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한국 전·후기 노인의 삶의 질 관련요인과 성별 차이 (Gender Difference in Quality of Life After Controlling for Related Factors among Korean Young-old and Old-old Elderly)

  • 정영해;조유향
    • 농촌의학ㆍ지역보건
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    • 제39권3호
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    • pp.176-186
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    • 2014
  • 본 연구는 노인의 삶의 질 관련 요인을 파악하고, 관련 요인을 통제한 상태에서 남 녀 노인의 삶의 질에 차이가 있는지 국민건강영양조사 제5기 1차년도 자료를 사용하여, 65세 이상 노인 1,339명을 대상으로 하였다. 자료분석 방법은 층과 집락 가중치를 지정하여 SPSS 20.0 복합표본분석방법으로 분석하였는데, 연령과 성별에 따른 일반적 특성과 건강행위 및 건강상태의 차이는 로지스틱회귀분석을, 삶의 질 차이는 일반선형모형분석을, 삶의 질 관련 요인은 후진제거방법을 이용한 일반선형모형으로 파악하였으며, 성별의 차이 역시 일반선형모형을 이용하여 검증하였다. 일반적 특성에서는 교육수준(p<.001)과 경제수준(p=.005), 동거여부(p<.001)가 성별에 따라 차이가 있었으나, 거주지역은 차이가 없었으며, 건강행위는 흡연(p<.001), 음주(p<.001), 운동(p=.045)에서 차이를 보였고, 건강상태에서는 비만정도(p<.001), 만성질환유무(p<.001), 스트레스(p<.001), 우울(p=.005), 자살사고(p<.001), 주관적 건강상태(p<.001)이 성별에 따라 차이가 있는 것으로 나타났다. EQ-5D는 노년전기, 후기 모두 여자노인보다 남자노인의 점수가 높았으며, 운동능력, 자가간호능력, 일상생활불편감, 통증/불편감, 불안/우울 등 모든 하위영역에서는 여자노인의 삶의 질이 남자보다 낮았다. 삶의 질 관련변수는 교육수준(p=.001), 경제상태(p=.001), 만성질환유무(p=.052), 동거여부(p=.002), 주관적 건강상태(p<.001), 연령(p<.001), BMI(p=.045)로, 이 변수들은 노인 삶의 질의 31.5%를 설명하였다. 노년기에서도 성 인지적 차이를 감안한 접근방안이 필요함을 제언한다.

일부 농촌지역의 결핵 치료 환자에 대한 실태 조사에 관한 연구

  • 이재희
    • 대한간호학회지
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    • 제1권1호
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    • pp.85-94
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    • 1970
  • This is a study of 21 tuberculosis patients receiving medical treatment at the Public Health Center in Kyongi Do, Pu Chun Gun and at the General Hospital. The results cover the findings of the period from May, 1969 to November 1970. The information obtained is based on personal interviews with the patients, and symptomatic diagnosis made from observations. The following statistics when not equalling 100% contain only the responses of the two extremes in each case. The findings of the research are as follows: 1. 52.3% of the patients in the study are males and 47.7% are females. 28.6% of the subjects are between 20 and 29 years of age and an equal percent are between 30 and 39 years. 2. 47.5% of the subjects had graduated from primary school, while only 4.8% had graduated from high school. 3. 57.1% of the patients said they had no religions beliefs, while 4.8% professed to being Buddhists or believing in superstition. 4. 47.3% of the people said they were unemployed, while 4.8% classified themselves as labourers. 5. In response to how tuberculosis was first detected in their respective cases, 52.6% became aware of their disease through X-ray results, while 4.8% were discovered to have tuberculosis when being treated for other diseases at the hospital. 6. When asked how many of the patients knew anything about their disease when treated, 57.1% knew nothing about tuberculosis when they received treatment, while 42.9% had some knowledge of the disease. 7. Of those who knew something about tuberculosis, 61.9% learned about from doctors and nurses, while 4.8% learned from other people. 8. 57.1% of the patients knew that tuberculosis is a communicable disease, while 42.9% did not know. 9. 52.4% of the patients did not know the cause of tuberculosis while 4.9% believed the disease was caused by a curse. 10. When asked about the extent of treatment, 52.4% responded that they had undergone continuous treatment, while 4.8% had not received treatment. 11.The reasons given for not continuing treatment were the following: economic factors 55.6%; side reactions to the treatment, lack of knowledge of how to get treatment, of the need for treatment, or of the positive effects of treatment 11.1%. 12. 61.9% of the subjects usually took the medical treatment at home, 9.5% took it in the mountains or at the beach. 13. 42.9% of the patients received drugs for treatment at the local public health center, while 4.8% received them at the hospital 14. 33.3% of the patients received P.A.S+I.N.H.+S.M. for treatment of tuberculosis, while 4.8% received P.A.S.+S.M.. and some secondary drug. 15. Of the patients who took some extra medicine for tuberculosis, 38.1% took a Chinese drug, while 9.5% took herb medicine. 16. 38.1% of the patients had continued treatment for three years, 4.8% had interrupted the treatment. 17. When asked about the development of the disease after treatment, the patients gave the following information: after one month, 90.5% thought the treatment helped, while 9.5% weren't sure; after one year, 55.6% thought it was good, while 5.5% thought it was not; after three years, 63.6% had a very bad condition. while 4.8% didn't know. 18. 61.9% of the patients were unconcerned about covering their mouths when they coughed, while 38.1% covered their mouths. 19. 57.2% were unconcerned they spit, while 23.8% spit into a waste basket. 20. 66.7% were unconcerned about sterilizing tableware, while 9.5% handled it separately. 21. 66.7% were unconcerned about ventilating their room, while 9.5% ventilated the room twice a week.

