• 한국호스피스완화의료학회:학술대회논문집
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• 한국호스피스완화의료학회 2000년도 동계학술대회
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• pp.162-174
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• 2000

The purpose of this hermeneutic study was to investigate the meaning of "good dying" of Chinese terminally ill cancer patients in Taiwan; the factors related to this morning; and the strategies cancer patients used to ensure "good dying". Indepth unstructured interviews, prolonged participant observations, and review of clinical records were selected as the methods for data collection. In the four and one-half month period of data collection, the researcher was in the role of a full time clinical nurse specialist who directly took care of the subject patients in 4 hospitals and in patients' homes. The 20 subject were selected purposively according to selection criteria and various demographic backgrounds. Interview transcripts and field notes comprised the data for analysis. The results were composed by 3 constitutive patterns and 12 themes. Achieving inner peace appeared to herald the good dying state. The "good dying" for Chinese terminally ill cancer patients in Taiwan meant peace of body, peace of mind, and peace of thought. The constitutive pattern of peace of body included 4 themes: (1)minimizing the agony of physical symptoms; (2)short period of dying process without lingering death; (3) cleanliness, neatness, and integrity of the body; and (4) mobility. The constitutive pattern of peace of mind included 5 themes: (1) yielding; (2) non-attachment; (3) not to be lonely; (4) settle down all affairs; and (5) being in a preferred environment and enjoying nature. The third constitutive pattern of peace of thought included 3 themes: (1) getting through day by day without thinking; (2) meaningful life; and (3) expectation that the suffering would be ending. Through understanding of the terminally ill cancer patient' needs in their meanings of "good dying", recommendations can be made for humanistic care. The findings of this study have recommendations for care givers daily contact with dying patients and for medical and nursing education.

• 한국보건간호학회지
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• 제18권2호
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• pp.276-285
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• 2004

The purpose of this study was to help in explaining the necessity of education on complementary and alternative medicine(CAM) and opening relevant curriculums in nursing education by grasping the kinds of CAM in which nursing students want to be opened. Data were collected from September 27, 2003 through October 20, 2003. A group of 865 nursing students were surveyed using questionnaires in seven universities whose curriculums on CAM have not been available. Collected data were statistically analyzed by using SAS 8.02 system, and the study results are as follows: 1. The average of subjects' behavior toward CAM was 3.52 of the total 5 with practical affairs 3.79. medical treatment 3.79, social concerns 3.84, and communication 3.78. 2. Most nursing students $(90.6\%)$ did not precisely understand the meaning of CAM although they had heard of it. Most of them $(85.5\%)$ had no experience of applying CAM. The study also revealed that more qualified CAM lecturers in the future are needed: specialist in the relevant field $(83.2\%)$, doctor and herb doctor $(6.5\%)$, clinical nurse $(6.0\%)$ and professor of the department of nursing science $(4.3\%)$. 3. Concerning students' behavior toward CAM, there were statistically significant difference between students from agrarian and fishing villages (F=4.91. p=.007) and the others. 4. CAM courses that students want were therapeutic touch (massage) $(22.9\%)$. aroma therapy $(14.8\%)$, manual healing methods $(14.7\%)$, treatment of blood vessel $(8.3\%)$, foot reflexology $(7.9\%)$, and heart remedy $(6.8\%)$. In conclusion, the study indicated that nursing students had positive attitudes toward CAM and for this. healers should have a frank talk with patients in order to maximize symptom-relieving effects. However, the study showed that most nursing students did not understand the exact meaning of CAM. Considered the fact that improvement of both health status and quality of life will be an important issue in the future, active introduction and education of CAM in nursing curriculum are a matter of necessity.

• 보건교육건강증진학회지
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• 제33권3호
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• pp.61-70
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• 2016

Objectives: The aim of this study was to investigate the effectiveness of a hospital-based smoking cessation intervention for increasing continuous abstinence rate from smoking in patients with cerebral infarction. Methods: One-hundred and two smokers with cerebral infarction who decided to quit smoking were enrolled in the smoking cessation intervention from December 2012 to February 2015. The smokers underwent six consecutive times of individual intervention with nurse specialist on smoking cessation including education on behavioral modification, counseling for withdrawal symptoms, and anti-smoking advice over a 12-month period. Results: Among the total participants, the continuous abstinence rate from smoking changed from 79.4% at 1 month to 60.8% at 12 months after discharge. The continuous abstinence rate from smoking after 12 months was 88.5% in participants who completed the entire program (6 times), while 51.3% in participants who did not complete the entire program (${\leq}5$ times) (P=0.001). After adjustment for general and smoking-related characteristics, complete implementation of hospital-based smoking cessation intervention was significantly associated with continuous abstinence from smoking after 12 months (odds ratio: 5.93; 95% confidence interval: 1.45-24.22). Conclusions: The hospital-based smoking cessation intervention might be effective for smoking cessation in patients with cerebral infarction, especially when the intervention was implemented thoroughly.

