure and pulse rate in the experimental group. On the basis of the above findings, this study suggests that foot reflexology can be an effective method of relieving pain and improving mood in clinical practice in women who have had mastectomy surgery.

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일개 대학병원 간호사의 암성통증관리에 대한 지식과 태도 (A University Hospital Nurses' Knowledge and Attitude about Cancer Pain Management)

  • 김선화;박상연
    • 한국산학기술학회논문지
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    • 제13권1호
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    • pp.254-263
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    • 2012
  • 본 연구는 일 대학병원 간호사 303명을 대상으로 암성통증관리에 대한 지식과 태도를 알아보고 통증 관리 교육을 위한 기초자료로 활용하기 위한 조사연구로 진행되었다. 연구 도구는 일반적 특성과 통증의 지식과 태도와 관련한 107문항으로 구성되었고 수집된 자료는 SPSS WIN 18.0을 이용하여 분석하였다. 연구결과 통증에 대한 일반적 지식의 정답률은 79.6%, 암성 통증 지식 점수의 정답률은 82.2%로 나타났고, 진통제 사용에 대한 지식의 정답률은 55.6%, 통증관리에 대한 태도의 정답률은 65.2%, 통증관리에 대한 지식과 태도의 전체 정답률은 70.7%로 나타났다. 일반적 특성에 따른 진통제 사용에 대한 지식은 연령, 교육정도, 직위, 총 근무경력, 현 근무지, 현 근무처 경력, 통증교육 경험에서 유의한 차이가 있었고 통증관리에 대한 태도는 성별, 교육정도, 현 근무지에서 유의한 차이가 있었다. 결론적으로 환자의 통증을 관리해야 하는 간호사의 통증과 관련한 항목별 지식과 태도의 평균점수가 높지 않음을 알 수 있고 대부분 통증 중재 방법으로는 진통제 투여에 의존하고 있는 것으로 나타났다. 따라서 간호사의 암성통증관리에 대한 지식과 태도를 향상시키기 위해 실무에 적용 가능한 교육 프로그램의 개발이 필요하고 개발된 교육 프로그램을 적용하여 임상간호사의 통증관리에 대한 지식과 태도의 변화를 반복 연구할 필요가 있다.

전인적 호스피스간호중재 프로그램이 입원한 호스피스환자의 통증과 불안에 미치는 효과 (Effects of Wholistic Hospice Nursing Intervention Program on Pain and Anxiety for In-patient of Hospice Palliative Care Unit)

  • 최성은;강은실;최화숙
    • 호스피스학술지
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    • 제8권1호
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    • pp.55-67
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    • 2008
  • 목적: 말기환자와 그 가족들은 신체적인 고통뿐 아니라 심리·사회적, 영적 측면에서 전인적인 고통을 겪고 있으므로 이러한 고통을 완화시켜주기 위해서는 간호사, 의사, 성직자, 사회복지사 등의 다학제(multi- discipline) 전문가들과 자원봉사자로 구성된 호스피스 팀에 의해 제공되는 호스피스 간호중재 프로그램의 개발이 필요한 현실이다. 본 연구는 단일군 전․후 유사실험 연구설계로 전인적 호스피스 간호중재 프로그램이 호스피스 병동에 입원한 호스피스 환자의 통증과 상태불안에 미치는 효과를 알아보고자 하였다. 방법: 자료수집은 P시 소재 S병원의 호스피스 병동에 입원한 18세 이상의 환자 27명을 대상으로 2004년 4월 6일부터 2005년 4월 20일까지 구조화된 설문지를 통해 수집하였다. 제공된 전인적 호스피스간호중재 프로그램은 전인적, 다학제적, 개별 및 집단적인 중재형태로 구성되어 있고, 상호협동적인 다학제 전문가팀(간호사, 의사, 성직자, 사회복지사, 무용치료사, 미술치료사, 자원봉사자)이 호스피스 대상자 병실이나 병동에서 매회 120분씩, 총 10회(총1,200분)에 걸쳐 실시한 프로그램이었다. 프로그램 효과를 측정하기 위한 도구로서 통증 척도는 윤영호(1998) 등이 한국형 간이통증 조사지(Korean Version of Brief Pain Inventory, BPI-K)로 개발한 도구 중 일부를 윤매옥(2000)이 사용한 도구, 상태불안 척도로는 Spielberger (1975)의 상태불안 측정도구(State-Anxiety Inventory)를 김정택과 신동균(1978)이 번역하여 사용한 도구를 사용하였다. 자료분석은 수집된 자료를 SPSS/WIN 12.0 프로그램을 이용하여 실수, 백분율, 최대값, 최소값, 평균, 표준편차, Paired t-test로 분석하였다. 결과: 본 연구의 결과는 다음과 같다. (1) 가설 1 ‘전인적 호스피스 간호중재 프로그램을 제공받은 입원 호스피스 환자(이하 실험군)는 실험 전보다 실험 후의 통증 정도가 낮을 것이다’ 를 검증한 결과 실험군은 실험 후의 통증 점수가 유의하게 낮아 가설이 지지되었다(t=-10.585, P= .000). (2) 가설 2 ‘전인적 호스피스 간호중재 프로그램을 제공받은 실험군은 실험 전보다 실험 후의 상태불안 정도가 낮을 것이다’ 를 검증한 결과 실험군은 실험 후의 상태불안 정도가 유의하게 낮아 가설이 지지되었다(t=-8.234, P= .000). 결론: 본 연구의 결과, 전인적 호스피스 간호중재 프로그램은 호스피스 대상자의 통증 및 상태불안을 완화시키고 향상시켜 신체 및 정서적 차원에서 그 효과가 확인되었으므로 호스피스 임상 실무에 적극적으로 활용할 수 있을 것이며, 그로 인해 호스피스 대상자의 통증을 조절하고 불안을 감소시켜 삶의 질을 총체적으로 높일 수 있는 데 기여하리라 사료된다.

