• Title/Summary/Keyword: Nursing approach

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The Program Development of Nursing Activities for Community Health Promotion (지역사회 건강증진 간호활동의 프로그램 개발)

  • Park, Jeong-Hee
    • Research in Community and Public Health Nursing
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    • v.10 no.2
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    • pp.291-306
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    • 1999
  • Health promotion has come to the fore through new concept approach in consequence of the increase of chronic diseases. increase of medical cost and social trend of putting more emphasis on the individual responsibility for health. Studies of health promotion can be classified into two types: one is micro intervention method which is mainly focused on modifying individual life style and the other. macro intervention method in which they put another emphasis on the environment the individual is surrounded. in addition to modifying individual life style. This study belongs to the later. This study aims to develop nursing activities and program it for the purpose of community health promotion. The process of the study can be briefed as follows: to draw out nursing contents to intervene for community health promotion: to promote community health to develop nursing action indicators; to develop nursing action indicators for the development of main nursing activities. And those developed nursing activities are programmed systematically. The community health promotion program is composed of a hierarchical structure with nursing process that the nurses are supposed to apply to perform professional nursing. the level of nursing perform. the main items of nursing process. health promotion nursing indicators. health promotion nursing activities. The conclusion of this study according to objectives are as follows. First. community health promotion contents at individual and community level are remained revised and complemented and those at organizational level are developed. The developed main contents of community health promotion nursing are as follows. 1) Revised individual level nursing contents: 35 items. 2) Developed organizational level nursing contents: 24 items. 3) Revised community level nursing contents: 36 items. Second. for the development of the health promotion nursing action indicators. principles were set up and applied as follows. 1. Developed indicators should be provided with such qualities as comprehensiveness. diversity. developability, availability. practicability. 2. Developed indicators should be provided with functional abilities to measure the conditions and changes in any phenomena or state. inspect the development of the states. control the implementing program. evaluate the result of program and grasp what nurses should do. 3. Developed indicators should be provided with relevance and sequence. 4. Developed indicators should be undergo inspections from the expert. The developed community health promotion action indicators developed in this study. observing above mentioned principles. are total 330 indicators of 95 items. Third. when the main nursing activities were developed for each nursing action indicator. five priciples were set up in accordance with each nursing action indicators to decide main nursing activities. Main nursing activities developed observing those principles. are total 1273. Forth. for the programming of the developed nursing activities. three principles were set up. 1. The nursing activities are systematized in line with (nursing process) (nursing client) (key items of nursing process) (nursing action indicators for health promotion) (nursing activities). 2. The program is constructed in downward and hierarchical order. 3. The program is constructed not in relation to same level activities but in relation to high and low level activities. The process step of programming of developed main health promotion nursing activities are; Step 1. The Developed nursing action indicators are classified into nursing process. Step 2. The main nursing activities are allocated per each nursing action indicators. Step 3. The statement of main nursing activities are inspected. Step 4. The items of main nursing activities allocated by a certain nursing action indicators are sequenced. taking into consideration the elaborateness of activity. the sequency of activity. familiarity of activity. the difficulty of activity. the interest of activity. the frequency of activity. Step 5. The whole developed program should undergo comprehensive and critical inspections.

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Lived Experience of Women체s Urinary Incontinence in Small Island (도서지역여성의 요실금 체험)

