• Child Health Nursing Research
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• 제5권1호
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• pp.70-83
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• 1999

The birth of a premature infant is distressing for its parents. The parents of a premature infant experience stress according to the infant's physical appearance and behavior, the environment of the neonatal intensive care unit (NICU) , and the alteration in the parental role. Especially, a mother of a premature infant feels distressed even after the discharge of the infant : therefore, she has difficulties in maternal role performance. The main purpose of this study is to identify the effects of the planned infant care information program in order to lower the stress level for mothers of premature infants caused by the birth and hospitalization in NICU of premature infants, to reduce the maternal role strain, and to promote the maternal role performance after the infants' discharge. This study employed two methods of research at the same time : quasi -experimental non-equivalent pre and post test to compare : non-equivalent post test to compare. The total number of subjects was 19 who were assigned to the research program : 12 mothers of premature infants at the NICU at the Ch university hospital and 7 at the NICU at the Y general hospital located in Chounju city. The data were collected for 79 days from August 18 to November 5, 1998. The questionnaire method was applied for the data collection, and the measures used in this study were Parental Stressor Scale : NICU(Miles, 1993), the Maternal Role Strain Measures ( Hobbs, 1968 ; Steffensmeier, 1982) , and Self Confidence Scale (Pharis, 1978). Research procedure is as follows : after preliminary examination, the experimental subjects, the mothers of premature infants at the Nl CU at Ch university hospital were provided with slide films and information developed by the researcher based on existing documents and data. It took two 60-minute sessions a week for two weeks, and the mothers' stress level was measured using the same instrument twice one week and two week after the infants' hospitalization. The stress level of the contrast subjects, the mothers at Y general hospital was measured during the same period. The experimental subjects were provided with booklets on matters that require attention after the infants' discharge and on developmental project, and they were educated to play the maternal role in person for 2-3 hours a week : breast-feeding, burping a baby, and changing diapers. One week after the infants' discharge, the maternal role strain and the maternal role performance were examined in two groups of the subjects. The analysis of collected data was done using descriptive statistics including real numbers, percentages, averages, and standard deviations. Mann-Whitney test ; x² test ; Repeated Measures Analysis of Variance ; ANCOVA Spearman's rho correlation coefficients. The results on this study were as follows. (1) The examination of the same quality showed that there were no differences in the general and obstetrical characters between the two groups. However, in terms of the characters of premature infants. just right after their birth, the infants at the contrast group weighed more than those at the experimental group(U=16.5, p=.02), and the former was in mother's womb longer than the latter(U=15.5, p=.02). (2) The stress level of the mothers provided with the plannned nursing intervention program became lower as time passed compared to the others'(F=16.61, p=.00) Even when the influence of weight at birth and the length of gestation was removed among the premature infants' characters, the mothers' stress levels made a statistical difference 2 weeks after the infants' hospitalization depending on treatment (F=8.00, p=.01) (3) The maternal role strain of the mothers provided with the planned nursing intervention program was lower than the others'(U=2.0, p=.00). Even when the influence of weight at birth and the length of gestation was removed among the premature infants' characters, the maternal role strain levels made a statistical difference 2 weeks after the infants' hospitalization, depending on treatment(F=14.72, p=.00). (4) The maternal role performance level of the mothers provided with the planned nursing program was higher than the others'(U=.0, p=.00). Even when the influence of weight at birth and the length of gestation was removed among the premature infants' characters, the mothers' stress levels made a statistical difference 2 weeks after the infants' hospitalization, depending on treatment(F=8.00, p=.01). (5) The correlation between a mother's stress level 2 weeks after her infant's hospitalization, the maternal role strain and the maternal role performance were compared : the stress and the maternal role strain were statistically irrelevant to each other(r=.33, p=.12) : the stress was found to be in inverse proportion to the maternal role performance(r=-.53, p=.02). The maternal role strain was in inverse proportion to the maternal role performance as well(r=-.50, p=.00). In conclusion, for the mothers provided with the planned nursing intervention program, their stress level was getting lower as time passed during the infants' hospitalization, their maternal role strain reduced when they took care of their infants after their discharge, and their maternal role performance level was high compared to the other mothers. Besides, the lower the stress level of mothers of premature infants was during the infants' hospitalization, the higher the maternal role performance after their discharge was. The lower maternal role strain was, the higher the maternal role performance was as well. These results of the study suggested that the nursing intervention program for the mothers of premature infants developed by the researcher would be effectively applied to nursing practice, and it would be a foundation for the development of this kind of program.

