• Perspectives in Nursing Science
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• 제3권1호
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• pp.47-60
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• 2006

BACKGROUND: Social, legal, and economic factors have changed the delivery of care to elderly who are frail and/or chronically ill. Increasing number of the elderly are now treated in the community, while living with or in close proximity to their family. It is evident that families play a major role of support for elderly persons in our society. This paper provides a review and analysis of studies that have investigated informal caregiving issues encompassing physical, psychological, emotional, and social domains. RESULTS OF THE REVIEW: Family caregiving often interfered with workplace and other responsibilities, creating physical, emotional, and financial stress for caregivers. Relatively high volumes of research addressed caregiving issues in the families of Alzheimer patients and in the areas of emotional and psychological impact of caregiving. Few studies explicitly investigated the role of informal caregivers in the management of other chronic conditions such as stroke or depression or physical consequences of long-term caregiving. While most studies were focused on negative aspects of caregiving, a few studies found it rewarding. Often the burden, stress, and socio-economic effects on the family caregiving for an elderly person were not sufficiently appreciated. CONCLUSIONS: Positive outcomes for both the caregiver and the care recipient are more likely to occur when effective levels of collaboration exist between health professionals and caregivers. As a first step, a better understanding of the caregiving experience such as caregiver characteristics, care recipient characteristics, and social stigma is important for nurses to minimize the burden of care so that appropriate interventions can be developed. In addition, further studies are needed to examine the role and needs of informal caregivers in the care of increasing number of frail and/or chronic ill elderly treated in the community.

• 한국직업건강간호학회지
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• 제4권호
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• pp.84-101
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• 1995

The periodic health examination have been shown the important role on early detection, early treatment and prevention of disease. Until now, there have been many studies that showed the effectiveness of the periodic health examination on the early detection and early treatment of disease to some extent. But there are few studies about primary prevention before health problem arise. In this case-control study, 29 newly detected hypertensive cases, 31 liver disease cases and 65 controls which are all available for 6-year data in the periodic health examination of a occupational field were compared to investigate the significant increase trend of health status between the groups. The results will be used for the occupational health nurses to provide appropriate primary prevention to the employees. The hypertensive and liver disease cases were divided observation-needed group and treatment-needed group. The data on systolic blood pressure, diastolic blood pressure, Body Mass Index and Broca Index in hypertensive cases and SGOT, SGPT, Body Mass Index and Broca Index in liver disease cases were analyzed by t-test and ANOVA. The specific findings are summarized as follows. 1. In the comparison between the hypertensive cases and controls, SBP and DBP of the observation-needed group and the treatment-needed group were significantly higher than the data of the controls for past 6 years. It was 2-3 years ago showing increase over 140/90mmHg of blood pressure in the hypertensive cases before they are categorized as hypertensive cases. In the observation-needed group and the treatment-needed group, the trend of the blood pressure for 6 years were significantly higher than the one of the controls. 2. In the comparison between the liver disease cases and controls, SGOT and SGPT of the observation-needed group and the treatment-needed group were significantly higher than the data of the controls for past 6 years. It was 2 years ago showing increase within upper normal limit of SGOT and 5 years ago of SGPT in the liver disease cases before they are categorized as liver disease cases. In the observation-needed group and the treatment-needed group, the trend of the liver enzyme for 6 years were significantly higher than the one of the controls. With these results, the author proposed that intervention for the primary prevention such as continuous follow-up, health education and weight control to the population who has over 140/90mmHg of blood pressure and upper normal limit of AST and ALT.

