• Perspectives in Nursing Science
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• 제10권1호
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• pp.12-23
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• 2013

Purpose: This study was conducted to investigate ICU nurses' perceptions of communication difficulties, the importance of and satisfaction with communication with doctors, other nurses, patients, and family, as well as to explore communication barrier with patient families. Methods: Investigators developed a 15-item communication perception questionnaire and 58-item communication barrier questionnaire. Communication barrier included 4 domains: nurses, family, environment, and patient condition. A total of 151 ICU nurses with a minimum of one year of ICU experience participated. Results: ICU patients ($3.38{\pm}0.73$) were the most difficult group to communicate with, followed by family ($3.32{\pm}0.72$), senior nurses ($3.25{\pm}0.74$), doctors ($3.21{\pm}0.68$), and nurse colleagues ($2.64{\pm}0.73$). Doctors ($4.61{\pm}0.53$) were the most important group to communicate with, followed by nurse colleagues ($4.52{\pm}0.54$), patients ($4.49{\pm}0.58$), senior nurses ($4.44{\pm}0.55$), and family ($4.43{\pm}0.61$). Satisfaction with communication was the highest with colleague nurses ($3.60{\pm}0.68$), then senior nurses ($3.37{\pm}0.74$), family ($3.18{\pm}0.71$), patients ($3.09{\pm}0.75$), and doctors ($3.06{\pm}0.83$).The total score of the communication barrier was $2.83{\pm}0.52$, where each domain was scored as follows: patient condition $3.13{\pm}0.74$, nurses $2.83{\pm}0.60$, environment $2.81{\pm}0.66$, and family $2.76{\pm}0.57$. The ICU nurses reported that communication was difficult due to 'sudden deterioration in the patient's condition', 'being too busy', 'a noisy environment', and 'information not being shared between family members.' Significant differences were noted by age, clinical experience, and marital status of nurse respondents. Conclusion: The findings indicated that development of a protocol on communication between nurses and doctors as well as development of an educational program on communication skills are necessary.

• 한국콘텐츠학회논문지
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• 제14권11호
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• pp.838-848
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• 2014

본 연구의 목적은 2% 클로르헥시딘 침상목욕 간호가 중환자실 입원환자의 MRSA (Methicillin-resistant Staphylococcus aureus) 발생률과 BSI (blood stream infection) 발생률에 미치는 효과를 검증하고 치료적인 침상목욕 방법을 제시하기 위함이다. 본 연구의 대상자는 서울에 소재한 1개 상급 종합병원의 내 외과계중환자실에 2010년 11월 1일부터 2011년 8월 15일까지 입실한 환자 전수로 하였으며, 실험군 188명, 대조군 199명으로 총 387명이었다. 2% 클로르헥시딘(MICROSHIELD $2^{(R)}$, 존슨앤존슨, 뉴질랜드) 침상목욕 간호를 실시한 실험군의 MRSA 발생률은 7.4%로 일반 비누와 액상 세정제를 사용하여 침상목욕 간호를 실시한 대조군의 MRSA 발생률 14.1%보다 유의하게 낮았다(p=.036). 실험군의 재원일수 1,000일당 MRSA 발생건수는 9.32건으로 대조군의 재원일수 1,000일당 발생건수 15.44건보다 낮았다(p=.099). 2% 클로르헥시딘 침상목욕 간호를 실시한 실험군의 BSI 발생률은 0.5%로 일반 비누와 액상 세정제를 사용하여 침상목욕 간호를 실시한 대조군의 BSI 발생률 5.0%보다 유의하게 낮았다(p=.011). 실험군의 재원일수 1,000일당 BSI 발생건수가 0.67건으로 대조군의 재원일수 1,000일당 발생건수 5.52건에 비해 낮게 나타났다(p=.052). 따라서 2% 클로르헥시딘 침상목욕 간호를 치료적 간호중재로 간호실무에 적극적으로 활용할 것을 제안한다.

• 대한간호학회지
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• 제29권2호
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• pp.215-224
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• 1999