• 근관절건강학회지
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• 제21권2호
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• pp.153-163
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• 2014

Purpose: This study was to analyze the job of coordinators working in the regional cardiocerebrovascular center. Methods: Using Developing a Curriculum (DACUM) method, the role of coordinators was defined and their duties and tasks were identified. The developed duties and tasks were classified and validated according to importance, difficulty, and frequency of the job. Results: A coordinator is defined as a clinical nurse specialist affiliated in a cardiocerebrovascular center. The coordinator is responsible for managing the major critical pathway to provide adequate medical service and providing education to the patient with myocardial infarction and cerebrovascular attack admitted via emergency room for prevention and management of disease. Ten duties and sixty-nine tasks were identified on the DACUM chart which represented the importance, difficulty, and frequency of tasks showed as A, B, C respectively. Based on determinant coefficient of the task, the highest ranked task was 'analysis for variation of CP' and the lowest was'investing the articles in stock'. Conclusion: The results of study showed that coordinators were doing various duties and tasks and they felt burden from their work and were in confusion. The results of this study can be used to develop training programs for coordinators and evaluation-scale of the coordinators' job performance as the basic data.

• Journal of Korean Biological Nursing Science
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• 제10권1호
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• pp.69-79
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• 2008

The purpose of this study was to evaluate the effect of cardiac rehabilitation education for CABG patients on anxiety & depression, self-esteem, general health status, health related quality of life, body mass index, serum lipid concentration (high density lipoprotein, low density lipoprotein, total cholesterol), heart rate and blood pressure. The subjects of the study consisted of 36 patients who underwent CABG at A hospital in Seoul, from January 1, 2006 to June 30, 2007. The experimental group (20 patients) received the individual education during the hospitalization. The control group (16 patients) received routine discharge education by ward nurses. Psychological variables, general health status and health related quality of life (QOL) after cardiac rehabilitation education were determined by self-reported questionnaire at 1st week, 3rd week and 6th week after the discharge. Physiological variables were measured in out patient visiting at 4th week after discharge. Score of anxiety & depression and health related QOL in the experimental group showed a significant decrease at 1st week, 3rd week and 6th week after the discharge compared with the control group. Score of self-esteem, general health status and physiological variables in the experimental group showed no significant difference from the control group.

• 디지털융복합연구
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• 제15권7호
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• pp.367-373
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• 2017

본 연구는 지속해서 증가하는 유방암 환자의 수술 후 신체 및 정신적 고통 완화를 도와주는 모바일 애플리케이션 서비스 제안에 목적이 있다. 먼저 연구 목적 달성을 위해 문헌연구를 통한 유방암의 전반적인 이해와 이와 유사한 서비스를 분석하였다. 이후 서비스 디자인 방법론인 더블 다이아몬드 디자인 프로세스 모델을 단계별로 적용하여 사후관리 중심의 1:1 맞춤형 전문가 코칭(coaching) 서비스를 제공하는 모바일 애플리케이션을 고안하였다. 세부적으로는 첫째, 현재 진행되는 프로그램 분석과 이해관계자들(유방암 환자, 보호자, 간호사 및 병원 내 암센터 용품 판매원)과의 인터뷰를 통해 사용자 니즈(needs)를 도출하였다. 둘째, 이를 기반으로 사용자를 대표하는 페르소나와 고객여정맵을 토대로 한 전체적인 시나리오를 시각화, 콘셉트 설정 및 키워드 도출로 본 연구를 구체화하였다. 셋째, 구체적인 기능 설명과 함께 효과적으로 전달하기 위한 프로토타입을 제작하여 최종 목표인 모바일 애플리케이션 서비스를 제안하였다. 본 서비스를 통하여 그들의 삶의 질을 향상시키는 서비스가 되길 기대한다.

• 한국의료질향상학회지
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• 제23권2호
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• pp.37-54
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• 2017

Objectives: The purpose of this preliminary study was to identify the nurses' perception regarding disclosure of patient safety incidents (DPSI) and to evaluate the effectiveness of education for DPSI. Methods: DPSI education was conducted for nurses majoring in clinical nurse specialist at an university. Before and after the education, the nurses made a questionnaire to evaluate the perception of DPSI. The questionnaires were divided into four categories: first, overall perception of the DPSI; second, recognition evaluation of the DPSI using hypothetical case, third, opinion on legal and nonlegal measures for facilitating the DPSI; and fourth, socio-demographic factors. The Wilcoxon signed rank test was performed on the DPSI questionnaire response to compare the perceptions before and after the education. Results: A total of 10 nurses participated in the education. DPSI education showed the possibility of improving the overall perception, necessity, effect, obstacle, and promotion method of DPSI, although there were also several responses where there was no statistical significance. In particular, DPSI education led to statistically significance change in the perception of obstacles for DPSI. For example, the number of respondents who agreed to the item "DPSI will increase the incidence of medical lawsuits." was 7 before education but decreased to 3 after education (P-value: .025) Furthermore, nurses' perception of DPSI from this study was generally positive regardless of education. Conclusion:In the future, it will be necessary to carry out DPSI education and training and to evaluate its effectiveness for more nurses.

