• 제목/요약/키워드: Physical science

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남자 청소년의 식행동 패턴에 따른 간식 섭취, 생활 습관 요인 및 비만과의 연관성 연구 (The association of snack consumption, lifestyle factors, and pediatric obesity with dietary behavior patterns in male adolescents)

  • 김민지;송수진;박소현;송윤주
    • Journal of Nutrition and Health
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    • 제48권3호
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    • pp.228-235
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    • 2015
  • 본 연구는 만 15~19세 남자 고등학생 902명을 대상으로 식행동, 간식 섭취, 식환경, 생활 습관에 대해 설문 조사를 실시하였고, 비만 판정을 위해 신장과 체중을 측정하여 식행동 패턴에 따른 간식 섭취 및 기타 요인과 비만과의 연관성을 분석하였다. 1) 청소년 식생활 지침의 항목을 이용하여 식행동을 평가한 결과 대상자들은 3가지 패턴으로 분류되었다. 식생활과 생활 습관 모두 건강한 패턴과 식생활과 생활 습관 면에서 건강한 요소와 비건강한 요소가 혼재되어있는 혼합 패턴, 그리고 마지막으로 식생활과 생활 습관이 전반적으로 바람직하지 않은 비건강 패턴이었다. 2) 각 패턴 별로 간식 섭취가 차이를 보였는데, 건강한 패턴은 과일, 우유, 호상요구르트의 섭취 빈도가 높았고, 혼합 패턴은 과일이나 호상요구르트 섭취 빈도가 높은 반면 라면, 아이스크림, 탄산음료, 사탕 섭취 빈도도 같이 높았으며, 비건강 패턴은 과일, 우유, 호상요구르트의 섭취 빈도가 다른 두 패턴에 비해 가장 낮은 반면 라면, 단 간식, 탄산음료 등의 간식 섭취 빈도는 가장 높았다. 3) 식환경을 포함한 생활 습관 요인도 패턴마다 상이했는데, 가정 내 식품 비치율은 각 식품 섭취 빈도와 유사하게 건강한 패턴과 혼합 패턴의 가정 내 과일 비치율이 비건강 패턴에 비해 높았다. 또한 혼합 패턴이 건강기능성 식품이나 식이 보충제 복용 비율이 가장 높았고, 비건강 패턴은 식사 속도, 수면 시간은 짧고 스크린 시간이 하루 2시간 이상인 비율이 가장 높았다. 4) 패턴 별 비만과의 연관성은 건강한 패턴을 기준으로 하였을 때, 혼합 패턴의 교차비는 1.11이었으나 유의하지 않았고, 비건강 패턴의 교차비는 1.88로 유의적이었다. 이상의 결과로부터 청소년의 식행동 패턴에 따라 간식 섭취 뿐 아니라 식습관, 생활 습관 요인이 차이를 보였으며 이러한 요인들이 비만과의 연관성에도 영향을 주었다. 식행동은 식품 섭취나 생활 습관 요인들과 서로 상호작용을 하므로 앞으로 청소년 비만 예방 및 관리를 위한 전략으로 적절한 영양 교육과 함께 식행동과 생활 습관을 함께 개선해 나갈 수 있는 방안을 모색하는 것이 필요하다.

에너지 섭취 조사를 위한 24시간 회상법의 정확도 평가: 여자노인을 대상으로 이중표식수법을 이용하여 (Accuracy of the 24-hour diet recall method to determine energy intake in elderly women compared with the doubly labeled water method)

