• Title/Summary/Keyword: Group Counseling

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한국 교인들의 목회간호 역할기대 (Parishioner's role Expectations of Parish Nursing)

  • 김정남;권영숙
    • 지역사회간호학회지
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    • 제11권1호
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    • pp.231-244
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    • 2000
  • Parish nursing is a community health nursing role developed in 1983 by Lutheran Chaplain Granger Westberg. An increasing emphasis on holistic care, personal responsibility for a healthy lifestyle, and changes in healthcare delivery systems have undoubtedly facilitated the establishment of an innovative nursing role in the community. Parish nurses are functioning in a variety of church congregations of various denominations. The parish nurse is a educator, a personal health counselor, a coordinator of volunteers. The parish nurses helps people relate to the complexed medical care system and assists people to integrate faith and health. The purpose of this study is to investigate what the korean parishioners want in parish nursing and what type of role expectation from parish nurse. The subjects were 1138 parishioners of 23 churches of various denominations in nationwide Korea. Data were collected by self-reported question naires from Feb 4 to June 25. 1999. The data were analyzed by using percentage. frequency. $x^2-test$. multiple Response set with SPSS program. The results are as follows: 1. Desired parish nursing contents by parish nurses are: psychological counselling(23.4%) out of private counselling. stress management(21.1 %) out of private health education. Emergency care(14.1%) out of group health education. Blood Pressure check-ups (19.0%) out of Health check ups. home visiting(44.9%) out of patient visiting method. B T. pulse, respiration and blood pressure check(15.0%) in Care to serve in home visiting. spiritual preparation to accept the death(41.7%) in hospice care, advices to choice of medical treatment using guide(50.1%) in introducing and guiding of health care facilities, pray(21.7%) in spiritual care' faith support. 2. Desired Health Teaching Content According to Period of Clients by Parish Nurse are: Vaccination(22.5%) in infant and toddler health management. sexual education(25.3%) in adolescent health management. prenatal care (29.5%) in pregnant health management. osteoporosis prevention and management (22.4%) in Middle aged health management. dementia prevention and management(25.5%) in elderly health management. 3. The expectant role from parish nurse is spiritual care faith support(14.1%). patient visiting care(13.2%), hospice care(12.9%), private counseling(12.8%), health check ups (11.1 %), volunteer organization and training out of believer(11.0%), private health education (9.3%), group health education (8.3%). 4. In Necessity of Performing Parish Nursing according to Region, Most(over 95%) responded that nursing program is needed. so there is no significance between regions. In Performing Parish Nursing in their church, Most(92.2%) responded they want to perform program. 5. In case of performing parish nursing, 52% out of the subjects responded they want to participated in parish nursing volunteer's activity, for example. to be in active to be a companion to chat(42.1%), necessity support (25.3%), donation support(25.0%), exercise support(18.2%), vehicles support (9.9%). As a result. in holistic care and spiritual care, the need of parish nursing and the role expectation from parish nurse are very high among korean believers. Therefore, I suggest parish nursing centering around Taegu and Kyungbuk province should be extended to nationwide. For extending parish nursing program. more active advertisement and research is needed. After performing parish nursing program through out the country, further comparative research between regions should be practiced and Korean parish nursing program will be developed and activated.

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대학생의 도박행동: 자기통제력의 매개효과 및 다집단 분석 (College Students' Gambling Behavior: Mediating Effect of Self-Control and Multiple Group Analysis)

  • 김덕진
    • 한국산학기술학회논문지
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    • 제18권6호
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    • pp.197-208
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    • 2017
  • 본 연구는 대학생의 도박행동과 관련된 선행연구와 문헌고찰을 토대로 가설적 모형을 구축하고 검정함으로써, 예방적 차원에서 학교 및 지역사회 정신보건 실무에 기초자료를 제공하고자 수행되었다. 대학생의 도박행동과 관련된 선행요인으로는 인지적 요인, 심리적 요인, 사회적 요인 그리고 자기통제력을 포함시켰다. 인지적 요인(비합리적 도박신념), 심리적 요인(우울, 불안), 사회적 요인(부모의 감독, 부모의 지지, 친구의 지지)은 외생변수로, 자기통제력과 도박행동(도박경험, 도박수준)은 내생변수로 하여 가설적 모형을 구성하였다. 또한 성별, 음주, 흡연, 인터넷 사용시간, 스마트폰 사용시간, 친구의 도박행동, 가족의 도박행동을 조절변수로 설정하여 그 효과를 분석하였다. 본 연구의 표적모집단은 국내의 대학생이며, 근접 모집단은 1개 광역도시와 4개의 지역도시에 소재한 7개 대학교에 재학 중인 남, 여 대학생 246명이다. 자료수집은 2016년 1월 25일부터 3월 31일까지 이루어졌으며, 자료분석은 SPSS 21.0과 AMOS 20.0 Program을 이용하여 공분산 구조분석을 실시하였다. 대학생의 도박행동을 예측하는 여러 요인들 중에서 자기통제력의 효과가 가장 크고, 예측된 모든 변수들에 대한 자기통제력의 매개효과가 나타났다. 따라서 대학생의 도박행동을 예방하기 위한 중재 개발 시 자기통제력을 증진시키는 방안을 우선적으로 고려할 것과 개인의 인지적, 심리적 요인과 사회적 요인들을 개선시킴으로써 자기통제력을 증진시키는 방안이 필요할 것으로 사료된다. 또한 성별을 고려한 접근 및 가족이나 친구를 포함하는 집단상담 프로그램 개발이 필요할 것으로 본다.