  • 이명희;신경림
    • Journal of Korean Academy of Nursing
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    • v.30 no.3
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    • pp.799-812
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    • 2000
  • This study adopts the phenomenological approach in order to explore the experience of urinary felt by the small island women and to find the meaning and structure of their experience, for the further understanding of them. This study succeeded in detecting five topics and three basic structure from eight participants, and followings are the comprehensive statement of them. The five topics include neglect of care after childbirth, unavoidable life in the tidal flat, shame which cannot be expressed even to their husbands, endless anxiety toward the expected future, and sad(dilemmatic) lived experience. The basic structure is that small island women who have urinary incontinence are apt to regard their disease as a natural destiny of women who fail to get adequate care after childbirth, and something to be endured to live in the seashore. They think of urinary incontinence as something so shameful that they cannot reveal it even to their husband and family. They believe that it even changes their personality since they must always stay alert in order to cope with the situation; for example, when it takes place unexpectedly, like too often to go to toilet, to change the underwears, to wake up in the middle of the night to go to toilet, to try not to laugh loudly, or to have showers. In addition, they accept it as a natural process of aging and incurable disease, and they consider themselves already ruined on the way of becoming uglier. They show dilemmatic abandonment: give it up unwillingly but at the same time think it is natural for others too. The unique experience of small island women with urinary incontinence implied in those statement are inseparable with the specific conditions for survival in the island. Unlike other diseases, it is considered the result of traditionally poor care after childbirth. However this misunderstanding that it is a natural phenomena for all the women who experience childbirth and aging and thereby incurable leads to an undesirable attitude toward urinary incontinence. According to the analysis, environmental conditions specific for small islands make the women there have distinct and unique experience concerned with urinary incontinence. Consequently, the future nursing plan for urinary incontinence in the small island area must be made and enforced with the consideration of these specific phenomenological meanings. Modern Korean nursing has basically been centered to hospital or urban areas. Besides, nursing intervention has long depended upon the research of western countries. This research, however, shows how greatly the regional and cultural characteristics influence the understanding of a certain disease, and is expected to make more specific and in-depth nursing approach enable for those who have urinary incontinence in small islands.

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The Effect of a Multidisciplinary Team Approach on the Rehabilitation of Stroke Survivors (뇌졸중 환자를 위한 팀접근 재활프로그램의 효과)

  • Cho, Bok-Hee
    • The Korean Journal of Rehabilitation Nursing
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    • v.6 no.2
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    • pp.137-151
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    • 2003
  • The purpose of this study was to develop a multidisciplinary team approach program for stroke survivors, and to identify its effects on their rehabilitation. The team was composed of 7 members: a rehabilitation nurse, a physician, a physical therapist, an occupational therapist, a therapeutic recreational therapist, a nutritionist, and a researcher. A quasi-experimental study was performed with 36 subjects: 18 in the experimental group and 18 in the control group, using a noneqivalent control group pretest-posttest design. The experimental group participated 4 times in rehabilitation programsfocused on information and emotional support provided by the rehabilation team-and received telephone counseling from the researcher. The control group did not receive any treatment. The selection criteria for the subjects in this study were: (a) patients who were diagnosed as having had an ischemic stroke within the last year, (b) patients free of any communication disorder, (c) and those having a primary caregiver who could assist in filling out the form assessing the level of ADL. The data were collected from patients who had been discharged from a tertiary hospital, between October 1st, 1999 and September 30th, 2000. The data were analysed by $X^2$ test, Fisher's exact test, ANCOVA, Wilcoxon's rank sum test, and Wilcoxon's signed rank test using an SAS program. The results were as follows: 1. In terms of physical variables (blood pressure, grasp power, and ADL) 1) There was a significant difference in blood pressure between the two groups (systolic pressure P= .012, diastolic pressure P= .050). 2) There was also a significant difference in grasp power between the two groups (affected side : P= .012, unaffected side : P= .010). 3) There was no significant change in the level of ADL between the two groups. 2. In terms of psychosocial variables (depression, self-efficacy, self-esteem, and social activities) 1) There were no significant differences between the two groups. However, all four psychosocial variables showed a tendency to improve in the experimental group, while only two variables (depression and self-efficacy) showed a simalar tendency in the control group. 2) The level of social activities in the control group decreased significantly after a month (P= .050). 3. The level of life satisfaction improved in both groups, but no significant difference was found. Stroke has high recurrence rate and requires considerable follow-up care. The program used in this study was developed and designed for stimulting the rehabilitation process of stroke survivors. Through the program period of one month (meetings were held weekly), a positive effect was detected in physical variables, although the psychosocial variables did not improve significantly. In retrospect, a one month period may not be an adequate length of time to improve the psychosocial variables, as the stroke survivors were complicated cases, and most of them were elderly. Further research is therefore recommended by increasing the length of program, so that its effect can be more noticeable.