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도시일부 중년여성의 체중상태와 건강행위 선택 비교 연구 (Perceived Weight and Health Behavior Characteristics -Normal and Overweight Middle-aged women-)

  • 조현숙
    • 대한간호학회지
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    • 제26권2호
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    • pp.387-398
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    • 1996
  • The objective of this study was to clarify whether there are any differences between normal and over-weight middle-aged(40∼59yrs)women in their perceived weight, health status, health conception and health behavior choices. The sample consisted of 39 normal weight and 55 over-weight (11% above on the Body Index Scale) women who live in Juan, Inchon. The Participants were randomly selected in each weight group considering socio-demographic factors. The findings from this study are summarized below. 1) Among the 55 overweight middle-aged women, 16 were above 20% on the Body Index Scale and 14 were above 30%. Twenty-five(45.5%) of the overweight group and 12(30.8%) of the normal weight group had one disease, and there were 12(21.8%) in the overweight group and 8(20.5%) in the normal weight group where one of the family members had a disease, but these differences were not statistically significant. The average monthly family income for the overweight group was ₩l,880,000 compared to ₩2,140, 000 for the normal weight group, but this difference was also not significant. The age range for the whole group was between 40 and 59(mean=46.8 for total, 48.6 for overweight and 45.7 for normal weight group). Again no significant difference found. Occupations were housemaker 53(56.4%), private business(13.8%), salarywoman(9.6%), and teacher (2.1%). Thirty housemaker(54.5%) from the overweight group and 23(59%) from the normal group did not constitute a statistically significant different. For the educational status, 34(61.8%) of the overweight women and 33(84.6%)of the normal weight group finished high school or more educational courses, but there was no significant statistical difference. Eleven(20.0%) of the overweight women and 5(12. 8%) of the normal weight group were single, but again no significant statistical difference was found. 2) A test for difference in health characteristics between two weight groups indicated that two groups do not show statistical differences in their perceived health status, health conception or health behavior choice. That is, the overweight group, also perceive their health status as good as the normal group, and regard ‘Health’ as a state that enables them to carry out social roles and functions rather than as the traditional concept of health as no disease or no symptoms. Moreover. the overweight group selected their health behaviors not for the prevention of diseases or maintenance of health but for promotion of health. To determine if no statistical difference might be related to the overweight group's failure of perceive themselves as overweight, the perceived and objective overweight status were compared by the chi-square analysis, and no difference was found(X/sup²=49.37, df=1, p=.000). However, 7(17.9%) of the normal group perceived themselves as being overweighted and 7(12.7%) of the overweight group thought they were of normal weight. Even though the overweight group employed in this study perceived themselves as being overweight, they regarded themselves as healthy as those in the normal weight group. It was shown that there was no statistical difference between two groups in health conception, and that they chose health behaviors to promote health status. 3) Perceived health conception was shown to be significantly related to health behavior choice (r= .28, p=.006 for whole group : r=.33, p=.014 for overweight group : and r=.12. p=.463 for normal group) .There was an indication that the more complicated the perceived health conception was, the more the trend of health behavior choice to promote health. This was especially true for the overweight group. But, the perceived health status did not related to health behavior choice statistically(r=.13, p=.202), and it was thought that reasons for selecting health behaviors were not related to their health status. That is, the overweight group perceive themselves as healthy as the normal weight group or thought that overweight itself does not incur any risk on their health. Data from two groups were combined and analyzed with multiple regression methodology, because the relationship pattern of the two groups was similar. The analysis showed that health behavior has a significant relationship with age and the perceived health conception(r/sup²=.1517, p=.05, F=8.133). It means they come to health behavior along with their health conception and their age rather than their weights, perceived weight, health status or other social characteristics. This study was intended to understand how overweight middle-aged women perceive ‘weight’ and ‘health’, and how they meet their health related needs in comparison with normal weight middle-aged women. Other factors related to the health behavior in overweight middle-aged woman need to be determined through further descriptive studies outlined in the following recommendations. a) Reseach with the study area expanded. b) Reseach with grouping more detailed : much more overweight and underweight group c) Reseach on restricted relationship between overweight and age or profession. d) Reseach on what overweight middle-aged women do to reduce their weight and what factors motivate them to do it

