• Journal of Hospice and Palliative Care
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• 제16권1호
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• pp.20-32
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• 2013

목적: 본 연구의 목적은 사전의료의향서 사용 집단을 대상으로 초안에서 도출된 한국형 사전의료의향서 콘텐츠의 구성 요소를 바탕으로 실제 사용자 집단에서 인지적, 심리적 및 사회적으로 수용 가능한 문장과 문항으로 구성된 문서를 구축하여 한국형 사전의료의향서 모델을 제시하는 것이다. 방법: 실제 사용자인 일반 성인의 보건의료정보 문해력과 정서적 수용성 및 작성 과정을 고려하여 초안을 작성하였으며 초안을 바탕으로 인지면담(Cognitive Interviewing) 방법을 통한 문항 개발 과정을 수행하였다. 대상자는 9명의 65세 이상 노인을 포함한 16명의 인지면담에 장애가 없는 성인이었다. 결과: 총 2회기에 걸친 인지면담 결과를 분석한 후 최종적으로 3개 속성(가치관, 의료지시[9문항] 대리인 지정)을 중심으로 총 430개 단어로 구성되는 모델을 확정 제안하였다. 결론: 본 연구에서는 한국형 사전의료의향서 문서를 효과적으로 향상시킬 수 있는 방법으로 인지면담을 사용하였으며 그 가능성을 검증하였다. 한국형 사전의료의향서 최종 모델을 위해서는 대규모 양적 연구를 통해 가용성을 검증하며, 신뢰도와 타당도를 확보하여 모델을 확정하는 과정이 포함된 추후연구가 필요할 것이다.

• Child Health Nursing Research
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• 제3권2호
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• pp.228-240
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• 1997

It is important to asess the risk factors of parenting and provide early intervention for promotion of the maternal caretaking ability. The purpose of the study was to identify the maternal burden of caretaking, the supporting and the educational need for the caretaking activities of the mother of infant. Sixty three mothers of infants who visited the wellbaby clinic of S university hospital and one health center during the period of November 1st, to 30th in 1996 comprised the subjects of this study, Data were gathered through the instruments that were developed by researcher. Statistical analysis of this study was used ANOVA and Pearson correlation. The results were as follows : 1) The mean score of the maternal burden of caretaking was 22.06. The maternal burden of caretaking was significantly high in the mothers who had vaginal delivery compare with the mothers who had caeserean section and in the muthers who gave artificial feeding compare with the group of breast or mixed feeding. 2) The mean score of the support need for the caretaking activities was 30.69. The support need for the caretaking activities was significantly high in the mothers who had the second child, compare with the mothers who had first or third child. And the support need for the caretaking activities was significantly high in the mothers who had caretaking help compare with the mothers who had no caretaking help. The specific subjects of 'mother-infant interaction', 'immunization' and 'prevention of accident' on the support need for the caretaking activities were relatively high. 3) The mean score of the educational need of caretaking activities was 29.3. The educational need of caretaking activities was significantly high in the mother who had the second child compare with the mothers who had first or third child. And the educational need of caretaking activities was significantly high in the mothers who had caretaking help compare with the mothers who had no caretaking help. The specific subjects of 'mother-infant interaction', 'emergency care' and 'prevention of accident' on educational need of caretaking were relatively high. 4) The maternal burden of caretaking was not correlated with the support need or the educational need of caretaking activities. But the support need of caretaking activities was significantly correlated with the educational need of caretaking activities. 5) The support and educational need of caretaking activities were significantly high in the mothers who wanted home care for caretaking their infants. Through the study, it was found that there is considerable maternal burden of caretaking as well as the support and educational need on the caretaking activities in the mothers whose child is young. Therefore developing the systematic and effective program is needed to meet the mother's need. The results of this study will be useful resources to develop the program. On the other hand, it can be recommanded that home health care will be one of the approach to support the mothers caretaking activities.

