• 제목/요약/키워드: Nursing approach

검색결과 945건 처리시간 0.029초

결손가정 중학생의 생활경험 (Life Experiences of Middle School Students from Broken Homes)

  • 최지현;정연강;염순교
    • 한국학교보건학회지
    • /
    • 제10권2호
    • /
    • pp.271-283
    • /
    • 1997
  • This study is designed for the school health education, contributing experience of life from middle school students from broken homes by describing specifically what they go through. And on this basis this study works out a grounded theory on the experience of life for middle school students from broken homes. The data was collected through a series of interviews with nine subjects singled out at each stage of research. With the permission of the subjects, the interviews were recorded and transcribed. The interviews lasted from 30 minutes up to one hour and 20 minutes. The in-depth interviewing methods and observations was used for data collection. The data was analyzed in the framework of grounded theory as mapped out by Strauss & Corbin (1990). By analyzing the materials eighty-three concepts were extracted, and they were united into 21 subordinate categories through the course of analysis. These were classified into nine precedence categories. The core category was found to be the adaptation of 'Wichookdem" or "Shrinkage". "Shrinkage" widows experienced was showed as the results "Self-reliance" and "Overcoming" through the course of generation and reaction, confrontation, and adaptation. According to the analysis findings of materials, the central phenomenon was showed as "shrinkage", the causal condition as "surprise", "Darkness", "Grudge", "Desolate", "Empty". The veins as presence of those around people and existence of support, and the meditate situation as self-support. For the strategy in solving "shrinkage", preparations of countermeasure and self-reinforcement were showed. And self-reliance and overcoming were the results. Through the contrast to the cases of ground materials, relation statements as follows were induced; (1) The weaker the suffering is, the weaker the "shrinkage" tends to be. (2) The stronger the suffering is, the stronger the "shrinkage" tends to be. (3) The more frequent and serious the suffering, the stronger the "shrinkage" tend to be. (4) The more infrequent and not serious the suffering is, the weaker the "shrinkage" tends to be. (5) The weaker the "shrinkage" is, the more self-control1ed the responses tends to be. (6) The stronger the "shrinkage" is, the more impulsive the responses tends to be. (7) The more satisfying the support is, the more self-controlled the responses to the "shrinkage" tends to be. (8) The more dissatisfying the support is, the more impulsive the responses to the "shrinkage" tends to be. (9) The more concrete the type of support is, the more self-controlled the responses to the "shrinkage" tends to be. (10) The more superficial the type of support is, the more impulsive the responses to the "shrinkage" tends to be. (11) The more self-controlled the responses are, the more self-reliant the subjects tends to be. (12) The more impulsive the responses are, the more conflict and wandering the subjects tends to be. (13) Whether the responses to the "shrinkage" express themselves in self-control or an impulse, it will be resulted in the form of either tension or pain. The following two were confirmed on the basis of repetitive relations; (1) If a subject's suffering is weak, infrequent and not serious, the "shrinkage" is weak. Also the subject's support is highly satisfying, and the support type is concrete. The responses to the "shrinkage" result in self-control which consequence is self-reliance with part. of it resulting in tension and pain. (2) If a subject's suffering is strong, frequent and serious, the "shrinkage" is strong. Also the subject's support is dissatisfying, and the support type is superficial. The responses to the "shrinkage" result in an impulsion whose consequence is wandering with part of it resulting in tension and pain. Through the results in this study, the following is to be suggested; O This research is basically aimed at analyzing the experience of the middle school students living in broken homes, for the more inclusive approach, the study for them is made systematically according to the type of their problems.

