• 대한간호학회지
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• 제26권1호
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• pp.223-247
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• 1996

This study was done to provide information which would lead to nursing care of the elderly being more holistically through an understanding of the phenomena of powerlessness based on the lived experience of powerlessness by the elderly, the meaning the elderly give to such phenomena, and what essence of powerlessness is. The methodology used in this study was Max Van Manen's phenomenological method based on the philosophy of Merleu-Ponty and a concerted approach was realized through the 11 steps suggested in the Van Manen's method. Data collection was done from March 2, 1995 to December 30, 1995. The subjects for this study were four elderly persons who lived with their families and who were over 60 years of age. Data were collected about the lived experience of the elderly, this researcher's experience of powerlessness, the linguistic meaning of powerlessness, idioms of the word or a feeling of powerlessness, and descriptions of powerlessness in the elderly as they appeared in the literature, are works, and phenomenological literature. All data were used to provide insights into the phenomena of powerlessness. Data about the experience of powerlessness by the elderly were collected through open interviews, participation, and observation. In the analysis of the theme of this study, the aspects of the theme, powerlessness in the elderly were clarified, thereby abstracting and finding meaningful statements by the elderly about their feeling of powerlessness, and then those significant statements were expressed as linguistic transformations. The summarized findings from the study are as follows : 1. Five meanings of powerlessness in the elderly were defined. 〈weakness〉, 〈dependence〉, 〈frustration〉, 〈worthlessness〉 and 〈giving up〉. 2. 〈Weakness〉 means that the elderly experience, not only their aging but also, their becoming weak and the loss of physical function frequently caused by diseases. 〈Dependence〉 means that the elderly experience dependence without any influence from the surroundings and that elderly patients who are hospitalized lose their autonomy, follow entirely their doctor's prescriptions, use aid equipment and directions, and depend only on those things. 〈Frustration〉 means that the elderly experience the loss of their roles from the past, there by feeling that there is no work for them to do anymore and therefore feel unable to do anything. 〈Worthlessness〉 means that the elderly experience the feeling of losing their social roles from the past, having no financial ability, thereby being a burden to their children or the people around them, and therefore regarding themselves useless. 〈Giving up〉 means that the elderly experience the feeling of closeness to death in the final stage of their lifetime, lose hope to be healed from their disease, and recognize the incontrollability of their own body. 3. From a general view of the meaning of the theme the powerlessness in the elderly-the most essential meaning of the theme is the 〈sense of loss〉. For the elderly are experiencing a sense of loss in the situation of being elderly and therefore being often hospitalized. Brief definitions of the five phenomena could be 〈weakness〉 meaning the loss of physical strength, 〈dependence〉 the loss of mentality caused by disease and hospitalization, 〈frustration〉 and 〈worthlessness〉 the loss of social performance caused by the loss of social functions from the past, and lastly 〈giving up〉 the loss of the controllability of such situations of aging and suffering disease. In light of the discussion above, it is understandable that the hospitalized elderly experience powerlessness not only as it related to their diseases but also to their normal aging, and this related to other characteristics of being elderly means that the 〈sense of loss〉 is the very essence of their powerlessness. 4. While most cases are of the normal elderly experiencing powerlessness in relation to their social network, cases of elderly who are hospitalized are of those experiencing powerlessness in relation to the loss of their physical desire. 5. The findings discussed above can serve as guidelines for nurses who take care of the ill elderly who are hospitalized and that can provide cues to appropriate nursing service, recognizing that the subjective experience of the objective age of the elderly is so important. Nurses can provide highly qualitative nursing service, based on their deep understanding of the suffering of the elderly due to feelings of powerlessness.

• 호스피스학술지
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• 제7권1호
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• pp.29-45
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• 2007

