• 제목/요약/키워드: Patient well-being

검색결과 296건 처리시간 0.029초

지역교회간호(Parish Nursing) - 일차건강간호를 위한 새로운 도약 (Parish Nursing : A New Challenge for Primary Health Care)

  • 노유자;백영미
    • 대한간호
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    • 제37권2호
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    • pp.53-62
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    • 1998
  • ursing as a profession is characterized by its holistic, mind-body-spirit approach to the patient. Also, nurses have historically been the leaders in health education and promotion. Parish nursing has a great potential for providing primary preventive health care. services as well as assisting people to access the health care system. While working in the community, parish nurses see the church as the new arena for delivering health care services. The parish nurse program was introduced by Granger Westberg in 1984. The concept of parish nursing is based on several beliefs; health is multidimensional and affects all aspects of an individual-physical, psychological, social, and spiritaul being. Parish nursing is one model in which churches can cooperatively work with health care institutions to address the needs of their parishioners. The role of the parish nurse is emphasized in four basic area: a) health education, b) health counseling, c) referal services, and d) facilitation and organization of support groups within the congregation. The parish nurse programs work chiefly in congregation or commuity where a certain language of faith is ready at hand. This means that the parish nurse works in an ecology of meanings and care which encourages the drawing on the message of God's grace, the practices and habits it encourages. The parish nurse may be involved in the church's health ministries and may work on either paid or volunteer basis; however, one of the most important qualification of the parish nurse is to have the nursing knowledge and skills to practice within the standards of Nursing Practice Act. The completion of standards of practice for professional nurses practicing as parish nurses had been identified as a priority by the HMA Executive Board (1996, HMA). In conclusion, parish nursing promotes health and healing by empowering the faith community, family, or individual to incorporate health and healing practices. There are several preconditions that should proceed to establish the foundation for successful development of the parish nursing program in Korea. First, reciprocal relationship with home health nursing should be considered. Second, correct terms and concepts of parish nursing should be studied and understood. Third, systematic study and investigation should be followed for further development of parish nursing. Fourth, strengths and weaknesses of different models should be studied to develop proper model of parish nursing for Korean situation. Finally, consensus of standardized education program and corporation with various religious communities as well as health institutions should be established. When these preconditions are met, the role of parish nursing as a new program for the promotion of holistic health will be established.

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뇌성마비아 어머니의 경험 (Lived experience of mothers who have child with cerebral palsy)

