• 제목/요약/키워드: Nursing approach

검색결과 945건 처리시간 0.031초

섬유근통증후군 환자의 질병 적응경험에 관한 근거이론 연구 (A Grounded Theory Approach on Peoples' Adaptation Experience with Fibromyalgia Syndrome)

  • 정추영;김명희
    • 한국산학기술학회논문지
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    • 제17권12호
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    • pp.381-393
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    • 2016
  • 본 연구는 근거이론 연구방법을 통해 섬유근통증후군 환자의 질병경험과 적응과정을 파악하고 이해하여 실체이론을 도출하고자 하였다. 본 연구의 참여자는 1개의 종합병원 류마티스 내과 외래에서 섬유근통증후군를 치료 중인 13명(여성 12명과 남성 1명)이다. 자료 수집은 2014년 1월부터 5월까지 개별 심층면담을 통해 이루어졌다. 이론적 표본추출법은 이론적 포화의 시점을 적용하였다. 필사된 면담의 내용은 Corbin과 Strauss (2008)의 근거이론방법으로 분석하였다. 연구결과 개방코딩을 통해 총 98개 개념과 26개 하위범주, 10개 범주가 도출되었다. 섬유근통증후군 환자의 질병 적응과정은 '불확실성과 한계상황인식'과 '자기통제 가능성 평가와 기대수준 결정', '적응전략 개발과 시도', '자기조절'의 4단계로 나타났다. 섬유근통증후군환자의 질병적응 유형은 확장형과 안정형, 표출형, 위축형의 4가지 유형으로 파악되었다. 또한 핵심범주인 '자기조절법 터득하기'로부터 '보호적 자기조절' 이론이 도출되었다. 본 연구결과 섬유근통증후군 환자들은 질병으로 인해 불확실한 상황에서 안정상태를 찾기 위해 자기조절을 반복적으로 활용하여 적응해가고 있음을 알 수 있었다. 따라서 본 연구결과를 근거로 대상자들의 질병 적응 유형에 따른 적합한 간호중재 및 가족을 포함하는 교육 프로그램의 개발이 필요할 것으로 사료된다.

체온측정시간 및 고막체온계의 정확도와 신뢰도에 관한 연구 (Study on the Body Temperature Measuring Time and Accuracy and Reliability of Tympanic Thermometer)

  • 정인숙;유은정
    • 기본간호학회지
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    • 제4권1호
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    • pp.19-30
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    • 1997
  • This study was to investigate the method for shortening the body temperature (BT) because it takes a long time and is impractical to measure axillary or oral BT with mercury thermometer, The first approach was to identify BT change according to the measuring time and determine the clinically not statistically avaiable and optimal BT measuring time. The second was to test the accuracy of tympanic thermometer. It can measure BT within a few seconds, so if it is approved accurate, we can save BT measuring time by substitute tympanic thermometer for mercury thermometer. This study was conducted from 1, to 30 June, 1996. The subjects were 12men students of medicalk college and 29 women students of nursing school. The results were as follows ; 1) The 3, 5, 7, 9, 11, 13minute-measured axillary BT and 3, 5, 7, minute-measured BT showed somewhat linear relationship with time. It was difficult to find the optimum measuring time which were clinically significant. 2) For axillary tempeiature, the measuring time which were not statistically different was 11 and 13minute. But the real BT difference between 3 and 13minute, or between 5 and 13minute were very small and was within the range of daily variation. 3) For oral temperature, there was no intervals which showed the statistically insignificant. But like as axillary temperature, the difference between 3 and 7, or 5 and 7 minute were trivial by $0.3^{\circ}C$ and by $0.1^{\circ}C$ respectively. 4) Tympanic temperatures were lower than oral BTs which were measured with mercury thermometer by $0.26^{\circ}C$ (with ear tug) and $0.15^{\circ}C$(without ear tug). 5) The reliability of repeated measure tympanic temperature was better than without ear tug. With above results, we can't determine the optimal and cilically significant oral and axillary measuring time using mercury thermometer. However, because the real differences between measuring times were very small, so we recommend further study for the aged, the infants and the febrile patients. And we can't sure the accuracy of tympanic temperature but the reliability was better with ear tug than without ear tug.

