• 제목/요약/키워드: Nursing intervention

검색결과 4,738건 처리시간 0.031초

중년여성의 우울 구조모형 (A Structural Model for Depression in Middle-aged Women)

  • 박금자;이경혜
    • 여성건강간호학회지
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    • 제8권1호
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    • pp.69-84
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    • 2002
  • The purpose of this study was to develope and test the structural model for depression in middle-aged women. A hypothetical model was constructed on the basis of previous studies and a review of literatures. The conceptual framework was built around eight constructs. Exogenous variables included in this model were volunteer activity, health status & economic status. Endogenous variables were meaning of life, self-esteem, perceived life stress & depression. Empirical data for testing the hypothetical model was collected using a self-report questionnaire from 216 middle-aged women in Pusan City. The Data was collected from May to June, 1999. Reliability of the seven instruments tested with Cronbach's alpha was ranged from .86-.94. For the data analysis, SPSS 7.5 WIN Program and LISREL 8.12 WIN Program were used for descriptive statistics and covariance structural analysis. The results of covariance structure analysis were as follows: 1. The hypothetical model showed a good fit with the empirical data. [$x^2$/df=2.87(p=.72), GFI=1.00, AGFI=.98, RMSR=.025, NFI=.99, standardized residuals ($-1.44{\sim}1.44$)]. 2. To heighten for the parsimony and fitness of the model, a modified model was constructed by deleting according to the criteria of statistical significance and meaning. 3. The modified model also showed a good fit with the data. [$x^2$=5.26(01=7,p=.63), GFI=.99, AGFl=.97, RMSR=.025, NFI=.99, standardized reslduals ($-1.50{\sim}1.45$)] Results of the testing of the hypothesis were as follows : 1. Self-esteem(${\beta}_{42}$=-.48, t=-5.64) had a negative and perceived life stress(${\beta}_{43}$=.20, t=3.21)had a positive direct effect on depression. Meaning of life had a negative direct(${\beta}_{41}$=-.17, t=-2.19) and a negative indirect effect through self-esteem on depression. Volunteer activity had a negative indirect effect through meaning of life, meaning of life and self-esteem on depression. Health status had a negative direct and a negative indirect effect through meaning of life, meaning of life and self-esteem on depression. Economic status had a negative indirect effect through perceived life stress on depression. Self-esteem was the most significant variable. 2. Volunteer activity(${\gamma}_{11}$=.43, t=6.78) and health status(${\gamma}_{12}$=.35, t=4.88) had positive direct effect on meaning of life. 3. Meaning of life(${\beta}_{21}$=.50, t=6.53) had a positive direct effect on self-esteem. Volunteer activity had a positive indirect effect through meaning of life on self-esteem. Health status had a positive direct(${\gamma}_{22}$=.18, t=2.23) and a indirect effect through meaning of life on self-esteem. Meaning of life was the most significant variable. 4. Economic status (${\gamma}_{33}$=-.44, t값=-6.01) had a positive direct effect on perceived life stress. The results of this study showed that self-esteem had the most significant direct effect on depression. Meaning of life and health status had significant direct effect on this self-esteem. Volunteer activity and health status had direct effect on meaning of life. The results of this study suggested that there is a need to develope intervention to promote degree of self-esteem and alleviate degree of depression in middle-aged women.

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입원 암환자의 피로와 삶의 질 (Fatigue and Quality of Life of Korean Cancer Inpatients)