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사춘기 여성들의 월경경험 (Menstrual Experience of Adolescent Girls)

  • 정현숙
    • 대한간호학회지
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    • 제26권2호
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    • pp.257-270
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    • 1996
  • Studies on menstruation have focused only on menstruation itself and menstrual disorders. The menstruating girls or women have been neglected. So, the purpose of this study was to understand menstrual experience of adolescent girls in their perspective and build a theory on it, The specific purpose of this study were to find initial reaction of the girls, their strategies to adapt to menstruation. consequences of their efforts, influencing factor, and patterns of experience. The subjects of this study were eleven adolescent girls who experienced menarche three months to twenty-six months before the interview time. They were selected purposively. Their ages were in range of twelve and sixteen. One of them was a elementary school girl, three high school girls, and seven middle school girls. Two girls were handicapped because of cerebral palsy. All of them had some knowledge about menstrual physiology and hygiene during menstruation. Data were collected from September, 1994 to July, 1995. Data collection & analysis were done according to the grounded theory methodology by Strauss & Corbin(1990). Data collecting method was the long interviews and observation. Each interview took from 1 hour to 2 hours. Interview were tape-recorded and transcribed later by author. Data were analyzed immediately after interviews. Based on the results of previous interview, next interview were planned until gathered data reached the saturation point. Results were as follows. One hundred and six concepts were found. Those concepts were grouped into twenty eight categories and then fourteen higher categories. Twenty eight categories were as follows. “want to hide”, “bewildered”, “sense of burden”, “sense of heterogeneity”. “gladness”. “sense of superiority”, “negative empathy”, “positive empathy”, “limited hygenic control”, “sense of timing”, “lack of knowledge”, “lack of support”, “advance knowledge”, “informational support”, “emotional support”, “endurance”, “prayer”, “disclosing”, “avoidance”, “diversion”, “sense of powerlessness”, “discovery of sex identity”, “sense of maturation”, “sense of stability”, “acceptance of menstruation ”. fourteen higher categories were as follows. “negative feeling”, “posive feeling”, “exchange of feeling”, “limited hygenic control”, “sense of timing”, “accumulated experience”, “dysmenorrhea”, “level of knowledge”, “need for support”, “perceived support”, “sharing of feeling”, “self-control”, “passive acceptance”, “active acceptance”. The core category was “emotional shaking”, which consisted of “positive feeling” and “negative feeling”. “Emotional shaking”comes up to every adolescent girls experiencing menarche, independently of any contextual conditions, and its dimension has two directions : positive one and negative one. Its influencing factors were time of menarche, advance knowledge, support from the significant persons, expression and self-regulation. Even if they showed different process of adaptation to menstruation, general process of adaptation were as follows : 1. stage of emotional shaking 2. stage of acceptance 3. stage of internalization of the menstrual experience. Seven patterns existed on the process of adaptation to menstruation after menarche. Those are as follows. 1. If girls thought their menarche came too early and they had not much knowledge on menstruation, they had a kind of negative feeling. If they did not get enough support and dysmenorrhea superimposed, they came to accept menstruation passively. 2. If girls had menarche too early. they had negative feeling, even though they had enough advance knowledge. But support helped them accept menstruation easily. 3. If girls had menarche too early, they had negative feeling, even though they had enough advance knowledge on menstruation. But by experiencing subsequent menstruations and disclosing feeling, they began to accept menstruation. 4. If girls had menarche too lately and they had enough advance knowledge on menstruation. they had positive feeling. If dysmenorrhea superimposed later, their feeling turned in to negative one. But they came to accept menstruation positively by disclosing feeling and getting support. 5. If girls had menarche too early, they had negative feeling, even though they had enough advance knowledge on menstruation. In addition to this. if dysmenorrhes superimposed while they did not get enough support, they felt powerless and came to accept menstruation passively. 6. If girls had menarche too early and did not get enough advance knowledge, they had negative feeling. But disclosing feeling and support made them get sense of homogeneity and began to accept menstruation. 7. If girls had handicap, they had negative feeling, even though they had enough advance knowledge and menarche was late. But Menarche made them get feel sexual identity. Their limited hygenic control and negative empathy from their mothers made them accept menstruation passively. To let adolescent girls take their menstrual experience as a part of their lives forming a positive sense of feminine identity, it needs qualified teaching and, support and deep concern of the significant others. Nurses including school nurses should try to develop an educational program, which include menstrual physiology. hygiene during menstrual period, meaning of menstruation and impact of menstruation on the development of female sexual identity.

