• 제목/요약/키워드: Nursing methodology research

검색결과 379건 처리시간 0.025초

Charlson Comorbidity Index를 활용한 폐암수술환자의 건강결과 예측에 관한 연구 (Health Outcome Prediction Using the Charlson Comorbidity Index In Lung Cancer Patients)

  • 김세원;윤석준;경민호;윤영호;김영애;김은정;김경운
    • 보건행정학회지
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    • 제19권4호
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    • pp.18-32
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    • 2009
  • The goal of this study was to predict the health outcomes of lung cancer surgery based on the Charlson comorbidity index (CCI). An attempt was likewise made to assess the prognostic value of such data for predicting mortality, survival rate, and length of hospital stay. A medical-record review of 389 patients with non-small-cell lung cancer was performed. To evaluate the agreement, the kappa coefficient was tested. Logistic-regression analysis was also conducted within two years after the surgery to determine the association of CCI with death. Survival and multiple-regression analyses were used to evaluate the relationship between CCI and the hospital care outcomes within two-year survival after lung cancer surgery and the length of hospital stay. The results of the study showed that CCI is a valid prognostic indicator of two-year mortality and length of hospital stay, and that it shows the health outcomes, such as death, survival rate, and length of hospital stay, after the surgery, thus enabling the development and application of the methodology using a systematic and objective scale for the results.

Impact of Self-Citations on Impact Factor: A Study Across Disciplines, Countries and Continents

  • Pandita, Ramesh;Singh, Shivendra
    • Journal of Information Science Theory and Practice
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    • 제3권2호
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    • pp.42-57
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    • 2015
  • Purpose. : The present study is an attempt to find out the impact of self-citations on Impact Factor (IF) across disciplines. The study examines the number of research articles published across 27 major subject fields covered by SCImago, encompassing as many as 310 sub-disciplines. The study evaluates aspects like percentage of self-citations across each discipline, leading self-citing countries and continents, and the impact of self-citation on their IF. Scope. : The study is global in nature, as it evaluates the trend of self-citation and its impact on IF of all the major subject disciplines of the world, along with countries and continents. IF has been calculated for the year 2012 by analyzing the articles published during the years 2010 and 2011. Methodology/Approach. : The study is empirical in nature; as such, statistical and mathematical tools and techniques have been employed to work out the distribution across disciplines. The evaluation has been purely under-taken on the secondary data, retrieved from SCImago Journal and Country Ranking. Findings. : Self-citations play a very significant part in inflating IF. All the subject fields under study are influenced by the practice of self-citation, ranging from 33.14% to 52.38%. Compared to the social sciences and the humanities, subject fields falling under the purview of pure and applied sciences have a higher number of self-citations, but a far lesser percentage than the social sciences and humanities. Upon excluding self-citations, a substantial amount of change was observed in the IF of subject fields under study, as 18 (66.66%) out of 27 subjects fields faced shuffle in their rankings. Variation in rankings based on IF with and without self-citation was observed at subject level, country level, and continental level.

캥거루 케어가 미숙아와 어머니에게 미치는 효과 : 체계적 문헌고찰 및 메타분석 (Effects for kangaroo care: systematic review & meta analysis)

