• 간호행정학회지
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• 제19권1호
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• pp.118-127
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• 2013

Purpose: The purpose of this study was to identify experiences of incidents and to explore the perceptions of Patient Safety Culture between two groups using nursing homes in Korea; employees and patients and their families. Methods: In 2010 in-depth interviews were used to collect data from 56 participants (38 employees, and 18 patients and family members). The data were analyzed using inductive content analysis. Results: The analysis scheme resulting from employees' data consisted of 7 categories and 22 subcategories, after 216 significant statements were analyzed and categorized. The 7 categories were education and training (24.5%), working attitude (23.6%), organizational system (19.0%), job satisfaction (18.5%), institutional environment (6.5%), manager leadership (4.2%), and work climate (4.7%). The analysis scheme resulting from patient and family data consisted of 6 categories and 7 subcategories after 24 significant statements were analyzed and categorized. Education and training among categories of employees were excluded. Conclusion: These findings indicate that an evaluation tool for patient safety culture should be developed for nursing homes in Korea.

• 한국항행학회논문지
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• 제18권6호
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• pp.625-632
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• 2014

유헬스 서비스는 사물인터넷 장치와 스마트 기기와 같은 모바일 장치를 사용하기 때문에 휴대가 간편한 소형 컴퓨팅 장치로 구성되어 있으며, 기존 컴퓨터에서 수행하던 작업을 동시에 수행할 수 있다. 환자의 생체정보를 이동통신망 환경에서 의료진과 환자 및 환자의 가족의 스마트기기로 실시간으로 전달할 수 있도록 bluetooth HDP기반의 메시지 구조를 사용하였다. ISO/IEEE 11073 PHD 표준을 기반으로 agent와 manager 사이의 통신 방법을 정의하였다. 의료진과 환자 및 환자의 가족이 스마트 기기를 통하여 실시간으로 확인할 수 있도록 안드로이드 기반의 모니터링 애플리케이션을 구현하여 일상생활에서 사용되고 있는 스마트 기기에서 동작을 확인함으로써 생체정보의 원활한 송수신을 확인하였다.

• Journal of Hospice and Palliative Care
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• 제26권2호
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• pp.69-79
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• 2023

Purpose: This study aimed to investigate the involvement of patients who died from hematologic neoplasms in the decision-making process surrounding the withdrawal of life-sustaining treatment (LST). Methods: A total of 255 patients diagnosed with hematologic neoplasms who ultimately died following decisions related to LST during their end-of-life period at a university hospital were included in the study. Data were retrospectively obtained from electronic medical records and analyzed utilizing the chi-square test, independent t-test, and logistic regression. Results: In total, 42.0% of patients participated in the decision-making process regarding LST for their hematologic neoplasms, while 58.0% of decisions were made with family involvement. Among these patients, 65.1% died in general wards and 34.9% in intensive care units (ICUs) as a result of decisions such as the suspension of LST. The period from the LST decision to death was longer when the decision was made by the patient (average, 27.15 days) than when it was made by the family (average, 7.48 days). Most decisions were made by doctors and family members in the ICU, where only 20.6% of patients exercised their right to make decisions regarding LST, a rate considerably lower than 79.4% observed in general wards. Decisions to withhold or withdraw LST were more commonly made by patients themselves than by their families. Conclusion: The key to discussing the decision to suspend hospice care and LST is respecting the patient's self-determination. If a patient is lucid prior to admission to the ICU, considerations about suspending LST should involve the patient input.

• 대한간호학회지
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• 제26권1호
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• pp.15-32
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• 1996

