• 제목/요약/키워드: Home Care Nursing

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고혈압환자에게 적용한 자가관리프로그램 중재 효과 (Effects of Self Care Program on Hypertensive Control in Hypertensive Patient)

  • 김옥란
    • 지역사회간호학회지
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    • 제14권4호
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    • pp.568-578
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    • 2003
  • 본태성 고혈압 환자를 대상으로 고혈압 자가관리를 증진시키고 생리적 지표인 혈압, 총콜레스테롤치를 감소시키기 위한 자가관리프로그램의 효과를 검증하기 위해 2001년 9월 15일부터 2002년 4월 30일 까지 상주적십자병원에 등록된 본태성 고혈압환자로서 혈압이 140/90mmHg 이상이거나 항고혈압제를 복용 중인 35세이상 75세 미만 남 여 70명을 대상으로 한 유사실험 연구이다. 식습관 변화에서 저염분섭취정도와 고칼슘 칼륨섭취 정도가 1차 사후 검사와 2차 사후 검사시 실험군에서 유의하게 높아졌고, 두 군 간에도 유의한 차이가 있었다(p<0.05, p<0.01). 그러나 동물성 지방섭취정도에는 1차 사후 검사와 2차 사후 검사시 실험군과 대조군 모두 유의한 차이가 없었으며 두 군간에도 유의한 차이가 없었다. 생활습관의 프로그램 중재 효과지수는 흡연이 1차 사후 검사시 0.797, 2차 사후 검사시 0.601, 운동이 1차 사후 검사시 0.600, 2차 사후 검사시 0.849이었다. 그리고 음주정도의 변화는 거의 없었다. 규칙적 항고혈압제 복용의 프로그램 중재 효과지수는 0.715이었다. 생리적 지표 중 수축기 혈압은 실험군과 대조군 모두 1차 사후 검사와 2차 사후 검사시 낮아졌으나 2차 사후 검사시 두 군 간에 유의한 차이가 있었다(p<0.05). 이완기 혈압은 실험군과 대조군 모두 1차 사후 검사와 2차 사후 검사시 낮아졌으나 (p<0.05), 두 군 간의 유의한 차이는 없었다. 총콜레스테롤치는 실험군이 2차 사후 검사시 낮아졌으나 유의한 차이는 없었고 두 군 간에도 유의 한 차이는 없었다. 이러한 결과를 바탕으로 고혈압자가관리증진프로그램이 식습관과 생활습관의 개선, 그리고 규칙적인 항고혈압제 복용을 포함하는 자가관리를 증진시키고, 수축기 혈압 감소에 영향을 미치는 것을 확인하였으며 장기적으로는 이완기혈압, 총콜레스테롤치 조절에 영향을 미치는 결과를 가져올 수 있을 것으로 본다.

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개호사고에서 손해배상책임에 관한 연구 -일본의 판례를 중심으로- (A Study on Compensation for Damage in Civil Litigation of Japanese Long-term Care Facilities)

  • 정다영
    • 의료법학
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    • 제19권2호
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    • pp.173-207
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    • 2018
  • 일본은 고령화가 빠르게 진전되어 이미 총 인구 중 65세 이상 인구가 차지하는 비율이 20% 이상인 초고령사회에 해당한다. 일본의 판례는 요양시설에 입소한 고령자가 사상을 당한 다수의 사안에서 요양시설의 손해배상책임을 인정하였다. 구체적인 사안들은 ①전도 또는 전락, ②배회 또는 무단외출, ③질식, ④욕창 및 ⑤이용자 간 사고의 5가지 유형으로 나눌 수 있다. 판례는 대부분의 사안에서 채무불이행책임을 중심으로 검토하였으며, 과실 또는 안전배려의무 위반을 인정하였다. 과실 또는 의무위반은 시설의 관리자 또는 직원이 입소자를 주시하고 주의를 기울일 의무를 위반한 경우 뿐 아니라, 경우에 따라서는 인적·물적 체제를 정비하지 못한 것 자체만으로도 인정된다. 특히 일본에서는 신속한 권리 구제를 위하여 손해배상에 관한 특약 조항이 있는 경우 원고는 사고 및 손해의 발생을 주장·입증하면 충분하고, 피고로서는 불가항력에 의한 사고임을 주장·입증하지 않는 한 손해배상책임을 부담한다고 하여 입증책임의 전환을 인정한다. 그런데 요양시설의 손해배상책임은 시설에서 대상자의 입소를 허락하고 서비스이용계약을 체결하는 것을 주저할 만큼 과중한 것이어서는 안 될 것이다. 이러한 점에서 일본 재판소가 상대적으로 과실상계와 소인감액을 널리 인정한 논리는 충분히 음미할 필요성이 있다. 개호사고 소송에서 법원의 판단은 구체적인 사실관계에 근거한 사례판단이지만, 개호사업자와 이용자에 대한 관계를 살펴보는 것은 향후 우리나라에서 개호사고 소송의 심리·판단 뿐 아니라 요양자의 일탈 및 사고 등을 인식할 수 있는 체제를 구축하기 위한인적·물적 체제를 구축하는 기준을 제시하는 법안을 입안함에 있어서도 시사점을 제공할 수 있을 것이다.

