• 한국콘텐츠학회논문지
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• 제16권7호
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• pp.279-290
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• 2016

본 연구는 활동기준원가계산을 이용한 간호원가 연구의 방법론적 질 평가를 위한 서술적 조사연구이다. 대상 논문은 RISS, KISS, DBpia와 국회도서관에서 수집하였고, 2015년 10월까지의 연구 중 8편의 연구가 선정되었다. 대상 논문의 방법론적 질을 평가하기 위한 평가틀은 활동기준원가계산의 5요소에 근거하여 구성하였다. 대상 논문의 87.5%가 의료기관의 간호단위를 분석대상으로 하였다. 활동기준원가계산 요소 중 자원 항목의 인건비 요인에 대해서는 8편 모두 방법론적으로 적절하게 기술되었으나, 자원 항목의 보조부문비 요인에 대해서는 2편의 연구를 제외하고는 적절하게 기술한 연구가 없었다. 이러한 결과를 바탕으로 향후 활동기준원가계산방법을 이용한 간호원가분석 연구 시행 시에는 원가 산출의 정확성을 높이는 것이 필요함을 알 수 있었다. 또한, 이러한 연구 결과는 간호실무에서 원가관리 및 성과관리에 유용하게 활용될 것이다.

• 성인간호학회지
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• 제24권6호
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• pp.659-667
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• 2012

Purpose: The study was to identify the level of Spiritual Health and Fatigue in women with breast cancer according to three treatment phases (post op phase, adjuvant phase, follow up phase). Methods: The research method was a cross-sectional descriptive study. Data were collected from 161 women patients with a diagnosis of breast cancer. Both in-patient and out-patient units from two general hospitals were the source of subjects. The subjects completed two standardized instruments: the "Spiritual Health Scale" developed by Highfield and the "Fatigue Scale" developed and revised by Piper. The data were analyzed using frequency, percentage, ${\chi}^2$, ANOVA, Scheff$\acute{e}$ test, Pearson's correlation coefficients, and Multiple regression. Results: The subscale scores of Self-Esteem of spiritual health and fatigue in patients with breast cancer differed among the three treatment phases (F=3.14, p= .046; F=3.31, p= .039). Significant correlations were found between spiritual health and fatigue. The variables which explained 29% of the variance in fatigue in breast cancer patients were education, religious belief, economic status, and spiritual health. Conclusion: The study results demonstrated that spiritual health significantly explain fatigue. It is needed to develop nursing interventions to improve the spiritual health of breast cancer patients to manage fatigue according to treatment phases.

• 중환자간호학회지
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• 제13권3호
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• pp.62-74
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• 2020

Purpose : This study aimed to investigate the prevalence and risk factors of mental health problems in patients discharged from the intensive care unit (ICU). Methods : This was a secondary analysis study using data from a multicenter prospective cohort of post-ICU patients. We analyzed data of 311 patients enrolled in the primary cohort study who responded to the mental health questionnaire three months after the discharge. Anxiety and depression were measured on the Hospital Anxiety-Depression Scale, and post-traumatic stress disorder (PTSD) was measured on the Posttraumatic Diagnostic Scale. Results : The prevalence of anxiety, depression, and PTSD in patients at three months after ICU discharge were 25.7%, 17.4%, and 18.0%, respectively, and 7.7% of them experienced all three problems. Unemployment (OR=1.99, p=.033) and unplanned ICU admission (OR=2.28, p=.017) were risk factors for depression, while women gender (OR=2.34, p=.009), comorbid diseases (OR=2.88, p=.004), non-surgical ICUs (trauma ICU: OR=7.31, p=.002, medical ICU: OR=3.72, p=.007, neurological ICU: OR=2.95, p=.019) and delirium (OR=2.89, p=.009) were risk factors for PTSD. Conclusion : ICU nurses should proactively monitor risk factors for post-ICU mental health problems. In particular, guidelines on the detection and management of delirium in critically ill patients should be observed.

• Child Health Nursing Research
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• 제27권3호
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• pp.297-307
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• 2021

Purpose: This descriptive study compared the perceived parental stress levels between parents with very low birth weight infants (VLBWIs) and nurses in the neonatal intensive care unit (NICU). Methods: In total, 83 parents of VLBWIs and 78 NICU nurses were enrolled. Data were collected with the Parental Stress Scale (PSS) and analyzed using the t-test and analysis of variance in SAS version 9.4. Results: The average PSS score was 3.31 among parents and 3.45 among nurses. The stress score was significantly higher among nurses with children (t=2.46, p=.016) and senior nurses (t=2.12, p=.037). There was a significant difference in the stress score according to parents' education (t=3.29, p=.002) and occupation (F=3.14, p=.049) in the sights and sounds subscale. Mothers had significantly higher stress scores than fathers in the parental role alterations subscale (t=2.32, p=.023). Parental stress scores were higher than those perceived by nurses in the infant's appearance and behaviors subscale for breathing patterns (t=2.95, p=.004), followed by jerky/ restless behavior (t=2.70, p=.008). Conclusion: Nurses should provide explanations to parents of VLBWIs in order to reduce parental stress about the appearances and behavior of VLBWIs. This is more important than aspect of the NICU environment and education about parental roles.

