• 제목/요약/키워드: Graduate nursing education

검색결과 786건 처리시간 0.03초

제2형 당뇨병 환자의 혈당 비조절 관련 요인분석: 국민건강영양조사(2010-2012) 자료이용 (Factors Associated with Poor Glycemic Control among Patients with Type 2 Diabetes Mellitus: The Fifth Korea National Health and Nutrition Examination Survey (2010-2012))

  • 박진현;임승지;임은실;김영대;정우진
    • 보건행정학회지
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    • 제26권2호
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    • pp.125-134
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    • 2016
  • Background: Glycemic control is an effective way to reduce the cardiovascular complications of diabetes, but more than half of the adults with diabetes in Korea are improperly controlling their glycemic levels. The purpose of this study is to identify the factors associated with poor glycemic control in type 2 diabetes patients. Methods: This study analyzed 1,261 subjects ${\geq}30years$ old diagnosed with type 2 diabetes who participated in the fifth Korean National Health and Nutrition Examination Survey (2010-2012). Poor glycemic control rates were defined as hemoglobin A1c (HbA1c) level ${\geq}7%$. To shed light on the causes of poor glycemic control, socio-demographics, diabetes severity, health status, and health behavior factors were adjusted and logistic regression was done. Results: Of the total 1,261 patients, 53.0% of patients with type 2 diabetes had HbA1c ${\geq}7%$. After running a logistic regression model, the odds ratio of poor glycemic control was higher in high school graduates than elementary school graduates; in people living in Chungcheong and Jeolla/Jeju than those living in Seoul; in the group with diabetes for over 5 years had diabetes less than 5 years; in a group with insulin and oral hypoglycemic agent treatment than non-treatment; in a group with hypertriglyceridemia than without hypertriglyceridemia; and in the group with slept less than 6 hours slept 7-8 hours. Conclusion: We need a comprehensive public health policy to reduce the poor glycemic control rates in type 2 diabetes patients. We should recognize the education levels, duration of diabetes, diabetes treatment, hypertriglyceridemia, and sleep duration were associated with poor glycemic control.

보건소 보건간호사의 역할변화, 역할수행의 장애요인과 만족도 (Role, Change, Job Satisfaction and Obstacles in Carrying out the Role of Public Health Nurses in Health Center)