The study was conducted to centum the construct of individual perception and preference for work characteristics as personal factors influencing Korean nurses' job satisfaction. The subjects of the study were 231 nurses who are currently working in intensive care units and have been for a minimum of 6 months. The study used the Staff Perception and Preference Scale(Song et al., 1997) to measure the individual's perception and preference on the technical. practice. and management components of the ideal work environment. The Korean version of the Staff Perception and Preference Scale consists of 16 items on perception and 13 on preference with each item related on a scale from 1(not at all) to 4(a great deal). Psychometric testing revealed that the preference and perception scale is internally consistent with Chronbach's alphas of .83 for perception scale arid .80 for preference scale. The subscales of the perception and preference scale also showed acceptable reliability for the early stage of the development of the instruments with Chronbach alphas of .62-.76 and .69-.83 respectively. Criterion-related validity of the scale was tested by examining correlations with individual growth need that is conceptually close to individual preference. but not to individual perception. Individual growth need was significantly related to individual preference(r＝.63, p<.05), but the correlation with the perception scale was not significant. A separate factor analysis for the each of perception and preference scales was performed with a three-factor loading solution based on a previous study. The results on the staff perception scale confirmed with varimax rotation that the items were cleanly and strongly loaded on technique. practice and management components, which together explained 50.7% of the variance. The factor analysis on the staff preference scale also yielded a three factor solution that explained 56.7% of the variance. but items on technique and management components were loaded together. This phenomena may due to the current nursing delivery system in Korea where nurses never experience either shared governance nor case management, and as a results they may not be able to consider management roles as their potential extended roles. Therefore, more efforts should be given to enhance nurses' autonomy and decision making in the technique, practice and management components of their work environment. Meanwhile, there is a need for continuously confirming and developing tools for individual perception and preferences to effectively enhance job satisfaction among Korean nurses through innovative work environments.

• 한국간호교육학회지
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• 제6권2호
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• pp.287-302
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• 2000

The purpose of the study are to examine the perception of the importance and performance of patient education of the clinical nurse and find out the interfering factors in practicing patient education. The data were collected from convenient sample of 256 clinical nurses working in the nursing units of adult patients except the psychiatric unit, obstetric unit, dental surgical unit and intensive care unit of one University Hospital in Seoul from September 29 to October 2, 1998. Three measurement tools of self-report- questionnaires developed by researcher used. For the content validity of the questionnaires, two sessions of panel discussion and a pilot test were done and finally factor analysis was done with Varimax method. Analysis of data was done with SAS program using frequency, percentage, means, standard deviation, Pearson's Correlation Coefficients, t-test and ANOVA. The obtained results were as follows : 1. The surveyed nurses perceived the importance of patient education at higher level with mean score of 4.08 among 5 point than their perception of practice( mean score : 3.42). 2. There was positive significant correlation(r=.29, p=0.0001)between nurses' perception of the importance of patient education and it's practice 3. Among the teaching contents for patients, 'information of diagnostic procedure and operation' and 'orientation of hospitalization' were perceived most important. And 'preparation for discharge' and 'understanding of disease and health promotion' were perceived least important 4. Among the teaching contents for patients, 'orientation of hospitalization' and 'information of diagnostic procedure and operation' were perceived highly performable. And 'understanding of disease and health promotion' and 'preparation for discharge' were perceived least performable. 5. Three types of interfering factors were identified as patient-factor, situational factor, nurse-factor. The mean degree of impediment with the interfering factors was at average level(3.09 among 5). The patient and situational factors of impediments were more interfering than nurse- factor for teaching patients. 6. In older age(p<.05), married state (p<.05), higher educational status (p<.01), higher clinical experience (p<.01) and higher position(p<.01), the score of perceived importance of patients education was more high. 7. In older age(p<.01), higher clinical experience(p<.001) and surgical unit (p<.01), the score of perceived performance of patients education was more high. In conclusion, in order to activate patient education practice in the clinical setting, the continuing education for patients education should be more emphasized and the effective teaching methods and materials should be developed to help patient teaching. And an organizational support such as budgeting for patient education and reimbursement system should be administrated.

• 산업경영시스템학회지
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• 제39권2호
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• pp.82-87
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• 2016

As contemporary society has become more complicated, specialized, and segmented, people are experiencing more diverse types of stress. In particular, while several factors associated with job stress have been examined among nurses, who belong to a professional group, the existing research has made no quantitative assessments of stress that reflect temporal differences in individuals. Therefore, the aim of this study is to understand the effects of job stress on alpha-amylase with regard to the working hours of nurses, to assess the variations in jobs stress over time, and provide basic data to improve the quality of nursing services. Ninety nurses working in three shifts in general, emergency, and intensive care wards of a university hospital in D City participated in this study. Salivary alpha-amylase (SAA) was extracted and analyzed at two-hour intervals from 07:00 to 15:00 from nurses on the day shift and from 23:00 to 07:00 from those working the night shift. The SAA level was highest between 23:00 and 01:00 for nurses in general wards ($mean{\pm}S.D.\;39.00{\pm}14.88$) and between 11:00 and 13:00 for those in both intensive care units and emergency wards ($mean{\pm}S.D.\;67.50{\pm}62.93$ and $mean{\pm}S.D.\;39.67{\pm}35.96$, respectively). The characteristic variation in SAA was significant between 23:00 and 01:00 (p < 0.01) and for those in their fifties or older (p < 0.01). The activation ratio of alpha-amylase, a stress reactant, showed an increase when the sympathetic nervous system was activated by mental stress; in addition, job stress was manifested with the effect of awakening at different time segments and at different ages among the nurses. With the aim of raising the level of service based on the nurses maintaining their mental health, it is necessary to focus sharply on the time segment for critical control and to conduct repetitive studies to determine the divisions of eustress critical values as well as to expand the population.