  • 박계월;고나영;전지혜;;;박종훈;김은경
    • Journal of Nutrition and Health
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    • 제53권5호
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    • pp.476-487
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    • 2020
  • 본 연구는 만 65세 이상의 여자 노인 23명을 대상으로 이중표식수법을 이용하여 측정한 에너지소비량을 기준으로 에너지섭취량을 조사하는 24시간 회상법의 정확도를 평가하였으며, 그 결과는 다음과 같다. 연구 대상자 평균 연령은 70.3 ±3.3세, 신장 및 체중은 각각 153.0 ± 5.9 cm와 56.0 ± 8.0 kg, 체질량지수 (BMI)는 23.9 ± 2.8 kg/㎡이었다. 24시간 회상법으로 산출된 총 에너지섭취량 (TEI)과 이중표식수법으로 측정된 총에너지소비량 (TEEDLW) 간의 피어슨 상관계수는 r = 0.482로 두 값 간에 의미 있는 양의 상관성 (p < 0.05)을 보여주었다. 그러나 24시간 회상법으로 조사된 3일간의 평균 에너지섭취량 (1,489.6 ± 211.1 kcal/day)은 이중표식수법으로 측정된 총에너지소비량 (2,023.5 ± 234.9 kcal/day)보다 -533.9 ± 228.0 kcal/day만큼 과소보고 되었으며, 두 값 간에 유의한 차이가 있었다 (p < 0.001). 총에너지섭취량과 총에너지소비량간의 과소보고율은 -25.9% ± 10.5%로 나타났다. Bland-Altman 방법으로 총에너지섭취량과 총에너지소비량간의 일치도 평가 결과로 두 값 일치 한계의 범위가 -980.8 kcal/day에서 -86.9 kcal/day로 음의 값으로 치우쳐 나타났다. 본 연구 결과에 따르면 에너지섭취량을 조사하는 24시간 회상법을 여자노인에게 적용시, 과소보고율이 -25.9%로 높았고, 에너지섭취량을 정확하게 예측한 비율 (오차범위 ± 10% 이내)도 8.7%로 낮았다. 따라서 여자노인을 대상으로 24시간 회상법으로 에너지섭취량을 조사하고자 하는 경우, 남자와는 다른 별도의 접근법이 강구되어야 할 것이다. 성별이 24시간 회상법의 정확도에 영향을 미치는 주요한 요인으로 보고된 만큼 향후 연구 대상자 수를 증가하여 더 다양한 연령에서 성별에 따른 차이를 평가하는 지속적인 연구가 필요하다고 사료된다.

해양 화학적 특성으로 본 대한해협의 수계 (Chemical Characteristics of Water Types in the Korea Strait)

  • 이원재;조규대;추효상
    • 한국수산과학회지
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    • 제17권3호
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    • pp.219-229
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    • 1984
  • 1983년 7월 $25{\sim}31$일의 대한해협에서 실시한 관측자료를 사용하여 대한해협 서수도 수계의 화학적 성분을 분석 조사하였다. 그 결과 낙동강 유출수, 쓰시마 난류수, 거제도 연안수 및 울산 연안수의 4개의 수계로 구분되었다. 한편 낙동강 유출수의 영향은 거제도쪽 보다 부산영도인 동해 남부 연안쪽이 더 컸다. 이들 수계의 특성으로 먼저 낙동강 유출수는 투명도 3m 이하, 수색 7인 황토색 물로 표면의 수온, 염분, 용존산소, 인산염은 각각 $18{\sim}19^{\circ}C,\;31\%0$ 이하, $4.5{\sim}50ml/l,\;0.25{\sim}0.5{\mu}g-atom/l$이었고 또 질산염과 규산염은 해역중 가장 높은 간인 $10.0{\mu}g-atom/l$ 이상이었다. 쓰시만 난류수는 투명도 15m 이상, 수색 $4{\sim}2$의 맑은 물로 표면수온 $23^{\circ}C$내외 염분$32{\sim}33\%0$의 고온 저염수이다. 또한 표면의 용존산소는 5.0ml/l이상, 인산염, 질산염, 규산염은 각각 0.25, 2.0, $2.5{\mu}g-atom/l$ 이하로 해역중 가장 낮은 값이었다. 거제도 연안수는 표면수온 $20{\sim}21^{\circ}C$, 염분 $33\%0$이상의 비교적 저온 고염이고 표면 용존산소량이 5.0ml/l 이하, 인산염 $0.5{\mu}g-atom/l$ 내외 질산염과 규산염은 각각 $3.5{\mu}g-atom/l$ 이하로 나타났다. 또한 울산 연안수는 관측 해역중 가장 표면수온이 낮은 $16^{\circ}C$ 이하, $33.5\%0$ 이상의 저온고염이고, 용존산소, 인산염, 질산염, 규산염은 상당히 높은 값을 가져 저층수의 연안용승으로 인한 것이 아닌가 생각된다.