  • 이화자;김이순;이지원;권수자;강인순;안혜경
    • Child Health Nursing Research
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    • 제2권1호
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    • pp.93-111
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    • 1996
  • The purpose of the study is to identify the lived experience of mothers who have children with cerebral palsy in order to understand their agony. Moreover, the result of study was to find some nursing intervention for disabled children and their mothers. For this purpose, ten mothers who are willing to cooperate with this research were selected at random from those who have children with the cerebral palsy, currently using the municipal facilities for the handicapped with cerebral malfunction. Data collection was done from October 4, 1994 th December 31, 1994. The data were collected by asking the mothers mentioned above with some unstructured open-ended questions, recorded on the tapes with permission by the interviewee in order to prevent missing of the interviewed contents. These collected data have been substantiated and properly analyzed on the basis of phenomenological approach initiated by Colaizzi's method. The results and validity are proved to be credible by means of the individual checking of the interviewed mothers. The results of this study are as follows : 1. When the mother is first informed of the diagnosis of cerebral palsy on her child, she usually misses the crucial timing needed for proper treatment of the child's disorder because she is notified through the doctor's indifference and his apparently inactive, matter-of-fact attitude. At first she suspects the doctor's diagnosis and tries to attribute it to the unknown cause from a certain genetic problem and then she quickly wants to deny the whole situation that her child is really suffering from the cerebral palsy. The reality is too much for her to accept as it is and she would not believe her child is abnormal. Therefore, she even attempts depend on the power of God for its solution. 2. The mother, who goes thorough this kind of uncommon experiences, is totally devoted to the treatment and care of the child and completely ignores her own life and happiness. At the same time, she feels sorry for her other normal children she believes having not enough care and concern. Also, she feels sorry for the sick child when the child's brothers or sisters show special concern for the patient out of sympathy. It is sorry and not satisfied for her that the child is growing with abnormality and neighbor other around have inappropriate attitudes. Likewise, she is discontent with her husband's lack of concern about the child's treatment. She believes that the health care system in this society isn't fulfilling its due purpose. In the state of her utmost distress and anxiety, she always feels the need of competent consultants, and is angry about that her child is treated as an abnormal being, she is trying to hide the child from other people and to make him or her disappear, if possible. Although she doesn't have harmonious relation with her husband, she id happy when he shows his affection for the child and she feels relieved and thankful when the relatives don't mention about the child's condition Since the child's overall status of health is continuously in unstable conditions, requiring her all-time readiness for an emergency, she feels guilty of her child's illness toward the fEmily members as if it was her own fault to have borne such an abnormal child and she feels responsible for the child morally and financially if necessary Because her life is centered on taking care of the child, she cannot afford to enjoy her own life and happiness. She is a lonely mother, fatigued, with no proper relationship with other people around her. With this sense of guilt and responsibility as a mother of an unusual disease, she has no choice but to grieve her destiny from which she is not allowed to escape. 3. Nevertheless, the mother with the child suffering from the cerebral palsy does not easily give up the hope of getting her child cured and she believes that in the long run, though slower than hoped, her abnormal son or daughter will be eventually cured to become a normal sibling someday. This kind of hope is sustained by the mother's strong faith coming from observing the progress of other similar children getting better. Sometimes she is encouraged to have this faith by other mothers who share the same painful experiences, believing that her child will improve even more rapidly than others with the same palsy. Full of hope, she painstakingly waits for the child's healing. Moreover, she plans to have another child. she thinks that the patient child's brothers and sisters only can truly understand and look after the patients. However, when she notices that the progress of other children under the treatment does not look so hopeful, she is distressed by the thoughts that her child may never get well. Too, she is worried that the patient's brother or sister will be born as the same invalid with the cerebral disease. She is discouraged to have another baby as much as she is encouraged to. She is also troubled by the thought that in case she has another baby, she will have to be forced. to neglect the patient child, especially when she does have an extra hand or some reliable person to help her with taking care of the patient.

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병동형 호스피스 대상자를 위한 전인적 호스피스 간호중재 프로그램의 개발 (Development of Wholistic Hospice Nursing Intervention Program for In-patient of Hospice Palliative Care Unit)

  • 강은실;최성은;강성년
    • 호스피스학술지
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    • 제7권1호
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    • pp.29-45
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    • 2007
  • People in the end of life and their families suffer in their physical disease and other aspects as a whole person. They need hospice care to palliate their total suffering in physical, emotional, social and also spiritual aspect through professional hospice team. To care their whole personal needs, hospice team must be a multi-discipline team which consists of medical doctors, nurses, social workers, pastors and volunteers. Recently those who die in hospice palliative care unit have trend to increase more than in home year by year. So it is necessary to develop the nursing intervention program to be performed by multi-discipline team approach for in-patient of hospice palliative care unit. The purposes of this study were to develop of wholistic hospice nursing intervention program for inpatient of hospice palliative care unit. The subjects of study were collected from 30 patients those who were over 18 years old and admitted in hospice palliative care unit of S hospital in P city with agreement in hospice palliative care in their terminal disease. The period of data collection was from December 15, 2003 to March 15, 2004. The result were as follows : 1. The result of Wholistic Hospice Nursing Program's development was as follow : A Wholistic Hospice Nursing Program was developed by me in this study is one of the service program for hospice palliative care unit. It was named as ‘Rainbow Program’ to be approached easily by hospice patients. The purposes of it are to improve the quality of life of the terminal patients with their dignity, to help them live in abundant and meaningful in their lives, to care them in peaceful in dying process with understanding them in whole personal, and also to palliate the grief and suffering of the bereaved. It was provided by hospice professionals(nurses, medical doctors, social worker, pastors, art therapists) and volunteers those who were educated in hospice for multi-diciplinary team approach to collaborate with each role play I 20-30 minuters of each through visiting their rooms individually and a place of hospice palliative care unit of S hospital in P city. The subjects of it were the terminal patients those who admitted hospice palliative care unit and their familes. with agreement in hospice palliative care in their terminal disease. The characteristics of it were multi-disciplinary team approach, whole personal care, individual care and total care according to their needs in their condition. The contents of it were pain control, symptom control, counseling patient, counseling family, hair cutting, hair shampooing, bed bath, recreation, taking a walk, event of culture(screen, recital, festival of praises, exhibition and so on), pastoral counseling, ritual service in bed, praying, service in bed, sing a worship praise, listening to the music, sharing remembrance of life, individual visiting music service(sing and praying), meditation Bible, art therapies(dance and drawing), social worker's counselling, confessing and sharing love and thanksgiving. The experimental group subjects participated in Wholistic Hospice Nursing Program which takes 120 minutes per session, total 10 sessions(total 1,200 minutes) altogether. In conclusion, this Wholistic Hospice Nursing Intervention can be used actively for whole personal well-being of the patients in hospice palliative in hospice palliative care unit and also applied in hospice practice as an useful model of multi-disciplinary team approach by hospice professionals.