• Archives of Plastic Surgery
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• 제34권4호
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• pp.466-470
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• 2007

Purpose: Active prevention is an essential component in reducing the development of pressure sores. For the high-risk patient group, following the certified pressure sore screening scale as well as educating the patient and the nurses who care for them can lead to optimal management of these patients. Applying a risk assessment scale along with a prevention strategy can reduce medical costs and length of stays at the hospital. The purpose of this study is to evaluate the efficacy of a new pressure sore risk assessment scale based on the universally recommended Braden scale and our prevention program. Methods: From June to August, 2003, our pressure ulcer risk assessment scale was applied to a total of 1882 patients admitted to the experimental group (intensive care unit, neurosurgery, general surgery, and oncology units). It was based on Braden scale. We analysed sensitivity, specificity, positive and negative predictive value and ROC curve to evaluate its efficacy. Pressure ulcer prevention program was composed of patient's education using protocol and specific nursing care. The incidence of pressure ulcers was also measured during the 3 months period, and those were compared to the control group of 1789 patients from March to May, 2002. Results: 118(6.27%) of the experimental group were high-risk with an incidence of pressure ulcers measuring 4 (0.21%). Sensitivity, specificity, positive and negative predictive value of our scale were 100%, 94%, 4%, 100%, respectively, and AUC(area under the curve) was 0.992. In the control group, the incidence of pressure ulcers was 11(0.61%). Statistical analyses using chisquared tests with a significance level of 5%, the results were such that ${\chi }^2=3.6482$(p=0.0561). The results proved to be statistically significant in borderline. Conclusion: The results from this study proved that pressure sore risk assessment scale based on Braden scale has an excellent efficacy, and shows that our pressure ulcer prevention program is partially effective in reducing pressure ulcer incidence.

• 한국화재소방학회:학술대회논문집
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• 한국화재소방학회 2012년도 춘계학술발표회 초록집
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• pp.190-193
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• 2012

The tools that classify the severity of patients based on the prediction of mortality include APACHE, SAPS, and MPM. Theses tools rely crucially on the evaluation of patients' general clinical status on the first date of their admission to ICU. Nursing activities are one of the most crucial factors influencing on the quality of treatment that patients receive and one of the contributing factors for their prognosis and safety. The purpose of this study was to identify the goodness-of-fit of CPSCS of critical patient severity classification system(CPSCS) and Glasgow coma scale(GCS) and the clinical usefulness of its death rate prediction. Data were collected from the medical records of 187 neurological patients who were admitted to the ICU of C University Hospital. The data were analyzed through $x^2$ test, t-test, Mann-Whitney, Kruskal-Wallis, goodness-of-fit test, and ROC curve. In accordance with patients' general and clinical characteristics, patient mortality turned out to be statistically different depending on ICU stay, endotracheal intubation, central venous catheter, and severity by CPSCS. Homer-Lemeshow goodness-of-fit tests were CPSCS and GCS and the results of the discrimination test using the ROC curve were $CPSCS_0$,.734, $GCS_0$,.583, $CPSCS_{24}$,.734, $GCS_{24}$,.612, $CPSCS_{48}$,.591, $GCS_{48}$,.646, $CPSCS_{72}$,.622, and $GCS_{72}$,.623. Logistic regression analysis showed that each point on the CPSCS score signifies1.034 higher likelihood of dying. Applied to neurologically ill patients, early CPSCS scores can be regarded as a useful tool.

• 한국콘텐츠학회논문지
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• 제18권12호
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• pp.75-91
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• 2018

여성이 대다수인 간호전문직에 남자간호사가 점차 증가하고 있으나, 그들은 성 고정관념에 따른 사회적 장벽에 부딪히며, 부서배치 등에서 차별을 경험하고 있었다. 본 연구는 병원 종사자들을 대상으로 성 역할 정체감과 성 고정관념이 남자간호사에 대한 편견에 미치는 영향을 확인하기 위하여 시도되었다. 연구 결과 양성성 집단은 성 고정관념과 남자간호사에 대한 편견이 다른 집단에 비해 낮았으며, 병원종사자들은 남자 간호사들이 일반인들에게 낯설고 생소하며, 응급실, 중환자실, 수술실 같은 병원의 특수 부서에서 주로 일할 것이라는 편견을 가지고 있었고, 성 고정관념은 남자간호사에 대한 편견에 양의 상관관계가 있었다. 따라서 의료기관은 남자간호사에 대한 편견을 해소하기 위해 양성 평등적인 조직문화를 구축하기 위한 계획을 수립하여 성 고정관념을 탈피하기 위해 노력하고, 간호조직 내에서 남성과 여성이 동등한 기회를 부여받을 수 있도록 해야 할 것이다.