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A Study of the Factor on Behavioral Change of the Psychiatric in-patient (정신과 입원환자의 행동변화에 영향을 주는 요소에 관한 연구)

  • 이소우;김태경
    • Journal of Korean Academy of Nursing
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    • v.14 no.2
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    • pp.84-92
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    • 1984
  • This article examined relationships between selected variables, such as demographic background, care, treatment variables, environmental characteristics, and patient's daily behavior and mood change. Relationship were determined between independent variabltherapeutic-rapeutie approach, demographic data, environmental management approach-,and dependent variable-patient's daily behavioral and mood change. 35 patients selected within some criteria in a psychiatric ward, were obserbed during 5 weeks by use of Wyatt's Behavior & Mood Rating Scale ac-cording to the object of the study. At the same time, the frequence of the care and treatment were collected. Criteria for sample selection and independent variables as an influential factor to the patient behavioral change, based on a literature revienw and clinical experiences. Pearson's correlation and multiple regression analysis were used to determine the influfntial factors to the patient behavioral change. Systematic reading (r=.8324), Psychiatrist's individual interview (r=.5764), tranquilizer (r=.3441) and hospitalization processing date (r=.4143) were related with patient's behavioral change. That is these 4 variables can be said to influence to the patient's behavior and mood. A stepwise multiple regression analysis of the effect of the independent varibles of systematic reading, psychintrists individual interview, tranquilizer and hospitalization processing date on the dependent variable, patient's behavioral change was carried out. Systematic reading with on R²of. 69 revealed to be the main influential factor to the patient's behavior and mood change, as the next factor psychiatrist individual interview. A total inclusion of these factors revealed a 73% prediction for the patient's behavior and mood change. But the most influential factor was the interaction of the systematic reading and psychiatrist's individual interview.

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Breast Cancer Risk Assessment Using the Gail Model: a Turkish Study

  • Erbil, Nulufer;Dundar, Nursel;Inan, Cigdem;Bolukbas, Nurgul
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.1
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    • pp.303-306
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    • 2015
  • Purpose: This study was conducted to determine risk of developing of breast cancer among Turkish women. Materials and Methods: Using a descriptive and cross-sectional approach, data were collected from 231 women. Breast cancer risk was calculated using the National Cancer Institute's on-line verson of called as the Breast Cancer Risk Assessment Tool or the Gail Risk Assesment Tool. Results: The average age of women was $45.0{\pm}8.06$ years. It was revealed that 6.1% of participants reported having first degree relatives who had had breast cancer, with only four women having more than one first-degree relative affected (1.7%). The mean five-year breast cancer risk for all women was $0.88{\pm}0.91%$, and 7.4% of women had a five-year breast cancer risk >1.66% in this study. Mean lifetime breast cancer risk up to age 90 years was $9.3{\pm}5.2%$. Conclusions: The breast cancer risk assessment tool can help in the clinical management of patient seeking advice concerning screening and prevention. Healthcare providers in Turkey can use this approach to estimate an individual's probability of developing breast cancer.

Factor Analysis on Behavior Change Mechanisms in Self-help Smoking Cessation (흡연행위의 자조적 변화기전에 대한 요인분석)

  • 오현수;김영란
    • Journal of Korean Academy of Nursing
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    • v.26 no.3
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    • pp.678-687
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    • 1996
  • Smoking is considered to be one of the important risk factors associated with various health problems. Thirty seven million people in America quit smoking in the past decade, with 90% quitting on their own(Americal Heart Association, 1986). According to McAlister(1975), 70% of smokers reported that they adopted a self-help smoking cessation approach rather than a formal treatment program. In our country, although, auccessful exsmokers have used, are not available, concerns about smoking cessation have increased, recently, due to changes in social and political attitudes to health promotion. This study was conducted to help smokers who had made a decision to adopt a self-helf smoking cessation approach instead of depending on a formal treatment program. It provided a structurd way for sucessful smoking cessation by identifying change mechanism factors which have been commonly used by smokers. The subjects selected for this study were 155 university students between 20 and 29. Years of age the results from the analysis of the collected data showed that seven factors in the self-help change processes significant, and they are named, Stimulus Control, Self-Determination, Information Management, Reinforcement Management, Helpful Relationships, Dramatic Relief, and Cognitive Restructuring. All of the factors except Self-Determination represent the same change mechanisms which are proposed by Prochaska et at.(1988). Self-Determination uniformly includes items belonging to various change processes. Therefore, it might be an transitional factor including strategies related to both cognitive and behavioral dimensions. In spite of this, noted that one item which gives meaning of Self-Determination shows the highest factor loading, it is named Self-Determination.