경인 지역의 정신 지체아 부모의 스트레스와 대응 (Stress and Coping among Parents of Mentally Retarded Children in the Kyoung-in area)

  • 구현영
    • 대한간호학회지
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    • 제25권4호
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    • pp.668-680
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    • 1995
  • The purpose of this study was to contribute to family nursing for reducing stress and improving coping of the parents of mentally retarded children. Data were collected through self-reported questionnaires during a period of 2 months between November 1994 and January 1995 in the Kyoung-in area. The subjects consist of 180 parents (90 mothers and 90 fathers) of mentally retarded children attending schools for the handicapped and 186 parents (93 mothers and 93 fathers) of normal children. The levels of general stress and of parental role stress were measured with the General stress scale and the Parental role stress scale, respectively, while the Coping scale was adopted to measure the level of coping. The data were analyzed by using Chi-square test. fisher's exact test, Repeated masured ANOVA, oneway ANOVA and Scheffe comparison test. The results were as follows ; 1. The level of general stress was significantly higher in the mothers and the fathers of the men-tally retarded than in the respective parents of the normal. Of the parents, the mothers experienced significantly greater level of general stress than the fathers did in both groups of the retarded and of the normal. 2. As for the parental role stress, the mothers and the fathers of the mentally retarded experienced significantly greater stress than respective parents of normal children did. In particular, the stress was significantly higher in the mothers than the fathers of these children in both groups. The difference in the levels of parental role stress experienced by mothers and by fathers was significantly bigger among those of the mentally retarded tnan among those of normal children. 3. No significant difference in the level of coping was observed between the mothers of both groups and the fathers of both groups. By contrast, the fathers revealed significantly greater scores in coping than the mothers in both groups. 4. General stress experienced by the fathers of the mentally retarded was different by health status, satisfaction with spouses, and the supports from their spouses. Health status, satisfaction with spouses, and monthly income Influenced parental role stress experienced by those fathers. Their level of coping was associated with their satis-faction with spouses and family life. 5. Of the mothers of the mentally retarded, the level of general stress was different by their health status, while parental role stress was related to the satisfaction with their spouses and the child's age. The level of coping among the mothers was different by the supports from their spouses. The above findings indicate that those parents of the mentally retarded did not take more coping strategies than those of the normal did, despite greater stress experienced among themselves. Hence, nursing intervention for managing stress should be given to those parents including fathers of mentally retarded children. Mothers of the mentally retarded, in particular, should receive high priority in planning nursing care, since they experience greater levels of both general stress and parental role stress than their spouses, which is most likey due to primary responsibility in child rearing given to them at home.