The clinical practice program for home care nurses was implemented in June 1994, to help to set up a hospital-based home care system in the Kwangju City area as a collaborative work between the Department of Orthopedic Surgery at Chunnam University Hospital and Chunnam University School of Nursing. Under the developed clinical practice strategy, the eight week training was given to five licensed home care nurses who had completed Part I and II of the home health care nursing practicum from June 1994. The purpose of this descriptive evaluation study was to identify the effectiveness of the clinical practice program for home care nurses specialized in the area of patient care for people with musculoskeletal function impairment. As a method in data analysis, data triangulation was used in the five home care nurse case evaluations. The variety of data analyzed include confidence score by home care nurse self-evaluation, patient and family member satisfaction scores, and competency score by preceptor evaluation. The study findings revealed that an increase rate in nursing performance didrate necessarily coincide with an increase not in competency score and also, not with the patient /family member satisfaction scores. And an order derived from the clinical performance scores of five home care nurses corresponded to those from three measurements-competency score, patient satisfaction score, and family member satisfaction score. However, it differed from the order associated with the confidence score. Consistency derived from the three objective evaluation methods may lead to the possibility that the level of competency measured by educator can be further explained by the levels of patient/family member satisfaction. The salient finding of this study was that, in case of nurse A who have had little clinical experience in the orthopedic patient care, there was a significant increase in the level of confidence and competency in subscale of professional skill with the home care clinical practice. Therefore, the effect of the clinical practice program would be successful for nurses who have had little experience in the area of specialization. The study results suggest that there might be some time difference in the development of cognitive sense (confidence) in performance and actual clinical performance (competency). In future research, relationships between the confidence and competency score, and between the confidence score and the patient satisfaction score should to be measured in different time frame to achieve a better explanation power of the study outcome.

• 대한간호학회지
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• 제37권4호
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• pp.431-441
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• 2007

Purpose: The purpose of this study was to identify the relationship among family stress, family meaning and family adaptation of families with high risk neonates. Method: The date was collected on the basis of self- report questionnaires (August 2004 to March 2005); Tow-hundred twelve parents, who had high risk neonates in C hospital's neonatal intensive care unit, participated on request. Results: Family sense of coherence, family meaning, social support, family stress, marital communication and patient condition had a significant, direct effect on family adaptation. Family cohesion, religion, confidence in the health professional, and length of stay had a significant, direct effect on family meaning. Conclusion: The results of this study suggest the consequences associated with high risk neonates may be alleviated by a family support intervention designed to improve parental communication skills as well as to maintain family cohesiveness. Medical care could also encourage more emotional support of parents towards their neonate.

• 융합정보논문지
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• 제9권5호
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• pp.77-85
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• 2019

본 연구는 재활병원에 입원하여 뇌신경계 재활 치료를 받고 있는 환자의 가족부담감 정도와 일반적 특성, 질병특성에 따른 부담감의 차이를 파악하고, 융합적인 영향요인을 규명하기 위한 서술적 조사연구이다. 재활병원에서 재활 치료중인 환자의 주 돌봄제공자인 가족 113명을 대상으로 설문조사하여 SPSS statistics 22 프로그램을 이용하여 분석하였다. 본 연구 결과는 환자가족의 부담감 수준은 평균 3.16로 나타났고, 가족의 부담감은 돌봄자의 연령, 교육수준, 돌봄자와의 관계에서 유의한 차이가 있었으며, 환자의 질병관련 특성에 따른 가족부담감은 유의한 차이가 없었다. 마지막으로 가족의 부담감에 미치는 영향 요인을 확인한 결과 돌봄자의 연령, 학력, 종교, 환자와의 관계가 예측요인으로 나타났다. 재활치료중인 가족부담감을 낮추는 중재 프로그램 개발에 일반적 특성을 고려할 필요가 있을 것이다.

• 대한가정학회지
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• 제50권1호
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• pp.121-139
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• 2012

This study aims to develop a program for enhancing family resilience in cancer patients along with their family members and verify its effectiveness. The subjects were inpatients with cancer and their families, totaling 46 subjects at an university hospital in Busan. They were divided into two groups, the participating group who were in an experiment and the control group who were not taking part in the experiment. Then family resilience was measured before and after completing the program sessions. The program was conducted once a week, 4 times, for two hours. The participating group of family resilience strengthening program showed higher family resilience compared with that of the control group. The results suggest that family resilience can be enhanced through adversity. It also verifies that family resilience of family members with cancer patients can be strengthened by expressing emotion, conveying deep affection, and sufficiently supporting one another through the family resilience strengthening approach.