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여성 카지노 시큐리티 종사원에 관한 연구 (A Study on Women's Casino Security Employees)

  • 김형석
    • 시큐리티연구
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    • 제62호
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    • pp.135-158
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    • 2020
  • 카지노에서는 고객과 종사원의 안전을 관리하는 시큐리티 종사원들이 매우 중요한 역할을 수행하고 있다. 특히 카지노에는 여성 종사원들의 비율이 높으며, 고객들 또한 여성과 남성의 비율이 비슷하기 때문에 여성 고객 혹은 여성 종사원이 사건 사고를 경험할 확률이 남성과 비슷하거나 높을 수도 있는 상황이다. 여성의 사건사고를 처리하는 여성 시큐리티 종사원은 여성 고객과 일반 여성 종사원들에게는 여성만이 할 수 있는 시큐리티 서비스를 제공할 수 있다. 하지만 카지노에서 시큐리티 업무를 수행하는 종사원들은 대부분 남성이며, 여성의 비율은 매우 낮다. 따라서 본 연구는 현재 카지노에서 여성으로서 시큐리티 업무를 수행하고 있는 종사원들에 관한 연구로서 이들이 카지노에서 시큐리티 업무를 수행하며 경험한 다양한 내용에 대해서 알아보기 위해 질적연구를 진행하였다. 총 5명의 연구 참여자들에게 총 3회에 걸쳐 인터뷰를 실시하여 수집된 자료를 분석하고 범주화 하였다. 첫 번째 질문인 카지노 시큐리티 업무의 시작 동기에 대한 요인은 교수님의 추천, 개인의 정보검색, 지인의 추천이다. 두 번째 질문인 업무 시 필요 능력에 대한 요인은 다양한 운동 능력, 좋은 신체조건, 외국어 능력이다. 세 번째 질문에서 업무의 만족요인은 업무의 희소성, 급여의 만족, 개인의 적성과 일치, 미래에 대한 기대감이며, 업무의 불만족 요인은 업무의 위험성, 고객에 대한 스트레스, 성별에 대한 차별, 주변의 시선, 교대 근무의 피곤함이다. 네 번째 질문에서 여성 카지노 시큐리티 종사원들의 필요성에 대한 요인은 여성 고객에게 차별화된 서비스 제공, 여성 종사원의 보호, 관련 전공 여성에게 기회 제공이다. 이렇게 나온 연구결과에 대해 카지노 시큐리티업무 20년 이상의 전문가와 인터뷰를 실시하였고, 여성 카지노 시큐리티 종사원은 필요요건이기 때문에 제도적, 인식적인 개선을 통해 발전 방향을 모색해야 한다고 하였다.

정부대행검사기관 선박검사원의 자격기준에 관한 연구 (Eligibility Standards for Recognized Organization Personnel Responsible for Statutory Survey)

  • 이상일;정민;전해동
    • 해양환경안전학회지
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    • 제26권4호
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    • pp.366-373
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    • 2020
  • 선박안전법 제77조 및 동법 시행규칙 제97조의2에 따르면 정부대행검사기관 선박검사원은 일반적으로 특정분야의 학력과 경력을 가지고 있거나 국가기술자격법상 면허를 취득해야 함을 알 수 있다. 하지만, 해사 고등학교 졸업생 및 해기사 단기양성과정 이수생의 경우 수·해양계 및 조선관련 학과를 졸업하지 않아 선박검사원 자격기준을 만족하지 못하고 있는 실정이다. 영국, 미국, 캐나다 등 주요 해운국가는 우리나라와 같은 규정이 없이 IACS 규정을 준용하고 있고, 일본의 경우 선박안전법에서 선박검사원의 자격 요건을 삭제하였다. 특히, IMO 및 IACS의 선박검사원 자격기준은 공학 또는 자연 과학 분야와 관련하여 고등교육기관에서 최소 2년 이상의 과정을 이수; 또는 해상 또는 해사 교육기관에서 자격을 취득하고 자격 있는 선박 사관으로 승선한 경력이 있는 경우; 그리고 관련 업무를 수행하는데 적합한 영어실력을 요구하는 것이 일반적이다. 이에 공무원임용시험령 제17조에 따라 학력제한을 금지하고 있는 점, 영국 및 일본의 선박검사관 응시자격에 학력제한이 없는 점 등을 감안하면 해사 고등학교 졸업생의 경우 충분한 승선경력 및 교육훈련을 쌓는다면 선박검사원 응시자격을 인정할 수 있을 것으로 판단된다. 또한 해기사 단기양성기관의 수료생의 경우 입학자격이 전문학사 이상의(3급 면허 취득학생의 경우) 학력을 보유하도록 되어 있고, 수료 후 일정한 승선경력을 갖추게 되므로 선박검사원 응시자격을 인정할 수 있을 것으로 판단된다.