  • 변혜선;김경덕;정복례;김경혜
    • Journal of Hospice and Palliative Care
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    • 제13권2호
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    • pp.98-108
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    • 2010
  • 목적: 본 연구는 암환자의 삶의 질, 피로 정도를 확인하고 삶의 질과 피로와의 관계를 파악함으로써 암환자의 삶의 질 향상을 위한 간호중재 개발에 필요한 기초자료를 제공하고자 실시되었다. 방법: 대상자는 D, Y, A시에 소재한 대학부속병원에서 암 진단을 받고 치료를 받는 입원환자 94명을 대상으로 하였으며, 자료는 2007년 5월 8일부터 8월 10일까지 구조화된 설명지로 수집하였다. 연구도구로는 피로는 FACIT (Functional Assessment of Chronic Illness Therapy, www.facit.org)에서 개발한 측정도구인 한국어판 FACIT-Fatigue Scale인 13개 문항과 삶의 질은 FACIT에서 개발한 한국어판 FACT-G (Version 4) 27개 문항을 이용하였다. 수집된 자료는 SPSS Win 12.0을 이용하여 실수와 백분율, 평균과 표준편차, t-test와 ANOVA, Pearson correlation coefficients로 분석하였다. 결과: 암환자의 피로 정도는 22.48로 중간 정도의 상태를 보였다. 암환자의 삶의 질 정도는 평균 55.52로 중간 정도였고, 삶의 질의 하위영역에서는 신체적 영역이 평균 15.96로 가장 높았고, 기능적 영역이 평균 11.34로 가장 낮게 나타났다. 암환자의 피로는 피로의 정도에 차이를 보인 일반적 특성은 없었으며, 피로의 정도에 차이를 보인 질병관련 특성은 치료형태(F=3.216, P< 0.05), 체중변화(F=9.094, P<0.001), 일상생활 수행상태(F=7.297, P<0.001), 운동(F=5.919, P<0.05), 수면(F= 4.546, P<0.05) 등이었다. 암환자의 삶의 질 정도에 차이를 보인 질병관련 특성은 치료목적(F=4.392, p<0.05), 체중변화(F=23.118, P<0.001), 일상생활 수행상태(F= 9.886, P<0.001), 운동(F=7.699, P<0.001), 수면(F=5.893, P<0.001)이었다. 암환자의 삶의 질은 피로(r=-0.752, P<0.001)와 유의한 역 상관관계가 있는 것으로 나타났다. 피로는 삶의 질 하부 영역 중 신체적 영역(r=-0.834, P<0.001), 정서적 영역(r=-0.610, P<0.001), 기능적 영역(r=-0.560, P<0.001)과 유의한 역 상관관계를 보였다. 결론: 암환자의 삶의 질에 피로가 중요한 변수임을 확인하였고, 암환자의 삶의 질과 피로는 유의한 역 상관관계가 있음도 확인하였다. 이상의 연구결과를 기초로 암환자의 전반적인 삶의 질과 하부영역별 삶의 질을 향상시키고 피로를 감소시킬 수 있는 간호중재 프로그램을 우선적으로 개발하고 적용해야 할 것이다.

율동적 운동요법이 유방절제술 환자의 퇴원후 적응상태에 미치는 영향 (An Effect of Rhythmic Movement Therapy for Adaptation State in Mastectomy Patients)

  • 이명화
    • 기본간호학회지
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    • 제2권1호
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    • pp.67-85
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    • 1995
  • 본 연구는 유방절제술 환자의 퇴원후 적응상태에 영향을 줄 수 있는 율동적 운동요법은 개발하고 그 프로그램이 유방절제술 환자에게 효과가 있는 지를 규명하기 위해 스트레스 적응모형을 사용하여 비동등성 대조군 전후 실험설계의 유사 실험 연구로 시도하였다. 1994년 7월 1일부터 9월 30일까지 부산시내에 소재하는 고신대학 부속 고신의료원 일반외과 외래에서 화학요법을 받고 있는 환자를 대상으로 대조군, 실험군을 선정하였고 실험군은 부산 송도 에어로빅에서 율동적 운동을 주2회 35-40분씩 6주동안 실시하여 10회 이상 참여하였고 대조군은 율동적 운동요법을 실시하지 않았다. 자료수집은 적응상태를 측정하기 위해 신체증상 측정도구와 관절각도지수, 신체상, 우울척도, 스트레스 지각측정도구, 사회적 적응척도를 사용하여 율동적 운동요법 전에 사전조사를 하고 10회가 끝난 후 사후조사를 하였으며 수집된 자료는 $spss/pc^+$$x^2-test$, t-test, two-way ANOVA, Pearson Correlation coefficient를 이용하여 분석하였다. 본 연구의 결과를 요약하면 다음과 같다. 첫째, 율동적 운동요법을 시행한 실험군과 시행하지 않은 대조군은 신체적 적응 수준에서 신체적 증상에는 유의한 차이가 없었고 관절각도지수는 유의한 차이가 있었다. 둘째, 율동적 운동요법을 시행한 실험군과 시행하지 않은 대조군은 심리적 적응 수준에서 우울, 신체상, 스트레스 지각정도에 유의한 차이가 있었다. 셋째, 율동적 운동요법을 시행한 실험군과 시행하지 않은 대조군은 사회적 적응 수준도 유의한 차이가 있었다. 넷째, 율동적 운동요법이 매개변수인 건강통제위 종류에 따른 적응수준의 차이는 율동적 운동요법은 타인통제위 성향이 있는 군에서 우울을 더 감소시켰고 사회적 적응수준을 더 증진시켰다. 다섯째, 제 적응수준간의 상관관계에서 신체적 증상과 신체상, 신체상과 사회적 적응은 정상관관계가 있었다. 스트레스 지각정도는 사회적 적응, 우울과 신체상, 우울과 사회적 적응은 부적상관 관계가 있었다.

