• 제목/요약/키워드: Nursing approach

검색결과 945건 처리시간 0.021초

다층모형을 적용한 조혈모세포이식 환자의 삶의 질 변화 영향요인 (Factors Influencing Changes in Quality of Life in Patients undergoing Hematopoietic Stem Cell Transplantation: A Longitudinal and Multilevel Analysis)

  • 송지은;소향숙
    • 대한간호학회지
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    • 제45권5호
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    • pp.694-703
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    • 2015
  • Purpose: This study was a prospective longitudinal study to identify changes in quality of life in patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT). It was based on Roy's adaptation model. Methods: The questionnaires were administered before HSCT, 30 and 100 days after HSCT. Of the 48 potentially eligible patients, 44 (91.7%) participated in the study and 40 (90.9%) completed the questionnaires at 100 days after HSCT. Multilevel analysis was applied to analyze changes in quality of life. Results: Overall, quality of life showed a decreasing tendency from pre-HSCT to 100 days after HSCT. The adaptation level of participants was compensatory. Type of conditioning was the significant factor influencing quality of life before HSCT (${\beta}_{00}$=79.92, p <.001; ${\beta}_{01}$= - 12.64, p <.001) and the change rate of quality of life (${\beta}_{10}$= - 1.66, p =.020; ${\beta}_{11}$=2.88, p =.014). Symptom severity (${\beta}_{20}$= - 1.81, p =.004), depression (${\beta}_{30}$= - 0.58, p =.001), social dependency (${\beta}_{40}$= - 0.35, p =.165), and loneliness (${\beta}_{50}$= - 0.23, p =.065) had a negative effect on changes in quality of life. Symptom severity and depression were statistically significant factors influencing changes in quality of life. Conclusion: According to the results of this study, the development of nursing intervention is needed to improve quality of life in patients undergoing allogeneic hematopoietic stem cell transplantation in the early immune reconstruction period. The interventions should include programs to enhance coping capacity and programs to help control symptom severity and depression. Also these interventions need to be started from the beginning of HSCT and a multidisciplinary approach would be helpful.

고혈압환자의 자가간호행위 유형에 관한 연구 : Q 방법론 적용 (A Study on Self-care Behavior Types of Hypertensives : Q-methodological Approach)

  • 박영임
    • 한국간호교육학회지
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    • 제5권1호
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    • pp.39-57
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    • 1999
  • Essential hypertension is a typical chronic disease requiring adequate and continuous management. And many studies supported that self-care was the essential factor to promote the wellbeing. The purpose of this study is to identify and understand the behavior patterns of self-care in hypertensives. As a research method, 35 Q-statements were collected through Individual interviews and review of the related literatures. 21 subjects were interviewed and the data were analyzed by the PC QUANL program with principal component analysis. There were 6 different self-care types classified as follows 1) Type 1 was the self-oriented control type, monitoring the blood pressure and taking the low salt diet. But they didn't take the anti -hypertensive drug and visit the health agency regularly. 2) Type 2 was the stress-control type. Their main activities were meditation to relieve the stress and communication with family. 3) Type 3 was called daily-life control type. This type tried to make their mind comfort and think positively. They also preferred walking and exercise regularly. 4) Type 4 was the medical-oriented control type, taking the anti-hypertensive drug, visiting the medical personnel and following the medical regimens. 5) Type 5 was the medication-oriented type. They only took the anti -hypertensive drug regularly and didn't any other self-care like as monitoring the blood pressure, taking the low salt diet and exercise. 6) Type 6 was called non-medication control type. This type had no medication, but tried to visit the health agency and health personnel. From the above results, it can be concluded that the self-care types were very various and self-care education have to provide individually according to the characteristics of self-care type. Another repeated study can be recommended to improve the nursing intervention the self-care behavior in chronic patient like as diabetics or rheumatoid arthritis.