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결핵환자 간호에 있어서 가정방문이 미치는 영향에 관한 조사 연구 (A Comparative Study of the Effects of Public Health Nursing: Home Visits to Patients with Tuberculosis)

  • 서미혜
    • 대한간호학회지
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    • 제4권1호
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    • pp.151-161
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    • 1974
  • Home visiting as a Public Health Horsing function is believed to be of therapeutic value to, the patient. However, home visiting is time consuming and expensive. Is the gain in knowledge and treatment for patients with Tuberculosis in Korea enough to make the necessary outlay in finances and personnel worthwhile\ulcorner While this study does not attempt to completely answer this question it does, under the following objectives, attempt to answer part of the question. The objectives of the study were to l) ascertain if there is a difference between patients, who receive home visits from the public Health Nurse and those who do not, in the following areas: a) their compliance with medical regimen, b) their ability to answer general questions about Tuberculosis, and c) their compliance with medical advice concerning prevention (B.C.G. immunization) and early diagnosis (contact X-rays), and 2) to determine if there is any correlation between the patient's answers to questions about Tuberculosis and his action both in the areas of treatment and prevention. The patients participating in the study were all newly diagnosed patients at Kwangju Christian Hospital. A control group and an experimental group were selected. The patients in the control group were seen according to the regular schedule at the Kwangju Christian Hospital except that they received no home visits from the Public Health Nurses. The patients in the experimental group were visited on an average of three times during the first two months of their treatment by the investigator, a Public Health Nurse. At the end of two months the patients in the two groups were compared as to compliance both in the treatment and preventive areas. They were also compared according to their answers to a questionnaire regarding both the prevention and treatment of Tuberculosis. The following results were obtained : 1. Patients in the experimental group (68.2%) showed a significantly higher compliance rate for medical treatment than patients in the control group (43.2%). 2. Patients in the experimental group (87.5%) showed a higher compliance rate for B.C.G. immunization than those in the control group (40%). 3. Women patients in the experimental group showed a higher mean score (7.2$\pm$2.6) on the questionnaire than did women in the control group (6.2$\pm$3.4). The results of this study seem to indicate that while home visiting is beneficial to the patient with Tuberculosis as far as treatment is concerned, something more concrete needs to be done if home visiting is to help the patient learn more about Tuberculosis and its prevention. Further study is indicated in the following areas: 1) A similar type of study over a longer period of time involving more subjects and using Korean Public Health Nurses to make the home visits. 2) Study to develop an adequate approach to education considering the problems unique to patients with Tuberculosis living in Korea.

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신생아 제대관리방법에 따른 제대탈락 시기와 제대주위 피부상태 비교 (Umbilical cord care differences in the time of cord separation and the skin condition of periumbilical area)

  • 박영애;김동연;최문진;박호란
    • Child Health Nursing Research
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    • 제6권2호
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    • pp.158-166
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    • 2000
  • The purpose of this study was to confirm the efficient umbilical cord care of healthy newborns in nursery. In order to determine the efficient care, the time of umbilical cord separation and the skin condition of periumbilical area were evaluated. The data were collected in sample of 529 normal, healthy newborns of C hospital in Seoul, from September 1st, 1999 to January 16th, 2000. The babies were randomly selected and allocated into four groups-alcohol swab/tub bath, alcohol swab/partial bath, natural dry/tub bath, natural dry/partial bath- by the methods of care. The mothers of babies were also surveyed by questionnaire about general characteristics. The data were analyzed by SAS program. The results of this study were as follows : 1. The average gestation period of newborns was 39+3 weeks. The average birth weight was 3.27Kg. In gender of babies, boys were 51.7% and girls were 48.3%. The 65% of newborns were born normal vaginal delivery, 35% were C-section. The feeding methods were 55.3% of the babies fed by mixed type, 22.9% by breast, and 21.8% by bottle. There was no significance among four groups by general characteristics. 2. The average time of umbilical cord separation was 8.27 days(SD=2.3). The time was no difference significantly among four groups(F=1.68, P=0.17). 3. The prevalence of the umbilical care complication did not show differences among four groups( 2=3.93, P=0.27). In conclusion, Nurses have preferred the traditional alcohol swab/partial bath method in care of newborns. But there was no difference among the ways to take care of umbilicus according to this study. The way to naturally is more efficient due to reduce the time and expense in umbilical care for normal babies of nursery. This also matched the change in approach to healthy population from intervention to nonintervention way. This could be suggested in education for normal and healthy babies care at home and nursery as a useful way. Endly, the further study about bacterial colony nda infection rate at umbilicus by ways of care is needed.