  • 임정희;김가은;신영희
    • 한국산학기술학회논문지
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    • 제17권3호
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    • pp.599-610
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    • 2016
  • 본 연구는 미숙아와 어머니를 대상으로 캥거루 케어 효과를 비교하기 위해 수행된 체계적 문헌고찰 및 메타분석 연구이다. 2015년 2월까지 출간된 무작위 임상실험연구를 검토하였으며, 국내문헌은 연구설계수준에 따른 제한 없이 비무작위 임상실험연구를 포함하였다. 문헌은 Ovid-Medline, CINAHL, PubMed와 국내 DB인 KoreaMed, 국립중앙도서관, 국회도서관, 국가과학기술전자도서관, KISS, RISS, 한국의학논문을 통해 ((kangaroo OR KC OR skin-to-skin) AND (care OR contact)) AND (infant OR preterm OR Low Birth Weight OR LBW), ((캥거루 OR 캉가루 OR 캉가루식) AND (케어 OR 간호 OR 관리 OR 돌보기 OR 피부접촉)) 등을 주요어로 조합하여 검색하였으며, 선택배제과정을 거쳐 최종 25편(n=3051)의 문헌이 분석에 포함되었다. 문헌에 대한 질평가는 SIGN에서 제시한 평가도구를 사용하였으며, 질평가 결과는 16편에서 ++, 9편에서 +로 평가되어 전반적으로 비뚤림 위험은 없는 것으로 판단하였다. 미숙아를 대상으로 한 캥거루 케어의 효과에 대한 메타분석 결과, 미숙아 사망률, 중증 감염/패혈증 발생률, 저체온 발생률, 병원입원기간, 모유수유율, 수면상태, 어머니의 불안, 어머니 역할수행 자신감, 어머니 역할수행 만족도에서 통계적으로 유의한 효과가 있었으며, 고체온 발생률, 미숙아의 성장발달(신장, 체중), 모아애착, 우울, 스트레스는 유의미한 차이가 없었다. 국내에서 캥거루 케어에 대한 무작위 임상실험연구 수가 적어 효과크기에 대한 확증적 결과를 얻는 데에는 다소 제한이 있었으므로 향후 이와 관련된 무작위 임상실험연구의 효과검증에 대한 노력이 지속적으로 이루어져야 할 것으로 사료된다.

고등학교와 대학교의 좋은 수업에 대한 관점 분석 -예비유아교사 및 현직교사를 대상으로- (The analysis of teaching perspective on good teaching for high school and higher education: pre-service teachers and teachers majored in early childhood education)

  • 고은현;박혜림
    • 한국산학기술학회논문지
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    • 제18권12호
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    • pp.182-188
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    • 2017
  • 이 연구는 수업이 지향해야 하는 가치에 대한 인식을 탐구하여 선행연구에서 밝혀왔던 좋은 수업의 세부 요소 및 특성들과 더불어 좋은 수업의 가치를 지향할 수 있는 수업의 우세 가치 유형을 분석하는 데 그 목적이 있다. 이를 위해 서울 및 수도권에 위치한 대학 유아교육과 재학생 및 졸업생을 대상으로 좋은 수업에 대한 포괄적인 인식과 관점을 객관적으로 지표화한 TPI를 활용하여, 예비 및 현직교사가 인식하는 좋은 수업에 대한 우세 가치 유형을 교차분석 및 일원분산분석과 사후검증(Tukey의 HSD)으로 분석하였다. 연구 결과 고등학교 수업의 우세가치는 학교유형과 관계없이 "양육" 관점으로, 대학교 수업은 "도제"관점으로 나타났다. 고등학교 수업에 관한 연구결과는 "양육"이 우세 관점으로 나타났으며, 국내외 연구 결과와 차이를 보이지 않았다. 그러나, 대학 수업의 경우 영미권에서는 도제 관점을 우세하게 인식하고 있으나 국내 연구에서는 도제 관점이 우세하여 드러나 차이를 보였다. 또한 현직 유아교사가 실습경험 없는 예비교사보다 "도제" 관점을 우세하게 인식하였다. 국내외 연구와 본 연구 결과를 비교 고찰하여 좋은 수업의 가치를 논의하였다. 향후 연구에서는 학교급과 전공을 세분화하여 예비교사 및 현직교사를 대상으로 한 분석이 요구된다.

뇌졸중 후 요실금에 대한 침치료 임상진료지침 (Clinical Practice Guideline for acupuncture in Post-stroke urinary incontinence)

  • 이지원;신병철;이명수;임성민;유정희;조충식;문상관;육태한;주종천;이의주
    • 사상체질의학회지
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    • 제29권4호
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    • pp.317-325
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    • 2017
  • Objectives This study is aimed to develop a Clinical Practice Guideline (CPG) on acupuncture treatment for the stroke patients with Post-stroke Urinary Incontinence(PSUI). Methods Experts committee, consisting of stroke or methodology specialists, searched Medline, EMBASE, Cochrane Library, China National Knowledge Infrastructure, and 19 Korean medicine journals. The search terms were selected to screen the randomized controlled trials (RCTs) or systematic reviews for the effectiveness of acupuncture on PSUI, compared with placebo or conventional group. Levels of evidence and grades of recommendations were appraised based on Recommendations for Development of Clinical Practice Guideline in Korean Medicine. Results & Conclusions 8 RCT were included to build the CPG. There was a strong evidence to support the effectiveness of acupuncture treatment for PSUI. The moderate evidence was presented that over 3 times a week of the acupuncture should be performed over 4 weeks on the acupoints, such as BL23, CV3, SP6, CV4, CV6, ST28, BL28, BL32, GV20, BL22, GV4 or ST36, for 15-30 minutes. 1-150 Hz frequency is suggested if electro-acupuncture treatments is performed with. It was also suggested that the procedure should begin at the acute stage just after the vital signs of the patients are stabilized. There was a moderate evidence to support safety of acupuncture treatment for PSUI. We recommend acu-points of constitutional acupuncture for Sasangin on the healthy side.