• 대한간호학회지
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• 제47권6호
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• pp.794-805
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• 2017

Purpose: Interface pressure is a factor that contributes to the occurrence of pressure injuries. This study aimed to investigate interface pressure at common sites of pressure injury (occipital, gluteal and peritrochanteric areas), to explore the relationships among risk factors, skin condition and interface pressure, and to identify risk factors influencing interface pressure. Methods: A total of 100 patients admitted to the intensive care unit were enrolled at a tertiary teaching hospital in Korea. Interface pressure was recorded by a scanning aid device (PalmQ). Patient data regarding age, pulmonary disease, Braden Scale score, body mass index, serum albumin, hemoglobin, mean blood pressure, body temperature, and oxygen saturation were included as risk factors. Data collected from July to September 2016 were analyzed using binary logistic regression. Results: The mean interface pressure of the occipital, gluteal, and right and left peritrochanteric areas were 37.96 (${\pm}14.90$), 41.15 (${\pm}16.04$), 53.44(${\pm}24.67$), and 54.33 (${\pm}22.80$) mmHg, respectively. Predictive factors for pressure injuries in the occipital area were age ${\geq}70$ years (OR 3.45, 95% confidence interval [CI]: 1.19~9.98), serum albumin deficit (OR 2.88, 95% CI: 1.00~8.26) and body temperature ${\geq}36.5^{\circ}C$ (OR 3.12, 95% CI: 1.17~8.17); age ${\geq}70$ years (OR 2.81, 95% CI: 1.10~7.15) in the right peritrochanteric area; and body temperature ${\geq}36.5^{\circ}C$ (OR 2.86, 95% CI: 1.17~6.98) in the left peritrochanteric area. Conclusion: Our findings suggest that old age, hypoalbuminemia, and high body temperature may be contributory factors to increasing interface pressure; therefore, careful assessment and nursing care of these patients are needed to prevent pressure injury. Further studies are needed to establish cutoff values of interface pressure for patients with pressure ulcers.

• International Journal of Advanced Culture Technology
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• 제7권2호
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• pp.28-33
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• 2019

Electronic health records (EHRs) enable us to use and re-use electronic data for various multiple purposes, such as public reporting, quality improvement, and patient outcomes research. Current hospital-acquired pressure injury (HAPI) risk assessment instruments have not been specifically developed for intensive care unit (ICU) patients and showed false positive rates in this specific populations. Previous research studies report a number of risk factors; however, it is still not clear what factors influence ICU HAPI in this population. As part of a larger research study, we performed an exploratory analysis by using a large electronic health record data. The aims of this study were to compare characteristics of patients who developed HAPIs during their ICU stay with those who did not, and to determine whether the two groups were different in the aspects of length of ICU stay, discharge disposition, and discharge destinations. We conducted chi-square test and t-test for group comparison. Association was examined by using bivariate analyses. Pearson correlation coefficients were used to examine correlation between LOS and number of medications. Our findings suggest a number of consistent and potentially modifiable risk factors, such as sedation, feeding tubes, and the number of medications administered. The mortality of the HAPI group was significantly higher than the non-HAPI group in our data. Discharge disposition was significantly different between the groups. 67% of the HAPI group transferred to intermediate or long-term care hospitals whereas 57.7% of the non-HAPI group went home after discharge. Awareness of these risk factors can lead to clinical interventions that can be preventative in the ICU setting.