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한국 변호사들의 연명치료중단에 대한 태도 (Attitude of Korean Lawyers toward Withdrawal of Life Sustaining Treatment)

  • 이경남;김분한;이훈희
    • Journal of Hospice and Palliative Care
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    • 제13권2호
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    • pp.81-88
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    • 2010
  • 목적: 본 연구는 연명치료중단에 대한 한국변호사들의 태도유형을 구분하고, 각 유형별 특성과 유형별 차이점을 파악하는 주관성 연구를 위해 실시되었다. 방법: 본 연구 설계는 Q 방법론을 이용하였다. 본 연구의 대상자는 32~69세의 변호사 24명을 대상으로 하였다. 연명치료중단에 대한 태도 유형을 확인하기 위한 Q 표본은 이들 중 5인을 대상으로 한 심층면담, 문헌고찰, TV토론을 통해 확보하여 34문항의 진술문을 구성하였다. 대상자에게 연구의 목적과 방법을 설명하여 동의를 구한 후 인구사회학적 특성을 파악하기 위한 질문지를 작성하였고, 9점 Q 표본 분포도상에 강제 분포하도록 하였다. 결과: 수집된 자료는 QUANL PC 프로그램으로 처리하여 최종적으로 유형을 구분하였다. 그 결과 5가지 유형이 구분되었으며, 제1유형은 연명치료중단에 대한 확고한 신념이 있는 '연명치료중단 선택형', 제2유형은 비용이 얼마나 소요되든지 생명연장술을 시행하여야 한다는 '생명연장술 추구형', 제3유형은 연명치료중단이나 생명연장술이나 모두 인간의 권리에 해당하며, 이런 권리를 충분히 행사하기 위해 제도적 장치를 요구하는 '제도요구형', 제4유형은 연명치료중단에 동의를 하지만, 본인은 연명치료중단을 선택하지 않을 것이라는 모순된 태도를 보이는 '자기모순형', 제5유형은 생명은 하나님만이 판단할 수 있다고 하고, 인간에게는 죽음을 선택할 권리가 없다는 '인명재천형'으로 분석되었다. 결론: 연명치료중단에 대한 한국 변호사들의 태도는, 제1유형 '연명치료중단 선택형', 제2유형 '생명연장술 추구형', 제3유형 '제도요구형', 제4유형 '자기모순형', 제5유형 '인명재천형'으로 나타났다.

간호사신문에 게재된 일-가정 양립 주제분석 (A Thematic Analysis of Nurses' Work-Family Balance in the Korean Nurses Association News)

  • 김미영;이경주
    • 한국산학기술학회논문지
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    • 제17권2호
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    • pp.446-457
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    • 2016
  • 본 연구는 질적 주제 분석방법을 적용하여 간호사신문에서 간호사의 일-가정 양립을 위한 주제가 어떻게 다루어지고 있는지 조사하였다. 자료 수집은 2012년 9월 14일부터 2015년 2월 10일까지 간호사신문 웹 사이트를 통해 수집하였으며, 분석 대상은 2000년부터 2014년까지의 일-가정 양립 관련 기사 총 473건이었다. 연구결과 일-가정 양립 정부정책, 일-가정 양립을 위한 대한간호협회의 활동 등 2개의 주제와 10개의 하부주제가 도출되었다. 일-가정 양립 정부정책으로는 육아 휴가 정책, 자녀양육 지원정책, 근무제도 개선정책, 가족친화적 문화정책이며, 일-가정 양립을 위한 대한간호협회의 활동으로는 다양한 근무형태 도입을 위한 활동, 24시간 직장보육시설 확충을 위한 활동, 유휴간호인력 지원 활동, 건강한 출산 양육환경 조성 활동, 가족친화적인 직장 환경을 위한 활동, 대체인력을 확보하기 위한 활동으로 도출되었다. 지난 15년간 일-가정 양립을 다룬 기사의 수는 양적으로 증가하는 양상이었으며, 국가적 사건이나 사회 분위기에 따라 그 관심의 정도가 다르게 나타났고, 대한간호협회의 활동이 정부의 정책과 유기적인 관련성을 나타냈다. 간호사신문이 일-가정 양립과 관련하여 앞으로 선도해야 할 방향은 양성평등을 대변하는 젠더관점으로의 전환, 모성보호관련 이행이 취약한 실태나 문제점 등을 심층적으로 공론화하는 등 간호사의 입장을 대변해야 함을 시사한다.