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임부의 태교인식과 태교실천에 관한 조사연구 (A Study on Recognition and Practice of Teakyo by Pregnant Women)

  • 신용분;고효정
    • 여성건강간호학회지
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    • 제6권1호
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    • pp.142-152
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    • 2000
  • This study is a descriptive study to offer an actual basic data as Nursing intervention strategy of nurses before delivery in order that pregnant women in Korea may effectively practice Taekyo by examining the relation after apprehending level of recognition and practice of our pregnant women about Taekyo. This study collected questionnaires from 801 pregnant women who visited general hospitals in 10 areas(Seoul, Daejon, chunan, Daegu, Kummi, $Ky{\check{o}}ngju$, $P{\ddot{o}}hang$, Busan, $J{\ddot{o}}nju$, and $Y{\ddot{o}}nkwang$) for prenatal care through an outpatient obstetrics and gynecology from July 15 to August 30, 1999. This study used the tool of lee, Ki Young(1993) revised an complemented by investigator to measure recognition of Taekyo and the tool of Jang, Shun Buk and Park, Young Ju(1996) revised and complemented by investigator to measure practice of Taekyo. The Cronbach's alpha value of each tool was .88 in recognition of Taekyo, while the value was .90 in practice of Taekyo. For data analysis, this study used the descriptive and statistical analysis, Pearson correlation, t-test, ANOVA, Tukey's post hoc contrast, and Stepwise multiple regression in accordance with the purpose of this study with using SPSS Win 7.5 program. The results were as follows ; 1. The practice of Taekyo was low in comparison with recognition of Teakyo by showing average 4.28 points and standard deviation 0.48 at level of recognition of pregnant women about Taekyo on the basis of 5 points and showing to show average 2.81 points and standard deviation 0.36 at practice level on the basis of 4 points. 2. They showed the higher level of recognition on Taekyo at high educational background of pregnant woman(F=3.735, p=.005), Roman catholicism (F=4.570, p=.002), satisfied married life(F=5.448, p=.004), high monthly income(F=6.096, p=.000) and cases of hoping pregnancy(F=2.525, p=.012). 3. They showed the higher level of practice on Taekyo at high educational background of pregnant woman(F=2.883, P=.022), Roman catholicism(F=3.616, p=.032), satisfied married life(F=19.924, p=.000), good health condition(F=2.386, p=.017), cases of hoping pregnancy(F=0.677, p=.000), cases of planning pregnancy with husband(F=3.024, p=.001), cases of regular prenatal care before delivery(F=0.241, p=.005), cases of maternal breast feeding (F=9.132, p=.000), and the number of less children(F=2.763, p=.041). 4. In result of examining correlation between recognition and practice of Taekyo, they showed high level of practice on Taekyo under high level of recognition of pregnant women on Taekyo by showing the statistically significant correlation. 5. In result of examining the related factors that affect recognition and practice of Taekyo y the object, practice of Taekyo had 16.8 percents of explanatory range, purpose of practicing Taekyo 8.5 percents of explanatory range, and monthly income 1.9 percent of explanatory range as variables of affecting recognition of Taekyo. The total explanatory range was 27.2 percents, Recognition of Taekyo had 16.1 percents of explanatory ragne, time of starting Taekyo 3.2 percents, health condition 2.2 percents of explanatory range, condition of hoping pregnancy 1.1 percent of explanatory range, satisfaction of married life 0.8 percent of explanatory range, and religion 0.6 percent of explanatory range as variables of affecting practice of Taekyo. The total explanatory range was 24.0 percents.