• Child Health Nursing Research
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• 제6권3호
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• pp.372-386
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• 2000

The purpose of this study was to provide basic data on preschool children for accident prevention and improve their health through sound, safe living environment with safety education established through more systematic method. Data were collected from 300 preschoolers(150 preschooler are assigned to experimental group and 150 preschoolers are assigned to control group) from 4 to 6 years old using APP paper test which consists of questions and drawings. To experimental group, safety education were done 4 times within the time of 30 minutes per 1 time using education books, video, OHP, slide. The findings of this study are as follows: 1. There were significant difference in behavioral character between experimental group and control group(χ2=11.690, p= 0.003). So, safety education have effect on the behavioral character of preschooler. 2. In the accident proneness on preschooler between experimental group and control group according to general characteristics, it proved significant difference in the case of accident prevention education were done, movement stability(χ2=8.844, p=0.012) and behavioral character(χ2=6.699, p=0.035), in the case of housing pattern is mixed-type, behavioral character(χ2=10.37, p=0.006), in the case of subjects' age is 4 years old, watchfulness(χ2=9.525, p=0.009), in the case of subjects' age is 5 years old, behavioral character(χ2=7.324, p=0.026), in the case of children's order is second, behavioral character(χ2=14.31, p=0.001), in the case of children's sex is boy, living safety(χ2=7.981, p=0.018), movement speed (χ2=6.661, p=0.036), bihavioral character(χ2=8.837, p=0.012), in the case of children's sex is girl, reasoning power(χ2 =9.78, p=0.008), in the case of childrens have no past accidental experience, behavioral character(χ2=9.862, p=0.007), in the case of nuclear family, movement speed(χ2=6.341, p=0.042) and behavioral character(χ2=9.326, p=0.009), in the case of mothers' age is under thirty behavioral character(χ2=16.40, p=0.000), in the case of mothers' school career is under high school graduate, behavioral character(χ2 =8.375, p=0.015), in the case of mothers' school career is beyond college graduate, reasoning power(χ2=9.803, p=0.007) and behavioral character(χ2=6.205, p=0.045), in the case of mothers' job is part time, movement speed(χ2=10.99, p=0.004), in the case of mothers have no job, movement stability(χ2=8.490, p=0.014) and behavioral character(χ2=10.11, p=0.006). The difference of accident proneness between experimental group and control group according to general characteristics, it also showed that there were significant difference in behavioral character compared to other area.. From this findings, we can guess that safety education change and guide preschoolers' behavioral character to desirable direction.

• 지역사회간호학회지
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• 제6권2호
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• pp.299-318
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• 1995

This study was conducted in order to grasp the condition of the Worker's knowledge and attitude about health management. And to offer the basic materials for the health promotion in industrial field. The objects were comprised 336 of volunteered who work in E.shoemaking factory. The material of this study was the questionair (chronbach a=.8871) suited to the purposed of this research which has been made through studying references. All the guestionaire were collected inmediately without explanation. The data collected from 18th September to 1st Octover. Analysis of the data was done utilizing SAS program for percentage, mean, ANDVA. The result are as follows: 1. General features of the objects of study. Male was highest (58.6%), mean age was 30.07 years, graduated high school was highest(59.2%), producer in present place of employment was highest (76.2%), mean career was 7.45 years. 2. The conditions of attitude about health man agement. Correct answer of health examination was 77.8%. Having experience of health examination was 69.5%, among them have regularity was 70.9%. Think it too much trouble to do not health examination was 69.7%. Have got to do health examination was 95.6%. The reason of set up health clinic was emergency care 58.9%, health education 22.1%. Using health clinic was 70.4%, by monthly was 53.0%. The reason of think it too much trouble to use not health clinic was 65.2% The need of health clinic was 96.4% 3. The conditions of knowledge about health management. When 5 points was given to 'very affirming' and 1 point was given to 'very deny', the total average was 3.67, the range was 2.96-4.54. Exactly, company must given to employee put in operative health examination was highest, worked 34 hours per week on harmful worked place was lowest. And knowing about kind of harmful work was 2.86, dangerous work was 2.90. 4. Correlation between the general features and attitude variables. Female group may have more knowledge on reason of health examination. Over 50 years aged group, middle school graduated group, white colored group, less then 1 year career group may have more knowledge on health examination. White colored group may have more attitude on health examination$(\chi^2=5.210,\;P<.07)$. High careered group may have more using on health clinic $(\chi^2=12.08,\;P<.007)$. 5. Difference between the general features and knowledge of health management. High educated group were highest score in knowledge (F=5.214, P<.002). White colored group were highest score in knowledge (F=23.019, P<.000). 6. Difference between the attitude and knowledge of health management. Needing of health examination group were highest score in knowledge. (t=2.54, P<.011). Using of health clinic group were highest score in knowledge(t=190, P<.048). Needing of health clinic group were highest score in knowledge(t=5.13, P<.000).