• 종양간호연구
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• 제1권1호
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• pp.5-17
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• 2001

It is known that aggressive treatment of chemotherapy, radiation and autogenous stem cell transplantation is effective for prevention of recurrence in the high-risk breast cancer patients. It was assumed that this procedure takes a longer time and decreases the quality of life more than the standard adjuvant chemotherapy. However, there are few studies comparing the quality of life of patients having bone marrow transplantation and adjuvant chemotherapy. Most of the studies were focused on the quality of life in one point of time, such as only during the early treatment stage, only overall quality of life rather than specific dimensions of the quality of life. The purposes of this study are 1) to identify the difference of the quality of life between two different treatment patterns, adjuvant chemotherapy and autogenous stem cell transplantation: 2) to identify the mostly affected dimension and the periods of time affected by the treatment patterns; and 3) to identify the trajectories of quality of life in each treatment pattern. This is a time series design that measures 4 different points of times. At the beginning of the study, 19 patients were placed in the chemotherapy group and 12 in the group of auto-peripheral blood stem cell transplantation. The inclusion criterion was the advanced disease stage of 3 or over with metastasis of more than 5 lymph nodes. The exclusion criteria were 1) anyone who has metastasis to other organ; 2) anyone who had psychological problems. Ferrell's Quality of Life Scale for Cancer Survivors 41 items on a 10 point scale was used. The QOL-CS includes 4 dimensions, which were labeled physical, psychological, social, and spiritual. The Cronbach‘s alpha of this scale was 0.89. Mann-Whitney U test and Friedman test were used to test each hypothesis. In comparison of the two groups, the quality of life of the bone marrow transplantation group dramatically increased at the 3rd and 6th month after transplantation, while the chemotherapy groups results stayed lower. The most affected dimension of the quality of life at the end of the treatment was the physical dimension. However, it and increased along with time, while the psychological dimension values remained low over the long-term period. Intensive nursing care is needed during the entire period of chemotherapy in all patients having chemotherapy, and is also required for right after cases of bone marrow transplantation.

• Journal of Korean Biological Nursing Science
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• 제3권2호
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• pp.1-20
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• 2001

본 연구는 기관절개술을 받은 환자의 기관절개부위에서 발견되는 포도상구균에 대해 povidon의 살균효과와 소독제 사용 횟수, 경과일수에 따른 변화를 관찰하는 것을 목표로 하고 있다. 연구대상은 2001년 1월 16일부터 2001년 2월 26일까지 D시내에 소재한 2개 종합병원의 신경외과 중환자실에 입원한 35명의 기관절개환자였으며, 수집된 자료는 SAS를 이용하여 백분율, t-test로 분석하였다. 연구결과는 다음과 같다. 포도상구균에 대한 povidone의 살균효과는 농도와 시간에 관계없이 강하게 나타났다. 1일 1회 소독 후 3일째부터 Staphylococcus aureus균이 검출되었고, 6일째에 가장 많이 검출되었다. Coagulase negative Staphylococcus균은 1일부터 3일까지는 거의 검출되지 않았으나, 4일째에 가장 많이 검출되었다. 소독횟수에 따른 균집락화 양상은 1일 1회 소독할 때보다 2회 소독시 황색포도상구균이 현저히 감소하였다. 항생제에 대한 Staphylococcus aureus와 Coagulase negative Staphylococcus의 내성검사를 한결과 Staphylococcus aureus는 Methicillin에서 72.7%, Imipenem에서 63.6%가 내성을 나타냈으며, Coagulase negative Staphylococcus는 Methicillin에서 37.5%, Imipenem에서 12.5%가 내성을 나타내었고, Vancomycin에는 모두 내성을 나타내지 않았다. 이상의 본 연구결과로써 기관절개환자의 절개부위에 대한 철저한 소독을 통해 병원감염을 예방할 수 있는 기초자료가 될 수 있는 것으로 사료되며, 다음과 같은 제언을 하고자 한다. 앞으로 더 많은 소독제와 다양한 균종과의 관계에 대한 연구가 시행되어야 할 것이며, 모든 의료인은 철저한 병원감염예방에 힘써야 할 것이다. 또한, 병원감염 예방과 간호 발전을 위한 소독전문인력을 양성하여 활성화시키는 것이 필요할 것으로 사료된다.