  • PDF

만성관절염 환자의 대응양상정도와 관련변수 분석 -원점수와 상대점수를 이용한 비교- (Comparison of Raw versus Relative scores in the Assessment of Coping Patterns in Chronic Arthritis Patients)

  • 전정자;문미숙
    • 근관절건강학회지
    • /
    • 제3권1호
    • /
    • pp.90-103
    • /
    • 1996
  • The purpose of this paper is to compare two approach to assessment of coping patterns. The sampling method was a purposive sampling technique. The study participants were out patients 113 of rheumatoid arthritis center of one University hospitals in Seoul. Datas were collected from Nov. 13 to Nov. 24, 1995. The instruments used for this study were Graphic Rating Scales of pain, The Beck Depression Inventory and Coping Patterns tool. The collected data were analyzed for frequency, means, SD, factor analysis., Pearsons' correlations and ANOVA. The results were summerized as follows ; 1. When raw scores were used : there were not correlation in all three coping patterns. 2. When relative scores were used : there were significantly correlated in all three coping patterns. 1) Active coping and Positive-cognitive coping (r=-0.352, p< 0.0001) 2) Positive-cognitive coping and Negative-cognitive coping (r=-0.594, p< 0.0001) 3) Active coping and Negative-cognitive coping(r=-0.544, p< 0.0001) The results of this research with relative scales provided more insight into the correlation in all three coping patterns. 3. Pearsons' Correlations were computed for each coping pattern, age, pain level, duration of pain and BDI. 1) Using raw score : (1) Active coping was significantly related to pain level(sensory score ; r=0.268, p<0.05, affective score ; r=0.266, p< 0.05) (2) Positive-cognitive coping was significantly related to age (r=-0.252, p< 0.05), pain level (sensory score ; r= -0.244, p< 0.05) (3) Negative-cognitive coping was significantly related to depression level (r=0.312 p< 0.0001). 2) Using relative score (1) Active coping was significantly related to pain level(sensory score ; r=0.299, p<0.05, affective score ; r=0.246, p< 0.05) (2) Positive-cognitive coping was significantly related to age (r= -0.187, P< 0.05), pain level (sensory score ; r=-0.317, p<0.0001, affective score : r=-0.305, p<0.0001) and depression level(-0.339, p<0.0001)) (3) Negative-cognitive coping was significantly related to depression. level(r=0.313, p<0.0001). 4. When raw and realtive coping scores were compared to those of age groups, religious groups and BDI level(high, middle, low) ; 1) Using raw score : (1) Active coping : there were not significantly difference (2) Positive-cognitive coping ; 20-39 age group and 50-59age group had significantly higher scores than over 60age group. BDI-low level group had significantly higher scores than other groups. (3) Negative-cognitive coping : 20-39age group and over 60age group had significantly higher scores than 40-49age group. Non-religious group had significantly higher scores than christian group. BDI-high level group had significantly higher scores than other groups. 2) Using relative score : (1) Active coping : over 60 age group had significantly higher scores than 20-39 age group and 40-49age group had significantly higher scores than 20-39 age group (2) Positive-cognitive coping ; 40-49age group, 20-39age group and 50-59age group had significantly higher scores than over 60age group. Christian group had significantly higher scores than non-religious group. BDI-low level group had significantly higher scores than other groups. (3) Negative-cognitive coping ; Non-religious group had significantly higher scores than christian group and buddhistic group. BDI-high level group had significantly higher scores than other groups. The current data suggest that relative scores may yield a different perspective on coping patters than raw scores. The use of relative scores reveals the relation clearly, without its being blurred statistically by the effect of other coping strategies or being relegated to a partial correlation. The use of relative scores holds promise for delineating the relations between ways of coping and health-related behavior.