People in the end of life and their families suffer in their physical disease and other aspects as a whole person. They need hospice care to palliate their total suffering in physical, emotional, social and also spiritual aspect through professional hospice team. To care their whole personal needs, hospice team must be a multi-discipline team which consists of medical doctors, nurses, social workers, pastors and volunteers. Recently those who die in hospice palliative care unit have trend to increase more than in home year by year. So it is necessary to develop the nursing intervention program to be performed by multi-discipline team approach for in-patient of hospice palliative care unit. The purposes of this study were to develop of wholistic hospice nursing intervention program for inpatient of hospice palliative care unit. The subjects of study were collected from 30 patients those who were over 18 years old and admitted in hospice palliative care unit of S hospital in P city with agreement in hospice palliative care in their terminal disease. The period of data collection was from December 15, 2003 to March 15, 2004. The result were as follows : 1. The result of Wholistic Hospice Nursing Program's development was as follow : A Wholistic Hospice Nursing Program was developed by me in this study is one of the service program for hospice palliative care unit. It was named as ‘Rainbow Program’ to be approached easily by hospice patients. The purposes of it are to improve the quality of life of the terminal patients with their dignity, to help them live in abundant and meaningful in their lives, to care them in peaceful in dying process with understanding them in whole personal, and also to palliate the grief and suffering of the bereaved. It was provided by hospice professionals(nurses, medical doctors, social worker, pastors, art therapists) and volunteers those who were educated in hospice for multi-diciplinary team approach to collaborate with each role play I 20-30 minuters of each through visiting their rooms individually and a place of hospice palliative care unit of S hospital in P city. The subjects of it were the terminal patients those who admitted hospice palliative care unit and their familes. with agreement in hospice palliative care in their terminal disease. The characteristics of it were multi-disciplinary team approach, whole personal care, individual care and total care according to their needs in their condition. The contents of it were pain control, symptom control, counseling patient, counseling family, hair cutting, hair shampooing, bed bath, recreation, taking a walk, event of culture(screen, recital, festival of praises, exhibition and so on), pastoral counseling, ritual service in bed, praying, service in bed, sing a worship praise, listening to the music, sharing remembrance of life, individual visiting music service(sing and praying), meditation Bible, art therapies(dance and drawing), social worker's counselling, confessing and sharing love and thanksgiving. The experimental group subjects participated in Wholistic Hospice Nursing Program which takes 120 minutes per session, total 10 sessions(total 1,200 minutes) altogether. In conclusion, this Wholistic Hospice Nursing Intervention can be used actively for whole personal well-being of the patients in hospice palliative in hospice palliative care unit and also applied in hospice practice as an useful model of multi-disciplinary team approach by hospice professionals.

• 정신신체의학
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• 제25권1호
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• pp.73-85
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• 2017

연구목적 자연스러운 본능으로서의 배고픔과는 다르며, 의식의 자아를 습격하듯이 위협적으로 찾아들기도 하며, 정서적 고통을 수반하기도 하는, 낯설고 이질적인 '이상한 배고픔'과 '강박적 폭식충동'이, 분석과정에서 어떤 경과를 취하며 어떻게 해소되고 치유될 수 있는지를 고찰하고 연구하고자 한다. 증상으로 체험되던 고통의 목적의 미에 대해 살펴보고, '식이장애' 증상군을 이해하고 조명하는 하나의 관점과 치료방법으로서, 분석의 치유모델을 제시하고자 한다. 방법 2008년 3월부터 2017년 2월까지 '이상한 배고픔'과 '폭식충동'을 주소로 용인정신병원 외래를 방문한 A, B, C를 연구대상으로 하였다. 주 1~2회, 1회에 55분, 분석을 시행하였으며, 의식과 현실의 상황, 어린시절을 포함한 개인사 및 가족력과 더불어 무의식(꿈, 환상)을 함께 살펴나갔다. 분석과정의 기록이 본 연구와 논문의 토대가 되었다. 결과 1) 의식과 무의식(꿈, 환상)을 함께 살펴나가고 꿈의 상과 상징을 주관단계로 이해하는 분석 과정을 통해서, '무의식의 의식화'와 '인격의 창조적 변환'이 진행되었으며, 피분석자 모두에서 '이상한 배고픔'과 '폭식충동'의 호전과 치유가 진행되었다. 2) 피분석자들의 꿈과 환상에서 '전체성의 원형(자기원형)'으로 볼 수 있는 '뱀'의 상(Imago)이 공통적으로 나타남이 관찰되었다. 3) 피분석자C의 환상에서 폭식충동이 뱀의 '상'으로 변환됨으로써 폭식충동이 점차 사라지고 마음의 평정을 회복하게 되었다. 투사(전이)를 인식하고, 외부대상(분석가)과의 분리(separation, detachment)가 이루어지게 되었으며, 무의식적이었던 심리적 내용이 인식됨으로써 '의식과 무의식의 합성'이 가능해질 수 있게 되었다. 결론 피분석자 A, B, C에서 배고픔과 폭식충동은 자신의 본성과 개성을 회복하고 자신의 전체가 되는 '자기실현'을 목적지로 하며, '무의식의 의식화 인격의 창조적 변환 세상과의 창조적 관계변환'으로 귀결되는, '창조적 충동'이라고 볼 수 있다. '창조(재탄생)'라는 목적의미를 내포하고 있으나 의식의 자아가 그 의미를 깨닫기 전에는 정서적 고통과 본능적 충동으로 체험되기도 하는 '창조적 충동'은, 꿈이나 환상을 통해 '상'과 '상징'으로 드러나게 됨으로써, 의식의 자아에게 그 의미가 알려지게 된다.