• 대한간호학회지
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• 제28권4호
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• pp.958-969
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• 1998

In this study, we attempted to investigate the needs and problems of the terminal cancer patients and their family caregivers to provide them with nursing information to improve their quality of life and prepare for a peaceful death. Data was collected from August 1, 1995 to July 31, 1996 at the internal medicine unit of S hospital in Seoul area with the two groups of participants who were family members of terminal cancer patients seventy four of them were in-patients and 34 were out-patients who were discharged from the same hospital for home care. The research tool used in this study has been developed by selecting the questionnaires from various references, modifying them for our purpose and refining them based on the results of preliminary study. While general background information about the patients was obtained by reviewing their medical records, all other information was collected by interviewing the primary family caregivers of the patients using the questionnaire. The data collected were analyzed with the SPSS PC/sup +/ program. The results of this study are summarized as follows ; 1) Most frequently complained symptoms of the terminal cancer patients were in the order of pain(87%), weakness(86.1%), anorexia(83.3%) and fatigue (80.6%). 2) Main therapies for the terminal cancer patients were pain control (58.3%), hyperalimentation(47.2%) and antibiotics(21.3%). 3) Special medical devices that terminal cancer patients used most were oxygen device (11.1%), and feeding tube(5.6%). Other devices were used by less than 5% of the patients. 4) The mobility of 70.4% of the patients was worse than ECOG 3 level, they had to stay in bed more than 50% of a day. 5) Patients wanted their medical staffs to help relieve pain(45.4%), various physical symptoms(29.6%), and problems associated with their emotion(11.1%). 6) 16.7% of the family caregivers hoped for full recovery of the patients, refusing to admit the status of the patients. Also, 37% wished for the extension of the patient's life at least for 6 months. 7) Only 38.9% of the family members was preparing for the patient's funeral. 8) 45.4% of family caregivers prefer hospital as the place for the patient's death, 39.8% their own home, and 14.8% undetermined. 9) Caregivers of the patients were mostly close family members, i.e., spouse(62%), and sons and daughters or daughter-in-laws(21.3%). 10) 43.5% of the family caregivers were aware of hospice care. 46.8% of them learned about the hospice care from the mass media, 27.7% from health professionals, and the rest from books and other sources. 11) Caregivers were asked about the most difficult problems they encounter in home care, 41 of them pointed out the lack of health professionals they can contact, counsel and get help from in case of emergency, 17 identified the difficulty of finding appropriate transportation to hospital, and 13 stated the difficulty of admission in hospital as needed. 12) 93.6% of family caregivers demanded 24-hour hot line, 80% the visiting nurses and doctors, and 69.4% the volunteer's help. The above results indicate that terminal patients and their family caregivers demand help from qualified health professionals whenever necessary. Hospice care system led by well-trained medical and nursing staffs is one of the viable answers for such demands.

• Child Health Nursing Research
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• 제8권1호
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• pp.32-43
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• 2002