  • PDF

완화 병동에서 임종기 섬망의 변화 양상과 선행 요인 (The Changing Patterns and Predisposing Factors of Delirium at End of Life in Palliative Care Unit)

  • 임미루;김상구;최서현;조진현;이문희;김혜영;배재남;이정섭;김원형
    • 정신신체의학
    • /
    • 제26권2호
    • /
    • pp.94-101
    • /
    • 2018
  • 연구목적 본 연구는 완화병동에 입원한 환자들에서 사망 직전에 발생하는 임종기 섬망의 발생을 사망 전 2주시점 전부터 관찰하여 변화양상과 선행 요인을 관찰한 연구이다. 방 법 2015년 10월부터 2017년 8월까지, 일 대학병원 완화병동에 입원한 말기 암환자 최종 180명을 대상으로 후향적 연구를 진행하였다. 대상자는 매일 3회 Richmond Agitation Sedation Scale과 Nursing Delirium Screening Scale로써 섬망의 세가지 아형으로 진단되었다. 결 과 임종 13일 전 섬망의 빈도는 46%였으며, 그 중 18.3%는 과활동성, 13.8%는 저활동성 그리고 혼합성 아형은 13.8%를 차지하였다. 과활동성 섬망은 임종일까지 점차 감소하는 양상이었으며, 저활동성 아형과 혼합성 아형의 섬망은 임종 4일 전까지 점차 증가하는 양상이었다. 임종 하루 전 86.9%의 환자들은 섬망으로 진단되었다. 다변량 분석에서 위장관 암보다 혈액학적 암이 낮은 임종기 섬망과 연관이 있었으며 과체중도 낮은 임종기 섬망과 연관이 있었다. 결 론 많은 완화의료 환자들은 섬망을 경험하였으며, 과체중은 임종기의 모든 아형의 섬망을 낮추는 보호인자로 고려되었다. 차후 임종기 섬망의 빈도와 위험 인자를 밝히는 전향적 연구가 필요할 것이다.

일반인 대상 웰 다잉 교육프로그램 개발을 위한 모델링에 관한 연구 (The Journal of Targeted at the general public for the Modeling of Well-dying Program Development)

  • 김광환;김용하;안상윤;이종형;이무식;김문준;박아르마;황혜정;심문숙;송현동
    • 디지털융복합연구
    • /
    • 제12권8호
    • /
    • pp.369-376
    • /
    • 2014
  • 죽음교육의 주체이자 대상인 의료진의 죽음에 대한 스트레스 정도와 수용방식을'병원 공간을 중심으로'분석하여 죽음교육에 활용하고자, 2014년 4월부터 동년 4월30일까지 대전지역 일반인 281명을 대상으로 조사했다. 분석 결과 죽음교육의 필요성에 대해, 죽음교육을 받은 경우 더 중요하다고 생각하였다. 환자가 회불 불가상태인 경우 의료진은 누구에게 알리는가의 물음에 전체적으로는 보호자가 가장 높았으며, 임종하기 적합한 장소로는 살던집이 가장 많았고, 의료기관, 사회복지시설 순으로 나타났다. 이상과 같은 결과를 활용하면 죽음이라는 현상을 이해하고 다룸에 있어 보건의료적 시각과 인문학적 시각, 사회적 시각을 동시에 수용하여 일반인에게 적용할 수 있는 죽음 교육 프로그램 개발을 위한 연구로 죽음준비프로그램을 대중화 일반화를 위한 기초자료로써 의의가 있다고 할 수 있다.

The Histone Methyltransferase Inhibitor BIX01294 Inhibits HIF-1α Stability and Angiogenesis