  • 안경숙;정문숙
    • 농촌의학ㆍ지역보건
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    • 제20권1호
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    • pp.1-13
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    • 1995
  • 본 연구는 변화되고 있는 지역사회보건사업의 요구에 따른 연도별 보건소 간호사들의 역할 변화, 역할 수행에 따른 장애요인 및 간호업무 수행과 관련하여 인지하는 직무만족도를 파악하고자 1992년 3월 19일부터 4월 11일까지 경상남도 보건간호사 270명을 대상으로 설문조사한 결과는 다음과 같다. 보건간호사들이 수행한 최우선 보건사업은 1970년 이전에는 가족계획사업, 1970 - 1979년대에는 간호업무, 1980 - 1989년대에는 모자보건사업, 1990 - 1992년대에는 간호업무이었다. 가족계획사업 내용의 우선순위는 1970년 이전에는 자궁내장치 삽입 권장과 경구피임약 또는 콘돔 배부에 역점을 두었으며 그 이후로는 가족계획 홍보를 우선으로 했다. 모자보건사업 내용의 우선순위는 1970년 이전부터 임부등록에 많이 두었으며 그 다음으로 산전진찰과 예방접종에 치중한 것으로 나타났다. 결핵관리사업 내용의 수선순위를 보면 각 년대마다 신환자 발견 등록에 치중하였으며 그 다음으로 환자관리 및 투약 주사에 비중을 두었다. 간호업무 냉용의 우선순위를 보면 1970년대 이전에는 순회진료에 역점을 두었으며 그 다음으로 주사 및 투약에 치중하였다. 전염병관리 내용의 우선순위는 1970년 이전부터 1순위였으며 그 다음으로 투약 및 주사에 치중하였다. 1990-1992년대에는 상담 및 교육이 2순위로 나타났다. 노인보건사업 내용의 수선순위가 1979년대 이전부터 순회진료가 1순위였으며 그 다음으로 검진보조가 2순위로 나타났다. 사업별 업무수행시 장애요인을 보면 가족계획 사업에서는 주민의 이해부족이 28.8%, 예산부족이 13.6%, 보건행정체계 미비가 11.9%였으며, 결핵사업에서는 주민의 이해부족이 32.5%, 업무과다(인원부족)가 15.6%, 기술이나 지식의 부족이 13.0%였다. 업무과다(인원부족)와 시설 장비의 부족이 각각 15.6%, 주님의 이해부족이 13.0%였다. 직급별 보건간호사의 직무만족도에서 경력이나 능력에 비해 승진기회여부는 불만이다가 8,9급이 64.7%로 높았으며 전문직 발전의 기회는 없다가 6,7급이 67.7%, 8,9급이 64.0%로 높았다. 보건업무에 필요한 물품과 시설의 만족여부에서 하위급으로 내려갈수록 만족도는 낮았으며 보수의 만족도에서는 적당하다가 6,7급이 64.7%, 너무 작다가 8,9급이 53.0%로 높았다. 직급별 보건간호사의 직업 긍지 만족도에서 직급이 높을수록 직업적 긍지의 직무만족도는 높았다. 직급별 현 직급에 대한 만족도는 하위급으로 내려갈수록 만족하는 사람의 비율은 높아졌다. 보건간호사의 경력(년)별 직무만족도에서 보건간호사 경력이 많을수록 직급, 승진기회, 전문직 발전의 기회에 대한 직무만족도는 낮게 나타났다. 보건간호사의 경력(년)별 직업 긍지 만족도에서 보건간호사 경력이 많을수록 직업적 긍지의 직무만족도는 높게 나타났다. 대상자의 37.6%가 이직할 의사가 있다고 하였으며, 승진기회의 부족, 근무여건의 불만이 이직 이유였다. 하력과 경력은 직무만족도 사이에 유의한 상관관계가 없었으며 직급이 낮을수록 직무만족도는 낮아 유의한 관련성을 나타내었다. 1차 보건의료사업을 수행토록 하기 위해서는 보건간호사의 인식이나 주민들의 인식을 새롭게 하기 위한 홍보활동 및 교육이 더 주어져야 할 것이며 보건간호사의 승진기회 및 직급에 대란 불만도가 높기 때문에 보건간호사의 승진제도개선 및 직무영역확대가 고려되어야 할 것이다. 그래서 간호업무에 만족할 수 있는 제도개선에 대해 고려해야 할 것으로 생각된다.

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사업장 보건관리 사업의 형태별 수행성과 분석 -비용편익 분석을 중심으로- (Performance of Occupational Health Services by Type of Service : Cost Benefit Analysis)