폐경에 대한 적응 과정 (Adaptation Process to Menopause)

  • 이미라
    • 대한간호학회지
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    • 제24권4호
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    • pp.623-634
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    • 1994
  • Although the average menopausal age has not changed, women's life span has increased. Today's women live longer after their menopause than those in the past, and this calls for attention in both nursing and medical fields. Many studies have revealed how women reacted to menopause and suffered from it. But they did not discriminate the menopausal meaning and effects from the climacteric phenomena. So, this author tried to clarify what menopause itself meant to the climacteric women, by means of grounded theory methodology. The interviewees were 21 women, whose ages were between 46 and 60 years. They were selected by theoretical sampling technique, and the author tried to include all levels of important variables such as age, educational background, religion and job. Data were collected by the author through in -depth interviews and observations in July, 1994. The interviews were mostly done in the homes of the subjects, or in some cases at the author's office or in a hospital. Interviews took from 30 minutes to 2 hours. Interviews were tape recorded and transcribed later by a research assistant. Data were analyzed as gathered, by the constant comparative method proposed by Strauss and Corbin. Eleven concepts were discovered from the data, and they were grouped under six higher order categories. These six categories were "to give menopause a meaning", "to experience value change", "to have self-help strategies", "to have no strategies", "to live a life worth living", "to have a sense of powerlessness" Among these "to experionce value change" was . selected as the core category. Five major categories were systematically integrated around the core category. Women's adaptation to menopause was defined as proceeding as follows : Most women felt relief and sorrow at the same time when they faced menopause, and some only sorrow or agony. Then, they consulted with others about menopausal symptoms, or tried to think of them by themselves. Finally, they gave menopause a meaning, which was that menopause and its symptoms were natural phenomena. But menopause made women reflect on them-selves and their past lives. As they reflected on themselves, their value on life began to change. As their value changed, some women seeked self help strategies. Those self help strategies were what they had learned from collegues, professionals or mass media. The quality of their lives depended on whether they practiced self help strategies or not. Three types of lives were found. Twelve women enjoyed a life worth living, and practiced the self help strategies, because they accepted menopause a chance to change. They were characterized by a high educational level, having a professional job and a sincere faith in God. Seven women were living as usual, because they did not have the necessity to change. They were high school graduates and house wives. Two women recognized menopause a chance to change, but they did not try self help strategies. Their characteristic was low educational level. Those who did not try self help strategies complained of powerlessness to varying degrees. The educational background, full-time jobs and faith helped women adapt to menopause positively. But social support was not helpful to women's adaptation to menepause. Three hypotheses were derived from the analysis. (1) The higher the educational level, the more theneed to change. (2) Women with higher educational background will practice self help strategies more than those with lower edcational background. (3) The more women practice self help strategies, the worthier lives they will live. Suggestions for further studies are as follows. (1) Studies to test hypotheses are needed. (2) A study to find the relationship between the degree of practicing self help strategies and locus of control. (3) Spiritual approaches would better be applied to help menopausal women. (4) Education through mass media should be given mere frequently.