The purpose of this study was to provide basic data on elementary school children's lifestyle and to contribute to developing on the health education program in elementary schools. The subjects were 1,412 children in 4 elementary schools in Gangwon-Do and Chonrabuk-Do area. Data collection was done from September to November 2001 by questionnaire and school health documents. The questionnaire corrected for the purpose of this study which had been developed by Bronson School of Nursing(1991), 'Lifestyle Questionnaire for School-age Children'. The questionnaire consists of 3 categories; 'Activities that promote health', 'Injury prevention', 'Feeling'. Cronbach coefficient alpha for the 29 items was .68. The data analyzed to obtain frequency, mean, percentage, t-test, ANOVA and Pearson correlation coefficient by SPSS Win program. The results of this study were as follows. 1. Females(50.2%) of gender, 6th grade(24.2%) of grade, nuclear family(82.0%) of family type, beyond college graduate(54.5%) of father's school career, under high school graduate(58.1%) of mother's school career, first of birth order(47.1%) were majority. Mean of father's age was 41.2 and mother's age was 38.1. 2. The mean of lifestyle was 66.4, feeling was 73.3, activities that promote health was 60.3 and injury prevention was 64.0. The highest degree of activities that promote health was 「I eat fruits」and injury prevention was 「I look both ways when crossing streets」and feeling was 「I enjoy my family」. The lowest degree of activities that promote health was 「I visit the dentist every tear」 and injury prevention was 「I wear a helmet when I go on bike trips」 and feeling was 「I think it is okay to cry」. 3. There were significant differences in lifestyle of gender(t=4.309, p=.000), grade(F=6.299, p=.000), father's age(t=2.534, p=.011), father's education(t=-4.933, p=.000), mother's education(t=-3.360, p=.001), birth order (t=5.363, p=.000). There were significant differences in activities that promote health of gender(t=-2.462, P=.014), grade(F=4.893, p=.000), father's education(t=-4.480, p=.000), birth order(t=4.343, p=.000), in injury prevention of gender(t=-4.452, p=.000), grade(F=8.636, p=.000), father's age(t=3.386, p=.001), mother's age(t=2.059, p=.040), father's education(t=-6.051, p=.000), mother's education(t=-5.173, p=.000), birth order(t=4.417, p=.000) and in feeling of gender (t=-3.285, p=.001), grade(F=7.526, p=.000), mother's age(t=-3.268, p=.001). 4. Activities that promote health was positively correlated with injury prevention(r=.432, p=.000), feeling(r=.210, p=.000), lifestyle (r=.785, p=.000). Injury prevention was positively correlated with feeling(r=.256, p=.000), lifestyle(r=.854, p=.000) also feeling was positively correlated with lifestyle(r=.504, p=.000). These findings suggest the need to develop nursing strategy to promote elementary school children's health. Because helmet use score in injury prevention marked the lowest score, it is necessary to encourage helmet use when planning injury prevention and health promotion.

• 한국학교보건학회지
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• 제9권1호
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• pp.55-67
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• 1996

This research has incorporated a postal survey from the principals, nurse-charging teachers and nurse-teachers of the fiftyfive elementary, middle and high school in Yang-pyeong county area where its supplementary rate of nurse-teachers is less than adequate. It is to analyse the current status of the school health service in the area and to come out with a plan to improve the school health program through the participations of the health related experts of the local community. The survey was done in the two months of period of April to May of 1994. The result of the survey follows. The student population in the Yang-pyeong county area is 13,998 and the school employee population is 904 which counts for about 19.2% of the whole population of the area. However, the supplementary rate of nurse-teachers is only 10.8% (4 in 55 schools) which is very low in terms of relativity. School health committee only exist in 17% of the whole number of schools in the area and 50 of school health committee answered that their activity do not meet the adequate level. Only 54. 3% of the whole school numbers has included the school health finance in their financial plans and the amount set for the school health finance is about 500,000 wons (100,000-1,600,000 wons). 64.9% of the schools in the Yang-pyeong county area have the permanent nursing room established in the school. But, often than the equipment for a simple physical examinations, their supply of the health related equipments are less than adequate. Particitations of school doctor in the school health service is at only 67.6% which pretty much include only the physical examinations. Nurse-charging teachers consider their utmost important role is to teach health education but, they answered that they spent most of their times and efforts on physical examinations & immunizations. The average number of students visition to the nursing room is 2.5 persons and complains for basic discomfort as headache, concussion, stomachache and indigestion problems and usual pills used are the analgesics and digestives. Physical examination is done in the most schools every year but, 51.4% of nurse-charging teachers answered the physical examination does not really help. About the emergency treatment ability, 75.7% reports that both manpower & equipment are short. The school food services are present in only 8 schools (21.6%) but, 89.2% of nurse-charging teachers answer that there is a definite need of the food service. The survey says that the utmost important environmental health and safety factors are the traffic accidents followed by improper heat system, lighting, the stools and desks that do not consider the student physical status The overall evaluation of school health program reports that there are adequate physical examination, immunization, environmental hygiene, and management of safety but, on the other hand, health education, health councelling & management of nursing room are not managed properly. The principals of the survey pool report shortage of public agency support, lack of understanding of school health, shortage of nursing equipments and school health finance as the barrier factors of school health. The nurse-charging teachers report on the same questions as their less than qualitifying expertise, extraload of work upon the nursing affairs, shortage of nursing equipments & school health finance. The head masters & nurse-charging teachers answered that they are desperate for the meetings of nurse-charging teachers, construction of school health councelling system & training education in order to improve school health and if these are available, they will actively participate in them. After the careful analysis of the survey result, it is apparent that through the relations of the manpowers, establishment of community-oriented school health is definitely in need in rural area where there is low supplementary rate of nurse-teachers and poor school health environment.