  • 조동란;김화중
    • 한국직업건강간호학회지
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    • 제4권호
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    • pp.5-29
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    • 1995
  • Occupational health services in Korea have been operated as dual types : one is operated by occupational health care manager and the other is health care agency without their own personnel. The performance of occupational health service should be different due to the variety of characteristics of health care manager and workplace, qualification of health care manager. This study is to analyze performance of occupational health care services with a particular consideration of job performance shape and efficiency, based on comparing those two types of health care management to show on the basic data for the settlement of more qualitative health care management system at workplace. For this study, total 391 places in Seoul and Inchon city area ; 154 places (39.4%) managed by designated health care manager and 237 places (60.6%) by the agency with their commission are selected as research samples. Tools for data collection are questionnares that have been investigated during the period of 20 September 1993-20 December 1993. Those data are compared with percentiles, mean, standard deviation and B/C ratio using SPSS PC program. Conclusions observed from the tests and each comparison could be summerized as follows : 1. Occupational health care have been accomplished at workplaces with designated people than with agencies people, and coverage rate of the occupational health care services has differences, due to management types. The reason of these results is due to visit only one or two times monthly by the agencies, while their own health care manager obsess, at the workplaces all the times. 2. Most of the expense for environmental control of all health care services expenditures shows that there is almost no fundamental improvement because more expenses are needed for procuring personal protective equipment and measuring work environment instead of environmental improvement. 3. It is investigated how much the cost of occupational health care services needs per worker, and calculated how much the cost needs per service hour per worker. The results from this show that the cost of occupational health services at workplaces with their own managers used less than the cost of health care agencies, eventually the former gives better services with less cost than the latter. 4. Benefit/Cost ratio is also produced by total benefit/total cost. The result from the above way reads 4.57 as a whole, while their own manager having workplaces reads 4.82 and the agencies do l.56. Even if their own manager performing workplaces spent more cost, this system produces more benefit than the agencies management. 5. The B/C ratio for medical organization such as local clinic, health care center and pharmacy shows more than or equal to at the workplaces controlled by the agencies. It is inferred that benefit would be much less than the cost used, with so being inefficient. 6. It is assumed that the efficiency ratio of health education is equal to reduction rate of workers medical organization visit. Estimated reduction rate 5%, 10%, 15%, show that the efficiency ratio of health education have an effect on producing benefits. It is estimated that more benefit can be produced if more qualitative education will be provided for enhancing health care efficiency. 7. Results of this study cannot be generalized because there are large scale of deviation in case of workplaces with less than 300 full time workers, but B/C ratio reads 2.69 as a whole and 3.25 at workplaces with their own health care manager are higher than 1.63 at the workplaces manged by the agencies. Finally, all the benefit concerning health care services could not be quantified, measured and shown on the value of money. This is a reason that a considerable part of benefits are so underestimated. This is also thought that measurement tools should be developed for measuring benefits of health care services with a comprehensive quantification. in the future. It is also expected that efficiency of occupational health care services should be investigated using cost-effectiveness analysis.

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수유양상과 중이염 발생과의 관계 (A Study on Relation Ship Between the Mode of Feeding and the Occurrence of Otitis Media)

  • 백예영;김일옥
    • 부모자녀건강학회지
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    • 제6권1호
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    • pp.70-81
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    • 2003
  • The otitis media has the highest rate of occurrence in 6-36 month after birth, and relatively high rate of occurrence to six years old. It is one of major cause for hearing loss problem because of its high rate of recurrence. The researcher observed at bed that feeding posture and feeding habit at night have some relationship with occurrence of otitis media. I found that medical research in this area was very weak, and it caused her to concentrate her research on the topic. This paper was undertook a retrospective case-control study to find out the relationship between the mode of feeding and the occurrence of otitis media among the otitis media patients and the healthy persons. As the controling groups, the researcher chose fifty eight mothers whose children received the treatment of otitis media(6-36 months after birth) from the pediatrics clinic of two general hospitals in Seoul, as the patient group, and forty five mothers who consulted with their child to well baby clinic at the general hospital and kindergarten in Seoul as the control group. The results of the survey can be summarized as followed : 1. "Otitis media patient group may have more lying posture mothers while feeding than the healthy control group". The first hypothesis is supported by the fact that the children who have lying posture feeding habit mothers are more easily exposed to otitis media than those who have sitting posture feeding habit mothers as the analysis show : $X^2=8.142$, p = .017 2. "Otitis media patient group may have higher rate of sleeping habit with milk bottle on the month at night than the healthy control group does". The second hypothesis was supported by the fact that the patients group has higher rate of expected sleeping habit than the healthy group dose as the analysis show : $X^2=4.35$, p = .037 3. "Otitis media can be found more in the artificial feeding group than in the healthy children group". The hypothesis is rejected by the analysis, $X^2=1.550$, p = .416. Though the hypothesis is not supported by this research, we need to encourage mothers to feed mother's breast milk on the ground that healthy group has mother's milk feeding tendency, and the best food for infants is their mother's milk, and psychological-sociological effects of breast feeding os quite good for children. It will improve the health of infants. It can be summarized as follows : Otitis media is more concerned with posture of feeding and night feeding habits than feeding modes. On the basis of this survey, feeding education problem for mothers of infants need to be developed. In the education, sitting-embracing posture of feeding, mother's breast feeding, and prohibition of children's lying posture feeding at night need to be emphasized.