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요양보호사의 직업의식과 영향요인 (The Factors Influencing of Professional Consciousness of Long-term Care Workers)

  • 김향수;김희경;박연숙
    • 한국노년학
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    • 제31권3호
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    • pp.591-606
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    • 2011
  • 본 연구의 목적은 노인장기요양보험제도로 신설된 요양보호사의 직업의식 정도와 영향요인을 파악하여 요양보호사의 직업의식을 높이기 위한 간호중재 개발에 기초자료를 제공하는데 있다. 서술적 연구로써 D시, C도 G시, C도 C시, K도 O시에 소재하고 있는 요양원 3곳, 재가복지센터 3곳, 요양병원 3곳의 요양보호사 185명을 대상으로 2009년 11월 12일에서 4주 동안 설문지를 이용하여 자료수집 하였고, 서술적 통계, t-test, ANOVA, Pearson's correlation coefficients, Multiple regression으로 분석하였다. 연구결과, 요양보호사의 평균연령은 48.1세, 대다수 여성(95.1%)이며, 기혼자로서 배우자가 있고(79.5%), 고등학교 이상 졸업자(76.8%)가 많았다. 요양보호사의 자기효능 정도는 평균점수 3.68점, 소명의식 3.41점, 외적 통제위 성격 3.23점으로 보통 이상이며, 내적 통제위 성격은 4.12점으로 내적 통제위 성격이 강한 것으로, 교육훈련 유효성은 3.71점, 직업의식은 3.97점으로 다소 높은 것으로 나타났다. 직업의식과 관련 요인들의 관계에서, 직업의식과 내적 통제위 성격은 낮은 정 상관관계(r=.378, p=.000)를, 외적 통제위 성격은 낮은 역 상관관계(r=-.356, p=.000), 자기효능(r=.420, p=.000), 소명의식(r=.636, p=.000), 교육훈련 유효성(r=.441, p=.000)은 보통 정도의 정 상관관계를 보였다. 요양보호사의 직업의식에 영향을 미치는 요인으로는 소명의식(B=.329, p=.000)이 가장 높은 영향을 주는 것으로 나타났으며 교육훈련 유효성(B=.250, p=.000), 내적 통제위 성격(B=.216, p=.000), 외적 통제위 성격(B=-.165, p=.002), 요양보호사 선택시 자기 특성 고려(B=.207, p=.004) 순으로 전체 설명력은 57.5%로 나타났다. 추후 요양보호사에게 소명의식 제고 교육을 위한 체계적인 교육과 내적 통제위 성격 강화훈련, 요양보호사의 역할과 업무를 정확히 규명 하는 것이 필요하며 이러한 요인들을 활용하여 직업의식을 높일 수 있는 교육과 연구를 제언한다.

마사지요법이 저체중아의 성장, 생리적 변화 및 모.영아 상호작용에 미치는 효과 (Effects of the Massage Therapy on Weight, Stress Hormone and Mother - Infant Interaction)

  • 김미예;김선희
    • 부모자녀건강학회지
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    • 제3권1호
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    • pp.1-14
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    • 2000
  • The Low Birth Weight infant birth rate in this country is a little more than 15 percent and is being increased. The survival rate of Low Birth Weight infant is over 90 percent and recently the rate runs is getting. However, because of the high risk of Low Birth Weight infant for handicap in growth, a preventive nursing intervention program for Low Birth Weight infant and their mother is considered to be necessary. Touch and massage, thus sensory stimulation has been considered to be important ensuring a normal growth of Low Birth Weight infant During the past decades sensory stimulation program has been used for premature and Low Birth Weight infants. Recently a study on the sensory stimulation for Low Birth Weight infants has bee n done in this country. Mother and infant relationship has a great influence on child's development. Especially, mother and infant interaction during one year after birth plays important role in child's social. affective and cognitive developments. But in the study of Low Birth Weight infants, the mother and infant interaction has been rare yet. However, there was no study effectiveness of the sensory stimulation on mother and infant interaction. In this respect, this study based on the importance of the nursing intervention, is intended to measure the effectiveness of the massage therapy in the aspects of weight, daily feeding amount, cortisolurine stress hormone and mother and infant interactions. This study has been conducted on the nonequivalent control group pretestposttest design in quasi experimental basis and Low Birth Weight infants from NICU of two Medical University Hospitals located in Taegu Metropolitan were selected in experimental group of 21 infants and control group of 20 infants. Data has been collected from May 1, 1999 to September 5, 2000. For the experimental group Field's sensory stimulation(tactile and kinesthetic stimulation) was applied 2 times a day for 10 days(10:00 - 11:00 hours in the morning and 19:00 - 20:00 in the afternoon) by nurse and mother. The electronic indicator scale (Cas Co. Korea) was used to measure infant's body weight. To determine urine cortisol concentration level under stress, rad immuno assay method was used. And to determine mother and infant interactions during feeding, tools developed by Kim Mi-Ye (1999) were used. Collected data were analyzed with SAS program using x-test, t-test, paired t-test and repeated measures ANOVA. Findings were as follows : 1. For the daily mean weight gain, the experimental group showed little higher than the control group, even though, there was no Statistically significant differences between two groups. 2. For the amount of daily mean feeding, the experimental group showed little higher than the control group, while there was no Statistically significant differences between two groups. 3. The level of wine cortisol concentration was increased in both groups, while no Statistical significance was shown between the two groups. 4. Mothers in experimental group were more likely to have higher mean scores in mother and infant interaction during feeding than mothers in the control group. Statistical significance was shown between the two groups(t= 5.78, P=.001). In conclusion, the massage therapy in this study showed with regard to even though through there was no statistically significance in the weight gain and urine stress hormone concentration. there was Statistical significantly higher in the mother and infant interaction during feeding. Based on the result of this study, it is considered that the massage therapy should be applied clinical practice and home to help a developmental growth and interaction of Low Birth Weight infants and mothers during the period of recovery.