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일부 여자 대학생들의 건강문제 호소에 관한 조사연구 (A Study of the Health Problem Complaints of University Women Students)

  • 양순옥
    • 대한간호학회지
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    • 제11권2호
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    • pp.105-123
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    • 1981
  • This study was carried out during the month of September 1976 to analyse and compare the health complaints of two groups of the university women, those who lived at home and those who lived in the university dormitory. The purpose of the study was to provide basic data required by the university health program for planning related to the health need of women students. The study sample consisted of 434 students living in the dormitory and 381 students living at home enrolled for the fall semester 1976 in a womens university in Seoul. The instrument used for the collection of data was an abridged version of a modified Cornell Medical Index. The questionarre included 35 items related to physical health complaint and 22 items related to mental health complaints. The data was treated by a computer (SPSS) using one way analysis, the Fishers' ratio and Chi-Square test at the 5% level were used for the test for statistical significance. The interpretation of this study is limited due to the sample which was restricted to one university and not randomly selected. To guide the direction of the study, it was hypothesized that the rate of expressed health problems of students living in the dormitory would be Venter than that of students living at home. The hypothesis was tested and rejected. The following is a summary of the findings; 1. Total health (physical and mental) complaints a. There was no statistically significant difference between the home and dormitory groups with regard to total health complaints expressed. b. The rate of total complaints expressed by the home group significantly higher than dormitory group only among third year students. c. There was no statistically significant between the home and dormitory groups in their satisfaction with their economic situation. d. The home group showed a significantly higher rate of complaints related to the Nervous System compared to that of the dormitory group. 2. Physical health complaints a. Students living at home showed a significantly higher rate of physical complaints than the dormitory group. b. When the year variable was controlled, the third year was the only group which showed a different rate between home and dormitory groups; the home group presented a higher rate. c. Since the year variable seemed to affect the physical complaints those data were further analysed to see whether the specific system areas were operating as variables in each year. The results were as follow: Among the home group, First year students showed a higher rate in Family History of Disease, while the third year students more Nervous System and Cardiovascular System complaints. Among the dormitory group, only fourth year students showed a higher rate in the Skeletal-Muscular System. This was the only area the dormitory group though only for the fourth year students supported the hypothesis. d. When the economic satisfaction variable was controlled, the satisfied group was the only group which showed a different rate between home and dormitory groups; the home group presented higher rate. e. Since the economic satisfaction variable seemed to affect the physical complaints those data were further analyzed to see whether the specific system areas were operating as variables in each economic satisfaction level, but there was no statistically significant difference between home and dormitory groups. 3. Mental health complaints a. There was no significantly difference between home and dormitory groups with regard to mental health complaints expressed. b. When the year variable was controlled the third year group was the only group which showed a different rate between home and dormitory groups; the home group presented a higher rate. c. Since the year variable seemed to affect the mental complaints, those data were further analyzed to see whether the specific system areas were operatings variables in each economic satisfaction level. The result were as follows: Among the home group, the third year students showed higher rates in Inadequacy and Anxiety. d. When the economic satisfaction variable was controlled, the very satisfied group was the only group which showed a different rate between home and dormitory groups: the home group presented a higher rate. Since the economic satisfaction variable seemed to affect the mental complaints, those data were further analysed to see whether the specific system areas were operating as variables in each economic satisfaction level, but there was no statistical significant difference between the home and dormitory groups. Although the social environment of dormitory life differs from family life, there was no difference in the rate of total health problem complaints between the home and dormitory groups but the home group showed a higher rate of physical health complaints than the dormitory group. Possible positive factors influencing dormitory life and negative factors influencing family life affecting health complaints must be explored in order to relate to the health needs of the university health program. This study could not define the causes for the fewer physical complaints of dormitory students living at home. Further study of such causal factors recommended in order to provide the data needed to contribute to a more effective health program.