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대학생활에서 이루어지는 교수-학생 상호작용에 관한 유형 분석 연구: 내러티브 분석 중심 (The Type and Dimension of a Faculty-Student Interaction: Narrative study focused)

  • 이봉숙
    • 한국산학기술학회논문지
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    • 제21권12호
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    • pp.300-309
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    • 2020
  • 본 연구는 지도교수를 중심으로 한 학생상담을 통해 이루어지고 있는 교수학생간 상호작용의 작동원리를 파악하고 유형화하고자 함이다. 이를 위해 질적연구방법 중 내러티브연구방법을 적용하여 교수학생간 상호작용 경험 속에 나타나고 있는 구조적 패턴과 기전을 파악해 보고자 하였다. 연구참여자는 학과소속 지도교수로부터 년 2회 총 6회 이상 학생상담을 경험한 4학년 여학생 10명을 대상으로 하였으며 심층인터뷰와 현장노트를 통해 자료를 수집하였다. 인터뷰 자료는 Burke(1945)가 내러티브 분석에서 사용한 행위주체, 행위동기, 행위결과를 중심축으로 자료를 분석하였으며 최종 도출된 상호작용 유형은 주도적 상호작용, 피상적 상호작용, 보은적 상호작용이다. 주도적 상호작용 유형은 학생이 교수와의 상호작용을 통해 성취지향적인 자아성자의 일면을 강하게 나타내고 있는 유형이다. 반면 피상적 상호작용 유형에서는 교수와의 교류를 통해 자아성장의 경험이 강하게 피력되지 않고 있는 특성이 있으며, 마지막 보은적 상호작용 유형은 정서지향적 측면을 중심으로 한 자아성장의 일면을 강하게 나타내는 특성을 지니고 있다. 세가지 상호작용 유형을 통해 교수자와 학생 모두 서로 발전시킬 수 있는 모델이 무엇이며 어떠한 노력이 필요한지 지도교수 중심 학생 상담의 순기능과 역기능에 대해 되새겨볼 필요가 있다.

암으로 자녀를 잃은 가족의 경험에 대한 질적연구 (The Experience of the Family Whose Child Has Died of Cancer)

  • 이정섭;김수지
    • 대한간호학회지
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    • 제24권3호
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    • pp.413-431
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    • 1994
  • The purpose of this study was to build a substantive theory about the experience of the family whose child has died of cancer The qualitative re-search method used was grounded theory. The interviewees were 17 mothers who had cared for a child who had died of cancer Traditionally in Korea, mothers are the care givers in the family and are considered sensitive to the family's thoughts, feelings. The data were collected through in-depth interviews by the investigator over a period of nine months. The data were analyzed simultaniously by a constant comparative method in which new data are continuously coded into categories and properties according to Strauss and Corbin's methodology. The 16 concepts which were found as a result of analyzing the grounded data were, -left over time, the empty place, meaninglessness, inner sadness, situational sadness, heartache, physical pain, guilt, resentment, regret, support / stigmatization, finding meaning in the death, changing attitudes about life and living, changing attitudes about health, changing religious practice and changing family relations. Five categories emerged from the analysis. They were emptiness, consisting of left over time, the empty place and meaninglessness ; sadness, consisting of inner sadness and situational sadness ; pain, consisting of heartache and physical pain ; bitterness, consisting of guilt, resentment, regret, sup-port / stigmatization and finding meaning in the death : and transition, consisiting of changing attitudes about life and living, changing attitudes about health, changing religious practice and changing family relations. These categories were synthesized into the core concept, -the process of filling the empty space. The core phenomenon was emptiness. Emptiness varied with the passing of time, was perceived differently according to support / stigmatization and finding meaning in the death, was followed by sad-ness, pain, and bitterness, and finally resulted in changes in attitudes about life and living and about health, and in changes in religious practice and family relations. The process of filling the empty space proceeded by ① accepting realty, ② searching for the reason for the child's death, ③ controlling the bitter feelings, ④ reconstructing the relationships ameng death, illness and health and ⑤ filling the emptiness by resolving causes of child's death, adopting, having another child or with work. Six hypotheses were derived from the analysis. ① The longer the bereavement, the mere the empty space becomes filled. ② The longer the hospitalization, the more sup-port the family needs. ③ The more the sadness, pain and bitterness are expressed, the mere positive changes emerge. ④ Family support faciliates the process of filling the empty space. ⑤ Higher family cohesiveness faciliates the process of filling the empty space. ⑥ The greater the variety of reasons attributed to the child's death, the greater the variety of patterns of change. Four propositions related to emptiness and bitter-ness were developed. ① When the sense of emptiness is great and bitterness is manifested by severe feelings of guilt and resentment, the longer the process of fill-ing the empty space. ② When the sense of emptiness is great and the family is highly motivated to get rid of the bitterness, the shorter the process of filling the empty space. ③ When the sense of emptiness is less and bitter-ness is manifested by severe feelings of guilt and resentment, the process of filling the empty space is delayed. ④ When the sense of emptiness is less and the family is highly motivated to get rid of the bitterness, the process of filling the empty space goes on to completion. Through this substantive theory, nurses under-stand the importance of emptiness and bitterness in helping the family that has lost a child through cancer fill the empty space. Further research to build substantive theories to explain other losses may con-tribute to a formal theory of how family health is restored after human tragedies are experienced.