  • Oh, Su Young;Seok, Ji Yoon;Choi, Young Sun;Lee, Sung Hee;Bae, Jong-Sup;Lee, You Mie
    • Molecules and Cells
    • /
    • 제38권6호
    • /
    • pp.528-534
    • /
    • 2015
  • Hypoxia-inducible factor (HIF) is a key regulator of tumor growth and angiogenesis. Recent studies have shown that, BIX01294, a G9a histone methyltransferase (HMT)-specific inhibitor, induces apoptosis and inhibits the proliferation, migration, and invasion of cancer cells. However, not many studies have investigated whether inhibition of G9a HMT can modulate HIF-$1{\alpha}$ stability and angiogenesis. Here, we show that BIX01294 dose-dependently decreases levels of HIF-$1{\alpha}$ in HepG2 human hepatocellular carcinoma cells. The half-life of HIF-$1{\alpha}$, expression of proline hydroxylase 2 (PHD2), hydroxylated HIF-$1{\alpha}$ and von Hippel-Lindau protein (pVHL) under hypoxic conditions were decreased by BIX01294. The mRNA expression and secretion of vascular endothelial growth factor (VEGF) were also significantly reduced by BIX01294 under hypoxic conditions in HepG2 cells. BIX01294 remarkably decreased angiogenic activity induced by VEGF in vitro, ex vivo, and in vivo, as demonstrated by assays using human umbilical vein endothelial cells (HUVECs), mouse aortic rings, and chick chorioallantoic membranes (CAMs), respectively. Furthermore, BIX01294 suppressed VEGF-induced matrix metalloproteinase 2 (MMP2) activity and inhibited VEGF-induced phosphorylation of VEGF receptor 2 (VEGFR-2), focal adhesion kinase (FAK), and paxillin in HUVECs. In addition, BIX01294 inhibited VEGF-induced formation of actin cytoskeletal stress fibers. In conclusion, we demonstrated that BIX01294 inhibits HIF-$1{\alpha}$ stability and VEGF-induced angiogenesis through the VEGFR-2 signaling pathway and actin cytoskeletal remodeling, indicating a promising approach for developing novel therapeutics to stop tumor progression.

뇌졸중환자의 신체적, 정신적, 사회적 요인이 건강증진행위에 미치는 효과 (The Effect of Physical and Psychological, and Social factors on Health Promotion Behavior among the stroke patients)

  • 김은주
    • 한국산학기술학회논문지
    • /
    • 제16권12호
    • /
    • pp.8525-8534
    • /
    • 2015
  • 본 연구는 신체적, 정신적, 사회적 요인이 뇌졸중환자의 건강증진행위에 미치는 효과를 파악하고자 실시하였다. 연구 대상자는 뇌졸중으로 진단받고 병원에 입원중인 환자 223명이었다. 자료분석은 기술적 통계, t-tset, ANOVA, pearson correlation과 Structural Equation Analysis을 사용하였다. 그 결과 건강증진행위와 상관관계에서는 주관적 건강(r=.56, p=.000), 가족지지(r=.68, p=.000), 의료적 지지(r=.65, p=.000), 피로(r=.27, p=.004), 행위의도(r=.75, p=.000)와 상관관계가 있었다. 뇌졸중환자의 건강증진행위에 영향을 미치는 요인으로는 신체적 요인인 수면(${\beta}$=-.156, p=.014), 정신적 요인인 주관적 건강(${\beta}$ =.283, p=.001), 행위의도(${\beta}$=.362, p=.000), 사회적 요인인 가족지지(${\beta}$=.219, p=.010), 의료적지지(${\beta}$=.246, p=.004)가 유의한 영향요인임을 알 수 있었다. 결론적으로, 뇌졸중환자의 건강증진행위는 수면이 좋을수록, 주관적 건강, 행위의도, 가족지지 의료적 지지가 높을수록 건강증진행위 점수가 높게 나타나 정신적, 사회적 요인이 건강증진행위에 중요한 요인임을 알 수 있었다. 그러므로, 사회심리적인 맞춤형 접근이 뇌졸중환자 건강을 유지, 증진, 재발예방을 위한 건강증진행위 프로그램 기초자료로 활용할 수 있다는데 의의가 있다.