An Intervention Model to Help Clients to Seek Their Own Hope Experiences: The Narrative Communication Model of Hope Seeking Intervention

  • Kim, Dal Sook;Kim, Hesook Suzie;Thorne, Sally
    • Journal of Hospice and Palliative Care
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    • 제20권1호
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    • pp.1-7
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    • 2017
  • 이 논문은 개인적으로 경험되는 독특한 희망경험을 찾도록 도와주기 위하여 저자들이 개발한 "희망 찾기 내러티브 커뮤니케이션 모델"에 대하여 서술한다. 모델은 희망과 희망경험의 본질에 대한 문헌 및 저자들의 연구결과들과 주관적인 의미들과 경험들로서 희망 개념, 개인 특수한 희망경험에 접촉하기 위한 방법으로서 이야기하기 과정 및 내러티브 구성의 개념, 그리고 개인중심커뮤니케이션의 통합에 근거 개발되었다. 모델을 적용한 한 연구의 희망 찾기 경험은 모델을 한층 명확하게 하였다. 개인중심커뮤니케이션을 통하여 이야기하기와 내러티브 구성을 통합하는 모델은 세 요소들-이야기하기 요소, 내러티브 중재 요소, 커뮤니케이션 요소-로 구성된다. 이러한 요소들은 화자로서의 대상자가 희망경험의 근본인 개인 특수 주제적 플롯을 가진 희망 내러티브를 생산하는데 필수적으로 요구되는 커뮤니케이션 촉진자로서의 중재자의 적극적인 참여 속에서 개인-특수 희망경험을 찾는 것을 목적으로 하는 하나의 중재로서 과정화된다. 대상자에서 이 모델을 적용하여 성공적인 개인 희망경험 찾기의 긍정적인 결과가 나타났다. 이 모델의 성공은 중재자의 모델에 대한 이해와 개인중심-커뮤니케이션 전략 적용능력에 기인된 것으로 보인다.

농촌형 노인 주간보호시설 모형개발 (Development of a Model of a Day Care Center for Rural Elderly People)

  • 강경숙
    • 지역사회간호학회지
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    • 제15권4호
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    • pp.551-565
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    • 2004
  • Purpose: The purpose of this study is to develop a day care center model focused on public health institutions for the elderly residing in their homes. Method: Research design for this study was a mult-level research, which consisted of a related literature review, an Internet search for knowledge of the current situation at home and abroad, on-site interviews, questionnaires collected from a sample of residents in a rural area, and a key-informants approach. Results: 1) The subjects of service - Generalized service should be provided to the elderly, 65 years and older, regardless of their assets. 2) The contents of service - Providing pre-health oriented and post-social welfare service that can integrate and satisfy a wide variety of public health and welfare needs of the elderly would strengthen the health care service of a day care center for the elderly. 3) Delivery system - Basic-level local self-governments should become a central operating body, and establishing a properly adjusted delivery system to a rural area after considering the efficiency and the access of vulnerable rural areas is needed based on modification of 'a Special Law for Agricultural and Fishery Areas' (rural public health center>rural health sub-center ${\rightarrow}$ unified health sub-center ${\rightarrow}$ public health hospital (public health center) ${\rightarrow}$ public welfare office). 4) Facility - Public health facilities such as public health centers and sub-centers should be located in areas that can easily access the facilities. 5) Funding - For day care center for the elderly in local self-government, the central government should modify a relevant implementation of subsidy in and provide some facilities and service regardless of the degree of self reliance of local self-government. 6) Human resources - It is needed to guarantee the period of workers of a day care center for the elderly, at least 3 to 5 years, with considering their specialty on aged care and avoiding circulation based positions. Furthermore, appropriate specially trained personnel such as medical workers and social workers should be placed to take care of both health service and welfare through strengthening of 'rules of law of elderly welfare,' Conclusion: future research is needed to test the model through a demonstration study using a model which may be developed in the future and to standardize the appraisal criteria of people hoping to enter a day care center for the elderly.