• 지역사회간호학회지
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• 제13권4호
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• pp.629-638
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• 2002

The impact of chronic diseases on patients and their families depends on how well the family members cope with it. Therefore, research on strategies for facilitating the coping of the families in a desirable manner is very important. Dementia management strategies refer to specific means families of dementia patients use to cope with dementing illness of their family members. This study was designed to examine type of dementia management strategies utilized by families and to identify factors influencing them. The subjects in this study were 103 conveniently selected demented patients and their primary caregivers who were registered to a public health center located in Chungcheong Province. The subjects were visited by 20 home visiting nurses, and the data were collected using a structured questionnaire. The data were collected form May 2, 2001 to June 2, 2001. The findings of this study were as follows. 1. The most frequently used types of dementia management strategies were active management (M=3.36, S.D=.96), and encouragement (M=2.94, S.D=.99). Criticism was least used type of dementia management strategy (M=2.71, S.D=.99). 2. The factors influencing each management strategy were as follows; 1) The criticism management strategy was most frequently used by the primary caregivers who graduated elementary school (F=3.21, p<.05). 2) The encouragement strategy was most frequently used by the primary caregivers in a case when the patients were in the mild stage of dementia (F=2.76, p<.05), when the patients never had any treatment experiences (F=2.01, p<.05), when the family could afford the provision of treatment for the patients (F=-2.44, p<.050), and when the primary caregiver had a job (t=2.90, p<.01). 3) The active management strategy was most widely used by the primary caregivers who could afford the provision of treatment for the patients (F=-2.31, p<.05) and were in their 70s (F=3.04, p<.05). This type of management strategy was significantly more used by those who discussed the difficulties of caring with their family members (F=3.46, p<.05). 3. The use of criticism management strategies was significantly correlated with the total level of burden of the primary caregivers. But the types of encouragement and active management strategies had negative correlations with the caregivers' burden although they were not significant. Since the findings of this study showed that the criticism management strategy had a significant positive relationship with caregivers' burden, those who are more likely to use the negative management strategy should be identified in future studies. The primary caregivers who are more likely to use negative strategy should be more closely monitored and be focused as the group who should be intervened in future studies.

• 한국보건간호학회지
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• 제12권2호
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• pp.122-135
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• 1998

This study was carried out to understand the nursing needs of postpartum women during the postpartum period. The goal of study was to obtain data needed to develop maternal education programs and to improve the nursing quality for postpartum women. A cross-sectional survey design was employed in this study. The subjects were 101 postpartum women who had delivery at 2 general hospitals in Chung-Buk. Korea. Data were collected from Sep. 29 to Nov. 28. 1997 by means of a structured questionnaire. The instrument used for this study was the one which was consisted of revised Maternal Concerns Questionnaire (MCQ) developed by Bull (1979). The data were analyzed through the SPSS/PC+ program by use of frequency, t-test and ANOVA. The results of the study were as follows; 1) The mean score of concerns about 'self' was 2.98 for primipara and 2.80 for multipara but was not statistically significant difference. Among the items of concerns 'for self', 'Being good mothers' was the highest (primipara 3.93. multipara 3.75). 2) The mean score of concerns about 'baby' was 3.64 for primipara and 3.53 for multipara but was not statistically significant difference. Among the items of concerns 'for baby', 'Normal growth and development' was the highest (primipara 3.91. multipara 3.90). 3) The mean score of concerns about 'husband' was 3.33 for primipara and 3.06 for multipara and was statistically significant difference (t=2.11. p=0.03). Among the items of concerns 'for husband', 'Husband being a good father' was the highest (primipara 3.87, multipara 3.77). 4) The mean score of concerns about 'family' was 2.65 for primipara and 2.80 for multipara but was not statistically significant. Among the items of concerns 'for family', 'Change in the family's lifestyle' was the highest(primipara 3.01, multipara 2.93, t=-1.99, p=0.04). 5) The mean score of concerns about 'community' was 2.48 for primipara and 2.42 for multipara but was not statistically significant. Among the items of concerns 'for community'. 'Getting to health care facilities' was the highest (primipara 2.48, multipara 2.42). 6) On considering the relationship between the postpartum women's nursing needs and their general characteristics, 'regularly antenatal care' was statistically significant (t=2.29. p=0.02). In conclusion, recognition of maternal concerns can be used by nurses to identify nursing diagnoses and to develop care plans that reflect the patient's priorities.