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중년후기 여성의 건강증진행위 모형구축 (A Model for Health Promoting Behaviors in Late-middle Aged Woman)

  • 박재순
    • 여성건강간호학회지
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    • 제2권2호
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    • pp.298-331
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    • 1996
  • Recent improvements in living standard and development in medical care led to an increased interest in life expectancy and personal health, and also led to a more demand for higher quality of life. Thus, the problem of women's health draw a fresh interest nowadays. Since late-middle aged women experience various physical and socio-psychological changes and tend to have chronic illnesses, these women have to take initiatives for their health control by realizing their own responsibility. The basic elements for a healthy life of these women are understanding of their physical and psychological changes and acceptance of these changes. Health promoting behaviors of an individual or a group are actions toward increasing the level of well-being and self-actualization, and are affected by various variables. In Pender's health promoting model, variables are categorized into cognitive factors(individual perceptions), modifying factors, and variables affecting the likelihood for actions, and the model assumes the health promoting behaviors are affected by cognitive factors which are again affected by demographic factors. Since Pender's model was proposed based on a tool broad conceptual frame, many studies done afterwards have included only a limited number of variables of Pender's model. Furthermore, Pender's model did not precisely explain the possibilities of direct and indirect paths effects. The objectives of this study are to evaluate Pender's model and thus propose a model that explains health promoting behaviors among late-middle aged women in order to facilitate nursing intervention for this group of population. The hypothetical model was developed based on the Pender's health promoting model and the findings from past studies on women's health. Data were collected by self-reported questionnaires from 417 women living in Seoul, between July and November 1994. Questionnaires were developed based on instruments of Walker and others' health promotion lifestyle profile, Wallston and others' multidimensional health locus of control, Maoz's menopausal symptom check list and Speake and others' health self-rating scale. IN addition, items measuring self-efficacy were made by the present author based on past studies. In a pretest, the questionnaire items were reliable with Cronbach's alpha ranging from .786 to .934. The models for health promoting behaviors were tested by using structural equation modelling technique with LISREL 7.20. The results were summarized as follows : 1. The overall fit of the hypothetical model to the data was good (chi-square=4.42, df=5, p=.490, GFI=.995, AGFI=.962, RMSR=.024). 2. Paths of the model were modified by considering both its theoretical implication and statistical significance of the parameter estimates. Compared to the hypothetical model, the revised model has become parsimonious and had a better fit to the data (chi-square =4.55, df=6, p=.602, GFI=.995, AGFI=.967, RMSR=.024). 3. The results of statistical testing were as follows : 1) Family function internal health locus of control, self-efficacy, and education level exerted significant effects on health promoting behaviors(${\gamma}_{43}$=.272, T=3.714; ${\beta}_[41}$=.211, T=2.797; ${\beta}_{42}$=.199, T=2.717; ${\gamma}_{41}$=.136, T=1.986). The effect of economic status, physical menopausal symptoms, and perceived health status on health promoting behavior were insignificant(${\gamma}_{42}$=.095, T=1.456; ${\gamma}_{44}$=.101, T=1.143; ${\gamma}_{43}$=.082, T=.967). 2) Family function had a significance direct effect on internal health locus of control (${\gamma}_{13}$=.307, T=3.784). The direct effect of education level on internal health locus of control was insignificant(${\gamma}_{11}$=-.006, T=-.081). 3) The directs effects of family functions & internal health locus of control on self-efficacy were significant(${\gamma}_{23}$=.208, T=2.607; ${\beta}_{21}$=.191, T=2.2693). But education level and economic status did not exert a significant effect on self-efficacy(${\gamma}_{21}$=.137, T=1.814; ${\beta}_{22}$=.137, T=1.814; ${\gamma}_{22}$=.112, T=1.499). 4) Education level had a direct and positive effect on perceived health status, but physical menopausal symptoms had a negative effect on perceived health status and these effects were all significant(${\gamma}_{31}$=.171, T=2.496; ${\gamma}_{34}$=.524, T=-7.120). Internal health locus and self-efficacy had an insignificant direct effect on perceived health status(${\beta}_{31}$=.028, T=.363; ${\beta}_{32}$=.041, T=.557). 5) All predictive variables of health promoting behaviors explained 51.8% of the total variance in the model. The above findings show that health promoting behaviors are explained by personal, environmental and perceptual factors : family function, internal health locus of control, self-efficacy, and education level had stronger effects on health promoting behaviors than predictors in the model. A significant effect of family function on health promoting behaviors reflects an important role of the Korean late-middle aged women in family relationships. Therefore, health professionals first need to have a proper evaluation of family function in order to reflect the family function style into nursing interventions and development of strategies. These interventions and strategies will enhance internal health locus of control and self-efficacy for promoting health behaviors. Possible strategies include management of health promoting programs, use of a health information booklets, and individual health counseling, which will enhance internal health locus of control and self-efficacy of the late-middle aged women by making them aware of health responsibilities and value for oneself. In this study, an insignificant effect of physical menopausal symptoms and perceived health status on health promoting behaviors implies that they are not motive factors for health promoting behaviors. Further analytic researches are required to clarify the influence of physical menopausal symptoms and perceived health status on health promoting behaviors with-middle aged women.