말기암 환자와 가족의 의료 및 간호 서비스 요구 (The Study on the Medical and Nursing Service Needs of the Terminal Cancer Patients and Their Caregivers)

  • 이소우;이은옥;허대석;노국희;김현숙;김선례;김성자;김정희;이경옥
    • 대한간호학회지
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    • 제28권4호
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    • pp.958-969
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    • 1998
  • In this study, we attempted to investigate the needs and problems of the terminal cancer patients and their family caregivers to provide them with nursing information to improve their quality of life and prepare for a peaceful death. Data was collected from August 1, 1995 to July 31, 1996 at the internal medicine unit of S hospital in Seoul area with the two groups of participants who were family members of terminal cancer patients seventy four of them were in-patients and 34 were out-patients who were discharged from the same hospital for home care. The research tool used in this study has been developed by selecting the questionnaires from various references, modifying them for our purpose and refining them based on the results of preliminary study. While general background information about the patients was obtained by reviewing their medical records, all other information was collected by interviewing the primary family caregivers of the patients using the questionnaire. The data collected were analyzed with the SPSS PC/sup +/ program. The results of this study are summarized as follows ; 1) Most frequently complained symptoms of the terminal cancer patients were in the order of pain(87%), weakness(86.1%), anorexia(83.3%) and fatigue (80.6%). 2) Main therapies for the terminal cancer patients were pain control (58.3%), hyperalimentation(47.2%) and antibiotics(21.3%). 3) Special medical devices that terminal cancer patients used most were oxygen device (11.1%), and feeding tube(5.6%). Other devices were used by less than 5% of the patients. 4) The mobility of 70.4% of the patients was worse than ECOG 3 level, they had to stay in bed more than 50% of a day. 5) Patients wanted their medical staffs to help relieve pain(45.4%), various physical symptoms(29.6%), and problems associated with their emotion(11.1%). 6) 16.7% of the family caregivers hoped for full recovery of the patients, refusing to admit the status of the patients. Also, 37% wished for the extension of the patient's life at least for 6 months. 7) Only 38.9% of the family members was preparing for the patient's funeral. 8) 45.4% of family caregivers prefer hospital as the place for the patient's death, 39.8% their own home, and 14.8% undetermined. 9) Caregivers of the patients were mostly close family members, i.e., spouse(62%), and sons and daughters or daughter-in-laws(21.3%). 10) 43.5% of the family caregivers were aware of hospice care. 46.8% of them learned about the hospice care from the mass media, 27.7% from health professionals, and the rest from books and other sources. 11) Caregivers were asked about the most difficult problems they encounter in home care, 41 of them pointed out the lack of health professionals they can contact, counsel and get help from in case of emergency, 17 identified the difficulty of finding appropriate transportation to hospital, and 13 stated the difficulty of admission in hospital as needed. 12) 93.6% of family caregivers demanded 24-hour hot line, 80% the visiting nurses and doctors, and 69.4% the volunteer's help. The above results indicate that terminal patients and their family caregivers demand help from qualified health professionals whenever necessary. Hospice care system led by well-trained medical and nursing staffs is one of the viable answers for such demands.