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정신과 입원환자의 입원기간에 따른 불안정도에 관한 연구 (A Study of the Anxiety Levels of Hospitalized Psychiatric Patients in Terms of Length of Hospitalization)

  • 김윤희
    • 대한간호학회지
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    • 제11권1호
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    • pp.45-63
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    • 1981
  • This study was done to determine the relationship between the anxiety levels of hospitalized psychiatric patients and various influencing variables. The purpose of this study was to determine factors that may help hospitalized psychiatric patients to experience lower levels of anxiety in relation to changing situations and provide the basic data for a dynamic approach which is important in the field of modern psychiatric nursing that understands and analyses the meaning of patients behavior. The anxiety may produce stress, which is a common experience among all human beings. Patients may merely feel uncomfortable in the state of mild anxiety, however, the severe state could be an obstacle to treatment and recovery from disease. The anxiety of the psychiatric patient is a factor which greatly influencing the patient's behavior, so his disorderd behavior is an expression of defence or pathologically fixed behavior. According the psychiatric patient's anxiety at the time of admission is the concern of the health team. The nurse's special concern has to do with understanding and supporting the patient and meeting his individual needs by frequent close contact during the entire hospitalization period, compared to other teamembers the nurse's responsibility in this regard is greated. So this study emphasizes the necessity of creating conditions these, but above all the psychiatric nurse should create a therapeutic environment by not only regarding the patient's behavior or symptoms but understanding the meaning of them. The subjects of this study were 57 psychiatric patients selected from the K neuropsychiatric hospital located in Kunsan city. Data were collected twice from the same patients within a 24 hour period after admission and 10 days after admission. (September 18th to November 8th, 1980). The data collected method was through direct interview, and the interview time was 20 minutes for each patient. Data analysis included Item Analysis & Internal Consistency Reliability Tests, Percentages, t-test, analysis of variance and stepwise multiple regression analysis. The findings of this study were as follows. A. Test of Hypothesis a. Hypothesis 1 :“The anxiety level of psychiatric patients within 24 hours after admission will be higher than those of the same patients 10 days after admission,”was accepted. (t = 3. 15 ; p < 0.005) b. Hypothesi 2:“The more the number of admissions the higher the level of anxiety related to two categories”, was accepted. (affective anxiety: F = 5.50, p < 0.005, Somatic anxiety: F = 9.12, p <.

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영아어머니의 자녀돌봄의 부담감과 지지, 교육 및 상담요구에 관한 조사연구 (The study on the maternal burden of caretaking, the support and educational need for the caretaking activities of the infants′ mother)

  • 한경자
    • Child Health Nursing Research
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    • 제3권2호
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    • pp.228-240
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    • 1997
  • It is important to asess the risk factors of parenting and provide early intervention for promotion of the maternal caretaking ability. The purpose of the study was to identify the maternal burden of caretaking, the supporting and the educational need for the caretaking activities of the mother of infant. Sixty three mothers of infants who visited the wellbaby clinic of S university hospital and one health center during the period of November 1st, to 30th in 1996 comprised the subjects of this study, Data were gathered through the instruments that were developed by researcher. Statistical analysis of this study was used ANOVA and Pearson correlation. The results were as follows : 1) The mean score of the maternal burden of caretaking was 22.06. The maternal burden of caretaking was significantly high in the mothers who had vaginal delivery compare with the mothers who had caeserean section and in the muthers who gave artificial feeding compare with the group of breast or mixed feeding. 2) The mean score of the support need for the caretaking activities was 30.69. The support need for the caretaking activities was significantly high in the mothers who had the second child, compare with the mothers who had first or third child. And the support need for the caretaking activities was significantly high in the mothers who had caretaking help compare with the mothers who had no caretaking help. The specific subjects of 'mother-infant interaction', 'immunization' and 'prevention of accident' on the support need for the caretaking activities were relatively high. 3) The mean score of the educational need of caretaking activities was 29.3. The educational need of caretaking activities was significantly high in the mother who had the second child compare with the mothers who had first or third child. And the educational need of caretaking activities was significantly high in the mothers who had caretaking help compare with the mothers who had no caretaking help. The specific subjects of 'mother-infant interaction', 'emergency care' and 'prevention of accident' on educational need of caretaking were relatively high. 4) The maternal burden of caretaking was not correlated with the support need or the educational need of caretaking activities. But the support need of caretaking activities was significantly correlated with the educational need of caretaking activities. 5) The support and educational need of caretaking activities were significantly high in the mothers who wanted home care for caretaking their infants. Through the study, it was found that there is considerable maternal burden of caretaking as well as the support and educational need on the caretaking activities in the mothers whose child is young. Therefore developing the systematic and effective program is needed to meet the mother's need. The results of this study will be useful resources to develop the program. On the other hand, it can be recommanded that home health care will be one of the approach to support the mothers caretaking activities.

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