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심장이식 수혜자의 사회적지지, 우울 및 건강상태 (Social Support, Depression and Health Status in Heart Transplantation Recipients)

  • 박병준;신나미
    • 중환자간호학회지
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    • 제7권1호
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    • pp.11-23
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    • 2014
  • Purpose: As the number of cases of heart transplantation (HT) and the survival rate have increased, concerns regarding post-HT life have grown. This study was conducted to explore the relationships of perceived social support to the depression and health status of HT recipients. Methods: This descriptive study targeted all recipients who had undergone HT at S University Hospital since 1994, and 32 recipients were recruited. Results: 90.6% of the recipients were men, and the average age at the time of surgery was $47.4{\pm}13.4$ years. The ejection fraction was increased from $18.47{\pm}5.63%$ to $63.25{\pm}7.57%$, and 31 cases of New York Heart Association (NYHA) class III and IV improved to class I or II after HT. The patients reported mild depression even with high perceived social support and improved health status after HT. Among those resource persons who offered support, they reported their spouse, doctors, and nurses as most meaningful to them. Conclusion: This study confirmed the positive effects of HT on the recipients' physical improvement. It also added the discovery that the importance of recipients' subjective perception of social support might be critical for their more successful recovery and adjustment to post-HT life. Focusing on a different approach to social support and types of social resources in the recovery phase is suggested for future studies on quality of life after HT.

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제 2형 당뇨 환자의 식이, 신체활동, 자가간호, 자기효능감과 심혈관 합병증 위험요소간의 관계 (The Relationship of Diet, Physical Activities, Self-efficacy, and Self-care with Cardiovascular Risk Factors among Clients with Type II Diabetes)

  • 이해정;김명수
    • 성인간호학회지
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    • 제19권2호
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    • pp.283-294
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    • 2007
  • Purpose: The purpose of this study was to identify predictors of cardiovascular risk factors of type 2 diabetic patients. Methods: Diabetic patients (N=160) were interviewed from November, 2003 to June, 2004. The 24 hour dietary recall, the International Physical Activity Questionnaire, the Diabetes Management Self-Efficacy Scale for patient with Type 2 diabetes, the Revised Summary of Diabetes Self-Care Activities Measure Scale and Parma Cardiovascular Risk Index were used to measure the predictors. Data were analyzed by descriptive analyses, Pearson correlation coefficients, and stepwise multiple regression using the SPSS WIN 10.0. Results: Mean dietary intakes of the participants were protein(P) of 64.5g, carbohydrate(C) of 280.74g, fat(F) of 30g, and calcium of 511.45mg. The ratio of CPF was 75:17:8. About 45% of the participants didn't exercise on a regular basis. The levels of self-efficacy, self-care, and cardiovascular risk factors of the participants were moderate. Self-efficacy was the most important predictor of cardiovascular risk factors along with self-care, exercising for more than 6 months, carbohydrate intakes and levels of physical activities. Conclusion: The findings of the study suggest that intervention programs increasing self-efficacy on diabetic management would be more beneficial than the fractional approach focusing only on diet or physical activities.

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문제중심학습방법 (Problem Based Learning : PBL) : 간호교육에 있어서의 새로운 학습방법 (Problem Based Learning : New teaching and learning strategy in nursing education)

  • 김희순
    • 한국간호교육학회지
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    • 제3권
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    • pp.26-33
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    • 1997
  • Problem-Based Learning(PBL) is at the forefront of educational reform. The acceptance of PBL as an educational approach with wide application represents a major change in thinking about educational processes and their relationships to the wider community. In 1969, PBL as a method was introduced at the Medical School of McMaster University in Hamilton, Canada. The most important advantages in PBL are acquiring knowledge that can be retrieved and applied, learning to learn(self-directed learning) and learning to analyze and solve Problems. PBL is widely used within the sector where it had its origin, namely health profession education. A generally accepted starting point in the development of a problem-based curriculum is the set of professional competencies of future graduates, which describe the typical problems professionals have to deal with. Formulating learning objectives highly depends on the format and content of the presented problems. Contrary to that, in a classic course in higher education, it is customary that teachers express objectives in a compulsory subject matter. Curricula which advocate problem-based learning generally use case studies in the form of paper cases, simulations and real patients with the intention of stimulating classroom discussion of clinical and basic science concepts within a problem-solving framework. One goal of using paper cases is to stimulate the learning of basic science within a clinical situation. Through self-directed study the students solve problems and explore the psycho-social dimensions within the cases. The general outcome based on the program evaluation research of PBL is that PBL students respond positively about the learning experience. In summary, PBL is a curriculum design and a teaching/learning strategy which simultaneously develops higher order thinking and disciplinary knowledge bases and skills by placing students in the active role of practitioners(or problem solvers) confronted with a situation(ill-structured problem) which reflects the real world.