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간호진단 프로토콜(Protocol)의 임상적용 효과에 관한 연구 (The Effects of Clinical Application of a Nursing Diagnosis Protocol)

  • 이향련;조미영;조결자;김윤희;김귀분;김광주;문희자;박신애;강현숙
    • 대한간호학회지
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    • 제19권1호
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    • pp.40-62
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    • 1989
  • This study was conducted to measure the effects of clinical application of a Nursing Diagnosis Protocol. The dependent variables were the degree of patient's satisfaction and the degree of nurse's satisfaction with the nursing activity. Analysis of the effect of the use of the nursing diagnosis protocol was based on the nursing record. The subjects for this study were 61 nurses(experimental group 31, control group 30) and 155 patients (experimental group 55, control group 100) on four internal medicine wards in K University Hospital in Seoul. Data collection was done from August to October 12,1988. The results obtained in this study can be summarized as follows, 1, Effect of the clinical application of the nursing diagnosis protocol. 1) The first hypothesis ; “nurses who use the nursing diagnosis protocol will have higher degrees of satisfaction than those who use traditional methods” was rejected (t=.54, df=58, p=.59). 2) The second hypothesis ; “patients nursed by nurses using the nursing diagnosis protocol will have higher degrees of satisfaction than those nursed with traditional methods” was supported(t=1.93, df=154, p=.05). 3) The third hypothisis : Major hypothesis ; “the nursing records of the experimental group, who used the nursing diagnosis protocol, will be more detailed than those of the control group” was supported (t=6.40, df=79.90, p=.000). (1) The first subhypothesis ; “The recorded data collection of the experimental group will be more detailed than that of the control group” was rejected (t=1.79, df=118, p=.07). (2) The second subhypothesis ; “The recorded patient's problem statement of the experimental group will be more detailed than that of the control group”, was supported. (3) The third subhypothesis ; “The nursing record of the experimental group will be more convenient for implementation than that of the control group” was supported. 2. Factors related to the nurse's degree of satisfaction with protocol. 1) No general characteristics(age, religion, education level, duty career, present duty career) were related to the nurse's degree of satisfaction. 2) Variables related to the nurse's degree of satisfaction were “satisfaction as a nurse” and “consider nursing as lifelong job” (t=-2.6, df=13.22, p=.02, t=2.41, df=23.85, p=.02). 3. Factors related to the patient's degree of satisfaction. 1) General characteristics related to the patient's degree of satisfaction with nurses using the protocol were age, educational level, and being married.(F=5.17, df=3/153, p=.00, t= -2.39, df=154, p=,01, f=5.91, df=2/153, p=.00) 2) The variables previous hospitalization, duration of hospitalization, the hospital unit presence of a relative, medical insurance, or medical diagnosis were not related to the patient's degree of satisfaction. 1. The experimental group's nursing record was more detailed than the control group's record with regard to the physical and psychological state of the patients. As noted above, the experimental group nurses, who use a nursing diagnosis had protocol were less satisfied than the control group who used traditional methods of the recording, but experimental group patients had a higher degree of satisfaction than the control group patients. The nursing records of experimental group, using the nursing, diagnosis protocol was more detailed than that of the control group. If the nursing diagnosis protocol is used in clinical nursing practice, the quality of nursing care may be improved.

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죽음의 태도에 관한 조사연구 -임종환자의 간호를 위하여- (A Study On The Attitudes Toward Death -For Nursing Care of The Terminally Ill-)