• 의료법학
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• 제24권4호
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• pp.103-128
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• 2023

현행 연명의료결정법에 따르면 연명의료를 시행하지 않거나 중단하는 결정은 임종과정에 있는 환자의 의사가 우선적으로 적용된다. 이러한 환자를 대상으로 하는 연명의료의 의사결정은 환자가 의식이 있는 경우에는 환자 본인이 연명의료에 대한 의사를 직접 서면이나 구두로 표시하거나 사전연명의료의향서와 연명의료계획서를 작성하는 것으로 자기결정을 행사할 수 있다. 반면에, 환자가 사전연명의료의향서나 연명의료계획서를 작성하지 않은 경우에는 환자 가족의 진술로 환자의 의사를 확인하거나 환자가족 전원의 동의로 연명의료중단등결정을 할 수 있다. 그러나 가족이 없거나 가족을 알 수 없는 무연고 환자인 경우에는 입원하기 전에 사전연명의료의향서와 연명의료계획서를 작성하지 않은 상태에서 의사표현을 할 수 없는 의학적 상태로 되면 환자의 의사를 알 수가 없어 환자에 대한 연명의료를 지속해야 할지 중단해야 할지에 대한 결정을 해야 하는 상황이 발생한다. 본 연구는 무연고환자의 경우에 연명의료결정을 위한 정책적 방안을 제시하고자 현행법상 무연고 환자에 대한 논의와 방안 검토했다. 첫째로, 성년후견인제도의 적용을 살펴보았지만, 성년후견인은 신체를 침해하는 의료행위에 대한 동의를 대신할 수 있지만 의료행위의 직접적인 결과로 사망할 수 있는 경우에는 가정법원의 허가를 필요로 하기 때문에 임종과정에 있는 급박한 환자에게는 적절한 방안이라고 할 수 없다. 둘째로, 연명의료결정법 제14조에 따라 의료기관윤리위원회에서 무연고 환자에 대한 연명의료중단등결정에 관한 심의에 대해 살펴보았다. 현행법상에서는 의료기관윤리위원회에서 무연고 환자에 대한 연명의료중단등결정을 할 수 없기 때문에, 개정을 통하여 무연고 환자에 대한 연명의료중단등결정에 대한 사항을 동법 제14조에 반영하거나 무연고 환자에 대한 규정을 따로 신설하여 개정하는 것이 필요하다. 또한 의료기관윤리위원회에서 무연고 환자에 대한 결정해야 하지만, 그런 결정을 하는 것에 대해서 해당 의료기관에서 할 수 없다면, 공용윤리위원회에서 무연고환자의 연명의료중단등결정을 할 수 있도록 법률을 개정할 필요가 있다.

• 정신신체의학
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• 제9권1호
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• pp.16-27
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• 2001

연구목적 : 본 연구는 정신분열병 환자의 가족이 겪는 각종 스트레스(불안, 우울, 거부감, 걱정 등)와 함께 가족의 대처 전략의 정도를 평가하고 단기가족교육 후 정신분열병에 대한 지식과 스트레스, 대처전략의 변화 정도를 대조군과 비교해 단기가족교육의 효과를 평가 하고자 하였다. 방법 : DSM-IV 진단기준에 따라서 분류된 정신분열병 환자의 가족 중에서 가족교육을 받은 24 명을 교육군으로 하고 동 질환으로 본과에 입원한 환자의 가족 중에서 22명을 선정하여 대조군으로 하였다. 교육군에게는 가족교육 전후에, 대조군에게는 환자 입원 시와 4주 이후에 두 번 설문지를 작성하도록 하였다. 사용된 설문지는 Family Coping Questionnaire(FCQ), Patient Rejection Scale(PRS), 걱정설문지, 지식설문지, Beck Depression Inventory(BDI), State-Trait Anxiety Inventory(STAI) 등이다. 결과 : 1) 교육군에서 걱정설문지, BDI, STAI-S는 사후평가 점수가 사전평가 점수보다 유의하게 낮았고 FCQ의 사회적 관심항목과 지식설문지는 사후평가 점수가 사전평가 점수보다 유의하게 높았다. FCQ요인에서는 회피와 관련된 사회적 관심의 전략이 사후평가 점수가 사전평가 점수보다 유의하게 높았다. 반면에 대조군에서는 모든 설문지에서 사전평가 점수와 사후평가 점수 사이에 유의한 차이가 보이지 않았다. 2) 교육군에서 걱정설문지의 점수 차와 STAI-S의 점수 차 사이, 걱정설문지의 점수 차와 STAI-T의 점수 차 사이에 유의한 정적 상관관계가 있었고 FCQ의 긍정적 상호작용항목의 점수 차와 PRS의 점수 차 사이, 지식설문지의 점수 차와 STAI-S의 점수 차 사이에는 유의한 부적 상관관계가 있었다. 반면에 대조군에서는 FCQ의 정보항목의 점수 차와 PRS의 점수 차 사이, 긍정적 상호작용항목의 점수 차와 PRS의 점수 차 사이에만 유의한 부적 상관관계가 있었다. 3) 교육군에서는 걱정설문지의 점수 차와 환자의 나이 사이에 유의한 정적 상관관계가 있었고 지식설문지의 점수 차와 환자의 유병기간 사이에 유의한 부적 상관관계가 있었지만 대조군에서는 유의한 상관관계가 존재하지 않았다. 결론 : 단기가족교육 후에 가족들의 지식이 증가하고 걱정과 불안감이 감소하였으며 환자에게서 벗어나 사회적 관심이 높아지게 되었다. 한편, 교육군에서는 지식의 증가에 따라 불안감이 감소했지만 대조군에서는 상관 관계가 없었다. 또한 교육군과 대조군 모두에서 지식의 변화와는 상관없이 거부감이 적어질수록 긍정적 의사소통의 대처전략을 많이 사용했고 대조군에서 거부감의 영향을 더 많이 받았다.

