• 간호행정학회지
• /
• 제3권2호
• /
• pp.95-107
• /
• 1997

간호학의 독자적인 지식체계의 구축을 위해서는 먼저 간호 연구가들의 간호철학 정립이 필요하다. 그러한 간호철학 정립을 워해 우선 간호학의 본질과 영역 그리고 간호학의 학문적 특성을 밝히는 것이 필요하다. 이 연구의 목적은 소외의 개념과 소외가 발생되는 상황 및 마르틴 부버의 사상을 이해하는 것이다. 이러한 개념들의 이해는 간호사들이 상호작용과 관계에 대한 문제점을 깨닫게 하여 관계와 상호작용을 향상시키게 된다. 소외는 현대 사회의 중요한 문제로 문화적 소외, 정치적 소외, 경제적 소외 기술과 기계에 의한 소외, 종교적 소외 등이 있다. 소외극복을 위한 간호의 한 방안으로 마르틴 부버의 관계사상에 기초를 둔 참된 만남의 상호관계 및 돌봄이 필요하다. 마르틴 부버 사상의 본질은 "너와 나" 관계이며 너와 나 관계는 5가지 특성이 있다. 1) 상호성 2) 직접성 3) 현재성 4) 강렬성 5) 표현불가능성 의료기술이 발전되고 복잡해짐에 따라 환자상태를 사정하는데 가계에 의존하며, 기계의 성능과 기계의 관리에 촛점이 맞추어지면서 환자와의 의미있는 의사소통은 점점 더 적어지는 결과를 낳게 되었다. 이러한 문제점 해결을 위해 의료진과 환자와의 "너와 나" 관계가 중요한데, 이 관계에는 의료진이 환자에게 성실하게 관심을 가지고 존경심과 온화함으로 대해야함이 포함되어야 한다. 궁극적으로 이 연구가 "나와 너" 관계개념에 대한 이해를 돕고 간호교육의 간호철학 정립을 위한 기초자료가 되기를 바라는 바이다.

• 디지털융복합연구
• /
• 제13권8호
• /
• pp.345-356
• /
• 2015

오늘날 의료가 단지 치료라는 개념을 넘어 서비스라는 인식이 확대되면서 의료서비스 소비 주체인 이용자들이 인식하는 의료서비스 질의 중요성은 날로 강조되고 있으며, 일차의료라고 해서 예외는 아니다. 이 연구는 65세이상 노인들이 보건소에서 제공하는 의료서비스의 질을 어떻게 인식하고 있는지 파악하고, 어떠한 요인들이 의료서비스 이용량과 관련성이 있는지를 탐색하고자 하였다. 이 연구는 서울시 보건소를 이용하는 노인들을 대상으로 연구원이 면접조사를 통하여 자료를 수집하였고, 총 307명의 설문자료를 분석하였다. 의료서비스 질은 융합적 요소를 고려하여 접근하였으며, 분석 결과, 이들의 구성항목 중에서 이용시설 및 환경, 환자중심진료, 의사의 전문적 지식 및 기술수준, 그리고 직원 및 간호사의 정서적 지지에 대하여 노인들이 긍정적으로 인식할수록 보건소의 의료이용이 증가하였다. 따라서 보건소가 쾌적하고 편리한 시설환경을 갖추고, 직원 및 간호사들은 이용자들과 원활한 의사소통을 위해 노력하며, 동시에 의사가 환자중심의 전문적인 의료서비스를 제공한다면 보건소의 의료서비스 질과 가치 향상에 도움이 될 것이다.