• 기본간호학회지
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• 제4권2호
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• pp.245-265
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• 1997

The purpose of this study was to promote the effectiveness in managing disease or injury, by examining the length of stay in hospital according to characteristics concerned before and after operation, and by serving as a basis for reducing that length. As a result of investigating the length of stay in hospital according to inpatient's personal characteristics, clinical features and other characteristics concerned, the following characteristics appeared significant. The characteristics that showed a significant difference about the length of stay in hospital before and after operation were the age and the fact whether one was married or not among inpatient's personal characteristics. The significant ones among clinical features were the route to be taken to hospital, the form of insurance, the experience of re-hospitalization, whether another disease coexisted, the experiment of changing department, whether a diagnosis was determined by consultation, whether an intensive care unit was used, whether re-operation was performed, the total number of case of the experience of re-hospitalization, inpatient who were again sent to hospital under the same diagnosis was not included in the investigation, which was pointed out as a limit in this study. The significant ones among other characteristics concerned were the date and season when the patients were taken to hospital and the doctor in attendance. The doctor in attendance appeared to give a significant impact on the length of stay in hospital before operation, but no significant difference was noted in the mean among the doctors in attendance. And those characteristics were not found regularly among the selected departments. As stated above, one way to reduce the length of stay In hospital was to diminish the length of stay in hospital before operation. The term of hospitalization before operation shall be reduced by grasping the factors that affected that length before operation and by conducting examination as many as possible in the out-patient department. Also, the efforts should be put on that length after operation. The management of hospital seemed to be successfully carried out if those factors affected that length were effectively controlled.

• 한국보건간호학회지
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• 제12권2호
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• pp.185-200
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• 1998

It has been contributed to public health that the hospital has multiplied in the aspect of number and has been a large size with development of modern medical science, meanwhile the problem of hospital infection is coming out seriously. Respiratory hospital infection among hospital infections develops, very commonly from patients having taken the operation of intubation or tracheostomy, which results from a big factor that the infection developed from medical appliances used for respiration aids, contamination of solution and infection of medical staff. This study is separated into four steps-the time to use normal saline and distillation water for storaging catheter which are the cause of the infection of solution to store distillation water and catheter, not to say the catheter used when the patient who should get tracheostomy operation takes suction. The purpose of this study is to offer the basic data which are needed to check contamination degree as time goes by and nurse intervention and grope for a new nursing intervention. The target of this study is hospitalized 1D an intensive care unit having 700 sickbeds which is located in IKSAN city and it targeted patients before 7 days passed after an operaion of a tracheostormy. Materials collected were analyzed by SPSS PC+ figures program. The result of this study were as follows ; 1. The gradual contamination levels of the normal saline used In suction are showing that colony increase in proportion to the length of time. 2. while colony increases in normal saline with the lapse of time. distillation water mixed with 5cc of potadine did not show any sign of the formation of colony from its preparation until it was used for 8 hours. 3. Such variables as the period of intubation insertion. the length of hospitalization in I.C.U. the age and the level of contamination of normal saline have no inter-relationship. Therefore. as the length of normal saline used In suction. the contamination level increases with the excelleration of the contamination speed. 4. Regarding the number of suction and the contamination level of the normal saline. We can observe correlation contamination level in the 3 step of suction(mean value:13.4) and the saline which was used for one hours(r=0.702. P=0.00l). four hours(r=0.694. P=0.00l). eight hours(r=0.488. P=0.029). Further we can observe contamination in the 4 step of suction (mean value: 17 .8) well as saline used for eight hours; [for one hours (r=0.64l. P=0.002). four hours (r=0.670. P=0.00l). eight hours (r=0.57 4. P=0.008)]. Thesedays clinics use normal saline by changing it. three times a day. however. the timing of saline change and the current suction methoed should be changed given the one hour used normal saline contamination number 79.850. Regarding the number of suction and the contamination lend of the normal saline.