허혈성 심뇌혈관질환자에서 폐쇄성 수면무호흡증 정도 및 영향요인 (Level of Obstructive Sleep Apnea of Patients with Ischemic Cardio-cerebrovascular Disease and Affecting Factors)

  • 김선화;황선영
    • 한국콘텐츠학회논문지
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    • 제18권4호
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    • pp.114-127
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    • 2018
  • 본 연구는 허혈성 심뇌혈관질환자의 폐쇄성 수면무호흡증 위험정도를 파악하고 그 영향요인을 규명하기 위해 시도되었다. 심뇌혈관집중치료실에 입원한 허혈성 심뇌혈관질환자 141명을 대상으로 구조화된 자가설문지 사용하였고, 펄스 옥시미터를 사용하여 세 시점에서 수면 중 혈중산소포화도를 측정하였으며 SPSS/WIN 20.0을 이용하여 통계분석을 시행하였다. 연구 결과 대상자의 평균연령은 $64.4{\pm}11.1$세였고 남자가 61%였다. 심뇌혈관질환자의 21.3%가 폐쇄성 수면무호흡증 고위험군으로 파악되었고 71.6%에서 수면의 질이 낮은 것으로 나타났다. 폐쇄성 수면무호흡증 고위험군의 수면 중기와 말기에 측정한 산소포화도는 저위험군보다 통계적으로 유의하게 낮은 것으로 나타났으며, 다중회귀분석 결과, 심뇌혈관질환자의 폐쇄성 수면무호흡증 영향요인으로서 과거흡연, 잦은 코골이, 비만, 운동부족이 확인되었다. 따라서, 본 연구결과는 심뇌혈관질환 간호에 있어 폐쇄성 수면무호흡증 또는 잦은 코골이를 위험요인으로 중요하게 인식하고, 심뇌혈관질환의 이차적 재발 예방을 위해 폐쇄성 수면무호흡증 고위험군의 조기선별 및 환자와 가족을 지지하고 건강행태 개선을 위한 상담과 퇴원교육을 강화하기 위한 기초자료로 활용될 것이다.

치과위생사의 근골격계 통증 해결 방법과 자기효능감이 근골격계 질환에 미치는 영향 (Effects of Dental Hygienist's Musculoskeletal Pain Resolution and Self-Efficacy on Musculoskeletal Disorders)

  • 문애은
    • 한국산학기술학회논문지
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    • 제19권2호
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    • pp.329-338
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    • 2018
  • 치과위생사의 근골격계 질환을 조사하고, 통증 조절과 자기효능감이 근골격계 질환에 미치는 영향을 분석하고자, 광주지역 치과위생사 483명을 편의 추출하여 자기기입식 설문조사를 시행하고 빈도분석, 교차분석, t-검정, 다중로지스틱 회귀분석을 실시하여 분석하였다. 연구결과 연구 대상자의 지난 1년간 근골격계 통증 유병율은 83.9%이었으며, 이중 근골격계 질환이 있는 경우는 29.8%이었다. 근골격계 질환에 영향을 주는 요인을 파악한 결과, 근골격계 통증 해결 방법이었다. 통증 해결 방법에서 병가, 작업전환이라고 응답한 군에 비해 병원, 한의원, 약국치료 라고 응답한 군의 근골격계 질환 교차비(odds ratio)는 0.22(95% 신뢰구간 0.14-0.34)로 음의 관련성을 보였다. 이것은 근골격계 장애가 있는 경우 병원, 한의원, 약국치료를 더 하지 않은 것으로 사료된다. 따라서 치과위생사의 근골격계 통증 관리를 위해서는 의학적 관리(한의학적 치료, 정맥주사나 약물 치료, 열과 냉동 치료, 스테로이드 치료, 상담 치료, 척수자극을 이용한 중재적 치료, 물리 치료, 스트레칭, 재활운동치료, 도수 치료)와 작업환경 요인을 개선할 필요가 있고 근골격계질환 예방법에 대한 적절한 접근이 필요할 것으로 생각된다.