• 한국생활과학회지
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• 제18권4호
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• pp.841-855
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• 2009

The main objective of this study is to examine the situations of group-homes for the elderly and clarify the problems of them. This study investigates the present conditions of welfare facilities and supply conditions. 4 group-homes were surveyed in Jeonju and Kwangju cities. Data was collected through various ways including the survey conducted by facility operators, the measurement of living space, and photo-takings. The major results of this study are as follows: 1) With the introduction of nursing care insurance in 2008, the increase of the demand and supply to group-home will be expected, due to less cost for recuperation. The care of elderly in homelike atmosphere is effective to the elderly suffering from dementia. Therefore, it is proper that the supply of group-homes for dementia will be needed. 2) Group-homes for the elderly are being supplied under the standards of welfare facilities in the present. Separate supply standards, however, are needed because they are not suitable for small scale group-homes. 3) To supply Group-homes for the elderly on a one-unit basis would cause various problems such as economical unreality, personnel distribution and so on. It is necessary to supply more than two units for more efficient management. 4) The management of group-homes for the elderly is financially unstable because the operating funds heavily depend on the users or people who are connected with the facilities through private networks. Therefore, additional support is needed to settle the financial problem. It would be helpful to build the public networking that provides information about the group-home for the elderly for the public. 5) In case of the increase in the supply of the group-home in a residential area, it could be helpful to promote the group-home to the public. 6) The operators state that the main problems of group homes for the elderly lie in financial difficulties and the shortage of professionals and volunteers. The financial, personnel, and material support for personnel and the supervision of management are required for the transparency and effectiveness of the facility management. In addition, the closer network and cooperation system with the community is required. 7) The present living environments for group-homes for the elderly leave much room for improvement, considering the physical condition of the elderly. The more careful selections in the color, shape, material, and equipment of the facilities should be made for the convenience of the elderly users.

• 대한간호학회지
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• 제22권4호
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• pp.491-505
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• 1992

The purpose of this research was to understand the structure of the lived experience of parents of a child terminally ill with cancer The research question was “What is the structure of the experience of parents of a child terminally ill with cancer\ulcorner” The sample consisted of 17 parents of children admitted to the cancer units of two university hospitals in Seoul. The unstructured interviews were carried out from October 10, 1991 through January 10, 1992. They were audio-recorded and analysed using Van Kaam's method. Parents ascribed the cause of the cancer to the mother's emotional imbalance during pregnancy, the mother's stress, failure to observe religious rites, food, the parent's sin, misfortune and pollution. The theme clusters were tension, fear and depression experienced during pregnancy, stress that children suffer from abusive parents, failure to observe religious activites, bad luck, and sins committed during a previous life. When the child suffered a recurrence of cancer, the parents experienced negative emotions, nervousness, sorrow. depression and death. The theme clusters were feelings of despair, helplessness, regret, guilt, insecurity, emptyness and apathy. The long struggle with cancer resulted in the loss of economic security, loss of psychological and physical well being, and social withdrawal. The theme clusters were the economic burden of medical cost, giving up treatment, debt, limited medical insurance coverage and blood transfusion. The loss of psychological well being included stress, lack of support systems, inability to carry out responsibilities, lack of trust of the medical ten family breakdown, inappropriate expression of emotion and not disclosing the diagnosis to the child. Physically the parents suffered fatigue, insomnia, loss of appetite, loss of weight, dizzness, headache, psychosomatic symptoms, and increased consumption of liquor and cigarettes. Social withdrawal was manifested by taking time off from work to look after the child, decrease of outside social activities and feelings of isolation. Influences on family life were spousal conflicts, negative response of siblings, separation of the family members and economic hardship. The theme clusters were blaming a spouse for the cause of the illness and disagreements, maladjustment, lonliness, hostility and depression of siblings. The high price of medical care over the long period was a major factor influencing the life of the family. Positive experiences during the child's long illness were the strengthening of support systems and religious beliefs and financial help from social organizations. The support of one's spouse primarily helped to overcome the stress of the long illness. In addition, support was received from parents of other children with cancer and from nurses and religious leaders. The nurse, by providing empathetic support, should be a person with whom parents can express their feelings and share their experiences.