• 한국간호교육학회지
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• 제6권2호
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• pp.287-302
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• 2000

The purpose of the study are to examine the perception of the importance and performance of patient education of the clinical nurse and find out the interfering factors in practicing patient education. The data were collected from convenient sample of 256 clinical nurses working in the nursing units of adult patients except the psychiatric unit, obstetric unit, dental surgical unit and intensive care unit of one University Hospital in Seoul from September 29 to October 2, 1998. Three measurement tools of self-report- questionnaires developed by researcher used. For the content validity of the questionnaires, two sessions of panel discussion and a pilot test were done and finally factor analysis was done with Varimax method. Analysis of data was done with SAS program using frequency, percentage, means, standard deviation, Pearson's Correlation Coefficients, t-test and ANOVA. The obtained results were as follows : 1. The surveyed nurses perceived the importance of patient education at higher level with mean score of 4.08 among 5 point than their perception of practice( mean score : 3.42). 2. There was positive significant correlation(r=.29, p=0.0001)between nurses' perception of the importance of patient education and it's practice 3. Among the teaching contents for patients, 'information of diagnostic procedure and operation' and 'orientation of hospitalization' were perceived most important. And 'preparation for discharge' and 'understanding of disease and health promotion' were perceived least important 4. Among the teaching contents for patients, 'orientation of hospitalization' and 'information of diagnostic procedure and operation' were perceived highly performable. And 'understanding of disease and health promotion' and 'preparation for discharge' were perceived least performable. 5. Three types of interfering factors were identified as patient-factor, situational factor, nurse-factor. The mean degree of impediment with the interfering factors was at average level(3.09 among 5). The patient and situational factors of impediments were more interfering than nurse- factor for teaching patients. 6. In older age(p<.05), married state (p<.05), higher educational status (p<.01), higher clinical experience (p<.01) and higher position(p<.01), the score of perceived importance of patients education was more high. 7. In older age(p<.01), higher clinical experience(p<.001) and surgical unit (p<.01), the score of perceived performance of patients education was more high. In conclusion, in order to activate patient education practice in the clinical setting, the continuing education for patients education should be more emphasized and the effective teaching methods and materials should be developed to help patient teaching. And an organizational support such as budgeting for patient education and reimbursement system should be administrated.

• 한국직업건강간호학회지
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• 제10권2호
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• pp.174-182
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• 2001