대학생의 도박행동: 자기통제력의 매개효과 및 다집단 분석 (College Students' Gambling Behavior: Mediating Effect of Self-Control and Multiple Group Analysis)

  • 김덕진
    • 한국산학기술학회논문지
    • /
    • 제18권6호
    • /
    • pp.197-208
    • /
    • 2017
  • 본 연구는 대학생의 도박행동과 관련된 선행연구와 문헌고찰을 토대로 가설적 모형을 구축하고 검정함으로써, 예방적 차원에서 학교 및 지역사회 정신보건 실무에 기초자료를 제공하고자 수행되었다. 대학생의 도박행동과 관련된 선행요인으로는 인지적 요인, 심리적 요인, 사회적 요인 그리고 자기통제력을 포함시켰다. 인지적 요인(비합리적 도박신념), 심리적 요인(우울, 불안), 사회적 요인(부모의 감독, 부모의 지지, 친구의 지지)은 외생변수로, 자기통제력과 도박행동(도박경험, 도박수준)은 내생변수로 하여 가설적 모형을 구성하였다. 또한 성별, 음주, 흡연, 인터넷 사용시간, 스마트폰 사용시간, 친구의 도박행동, 가족의 도박행동을 조절변수로 설정하여 그 효과를 분석하였다. 본 연구의 표적모집단은 국내의 대학생이며, 근접 모집단은 1개 광역도시와 4개의 지역도시에 소재한 7개 대학교에 재학 중인 남, 여 대학생 246명이다. 자료수집은 2016년 1월 25일부터 3월 31일까지 이루어졌으며, 자료분석은 SPSS 21.0과 AMOS 20.0 Program을 이용하여 공분산 구조분석을 실시하였다. 대학생의 도박행동을 예측하는 여러 요인들 중에서 자기통제력의 효과가 가장 크고, 예측된 모든 변수들에 대한 자기통제력의 매개효과가 나타났다. 따라서 대학생의 도박행동을 예방하기 위한 중재 개발 시 자기통제력을 증진시키는 방안을 우선적으로 고려할 것과 개인의 인지적, 심리적 요인과 사회적 요인들을 개선시킴으로써 자기통제력을 증진시키는 방안이 필요할 것으로 사료된다. 또한 성별을 고려한 접근 및 가족이나 친구를 포함하는 집단상담 프로그램 개발이 필요할 것으로 본다.

The Decision-Making Journey of Malaysian Women with Early Breast Cancer: A Qualitative Study

  • Abdullah, Adina;Abdullah, Khatijah Lim;Yip, Cheng Har;Teo, Soo-Hwang;Taib, Nur Aishah;Ng, Chirk Jenn
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제14권12호
    • /
    • pp.7143-7147
    • /
    • 2013
  • Background: The survival outcomes for women presenting with early breast cancer are influenced by treatment decisions. In Malaysia, survival outcome is generally poor due to late presentation. Of those who present early, many refuse treatment for complementary therapy. Objective: This study aimed to explore the decision making experiences of women with early breast cancer. Materials and Methods: A qualitative study using individual in-depth interviews was conducted to capture the decision making process of women with early breast cancer in Malaysia. We used purposive sampling to recruit women yet to undergo surgical treatment. A total of eight participants consented and were interviewed using a semi-structured interview guide. These women were recruited from a period of one week after they were informed of their diagnoses. A topic guide, based on the Ottawa decision support framework (ODSF), was used to facilitate the interviews, which were audio recorded, transcribed and analysed using a thematic approach. Results: We identified four phases in the decision-making process of women with early breast cancer: discovery (pre-diagnosis); confirmatory ('receiving bad news'); deliberation; and decision (making a decision). These phases ranged from when women first discovered abnormalities in their breasts to them making final surgical treatment decisions. Information was vital in guiding these women. Support from family members, friends, healthcare professionals as well as survivors also has an influencing role. However, the final say on treatment decision was from themselves. Conclusions: The treatment decision for women with early breast cancer in Malaysia is a result of information they gather on their decision making journey. This journey starts with diagnosis. The women's spouses, friends, family members and healthcare professionals play different roles as information providers and supporters at different stages of treatment decisions. However, the final treatment decision is influenced mainly by women's own experiences, knowledge and understanding.