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Village Voices: Lessons about Processes for Disease Prevention from a Qualitative Study of Family Health Leaders in a Community in Northeastern Thailand

  • Jongudomkarn, D;Singhawara, P;Macduff, C
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권10호
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    • pp.4401-4408
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    • 2015
  • Background: Cancer is a primary source of concern in Thailand and other countries around the world, including the Asian-Pacific region. Evidence supports that an important contributing cause of cancer and other chronic illnesses such as stroke, diabetes, and hypertension is excessive alcohol consumption. Studies conducted in Thailand reveal a worrisome rise in the number of new and regular drinkers in communities. Therefore, actions for primary, secondary and tertiary prevention of problem drinking are necessary. In recent years nurses in North East Thailand have been developing and implementing the Khon Kaen Family Health Nursing model to embed disease prevention in communities through the actions of family health nurses and local family health leaders. Aim: The aim of this qualitative research was to better understand the experiences of the local family health leaders using this model and to synthesize lessons learned. Materials and Methods: As part of a participatory action research approach involving analysis of focus group discussions and individual interviews, the experiences of 45 family health leaders were synthesized. Results: Four main themes were identified, namely: i) Family first: role modeling beginning at the personal and family level. ii) Local leverage: using village community forums to reduce alcohol drinking. iii) Gentle growth: making the first step and treading gently; and iv) Respect, Redemption, Rehabilitation: valuing the person to re-integrate them in the village society. Conclusions: As alcohol consumption in the village declined significantly following the prevention program, these findings illuminate how low-tech integrated prevention approaches may be very useful, particularly in rural communities. The lessons learned may have relevance not only in Thailand but in other countries seeking to prevent and mitigate behavior that conduces to diseases such as cancer.

한국 중년여성의 성인 자녀와의 분리경험에 대한 근거이론적 접근 (A Grounded Theory Approach on the Parting Experience of Korean Middle-aged Women with their Children)

  • 신수진;박복남;강효영
    • 성인간호학회지
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    • 제17권5호
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    • pp.719-731
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    • 2005
  • Purpose: This research was conducted to explore the experience of middle-aged women parting with their children and to develop a grounded theory. Method: The participants were 11 women in their 50's who had experienced parting with their children due to schooling, military service and marriage. The grounded theory methodology based on symbolic interactionism was used. Results: 106 concepts, 30 subcategories and 14 categories were derived from the analysis through processes of open coding, axial coding and selective coding. The central phenomenon was 'happy but sad' and the core category was a process of 'independence that is sorrowful yet delightful'. Four types were identified; the independent-type; submissive -type; family-reliant-type ; and fragile-type; based on the attachment to the child, state of mind, satisfaction of the situation, family support system and self-achievement. Conclusion: This research identified that the modern Korean middle-aged women who are considered to be the 'sandwich generation' since they have experienced a turbulent history and the change from a confucian parent-child lifestyle to a couple-oriented one, moved away from an attitude dependent on children in parting with them and started preparing for an independent late life. Based on the results, the verification research is advised on the variables that affect the experience of parting with children.