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뇌성마비아 부모의 부담감 및 가족기능에 관한 연구 (A Study on Family Functioning and Burden of Parents with Cerebral Palsy Children)

  • 이화자;어용숙
    • Child Health Nursing Research
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    • 제6권2호
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    • pp.199-211
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    • 2000
  • Today, more chronically ill and handicapped children are being cared for at home by a family member caregiver. The task of caring for a family member may feel burden that the caregiver has less time and money and more work. Family functioning and their burden have influence on coping and adaptation of families with chronically-ill children. This study attempted to identify the levels of burden and family functioning in families of children with cerebral palsy and to examine their relationships. The instruments were burden scale developed by Suh and Oh(1993), and a modified Feetham Family Functioning Survey based on Roberts and Feetham.(1982). The subjects were 98 parents of children, under 15 years, who have cerebral palsy and being treated and living in Pusan. Data were collected through a self-administered question- aire from April 26 to May 29. The collected data were tested using frequencies, percentiles, means, t-test, ANOVA, and Pearson correlation coefficient with SPSSWIN program. The results of this study were as follows ; 1. The mean rating scores of burden and family functioning were 2.79±.51 and 4.12±.69, respectively. 2. The relationships between general character- istics and burden were statistically significant difference : degree of children's handicap(F=6.333, P<.01). The relationships between general characteristics and family functioning were statistically significant differences : familial relation with the children(F=3.628, P<.05), caregiver's health status(F=4.359, P<.05), age of children (F=4.185, P<.05), and duration of treatment (F=6.802, P<.01). 3. In families of children with cerebral palsy, there was significantly negative correlation between the burden of parents and the performance of family functioning(r=-.230, P<.05). There were significantly negative correlations between the burden of parents and the satisfaction of family functioning (r=-.211, P<.05), and between the perceived importance and the satisfaction of family functioning(r=-.481, P<.01); however, there was a positive correlation between the performance and the perceived importance of family functioning(r=.425, P<.01). In conclusion, this study suggests that families of children with cerebral palsy need family-focused nursing interventions as supportive care for relieving their burden and for improving family functioning.

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골반저근육 운동 프로그램이 긴장성 요실금 여성의 요실금정도, 요실금량 및 최대 질수축압에 미치는 영향 (The Effect of Pelvic Muscle Exercise Program on Women with Stress Urinary Incontinence in the Degree and Amount of Urinary Incontinence and Maximum Vaginal Contraction Pressure)

  • 김소영;박정숙
    • 성인간호학회지
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    • 제12권2호
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    • pp.267-277
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    • 2000
  • The purpose of this study was to help the women with stress urinary incontinence lead more comfortable life, by letting them to do pelvic muscle exercise and to learn by direct experience the effect that urinary incontinence is controlled. The research design was a one-group pretest-posttest design. The subjects were 16 middle-aged women(over 38) with stress urinary incontinence. The study was conducted from August 1, to October 11, 1999. Women trained themselves for muscular strength and endurance, every the other day for each exercise for six weeks at home(that means each exercise for more than three days a week) in the pelvic muscle exercise program which was developed by Dougherty et al., and filled out exercise participation card every week. They visited laboratory once a week to get visual feedback, by means of Perineometer, of how the pelvic muscle exercise was going on. Stress Urinary Incontinence Scale that Lee, Young-Sook revised and supplemented Hendrickson's original scale was used for measuring the frequency and situation scores of urinary incontinence, "30 minute pad test" was carried out for measuring the amount of urinary incontinence, and Perineometer was used for measuring maximum vaginal contraction pressure. Percentage, mean, standard deviation and Wilcoxon signed ranks test were used for data analysis by means of SPSS/PC+ WIN 9.0 program. The results were summarized as follows : The hypothesis 1 that after carrying out pelvic muscle exercise program on women with stress urinary incontinence, the weekly degree of urinary incontinence would reduce compared to before the exercise was supported. The hypothesis 1-1 that after carrying out pelvic muscle exercise program on women with stress urinary incontinence, the weekly frequency of urinary incontinence would reduce compared to before the exercise was supported (p=.003). The hypothesis 1-2 that after carrying out pelvic muscle exercise program on women with stress urinary incontinence, the situation scores of urinary incontinence would reduce compared to before the exercise was supported(p=.044). The hypothesis 2 that after carrying out pelvic muscle exercise program on women with stress urinary incontinence, the amount of urinary incontinence would reduce compared to before the exercise was supported(p=.001). The hypothesis 3 that after carrying out pelvic muscle exercise program on women with stress urinary incontinence, the maximum vaginal contraction pressure would increase compared to before the exercise was supported (p=.012). These results suggest that pelvic muscle exercise program has an effect on women with stress urinary incontinence in the degree and amount of urinary incontinence and maximum vaginal contraction pressure. So it is judged that training women with stress urinary incontinence for pelvic muscle exercise is an effective nursing intervention strategy in order to care urinary incontinence.