• 근관절건강학회지
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• 제27권1호
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• pp.12-21
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• 2020

Purpose: The study was to develop a tailored education and coaching program (TECP) for cancer patients, and to identify the effects of TECP on pain severity, daily living impairment, barriers on pain management, self-efficacy, and pain management satisfaction. Methods: A randomized controlled trial was used. Patients referred to an oncology nurse specialist from oncologists for pain management were randomly assigned to TECP (25) or usual education program (UEP, 22). The intervention was offered by educating the method of taking opioid medication, managing opioid-induced side effects, reducing pain misconceptions and enhancing self-efficacy for communicating with a medical team on cancer pain severity, and pain-related impairment. Patients completed questionnaires before the education program and on the next visit 3~4 weeks later. Data were analyzed by SPSS 19.0 program using percentage, frequency, mean, standard deviation, x² test and independent t-test. Results: At all levels, pain severity improved significantly in the experimental group-worst pain (8.16 to 3.80, p<.001), average pain (6.16 to 2.52 p=.008), and least pain (3.32 to 0.96, p=.038)-but not in the control group. Pain management satisfaction also showed significant differences (t=2.93, p=.005) between experimental (4.70±0.49) and control (4.17±0.73) groups. Interference with daily living, barriers to managing cancer pain, and self-efficacy for managing pain improved in both groups but there were no significant differences. Conclusion: The findings suggest that TECP should be considered for outpatients who need cancer pain management.

• Acute and Critical Care
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• 제33권4호
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• pp.252-259
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• 2018

Background: The aim of this study was to investigate the effects of using a systematic approach to tracheostomy care by a clinical nurse specialist and surgical intensivists for patients with a tracheostomy who were transferred from the surgical intensive care unit (SICU) to the general ward. Methods: In this retrospective study, subjects were limited to SICU patients with a tracheostomy who were transferred to the general ward. The study period was divided into a preintervention period (January 1, 2007 to December 31, 2010) and a postintervention period (January 1, 2011 to December 31, 2014), and electronic medical records were used to analyze and compare patient characteristics, clinical outcomes, and readmission to the SICU. Results: The analysis included 44 patients in the preintervention group and 96 patients in the postintervention group. Decannulation time ($26.7{\pm}25.1$ vs. $12.1{\pm}16.0days$, P=0.003), length of stay in the general ward ($70.6{\pm}89.1$ vs. $40.5{\pm}42.2days$, P=0.008), length of total hospital stay ($107.5{\pm}95.6$ vs. $74.7{\pm}51.2days$, P=0.009), and readmission rate of SICU decreased due to T-cannula occlusion (58.8% vs. 5.9%, P=0.010). Conclusions: Using a systematic approach to tracheostomy care in the general ward led to reduction in decannulation time through professional management, which resulted in a shorter hospital stay. It also lowered SICU readmission by solving problems related to direct T-cannula.

• 근관절건강학회지
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• 제29권2호
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• pp.81-90
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• 2022

Purpose: The purpose of this study was to evaluate the efficacy of applying a defecation encouragement program for patients undergoing total knee replacement arthroplasty (TKRA). Methods: This program was based on the nursing best practice guideline: prevention of constipation in the older adult population by the National Guideline Clearing House (NGC) in 2011, which included fluid intake, bowel training, and abdominal and pelvic floor exercises. A team of one orthopaedic clinical nurse specialist and six orthopaedic nurses with a 10 years of clinical experience applied and assisted patients with the program. Formal counsel was provided by one orthopaedic doctor, one gastroenterologist, and one exercise therapist. Patients who defecated one day prior to or on the day of TKRA surgery were included. Data collected from 72 subjects were analyzed using SPSS/WIN 21.0. Results: Time until first defecation after surgery was 2.4±1.1 days in experimental group, which was significantly shorter than the 3.5±0.9 days in control group (t=4.28, p<.001). Constipation assessment scale showed significantly lower points (t=2.55, p=.013) in experimental group (1.3±1.2) compared to control group (2.6±2.6). The experimental group and control group were 17.3±7.67 and 23.7±14.43, respectively, and the experimental group used less laxatives (t=2.83, p=.021). Conclusion: A defecation encouragement program was proved to be an appropriate nursing intervention for patients undergoing TKRA. This study confirmed that constipation is a nursing problem that can be sufficiently prevented if nurses are interested and encourage defecation.