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지역사회치위생학 현장(보건소)실습 성과평가 내용분석 (Contents analysis of the community dental hygiene practice outcome evaluation)

  • 이가영;한양금;김영경;임현주;권양옥;김한미;박정란;김남희
    • 한국치위생학회지
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    • 제16권1호
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    • pp.37-43
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    • 2016
  • Objectives: The purpose of the study is to evaluate the contents analysis of the community dental hygiene practice in the dental hygiene students and suggest the outcome based evaluation index of community dental hygiene practice. This study will provide the basic data for the community nursing and social welfare practice. Methods: A self-reported questionnaire was completed by 82 dental hygiene professors and 254 dental hygienists in community health centers after receiving informed consent based on institutional review board from 5th Dec 2014 to 30th Jul 2015. A total of 49 professors and 134 dental hygienists gave the complete answers. The study instrument was adapted from the literature review. The questionnaire consisted of evaluation, purpose of evaluation, and evaluation format. Data were analyzed using SPSS 20.0 program. The contents analysis was carried out through input, process, output, and outcome. Results: The practice outcome evaluation was conducted in 62.9% of the dental hygiene departments and 32.9% of the community health centers. Most of the dental hygiene professors chose "To know what students learned(27.3%)" and "To ensure student's role and behavior in practice(27.3%)." as the purpose of evaluation. The public dental hygienists chose "To score the practice grade(42.1%)." The evaluation method was done anonymously. Conclusions: The outcome based evaluation in community dental hygiene practice was the best method to evaluate the practice education for the competency of the dental hygiene students.

미국거주 한국인 이민자들의 암과 식품에 대한 지식과 신념 (Knowledge and Beliefs About the Association Between Diet and Cancer Among Korean Immigrants in the U.S.A.)

