• 제목/요약/키워드: Clinical adjustment

검색결과 282건 처리시간 0.028초

교대제 개선 시범사업이 간호사의 교대근무 적응, 일과 삶의 균형 및 이직의도에 미치는 효과: 혼합연구방법 (The Effects of a Shift Improvement Pilot Project on Nurses' Shift Adjustment, Work-Life Balance, and Turnover Intention: A Mixed-Methods Study)

  • 최수정;김미순;전미경;최진주;손숙연;김은혜
    • 임상간호연구
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    • 제29권3호
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    • pp.223-237
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    • 2023
  • Purpose: This study aimed to investigate the impact of a nurse shift improvement pilot project on nurses' shift adjustment, work-life balance, and turnover intention, as well as nurses' experiences of participating in the pilot project. Methods: An explanatory sequential mixed-methods study was performed. Survey data was collected from a total of 1,051 nurses both in participant and non-participant groups. For the qualitative study, focus group interviews were conducted with 22 nurses who participated in the shift improvement pilot, including 12 staff nurses, 7 nurse managers, and 3 substitute nurses. Results: There were significant positive effects on the key variables of nurses' shift adjustment, work-life balance, and turnover intention in the group that participated in the nurse shift improvement pilot project. Based on the qualitative study, participants in the shift improvement pilot project indicated that it enabled nurses to recover their circadian rhythm, and achieve a better work-life balance, and they wanted to continue working as a nurse, and hoped expanded application of the pilot project. Conclusion: In order for expanded implementation of the pilot project and continued improvement in the shift system, we recommend establishing compensation standard, systematizing the use of substitute nurses, developing guidelines for shift schedules, and expanding the shift improvement pilot project to other departments such as the emergency room.

다운증후군 자녀를 둔 어머니의 적응 (Mothers' Adjustments in Raising Children with Down Syndrome)

  • 김미영
    • 임상간호연구
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    • 제14권2호
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    • pp.19-29
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    • 2008
  • Purpose: The purpose of this study was to explore mothers' adjustments in raising children with Down syndrome and to develop a grounded theory about their adjustments. Method: Three mothers from each group of children in the ages below 7 years, 8-13 years, 14-19 years, and over 20 years participated in the study. Data were collected through an in-depth interview from twelve participants having a child with Down syndrome. Then it was analyzed simultaneously using the grounded theory method. Results: 'Adjustment of mother's expectation according to child's status' was emerged as a core category. The adjustment process was categorized into five stages: shocking, embracing, doing one's best with passion, lowering anticipation, and accepting another living. Conclusion: Being the mother of a child with Down syndrome is not considered to be a negative experience. There are positive experiences along with some more negative ones. Nurses working with families that include children with Down syndrome need to be aware of the obstacles the families will face and should advise necessary support.

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가철성 의치의 유지관리 (Maintenance care for removable denture)

  • 조리라
    • 대한치과의사협회지
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    • 제54권12호
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    • pp.996-1023
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    • 2016
  • There are many kinds of maintenance care services for removable denture patient. Adjustment of the denture base and occlusion should be performed regularly not only for pain relief but also for maintaining the denture function. Direct and indirect relining are needed frequently in specific cases including mandibular distal extension case or non-symmetric residual teeth situation. Surface treatments for metal and resin are essential in the relining procedure. Clinical process for the denture repair is similar to indirect relining which needs inter-occlusal registration. Especially, the peridontal maintenance care and caries prevention are most important way to preserve the abutment teeth in partial edentulism. Moreover, the caring method for the denture and the tissue should be instructed to the denture patient.

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S.Minuchin 의 구조적 가족치료이론의 한국적 재조명 (Korean Review on the S.Minuchin's Structural Family Therapy Theory)

  • 손정영;김순옥
    • 가정과삶의질연구
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    • 제9권2호
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    • pp.345-366
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    • 1991
  • The concrete purpose of this study is to examine the possibility of applying S.Minuchin's structural family therapy theory to each clinical families so that it can solve efficiently the clinical problems Korean family. The test results are as follows: 1)The Results of Question I : Types of Korean family problems can be divide into six. Then the most frequent type of problem was marital problem. 2) The Results of Question II: Korean normal family showed rater difussed boundary and higher rate of wife dominant type than that of husband dominant type in aspect of boundary and power, and had low tendency toward alignment and neutral adjustment. 3)The Results of Quesion III; Amidst the clinical families, family structural traits of the families which have marital problems showed a clear boundary, the tendency toward alignment, and higher tate of husband dominant type than that of wife dominant type. And family structural traits of children problem family had the tendency of alignment and showed little wife-dominanted families in power. Finally, mother-in -law and daughter-in-law problemed family had several characters such as diffused boundary, the tendency of alignment and high adjustment. 4)The Results of Question IV : As a result of camparing problemed families with normal families in family structure, there was high adaptability of S.Minuchin's structural theory to the two family groups; the groups of marital problems and those of children problem.