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Motor Learning in Elderly: Effects of Decision Making Time for Self-Regulated Knowledge of Results During a Dynamic Balance Task

  • Jeon, Min-jae;Jeon, Hye-seon
    • 한국전문물리치료학회지
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    • 제23권4호
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    • pp.16-26
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    • 2016
  • Background: Deficiencies in the ability to maintain balance are common in elderly. Augmented feedback such as knowledge of results (KR) can accelerate learning and mastering a motor skill in older people. Objects: We designed this study to examine whether one session of Wii-Fit game with self-regulated KR is effective for elderly people, and to compare the effect of two different timings of self-regulated KR conditions. Methods: Thirty-nine community-dwelling elders, not living in hospice care or a nursing home, participated in this study. During acquisition, two groups of volunteers were trained in 10 blocks of a dynamic balancing task under the following 2 conditions, respectively: (a) a pre-trial self-regulated KR ($n_1=18$), or (b) a post-trial self-regulated KR ($n_2=21$). Immediate retention tests and delayed retention tests of balancing performance were administered in 15 minutes and 24 hours following acquisition period, respectively. Results: In both groups, significant improvements of balancing performances scores were observed during the acquisition period. Regardless of the group, mean of balancing performance scores on retention tests were well-maintained from the final session. There were no significant differences between groups in balancing performance scores during the acquisition period (p>.05); however, the post-trial self-regulated KR group exhibited significantly higher balancing performance scores in both the immediate retention test and delayed retention test than that of the pre-trial self-regulated KR group (p<.05). Conclusion: Therefore, subjects who regulated their feedback after a dynamic balancing task, during the acquisition period, experienced more efficient motor learning during the retention period than did subjects who regulated their feedback before a dynamic balancing task. Accordingly, in case of presenting the KR of motor learning in clinical settings to elders who reduced dynamic balance abilities, the requesting time of KR is imperative according to self-estimation processes as well as types of KR and practice.

자녀를 둔 어머니의 출산과정 경험 (An Ethnographic Research Study on Childbearing Process of Mother with Children in Korea)

  • 김영희
    • 여성건강간호학회지
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    • 제7권3호
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    • pp.271-283
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    • 2001
  • The childbearing process is a sociocultural phenomenon of a woman who gives birth to a child as well as a biological phenomenon. The purpose of this ethnographic research study was to explore the experience of childbearing process of mothers with children from pregnancy to the 3 months postpartum in Korea and to understand deeply the perspectives of childbearing women reflected on Korean sociocultural values. A convenient sample of 10 childbearing women were observed from January to October 2000 through field work in Seoul, Korea. Data analysis was accomplished under ongoing process. The results of this study were as follows : The mothers with children experienced self-reflection, family relation, and physical adaptation during pregnancy. In self-reflection, all mothers experienced universality and diversity in their self-discovering process. The universal experiences were maturation, life with family and priority on maternal value between being a mother and a woman. The diverse experiences were taking a dual role of working mother, emotional drift of a resigned mother, and disheartened life of a mother who has two daughters. In family relation, the foundation of the new marital relationship were attained during childbearing process and sexual life were changed for the benefit of a healthy mother and a healthy baby. All mothers established friendly relations with their mothers, but established friendly or conflicting or constraining relations with their mother-in-laws due to husband based family culture. In physical adaptation, the informants endured well the physical discomfort and recognized general appearance change. Also maternal-fetal interaction occurred and mothers realistically felt motherhood and accepted themselves as mother-to-be. The mothers prepared for the best delivery, look for a safe childbirth center, newborn goods, endorsed family coping during hospitalization and responded labor pain to make it more endurable, less painful, fast passed owing to labor recognition of the natural process to be a mother. After childbirth, they felt emancipation, satisfaction, accomplishment, more easiness, actually feeling as mother-to-be, emptiness, and showed response to the sex of newborn. Their Sanhujori practice was different according to the Sanhujori environment including provider, place, time in postpartum and reflected on Sanhubyung. The mothers felt actually mother-to-be and happiness during lactation regardless of feeding pattern. These mothers had a different maternal image about rearing subjecthood through their child-rearing experience. But all mothers felt need for family support and social support. The universal rearing response were actual feeling of mother-to-be, a strenuous experience, a pride on child-rearing, confusion, reflecting marital relationship, and wondering rivalry among children. In conclusion, mother of all with children went through self-discovery, self-reflection and made connections with the family as a mother and as a woman simultaneously during the childbearing process. Therefore it is suggested when harmony and balance between a mother and a woman is accomplished, the woman will lead a healthy and high quality of life. Also, this study sought to confirm the sociocultural factors affecting the childbearing process from the perspectives of the women with children. Therefore health care providers must understand deeply the childbearing women with children based on this finding of and try a integrative approach with new ideology of maternity with biocultural perspectives in a clinical setting.