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유전자 알고리즘 및 인공신경망 이론을 이용한 쏘일네일링 굴착벽체 시스템의 최적설계 (Optimum Design of Soil Nailing Excavation Wall System Using Genetic Algorithm and Neural Network Theory)

  • 김홍택;황정순;박성원;유한규
    • 한국지반공학회논문집
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    • 제15권4호
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    • pp.113-132
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    • 1999
  • 국내에서는 근래에 들어, 다양한 지반조건 및 현장여건을 지닌 지하굴착 및 사면보강 등의 현장에 쏘일네일링 공법의 적용이 점차 확대되어 왔다. 또한 쏘일네일링 공법의 설계는 일반적으로, 한계평형적 해석방법에 의거해 보강토체의 활동에 대한 소요안전율을 만족하는 단면을 우선 결정한 다음, 수치해석 프로그램을 이용하여 이 단면 전면벽체에서 예상되는 최대변위를 추가로 확인하는 비교적 단순화된 과정을 통해 이루어져 왔다. 그러나 쏘일네일링 공법의 경우 관련 설계변수가 비교적 다양한 특징을 지니고 있으며, 따라서 이와 같은 설계변수들 사이의 상호 연관성을 고려하는 보다 합리적인 설계법 제시 차원의 노력이 지속적으로 요구되는 실정이다. 이외에도 원지반 흙의 비등방성, 채취시료의 교란 정도 및 측정상의 오차 등 설계에 적용되는 각종변수가 지니고 있는 불확실성 등을 감안할 때, 현재 시점에서는, 축적된 다양한 현장의 계측자료를 수집하여 관련 설계변수 사이의 상호 연관성을 체계적으로 분석하려는 노력과 더불어 신뢰성 있는 효율적인 기법을 이용하여 경제성이 강조되는 최적화 설계 차원의 노력도 요구되는 시점으로 판단된다. 이와 같은 목적의 일환으로, 본 연구에서는 유전자 알고리즘을 이용하여 쏘일네일링 굴착벽체 시스템의 시공비용 최소화를 위한 최적설계기법을 제시하였으며, 또한 제시된 최적설계기법의 전제조건중의 하나로 고려되는 숏크리트 전면벽체의 발생변위를 합리적으로 예측하기 위해 인공신경망 이론을 도입하였다. 다양한 비교.분석과 더불어, 최종적으로는 제시된 쏘일네일링 굴착벽체 시스템 최적화 기법의 적합성 여부를 종합적으로 확인하기 위해, 실제 시공이 이루어진 현장의 설계단면과 제시기법에 의거해 최적화된 설계단면을 서로 비교.분석하였다.칠음 정도의 정량화 작업을 연구한 것이다.M SDS와 117mM $SOFTANOL\circledR-90$의 Log $K_m$은 각각 2.95-3.76, 2.95-3.49의 값을 나타내었다. 또한 SDS와 $SOFTANOL\circledR-90$의 경우 Log $K_m과\; Log\; K_{ow}$는 선형적인 관계를 보였다. 계면활성제 용액에서 BTEX의 분배 개념은 지반내 포집되어 있는 소수성 유기 오염물의 제거를 통한 지반복원과 효율성 평가에 중요한 역할을 할 것이다.largely ignored since the introduction of western medical science, and was considered something used only by the aged or the uneducated. Moreover, Health concerned practices and customary traditional therapy have been discarded in the clinical medicine as "unscientific" or "unsystematic". As described above, it is true that Korean nursing has developed in the quantitative aspect only adhering to western nursing intervention. Now it is the time to stop to hold ourself and to look back our past. To find and develop the originality of Korean nursing to