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세브란스 호스피스 추후관리 프로그램의 효과에 관한 연구 (A STUDY OF THE EFFECTIVENESS OF THE BEREAVEMENT PROGRAM OF SEVERANCE HOSPICE)

  • 왕매련
    • 대한간호
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    • 제31권2호
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    • pp.51-69
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    • 1992
  • Grief that is not acknowledged and worked through may manifest itself in some emotional, mental or physical problem. In recent years much has been learned about coping with grief which the hospice program can utilize to help family members cope with their grief. This study was carried out to determine the helpfulness of the bereavement care of Severance Hospice and to learm more about the grief response of the bereaved. The tools used to collect data were an assessment form used in the bereavement program and the Grief Experience Inventory developed by Sanders and revised and translated 'by the researcher. Data was obtained from bereaved family members(54 for the final grief assessment and 39 for the grief response assessment) receiving bereavement follow-up, from July 1989 to March 1991. Results of the study were as follows: 1. Final Grief Assessment Regarding the resolution of their grief the majority of the bereaved accepted the reality of the death of their family member, while slightly more than three-quarters were able to express their feelings toward their loss. A large majority had returned to activities of daily living well or fairly well and had reinvested their energy in a person other than the deceased. In addition, the physical condition of the majority was good or fairly good. A majority of the bereaved considered the bereavement care to be helpful and almost three-quarters were not considered to be in need of more follow-up. 2. Grief Response Assessment Age was found to have a modoerately positive correlation to appetite disturbance(r=.41, P<.Ol) and loss of vigor(r=.37, P<.Ol) A moderately positive correlation was found between the number of contacts and sleep disturbance(r=2.38, P<.01) Significant differences were found between men and women in regard to guilt(t=2.38, P<.05), social isolation(t=2.44, P<.05) and depersonalization(t=2.07, P<.05) with men having the more intense grief. Significant differences were found in the grief responses of somatization(F=5.82, P<.001), physical symptoms(F=5.87, P<.OOl), appetite disturbance(F=4.40, P<.Ol), despair(3.79, P<,Ol), anger(Fp2.83, P<.05), social isolation(F=3.61, P<.05), guilt(F=3.62, P<.05) and depersonalization (F = 2.58, P <.05). In the first six of these grief responses mothers scored highest, followed by husbands and then wives, In the grief response of guilt, daughters scored highest and on the grief response of depersonalization sons scored highest. Only one grief response, that of sleep disturbance(t= -2.19, P<.05) was found to be statistically significant, with those family members who died at home having the higher scores. Based on the results of this study several suggestions are presented as follows: 1. Since unresolived grief can have a detrimental effect on the bereaved person's mental and phys. ical health it would be good for the nurse, to include questions related to death of family members and the bereaved person's response to the grief, in her nursing assessment. And in the case of unresolved grief the nurse should encourage the person to talk with a trusted friend or counselor and express their fellings of grief. 2. A study to determine the degree of resolution of the grief of those in the bereavement program could be carried out by use of the Grief Experience Inventory early in their bereavement and again 13 months after the death of their family member. 3. A comparison of the grief response of the bereaved in the bereavement program and bereaved not in the program could be carried out using the Grief Experience Inventory. 4. After bereavement programs have been started in other hospice programs it would be good to carry out a joint study of bereavement outcomes of those in the bereavement programs.