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A Grounded Approach to Bringing up experiences in Mothers who have the first baby (초산모의 양육경험에 대한 근거이론적 연구)

  • Kim, Mi-Jong
    • Korean Parent-Child Health Journal
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    • v.5 no.1
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    • pp.62-74
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    • 2002
  • The purpose of this study was to explore bringing-up process of mothers with first baby in the context of Korean culture. The field survey was performed with four primiparae during four months from September, 2000 and grounded theory approach was used for data analysis. The results indicated that there were 27 primary categories and 12 secondary categories. Unclearness was extracted as an expression of the core category of bringing-up process. The subjects was faced with care of their baby after delivery and experienced formation and deepening of unclearness. After that, they also went through expression and disentanglement of complication caused by unclearness. It is found that the core concept of this study, the unclereness("Magmagham" in Korean) means a confusion, a burden, a helplessness and a hardness. New mothers make an effort to resolve this situation with strong motherhood in their mind. By supports from significant others, they are empowered and some mothers get depressive feelings. The findings of this study are contributed for nurses to understand new mothers in developmental crisis. We suggested that the nursing intervention strategies including learning baby care skills and preparing emotionally a motherhood must be given new mother during pregnancy period.

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Multidisciplinary Approach to Breast Cancer Care

  • Juon, Hee-Soon
    • Perspectives in Nursing Science
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    • v.4 no.1
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    • pp.1-8
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    • 2007
  • Aim: The purpose of this paper is to present the importance of multidisciplinary strategies in cancer prevention and control, especially comprehensive breast cancer care. Background: Worldwide, breast cancer is the most common cancer diagnosed among women and is the leading cause of cancer deaths. Although the incidence of breast cancer in Asian countries is still lower than in Western countries, the rate of increase for the last two decades is striking. Methods: Data on cancer mortality, incidence, and risk factors were summarized by using the most recent data available from population-based cancer registries affiliated with the International Union Against Cancer, the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program and the CDC's National Program of Cancer Registries (NPCR). Results: Global differences in breast cancer incidence and fluctuations in rates within a country still exist. The incidence of breast cancer in Asian countries was lower than in Western countries. Breast cancer incidence in the United States decreased each year during 1999-2003. On the other hand, morbidity and mortality related to breast cancer in Asia has increased significantly. Conclusion: Multidisciplinary strategies to reduce breast cancer mortality and promote breast cancer awareness are addressed. Lessons learned from multidisciplinary approaches to cancer treatment and control will be valuable in implementing future breast cancer research in the fields of basic, clinical, and population research in Asia.

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Effects of Comfort Nursing Measures on Postoperative Recovery of Patient (안위대책 간호가 수술 후 회복에 미치는 영향)

  • 한윤복
    • Journal of Korean Academy of Nursing
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    • v.3 no.1
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    • pp.85-95
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    • 1972
  • For the purpose to clarify the effects of nursing, intervention with comfort measures which promote rest, exercise and sleep on the patient′s rehabilitation, this study was carried out on 119 postoperative patients at St. Mary′s Hospital, the National Medical Center and Seoul Red Cross Hospital during the 9 months period from March 1971 to November 1971. In this study one experimental nursing approach was utilized; an emphasis on interpersonal techniques along with physical care-comfort measures. A daily evening care including support and instruction was given to facilitate interaction of nursing to the experimental group by the investigator. For the control group, routine hospital nursing care was performed. The nursing observation was followed for 4 days postoperatively and recorded in check list. The results of the findings were as follows. 1. 3.5% of control group and 32.3% of experimental group got out of bed within 24 hours postoperatively. 38.6% of control group got out of bed within 72 hours postoperatively where only 16.1% of the experimental group did (x$^2$= 19.865, p<0.005). Interaction in nursing is, in turn, significantly more effective than the usual routine care in improving rate of healing. 2. The irritations and tension that may interfere patient′s sleep and rest at night can be reduced to a minimum if nursing environment is better controlled with planned nursing care for individual patient. Various treatments which tend to give patient discomfort may preferably be performed before 6 p.m. if not absolutely indicated. 3. During 4 days of observation the patients without administration of sedatives and analgesics postoperatively were 25.9% in the experimental group where as 10.5% in the control group. The frequency of administration of sedatives and analgesics in average was 1.4 in the experimental group, and 2.0 in the control group. This indicates that not all postoperative discomforts expressed by the patients should be regarded as incision pain, and those discomforts could be relieved to a certain extent by nursing interventions effectively. 4. There were significant differences between the responses to nursing care given in the experimental group and 33% of the control group in average through 4 days of observation responded "good". 3.6% of the experimental group and 17. 1% of the control group responded "poor" in this study. It was recommended that the study be replicated in a more defined and controlled manner. Some alternative areas for investigation were suggested.