  • 유계주
    • 대한간호학회지
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    • 제4권1호
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    • pp.162-178
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    • 1974
  • The present study is purported to provide a basic information to be utilized by nurses to care and attend effectively for patients nearing the moment of death. Therefore, the primary purpose of the study has been placed upon grasping an understanding of the trends of death in general. For this purpose: 1. By utilizing the schneidman questionnaire, the trend of death has been categorized by 6 parts and analyzed. 2. A search has been conducted to find out dying patient's needs, nurse's attitudes viewed by the patient, and nurse attitudes to dying patient. The followings are itemized results of analysis: 1. Analysis by the schneidman questionnaire. (1) In general concepts of death. the first sighting of the occurrence of death was experienced upon strangers, grandfather and great grandfather. The death is openly discussed among people of all ages and sex. Ages in which the death is mostly feared were from 12 to well over 70 yews old that are evenly distributed regardless of difference in age. (2) As to the attitudes toward death the occurrence of death to most closely associated person influenced most upon the attitude of their own termination of lives. Among the reading materials, the maximum influence was effected by the Bible. In terms of religion, the thoughts of death were Influenced by religions education in case of the believers of the western religions (36%), and by their own health and physical conditions in case of the believers in the oriental religions (35%). In case of non-believer, their attitude toward death were largely determined through their own thinking meditation (45%). People aged 20 or thereunder revealed that they wished to know the day of their own death to be occurred (58%). However, the older the less thor wanted to know. (3) As to the choosing the time of death, 57% preferred senility, and 30% preferred the time in mediately following the prime period of their lives in general. In terms of religion, 85% of the believer in the oriental religion preferred senility, and 67% in the western religion, 58% in others, Therefore. the desiring of their lives to be terminated in earlier stage, not by the natural senility. sequenced as follows : Others, western religions and oriental religions. (4) Referring to the disposal of the corpse under the assumption that it had already occurred, majority desired the burial system. There has been seen a slight tendency to consider the importance of holding funeral services for the sake of survivors. Concerning the life insurance policy, it showed that the nurse had less belief in it than the patient (5) Upon the subject of life-after-death. religion wise, 72% of western religion believers preferred to have an existence of life-after-death: Among the believers of oriental regions, 35% desired this category, 30% did not mind either way. and 35% did not desire the existence of such a life-after-death. In others, 53% did not mind whether or not such a life existed. (6) In general, serious thoughts were not being attended to the commitment of suicide. 37% emphasized that such an act should be prevented. However, 30% insisted that such commitment should not be bothered, and that society possesses no right to prevented it. More male wished to commit suicide (13%) than females (9%). 2. Nurse's attitudes toward terminal patients and patient's needs. In the instance where the patient realized that their death is imminent, most of them showed desire to discuses mainly on the problems of life. When faced a situation of this nature, it is revealed that 40% of nurses could not furnish appropriate care for them.

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노인의 무력감 완화를 위한 심리 재활에 관한 연구 (A Study on Psychological Rehabilitation to Decrease Powerlessness in the Elderly Population)

  • 김조자;임종락;박지원
    • 대한간호학회지
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    • 제22권4호
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    • pp.506-525
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    • 1992
  • Older people, because of the psychological and physiological changes related to the aging process are more vulnerable to experiencing powerlessness than any other age group. This self destructive cycle of depression in older people related to the experience of continued and long term powerlessness can lead even to death. The purpose of this study was to measure powerlessness and resources to increase power in older people, and to measure the effectiveness of a psychological rehabilitation program for reducing powerlessness. The research methodology used was a two step process. In the first step, a survey was done of perceived powerlessness and power resources comparing four groups of elderly people ; those living at home, those in hospital, those living in nursing homes and those attending educational programs for the elderly. The total sample size was 236. In the second step, a psychological rehabilitation program was carried out, pre and post measurements were taken related to this program. The sample consisted of 29 residents in a nursing home. The results of the study are as follows : 1. Powerlessness was classified as cognitive, emotional, activity and learning. The lowest score for powerlessness was in the area of activity, that is the people in the sample felt more power concerning their activities. The highest score was in the area of cognition where they felt they had less power. 2. When the different groups of elderly were compared, it was found that the residents of the nursing home had the highest score on perceived powerlessness and the group who were living at home had the lowest score. 3. Among the general characteristics, the factors influencing the powerlessness score were age, sex, level of education, financial resources and health status. In the interaction effects among these factors, it was found that level of education and health status were factors influencing perceived powerlessness. The elderly with lower education and poorer health status had the higher scores for perceived powerlessness. 4. The power resources could be classified into the following areas : physical strength, emotional strength, positive self-image, energy, knowledge, motivation and belief system. Belief system was given the highest score among the power resources and energy, knowledge and motivation were given low scores. 5. The group participating in an educational program for the elderly had the highest score for power resources while the group made up of residents of a nursing home had the lowest score as well as the highest score for perceived powerlessness. 6. The factors influencing the power resource scores were sex, level of education, financial resources and health status. In the analysis of the interaction effect among the factors, it was found that sex, level of education and financial resources were the factors that influenced the power resource score, that is, women, those with a low level of education and those with poor financial resources reported a lower level of power resources. 7. There was a negative correlation between perceived powerlessness and power resources in the elderly in this study. Since power resources explainded 49% of the variance for powerlessness, it can be concluded that the power resources can be used to reduce powerlessness. 8. The psychological rehabilitation program was carried out with the nursing home residents over a period of five weeks. No statistically significant difference was found in the scores on powerlessness between the pre and post tests, but there was a slight decrease in the raw scores on the post test for emotional, activity and learning powerlessness. There was a statistically significant increase in the power resource scores for emotional strength, positive self-image, energy, knowledge and motivation in the post test as compared to the pre test. In conclusion, the study indicates that a psychological rehabilitation program for the elderly could be effective in increasing power resources and this in turn could lead to a decrease in perceived powerlessness.