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지역사회 재가 만성정신질환자 가족의 부담감과 정신보건서비스요구와의 관련성 (The Relationship between Family Burden and Mental Health Service Needs of Family for Home-based Chronic Mental Patients in Community)

  • 김인홍
    • 농촌의학ㆍ지역보건
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    • 제33권3호
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    • pp.269-278
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    • 2008
  • = ABSTRACT = Objectives: This study was carried out to identify the relationships of family burden and mental health service needs of chronic mental patients in community. Methods: Objects of the study were 153 chronic mental patients in community of P. city in korea. Data were collected from December, 2007 to February, 2008 using structured questionnaire. Research tools of this study were family burden tool developed by Pai & Kapur (1981) and mental health service needs tool developed by Kim (2003). Results: The average grades for family burden was 1.62 points. And the biggest part of family burden was economic burden(1.74), followed by interrupt of daily life(1.67), interrupt of family relationship(1.64), interrupt of family leisure (1.57), effects of mental health(1.50), and effects of physical health(1.43). The average grades for mental health service needs was 2.72 points. And the biggest part of mental health service needs was rehabilitation service(3.09), followed by social service(2.87), and Psychiatric medical service(2.21). Positive correlation showed between all parts of family burden. And, positive correlation showed between psychiatric medical service and interrupt of daily life(r=.281, p<.01), psychiatric medical service and effects of physical health(r=.355,p<.01), social service and effects of mental health(r=.213,p<.01). Conclusion: The family burden for care giver of mental patients was related with all parts of family burden and mental health service needs of family. Thus, these results should be considered to reduce family burden for care giver of mental patients in community.

유방절제술 환자의 신체기능과 피로 (Physical Function and Fatigue in Mastectomy Patients)

  • 유양숙
    • Journal of Hospice and Palliative Care
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    • 제6권2호
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    • pp.164-171
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    • 2003
  • 목적 : 본 연구는 유방절제술 환자의 신체기능과 피로를 파악하여 수술 후 적응을 돕고 삶의 질을 향상시키기 위한 중재 개발에 기초 자료를 마련하고자 실시되었다. 방법 : 2003년 3월부터 6월까지 서울 C 대학병원에서 유방절제술을 받은 환자 63명을 대 상으로 어깨관절 가동범위, 어깨관절 기능, 신체적 자각증상 및 피로 정도를 측정하였다. 결과 : 환측의 어깨관절 가동범위는 건측에 비해 유의하게 낮았다. 어깨관절 기능이 가장 높았던 문항은 '바지 입기'였으며, 가장 낮았던 문항은 '등지퍼 올리기'였다. 신체적 자각증상의 정도가 가장 높았던 문항은 '감각이 둔하다'였으며, 가장 낮았던 문항은 '가렵다'였다. 4. 피로 때문에 가장 방해가 되었던 문항은 '일상적인 생활(집 밖의 일과 매일하는 허드렛 일)'이었다. 결론 : 유방절제술 후 신체기능을 향상시키고 피로를 감소시키기 위한 효과적인 중재가 필요하다.

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국악장단을 이용한 음악치료가 치매노인의 상지기능 향상에 미치는 영향 (Effect of Music Therapy Using Korean Traditional Rhythmic Modes on the Upper Extremity Function of Elderly People with Dementia)