• 기본간호학회지
• /
• 제6권3호
• /
• pp.382-396
• /
• 1999

This study was attempted to prove the effect of emotional stability and vital signs applying music therapy program to the children admitted in the PICU. Data were collected from July to September, 1997. The subjects were 30 patients admitted in the PICU of 'S' University Hospital which were divided into two groups of experimental and control. Each group had 15 subjects. Method was nonequivalent control group pretest-postteset repeated design, observing vital signs and activity of subjects prior, during, and after the music intervention. The study tools were cassette tapes of 'Mother's music whose babies want to listen' and Space-lab patient monitor. Data were analyzed using the $SPSS/PC+;x^2$ test and t-test to analyze of the general characteristics ; paired t-test to prove hypotheses. Result were as follows; 1. Infants lower than seven months showed changing into stable vital signs from applying the music therapy, however infants from eight months to three-year old showed no change in vital signs. 2. Vital signs changed to stabilized condition in infants lower than seven months were heart rate and respiration rate. 3. The stability of vital signs during music therapy turned back to the previous state while terminating music therapy. 4. The effect of music therapy in the state of activity had on both infants group of lower than seven months and from eight months to three-year old, particularly more effective in the later group. I recommend follows on the base of above results ; 1. As above results shows, listening to music is effective on infants and toddler, intervention with music therapy appropriate to chidlren's age is hot recommended. 2. Comparative study with noise blocking effect and music therapy effect within the ICU environment be recommended. 3. The repeated study on when the exact time is and how many repeat the music therapy to show the above mentioned effect be recommended. 4. We recommend this music therapy to be done in the recovery room, isolating room, operating room as well as ICU.

• Asian Pacific Journal of Cancer Prevention
• /
• 제13권6호
• /
• pp.2453-2458
• /
• 2012

Background: The healthcare needs of cancer patients are complex and persons involved in their caregiving process are faced with many issues that need to be addressed. The entire family and particularly the person taking on responsibility for patient care develop expectations from healthcare professionals, especially nurses. Objective: The study was conducted to evaluate the impact of a home education program provided to caregivers of cancer patients on the level of their perceived social support and problems in caregiving. Interventions/Methods: The caregivers of thirty seven cancer patients of 2,400 registered people in a family center were given an educational program in this descriptive and cross-sectional study twice a week for a month during the period of March 2011 - April 2011. Results: Of all caregivers, 56.8% were between the ages 36-40, 94.5% were female, 91.9% had received no education on caregiving, 81.0% stated that they mostly felt physically and mentally inadequate in their caregiving. Perceived Social Support from the family indicated a significant difference at $8.05{\pm}4.38$ before and $11.7{\pm}4.97$ after the education. A comparison of the mean scores of caregivers on emotional issues before and after the education revealed the following: spiritual distress scores were $2.54{\pm}0.69$ before and $2.44{\pm}0.43$ after the education; hopelessness scores, $2.24{\pm}0.59$ before and $2.23{\pm}0.38$ after the education; ineffective individual coping was $3.89{\pm}1.42$ before and $2.45{\pm}0.59$ after the education; competing needs in decision-making were $3.54{\pm}0.69$ before and $2.10{\pm}1.24$ after the education; depressive feeling were $3.01{\pm}1.53$ before and $2.02{\pm}0.99$ after the education (p<0.05). Conclusions: Positive effects of home education on levels of perceived social support and caregiving problems of caregivers of cancer patients were observed. Home educational programs for caregivers of cancer patients are important for both better understanding of the requirements of their patients and themselves.

• 대한간호학회지
• /
• 제27권2호
• /
• pp.289-302
• /
• 1997

The main purpose of this study was to identify the effects of integrated stress management program on the stress symptoms of psychophysiological patients. especially patients with peptic ulcer. The study employed a quasi-experimental design using two different experimental groups. The samples in the integrated stress management program participated in autogenic training with biofeedback. discussions on effective coping method. cognitive. behavioral, and emotional management. They were also provided with an educational booklet on stress management and an tape on progressive muscie relaxation. Each session lasted one hour and the program consisted of seven sessions over four weeks. The other group was only given an tape on progressive muscle relaxation. The data were collected from May 20 to september 25, 1996. A total 47 patients from one university hospital located in Seoul participated, experiment group 1(integrated stress management training) had 23 subjects and experiment group 2(progressive muscle relaxation training) had 24 subjects. The effects of these programs were measured by the stress symptom scale developed by Kogan(1991) which was translated by Lee(1992) and the healing status of the ulcer evaluated by a physician. The data were analyzed using Chi-square test, t- test, ANOVA, repeated measure ANOVA. The result are as follows : 1. The integrated stress management group reported a significantly lower stress symptom score than the group given the progressive muscle relaxation only. 2. The integrated stress management group showed a significantly improved ulcer status as compared to the group given a progressive muscle relaxation only. In conclusion, it was found that the integrated stress management program was more effective in decreasing self-reported stress and physiological symptoms among patients with peptic ulcer as compared to the progressive muscle relaxation group. Based on this finding, the following suggestions can be made. 1. It is necessary to broaden the scope of nursing practice for psychophysiological patients so nurses can include stress management as part of patient care. 2. It is necessary to develop stress management program for other patients whose symptoms are known to be related to stress. 3. It is necessary to replicated this study with a larger sample in different settings.