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일차성 방광요관역류 소아에서 항생제 예방요법 중에 발생한 재발성 요로감염의 빈도와 위험인자 (Incidence and Risk Factors of Recurrent Urinary Tract Infections during Antibiotic Prophylaxis in Children with Primary Vesicoureteral Reflux)

  • 조수진;김현진;이정원;이승주
    • Childhood Kidney Diseases
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    • 제9권1호
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    • pp.46-55
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    • 2005
  • 목 적 : 일차성 방광요관역류 소아에서 재발성 요로감염은 신반흔의 원인으로 장기간 저용량 항생제 예방요법이 권장되어 왔다. 그러나 최근 항생제 예방요법의 효과에 대한 의문이 제기되었고 항생제 내성에 대한 우려도 있었다. 이에 일차성 발광요관역류 소아에서 항생제 예방요법의 효과에 대한 기초자료를 얻기 위하여 항생제 예방요법에 발생한 재발성 요로감염의 빈도와 위험요인을 조사하고자 하였다 방 법 : 1995년 3월부터 2001년 12월까지 이대목동병원 소아과에서 첫 발열성 요로감염 후에 일차성 방광요관역류가 발견되어 1년간 저용량의 trimethoprim-sulfimethoxazole을 투여 받은 91명을 후향적으로 조사하여 재발성 요로감염의 빈도와 요로감염의 위험요인들을 분석하였다. 결 과 : 재발성 요로감염은 31.9%(29/91)에서 발생하였고 이는 0.32회/환자년 이였다. 발열성 요로감염은 0.26회/환자년이였고 비발열성 요로 감염은 0.07회/환자년이였다. 포경 남아에서 요로 감염의 재발율은 37.2%(19/54)로 포경이 없는 남아의 0%(0/5)에 비하여 유의하게 높았다(P=0.025). 위험 예측치는 신반흔에서만 유의하게 높았다[RR=3.8(95% CI 1.0-14.1), P=0.04]. 여아, 연령, 급성신우신염, 배뇨장애 및 원인균 등은 위험인자로 작용하지 않았고 방광요관역류의 정도에 짜른 유의한 차이도 없었다. .결 론 : 일차성 방광요관역류가 있는 소아에서 항생제 예방요법은 요로감염의 재발을 억제하지 못히였다. 포경과 신반흔이 재발성 요로감염의 위험요인이였고 방광요관역류의 정도에 따른 차이는 없었다. 일차성 방광요관역류 소아에서 우선적으로 포경과 신반흔이 없는 소아에서부터 항생제 예방요법을 시행하지 않는 무작위 대조연구가 필요할 것으로 생각된다.