This study was performed to find out the differences between noise levels of hospital wards and the nurses efforts for noise management in some general hospitals. The hospital wards selected were the intensive care unit(ICU), the emergency room(ER), the nursery room(NR), the internal medicine(IM), the general surgery(GS) among the 5 general hospitals located in Seoul. The data were collected from August 3 to September 13, 1999 through questionnaire survey and noise measurement in each nursing station of hospital wards. Data analysis was done by SPSS 8.0 package among the 305 questionnaires and 24 hours monitored noise levels. Frequency, Chi-square and ANOVA test were used. The study results were as belows: 1. The noise level measured by 24 hours monitoring survey were exceeded on the standard limit in all the hospital wards. Data also showed that noise levels were significantly different in each ward among the three shifts working duties. 2. The subjects were all female nurses. They were mostly working in the ICU ward(28.9%). They were 26~30 years old (43.9%), junior college graduates(57.0%), working for 1~5 years(55.1%) as staff-nurse(85.6%). There were no significant differences between hospital wards and general characteristics of nurses. 3. The noise levels perceived by nurses were regarded as 'Highly noisy'(56.4%), especially during the 11:30 and 15:30 (30.2%) o'clock. Data also showed that noise education was not ever given to nurses(89.9%). Nurses also responded that they hardly put an effort to reduce noise level(54.8%). However, there were significant differences between wards and noisy working time, experience of noise education and level of effort for noise reduction. 4. Nurses also perceived the ventilator alarm and EKG-alarm as the most disturbing sounds in the ICU, human voice and telephone ringing in the ER, human voice and EKG-alarming in the NR, human voices and telephone ringing in IM and GS both wards respectively in order. There were significant differences between hospital wards and noise making factors. 5. Nurses were shown that they regarded highly 'Sound reduction of the human voice', 'Careful handling on medical instruments', and 'Immediate appliances on alarming materials' as the practical method for noise management. There were significant differences between hospital wards and behavioral practical efforts for noise management. According to that results, the statistical differences were shown in the 24 hour monitored noise levels in each ward. Also, nurses perceived the noise severity differently and they approached variously on the practical efforts for noise reduction in each ward. Thus, author thinks that concrete and systematic endeavor will be necessary for noise reduction and management in hospitals for better working and healing environment for both of patients and staffs.

• 지역사회간호학회지
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• 제6권2호
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• pp.259-274
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• 1995

The study is to grasp the problems related to operation of Maternity clinic of public health centers in seoul and needs for public health of community in relation to consumers and providers in order to improve efficiency of community public health for mothers and children. Four pregnancy woman, who receive medical care at the maternity clinic of M public health centers in seoul and understand the purpose of this study, and one nurse who works at the were the objects of this field study. Participating observation and intensive interviews were conducted to collect data. All of them were performed as necessary from time to time since December, 1994, and not during a specific period. Through an data analysis in the order of sector analysis and classification analysis, the data were classified into specific patterns and the results are the following; 1. All of the subjects were using both private hospitals and public clinics, but managing activities prior to delivery were not carried out in accordence with theories for those activities. 2. The subjects showed two types of response to utilizing maternity clinic. they answered that the advantages of the clinic were 'short waiting time for medical treatment', 'medical treatment by female doctors' and 'economical benefit.' Meanwhile, they gave negative response to the problems of 'non-implementation of delivery' 'uncleanness and insufficient facilities', 'limited time of treatment', 'lack of expertise' and 'want of public health education for materity.' 3. Problems related to operation of maternity clinic were 'lack of experts', 'irrational facility structure' and 'absolutely lack budget'. In terms of the status of managing the subjects, 'programs only aimed at attaining the central-government-assigned objects' and 'limited management before and after delivery by non-implementing delivery' were pointed out to be problems. Regarding public health education before delivery and PR relations, 'superficial public health education for maternity' and 'absence of PR programs' were named. In planning and evaluation, 'absence of autonomous planning and evaluation by the clinic itself' was a major problem in operating the clinic. 4. 'Substantial health education and PR', 'supplementation of facilities and eqipment', 'development' and supply of demanded service by the subjects', 'implementation of autonomous programs', and 'reinforcement of supplementary education' were presented as alternatives for efficient opration of maternity clinics.

• 기본간호학회지
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• 제22권3호
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• pp.249-257
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• 2015

Purpose: The purpose of this pilot study was to investigate the effects of mechanical interventions for deep vein thrombosis (DVT) prophylaxis in surgical intensive care unit (SICU) patients. Methods: The participants were assigned to the intermittent pneumatic compression (IPC) and graduated compression stocking (GCS) intervention. Patients who met the criteria were selected for comparison from our previous study. Data for 140 patients were included in the final analysis. Results: The mean age was 57.5 (${\pm}15.7$) and 61.4 % were men. About forty-seven percent of the participants were 61 years or over. In the second duplex scan, 3, 2 and 1 critically ill patients developed deep vein thrombosis in the control, GCS, and IPC groups, respectively. Incidences of DVT were 6.0%, 5.0%, and 2.0% for the control, GCS, and IPC groups, respectively. This difference was not significant. Relative risks of no intervention were 3.0 and 1.2 compared with IPC and GCS application. There were no significantly different variables among the three groups before the intervention except for diagnosis on admission. Conclusion: Although it may difficult to conclude that mechanical prophylaxis effectively prevents DVT among SICU patients because there was no statistical significance in this study, but incidence rates among the three groups differed greatly. The findings reveal that further study should be conducted with larger samples and randomized controlled trial for SICU patients.