임상 치과위생사의 업무 및 이직요인 연구 (A Study on the Work and Turnover of Clinical Dental Hygienists)

  • 유은미;한화진
    • 치위생과학회지
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    • 제11권1호
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    • pp.41-46
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    • 2011
  • 본 연구는 치과위생사의 업무 및 이직요인에 대한 연구를 통해 그에 따른 문제점을 파악하고 개선방향을 제시하기 위해서 서울, 경기, 인천지역에 소재한 치과 병(의)원에 근무하고 있는 치과위생사 383명을 대상으로 자기기입식 설문지를 이용해 조사 후 다음과 같은 결론을 얻었다. 1. 근무기관별 치과위생사의 업무에 대한 견해를 살펴보면 주 업무는 진료협조가 가장 많았고, 치과위생사가 가장 힘들어 하는 업무에 대해서는 치과의원(54.3%)과 치과병원(30.0%)모두 진료상담으로 조사되었다. 2. 경력별로 치과위생사의 업무에 대한 견해에서 주 업무에 대해서 전체적으로 진료협조라고 가장 많이 조사되어 통계적으로 유의한 차이를 보였으며(p<.05), 가장 힘든 업무에 대해서는 진료상담이라고 가장 높게 조사되었다. 3. 근무기관 별 주력해야 할 업무로는 치과의원(35.5%), 치과병원(50.2%)가 예방치과처치 업무로 조사되었으며, 경력별 주력해야할 업무도 2년 미만, 2-4년, 4-7 년, 7년 이상 모두 예방처치업무가 높게 조사되었다. 4. 개선분야에 있어서 치과의원은 근무환경개선(27.2%), 치과병원은 급여인상(37.1%)이 우선시되어야 한다는 것으로 조사되었는데, 7년 이상의 경력을 가진 치과 위생사들에게선 기혼자 재취업(25.9%)이 높게 조사되었다. 5. 근무기관별 치과위생사의 이직이유에 대해서 치과의원에서 직장상사와의 불화(39.3%)가 가장 많았으며 치과병원에서는 급여 불만족(28.6%)이 가장 높게 조사되어 통계적으로 유의한 차이를 보였다(p<.05).

과체중과 비만 여성의 HbA1c 지표에 따른 당뇨병 예방을 위한 영양상담의 효과 (Benefits of Nutrition Consultation for Preventing Diabetes According to HbA1c Levels in Overweight and Obese Women)

  • 권용진;선우섭;문황운;박유경
    • 대한영양사협회학술지
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    • 제19권2호
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    • pp.112-123
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    • 2013
  • HbA1c was recently adopted as a reliable indicator for screening diabetes. This study investigated the ability of nutrition consultation to prevent diabetes in overweight women (BMI 23 $kg/m^2$ or more) using HbA1c as an indicator. Twenty overweight and obese women (with $HbA1c{\geq}5.7$%) completed the 12-week nutritional study, with individual and personalized nutrition counseling performed every 2 weeks. The main study guidelines involved the following: 1) reducing the intake of high fat foods and alcohol, 2) consuming a large amount of vegetables, 3) reducing the intake of simple sugars and empty-calorie foods, and 4) increasing physical activity to ${\geq}30$ min/day. Anthropometric (height, weight, BMI, body muscle (kg), body fat (%), waist and hip circumference, blood pressure) and biochemical parameters (fasting blood sugar (FBS), HbA1c, lipid profiles, hs-CRP) were measured before and after the nutrition consultation. After 12 weeks, the HbA1c<5.7% group had significant decreases in BMI, WC, HC, WHR, HbA1c, hs-CRP and also dietary intake of energy (P<0.01), carbohydrates, lipids (P<0.01), proteins (P<0.01) and cholesterol was significantly decreased (P<0.05). In the HbA1c ${\geq}5.7$% group, HbA1c, TC, LDL, NON-HDL, hs-CRP and dietary intake of energy, carbohydrate, lipid, protein, and cholesterol significantly decreased (P<0.05). These results suggest that nutrition consultation effectively helps to prevent diabetes in overweight and obese women after applying HbA1c standards. Overall, the improvement in all markers measured suggest that HbA1c is a good indicator for blood glucose regulation, helping to prevent diabetes.