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영상 재구성 방법에 따른 Bone SPECT 영상의 질과 검사시간에 대한 실효성 비교 (Comparison of Effectiveness about Image Quality and Scan Time According to Reconstruction Method in Bone SPECT)

  • 김우현;정우영;이주영;류재광
    • 핵의학기술
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    • 제13권1호
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    • pp.9-14
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    • 2009
  • 최근 영상 처리 기법의 발전으로 영상의 질은 저하시키지 않고 검사 소요시간을 단축시키는 방법들이 개발되고 있다. 특히 단층 촬영의 경우 영상 재구성 방법을 개선하여 영상의 질이 우수한 영상을 획득할 수 있게 되었다. Philips사의 PRECEDENCE 16 감마카메라를 이용해 보편적으로 시행하고 있는 분석법에 의한 FBP 방법과 반복법에 의한 Astonish, 3D OSEM 방법을 이용해 각각 영상을 재구성하여 정성적인 분석과 정량적인 분석을 통해 영상 획득시간을 다르게 한 영상간의 비교와, 동일한 시간으로 획득한 영상을 비교하여 영상의 질이 우수한 재구성 방법에 대해 연구 하였다. 정성적인 분석을 위해 blind test를 한 결과, 영상 획득시간에 따른 영상의 질은 거의 차이가 없는 것을 확인할 수 있었다. 또한 정량적인 분석을 통해서도 영상 획득시간에 따른 영상의 질은 통계적으로 유의한 차이가 없었다. 하지만 영상 획득시간이 동일한 영상을 재구성 방법에 따라 분석한 결과는 통계적으로 유의한 차이가 있음을 확인할 수 있었다. 영상의 질은 반복법을 이용하는 Astonish에 의해 재구성된 영상이 해상력이 좋고 임상적으로 진단적 정보를 제공하는데 우수한 영상으로 판단된다. 영상을 재구성하기 위한 소요시간이 길고 저장 공간의 부족 등으로 현재까지 많이 사용되지 않던 반복법에 의한 재구성 방법이 영상의 질은 향상시키고 검사시간은 단축 할 수 있는 방법이 될 수 있음을 확인하였다.

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의무기록사의 직무만족도 및 조직몰입도 (The Level of Job Satisfaction and Organizational Commitment of Medical Record Technicians)

  • 최은미;김영훈
    • 한국병원경영학회지
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    • 제8권3호
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    • pp.72-91
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    • 2003
  • The purpose of this study is to investigate the recognition of health information managers, and to analyze the level of job satisfaction and organizational commitment of medical record technicians. The data for this study were collected through a self-administered survey with a structured questionnaire to 172 subjects from medical record technicians working in hospitals in Seoul and Gyeonggi Province as well as the faculty of medical schools across South Korea. In this analysis frequency, t-test, ANOVA, factor analysis and structural equation model were used. The main findings of this study are as follows: 1. As for recognition of the seven dimensions in the role of health information managers, the role as clinical data specialist received the most positive feedback, followed by document & repository managers, patient information coordinators, health information managers, data quality managers, security officers and research & decision support analyst. 2. The level of job satisfaction among medical information handlers and managers averaged 3.14. In terms of the factors in the work environment concerned with job satisfaction, being able to work independently and as team players reached the top among 6 factors with the average of 3.39, followed by professional position, salary & rewards, expectations for job performance and administration. 3. The average rate of organizational commitment stood at 3.09. Respondents tend to be focused on present tasks rather than future-oriented tasks. 4. The result of the analysis based on the relationship between recognition as health information managers, job satisfaction and organizational commitment found that all analysis are statistically meaningful. The more the respondents were aware of their roles as health information managers, the more they tended to be committed to their work and satisfied with their work. The more the respondents were committed to their work, the more satisfaction was seen. The effects of recognition as health information managers on organizational commitment measured 0.27 and for job satisfaction it was 0.17. The effects of organizational commitment on job satisfaction stood at 0.71. The feasibility of the model meets the standard at Chi-square value of 66.755 and the P value of 0.057. The Normed Fit Index (NFI) of 0.930 was in compliance with the standard for model feasibility and the squared multiple correlation coefficient of this model was 8% in organizational commitment and 60% in job satisfaction.

