• 대한불안의학회지
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• 제6권1호
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• pp.17-23
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• 2010

Objective : This study compared the psychological stresses of depressed patients' families with those of schizophrenic patients' families. We investigated the influence of depressive patients' clinical features and their families' demographic characteristics on the families' depressive symptoms and stresses. Methods : Participants were 23 family members of depressed patients and 20 family members of schizophrenic patients. We measured the patients' clinical features (duration of illness, number of previous hospitalizations, and satisfaction with medication), and each family member's socioeconomic status and psychological characteristics (depressive mood, anxiety, family stress, and stress response), analyzing the data via independent t-test, chi-square test, and correlation and hierarchical multiple regression analyses. Results : The depressed patients' average clinical global impression (CGI) was significantly higher than that of the schizophrenic patients. The depressed patients' family members showed stress responses significantly higher than those of schizophrenic patients' family members. Furthermore, in depressed patients, frequency of hospitalization was positively correlated with family members' stat anxiety. For both patient types, family stress was positively correlated with the patient's severity of illness and the family's state anxiety, trait anxiety, and stress response ; socioeconomic status was positively correlated with the family's depressive symptoms ; the family's state anxiety positively correlated with the family's trait anxiety and stress response ; and the family's trait anxiety positively correlated with the family's stress response. Socioeconomic status predicted the family's depressive symptoms, and socioeconomic, illness severity and stress response predicted family stress. Conclusion : These findings suggest that both depressed patients' families and schizophrenic patients' families suffer from psychological stress. The study data also have important clinical implications, in that families of depressed patients need psychiatric intervention, as well as the patients themselves. In particular, family intervention should focus on psycho-education and stress coping strategies.

• Journal of Hospice and Palliative Care
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• 제3권1호
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• pp.60-73
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• 2000

목적 : 연구의 목적은 말기 암환자의 총체적 고통의 내용과 총체적 고통의 관련요인을 파악하는 것이다. 방법 : 본 연구는 후향적 서술적 연구로 연구의 표본은 1단계에서는 1997년에 일개 대학에서 운영하는 호스피스 사업소에 등록된 환자전수를 대상으로 하였고 2단계에서는 4명의 호스피스 간호사에 의해 선정된 가장 고통이 심한 5명의 환자를 대상으로 하였다. 자료 수집 방법은 Twycross model의 분류 틀을 사용하여 호스피스 환자의 의무기록지를 분석하고 5명의 환자들을 담당하였던 호스피스 간호사와의 심층면담을 통해 의무기록지의 내용을 보충하였다. 또한 호스피스 정규 Team meeting시 사례연구를 통하여 고통의 내용과 관련요인을 확인하였다. 자료의 분석은 SPSS를 이용하여 서술적 통계를 사용하였고 간호사와의 심층 면담은 내용을 분석하였다. 결과 : 말기 암환자들이 주로 경험하는 주요문제들은 통증과 변비, 가족대응, 영적 고뇌(우울, 불안 등) 등으로 통증조절뿐만 아니라 가족의 대응 및 지지, 심리적 영적 지지와 함께 다른 증상조절에 필요한 적절한 간호중재가 요구됨을 나타내고 있다. Twycross model이 문화적인 차이가 있는 한국에도 정도의 차이는 있지만 죽음이라는 사실을 당면한 환자에게 유용한 총체적 고통 model로 사료된다. 결론 : 본 연구의 결과 Twycross model이 한국적 상황에서의 총체적 고통을 설명하는데 유용하였으나 새로운 요인들이 첨가되었으므로 한국의 말기 암환자에 대한 평가가 필요하다.

• 한국방사선학회논문지
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• 제10권3호
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• pp.145-152
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• 2016

방사선치료중인 암 환자를 대상으로 하여 환자의 일차 환경에 속하는 가족지지와 의료인 지지로 구성된 사회적 지지와 삶의 질과의 관련성을 알아보고자 본 연구를 실시하였으며, 연구대상자는 서울특별시에 소재한 일개 대학병원 방사선종양학과에서 방사선치료중인 암 환자들 중 2012년 1월 25일부터 2012년 4월 30일까지 조사가 가능하였던 199명을 대상으로 하였다. 수집된 자료 분석은 SPSS/WIN 18.0 통계 프로그램을 이용하여 t-test, 분산분석, 상관관계분석 및 다중회귀분석을 이용하여 사회적 지지를 비롯한 독립변수와 종속변수인 삶의 질과의 관련성을 알아보았다. 결론적으로 방사선 치료중인 암 환자가 지각하는 가족지지가 높을수록 삶의 질도 높게 나타나 유의한 관련이 있음을 알 수 있었다. 따라서 방사선치료중인 암 환자들의 삶의 질을 향상시키기 위해서 가족지지 및 사회적지지 등을 강화시킬 수 있는 중재 전략의 개발이 필요할 것으로 생각되며, 더 나아가 향후 삶의 질을 영역별로 세분화하여 다양한 측면을 분석할 추가적인 연구가 필요하다고 생각된다.