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화학요법을 받는 부인암환자의 구강불편감에 관한 연구 (A study on oral discomfort in gynecological cancer patients undergoing chemotherapy)

  • 정재원
    • 대한간호학회지
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    • 제25권2호
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    • pp.372-389
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    • 1995
  • The frequency with which administration of chemotherapy for gynecological cancer treatment is used has increased along with the use of surgery and radiotherapy Among the various side effects of chemotherapy, stomatitis causes a problem of function and sensation in the oral cavity. This oral discomfort can be categorized into two components ; perceived oral symptoms and observed oral symptoms. If the oral problem continues, it may cause infection, bleeding and nutritional deficiencies. As a result of this condition, compliance with the treatment process can be affected as well as the prognosis for the cancer patients. But as the oral discorrfort usually appears after chemotherapy, it is often not reported to the health care personnel as a patient problem. Without problem identification of the oral discomfort and ability to assess the problem, effective intervention cannot be planned. Therefore, this study was conducted to identify the pattern and the degree of oral discomfort due to cancer chemotherapy and thus to provide data for identification of the patient problem and for nursing assessment. The design of this study was a longitudinal de-scriptive study The subjects were in - patients who received chemotherapy under the diagnosis of gynecological cancer between Mar. 15, 1994 and May 15, 1994 at a general hospital in Seoul, Korea. The number of subjects was 64 and they were divided into two groups, one of 41 (A : 5FU & Neoplatin), the other of 23(B : Neoplatin, Cytoxan, Adriamycin), according to the treatment regimen. The data were collected for 24 days using self-re-port instruments. The instruments were the 「Perceived Oral Symptom Assessment Tool」 and 「Observed Oral Symptom Assessment Tool」 developed by this researcher. Data were analyzed using the SPSS-PC program, ANOVA, t-test, paired t-test and the Pearson Correlation Coefficient were applied. The results of this study are as follows : 1. In A regimen the peak time for perceived oral symptom scores was the fifth day after chemotherapy, and the tenth day for observed oral symptom scores. Both of the problems started on first day of chemotherapy and were not resolved completely until the 24th day after treatment. 2. In B regimen, the peak time for perceived oral symptom scores was on the seventh day after chemotherapy, and the eighth day for observed oral symptom scores. It was noted that perceived oral symptom scores were higher than observed oral symptom scores consistently for 24 days. Both also started on first day of chemotherapy, and were not resolved completely until the 24th day after chemotherapy. 3. There were no differences statistically in perceived oral symptom scores between A and B regimen. The loss of appetite and xerostomia caused the most severe discomfort in both of these two groups. 4. The were no differences statistically in observed oral symptom scores between the A and B regi moil. In the A regimen, the highest observed symptom scores were the lips, gingiva, tongue and buccal membrane in that order. But in the B regimen, the highest observed symptom scores were tongue, lips, buccal membrane and gingiva in that order. 5. In A regimen, the patients who had gingival edema and dentures had significantly higher perceived oral symptom scores. And those who had gingival edema and bleeding, foul odor and aphthous stomatitis had significantly higher observed oral symptom scores. 6. In B regimen, the patients who had the experience of stomatitis in the last course of chemotherapy had significantly higher perceived oral symptom scores. Those who had gingival edema had significantly higher observed oral symptom scores. 7. In the A regimen there was no correlation between lab values for lymphocytes and albumin with perceived oral symptom scores and observed oral symptom scores. In the B regimen, there was a significant negative correlation between lymphocytes and albumin with the observed oral symptom scores, but not between perceived oral symptom scores and lymphocytes and albumin values. In conclusion, the nurse should expect that the patient undergoing chemotherapy will complain severely about subjective discomfort and before objective physical change is observed. Also the patients who have chronic oral problems such as dentures, gingival edema and bleeding, foul odor, aphthous stomatitis will complain of severe oral discomfort due to chemotherapy.