여대생의 피부건강관리에 대한 주관성 연구 : Q 방법론적 접근 (A Research on the Subjectivity of the Female University Students Regarding the Management of the Health of the Skin: An Application of Q-methodology)

  • 윤정아
    • 한국융합학회논문지
    • /
    • 제9권7호
    • /
    • pp.277-283
    • /
    • 2018
  • 본 연구는 Q 방법론을 적용하여 여대생의 피부건강관리에 대하여 개인들이 가지고 있는 주관성의 유형을 파악하고, 그 특징을 비교 분석하고자 시도하였다. 연구대상은 일개 대학 여대생 41명을 P표본으로 하여 총 141개의 Q 모집단으로부터 34개의 Q표본을 선택하여 9점 척도 상에 강제 분포하도록 하였으며, 대상자를 인터뷰하고 그에 대한 내용을 기록하였다. 자료는 QUANL program으로 분석하였다. 연구 결과 4개의 유형이 발견되었으며, 피부 관리에 있어 전문성을 중요시 하는 '전문적 지식 추구형', 기능성 화장품보다는 자연피부의 중요성을 나타내는 '자연지향형', 고기능성 화장품이나 적극적 피부관리를 추구하는 '적극적 자기관리형', 건강보다는 외형적인 부분을 중요시하는 '자기 과시형'으로 나타났다. 따라서 본 연구결과를 바탕으로 여대생의 피부건강관리에 대한 각 유형별 특성을 이해하고 이에 따른 피부건강관리를 위한 차별화된 교육방법이나 접근방법이 고려되어야 할 것이다.

한국 시설호스피스의 원리와 실제

  • 강승계;김수호;김신수;박희명;송근옥;원주희;이명숙;이성옥;이옥제;이은의;이채영;이현미;허필석
    • 호스피스학술지
    • /
    • 제2권1호
    • /
    • pp.87-111
    • /
    • 2002
  • The hospice activities in Korea have still stood in the premature stage, although the contemporary hospice program, which professionally accommodates terminally ill patients, appeared in the history 35 years ago. Especially, the availability of the facility hospice is not only poor in number, but also lack of a guideline for the conduct of the facility. Saemmul Hospice has keenly felt the necessity of more facility hospices and has interchanged experiences and informations with people interested in hospice. However, the number of facilities has fallen short of one's expectations, and many problems have been revealed in order to maintain the operation. This paper was written in order to improve these atmospheres and to help more terminally ill cancer patients properly. This paper clarifies in detail the principle of management, the method of practice in each departments of Saemmul Hospice, expected effects and supplemental items. We try to provide concrete and practical informations and to help extensively for all peoples who are to begin or currently working. 1.Facility: It secures, maintain, and manage the hospice environment for all around care of patients effectively. 2.Education and Volunteer: It trains and manages hospice volunteers devoted to hospice. 3.Financial: It manages donation by healthy soul with an effective method. 4.Administration and Organization: It executes the administration efficiently and constitutes the organization to operate. 5.Medical and Nursing: It offers the maximum professional supports to a hospital. 6.Medicine and alternative medicine: It improves the quality of life of patients by medical and pharmaceutical approach and by other possible methods available. 7.Nutrition: It helps patients to have diets in accord with the order of the creation. 8.Belief: It offers spiritual care which allows the profound relationship with God. 9. Funeral ceremonies: Funeral ceremonies may heal grieves of families faced with their deaths. 10. Bereaved families: It supports the families after the deaths of patients. 11.Reception and consultation: It seeks to help the patients who meet the purposes for which Saemmul Hospice is established. 12.Publication: It allows publicity activities for Saemmul Hospice. Facility hospice programs are able to overcome the disadvantages that the other type of the hospice possess, like as the economic burdens of the families, and the patients' losses of comforts of home after being transferred to a hospital. Facility hospice can provide home atmosphere with professional manpower and facilities like hospital to the patients. Therefore, it can also improve patients' qualities of life and make them comfortable death. We anticipate that the hospice program in Korea would be more active to let more people be indebted to maintain the nobel human dignity and to cross beautifully in the most painful process of dying in the journey of their lives.

  • PDF