• 농촌의학ㆍ지역보건
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• 제37권2호
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• pp.67-75
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• 2012

최근, 정부차원의 공공보건의료 개선을 위한 노력이 진행 중이지만 실제 의사, 간호사, 보건직등 의료기관 종사자들의 공공보건의료에 대한 역할의 필요성에 대한 인식과 책임감에 대한 조사는 부족한 실정이며 성공적인 공공보건의료의 역할 수행을 위해서는 모든 의료 종사자들의 역할 인식과 직종간의 유기적인 협력이 필요하다. 이에 일개 국립병원 의료 종사자들을 대상으로 공공보건의료에 대한 역할 인식과 기능수행에 대한 조사를 시행하였다. 일개 국립대학병원 직원을 직종별로 20%를 무작위 추출하여 323명을 대상으로 설문 조사를 시행하였다. 의사직 103명(38.9%), 간호직 98명(37.0%), 기타직 64명(24.1%) 등 총 265명(80.2%)이 참여하였다. 의료 종사자들은 공공보건의료시책의 수립 시행 및 평가 지원사업, 국가 또는 지방자치단체의 보건의료 활동에의 참여 및 지원사업, 민간보건의료기관에 대한 기술지원 및 교육사업, 취약계층에 대한 보건의료, 노인, 장애인, 정신 질환자 등 타 분야와의 연계가 필수적인 보건의료, 아동과 모성에 대한 보건의료 등 공공보건의료의 필수적인 6가지 항목에 대하여 공공보건의료 기관으로서의 역할 인식이 부족하였다. 반면 주요 질병관리사업, 공공보건의료에 관한 전문적인 연구 및 검사사업, 보건의료인의 교육훈련사업, 전염병 예방 및 관리, 응급환자의 진료, 민간보건의료기관이 담당하기 어려운 예방보건의료 등 6 가지 항목에 대해서는 중요하게 인식하고 있었다. 대체적으로 보건의료기관 종사자의 공공보건의료기관으로서 역할과 책임의식에 대한 인식이 부족하며 앞으로 공공병원의 공공성 강화를 위하여 공공보건의료 전담인력 확보와 계획적인 공공보건사업에 대한 교육이 필요할 것으로 사료된다.

• 한국간호교육학회지
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• 제5권1호
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• pp.97-105
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• 1999

Based on literature, status and role of the NP in America was reviewed. The process of developing NP program in America suggests us many things. In America, nurse practitioners have sustained a mutually beneficial status with their patients for over thirty years. Excel fence in academic education and clinical training will enable nurse practitioners to continue to provide quality health care. The magnitude changes in the health care system of the United States, the challange of providing real access of health care continues. Lack of access to adequate primary care was the driving force in the initial 1965 Federal Involvement in developing the NP role. In 1993 President Bill Clinton's health care reform initiative provided policy support for NPs as primary care providers. The Institute of Medicine explicitly recognized NPs as an integral part of the primary care team. In addition, several national reports recognized NPs as affordable, accessible, high-quality care providers. The recent passage of direct Medicare reimbursement for NPs reflected public policy statements coincided with and likely contributed to a growth spurt in the NP workforce. From 1965 to 1977 NP programs offered traditional primary care clinical tracks(adult, family, woman's health, and pediatrics) for relatively small clusters of students in a variety of institutional settings. From 1978 to 1990 these educational programs were incorporated into graduate schools of nursing. By 1990 the majority of NPs received educational preparation in master's-level nursing programs. A new emphases was placed on postmaster's NP programs designed for master's prepared clinical nurse specialists and nurse managers. he the health care system shifted hospital nursing resources toward community-based care, these master's -level nurses sought additional NP preparation. NP educational programs are defined as the educational structure in which one or more NP clinical tracks are offered. NP clinical tracks, in turn, offer curriculum and supervised clinical experiences that match standards in specific practice areas such as family(FNP), adult(AUP), geriatrics(GNP), pediatrics(PNP), women's health (WHNP), neonatal (NNP), and acute care(ACNP). There were indications that NP practice was expanding into new clinical areas as evidenced by new types of tracks, particularly in acute care and psychiatry. The increase in acute care NP students likely reflects the increased demand from hospitals and other acute care settings. In Korea, change of nurse's role into nurse practitioner's role may have many difficulties. The need of health consumer, policy support of government, approval of medical care team are all essential component. Every nursing personnel make effort to planning the new health care delivery system.