• 대한간호학회지
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• 제4권3호
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• pp.93-104
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• 1974

Regardless of a patient's diagnosis, the care of his skin has been a primary concern of nurses throughout the years. Nurses has washed, dried, and rubbed the skin and have changed his position so as to keep the patient's skin in good condition and to protect him from pressure sores. However, we still find many-patients suffering from the pressure sores which may take many mothers or years of treatment and cost a lot to be repaired. In view of expensive cost for treatment of the sores and low ratios of nursing staff per patient for intensive nursing care, prophylaxis of the bed sores with sufficient aids is extremely important both for patients and for nurses. Therefore, the unique purpose of this study was to determine whether sponge is good enough to treat and prevent the pressure sore as compared with gel pad and sheepskin. Sixty patients in the age range of 15 through 45 who were in unconscious status or have difficulty of mobility were chosen between January and March of 1974 at Seoul National University Hospital. They were randomly assigned to each treatment and observed on every 4th day with regard to level of consciousness, status of mobility, moisture or dryness of the bed, general skin condition, intake of nutrition, vital signs and intervals of position change in comparison with the changes of skin over the bony prominences. The study results were reviewed in a statistical method analysis of valiance-to obtain the following findings: 1. There was no significantly different changes of skin over the sanctum or the trochanter in each group using get pad, sheepskin or sponge. It means that we may substitute sponge for expensive gel pad or sheepskin. 2. There was no significant difference among mean changes of patient's skin in relation to sheepskin, gel pad and sponge. 3. There was no significant changes of patient's akin in relation to level of consciousness, status of mobility, intake of nutrition, general skin condition, temperature, blood pressure or interval of position change. 4. There were no meaningful interactions between each treatment and level of consciousness, moisture or dryness of the bed, intake of nutrition, general skin condition, temperature or blood pressure. 5. Sheepskin and gel pad had significantly better influence on patients with limited mobility than on patients with immobility, and sponge on patients with immobility on than patients with limited mobility, 6. Sheepskin and sponge had meaningfully totter influence on patients changing position at below 2-hour interval, gel pad at 2-4-hour interval, sheepskin at 4-6-hour interval, and three of them at above 6-hour interval.

• The Journal of Korean Physical Therapy
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• 제6권1호
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• pp.49-60
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• 1994

Stress is experienced when a person tries to maintain stability in the face of life change but is not able to meet the adaptive demands of change. This can be especially true for the parents who has a cerebral palsy childs who needs long term rare, where parents, are the primary source of care and responsibility. Successful coping leads to maintenance of the parents role and this has an effect on the health status of the child. This descriptive study was attempted to identify stress factors, levels and helpful coping patterns for parents who must take care of cerebral palsy children. Data were collected from 43 subjects who were parents of children diagnosed with cerebral palsy The informations gathered from March 25, 1994 to April 14, 1994 by means of structured questionnaires were analyzed. Two instruments were used to collect the data 1) Lee's stress questionnaire consisted of 33 stress factors and measured by four point Likert scale. 2) Modified Chronic Health Inventory for parents: The modified CHIP included 43 items of coping methods with four point Likert scale. The results of this study were as follows: 1) Stress items could have a maximum score of three points, for a total possible score of 132 points. The mean score for the total was 92.02 points. The item mean score was 2.85 points showing that the parents were experiencing moderate to much stress. 2) The items with the highest stress items were 16 items. The stress items with the lowest mean scores were 10 items. 3) Of the stress categories: The highest stress category was related to changes in the illness status of the child and difficulty in taking rare of the child. The second stressful category was related to the prognosis of the child's condition. The least stress was noticed to social-personal relationships and the responsibility of the care givers. 4) Items measuring coping in the parents had a maximum score of three points each with a total possible roping score of 172 points. The mean score for the total was 103,9 paints. The item mean score was 2.42 points indicating that there were responses of little helpful to moderately helpful on each coping pattern. 5) The most helpful coping items were 7 items. The least helpful coping items were 2 items. 6) Effectiveness of the coping for each patterns was examined : Understanding the illness condition from communication with parents of children with the same condition and consultation with the medical team was the most helpful coping pattern. Family's coorperation and integration and optimism were a moderately helpful coping pattern. Social support psychological stability and self esteem were the least helpful toping pattern. In conclusion, the highest stress for parents of children with cerebropalsy was found to be very stressful changes in the illness of the child and to taking care of a child who is suffering. The parents were helped by the coping methods using understanding of the illness condition through consultation with the medical learn and communication with parents in the same situation. Based on the knowledge, care could develop intervention strategies appropriate for them, help them to develop their effective coping patterns, and give support them in the process of coping with their stress.