  • Cho, Jae-Kyung;Kim, Katherine;Elena Yu
    • 보건교육건강증진학회지
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    • 제15권1호
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    • pp.133-149
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    • 1998
  • 본 연구는 미국에 사는 한국인 이민자들의 암예방과 식품에 대한 지식과 신념에 관하여 알아보는데 그 목적이 있다. 본 연구의 도구로는 미국 국민 건강연구조사 (NHIS)의 설문지를 한국어로 번역하였고, 연구의 대상자는 미국의 시카고에 거주하는 263명의 한국인 이민자들이다. 본 연구의 주된 연구결과는 다음과 같았다. (1) 대부분의 대상자(83.3%)들은 한국음식을 먹고 있다고 답하였다. (2) 대상자들의 47.5%가 영어를 전혀 못 읽거나 거의 못 읽는다고 답하였다. (3) 식생활 변화를 하지 않는 이유에 대해 현재 먹고 있는 음식을 즐기기 때문에 식생활을 바꾸고 싶지 않다는 답이 가장 많았다. (4) 우리가 먹고 마시는 음식과 관계 있는 주요질병에 대해서 25.4%의 응답자만이 암이라고 답하였다 (미국 NHIS 에서는 48%). (5) 응답자의 48.3%만이 섬유소에 대해 들어보았다고 응답하였다. (6) 7.1%의 응답자만이 섬유소가 많은 음식으로 corn flakes와 bran flakes를 고를 수 있었다. 이 결과로 보아 한국인 이민자들이 미국음식에 대해 잘 모르는 것으로 보인다. (7) 약 62%의 응답자들이 암예방에 관한 무료 보건강좌에 참석하고 싶다고 응답하였다. 보건강좌 장소에 대해 "교회'라고 답한 응답자가 가장 많았다. (8) 질병예방에 관한 정보를 어디에서 얻느냐는 질문에 대하여 "신문"이라고 답한 응답자가 가장 많았다. 본 연구에서 얻은 결과를 볼 때 대부분의 응답자들이 미국 정부에서 하고 있는 암예방 교육의 혜택을 받고 있지 않는 것으로 나타났다. 한국인 이민자들의 문화적 배경에 맞는 암교육이 필요하며, 영어를 잘 못하는 이민자들을 위해 한국말로 번역된 보건교육자료를 사용하여야 한다.교육자료를 사용하여야 한다.표현을 위하여 확장된 기본 모델을 중심으로 각 레벨의 구성 요소들의 형식적 의미(formal semantics)와 레벨 내 혹은 레벨 구성요소들간의 관계성(relationship), 그리고 제약조건의 표현과 질의 추론 규칙들을 식별하여 FOPL(First Order Predicate Logic)로 표현한다. 또한, 본 논문은 FOPL로 표현된 predicate들과 규칙들을 구현하기 위하여 Prolog로 변환하기 위한 이론적 방법론을 제시하고 정보자원 관리를 위한 기본 함수들과 스키마 진화(schema evolution)를 위한 방법론을 제안한다. 최저 잔류탁도를 나타내는 최적 응집제 주입량에서의 Zeta potential은 원수탁도가 5NTU일 경우 Alum, PAC 및 PACS 모두 -20mV∼-15mV사이였으며, 원수 탁도가 10NTU인 경우에는 0∼0.5mV 범위에 있는 것으로 나타나 응집제 종류 및 주입량이 상이하더라도 응집효율이 가장 양호한 상태에서의 Zeta potential은 일정한 범위내에 있는 것으로 나타났다.각 각 11.1, 10.2, 12.2 그리고 13.0%의 발달율을 보여 유의적인 차이를 보이지 않았다. 4. 수정 후 114 시간 개별배양된 수정란으로부터 분리된 small과 large의 할구를 공핵체로 사용한 처리구에서 핵이식 수정란의 세포융합율에 있어서 각각 71.0, 71.4, 69.9 및 77.1% 의 융합율올 보여 유의적인 차이를 나타내지 않았으며, 핵이식 수정란의 배반포기배로의 발달율에 있어서도 각각 11.4%, 8.0%, 17.2% 그리고 12.9% 의 발달율을 보여 유의적인 차이를 보이지 않았다. 이상의 결과로 보아 핵이식 수정란을 효율적으로 생산하기 위하여 수핵난자의 세포질에 ionomycin 과 DMAP 의

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우리나라 성인의 비누로 손씻기 실천 관련요인 (Related Factors to Handwashing with Soap in Korean Adults)

