• 감성과학
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• 제23권1호
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• pp.79-88
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• 2020

본 연구는 요양병원에 근무하는 간호사를 대상으로 죽음인식, 임종간호스트레스, 임종간호수행간의 관계를 파악하고 이를 기반으로 임종간호수행에 영향을 주는 주요 요인을 파악하기 위한 것이 궁극적인 목적이다. 본 연구는 전라남도 3개 도시에 위치한 요양병원간호사를 대상으로 연구를 수행하였으며, 조사도구는 죽음인식, 임종간호스트레스, 임종간호수행 설문지를 활용하였다. 수집된 자료는 기술통계를 수행하였으며, 변수간의 상관성을 분석하기 위하여 피어슨상관분석을 수행하였으며, 주요 영향인자를 분석하기 위한 회귀분석을 실시하였다. 통계분석은 SAS 9.1 ver.을 사용하였다. 간호사 자신의 정신적, 업무적 스트레스가 임종간호수행에 많은 어려움을 야기하고 간호사는 임종환자를 자주 경험하면서 임종간호스트레스가 높아진다. 죽음인식과 임종간호스트레스는 임종간호수행과 상관관계가 있는 것으로 나타났으며, 임종간호수행에 영향을 미치는 요인은 임종간호스트레스와 임상경력 이었다. 요양병원간호사의 임상경력이 많은 사람일수록 임종간호수행도가 높았으므로 임상경력을 고려한 임종간호수행이 이루어져야 하며, 임종간호수행에 있어 스트레스를 줄일 수 있는 방안과 임종간호수행에 영향을 주는 다른 요인을 심도 있게 파악하여 요양병원 실정에 맞는 임종간호수행 및 교육이 필요하다고 사료된다.

• Journal of Hospice and Palliative Care
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• 제20권4호
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• pp.221-225
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• 2017

인간의 영혼에 대한 보살핌은 양질의 임종간호의 핵심 요소이다. 의미치료는 인간의 주요 동기가 삶의 의미와 목적을 발견하는 것이라는 전제에 기반을 두고 있으며, 호스피스 간호에서 환자, 가족 및 사랑하는 사람들에 대한 보살핌에 도움이 될 수 있다. 자신의 인생 경험, 가치관, 태도에 관한 질문을 제기할 때 소크라테스식 대화법을 사용하는 것은 성찰을 불러 일으키는 유용한 방법이다. 마지막 순간까지도 의미의 추구를 위한 지침은 세 가지 범주의 과제 또는 행동, 사랑과 아름다움의 경험 및 변화될 수 없는 운명에도 불구하고 선택된 태도들에서 찾을 수 있다. 자기 초월, 또는 다른 사람들의 이익을 위해 자아를 벗어나는 것은 삶에 의미를 부여할 수 있다. 고난에는 의미가 없지만 고난에도 불구하고 의미를 찾을 수 있다. 의미 중심의 치료 프로토콜의 적용이라는 새로 급성장하는 연구는 영적안녕과 삶의 의미 및 목적에 대한 인식을 향상시키는 데 유망하다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권15호
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• pp.6331-6334
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• 2015

Background: The main purpose of this study was to survey the education and training of certified gynecologic oncologists and fellows in Thailand. A secondary objective was to study the problems in fellowship training regarding palliative care for gynecologic cancer patients. Materials and Methods: A descriptive study was conducted by sending a questionnaire regarding palliative care education to all certified gynecologic oncologists and gynecologic oncology fellows in Thailand. The contents of the survey included fellowship training experience, caring for the dying, patient preparation, attitudes and respondent characteristics. Statistics were analyzed by percentage, mean and standard deviation and chi-square. Results: One hundred seventy completed questionnaires were returned; the response rate was 66%. Most certified gynecologic oncologists and fellows in gynecologic oncology have a positive attitude towards palliative care education, and agree that "psychological distress can result in severe physical suffering". It was found that the curriculum of gynecologic oncology fellowship training equally emphasizes three aspects, namely managing post-operative complications, managing a patient at the end of life and managing a patient with gynecologic oncology. As for experiential training during the fellowship of gynecologic oncology, education regarding breaking bad news, discussion about goals of care and procedures for symptoms control were mostly on-the-job training without explicit teaching. In addition, only 42.9 % of respondents were explicitly taught the coping skill for managing their own stress when caring for palliative patients during fellowship training. Most of respondents rated their clinical competency for palliative care in the "moderately well prepared" level, and the lowest score of the competency was the issue of spiritual care. Conclusions: Almost all certified gynecologic oncologists and fellows in gynecologic oncology have a positive attitude towards learning and teaching in palliative care. In this study, some issues were identified for improving palliative care education such as proper training under the supervision of a mentor, teaching how to deal with work stress, competency in spiritual care and attitudes on responsibility for bereavement care.