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뜸요법이 여성노인의 만성요통, 일상생활기능장애 및 수면양상에 미치는 효과 (The effects of Moxibustion Therapy on Chronic Low Back Pain, Daily Living Disability and Sleep Pattern in Elderly Women)

  • 김혜정
    • 한국산학기술학회논문지
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    • 제17권7호
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    • pp.301-310
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    • 2016
  • 본 연구는 만성요통을 호소하는 여성노인을 대상으로 뜸 요법을 중재 방법으로 적용하여 일상생활기능장애 및 수면 양상을 효율적으로 관리 할 수 있는지 그 효과를 규명하기 위해 시도된 비동등성 대조군 전후 실험연구이다. G시에 거주하는 여성노인(실험군 30명, 대조군 30명)으로 2015년 3월 15일부터 5월 31일까지 뜸 요법을 12주간 주 1회 총 12회 뜸 요법을 적용하였고, 추후조사는 사후조사 2주후에 실시하였다. 뜸 요법은 요혈인 신수(腎諭)와 아시혈, 대장수(大腸兪), 요양관(腰陽關), 요수(腰兪)을 취혈하였다. 무극보양뜸 7혈인 족삼리(足三里) 곡지(谷地), 중완(中脘), 중극(中極)과 수도(水道), 폐수(肺愈), 고황과 천추(天樞), 위중(委中)부위에 각각 5장씩 뜸처치를 실시하였다. 연구도구는 요통정도를 사정하기 위해 Scott & Huskisson(1979)이 개발한 시각적 상사척도(Visual Analog Scale ; VAS)를 사용하였고, 일상생활기능장애 측정 도구는 Fairbank 등(1980)이 개발하고 임현술 등(1998)이 번역 수정한 Oswestry Disability Index를 이용하여 측정하였다. 수면양상 측정 도구는 오진주, 송미순, 김신미(1998)가 개발한 수면 측정 도구를 이용하였다. 자료분석은 SPSS/WIN 18.0을 사용하였으며 Chi-square test, t-test, repeated measures ANOVA를 실시하였다. 대조군에 비해 뜸 요법을 제공받은 여성노인의 통증점수(F=2510.32, p<.001), 일상생활기능장애 점수(F=1937.82, p<.001), 수면양상점수((F=15.54, p<.001)가 유의한 차이로 나타났다. 따라서 뜸요법은 통증과 일상생활기능장에를 감소시키고, 수면의 질을 향상시키는데 긍정적인 기여를 하는 것으로 나타나 향후 뜸요법이 만성요통을 호소하는 노인에게 간호중재로 활용할 필요가 있다.

관절통환자의 통증정도와 통증연관 행위에 관한 연구 (The Pain Behavior of Patients with Joint Pain)

  • 이은옥;한윤복;김순자;이선옥;김달숙;김조자;김광주;김주희;박점희
    • 대한간호학회지
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    • 제18권2호
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    • pp.197-210
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    • 1988
  • The purposes of this study were : 1) to assess the level of pain and to identity the varieties and the degree of pain-related behavior, 2) to measure the level of correlation between the level of pain and the degree of pain- related behavior, 3) to test the correlation between the Korean Pain Rating Scale (KPRS) and Graphic Rating Scale(GRS), and 4) to gather data relevant to the Socio-demographic status of the subjects. The level of pain was measured by KPRS and GRS developed by the researchers. The KPRS consists of three dimensions ; the sensory, the affective and the miscellaneous and the GRS of two separate scales ; the intensity scale and the unpleasantness scale. Of the 2, 025 who had visited orthopedic and neurosurgical out-patients department of 11 university hospitals in various districts of Korea with the episode of Joint pain, 405 subjects were self-selected by responding to the data gathering tools and questionaires mailed. The results are summaried as follows : 1. Maale(217, 53.6%) exceeded female patients(188, 46.4%) in number and the onset of joint pain was more prevalent in the age groups of the 20s and the 30s. 160(39.5%) had been hospitalized for the treatment of, and 87(21.5%) had retired because of the joint pain. 2. Mean pain score measured by KPRS was 128.31 (range; 0-1.344.8) ; mean sensory score was 43.23(range ; 0-645.88%), mean affective score was 46.09(range ; 0- 356.72), and mean miscellaneous score was 39.99(range ; 0-341.68). Mean pain scores measured by GRS were ; sensory intensity score ; 109.1(range ; 0-200) and distress score ; 99.1 (range ; 0-200). 3. The prevalent sites of joint pain revealed to be the right knee joint(203; 50.1%), left knee joint(181(44.7%), left ilium(147, 36.3%), lumbar region (106; 26.2%), hip joint(92; 22.7%) and the ankle(84; 20.7%). 4. The average sleep hour was 6.8hours per day and the average rest hour during the day hours was 3.3hours (range 0-20). 5. The average duration of suffering from joint pain was 49.1 months. 6. Most of the subjects(298; 73.6%) used some sorts of pain relieving practices ; the most prevalent pain relieving practice was the compliance with the physician prescribed treatments(34.4%). 7. The level of discomfort in carrying out the ADL(activities of daily living was 101.16(38.83) and the level of needs for aid in carrying out the ADL was 76.62(31.79). 8. The interrelation between KPRS total score and GRS sensory intensity score(.4438), as well as that of GRS distress score(r=.4446) were not highly correlated, however, sensory and affective dimension within KPRS (.7547) and pain intensity and distress score of GRS(.6975) revealed moderate intercorrelation. 9. Pain-related behaviors such as discomfort in carrying out ADL, the need for aids in carrying out ADL, frequency of pain relieving practices, varieties of pain sites and length of rest hours during the day hours revealed to be highly correlated with the level of pain measured by KPRS, GRS sensory intensity scale and GRS distress scale. The following are recommended ; 1. Test for the correlation of KPRS total score and the summated score of GRS ; sensory intensity and distress scores. 2. Possibilities of utilization of the pain-related behaviors which revealed high correlation as indirect assessment tool for measuring the level of pain.