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모유수유교육과 추후간호방법이 산모의 모유수유실천율과 모유수유방법에 미치는 효과 - 가정방문과 전화상담을 중심으로 - (Effect of Breast-feeding Education and Follow-up care on the Breast-feeding Rate and the Breast-feeding Method - Focused on Home Visit and Phone Counselling -)

  • 박숙희;고효정
    • 여성건강간호학회지
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    • 제7권1호
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    • pp.30-43
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    • 2001
  • This was a pre-experimental study to confirm the breast-feeding ability and effect of follow up care on the breast-feeding rate and the breast-feeding method by the mother-infant breast-feeding assessment tool for the mothers who got the breast-feeding education. The subjects were 46 mothers who experienced normal delivery of infants at a college hospital in K-city, Kyungsangbuk-do, from July 1 to October 21, 2000. The instrument for data obtainment were The Mother-Infant Breast-Feeding Assessment Tool of Johnson et al. (1999), and The Breast- Feeding Method Measurement Tool of Jeong, Geum-hee(1997). This instrument was reliable, showing Cronbach $\alpha$.751. This study classified them into 3 groups: at high risk for breast-feeding failure, at risk for breast-feeding problems, and at low risk for breast-feeding failure by the mother-infant breast-feeding assessment tool on the day of discharge from the hospital after delivering individual breast-feeding education to the subjects. This study investigated the breast-feeding rate and the breast-feeding method through mail questionnaire at the four week after childbirth, and through the phone counselling and the home visit for follow up care at the first week and the second week after childbirth. The sixth week after childbirth, this study investigated the breast-feeding rate by phone. The data analyzed the hypothesizes by $x^2$-test, paired t-test, ANOVA, Wilcoxon signed rank test, Wilcoxon rank sum test and trend analysis using SPSS/PC+ WIN 10.0 program. The results were as follows : 1) Hypothesis 1-1, "there won't be any difference the breast-feeding rate of a group at risk for breast-feeding failure by the time elapsed" was supported through constant the breast-feeding rate, because changes in the breast-feeding rate by the time elapsed after childbirth wasn't statistically significant(t= -1.501, p=.270). Hypothesis 1-2, "there won't be any difference the breast-feeding rate of group at low risk for breast-feeding failure by the time elapsed" was supported through constant the breast-feeding rate, because changes in the breast-feeding rate by the time elapsed after childbirth wasn't statistically significant(t=-1.732, p=.225). 2) Hypothesis 2-1, "there won't be any difference between the breast-feeding method of group at risk for breast-feeding failure for four weeks after childbirth and just after childbirth” was rejected, because the mean point of post test appeared to be higher than that of pre test(t=-7.267, p=.000). Hypothesis 2-2, "there won't be any difference between the breast-feeding method of the group at low risk for breast-feeding failure for four weeks after childbirth and just after childbirth" was rejected, because the mean point of post test appeared to be higher than that of pre test(t=-2.501, p=.012). 3)The 3rd hypothesis, "there won't be any difference between breast-feeding method of groups at risk for breast-feeding problems and at low risk for breast-feeding failure at the 4th week after childbirth and just after childbirth" didn't show any difference between the breast-feeding method of groups at risk for breast-feeding problems and at low risk for breast-feeding failure in the advance test(t=-1.521, p=.130) but there was difference between them in post test (t=-2.012, p=.044). As a result, the 3rd hypothesis was supported by pre test, but it was rejected by post test. In conclusion, this study confirmed breast- feeding education and follow up care just after childbirth were effective for the breast-feeding rate and method. Accordingly, it is proposed that successful nursing intervention of breast-feeding to be necessary by continuously providing follow up care through the mother-infant breast-feeding assessment tool as well as to execute individual breast-feeding education to mothers just after childbirth.

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