초등학교 아동의 문제행동 수정을 위한 미술치료 사례 연구 (A Case Study on Art Therapy for the Behavior modification of Elementary School Children)

  • 신화정
    • 초등상담연구
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    • 제7권1호
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    • pp.227-248
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    • 2008
  • This study aims to examine the effects of art therapy on challenging behavior of schoolchildren. For this purpose, I selected one class of 4th year student of S primary school, located at Jeongeup city, Jeonlabukdo, and selected 4 study subjects through examination of K-CBCL children. juvenile behavior evaluation scale, characters, school life and K - HTP test. With regard to procedure of this study, I carried out art therapy program at the art class for 60 minutes one time a week for 4 months, a total of 17 sessions from Apr. 3, 2007 to July 24, 2007. I made this program with some modification in reference to Arts Therapy Technique (Counpia Remote Training Center, 2005), Group Art Therapy (Choi Seon Nam. Kim Gap Sook. Jeon Jong Kuk, 2007) and the Effects of Peer Group Art Activity on Sociality Skill of Offensive Children (Park Ju Yeon. Lee Byeon In, 2005). For each child, I compared and analyzed the changes in score of K-CBCL children. juvenile behavior evaluation scale, behavior by K-HTP (dynamic house-wood-human figure test) analysis and by school life(KSD) image analysis before and after treatment. I also carried out qualitative analysis on behavioral feature of each child for each session. This study obtained the following conclusions. First, child A showed positive change in comparison before and after art treatment program of score K-CBCL children. juvenile behavior evaluation, K-HTP image test and school life. Since he was so active and wanted to obtain good evaluation from anyone that he frequently had quarrel with friends, spoke against others well and beaten others much but was changed and did not speak against others or beat. Second, child B showed clear difference in comparison before and after art treatment program of score K-CBCL children. juvenile behavior evaluation, but no significant difference in K-HTP image test and school life. However, I observed substantial changes. While he could not speak frankly to others, felt empty in mind and was offensive in personal relations, he was changed, did not have quarrel with others or speak against others that much and improved his relationship with friends or teachers. Third, child C showed positive change in score of K-CBCL children juvenile behavior evaluation after art therapy program. In comparison of K-HTP image test and school life treatment before and after treatment, he still longed for mothers in mind but found rather stable after treatment. Fourth, child D showed positive chance in score of K-CBCL children. juvenile behavior evaluation scale after art therapy program, but almost no changes in K-HTP image test. But he depicted good relationship and socializing with other friends in school life. While he could not carry his point due to social immaturity and felt depressed, he got more confident. This result of study showed that art therapy had positive effects on correction of schoolchildren.

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Determinants of Choice of Surgery in Asian Patients with Early Breast Cancer in A Middle Income Country

  • Teh, Yew-Ching;Shaari, Nor Elina Noor;Taib, Nur Aishah;Ng, Char-Hong;See, Mee-Hoong;Tan, Gie-Hooi;Jamaris, Suniza;Yip, Cheng-Har
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권7호
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    • pp.3163-3167
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    • 2014
  • Background: Breast-conserving surgery (BCS) plus radiotherapy is equivalent to modified radical mastectomy (MRM) in terms of outcome. However there is wide variation in mastectomy rates dependent both on tumour and patient characteristics. Objective: This study aimed to assess the determinants of surgery choice in Asian patients with early breast cancer in a middle-income country. Materials and Methods: 184 patients with early breast cancer treated between Jan 2008 and Dec 2010 were recruited to complete a questionnaire. Chi-square test was used to analyze the association between surgery choice and demographic and tumour factors, surgeon recommendation, family member and partner opinions, fear of recurrence, avoidance of second surgery, fear of disfigurement, interference with sex life, fear of radiation and loss of femininity. Results: 85 (46%) had BCS while 99 (54%) had mastectomy. Age >60, Chinese ethnicity, lower education level, and larger tumour size were significantly associated with mastectomy. Surgeon recommendation was important in surgery choice. Although both groups did not place much importance on interference with sex life, 14.1% of the BCS group felt it was very important compared to 5.1% in the mastectomy group and this was statistically significant. There was no statistical difference between the two groups in terms of the other factors. When analyzed by ethnicity, significantly more Malay and Indian women considered partner and family member opinions very important and were more concerned about loss of femininity compared to Chinese women. There were no statistical differences between the three ethnic groups in terms of the other factors. Conclusions: When counseling on surgical options, the surgeon has to take into account the ethnicity, social background and education level, age and reliance on partner and family members. Decision-making is usually a collective effort rather than just between the patient and surgeon, and involving the whole family into the process early is important.