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Models for Spiritual Care in Hospice and Palliative Care

  • Kang, Kyung-Ah
    • Journal of Hospice and Palliative Care
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    • 제21권2호
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    • pp.41-50
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    • 2018
  • 영성은 인간의 본질적인 부분으로 말기 환자와 가족의 실제적인 영적요구 충족을 위한 영적돌봄은 HPC에서 가장 중요한 영역이다. 말기환자와 가족의 실제적인 영적요구에 부응하는 돌봄모형을 확인하기 위해 최근 보건의료계에서 가장 많이 사용하는 국 내외 database를 검색하여 분석한 결과, 영성은 전인적 존재인 인간의 본질적인 부분으로, 삶의 위기상황에 더욱 충족되어야 할 존재론적 특성으로서, 말기 환자의 영성평가는 HPCT이 기본적으로 갖추어야 할 역량임이 확인되었다. HPC에 evidence based theory로 활용 가능한 총 10개의 모델이 제시되었다. 세 개의 모델들은 영적돌봄 결과에 초점을 둔 모델로서, spiritual health, QOL, and coping을 중요한 outcome으로 보는 모델들이었다. 영적돌봄수행에 초점을 둔 모델은 7개였으며, HPCT의 다학제간 협력을 통한 돌봄과정을 나타낸 'Wholeperson Care Model', 인간의 보편적인 실존적 요구충족이 보완된 'An Existential Functioning Model', 대상자의 문화적, 그 외 다양성을 고려하는 'An Open Pluralism View', HPCT와 말기환자와의 관계중심모델인 'A spiritual-relational view' and 'The Framework of Systemic Organization', 영적돌봄과정의 전체적 역동을 설명하는 'The principal components model' and 'The Actioning Spirituality and Spiritual care in Education and Training model'이 있다. 이러한 모델을 토대로 HPC에서 가장 최선의 영적돌봄 모델 구축을 위한 지속적인 임상연구 노력이 계속될 필요가 있겠다.

한의원의 경영 현황과 정책 인식도에 대한 조사 연구 (Survey on the current status of the management of traditional Korean medical clinics and perception of the policies)

  • 박요한;강병갑;신현규
    • 대한한의진단학회지
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    • 제18권3호
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    • pp.205-216
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    • 2014
  • Objectives The purpose of this study is to help improve the management of traditional Korean medical(TKM) clinics and the policies for supporting them, by conducting a survey of the practitioners of TKM. Methods Stratified sampling was conducted based on regional location, and 700 samples were selected in a random manner from the membership list. The questionnaire was delivered and returned by mail. The survey was conducted between 20 July and 31 August 2010. A total of 177 questionnaires (recovery rate: 25.28%) were recovered and analyzed for the study. Results 1. The the survey indicate that the overall size of TKM clinics has fallen compared with previous survey, while the average number of beds per clinic has remained unchanged at 7.9. The sale of medicine as a proportion of total monthly sales has increased. 2. There has been no change in the composition of clinical staff as there are three nursing assistants. Although the average daily number of patients to clinics has remained at around 33.90 compared with ten years ago, the number of patients requiring seeking acupuncture treatment has increased while the number of those treated with medication has decreased. 3. Clinicians in TKM have indicated their preference for a binary system that separates TKM from western medicine (57.4%). The respondents do not favor the separation of dispensary from medical practice (81.5%), marks of origin for medicinal herbs (68.9%), disclosure of the prescriptions (67.2%), and the overseas expansion of Korean medical services (70.4%). However, they indicated that they are very much in favor of being granted the authority to employ and give orders to medical technicians (96.0%). 4. The respondents selected Korea as the country that maintains a proper academic system for traditional medicine (45.5%), and are not in favor of opening Korea's traditional medicine market under an Free Trade Agreement(FTA) with China (72.7%). Conclusion The overall status of the management of TKM clinics has declined compared with the preceding decade. There has been only a slight change in clinicians' opinion of the related policies and regulatory issues.