• 한국응급구조학회지
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• 제5권1호
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• pp.37-51
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• 2001

This study is aimed at examining the ethical values of EMT students. The results below are based on the revised questionnaires, which can be applicable to EMT from the original questionnaires developed by Lee(1990), with a sample of 124 students consisting of 63 first and 61 second year students, conducted November 2-8, 2001. Data were analyzed using SPSS in terms of means, standard deviations, t-test, ANOVA, Pearson's correlation coefficient. The results are as follows: 1. In the area of Human life, all subjects showed utilitarian disposition. All respondents perceived the item "When patients recognizing there is no hope for survival ask for euthanasia, it is ethically right to accommodate their opinions." as the most utilitarian item, whereas they perceived the item "When an hopeless patient is on cardiac arrest, it is ethically right to do CPR as the most deontoogical item. 2. In the area of patient relationship, all students of two groups took on deontoogical characteristics, but there were no statistically significant differences between two groups. All students perceived an item "EMT have to keep it secret if patients disclose their suicide intentions and ask for absolute secrecy" the most utilitarian item, whereas they perceived an item "Even though patients act and speak in a very rude manner, EMT people should do their best to provide care for patients." as the most deontoogical item. 3. In the area of task relationship, first year students perceived an item "Given time limitations, it is ethically right to give priority to the patients who can be rehabilitated over the patients who can't be fully recovered." as the most utilitarian item, whereas second year students perceived an item "Under no circumstances should any placebo be administered to patients." as the most utilitarian item. All students perceived an item "When EMT students see an unconscious person lying in the street, they have to give him/her emergency treatment." as the most deontoogical item. 4. In the area of coworker relationship, all students of two groups took on deontoogical disposition, but there were no significant differences between two groups. All students of two groups perceived an item "Suppose you are regarded as the person who would be promoted. However, you think that your coworker is more competent than you. In that case you should tell your supervisor about your coworker." as the most utilitarian item. First year students perceived an item, whereas second year students perceived an item "When you observe coworkers' misconduct at work, it is ethically right to ignore their misdeeds." as the most deontoogical item. 5. This study demonstrated that for the first year students, there is a correlational relationship between areas of human life and task relationship, and between areas of task relationship and coworker relationship, whereas for the second year students, there is a correlational relationship between areas of human life and task relationship. 6. In areas of human life and task relationship, there are significant differences according to attitudes toward EMT and attendance at ethics training sessions. In the area of coworker relationship, there are significant differences according to religion, attendance at ethics training sessions, and a code of ethics. Recommendations for future research, 1. Sample items to measure ethical values and the instrument tailored to the needs of EMT should be developed. 2. A longitudinal study to track ethical value changes according to the amount of work experience is needed. 3. A code of ethics and/or ethics training, which could apply in actual situations, should be implemented.

• Child Health Nursing Research
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• 제2권1호
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• pp.93-111
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• 1996