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입원환자 가족의 호스피스 인지 및 요구도 (The Knowledge and Needs of Hospice for Inpatients' Family)

  • 고성희;김현경
    • Journal of Hospice and Palliative Care
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    • 제8권2호
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    • pp.131-142
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    • 2005
  • 목적: 본 연구는 일개 종합병원에 입원한 환자의 가족을 대상으로 호스피스에 대한인지 및 요구도를 사정하기 위해 시도되었다. 방법: 2003년 3월부터 5월까지 J 종합병원에 입원한 환자가족 277명을 대상으로 자기보고식 설문지를 통해 자료를 수집하였고, SPSSWIN 10.0으로 분석하였다. 결과: 대상자 중 호스피스에 대해 들어 본 적이 있는 경우가 232명(83.8%)이었고, 매스컴을 통해 들은 경우가 107명(38.6%)으로 가장 많았으며, 213명(76.9%)이 호스피스란 환자의 남은 생을 끝까지 충만하게 살고 편안한 죽음을 맞도록 돕는 일이라고 제대로 알고 있었다. 233명(84.1%)이 호스피스가 필요하다고 인식하였고, 220명(79.4%)이 본인이나 가족이 호스피스 간호가 필요하다면 받겠다고 응답한 반면 가족이나 주변사람이 호스피스 간호를 받아본 경험이 있는 경우는 25명(9.0%)에 불과하였다. 만약 불치병(말기암)이라면 미리 죽음을 준비해야 한다고 생각한 응답자는 212명(76.5%)이었고, 243명(87.7%)이 그 상태에 관하여 진실을 알고 싶어하였다. 불치병에 걸린 사람에게 이루어져야 할 조치로는 최소한의 통증과 평화로운 죽음을 위한 신체적, 정신적, 영적 간호가 필요하다고 올바르게 지적한 자가 173명(62.5%)으로 가장 많았다. 임종시 가족과 함께 있고 싶다고 응답한 경우가 177명(63.9%)으로 가장 많았고, 73명(26.4%)은 가장 도움이 되는 호스피스요원으로 간호사를 꼽았다. 임종환자들만을 위한 호스피스 병동 운영에 대하여 226명(81.6%)이 찬성하였고, 대상자들이 선호한 호스피스시설의 운영형태는 병동형 66명(23.8%), 시설형 57명(20.6%), 공공의료형 56명(20.2%), 산재형 47명(17.0%), 가정형 34명(12.3%)의 순으로 나타났다. 결론: 본 연구의 결과 입원환자 가족의 호스피스에 대한 인지 및 요구도는 전반적으로 높았으며 일반적 특성에 따라 호스피스 인지 및 요구도에 차이를 보였다. 따라서 대상자의 일반적 특성을 고려한 개별적이고 다양한 접근을 시도할 수 있는 호스피스 교육 및 중재 프로그램을 개발하여 수행해야 할 것이다.