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한국 중년 여성의 운동 생활문화에 관한 탐색적 연구 - Q 방법론적 접근 - (An Inquiry into Exercise Behaviors of Middle-aged Women in Korea - A Q-methodological approach -)

  • 윤은자;류은정
    • 성인간호학회지
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    • 제15권1호
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    • pp.94-104
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    • 2003
  • Purpose: This study was performed to identify the factors which affected exercise and the perceived exercise behaviors in women according to Q-methodology and to provide basic strategies for health promotion of middle-aged women in Korea. Method: Q-methodology provides a scientific method for identifying perception structures that exist within certain individuals or groups. Thirty subjects in Seoul, Incheon, Chung-buk classified 35 selected Q-statements in to 9 points standard. The collected data was analyzed by using a QUANL pc program. Result: Principal component analysis identified 3 types of exercise behavior of middle-aged women in Korea and named by the researcher. They are called persistent activity preference type, living-exercise preference type, exercise mania type. In persistent activity preference type, the middle-aged women thought activity was very helpful to achieving health and releasing stress or fatigue. Also, they recognized the relationship between physical health and psychological health. In living-exercise preference type, the middle-aged women preferred maintaining stability or nonactivity to intended exercise or activity for health. In exercise mania type, the middle-aged women thought there was no other way to keep her health than to exercise. Conclusion: The findings of this study will provide the health care provider including nurse with useful information. It's very important to offer appropriate exercise intervention to the middle-aged women of each type by taking into consideration the characteristics of individual types.

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대학생의 정신건강 예측구조모형 (Prediction Structure Model of Mental Health of University Students)

  • 전미경;오경옥
    • 디지털융복합연구
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    • 제15권2호
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    • pp.251-262
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    • 2017
  • 본 연구는 Bronfenbrenner의 생태학적 체계이론을 바탕으로 대학생의 정신건강에 영향을 미치는 요인을 구분하고 통합적인 모형 구축과 정신건강 증진을 위한 간호중재 개발의 기틀을 마련하고자 한다. 연구방법은 횡단적 조사연구로 대학생을 대상으로 하였다. 일반적 특성 및 정신건강관련 특성은 SPSS 20.0 프로그램을, 모형의 적합도검증, 가설검증은 Amos 20.0 프로그램을 이용하였다. 연구결과에서 모형의 적합도 지수는 $x^2=614.90$(p=.000), Q값=3.5, GFI=.88, AGFI=.84, NFI=.92, NNFI=.94, CFI=.94, RMR=.02, RMSEA=.08 적합도를 나타내어 연구모형이 가정에 적합한 것으로 나타났다. 연구결과 정신건강에 스트레스가 가장 높은 영향을 미치고 있으며 스트레스 대처 방안과 자아 존중감, 부모의 양육태도가 정신건강에 영향을 미치는 것으로 확인되었다. 대학생의 정신건강을 증진시키기 위해서는 스트레스 관리, 자아존중감 증진, 스트레스 대처 능력 향상을 도모하는 간호중재를 개발하고, 학교현장 및 정신보건 실무에 활용하는 중재가 수행되어야 할 것으로 생각된다.

소방공무원의 대처, 자기노출, 반추, 조직문화가 외상 후 성장에 미치는 영향 (Influence of Coping, Self-Disclosure, Ruminant, and Organizational Culture on Traumatic Growth of Firefighters)

  • 고영심;하영미;김지아;조한아
    • 디지털융복합연구
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    • 제18권4호
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    • pp.357-369
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    • 2020
  • 본 연구는 소방공무원의 대처, 자기노출, 반추, 조직문화와 외상 후 성장(Posttraumatic Growth, PTG)의 정도를 살펴보고, PTG의 영향요인 규명을 위해 시행되었다. 자료수집은 경상도 소재 3개 소방서에 근무하는 소방공무원 103명을 대상으로 실시하였다. 연구결과 중~고 수준 PTG가 46명(44.7%)로 평균 58.07점이었으며 전체 PTG 평균은 44.56점으로 나타났다. PTG에 영향을 미치는 요인은 정서중심대처, 자기노출, 의도적 반추와 혁신지향 조직문화로 나타났으며 네 변수의 PTG에 대한 설명력은 45.9%로 나타났다. 소방공무원의 PTG촉진을 위해 정서중심대처, 자기노출, 의도적 반추 뿐 아니라 혁신지향 문화구축이라는 조직측면의 접근이 필요하며 이러한 결과는 소방공무원의 PTG 향상을 위한 중재방안에 활용될 수 있다.