• 대한간호학회지
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• 제25권4호
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• pp.709-728
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• 1995

The job related activities of sixty nine nurses, working in the emergency rooms of three university hospitals, were analyzed for six days according to preestablished checklist of nursing activities ; the frequency of these activities and the amount of time spent in each specific nursing activity. The established checklist was monitored every five minutes for the duration of the duty autu, thus producing 414 items of data. The data were not gathered on consecutive days but over the period of one month from May 6, 1994 to June 5, 1994. The following conclusions are derived from analysis of the data : 1. Twelve categories of nursing activities were obtained : The primary activity was communication related to the patient and all information pertaining to the patient. Other activities included maintaining the patient's record, observation and assessment of the patient, cooperation with other medical personnel, management of equipment and drugs, procedure and treatment, specimen collection, consultation and education for the patient, including drug management and personal hygiene and any other relevant education to the patient's condition. 2. The average frequency of categorized nursing activity can be classified as follows : communication related to patient was the highest at 17.6 times. The next was maintaining the patient's record at 17.3 times. The observation and assessment occurred 16.9 times. Consultation and education for patients and family, 8 times, medication, 5.7 times, and procedures and treatments, 6 times. 3. The average time required for each activity was as follows : 230.1 minutes (or maintaining the patient's record, 204.9 minutes for communication related to the patient, 199.2 minutes for observation and assessment, 71.2 minutes for medication, 66 minutes for consultation and education of the patient and family, and 51.8 minutes for procedures and treatment. 4. The most demanding nursing activity in the emergency room for the nurse was answering questions from the patient's family, maintaining communication between the medical staff, maintaining and reviewing the patient's charts, writing prescriptions and monitoring 1. V. infusion rates. 5. The most time consuming nursing activities for the emergency room nurse include maintaining and following the patient's charts, communication between the medical staff, answering questions from the patient's family, observation of the patient and relaying all of the appropriate patient information to the incoming nurses during a shift change. 6. The F-test was administered to measure the required time for the categorized nursing activities according to day, evening, and night-shift nurses. There were significant differences (p<.05) in specimen collection, observation and assessment, cooperation between medical staffs, personal hygiene, communication related to patient, education and re-search. Posterior multiple comparison test showed that specimen collection, cooperation between medical staffs and personal hygiene were mostly done by the evening-shift nurses. Also most observations and assessments were done by the night-shift nurses. Education and communication to patients were done by day-shift nurses. Thus there were significant difference between shifts for the main nursing activities. So there should considev a reallocation of the duty of nurses on each shift. 7. The F-test also indicated that there wes a similarity in time duration for procedures and treatments and for cooperation between medical staff and nurses in all three hospitals. However, the remaining categories of nursing activities also showed a significant difference between the three hospitals. This indicated that there were differences in each emergency room that influence time for each categorized nursing activities and this should be given more consideration. Recommendations : 1. A seasonal difference should be considered in the activities of nurses in the emergency room and a comparative analysis should be carried out to deter-mine seasonal differentiation. 2. A study on more objectively measurable nursing activities should be administered as well as one determining the subjective responds towards nursing activities in the emergency room.

• Journal of Hospice and Palliative Care
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• 제9권2호
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• pp.106-111
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• 2006