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암환자와 배우자의 부부적응에 대한 부부의사소통의 영향 - 자기효과와 상대방효과를 중심으로 - (The Effect of Communication on Marital Adjustment of Cancer Patients and their Spouses - Focusing on the Actor Effect and Partner Effect -)

  • 이인정
    • 한국사회복지학
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    • 제63권2호
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    • pp.179-205
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    • 2011
  • 암환자에게 부부적응은 심리적인 안녕 뿐만 아니라 치료경과 및 생존율에 영향을 미치는 것으로 보고되고 있어 이들의 부부적응을 도모하기 위한 사회복지 노력과 관심이 절실히 필요하다 하겠다. 이에 본 연구는 암환자와 배우자의 커플자료를 수집하여 이들의 부부적응에 대해 조사하였으며, 기초자료가 미비한 실정에서 부부관계의 지표로 부부적응에의 필수고려 요인으로 지목되고 있는 부부의사소통의 영향을 조사하였다. 또한 암환자와 배우자의 상호의존성을 고려하여 부부의사소통이 부부적응에 미치는 영향을 자기 자신에게 미치는 영향(자기효과), 상대방에게 미치는 영향(상대방효과)을 고찰하였다. 이를 통해 부부적응에 긍정적 부부의사소통의 중요성을 제시하였으며, 부정적 의사소통 유형인 요구-철회의사소통에서 환자의 배우자에 대한 상대방효과가 유의한 것으로 나타나 환자에 대한 의사소통 교육에의 필요성을 제시하였다. 이러한 연구결과를 바탕으로 실천적 함의 및 후속연구에 대한 제언을 제시하였다.

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Profiling of endogenous metabolites and changes in intestinal microbiota distribution after GEN-001 (Lactococcus lactis) administration

  • Min-Gul Kim;Suin Kim;Ji-Young Jeon;Seol Ju Moon;Yong-Geun Kwak;Joo Young Na;SeungHwan Lee;Kyung-Mi Park;Hyo-Jin Kim;Sang-Min Lee;Seo-Yeon Choi;Kwang-Hee Shin
    • The Korean Journal of Physiology and Pharmacology
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    • 제28권2호
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    • pp.153-164
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    • 2024
  • This study aimed to identify metabolic biomarkers and investigate changes in intestinal microbiota in the feces of healthy participants following administration of Lactococcus lactis GEN-001. GEN-001 is a single-strain L. lactis strain isolated from the gut of a healthy human volunteer. The study was conducted as a parallel, randomized, phase 1, open design trial. Twenty healthy Korean males were divided into five groups according to the GEN-001 dosage and dietary control. Groups A, B, C, and D1 received 1, 3, 6, and 9 GEN-001 capsules (1 × 1011 colony forming units), respectively, without dietary adjustment, whereas group D2 received 9 GEN-001 capsules with dietary adjustment. All groups received a single dose. Fecal samples were collected 2 days before GEN-001 administration to 7 days after for untargeted metabolomics and gut microbial metagenomic analyses; blood samples were collected simultaneously for immunogenicity analysis. Levels of phenylalanine, tyrosine, cholic acid, deoxycholic acid, and tryptophan were significantly increased at 5-6 days after GEN-001 administration when compared with predose levels. Compared with predose, the relative abundance (%) of Parabacteroides and Alistipes significantly decreased, whereas that of Lactobacillus and Lactococcus increased; Lactobacillus and tryptophan levels were negatively correlated. A single administration of GEN-001 shifted the gut microbiota in healthy volunteers to a more balanced state as evidenced by an increased abundance of beneficial bacteria, including Lactobacillus, and higher levels of the metabolites that have immunogenic properties.

간호관리료 차등제를 반영한 DRG수가 조정기전 개발 (Development of the DRG Fee Adjustment Mechanism Reflecting Nurse Staffing Grades)

  • 김윤미;김세영;김지윤
    • 임상간호연구
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    • 제19권3호
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    • pp.321-332
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    • 2013
  • Purpose: Korean health insurance extended application of the Diagnosis Related Groups (DRG) payment system to tertiary and general hospitals from July, 2013. This study was done to develop a DRG fee adjustment mechanism applied to levels of nurse staffing to assure quality nursing service. Methods: Nurse stafffing grades among hospitals in Korea were analyzed. Differences and ratio of inpatient costs by nurse staffing grades in DRG fees and differences of DRG fee between tertiary and general hospitals were compared. Results: In 2013, nurse staffing grades in tertiary and general hospitals had improved, but other hospital nurse staffing grades remained at the 2001 level. Gaps of inpatient costs between first and seventh nurse staffing grades were over 10% in 4 out of 7 DRG diagnosis; However differences of DRG fee between tertiary and general hospitals were only 4.51% and 4.72% respectively. A DRG fee adjustment mechanism was developed that included nurse staffing grades and hospitalization days as factors of the formula. Conclusion: Current DRG fees motivate hospitals to decrease nurse staffing grades because cost reduction is bigger than compensation. This DRG fee adjustment mechanism reflects nurse staffing supply to motivate hospitals to hire more nurses as a reasonable compensation system.