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The Study on Service Design Development for Pharmacy Users: Using Smart Phone Application

  • Lee, Dong-Min;Park, Hye-Jung;Lee, Dong-In
    • 대한인간공학회지
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    • 제31권1호
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    • pp.93-100
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    • 2012
  • Objective: This study is to review the current state of services offered to pharmacy users, and develop a service design converging a prescription service and a smart phone application service in order to enhance patients' experience at pharmacies and home. Background: Under the new medical system; separation of prescribing and dispensing drugs, a doctor writes a prescription to their patients and patients have their prescription filled at the pharmacy. As the number of flue, allergy and atopy patients has increased, waiting lines have been longer at pharmacies. Besides, the current medical service system lacks of providing proper information on prescribed pills to patients. There are already services offered during waiting times such as offering free drinks, magazines or suggesting general drugs which you can buy without prescription, however they neither cover the current medical service's shorts nor shorten the waiting time. Method: I researched objective and perceived waiting times reduction methods, the current service status at pharmacies, and the government's policy direction in a medical service. Also, I observed a patient's journey from the hospital to pharmacy and then home. I examined the circumstance at pharmacies, patients' behaviors and their thoughts during their journey, and extracted three main goals to design a service in order to help patients have positive perception during the waiting time; (1) to reduce the perceived time by the way of visualizing time and offering readings about what patients consider necessary, (2) to educate patients what they are into and how to get through, (3) to establish trust among patients, doctors and pharmacists. Based on three goals, I designed a structure and a wireframe for a new service application of smart phones. Results: With a new service design for pharmacy users, users can track their medical record and visit the information about their current medical treatments anytime. Also the service helps patients build reliable relationships with doctors and pharmacists. Conclusion: Experience is not just an activity but series of multiple activities. The serving range of a medical service should not be determined by stakeholders but user's holistic experience. By approaching a service design with a holistic vision, it can enrich not only a temporary experience but also a whole life well being. Application: Since there are already many service applications advising patients about their illness and finding right doctors, this service design is focused on the experience from getting a prescription till feeling better. The next move is to combine those two parts medical services and design an integrated service application. As a prescription is going to be coded in numbers, we might consider to design an un-attended pharmacy which can shorten huge amount of time for filling prescriptions.

A cross-sectional study of the association between mobile phone use and symptoms of ill health

  • Cho, Yong Min;Lim, Hee Jin;Jang, Hoon;Kim, Kyunghee;Choi, Jae Wook;Shin, Chol;Lee, Seung Ku;Kwon, Jong Hwa;Kim, Nam
    • Environmental Analysis Health and Toxicology
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    • 제31권
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    • pp.22.1-22.7
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    • 2016
  • Objectives This study analyzed the associations between mobile phone call frequency and duration with non-specific symptoms. Methods This study was conducted with a population group including 532 non-patient adults established by the Korean Genome and Epidemiology Study. The pattern of phone call using a mobile phone was investigated through face-to-face interview. Structured methods applied to quantitatively assess health effects are Headache Impact Test-6 (HIT-6), Psychosocial Well-being Index-Short Form, Beck Depression Inventory, Korean-Instrumental Activities of Daily Living, Perceived Stress Scale (PSS), Pittsburgh Sleep Quality Index, and 12-item Short Form Health Survey where a higher score represents a higher greater health effect. Results The average daily phone call frequency showed a significant correlation with the PSS score in female subjects. Increases in the average duration of one phone call were significantly correlated with increases in the severity of headaches in both sexes. The mean (standard deviation) HIT-6 score in the subgroup of subjects whose average duration of one phone call was five minutes or longer was 45.98 (8.15), as compared with 42.48 (7.20) in those whose average duration of one phone call was <5 minutes. The severity of headaches was divided into three levels according to the HIT-6 score (little or no impact/moderate impact/substantial or severe impact), and a logistic regression analysis was performed to investigate the association between an increased phone call duration and the headache severity. When the average duration of one phone call was five minutes or longer, the odds ratio (ORs) and the 95% confidence intervals (CIs) for the moderate impact group were 2.22 and 1.18 to 4.19, respectively. The OR and 95% CI for the substantial or severe impact group were 4.44 and 2.11 to 8.90, respectively. Conclusions Mobile phone call duration was not significantly associated with stress, sleep, cognitive function, or depression, but was associated with the severity of headaches.