  • 이윤희;이무식;홍수진;양남영;황혜정;김병희;김현수;김은영;박윤진;임고운;김영택
    • 한국학교ㆍ지역보건교육학회지
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    • 제17권1호
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    • pp.89-99
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    • 2016
  • Objectives: This cross-sectional study aims to investigate the prevalence and factors relating to handwashing with soap among Korean adults. Methods: Study subjects consist of 755 adults who have been contacted in September 2013 via telephone surveys. The data collected has been analyzed using descriptive statistics, a chi-square test and a logistic regression analysis. A primary purpose is to understand the prevalence of handwashing with soap more than 8 times daily and for 30 seconds per wash among adults. Independent variables include socioeconomic levels, the participants' perception and knowledge of handwashing and their educational experiences relating to handwashing. Results: The overall percentile of people who wash their hands with soap 8 time per day for 30 seconds or more per wash was 16.0%, which is 121 people out of 755 study subjects. In univariate analysis, age, education levels, monthly average income, handwashing habits, perceptions relate to the importance of handwashing, self-assessment of handwashing, environment of public toilet, and the completion of handwashing education shows significant result. Significant differences also appear (p<0.05) in logistic regression analysis on binary variables. There is a strong correlation between daily frequency of handwashing and willingness to wash hands while outside. For example, people who wash their hands very often while outside are 2.24 times (95% C.I. 1.29-3.87) more likely to practice handwashing with soap 8 times per day for 30 seconds or more per wash than those people who only intermittently wash their hands while outside. Furthermore, people with general unwillingness to wash their hands while outside are 4.61 times (95% C.I. 1.22-3.28) less likely to practice handwashing with soap 8 times per day for 30 seconds or more per wash than those with general willingness. Conclusions: This study has been carried out to identify the decision factors in practicing handwashing with soap for Korean adults. In univariate analysis, age, education level, monthly average income, handwashing habits, handwashing self-assessment, public toilet environment, completion of handwashing education and so forth have been identified to be the decision factors. This study result shows that the overall level of cleanliness of public toilet perceives to be poor and it suggests that the environment of public toilet needs to be enhanced. As the handwashing habits and handwashing-self assessment have been identified to be the significant decision factors for handwashing, there search and approach in these factors need to be developed further.

병원 구성원들의 직종별 조직몰입의 영향요인에 관한 연구 (Factors affecting the Organizational Commitment of Industrial Accident Hospital Employees by Job Category)

  • 방용주;하호욱;손태용
    • 한국병원경영학회지
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    • 제7권4호
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    • pp.24-56
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    • 2002
  • The purpose of this study was to analyze the characteristics of socio-demographic, organizational culture, organizational conflict and organizational commitment, and to examine the interrelation of influential factors in the organizational commitment. The data for this study were collected through a self-administrated survey with a structured questionnaire to 1,027 subjects from several medical doctor staff members, nursing staff members, administration staff members, pharmacist, and technical expert of eleven hospitals. The data were collected by self-reporting questionnaire from July 29 to September 7, 2002. In this analysis frequency test, t-test, ANOVA, multiple regression were used. The main results of this research is as following; 1. According to socio-demographic characteristics the respondents' level of the organizational commitment was higher in a administration staff members than others, for males than females, and for employees aged more than forty, as working for longer time, and as higher level of the working position. 2. According to the organizational culture characteristics the progressive culture, affiliative culture, and task-focused culture among many types of organizational culture were moderately and positively correlated with the level of the organizational commitment while the hierarchical culture was negatively correlated. 3. According to the organizational conflict characteristics as the respondents who got less conflict experience in the organization, their level of the organizational commitment was higher. And, technical conflict experiences were expressed greater than hierarchical conflict experiences. 4. According to the job satisfaction characteristics as his or her satisfaction that is about the promotion, working itself, salary, and fellowship in the organizational was higher, the level of the organizational commitment was higher. The most important factor of the satisfactions was the fellowship among the respondents while the level of job satisfaction for the promotion and salary was average. 5. Overall, according to the result of Multiple Regression as older age and longer working hours, the level of the organizational commitment was higher and as a higher level of the satisfaction for the promotion, working itself, salary, and fellowship in the organization, it caused more effective factors for the organizational commitment. 6. According to the result of Multiple Regression for the doctor staff members in special hospitals rather than general hospitals the hierarchical culture and task focused culture was positively correlated with the satisfaction of working itself while hierarchical conflict factors in the organizational conflict characteristics was negatively correlated with the organizational commitment. For the nursing staff members the affiliative culture and the job satisfaction for the promotion, working itself, salary, and fellowship were positively correlated with the organizational commitment. For the administration staff members as the job satisfaction for the fellowship was positively correlated with the organizational commitment. For medical and pharmacy staff members as more working experience, correlation with the organizational commitment was positive. Besides, as he or she has a high perception of the affiliative culture, it caused statistically more effective factors for the organizational commitment. For the skill and technicians, male worker expressed greater organizational commitment in the organization than female worker. And also older age along with higher education also showed higher organizational commitment. Moreover, the job satisfaction for the fellowship was positively correlated with the organizational commitment. This study identified the major effective factors of the organizational commitment and analyzed the differences among the job category. In that respect, it is significant for the study to be able to provide a reference for managing hospital of industrial accident and organizational development. However, this study has a problem, which is not to identify a valuable model for examining the relationship between organizational factors such as organizational culture, conflict, satisfaction, and commitment. Therefore, further study is needed and strengthened in the field of organizational commitment for hospital for industrial accident.