목적: 말기 암환자에서 마약성 진통제를 사용한 통증 조절과 호스피스를 통한 보존적 치료는 매우 유용한 치료 방법이다. 그러나 많은 환자들과 환자의 보호자들은 중독과 내성에 대한 두려움 때문에 마약성 진통제의 사용을 충분히 하지 못하고 있다. 그리고 또한 다수의 환자와 보호자들은 호스피스가 환자의 상태가 돌이킬 수 없는 지속적으로 악화되는 것과 같이 생각하기 때문에 호스피스를 받아들이는 것을 꺼려한다. 이 연구의 목적은 한국 문화에서 가족구성원이 건강관리에 결정적인 역할을 하기 때문에 말기 암 환자의 보호자들의 호스피스와 마약성 진통제의 사용에 대한 인식도를 분석하고 평가하였다. 방법: 이 연구에서는 총 54명의 말기 암환자의 보호자들이 참가했다. 설문지는 총 마약성 진통제와 호스피스에 관한 15문항으로 구성되었다. 결과: 연구는 다음과 같은 결과를 나타내었다. 1) 환자보호자의 반 이상(56.7%)이 호스피스에 대한 인식이 없었다. 2) 환자 보호자의 81.8%가 호스피스 치료가 말기 암환자에게 유익하다는 데 동의했다. 3) 보호자의 85.1%는 경제적 부담을 갖고 있었다. 4) 환자의 83.2%가 24시간 동안 통증의 호소했다. 5) 보호자의 85.8% 마약성 진통제가 통증을 조절할 수 있음을 믿고 있었으나 또한 79.1%와 79.6%보호자들은 마약성 진통제의 사용이 중독과 내성을 발생시킨다고 믿었다. 결론: 여전히 통증 조절을 위한 마약성 진통제 사용에 있어 보호자의 벽이 존재했다. 또한 말기 암 환자 보호자에게 호스피스에 대한 정보가 부족했다. 그러므로 약사와 의사 의한 마약성 진통제에 대한 교육이 통한 말기암환자에 있어 적절한 통증 조절을 위해 필요하다. 그리고 호스피스에 대한 좀 더 정확한 정보를 말기 암 환자에게 제공하여야 한다.가족간병인의 삶의 질에 많은 영향을 주는 교정 가능한 인자로 나타났다. 말기 암 환자 간병인의 간병 시간 및 경제적 부담을 감축하기 위한 사회적 지원이 필요하다. 봉사자와의 관계는 매우 좋다가 81.2%로 대부분을 차지하였고, 병원직원과의 관계는 매우 좋다가 69.7%였고, 다음은 대체로 좋다가 21.2%의 순이었다. 봉사활동에 대해 가족이나 친구의 지지는 어떠한가는 매우 좋다가 83.2%로 대부분을 차지하였다. 2. 대상자의 자원봉사활동 만족도는 평점 $3.09{\pm}0.49$(도구범위 $1{\sim}4$점)로 중간정도이었다. 영역별로 살펴보았을 때 만족도가 가장 높았던 영역은 사회적 접촉영역($3.48{\pm}0.61$)이었고, 다음은 성취영역($3.43{\pm}0.53$), 사회적 인정영역($3.35{\pm}0.70$)의 순이었다. 만족도가 가장 낮았던 영역은 사회적 교환영역($1.65{\pm}0.63$)이었다. 3. 대상자의 인구사회학적 특성에 따른 봉사활동 만족도를 분석한 결과 성별(t=2.038, P=0.044), 결혼상태(F=3.806, P=0.013)에 따라 유의한 차이를 보였다. 4. 대상자의 자원봉사활동 실태에 따른 봉사활동 만족도를 분석한 결과병원봉사활동기간(F=3.326, P=0.008), 봉사활동을 하는 주된 이유(F=2.707, P=0.035), 봉사활동을 위한 교육을 받은 여부(t=-1.982, P=0.050), 봉사활동의 평가 빈도(F=7.877, P=0.000), 봉사활동이 자신의 기술이나 능력에 적합도(F=2.712, P=0.049), 관리자와의 관계(t=-2.517, P=0.013), 다른 병원직원과의

• 대한간호학회지
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• 제32권1호
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• pp.40-49
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• 2002

The purpose of this study was to investigate the influencing factors on health behavior among patients with coronary artery disease. Method: The subjects were 95 patients who visited the out-patient department of a university hospital for follow-up. The four health belief concepts (motivation, benefit, barrier, seriousness), general self-efficacy, health behaviors on medication, diet, exercise, stress management, smoking, and drinking were measured. Result: There were significant differences in the health behavior scores of subjects according to family support and the experience of surgical procedure. Subjects were found to have a high degree of compliance in taking medication. However subjects reported the lowest degree of compliance in regular exercise. In the multiple regression analysis, surgical procedure and motivation were significant predictors to explain diet. Motivation and barrier were significant predictors to explain exercise. Self-efficacy, motivation and family support were significant predictors to explain stress management. Family support and seriousness explained 16% of variance in drinking. Also, family support explained 30% of variance in smoking. Conclusion: Since predicting factors on each health behavior indicator were different, then nurses should consider these differences to construct strategy enhancing patient's recovery.