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Ethnosientific Approach of Health Practice in Korea (한국인의 건강관행에 대한 민속과학적 접근)

  • 김귀분;최연희
    • Journal of Korean Academy of Nursing
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    • v.21 no.3
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    • pp.396-417
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    • 1991
  • In order that nursing care an essential quality of nursing practice be acceptable and satisfying, it is necessary that client's culture be respected and that nursing practice be appropriate to that culture. Since cultural elements are an important influence on health practices and life patterns related to medical treatment, recovery from and prevention of disease, nurses need to have an understanding and knowledge of social and cultural phenomena to aid in the planning of nursing interventions. To understand the health practices surrounding health and illness, the health beliefs and practices of both folk and professional healing systems should be ascertained. Cultural data are required to provide care of high quality to clients and to reduce possible conflict between the client and the nurse. It is nursing's goal to provide clients from various cultures with quality nursing care which is satisfying and valuable. The problem addressed by this study was to identify Korean health practices which would contribute to the planning of professional caring practice with the culture : ultimately this study was intended to make a contribution to the development of the science of nursing. The concrete objectives of this study were ; 1) to identify Korean health practices, 2) to interpret the identitial health practices through traditional cultural thought, and 3) to compare the Korean health practices with those of other cultures. The investigator used the ethnosceintific approach outlined by spradly in a qualitative study. To discover ancestral wisdom and knowledge related to traditional health practeces, the subjects of this study were selected from residents of a small rural mountain village in south west Korea, a place considered to be maintaining and transmitting the traditional culture in a relatively well -preserved state because of being isolated from the modern world. The number of subjects was 18, aged 71 to 89. Research data were collected from January 8 to March 31, 1990. Five categories of health practices were identified : “Manage one's own mind”, “Moderation in all thing”, “Live in accord with nature”, “Live in mutuality with others”, and “Live to the best of one's ability”. Values derived from these ways of thinking from Confucianism, Taoism and Buddhism help fashion a traditional way of life, examplified by the saying “Benifience to all”. Korean thought and philosophy is influenced primerily by Confucianism, Confucian principles of ethics, embedded deeply in the peoples' minds, form the idea that “heaven and human being are intimately united” based on concept that “heaven is, so to speak, reason”. Twoe Gae's theory of existential subjectivity develops the concept of self which is the basis of the spirit of reverence in modern Confucian philosophy. The human md is granted from heaven out of the idea of matter, and what control the mind is the spirit of reverence. Hence the idea of “The primacy of the mind" and provided that one should control one's own mind. The precepts of duty to parents, respect for elders and worship of ancestors, and moderation in all behavior put a restraint on life which directed that one live earnestly according to Nature's laws with their neighbors. Not only Confucianism, but also Buddism and Taoism have had an important effect upon these patterns of ideas. When compared with western culture, Korean health practices tend to be more inclusive, abstract and intuitive while westerner health practices found to be mere concrete, practical and personal. Values and beliefs based and pragmatism and existentialism infuence western civilization, Ethical values may be founded on utilitarianism, which considers what is good for the persons in their circumstances as the basis of conduct and takes a serious view of their practical lives including human aspirations rather than an absolute truth. These philosophical and ethical ideas are foundations for health practices related to active, practical and progressive attitudes. This study should be enable nursing not only to understand clients as reflections of the traditional culture when planning nursing practice, but to dovelop health education corresponding to cultural requiments for the purpose of protection against disease and improvement of health, and thus promote sound health practice. Eventually it is hoped that through these processes quality nursing care as the central idea of the science of nursing will be achieved.

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