• 대한방사선기술학회지:방사선기술과학
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• 제42권6호
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• pp.461-467
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• 2019

The purpose of this study was to investigate the knowledge, attitudes and behaviors of radiation protection in operating room and intensive care unit nurses. The Participants for this study consisted of 240 nurses working in operating rooms and intensive care units of 7 general hospitals located in Busan, South Korea. The data were collected from Feb. 15 to Feb. 29, 2016. The study results were as follows. First, 72.9% of the nurses had never been educated for radiation safety. Second, the mean score of knowledge for radiation protection was 9.21. The knowledge score of radiation safety educated nurses is higher than uneducated of nurses(t=-5.67, p<.001). Third, The mean score of attitude towards radiation protection was 41.80. The attitude score of radiation safety educated nurses is lower than uneducated of nurses(t=0.02, p<.030). Fourth, the mean score of behavior for radiation protection was 32.57. The behavior score of radiation safety educated nurses is higher than uneducated of nurses(t=0.35, p=.001). Consequently, it was found that nurses had lack of the radiation safety education. Overall knowledge and behavior towards radiation protection was low. Therefore, it is necessary to raise awareness of radiation protection and to educate, manage, and improve processes to increasing compliance with protective measures against radiation.

• 중환자간호학회지
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• 제14권3호
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• pp.26-36
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• 2021

Purpose : This study aimed to present the incidence of pressure ulcers and identify different associated factors according to the time of occurrence of pressure ulcers in intensive care unit (ICU) patients. Methods : The participants were 313 patients who reported pressure ulcers among 2,908 patients in ICUs at a large tertiary hospital in Gyeonggi-do. Among them, 220 patients (70.3%) had a pressure ulcer before admission, and 93 patients (29.7%) reported newly developed pressure ulcers after admission to the ICU. Data were collected between August 2018 and April 2019. Along with the time of occurrence and characteristics of pressure ulcers, diverse associated factors were gathered through electronic medical records. Data were analyzed using descriptive statistics, independent t-tests, and 𝑥²-tests. Results : Different risk factors associated with pressure ulcers in ICU patients according to the time of occurrence were main diagnosis, score of acute physiology and chronic health evaluation, score of Richmond agitation sedation scale, level of consciousness, administered sedatives, use of a ventilator, insertion of a feeding tube, and the duration of fasting period. Conclusion : Based on the results of this study, healthcare providers, especially ICU nurses, should try to detect early signs and symptoms of pressure ulcers, taking into account the derived factors associated with pressure ulcers in ICU patients. Practical intervention programs and strategies considering the factors associated with pressure ulcers must be developed to prevent and alleviate such ulcers in ICU patients in the future.

• 간호행정학회지
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• 제7권2호
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• pp.301-314
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• 2001

The main purpose of this research is to describe comprehensively the processes of clinical decision making in novice critical care nurses through clinical experience. This research was an exploratory, longitudinal study using a fieldwork approach incorporating "think-aloud" method and in-depth interviews with the study participants. The study participants consisted of 5 novice nurses assigned to critical care units at a tertiary medical center located in Seoul, among a group of 27 novice nurses who started at the same period at this hospital. The data were collected from March 1999 to April 2000. The major findings of the study is that the novice nurses followed the analytic linear model of clinical decision making in the beginning, but were changed increasingly to follow the comprehensive, integrated model of clinical decision making. Through repeated experience that resulted in increasing repertoire of clinical schema and familiarity of task environments of clinical practice the novice nurses expanded their ability to arrive at comprehensive integration of information and to arrive at accurate and time-efficient decisions. Both the analytic, linear model mostly used at the beginning period and the comprehensive, integrated model that seems to be the mode significantly dependent upon experience seem to have strengths and weaknesses as decision making processes in clinical situations. Hence, it is imperative to develop an effective orientation and training program for novice nurses through the use of clinical preceptors. In addition, students should be exposed to the process of clinical decision making early in their nursing education through an appropriate clinical experiences and clinical assignments.

• 기본간호학회지
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• 제9권3호
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• pp.349-359
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• 2002

Purpose: The purpose of this study was two-fold : to describe the level of recognition of nosocomial respiratory infections by ICU nurses and to compare self evaluation and objective evaluation of nosocomial respiratory infection control practices by ICU nurses. Method: Data were collected from 78 nurses in intensive care units in one university affiliated hospital in Kyung Ki Province. Data were collected from March 4 to March 18, 2002. The recognition and self evaluation data were collected through a self report questionnaire and an objective evaluation which was done by observing the actual behavior of the nurses. Result: The results of this study showed that there was a significant positive relationship between recognition scores and self evaluation scores. However, there was no significant relationship between level of recognition and objective evaluation, nor between self evaluation and objective evaluation of infection control Practices by ICU nurses. Conclusion: ICU nurses In this study gave higher scores on self evaluation of their practice than were shown in the observation evaluation of actual practice. Moreover, in the objective evaluation the nurses had the lowest score on the item, 'washing hands before taking care of patients'. The results indicate that it is necessary to develop a standardized practice manual on nosocomial respiratory infection control in the ICU. Also, it is necessary to have a program to transfer knowledge into actual practice.