• 한국정보전자통신기술학회논문지
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• 제11권4호
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• pp.346-354
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• 2018

The purpose of this study was to examine the difference in the association between caregiver's activities and caregiving burden according to gender and family relationship of caregivers of older people with dementia. This study used data from the Caregivers of Alzheimer's Disease Research survey (n=476). The association between caregiving activities and care burden was analyzed by multiple regression. In this study, the caregivers were predominantly spouses, followed by daughters. The care burden, especially personal burden, and depression were significantly higher in women than men. The spouses (either male or female), compared with the sons and daughters, spent significantly more time providing care. Care time and depression of caregivers and physical disability of the patient were significantly correlated with care burden. Among the caregiving activities, using transportation, dressing, eating, looking after appearance, and supervising were significantly associated with care burden. The daughters and daughters-in-law presented more care burden with higher number of care days, and the female spouse who were younger tended to experience higher care burden. Daughters who provided longer time looking after appearance exhibited higher care burden. For female spouse, eating time was significantly associated with care burden. The association between caregiving activities and care burden of caregivers of people with dementia differed by gender and family relationship with the patient. This study was characterized by analyzing the effect of caregiving activities on caregiving burden by gender and family relationship of caregivers.

• 대한간호학회지
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• 제30권3호
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• pp.584-594
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• 2000

The purpose of this study was to identify emotional responses, of stroke patients using Q analysis. From the data analysis, five types of emotional responses in stroke patients were classified as follows. 1. Acceptance and Overcoming : They attached to life strongly and had self-confidence of recovery. They were striving against their situation through using anything else good for their recovery. 2. Anger Type : They recognized a labile feeling and were angered easily. They had a self-confident and self-esteemed personality before they had a stroke. 3. Conflict Type : They wanted interaction with others. This individual recognized that no one knows their agonies. They were thankful to god or their family, while they could not control their minds. Their family supports were low. 4. Deficiency of self-esteem Type : They had a self-confidence of recovery, but they were in fear of interaction with others. Especially, they were ashamed of themselves. They have a high sense of responsibility and nigh self-esteem for themselves before they had a stroke. 5. Despair Type. : They were sorry to trouble their family. They felt depression, anxiety, darkness, uselessness of themselves, and they wanted to die. They recognized financial burden. for their family. The characteristics of the five types of stroke patient identified in this study will be used to assess emotional nursing needs for stroke patients. The findings of this study will provide practical guidelines for developing nursing interventions for stroke patients based on the characteristics of subjectivity types.

• 대한간호학회지
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• 제17권3호
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• pp.177-183
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• 1987

This study investigated and evaluated a method effectively promote a communication function in families with a schizophrenic patient and the patients' interaction, by a family approach using reinforcement of functional communication between patients and their parents. The subjects of the study were patients receiving treatment in Won Gwang University Mental Hospital from July 1985 to July 1986, and their families. In the experimental group, a family approach using reinforcement of functional communication twice a week was taught. Each of the six sessions took sixty minutes, during which the interviews and questionaires were carried out. The total number of patients receiving treatment in the hospital at that time, 42, were divided by a systematic method into 20families in an experimental group and 22 in a control group. The results from testing the hypotheses established in this study, to analyse the effects of family approach through reinforcement of functional communication, are as follows; The results of the test of the first hypothesis are shown in Table 1. “patients and their parents in an experimental group receiving group training in reinforcement of functional communication will show a greater degree of interaction than those of the control group” was supported. Significant differences included Main Effects p＜.001, Interactions p＜.001 and Explained p＜.001 in the interactions of patients, and mothers. Scores were higher for the experimental group after the treatment as well as higher than the control group.

• 성인간호학회지
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• 제19권3호
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• pp.470-482
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• 2007

Purpose: This study aimed to describe the experience of family breakdown of Hwabyung patients in a socio-cultural context. Methods: Data for this study came from 5 participants, 2 family members and 1 friend of participant by interviews and participant observations from January 2006 to April 2007. Sociology of everyday lives analyzing method were adopted. Results: There were two processes of family breakdown ; sudden on set and progressive processes. The sudden breakdown was unpredictable death of a husband, the significant family member. On the other hand, their family structure and function were broken down through the husband, who repeatedly destructive and malicious behaviors. The experience of family breakdown of middle-aged women with Hwabyung in a socio-cultural context was weakened or severed family-relationships, exhaustion of economic sources, and the breakdown of participant's body. Participant's experience of family breakdown were influenced by Korean culture, the patriarchal social system and the clan-centered family system. Conclusion: Hwabyung is the result of a clan-centered family system and patriarchal system. The approach to Hwabyung should involve not only the person with the illness but also their family.