• 대한간호
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• 제34권5호
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• pp.68-81
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• 1996

In order to see the development of nursing related research activities in Korea over the last three decades, abstracts of almost all of the Masters and Ph. D. theses that had appeared from 1961 up to August 1991 were collected. Number of theses amounted to 1779(76%) out of a total of 2354 theses. We analysed the papers research patterns, which are research problem, research design, population, place. Here is what we have found. 1). The types of research problems were as follows. 58.0% papers did factor-analysis, 29.1% studied factor~relations, 11.4% situation relations and 1.5% did situation~creations. With respect to the years, we found that the factor-analysis papers decreased with time but the factor~relating, the situation -relating, and the situation~creating papers were increased. Especially the situation-creating paper increased notably since the 80s'. Relating to the kind of degrees, we found that for M.S.theses 60.2% of the papers did factor-analysis, 29.0% the factor-relating studies, 10.4% the situation-relating studies, and 0.4% the situation -creating studies. For the Ph.D. theses 30.5% did the factor~relating, 30.5% the situation-relating. and 20.0% the situation-creating papers. Considering the graduate schools, we found that the regular graduate schools and the graduate school of education produced about the same number of papers of each kind, but 81.2% and 64.6% papers produced by the graduate school of public health and the graduate school of public administration, respectively, did the factor-analysis thus taking majority of the papers. 2). Research designs were as follows : 10.8% experimental studies, 89.0% non experimental studies, and 0.2% quality studies were found. So the majority of the research designs were nonexperimental. We see a meaningful difference between the M.S.theses showing 9.8% experimental studies and 90. 1% nonexperimental studies. and Ph.D. theses showing 28.4% experimental studies and 68. 4% nonexperimental studies. Relating to the graduate schools, we find that the regular graduate schools and the graduate school of education with 15.8% and 10.6% experimental studies respectively, did a little more experimental studies than other schools. but still the regular graduate schools, the graduate school of public health, and the graduate school of education each show 83.8%, 97.4%, and 89.4% nonexperimental studies, so most schools are concentrating on nonexperimental studies. 3). On the relation between research problem and research design, experimental studies show 88.0% of situation-relations and 6.8% of factor-relations. Nonexperimental studies had factor-analysis taking the majority by 64.4% and 31.9% were factor-relations. 4). On the research subjects, we have 90.8% of the papers dealing with a single subject and 9.2% of the papers dealing with two or more subjects. Most of the research subjects are patients or nurses for the regular graduate schools and the graduate school of education, but for the graduate school of administration as much as. 60% of the studies took nurses as subjects. Subjects taken were patients, nurses. and students in decreasing order for the M.S. theses and for patients, women, and nurses again in decreasing order for the Ph.D.theses. 5). On the places of study, we've had 47, 8% of the studies done in hospital rooms, 15, 1% in schools, and 9, 6% in the local community, With respect to the years, we found 36.7% in the hospital rooms, 22.4% in the schools, and 14, 8% in the local communities in the 1970's and 50.1%in the hospital rooms, 13.4% in the schools. and 9, 2% in the local communities in the 80's.

• Child Health Nursing Research
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• 제19권2호
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• pp.102-110
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• 2013