• 대한예방한의학회지
• /
• 제27권2호
• /
• pp.73-84
• /
• 2023

Objectives : We tried to propose the direction of Korean medicine education through the consideration of 'professionalism as a competency beyond knowledge-skill' that modern medicine should take and therefore the perspectives of the competency-based curriculum in Korean medicine education. Methods : Competency-based curriculum, professionalism education phase and competency at medical school, student demand survey, Korean medicine education Accreditation Standards, and related research articles were used. Results : Proposed development measures to cultivate students' professionalism in Korean medicine education are as follows. self-care and emotional stability programs, communications between patient and doctor and among the colleagues, career exploration programs based on global medical trends and government policy, standardized professional training programs, and the evaluation of teaching experiences and achievements. Conclusions : The main purpose of the reorganization of the competency-based curriculum should be for improving Korean medicine education. The contents of phase performance, process performance, and course performance should be carefully organized so that the core contents and spirit of traditional Korean medicine can be achieved. In modern medicine, education of professionalism has been used to cover the problems that arise from taking achievement goals only from a biomedical perspectives. Accordingly the education of professionalism is also important in Korean medicine education as the modern Korean medicine follows the aspect of modern medicine,

• Journal of Preventive Medicine and Public Health
• /
• 제56권2호
• /
• pp.154-163
• /
• 2023

Objectives: Systemic lupus erythematosus (SLE) or lupus patients usually experience various physical and psychological challenges. Since the coronavirus disease 2019 pandemic, these challenges have become even harsher. Using the participatory action research approach, this study evaluated how an e-wellness program (eWP) impacted SLE-related knowledge and health behaviors, mental health, and quality of life among lupus patients in Thailand. Methods: A 1-group, pretest-posttest design study was conducted among a purposive sample of lupus patients who were members of Thai SLE Foundation. The 2 main intervention components were: (1) online social support, and (2) lifestyle and stress management workshops. Sixty-eight participants completed all the study requirements, including the Physical and Psychosocial Health Assessment questionnaire. Results: After being in the eWP for 3 months, participants' mean score for SLE-related knowledge increased significantly (t=5.3, p<0.001). The increase in sleep hours was statistically significant (Z=-3.1, p<0.01), with the percentage of participants who slept less than 7 hours decreasing from 52.9% to 29.0%. The percentage of participants reporting sun exposure decreased from 17.7% to 8.8%. The participants also reported significantly lower stress (t(66)=-4.4, p<0.001) and anxiety (t(67)=-2.9, p=0.005). The post-eWP quality of life scores for the pain, planning, intimate relationship, burden to others, emotional health, and fatigue domains also improved significantly (p<0.05). Conclusions: The overall outcomes showed promising results of improved self-care knowledge, health behaviors, mental health status, and quality of life. It is recommended that the SLE Foundation continues to use the eWP model to help the lupus patient community.

• 한국병원경영학회지
• /
• 제7권3호
• /
• pp.1-24
• /
• 2002

The purpose of this study was to find the factors affecting the bum out syndrome and its degree in terms of personal, organizational and clients characteristics, and then to find the ways to reduce or eliminate those factors. The 228 doctors and the nurses who worked at the emergency departments in 6 general hospitals with more than 700 beds in Seoul were surveyed from April 15, 2002 for 15 days. A structured self-recording questionnaire was used; the t-test and ANOVA was used to analyse the median difference between the occupation, and multiple regression was employed to find the factors affecting the bum-out syndrome. The summary of this research analysis is as follows : First, of several variables, the highest frequency of the burn-out was the emotional burn-out followed by lack in personal touch toward the patients, decrease in sense of personal achievement. These results indicate that the doctors and nurses in emergency departments experience higher degree of burn-out than the social workers and the nurses who work at other departments in heath care environment as other studies revealed. Second, the analysis of the total burn-out factors showed the lower self respect, younger age, heavier work load, higher dissatisfaction rate toward remuneration and not-so-smooth relationship with the patients and their relatives the higher burn out rate. These variables explained 54% of the total variables. Third, the nurses experienced more burn-out syndrome than the doctors. The degree of self-respect, work pattern, relationship with the clients, age and remuneration were the causes of the burn-out. The doctors recorded lack in personal touch toward the patients more, while the nurses more to emotional exhaustion. The limitations of this research are the subjective answers of the respondents to certain questions and differences in sample numbers of each hospital in which some reservation can be exercised in explaining statistical significance of the data, and generalizing the conclusion. Despite of its limitation, this research has its own merit as an unpreceded research in this field, and provision of the basic materials to prevent and find causes of the burn-out syndrome among the doctors and nurses in the emergency departments.