  • 주민애;박혜영
    • 한국콘텐츠학회논문지
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    • 제17권1호
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    • pp.222-232
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    • 2017
  • 본 연구는 국악장단을 이용한 음악치료가 치매노인의 상지기능 향상에 미치는 영향을 살펴보고자 하였다. 연구 참여자는 B시에 소재하는 요양원의 장기요양보호 적용을 받고 있는 만 65세 이상의 치매진단 환자 13명이며, 상지기능평가(MFT), 일상생활동작, 인지기능검사(관리기능)에 대해 음악치료 전 후의 점수차이를 분석하였다. 연구결과 국악장단의 청각적 자극은 치매노인의 상지기능 향상에 유의한 변화를 가져왔으며, 일상생활은 물론 치매평가의 관리기능까지 증진시킬 수 있다는 것을 확인하였다. 이는 임상현장에서 치매노인을 대상으로 국악장단을 활용한 음악중재의 타당성을 제시하는 기초자료로 활용 될 수 있으며, 또한 치매노인을 위한 음악치료프로그램의 개발 시 국악장단이 이들의 신체기능 뿐만 아니라 인지기능에도 영향을 줄 수 있다는 것을 시사한다.

학교보건간호를 통한 금연 교육의 실태에 관한 연구 (A Study on Non-smoking Education status through School Health Care Services)

  • 정연강;장영미
    • 한국학교보건학회지
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    • 제7권2호
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    • pp.135-143
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    • 1994
  • This study is aimed at providing basic information necessary to set up education program and strategies to prevent high school students from smoking by school health care service. The main groups of study are 814 third-grade male students, 557 parents and 362 teachers, who were randomly chosen at 8 high schools in Seoul. Date analysis consisted of Chi-square test and percentage. The findings of the study are as follows: 1. The less interesting family life is, the more increasing current smoking rate is, (ex-smoking rate 53.5%, re-smoking rate 40.3%, current smoking rate 24.3%) 2. According th the results of $x^2$-test for the school life and the smoking, the students above ranking 41 showed th increase as 48.7% for continuous smoking, 18.9% for re-smoking, 67.6% for the present smoker. But it turned out that the students belonged to ranking 10 were not experienced the smoking. So it showed that there was a correlation between score and smoking. 3. It is noted that 93.3% of students, 93.3% of parents and 96.1% of teachers recognize harmful effect of smoking. But less than 70% those have recognized only half of all smoking knowledge. 4. There is a significant difference in the contends and types of education between parents and teachers. 5. For the time of home education and school health education to prevent the smoking, it turned out that 44.9% of students, 42.4% of parents, and 47.4% of teachers considered the optimal time as a high school' days. In addition it appeared that 40.5% of students, 33.4% of parents, and 54.6% of teachers recognized the necessity of the early education before the elementart school. For the optimal time to begin school health education, it showed that the middle school days were indicated from 56.6% of students, 52.7% of parents, the elementary school days were 54.6% of parents, the elementary school days were 54.6% of teachers.

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고등학생의 호스피스자원봉사 경험자와 비경험자의 죽음에 대한 태도와 삶의 의미 비교 (The Influence of Hospice Volunteering and Death Education on High School Students' Attitude toward Death and Meaning of Life)

  • 류청자
    • 한국학교보건학회지
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    • 제29권3호
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    • pp.310-317
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    • 2016
  • Purpose: This descriptive research was carried out to identify how high school students' attitude to death and their meaning of life were affected by hospice volunteering and death education. Methods: This study is based on a structured questionnaire designed for 180 high school students who were given death education while doing volunteer work at non-profit hospice hospitals and another 288 high school students not doing any hospice volunteer work. The collected data was processed by the SPSS 20.0 program and then analyzed by $x^2$ test, t-test and ANOVA test. Results: High school students' attitude to death and their meaning of life showed significant differences depending on whether or not they had volunteered at hospice hospitals. The group with hospice volunteering experience tended to be more negative about death and have a higher meaning of life compared to those without hospice volunteering experience. Students with proper hospice recognition made up 52.4%, those who expressed hopes to receive hospice-care themselves if necessary accounted for 70.5%, and those who said they would like to take care of their family members either at home or at a hospice center if any of them got incurably sick comprised 59.0%. Those who thought dignified death is to be with one's family or any other meaningful person were 47.6% and 18.5% of the students thought that 'thinking they had led a meaningful life' was the core of a dignified death. Conclusion: Given the above results, it became clear that hospice volunteering and death education can affect high school students' meaning of life and their attitudes toward death.