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학생뇨검사 유소견자의 추후검사율 및 관련 요인 (A Study of Follow-up Test' and Related Factors in Students Who have Positive Result in Urine Tests)

  • 김동식;박재용;감신;차병준
    • 한국학교보건학회지
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    • 제10권2호
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    • pp.157-167
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    • 1997
  • 경상북도 내 중 고둥학생들의 요검사 결과 유소견자들의 추후검사율 및 그 요인을 알아보기 위하여 767명의 유소견자에 대해 설문지를 이용해 조사한 결과는 다음과 같다. 추후검사 실시율은 36.2%로 낮은 편이었는데, 중학생은 39.2%로 남자 41.5%. 여자 38.1%였고, 고등학생은 34.1%로 남자 29.7%. 여자 37.5%였다. 추후검사율은 부모의 관심도가 많은 학생이 40.6%로 그저 그런 학생의 28.5%에 비해 유의하게 높았다(p<0.01). 그리고 건강관심도가 높을수록 높았으며, 요검사 결과의 의미를 알고 있었는 학생이 51.9%로 그렇지 않는 학생의 29.0%에 비해 높았다. 양호교사가 배치되어 있는 경우(39.2%)가 그렇지 않은 않은 경우(29.2%)보다 추후검사율이 높았고, 요검사 결과에 대해 보건지도를 학교에서 받은 학생(48.5%)이 받지 않은 학생(28.8%)에 비해 높았으며, 병원방문을 학교에서 권유받은 학생(49.7%)이 받지 않은 학생 (14.9%)에 비해 유의하게 높았다(p<0.01). 검사결과가 부모에게 통보되지 않은 경우의 추후검사율은 5.4%, 학생 자신이 부모에게 통보한 경우가 45.8%, 학교에서 직접 부모에게 통보한 경우가 54.5%로 유의한 차이가 있었다(p<0.01) 다중 로지스틱 회귀분석결과 추후검사 여부에 유의한 영향을 미치는 변수는 가정의 경제수준, 부모 관심도, 검사결과 의미 인지 여부, 병원방문 권유여부, 부모님 통보 방법이었다(p<0.05). 즉, 가정의 경제수준이 높을수록, 부모 관심도가 많은 경우가, 검사결과의 의미를 알고 있는 경우, 학교에서 병원방문 권유를 받은 경우, 학교에서 부모님에게 직접 통보할수록 추후 검사율이 높은 것으로 나타났다. 추후검사의 검사기관은 병의원이 73.7%로 가장 많았고. 보건소가 18.3%였으며, 방문시점은 검사결과를 안지 1~7일 사이가 57.2%로 가장 많았다. 추후검사 결과, 이상이 있는 것으로 판명된 학생은 10.8%였다. 추후검사를 하지 않은 이유는 귀찮아서 26.6%, 어떻게 할지 몰라서 24.2%, 믿을수 없어서 16.0%의 순이었다. 이상의 결과를 올 때, 학생 요검사 실시 후 보다 효과적이고 바람직한 추후관리를 하기 위해서는 가정과 학교가 같이 노력하여야 되겠는데, 학교에서는 검사 결과에 대한 보건지도를 적극적으로 실시하고, 검사 결과 유소견자에 대해서는 반드시 학교에서 부모에게 전화나 우편으로 직접통보하여야 한다. 또한 요검사에 대한 학생들의 관심과 이해를 높일 수 있도록 사전교육을 실시하고 검사의 신뢰성을 높일 수 있게끔 검사에 철저를 기하고 사후관리를 적극적으로 하여 학생들의 신뢰를 얻는 노력도 병행하여야 하겠다.