• 한국과학예술포럼
• /
• 제19권
• /
• pp.417-424
• /
• 2015

최근 한국 내에서 서비스 디자인을 가장 활발히 연구하고 적용하는 분야 중 하나가 의료서비스 업계이다. 건강에 대한 관심의 고조로 의료서비스는 치료, 간호뿐 아니라 예방, 관리, 재활의 주체로 그 영역이 넓어지고 있다. 보건 의료 종사자는 서비스 공급자이며. 서비스를 제공받는 고객에게는 서비스 제공자의 전문적인 지식과 능력, 그리고 의료기술에 대한 신뢰가 가장 중요하다. 또한 그에 못지않게 의료기관의 시스템, 종사자들의 태도, 정보의 전달, 터치 포인트 등의 경험은 고객의 만족도를 좌우하는 주요한 요소가 되므로 이를 다루는 서비스 디자인은 더욱 주목 받고 있다. 특별히 다른 서비스업보다 고객의 예민한 상황과 감정을 다루어야 하는 의료서비스분야의 특성상 전문성이나 환경, 그리고 제품의 개선만으로는 충분한 만족감을 주기 어렵다. 그것은 감정 노동자라고 할 수 있는 서비스 제공자인 의료 종사자의 서비스 마인드와 태도의 변화가 함께할 때 실질적인 효과를 얻을 수 있기 때문이다. 따라서 이를 위한 교육이나 문제의식을 갖고 자체적으로 해결할 수 있는 시스템 등이 궁극적인 솔루션이라고 할 수 있다. 이 논문에서는 서울대학교병원에 적용된 서비스 제공자들을 위한 서비스 디자인 시스템과 교육 등을 포함한 몇 가지 방법을 소개하고 그 효과에 대해 다루고 있다.

• 정신신체의학
• /
• 제27권2호
• /
• pp.138-146
• /
• 2019

연구목적 말기 암 환자에서 우울증이 암의 경과 및 예후와 관련성이 있다고 알려져 있으며, 암 환자의 생존율과도 부적 관련성이 보고된 바 있으나 국내에서는 연구가 부족한 실정이다. 본 연구에서는 완화 병동에 입원한 말기 암 환자에서 우울 증상과 생존율의 관련성을 분석하였다. 방 법 2015년 10월부터 2018년 8월까지 한 대학병원의 완화 병동에 입원한 291명을 대상으로 후향적 연구를 진행하였으며, 대상자는 혈액종양내과 전문의가 최종적으로 진단 확정한 2개월 미만의 예상 생존 기간을 가진 말기 암 환자로 하였다. 생존기간은 완화 병동에 입원 후부터 완화 병동에서 임종 시까지의 기간으로 하였으며, 3일 이내 사망하거나 일반 병실로 전실 및 다른 병원으로 전원을 간 환자는 제외하였다. 입원 시 Patient Health Questionnaire-9 (PHQ-9)으로 우울증을 평가했으며, 291명의 환자 중 146명(50.2 %)이 PHQ-9를 완료했으며, 145명(49.8 %)은 의식 저하 또는 환자의 거부로 인해 평가되지 않았다. 결 과 Kaplan-meier 생존 분석에서, 4주 생존율은 우울하지 않은 군(PHQ-9<10)에서 45.4%, 우울증 군(PHQ-9≥10)에서 18.7%였다. 우울증의 중증도에 따라 Cox 비례위험 모델에서, 중등도(moderate), 중증(moderately sever) 및 고도(severe)의 우울증 군의 사망 위험은 최소(minimal) 우울증 군보다 각각 2.778, 1.882 및 3.423배 높았다. 결 론 완화 병동에 입원한 말기 암 환자 중, 우울증이 있는 군에서 우울증이 없는 군보다 생존기간이 짧았다. 우울증 치료가 말기 암 환자의 생존율을 증가시키는지를 알기 위해 추가 연구가 필요하다