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만성통증 환자의 통증 조절 (Chronic pain control in patients with rheumatoid arthritis)

  • 은영
    • 근관절건강학회지
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    • 제2권1호
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    • pp.17-40
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    • 1995
  • Rheumatoid arthritis is the one of the chronic diseases, one of its major symptoms is a chronic pain. Despite developing medical treatment and surgical techniques, it is suggested that to control the pain is the goal of the treatment. But pain is an inner experience and even those closest to the patient cannot truly observe its progress or share in its suffering. The National Academy of Sciences Institute of Medicine's report on Pain and Disability concluded that there is no objective measure of pain-(exactly) no pain thermometer-nor can there ever be one, because the experience of pain is inseparable from personal perception and social influence such as culture. To explore chronic pain experience is to understand the process and property of the patient's perception of pain through the response to pain, the coping with pain, and the adaptation to pain. Therefore a qualitative study was conducted in order to gain an understanding of pain experience of patients with RA in korea. I used naturalistic inquiry as a research methodology, which had 5 axioms, the first is that realities are multiple, constructed, and holistic, the second is that knower and known are interactive, inseparable, the third is only time and context bound working hypotheses(idiographic statements) are possible, the forth is all entities are in a state of mutual simultaneous shaping, so that it is impossible to distinguish causes from effects and the last is that inquiry is value-bound. Purposive sampling was conducted as a sampling. 20 subjects who experienced pain over 10 years, lived in middle-sized city and big city in Korea, and 17 women and 3 men. The subject's age was from 32 to 62 (average 48.8), all were married, living with their spouse and children, except two-one divorced and the other widow before they became ill. I collected data using In depth structured interview. I had interviews two or three times with each subject, and the interviews were conducted at each subject's home. Each interview lasted about two hours an average. A recording was taken with the consent of the subject. I used inductive data analysis-such as unitizing and categorizing. unitizing is a process of coding, whereby raw data are systematically transformed and aggregated into units. Categorizing is a process wherby previously unitized data are organized into categories that provide descriptive or inferential information about the context or setting from which the units were derived. This process is used constant comparative method. The pain controlling process is composed of behavior of pain control. The behaviors of pain control are rearranging of ADL, hiddening role conflict, balancing treatment, and changing social relation. Rearranging of ADL includes diet management, sleep management, and the adjustment of daily life activities. The subjects try to rearrange their daily activities by modified style of motions, rearranging time span & range of activities, using auxillary facilities, and getting help in order to keep on the pace of daily life. Hiddening role conflict means to reduce conflicts between sick role and their role as a family member. In this process, the subjects use two modes, one is to control the pain complaints, and the other is to internalize the value which is to stay home is good for caring her children and being a good mother. To control pain complaints is done by 'enduring', 'understanding' the other family members, or making them undersood in order to reduce pain. Balancing treatment is composed of two aspects. One is to keep the pain within the endurable level, the other is to keep in touch with medical personnel in order to get the information of treatment and emotional support. Changing social relation is made by information seeking and sharing, formation of mutual support relation, and finally simplification of social relationships. The subjects simplify their social relationships by refraining from relations with someone who makes them physically and psychologically strained. In particular the subjects are apt to avoid contact with in-laws, and the change of relation to in-laws results in lessening the family boundary. In the course of this process, they confront the crisis of family confict result in family dissolution. This crisis is related to the threat of self-existence. Findings from this study contribute to understanding the chronic pain experience. To advance this study, we should compare this result with other cases in different cultural contexts. I think to interpret these results, korean cultural background should be considered. Especially the different family concept, more broader family members and kinship network, and the traditional medical knowledge influences patients' behavior.

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