• 대한간호학회지
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• 제27권4호
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• pp.933-942
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• 1997

There has recently been an increased interest in women's health from, various disciplines, with different perspectives presented according to each profession's academic background. This has led to many instances of incorrectly defining, or misinterpretation, of the issues even among professionals. Nurse scholars as well as practitioners who work in women's health care need to have a clear conceptual understanding of women's health in order to build a body of knowledge, delineate curricular activities, and set directions for professional nursing interventions. In addition, a conceptual model that may be directly utilized in practice is needed to maintain and promote women's health issues. The purpose of this study was to apply a Hybrid model, analyzing conceptual definitions and discussions related to women's health gathered from review of the literature. Further to compare analyticals the concepts and properties observed from field work, so as to present a final definition of women's health and, build a conceptual framework for a united comprehensive perspective on the concept as well as on nursing practice. Data collection and analysis consisted of a theoretical stage, field work stage, and final analysis. A heterogeneous group of professionals and lay persons, 39 in all, participated in the field work. Study findings Include several subconcepts under the concept of women's health : a woman's whole life, holistic health, quality of life, awareness of being a woman, individual nursing, self care ability, reproductive health, and family health. Thus, a comprehensive definition was built, 1. e., "Women's health care be defined as improvement in the quality of life of women through attainment of holistic health throughout the life span. With reproductive health at the core, the concept is directly related to family and national health, and includes taking care of one's own health based on awareness of being a woman and utilizing self care activities. Women's health care issues are unique and allow various responses, therefore women's health professionals need to apply individual approaches to reach solutions in attaining holistic health and improving quality of life." The constructual factors of women's health were found to be reproductive functions, diseases more common in woman, self actualization, mental health, women's health policies, sexuality, midlife changes, and marital relations, with each factor having more than three properties. Positive factors affecting women's health were found to be a normal childbearing process, a healthy lifestyle, active health management, health information, support, and resources, and interpersonal relationships. Negative factors were found to be overwhelming role stress, cultural oppression, gender inequality, distorted sexual identity, economic difficulties, misuse and/or abuse of substances, and stress. The model of women's health may be visualized as a balance scale set upon a woman's life, supporting 4 concentric circles. The innermost circle and second circle incorporate conceptual definitions of women's health, and the outer two circles represent the constructional factors and properties of women's health. Each circle has its own color that symbolizes the conceptual meaning. Positive and negative factors are represented as weights at either end of the scale, and are affected by nursing intervention, i. e., health and wellness increase when positive factors are stronger, whereas disease and illness increase when negative factors are stronger. This model is only a preliminary effort and requires much discussion and testing to be further developed. Continuous research is also required.

• Journal of Hospice and Palliative Care
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• 제20권4호
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• pp.253-263
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• 2017

목적: 본 연구는 상급종합병원 간호사의 임종간호수행 증진 프로그램 마련을 위해 임종간호 스트레스와 임종간호수행의 관계를 규명하고, 공감역량과 극복력의 매개효과를 분석하고자 하는 것이다. 방법: 본 연구는 2017년 8월 15일부터 8월 30일까지 B 광역시 소재 D대학교병원 간호사 218명을 대상으로 자료수집이 이루어졌다. 자료 분석은 IBM SPSS/WIN 21.0 software를 사용하였으며 t-test, ANOVA, Pearson's correlation coefficients, 회귀분석으로 분석하였다. 결과: 임종간호 스트레스는 공감역량(r=-0.345, P<0.001), 극복력(r=-0.223, P=0.001), 임종간호수행(r=-0.260, P<0.001)과 음의 상관관계였으나 공감역량(r=0.467, P<0.001)과 극복력(r=0.358, P<0.001)은 임종간호수행과 양의 상관관계를 보였다. 임종간호 스트레스와 임종간호수행 간의 관계에서 공감역량은 완전매개 효과(${\beta}=0.409$, P<0.001), 극복력은 부분매개효과(${\beta}=0.294$, P<0.001)를 보였다. 결론: 본 연구결과를 바탕으로 간호사의 공감역량과 극복력을 향상시킬 수 있는 프로그램 마련이 임종간호 수행 증진에 큰 도움이 될 것이다.