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호스피스 병동에 입원한 말기 암환자의 통증 예측요인 (Factors for the Prediction of Pain in Terminally Ill Cancer Patients in Hospice Units)

  • 용진선;한성숙;노유자;홍현자
    • Journal of Hospice and Palliative Care
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    • 제5권2호
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    • pp.125-135
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    • 2002
  • 목적 : 본 연구는 호스피스 병동에 입원한 말기 암 환자의 통증과 통증에 영향을 미치는 요인인 우울, 불편감, 신체적 간호 시행 횟수, 진통제 사용, 및 영적상태를 평가하기 위한 서술적 조사 연구이다. 대상 : C 대학 3개 부속병원의 호스피스 병동에 새로 입원한 말기 암환자 58명을 대상으로 하였다. 자료수집은 1998년 1월부터 1999년 1월까지 1년간 연구원들의 직접 면접으로 실시하였다. 수집된 자료는 ANOVA, Pearson correlation oefficient, 및 Multivatiate mulitiple regression으로 통계 처리하였다. 결과 : 1) 인구학적 특성:대상자의 나이는 평균 57세 이었고, 60세 이상이 28명(48.3%)으로 가장 많았다. 교육정도는 고등학교 이상 졸업자가 약 53%를 차지하였고, 종교는 가톨릭이 62.1%로 가장 많았다. 결혼 상태는 대부분이 기혼(89.7%)이었고, 가족 수는 2명인 경우가 25.9%, 4명이 19.0%, 없는 경우가 17.2%, 3명이 15.5 % 순이다. 임상적 특성으로 진단명은 위암이 24.1%, 폐암이 17.2%, 직장암이 13.8% 순 이었다. 호스피스 병동에 입원하게된 동기는 통증완화가 67.2%, 영적 간호가 39.7%, 증상완화가 27.6%였다. 수술을 받은 경우는 44.8%, 받지 않은 경우가 55.2%였다. 가족력에 암이 있었던 경우는 27.6%이었고, 일상 수행 정도는 부분적으로 가능한 경우가 65.5%로 가장 많았으며, 전혀 불가능이 22.4%, 그리고 12.1%는 가능하였다. 돌봄과 관련된 특성에서 주 돌봄 제공자가 주로 가족(72.4%)이었으며, 간호 장소는 84.5%가 병원을 선호하였고 그 이유는 통증 조절(51.7%), 언제나 치료가 가능한 점(15.5%), 정서적 안정(15.5%), 그리고 영적 간호(12.1 %) 순으로 나타났다. 대상자 모두는 가정에서의 간호를 염려하고 있었는데 그 이유는 통증 조절이 어렵다는 것(77.6%), 영적 간호 제공자 부재(15.5%), 돌봐줄 사람의 부재(13.8%), 및 가족의 부담감(6.9%)이었다. 통증의 종류를 보면, 대상자의 53.4%가 심부 통증, 20.7%가 복합적인 통증, 17.3%가 내장 통증, 5.2%가 신경성 통증, 3.4%가 표재성 통증을 호소하였다. 마약성 진통제를 사용한 경우는 77.6%였다. 통증 정도는 평균 4.69점이었고, 우울감은 6.13점, 불편감은 4.13점, 그리고 신체간호 시행은 2.59점이였다. 2) 통증과 통증 관련요인과의 상관 관계 :통증과 우울(P<.05), 통증과 신체적 간호(P<.05), 통증과 불편감(P<.05), 우울과 불편감(P<.05)사이에 순 상관 관계를 보여, 우울하고 불편감이 심할 수록 통증이 더 심했으며, 신체 간호 횟수가 많은 경우일수록 통증을 더 느꼈고, 우울할 수록 불편감도 더 심했다. 3) 통증예측 요인 분석: 우울 정도(${\beta}=0.41$, P=0.0049) 와 마약성 진통제 사용 여부(${\beta}=2.11$, P=0.0132)가 환자의 통증 정도($R^2=.46$)에 유의하게 영향을 미쳤다. 결론 : 본 연구의 결과 말기 암환자들 대부분이 입원 당시 중등도 이상의 통증이 있었으며, 통증정도는 우울과 불편감 그리고 신체간호 횟수와 상관관계가 있었고, 우울과 마약성 진통제 사용이 통증 예측인자로 나타났다. 그러므로 말기 암환자의 통증을 완화하기 위해서는 약물요법은 물론 신체적, 심리적, 및 영적 측면과 관련된 총체적인 접근에 의한 다학제간의 중재프로그램이 마련되어야 한다고 본다.

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