• 기본간호학회지
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• 제7권2호
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• pp.239-255
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• 2000

The purpose of this study was to explore the care needs of family-caregivers caring for patients with a CVA and the level of self care of the patients. The subjects for the study were 112 patients with a CVA and their caregivers. These patients were seen in a hospital or out-patient-department(OPD) at two oriental medical hospital in Jeonbuk province. The survey instruments used in this study were Kang's ADL checklist for self care of patients and Kim's Likert-style checklist for care needs of family-caregivers to patient with CVA. The survey was conducted from July 4 to August 30, 1999. Internal validity by calculation of Cronbach's alpha was 0.95, which was regarded as high. The survey results were analyzed using the SPSS program, with percentages, means, t-test, ANOVA and Pearson's correlation coefficients. The results of this study are as follows : 1. The level of self care for patients with a CVA was : 1) complete dependence(M=14.9, 13.1%), 2) complete independence(M=23.6, 20.9%), 3) incomplete independence(M=23.9, 21.0%), 4) incomplete dependence(M=26.6, 25.0%), 5) dependence and independence(M=23.0, 20.0%). The items for which there was a high level of self care were : 1) drinking(M=3.62), 2) eating (M=3.25), 3) position returning(M=3.18) : and the items for which there was a low level of self care were : 1) ascending and descending stairs(M=2.08), 2) walking(M=2.47). 3) putting on and taking off trousers(M=2.55). 2. The mean score of the sum of the care needs of the family-caregivers was : 1) need for immediate care and help: 2) need of the way to communicate with patient: 3) need for education and assistance related to physical functional level: 4) need to be informed about the disease, treatment and care: 5) need for social support and consultation: 6) need for appreciation: 7) need for management of nursing problems related to immobility. The highest meed factor was the need for immediate care and help(M=3.47): and lowest need factor was the need for management of nursing problems related to immobility(M=2.80). 3. There were significant differences between the level of care need and general characteristic of the caregivers, there were family-caregivers age(P=0.001), marital status (P=0.276), occupation (P=0.006), monthly income(P=0.000), Patient's relationship to caregivers(P=0.004) and health(P=0.000). 4. There were significant differences between the level of self care and general characteristic of the patients, there were patient paralytic condition(P=0.01), blood pressure(P=0.01), and length of suffering(P=0.03). 5 There were significant differences between the level of care need and the general characteristic factors, which were CVA patient's blood pressure (P=0.05), problem of medical fee (P=0.05). 6. There was significantly correlation with the family-caregivers care need and the level of self care in the CVA patient(r=0.300, P=0.000). As a result, need to promote the level of self care in patients and to meet the care need of family-caregivers for more efficient nursing of CVA patients, is emphasized. Therefore more study is needed on an efficient way to provide rehabilitation and quality nursing interventions for family-caregivers and patients with CVA.