The purpose of the study is to identify the lived experience of mothers who have children with cerebral palsy in order to understand their agony. Moreover, the result of study was to find some nursing intervention for disabled children and their mothers. For this purpose, ten mothers who are willing to cooperate with this research were selected at random from those who have children with the cerebral palsy, currently using the municipal facilities for the handicapped with cerebral malfunction. Data collection was done from October 4, 1994 th December 31, 1994. The data were collected by asking the mothers mentioned above with some unstructured open-ended questions, recorded on the tapes with permission by the interviewee in order to prevent missing of the interviewed contents. These collected data have been substantiated and properly analyzed on the basis of phenomenological approach initiated by Colaizzi's method. The results and validity are proved to be credible by means of the individual checking of the interviewed mothers. The results of this study are as follows : 1. When the mother is first informed of the diagnosis of cerebral palsy on her child, she usually misses the crucial timing needed for proper treatment of the child's disorder because she is notified through the doctor's indifference and his apparently inactive, matter-of-fact attitude. At first she suspects the doctor's diagnosis and tries to attribute it to the unknown cause from a certain genetic problem and then she quickly wants to deny the whole situation that her child is really suffering from the cerebral palsy. The reality is too much for her to accept as it is and she would not believe her child is abnormal. Therefore, she even attempts depend on the power of God for its solution. 2. The mother, who goes thorough this kind of uncommon experiences, is totally devoted to the treatment and care of the child and completely ignores her own life and happiness. At the same time, she feels sorry for her other normal children she believes having not enough care and concern. Also, she feels sorry for the sick child when the child's brothers or sisters show special concern for the patient out of sympathy. It is sorry and not satisfied for her that the child is growing with abnormality and neighbor other around have inappropriate attitudes. Likewise, she is discontent with her husband's lack of concern about the child's treatment. She believes that the health care system in this society isn't fulfilling its due purpose. In the state of her utmost distress and anxiety, she always feels the need of competent consultants, and is angry about that her child is treated as an abnormal being, she is trying to hide the child from other people and to make him or her disappear, if possible. Although she doesn't have harmonious relation with her husband, she id happy when he shows his affection for the child and she feels relieved and thankful when the relatives don't mention about the child's condition Since the child's overall status of health is continuously in unstable conditions, requiring her all-time readiness for an emergency, she feels guilty of her child's illness toward the fEmily members as if it was her own fault to have borne such an abnormal child and she feels responsible for the child morally and financially if necessary Because her life is centered on taking care of the child, she cannot afford to enjoy her own life and happiness. She is a lonely mother, fatigued, with no proper relationship with other people around her. With this sense of guilt and responsibility as a mother of an unusual disease, she has no choice but to grieve her destiny from which she is not allowed to escape. 3. Nevertheless, the mother with the child suffering from the cerebral palsy does not easily give up the hope of getting her child cured and she believes that in the long run, though slower than hoped, her abnormal son or daughter will be eventually cured to become a normal sibling someday. This kind of hope is sustained by the mother's strong faith coming from observing the progress of other similar children getting better. Sometimes she is encouraged to have this faith by other mothers who share the same painful experiences, believing that her child will improve even more rapidly than others with the same palsy. Full of hope, she painstakingly waits for the child's healing. Moreover, she plans to have another child. she thinks that the patient child's brothers and sisters only can truly understand and look after the patients. However, when she notices that the progress of other children under the treatment does not look so hopeful, she is distressed by the thoughts that her child may never get well. Too, she is worried that the patient's brother or sister will be born as the same invalid with the cerebral disease. She is discouraged to have another baby as much as she is encouraged to. She is also troubled by the thought that in case she has another baby, she will have to be forced. to neglect the patient child, especially when she does have an extra hand or some reliable person to help her with taking care of the patient.

• 디지털융복합연구
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• 제11권8호
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• pp.219-225
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• 2013

본 연구는 아동의 안면 연부조직에 발생되는 열상에 영향을 미치는 요인을 확인하기 위한 서술적 조사 연구이다. 자료 수집은 2010년 4월부터 2011년 5월까지 인천 I 종합병원의 응급실에 내원 후 성형외과에 의뢰되어 치료한 소아 안면열상 환자 126명을 대상으로 실시하였다. 분석결과 모든 연령별로 남녀의 발생 빈도는 유의한 차이를 보였다(p<.05). 손상 발생 장소는 집 밖에서 발생된 경우가 49%, 손상의 원인은 미끄러짐(42%), 부딪침(40%)이 많았다. 계절별로는 여름이 30.2%로 가장 많았고, 발생 시간대는 12~16시가 56%로 가장 많이 발생되었다. 손상 후 내원시간은 1시간 이내의 경우가 대부분(83%) 이었다. 손상 부위는 이마부위 발생 빈도가 가장 높게 나타났고(26%), 손상의 깊이는 피하조직까지 손상된 경우가 54%, 손상의 길이는 1~2cm가 46%로 가장 많았다. 손상 국소마취를 통해 봉합치료한 경우는 40%, 동반골절이 있는 경우는 4명(1.53%)이었다. 결론적으로 안면 열상 후 봉합으로 영구적인 상흔을 남길 수 있으며, 외모의 기형을 초래할 수 있으므로 발생 상황과 손상기전에 대한 상세한 조사를 통해 보다 안전한 생활환경을 조성하는 방법을 모색하고 아동의 사고 발생을 예방하기 위한 안전 교육이 필요하겠다.