• 한국콘텐츠학회논문지
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• 제21권7호
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• pp.222-237
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• 2021

본 연구의 목적은 요양보호사의 직무스트레스 및 직무소진 완화와 치유를 목적으로 ACT 집단상담 프로그램을 개발하고 그 효과를 확인하는 데 있다. 이를 위해 프로그램의 목표 및 이론적 모형, 내용, 운영 및 평가를 구성하였으며 절차에 따라 적용하였다. 주요 연구결과는 다음과 같다. 첫째, 연구대상의 직무스트레스를 측정한 결과 프로그램 참여 집단에서 긍정적인 변화가 있었다. 둘째, 연구대상의 직무소진 수준을 측정한 결과 프로그램 참여 집단에서 긍정인 변화가 있었다. 셋째, 연구대상의 역할갈등 수준을 측정한 결과 프로그램 참여집단에서 긍정적인 변화가 있었다. 넷째, 연구대상의 역할과다 수준을 측정한 결과 프로그램 참여 집단에서 긍정적인 변화가 있었다. 다섯째, 연구대상의 역할모호 수준을 측정한 결과 프로그램 참여 집단에서 긍정적인 변화가 있었다. 본 연구는 실무적 시사점으로서 각종 요양보호사 교육과정에 ACT이론 및 실천방안을 내용에 포함시킴으로서 직무 소진과 직무 스트레스에 대한 대응력을 높이고 궁극적으로 요양보호사의 심리적 유연성을 높임으로서 일과 삶을 대하는 태도의 본질적 변화의 기회를 제공할 것에 대해 기술하였다.

• 한국간호교육학회지
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• 제26권1호
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• pp.56-66
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• 2020

Purpose: The purpose of this study was to explore nursing students' experiences with patient deaths during clinical practice. Methods: The participants were ten nursing students who had experienced patient deaths during clinical nursing practice at a university hospital in Korea. Individual in-depth interviews were conducted, and the data were analyzed using the content analysis method suggested by Graneheim and Lundman (2004). Results: The participants' experience was structured into six categories: experiencing various emotions in facing patient deaths, viewing oneself as a nursing student at the scene of a patient's death, thinking about death again, finding a pathway of understanding and support for patient death experiences, impressions and regret felt while actually observing terminal care, and picturing oneself as a future nurse dealing with a patient's death. Conclusion: Based on this study, stress management and self-reflection programs are suggested for nursing students who have experienced patient deaths. Practical nursing education for patient death and end of life care is also needed.

• 임상간호연구
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• 제25권3호
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• pp.237-250
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• 2019

Purpose: The aim of this study was to investigate the satisfaction of newly graduated nurses with educational programs and their experiences in role transition. Methods: Data were collected from November 1 to December 15, 2018 and 483 new graduate nurses working at 15 tertiary hospitals and 10 general hospitals participated. For data collection, self-report questionnaires including the Casey-Fink Graduate Nurse Experience Survey tool and satisfaction with education were used. Data were analyzed using descriptive statistics, t-test, and one-way analysis of variance. Results: Satisfaction with education ranged from 3.09 to 3.27, and satisfaction with preceptors was 3.45(maximum 4). The skill that new nurses ranked as most difficult during the first 3 months was charting/documentation, and throughout a whole year, the top 4 difficult skills were cardiopulmonary resuscitation/emergency response, ventilator care, end-of-life care, and prioritization/time management. In comfort/confidence, new graduates felt most comfortable with support and least comfortable with patient safety. More than 50 percent of new graduates experienced stress during role transition, and the most frequently experienced stressors were related to job performance and personal life. Levels of satisfaction with education and comfort/confidence differed according to the hospital type and number of preceptors for new nurses. Conclusion: In order to facilitate the transition of new graduate nurses to professional nurse, an extended period of education, systematic and standardized transition programs, and continuous support during the first year of practice are required.