한국 간호이론 정립을 위한 연구 I-동의보감을 중심으로 본 인간관- (A Study for the Development of BoreanNursing TheoT : A Humanistic Approach based on Shinhyung,- Naekyungpyun in Dongeuibogam)

  • 신경림
    • 대한간호학회지
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    • 제27권1호
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    • pp.141-155
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    • 1997
  • The universe has its order of yang and yin : all creation are continuously generated, grow and die, which is the results of the harmonious operation by yang and yin. Among all creation, the human is one of the samjae(three bases of the world, which are heaved earth, and man) and he is from the combined sukhi(a superior khi) of yang and yin. And human life itself is basically a condensed jonghyul (life blood) and at the same time it is only a transient joining of sadae(the four elements of earth, air, fire and water). Yang and yin, the two axes of the world, therefore. are the most crucial and fundamental concept to explain the generation and extinction of alt creation, to understand people in time and space. to find out the reality of human life as an organism, and, at last, to observe the state of human health. If so, what is the most essential idea in yang and yin\ulcorner It is taegeuk(chungkhi) or tao(of one yang and one yin). If the property of heaven and earth is kongon, taegeuk is a khi and tao a principle. And it can be said that a human body is merely a union of hyung and khi, that human life is an essence of sambo, jeongkhishin, that human health is a harmoninzed coordination of yang and yin because it is from the combined sukhi of yang and yin. Hyung. a vessel for sambo, jeongkhishin, is at the bottom and shin is on the top : the personality and the disposition of individuals differ according to their working. Thus. on the basis of the above discussion. the following can be offered as some suggestions for Korean Nursing Theory. Though human beings are part of Nature, they are the most eminent microcosm among all creation. So, as a subjet for nursing, a person should be understood with khijok kyoryu rather than with logical thinking, then mutual trust between the patient and the nurse can be established. The health of a person depends on the harmony of yang and yin. To be healthy, a person should consider harmonization with Nature(including his surroundings) as well as a balanced human relationships in society. Moreover, it is crucial for each person to obtain hoshim as a method of mind control rather than to only treat the symptoms of disease.

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인체 팬텀(Rando Phantom)을 이용한 CBCT의 Setup 유용성 평가 (Evaluation of Setup Usefulness of CBCT using Rando Phantom)

  • 장은성
    • 한국콘텐츠학회논문지
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    • 제11권7호
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    • pp.234-238
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    • 2011
  • 온보드영상장치(OBI)를 사용하고 있는 콘빔CT(CBCT)를 이용하여 인체 팬텀 자세 및 위치와 모의치료시 인체 팬텀 자세 및 위치를 비교하여 CBCT의 3D 타깃 위치의 유용성을 평가하고자 한다. 실제방사선 치료와 동일한 과정으로 모의 치료계획을 하기 위해서 인체 팬텀(The Rando Phantom) 을 set up 한다. 기준점에 놓인 인체팬텀에서 CBCT를 이용하여 평행이동 및 회전이동 하였다. 이때 얻어진 영상들의 위치 차이에 대한 평균 및 편차를 인체 팬텀의 실제 이동 값과 비교하였다. 실험은 10회씩 반복하여 오차의 표준 편차를 구하였다. CBCT로 획득한 영상과 모의치료 시 획득한 CT영상을 비교하는 3D/3D 매칭에서 평균 setup의 residual error의 평균 및 표준편차는 lateral $0.2{\pm}-0.2$ mm, longitudinal $0.4{\pm}0.3$ mm, vertical $-0.4{\pm}0.1$ mm 로 각각 0~4 mm의 범위 이내로 나타났다. 모의실험 된 회전 내용은 $0.4{\pm}0.2$ mm, $0.3{\pm}0.3$ mm, 그리고 $0.3{\pm}0.4$ mm이다. 회전에 의한 error는 $0{\sim}0.6^{\circ}$ 범위이다. 인체 팬텀을 이용한 CBCT 3D/3D 매칭은 모의 치료 시와 환자 치료 시 정확한 정합을 함으로써 error를 최소화 하였다.