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만성질환자 배우자의 돌봄 경험에 대한 이론 구축 (A Theory Construction on the Care Experience for Spouses of Patients with Chronic Illness)

  • 최경숙;은영
    • 대한간호학회지
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    • 제30권1호
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    • pp.122-136
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    • 2000
  • Chronic illness requiring attention and management during a long period of time puts great burden onto patients, their family and society. For patients with chronic illnesses, providing social support is the most important, and the fundamental support comes from their spouses. Amount and quality of support from spouses seems to differentiated according to the sex of patients. Female patients tend to believe that their spouses are not very supportive. Therefore, the researchers assessed the burden of husbands of female arthritis patients to discover the factors that result in greater burden. Also, they developed a theoretical model of husbands′ care for their wives through a qualitative research into husbands′ experience. Method 1: The study material was 650 female arthritis patients registered in an arthritis clinic. The questionnaire about the disease experience of female arthritis patients and the burden of husbands were sent. Returned questionnaires numbered 210(32.3%) and 27 were excluded because of inadequate answers. The remaining 183 questionnaires were analyzed. The mean age of the patients was 51 years and the mean age of spouses was 55 years. The mean marital period was 28 years. The average duration since diagnosis was 9.1 years. Education level was varied from primary school to graduate school, and average income/month was 1,517,300 won. Method 2: Initial questionnaire studies on the burden of husbands were performed. Among 183 responding husbands, 23 consented to participate for a qualitative research. Data was obtained by direct and telephone interviews. The mean age of participants was 58 years, and the educational level and socioeconomic status also varied. Result: 1. Husbands′ burden: The average burden was 57.68 with a range of 6-96. 2. Burden and general characteristics: The husband′s burden correlated with the age of the patients, numbers in the family, therapy methods, patient′s level of discomfort, patient′s disease severity, patient′s level of dependence and the husband′s understanding of the level of severity. 3. Linear correlation analysis on burden: The husbands′ burden is explained in 22.5% by husband′s recognition of level of severity and husbands′ age. 4. There were four patterns of the burden on husbands: both objectve burden and subjective burden were high(pattern I), both of objectve burden and subjective burden were low(pattern II), objective burden was high but subjective burden was low(pattern III), objective burden was low but subjective burden was high(pattern IV). The pattern was correlated with the family income, educational level of the patients and their husbands, therapy methods, patient′s level of discomfort, patient′s disease severity, patient′s level of dependence and husband′s understanding of level of severity. 5. The core category of the caring experience of the husbands with arthritis patients was "companionship". The causal factor was the patients′ experience due to symptoms : physical disfigurement, pain, immobility, limitation of house chores, and limitation of social activities. Contextural factors are husbands′ identification of housework and husbands′ concern about the disease. The mediating factors are economic problems, fear of aging, feeling of limitation and family support. The strategy for interaction is mind control and how to solve emotional stress. The "companionship" resulted from caring activities, participation of household activities, helping patients′ to coping with emotional experience. 6. Companionship is established through the process of entering intervention, and caring state of mind. Entering intervention is the phase of participation of therapy and involvement of houseworks. The caring phase consists of decision on therapy, providing therapy, providing direct care, and taking over the household role of wife. Through caring phase, the changing phase set a stage in which husbands consolidate the relationship with their wives, and are reminded of the meaning of marriage. As a result, in changing phase, husbands′ companionship is enhanced. In conclusion, nursing care of chronic illnesses should include a family member especially the spouse. All information on disease shoud be provided to patients and whole family member. Strong support should also be provided to overcome difficulties in taking over role of other sex. Then the quality of life of patients and families will be much improved.

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