남성 척수손상 장애인의 성실태 및 성적응에 미치는 요인 (Sexual Activity and Factors Influencing the Sexual Adjustment in Men with Spinal Cord Injury)

  • 김선홍;이범석;한숙정
    • 임상간호연구
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    • 제20권3호
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    • pp.290-302
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    • 2014
  • Purpose: The purpose of this study was to identify sexual activities of males with spinal cord injury (SCI) and influential factors of sexual adjustment. Methods: A correlational survey was conducted among a total of 135 males with SCI. Results: After SCI, patients maintained low levels of sexual adjustment, and a main obstacle of sexual rehabilitation was decreased erectile function (65.2%). Sexual desires recovered in 84.4%, with 62.4% patients reporting more than once intercourse experiences. The erectile function of participants with normal, decreased or no erectile function were 13.0%, 62.6% and 24.4%, respectively. 8.1% of the participants reported no problem with ejaculation. Patients with incomplete SCI had better preserved erectile function than those with complete SCI (t=-4.627, p<.001). Patients with upper motor neuron injury had better preserved erectile function than those with lower motor neuron injury (t=2.446, p =.016). Sexual adjustment was relevant to age, job, degree of injury, post-injury period, sexual desire, intercourse experience, erection therapy, erectile function, and sexual health. Sexual adjustment was a factor of sexual health with a power of 24.2%. Conclusion: The main obstacle of sexual rehabilitation for males with SCI decreased erectile function. Erection and ejaculation are dependent on the severity and level of SCI. The major influence on sexual adjustment is sexual health.

머신러닝을 이용한 급성심근경색증 환자의 퇴원 시 사망 중증도 보정 방법 개발에 대한 융복합 연구 (Convergence Study in Development of Severity Adjustment Method for Death with Acute Myocardial Infarction Patients using Machine Learning)

  • 백설경;박혜진;강성홍;최준영;박종호
    • 디지털융복합연구
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    • 제17권2호
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    • pp.217-230
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    • 2019
  • 본 연구는 기존 동반질환을 이용한 중증도 보정 방법의 제한점을 보완하기 위해 급성심근경색증 환자의 맞춤형 중증도 보정방법을 개발하고, 이의 타당성을 평가하기 위해 수행되었다. 이를 위하여 질병관리본부에서 2006년부터 2015년까지 10년간 수집한 퇴원손상심층조사 자료 중 주진단이 급성심근경색증인 한국표준질병사인분류(KCD-7) 코드 I20.0~I20.9의 대상자를 추출하였고, 동반질환 중증도 보정 도구로는 기존 활용되고 있는 CCI(Charlson comorbidity index), ECI(Elixhauser comorbidity index)와 새로이 제안하는 CCS(Clinical Classification Software)를 사용하였다. 이에 대한 중증도 보정 사망예측모형 개발을 위하여 머신러닝 기법인 로지스틱 회귀분석, 의사결정나무, 신경망, 서포트 벡터 머신기법을 활용하여 비교하였고 각각의 AUC(Area Under Curve)를 이용하여 개발된 모형을 평가하였다. 이를 평가한 결과 중증도 보정도구로는 CCS 가 가장 우수한 것으로 나타났으며, 머신러닝 기법 중에서는 서포트 벡터 머신을 이용한 모형의 예측력이 가장 우수한 것으로 확인되었다. 이에 향후 의료서비스 결과평가 등 중증도 보정을 위한 연구에서는 본 연구에서 제시한 맞춤형 중증도 보정방법과 머신러닝 기법을 활용하도록 하는 것을 제안한다.

정신분열증환자의 연성 신경학적 증상과 임상변인과의 관련성 (Relationship Between Neurologic Soft Signs and Some Clinical Variables in Patients with Schizophrenia)

  • 채정호;함웅;이정균
    • 생물정신의학
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    • 제2권1호
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    • pp.115-122
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    • 1995
  • This study was performed to know the relationship between neurologic soft signs (NSS) and clinical variables such as psychopathology. history of illness, and premorbid social adjustment in patients with schizophrenia. The authors evaluated NSS in 31 patients with schizophrenia using the structured tool for measuring neurologic abnormalities, Neurological Evaluation Scale- Korean Version(NES-K). Relationships between NSS and clinical variables such as duration of illness, intensity of precipitating stressors, duration of outpatient treatment, schooling, peer relationship, total duration of unemployment, total days of psychiatric admission, age, total days of being medicated, age at the first psychiatric admission, frequency of admissions, content of treatment, social adjustment, and severity of symptoms were analyzed. Differences between paranoid and non-paranoid schizophrenics were examined. In addition, Differences between patients with schizophrenia who have predominant positive symptoms and who have predominant negative symptoms were examined too. Total scores of NES-K were correlated with lower schooling (${\gamma}$=0.44, p<0.01). Scores of motor coordination subcategory were correlated with poor peer relationship(${\gamma}$=0.67, p<0.001). Other clinical variables were not correlated with any scores of NES-K. Paranoid and non-paranoid schizophrenics were not different in scores of NES-K. Also positive and negative schizophrenics were not different in scores of NES-K. Most clinical variables except schooling and peer relationship were not related with NSS. This results indicated that the meaning of these signs was not fully be understood. Introduction of the new classification concepts such as deficit or non-deficit syndrome will be helpful to elucidate the meaning of NSS in patients with schizophrenia.

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