• Journal of Ginseng Research
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• 제33권2호
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• pp.155-159
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• 2009

Sudden idiopathic sensorineural hearing loss is a disease that develops within several hours to several days. Its etiology has not yet been verified, but the disturbance of the circulation of blood in the inner ear, inner-ear hydrops, and viral infection are considered possible causes of the disease. This study was conducted to evaluate the effect of Panax ginseng extract, which is known to have a vasodilatory effect, on sudden sensorineural hearing loss. Sixty-nine patients suffering from sudden sensorineural hearing loss were admitted to Korea University Anam Hospital from March to December 2008. They were divided into the experimental (30 ears) and control (39 ears) groups. Ginseng extract (2700 mg/day, 4 weeks) was added to the therapeutic regimen in the experimental group. The effect of ginseng extract therapy was analyzed according to the factors relating to the prognosis. A considerable hearing improvement was documented in both groups (32.2 dB in the experimental group and 25.8 dB in the control group). However, there was little beneficial effect of ginseng extract on additional hearing improvement compared with control. The total recovery rate of the experimental group (80.0%) was better than that of the control group (58.9%), and the experimental group's high-tone hearing gain at 3 kHz (29.7 dB) was better than that of the control group (21.7 dB). The results of the study suggest that the effects of ginseng therapy tend to be superior to those of the conventional therapy, but the difference between the two is not statistically significant. The hearing gains tend to be in the higher frequencies and may be due to the promotion of cellular differentiation from the supporting cells.

• 한국치위생학회지
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• 제9권4호
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• pp.768-783
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• 2009

Objectives : The purpose of this study was to analyze dental records performed through a dental hygiene process and provide basic data on clinical training education for dental hygienists. Methods : The dental hygiene records of 440 senior dental hygiene students in Y University from March 2005 to September 2008, were examined. The needs of the clients confirmed by the dental hygiene diagnosis was based on Human Need Theory. The client's needs and the number of visits were analyzed according to the general characteristics(gender, age). The contents of the dental hygiene implementation performed according to the needs were divided into dental hygiene care and oral health education. The dental hygiene evaluation was classified into 'Met of Goal', 'Partially Met of Goal', and 'Unmet of Goal' according to the dental hygiene diagnosis. Data analysis was performed for the Frequency statistics and a Fisher's exact test using SPSS 12.0K for Windows. Results : 1. The clients were mostly aged in their 20's(307 clients). 2. The dental hygiene care usually performed was 'Scaling' and 'Recommendation to visit a dental clinic', and the education performed was 'How to brush teeth'. The implementation result from the need to Freedom of Stress was as simple as 'Be careful when treating' and 'Explanation of medical treatment and tools'. 3. The dental hygiene evaluation showed a higher met rate in the field of education than in that of the dental hygiene care. The reason for unmet the goal was 'Lack of the client's efforts and they didn't visit dental clinic'. Conclusions : The search for a range of clients for dental hygiene process should be made through effective connections between the local community institutions and schools. It was suggested that they should be strength the practical exercises for clients suffering dental anxiety and stress in dental treatments. In addition, education and attempts to motivate the clients should be performed according to their characteristics.

• Journal of Acupuncture Research
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• 제23권3호
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• pp.207-214
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• 2006

Objectives : This study is designed in order to evaluate the therapeutic effect of Scalp Acupuncture and Do-ma Acupuncture related with Governer Vessel(Dok) and Bladder Meridian(Chok-taeyang) on acute low back pain Methods : We investigated 30 patients suffering from acute low back pain were admitted to Dunsan O.M.hospital from March. 1st 2005 to December. 30th 2005. We divided into two groups: one group was treated with Scalp acupunture, another group was treated with common acupuncture. 30 patients, were diagnosed only straightened curvature on lateral view of lumbar spine X -ray. Scalp acupunture related with Governer Vessel(Dok) and Bladder Meridian(Chok-taeyang) and Do-ma acupuncture. To estimate the efficacy of treatment that applied for two groups, we compared the visual analog scale(VAS), Oswestry disabiliby index(ODI) and Straight Leg Raising Test(SLRT) score of two groups statistically. Results : Both Scalp acupuncture related with Governer Vessel(Dok) and Bladder Meridian (Chok-taeyang) and Do-ma acupuncture therapy showed good effect on acute low back pain. It was proved by the difference between VAS, ODI and SLRT score checked before treatment and what checked after treatment on each groups. Conclusion: The therapeutic effect of Scalp Acupuncture and Do-ma Acupuncture on acute low back pain can be recommended as a useful therapy to treat acute low back pain.