미국 임상영양치료(MNT)의 법제화 과정 및 수가 체계 (A Review of the Medical Nutrition Therapy (MNT) of the U.S. Medicare System)

  • 박은철;김현아;이해영;이영은;양일선
    • 대한지역사회영양학회지
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    • 제7권6호
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    • pp.852-862
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    • 2002
  • The purposes of this study were 1) to review the Medical Nutrition Therapy (MNT) Act of the United States, 2) to introduce the efforts of the American Dietetic Association (ADA) to expand the Medicare coverage for MNT and 3) to provide information about the reimbursement under Medicare Part B for the cost of MNT. The MNT Act defined MNT services as “the nutritional diagnostic, therapeutic, and counseling services provided by a Registered Dietitian or nutritional professional for the purpose of managing diabetes or renal diseases”. Also, the MNT Act defined “conditions for coverage of MNT”, “limitations on coverage of MNT”, and “qualifications of MNT service provider”. To expand the coverage of Medicare to include MNT, the ADA realized the need for development of a protocol for MNT, as well as studies to evaluate the effectiveness and cost-effectiveness of the MNT protocol developed. Therefore, the ADA supported the studies to develop a strong database of scientific investigations of nutritional services. Furthermore, the ADA needed credible data that could be used by Policy makers, so the ADA contracted with the Lewin Group to if out the study to gather the additional data needed to strengthen the ADA's position. In the report of the Lewin Group, which was entitled, “The Cost of Covering Medical Nutrition Therapy under Medicare : 1998 through 2004”, it was concluded, that if coverage for MNT in the Part B portion of Medicare had begun in 1998, by 2004, approximately $ 2.3 billion would have been saved through reduced hospital spending under Part A of Medicare ($ 1.2 billion) and reduced physician visits under Part B ($ 1.1 billion) Effective January 1 2002, the US Congress extended Medicare coverage to include MNT to beneficiaries with diabetes or renal diseases. The Centers for Medicare and Medicaid Services (CMS) established the duration and frequency for the MNT based on published reports or generally accepted protocols (for example, protocols suggested by the ADA). The number of hours covered by Medicare is 3 hours for the initial MNT and 2 hours for a follow-up MM. In 2002, a Medicare coverage policy was made to define the Physician's Current Procedural Terminology (CPT) codes 97802, 97803, and 97804 for MNT.

임상실습전 멘토링 교육프로그램의 효과 -간호대학생을 중심으로- (Effects of Mentoring Education Program on Nursing Students before their Clinical Practice)

  • 박수호;유하나
    • 실천공학교육논문지
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    • 제12권1호
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    • pp.109-116
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    • 2020
  • 멘토링의 효과는 멘티의 역량강화, 지식향상, 적극적 태도 등 긍정적 효과를 가져온다. 간호대학생들이 임상실습에서 겪는 가장 큰 어려움은 현장적응, 자신감 부족 등으로 보고되었다. 따라서 본 연구는 간호대학생에게 임상실습 전 문제해결능력, 학습태도, 간호술기에 대한 자신감을 향상시키고자 멘토링 프로그램을 개발하여 효과를 평가하였다. 멘토링 프로그램을 개발하기 위해 연구책임자를 포함한 교수 및 임상간호사로 구성된 전문가 집단이 임상실습에서 가장 많이 요구되는 간호행위 및 지식 등에 대한 논의를 거쳐 11개의 주제를 선정한 후 내용을 구성하였다. 프로그램 운영에는 14명의 멘토가 투입되어 2일동안 9~10명으로 구성된 그룹에게 실습, 상담, 동영상, 상황별 토론 등을 운영하였다. 자료수집기간은 2018년 12월부터 2019년 1월까지이고, 프로그램의 효과는 문제해결능력, 학습태도, 간호행위 수행자신감 도구로 평가하였다. 연구결과는 프로그램 참여 후 학습태도, 간호술기 수행자신감이 유의하게 증가하였지만, 문제해결능력은 통계적으로 유의한 차이가 없었다. 본 연구는 정형화된 교내실습교육에서 벗어나 멘토링 방법을 사용하여 교육효과를 향상시켰다는 점에서 의의가 있다. 추후 멘토링 교육프로그램이 단기간이 아닌 임상실습 전, 중, 후에 적용하여 간호학생의 문제해결능력에 영향을 미치는지 평가할 필요가 있을 것이다.