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만성질환자 배우자의 돌봄 경험에 대한 이론 구축 (A Theory Construction on the Care Experience for Spouses of Patients with Chronic Illness)

  • 최경숙;은영
    • 대한간호학회지
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    • 제30권1호
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    • pp.122-136
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    • 2000
  • Chronic illness requiring attention and management during a long period of time puts great burden onto patients, their family and society. For patients with chronic illnesses, providing social support is the most important, and the fundamental support comes from their spouses. Amount and quality of support from spouses seems to differentiated according to the sex of patients. Female patients tend to believe that their spouses are not very supportive. Therefore, the researchers assessed the burden of husbands of female arthritis patients to discover the factors that result in greater burden. Also, they developed a theoretical model of husbands′ care for their wives through a qualitative research into husbands′ experience. Method 1: The study material was 650 female arthritis patients registered in an arthritis clinic. The questionnaire about the disease experience of female arthritis patients and the burden of husbands were sent. Returned questionnaires numbered 210(32.3%) and 27 were excluded because of inadequate answers. The remaining 183 questionnaires were analyzed. The mean age of the patients was 51 years and the mean age of spouses was 55 years. The mean marital period was 28 years. The average duration since diagnosis was 9.1 years. Education level was varied from primary school to graduate school, and average income/month was 1,517,300 won. Method 2: Initial questionnaire studies on the burden of husbands were performed. Among 183 responding husbands, 23 consented to participate for a qualitative research. Data was obtained by direct and telephone interviews. The mean age of participants was 58 years, and the educational level and socioeconomic status also varied. Result: 1. Husbands′ burden: The average burden was 57.68 with a range of 6-96. 2. Burden and general characteristics: The husband′s burden correlated with the age of the patients, numbers in the family, therapy methods, patient′s level of discomfort, patient′s disease severity, patient′s level of dependence and the husband′s understanding of the level of severity. 3. Linear correlation analysis on burden: The husbands′ burden is explained in 22.5% by husband′s recognition of level of severity and husbands′ age. 4. There were four patterns of the burden on husbands: both objectve burden and subjective burden were high(pattern I), both of objectve burden and subjective burden were low(pattern II), objective burden was high but subjective burden was low(pattern III), objective burden was low but subjective burden was high(pattern IV). The pattern was correlated with the family income, educational level of the patients and their husbands, therapy methods, patient′s level of discomfort, patient′s disease severity, patient′s level of dependence and husband′s understanding of level of severity. 5. The core category of the caring experience of the husbands with arthritis patients was "companionship". The causal factor was the patients′ experience due to symptoms : physical disfigurement, pain, immobility, limitation of house chores, and limitation of social activities. Contextural factors are husbands′ identification of housework and husbands′ concern about the disease. The mediating factors are economic problems, fear of aging, feeling of limitation and family support. The strategy for interaction is mind control and how to solve emotional stress. The "companionship" resulted from caring activities, participation of household activities, helping patients′ to coping with emotional experience. 6. Companionship is established through the process of entering intervention, and caring state of mind. Entering intervention is the phase of participation of therapy and involvement of houseworks. The caring phase consists of decision on therapy, providing therapy, providing direct care, and taking over the household role of wife. Through caring phase, the changing phase set a stage in which husbands consolidate the relationship with their wives, and are reminded of the meaning of marriage. As a result, in changing phase, husbands′ companionship is enhanced. In conclusion, nursing care of chronic illnesses should include a family member especially the spouse. All information on disease shoud be provided to patients and whole family member. Strong support should also be provided to overcome difficulties in taking over role of other sex. Then the quality of life of patients and families will be much improved.

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