목적 본 연구의 목적은 북한이탈 어머니의 영유아 자녀 양육 경험이 무엇인지 그 경험 과정을 확인하고, 양육과정을 통해 심리사회적 문제를 어떻게 해결하는가에 대한 실체이론을 개발하는 것이다. 방법 연구참여자는 이론적 표본추출을 통하여 선정하였고 연구 자료는 심층면담과 참여관찰 및 참여자의 의무기록 등을 사용하여 수집한 후 Strauss와 Corbin (1998)의 근거이론방법을 적용하여 분석하였다. 결과 연구 결과 개방코딩 과정에서 62개의 개념과 23개의 하위범주, 11개의 범주가 도출되었으며 북한이탈 어머니의 영유아 자녀 양육 과정의 핵심범주는 '희망을 가지고 키워가기'로 밝혀졌다. 시간 흐름에 따른 양육 과정은 '양육 환경 변화 인식기', '양육 방법 조정기', '자신감 형성기'의 3단계로 나타났으며 양육 과정의 유형은 기대하기형, 지켜보기형, 걱정하기형의 세 가지 유형으로 구분되었다. 결론 본 연구의 결과는 영유아 자녀를 돌보는 북한이탈 어머니들의 양육경험을 이해하고 개별적인 간호를 제공하는데 기초가 될 이론적 기틀로 활용할 수 있을 것이며 북한이탈주민이 급증하고 이에 따라 동반 입국하는 아동의 수도 함께 증가하고 있는 현 시점에서 이 아동들의 건강 유지 및 증진을 위한 간호 실무에 매우 중요한 초석이 될 것이다.

• 한국보건간호학회지
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• 제19권2호
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• pp.274-283
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• 2005

Purpose: To survey the functional status, self-esteem and depression of a community of indwelling clients with total laryngectomy, and to evaluate the correlation among these three variances. Methods: From May 2002 to October 2002, 76 clients who had undergone total laryngectomy more than three months ago were surveyed with using Baker's functional status in head & neck cancer-self report, Rosenberg's self rating self-esteem scale and Zung's self rating depression scale. Results: 1. The functionaI status score was $48.67{\pm}10.12$. The subjects aged 70 years or older had significantly higher scores than the subjects aged $50{\sim}59$ years. The group of clients who were operated on more than five years ago showed higher scores than the patients operated on within a year. 2. The self-esteem score was $30.47{\pm}6.44$. 3. The depression score was $47.26{\pm}8.01$. The subjects who bad three family members and the subjects who had five family members had significantly higher scores than the subjects who had two family members. 4. A significant correlation found between the functional status and self-esteem. Significant negative correlations were found between the functional status and depression and also between self-esteem and depression. Conclusion: Remarkable correlations were observed among functional status, self-esteem and depression. Nurses should consider the status of layngectomy patients and pay more attention to their pre- and post- operative nursing care and rehabilitation.

• 한국보건간호학회지
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• 제19권2호
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• pp.371-381
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• 2005

Purpose: The purpose of the study was to develop the day care program for the demented elders and to determine the effects of multiple activity therapies on the physical, emotional, cognitive, social function and physiological indicators of dementia elders in day care center. Method: A total of 13 elders with mild dementia in the data care center were participated. Manual and guideline of data care program was developed. Data care program was composed of movement/exercise, foot massage, music therapy, horticultural therapy, and art therapy. Data care program was performed by trained intervener for 32 weeks. Instruments were physical functioning such as hand grip strength., vital capacity, chiar stand test, sit and reach test, one leg standing, Berg' Balance scale, 6m Walk Velocity, stair climb, ADL, GDS-K, MMSE-K, Integrative Social Functioning Scale, cortisol, Ig A and Ig G. These were measured at the baseline, 16-week, and 32-week post-intervention by the trained nurses. Data were analyzed as Wilcoxon signed rank test. Results: For Hand grip, balance, and vital capacity, there was a significant difference between baseline and 16-week post-intervention(p<.05). For one leg standing, 6m velocity, there was a significant difference between 16-week post-intervention and 32-week post-intervention(p<.05). For Stair climb, there was a significant difference between baseline and 32-week post-intervention(p<.05). For depression and social functioning, there was no significant difference among baseline, 16-week, and 32-week post-intervention. For cognitive functioning, there was a significant difference between baseline and 32-week post intervention(p<.05). There was a significant difference of cortisol, and Ig G between baseline and 32-week post-intervention(p<.05). Conclusion: It would appear that physical fitness, functional performance, ADL, depression, social and cognitive functioning, and physiological indicator of community dwelling elders with dementia can be improved through day care program using multiple stimuli.