• 한국식품위생안전성학회지
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• 제26권3호
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• pp.260-265
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• 2011

Fe-NTA는 전립선에 산화 스트레스를 일으킨다고 보고되어 있으며, 본 연구자는 랫드에 항산화 효과가 있다고 알려진 차전초잎 추출물(P. asiatica leaf extract, PLE)올 1, 2 또는 4 g/kg body weight (b.w.) 1주일간 경구 투여하고 ferric nitrilotriacetate (Fe-NTA)의 복강 주사로 전립선에 손상을 일으킨 후 차전초가 전립선에서 산화 스트레스를 얼마나 억제하여 주는지를 항산화 바이오 마커들인 reduced glutathione (GSH), glutathione-S-transferase (GST), glutathione reductase (GR) 및 지질과산화물의 척도인 malondialdehyde (MDA)를 통해서 측정하였다. 전립선 기능 이상 시 증가되는 GSH 및 GR은 아무것도 처리하지 않은 대조군(193.84${\pm}$37.78 mmol/g tissue, 31.32${\pm}$3.85)에 비해 Fe-NTA로 산화스트레스를 유발한 그룹에서 101.89${\pm}$24.31, 15.74${\pm}$2.92mmol/g tissue 48%의 감소를 나타낸다. 반면 PLE 1 g/kg b.w.을 투여한 그룹에서는 GSH 및 GR 수치가 119.01${\pm}$1.23 mmol/g tissue와 19.24${\pm}$0.53 mmol/g tissue, 2 g/kg b.w.을 투여한 그룹에서는 150.80${\pm}$34.11 mmol/g tissue와 19.17${\pm}$3.31 mmol/g tissue 마지막으로 4 g/kg b.w. 투여 그룹에서는 182.99${\pm}$10.89와 26.88${\pm}$4.40 mmol/g tissue로 Fe-NTA만 처리한 그룹에 비해 농도 의존적으로 GSH와 GR 함량이 회복되는 경향을 보이며, 이는 GSH 함량이 농도에 따라 약 l.2, 1.5, 1.8배 증가, GR 함량이 약 1.2, 1.22, 1.7배 증가한 것이다. 이렇듯 정자 보호와 전립선 조직 세포 보호에 관련이 있는 GSH와 GR값이 유의적 차이로 회복되는 결과에 따라 PLE의 전립선 보호 효과를 확인하였다. 또한, 항산화의 또 다른 바이오 마커인 GST 값은 아무것도 처리하지 않은 그룹 96.11${\pm}$6.23 mmol/g tissue에 비해 Fe-NTA 만 처리한 그룹 53.29${\pm}$11.45 mmol/g tissue이 약 45% 정도 감소하였지만, PLE 1, 2 또는 4 g/kg b.w.을 투여 한 그룹에서 각각 65.74${\pm}$9.79 mmol/g tissue, 76.54${\pm}$4.44 mmol/g tissue, 91.66${\pm}$5.53 mmol/g tissue의 값을 나타내며 Fe-NTA에 의해 생성된 산화 스트레스의 자유라디칼을 효과적으로 억제함을 확인하였다. 또한, 전립선에서 철 이온에 의해 유도된 산화스트레스에 의해 발생된 지질과산화물을 측정하였을 때 Fe-NTA에 의해 산화 스트레스만 유발한 그룹은 192.74${\pm}$33.20mmol/g tissue로 대조군 그룹의 75.66${\pm}$14.90 mmol/g tissue 보다 2.55배 높은 MDA를 생성한 것으로 지질과산화가 많이 일어난 것을 확인하였으나, PLE 1, 2 또는 4 g/kg을 투여한 그룹의 MDA의 생성량은 137.84${\pm}$23.29, 125.16${\pm}$16.69, 85.98${\pm}$5.12 mmol/g tissue로 약 29%, 35%, 55% 감소한 것을 확인하였다. 랫드의 전립선에서, 독성을 유발하는 Fe-NTA를 투여 후 PLE를 투여하였을 때 전립선 인지질 막의 손상지표인 MDA의 농도 의존적 감소와 항산화 및 정자 보호의 전립선 기능의 지표인 GSH, GR의 값이 증가하였다. 위의 결과들을 종합하였을 때, 우리는 Fe-NTA가 전립선에서 산회스트레스를 유발하고, 전립선 인지질 막의 손상을 줄 수 있으며, PLE는 이러한 전립선 손상을 항산화 효과를 기본으로 하여 전립선 보호 효과가 있음을 확인하였다.