• Clinical and Experimental Pediatrics
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• 제51권10호
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• pp.1071-1076
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• 2008

목적: RSV 호흡기 바이러스 감염은 해마다 영유아에서 심한 호흡기 질환의 중요한 원인이 되고 있다. 이에 따라 최근 검사 방법이 간편하고 결과를 빨리 알 수 있는 면역 크로마토그래피법이 신속 항원 검사법으로서 소개되어 그 정확성과 임상에서의 유용성이 많이 연구되고 있으나 국내에서는 연구례가 드문 실정이다. 이에 저자들은 이 검사법의 정확성과 유용성을 평가하여 실질적인 검사법으로 정착시키고자 하였다. 방법: 2007년 4월부터 2008년 3월까지 발열, 기침, 천명, 호흡곤란, 빈호흡 등의 증상으로 외래 내원 및 입원치료를 받은 112명의 환아를 대상으로 비인두 가검물을 채취하여 RSV Respi-Strip과 효소 면역 측정법, RT-PCR(ASTEC)을 동시에 시행하였다. RT-PCR을 표준으로 하여 RespiStrip 과 EIA의 결과를 비교 분석하여 정확성과 유용성을 평가하였다. 결 과: RSV RespiStrip, RT-PCR, EIA에 양성을 보인 환아는 각각 42명, 45명, 39명 이었다. RespiStrip는 RT-PCR 검사법에 대하여 민감도 88%, 특이도 94%, 양성 예측도 90%, 음성 예측도는 92% 였으며 위양성률과 위음성률 그리고 일치도가 각각 5.9%, 11%, 83% 로 나왔다. EIA는 RT-PCR 검사법에 대하여 민감도 84%, 특이도 94%, 양성 예측도 90%, 음성 예측도 90%, 일치도 79% 로 나왔다. 결론: 신속 항원 검사가 비교적 민감도가 높으므로 RSV 감염의 선별 검사로서 적합하다고 생각한다. 외래 진료실에서 빠르고 경제적이며 간편하게 검사하여 조기에 적절한 치료를 함으로써 합병증을 예방할 수 있고 아울러 불필요한 항생제의 사용을 줄일 수 있다. 앞으로 이러한 신속검사가 실제 임상에서 많이 적용되리라 기대된다.

• 국제지역연구
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• 제21권2호
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• pp.71-96
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• 2017

본 연구는 북한 계획경제의 실패로 나타난 빈곤화가 시장화를 통하여 극복되는 과정을 분석하였다. 계획과 시장의 융합으로 나타난 경제정책을 제도로 인식하고 7.1경제관리조치와 6.28신경제관리조치를 중심으로 시장화를 자생적인 시장화(1990~2001년), 유통중심의 시장화(2002~2011년), 생산중심의 시장화(2012~2017년)로 시대구분을 하고 주요사건, 경제순환구조, 경제행태를 분석하였다. 분석결과 첫째, 시장화의 과정은 농민시장 확대, 유통 중심의 시장화, 생산 중심의 시장화 그리고 금융 중심의 시장화로 계속 시장화가 진화되면서 빈곤화가 어느 정도 극복되어 가고 있다. 둘째, 기업제도, 농업제도, 금융제도가 시장경제 방향으로 진전되어가고 있으며 소규모 사유화부터 시작하여 대규모 사유화가 진전되고 있다. 셋째, 완전한 빈곤화를 탈출하기 위해서는 외자유치를 통하여 공업화 산업화를 건설해야 하는 상황에 놓여있으며, 농업개혁, 기업개혁, 가격개혁, 재정개혁, 금융개혁, 무역 직접투자개혁, 유통개혁 등 거의 전 분야에 걸친 경제체제 개혁이 되어 글로벌 경제에 결합시키고 그 과정 속에서 고용확대, 외화획득, 기술획득을 실현해야 한다. 이러한 일련의 경제구조의 변화 방향들은 공적부문과 중앙집권화(Public sector & centralized)에서 사적부문과 분권화(Private sector & decentralized)로 바뀌고 있다.