• 대한간호학회지
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• 제24권4호
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• pp.597-615
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• 1994

This study is designed to facilitate the creation of home environment conducive to the family taking care of chronic bed-ridden patients with more effective method. The need for this study has emerged against the background of marked changes in the structure of ailments and causes of death, resulting in the number and plights of chronic bed-ridden patients as well as of a rapid increase in demand for medical care and resulting premature discharge. Keeping these in mind, this study focused on home-wards where the majority of chronic bed-ridden patients are being cared for. Despite. their overriding importance, home-words are less than efficient in caring (or chronic bed-ridden patients. These circumstances require the designing of home-wards that can offer greater comfort to patients and at the same time make things easier for caregivers, on the basis of an overall analysis of patients' life and home - ward situation. According1y this study adopted a Participant Observation Method derived cultural anthropology, Toward this end, 3 patients were chosen as subjects of this study for intensive interviewing and participant observation. In the process of this field re-search efforts were made to collect emprical data, that is, to faithfully record the words of the subjects and their caregivers for analysis and interpretation. The findings of these analyses are as follows. Firstly, the chronic bed-ridden patients are mostly being taken care by close family members. Secondly, a room for the exclusive use of the patient, floor, kitchen, bathroom and multipurpose space were found to be necessary for proper caring of the patient. These spaces were respectively used with a view to 1) accomodating the patient as well as caregivers' activities, 2) keeping general and medical supplies and other appliances for patient's care and drying the patient's washing, 3) preparing and keeping the patient's foods and beverages, 4) keeping the supplies necessary for cleaning the patient's body and treating the patient's eliminations, 5) washing the patient's clothes, underwears and bedclothes. The patient's room in turn is subdivided into six portions in terms of uses : specifically the places for accomodating 1) the patient, 2) medical supplies, 3) medicines, 4) linens St clothes, 5) bedclothes and, 6) diapers. Thirdly, the activities of the caregiver are subdivided into seven key areas : hygiene, exercise, diet, elimination, therapeutic nursing, prevention of sore, and other activities. Each area is further classified into several different activities of caring. These activities we mainly carried out in the patient's room. Fourthly, the supplies for caring the chronic bed-ridden patient is divided into two large domains : medical and general supplies. Finally, three main problems areas were found in this study on the part of caregivers, that is, sore prevention, hygiene problem related frequent urination / defecation, the caregiver's physical, psych ological and emotional burden. In consideration of the aforesaid problem areas, a model home-ward was developed in this study. The newly-developed model has been found to have the following six advantages. Firstly, the time and effort required for maintaining the patient's hygiene are reduced, thus relievins the caregiver's physical and psychological bur-den. Secondly, the patient's hygiene can be maintained in satisfactory conditions, because the patient's eliminations are more easily removed. Thirdly, skin irritations caused by the patient's eliminations were remarkably reduced and so were the patient's sores due to moisture and bacteria. Fourthly, the home-ward have a tilt-table ef-fect thanks to the inclining room floor. This improves the patient's cardiovascular function as well as constantly changes pressed skin areas and thus prevents sores. Fifthly, improved shelf arrangements help make the best use of patient's supplies. Sixthly, the trouble of continuously changing clothes, underwears, diapers & bedclothes is remarkably reduced simply by covering the patient with cotton sheets when laid in bed. This is espected to cut down expenses by reducing the comsumptions of diapers and other disposable supplies.