• 대한예방한의학회지
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• 제5권1호
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• pp.10-30
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• 2001

Oriental medicine needs to be armed with theories on health-improvement concept under it and basic data matching its views, in order to participate in the health-improvement service in industrial work places. The Orient medicine health-improvement program defines factors that determine individuals' lifestyle, and provides information and technologies for workers to practice in life. To that end, this research compares and analyzes health-improvement concept and health care, defines relations between individuals' health state and their lifestyle as the basic data needed to perform health-improvement business for workers. 1. The subjects employed for this research is categorized into; by gender, males 52.1% and females 47.9% with no big difference between them; and by age, 20s, 6.1%, 30s. 33.9%, 40s, 34.1%, and 50s, 24.8% with 30-50 accounting for most of it. By marriage status, unmarried represents 7.1%, and married 79.1% with most of them married; by revenue, under one million won represents 3.0%, 1-2 million won 26.4%, 2-2.49 million won 11.2%, above 2.5 million won 11.2%, and 1-2.5 million won a majority. By living location, owned houses represents 65.4%, rented houses 14.7%, monthly-rented 9.5%; and by education, elementary and middle school represent 16.9%, high school and its dropouts 22.6%, and junior college and higher 51.6%, with high school and higher occupying most of the group. 2. By job, office workers and managerial workers represent 12.3%, part-timers 21.0%, manual workers 11.4%, jobless 0.6%, professionals 35.6%, service 0.6%, housewives 8.4%, and equipment/machinery operation/assemblers 10.1%. Of this, jobless and part-timers, totaling three, are dropped from this research. By years worked, 0-3.9 years represents 9.7%, 4-7.9 years 6.7%, 8-14.9 years 18.4%, above 15 years 28.7%, and no respondents 36.5%. 3. The degree of the subjects practicing life-improvement lifestyle, on a scale of 1 to 4, is an average of 2.69, personal relations 3.04, self-realization 2.92, stress management 2.76, nutritional state 2.73, responsibility for health 2.47, and athletic activities 2.18, with personal relations earning the highest points and athletic activities the lowest. As for factors influencing health-improvement lifestyle, there is no significant difference between gender, age, and marriage status. Meanwhile, there is significant difference between revenue, dwelling pattern, education level, etc. That is, higher income-bracket, owned houses, rented houses, monthly-rented houses, and higher-educated, in this order, show higher average in health-enhancement lifestyle. By job, housewives, manual workers, office workers, professionals, equipment/ machinery operation/ assemblers, and part-timers, in this order show higher points, while there is no difference with significance by years worked. 4. Factors that affect health-improvement lifestyle are shown below. Self-realization is influenced by age, marriage status, type of dwellings, and level of education; responsibility for health by type of dwellings; athletic activities by gender and age; nutrition by age, marriage status and type of dwellings; personal relations by marriage status; and stress management by type of dwellings. 5. Areas with high points by job show this: in self-realization, office workers, manual workers, housewives, professionals, equipment/ machinery operation/ assemblers, in this order, show difference with significance; in the area of responsibility for health, manual workers, housewives, equipment/ machinery operation/ assemblers, professionals, office workers and part-timers, in this order, do. In athletic activities, manual workers, housewives, office workers, professionals, equipment/ machinery operation/ assemblers, and part-timers, in this order, show difference with significance; in nutrition, housewives, office workers, manual workers, professionals, equipment/ machinery operation/ assemblers, and part-timers, in this order do; and in stress, housewives, office workers, manual workers, professionals, equipment/ machinery operation/ assemblers, part-timers, in this order do. By years worked, more years showed higher points in the area of responsibility for health and nutrition; in the area of athletic activities, above 15 years, 4-8 years, below 4 years and 8-14 years, in this order, show higher points; and no difference shows in realization, personal relation, and stress area. 6. To look at correlation between overall and divisional health-improvement practice degree, this researcher has analyzed it using Person's correlation coefficient. Self-realization, responsibility for health, athletic activities, nutrition, support for personal relations, and stress management show significant correlation with the sub-divisions, while all health-improvement lifestyle shows significant correlation with the six sub-divisions.