• Title/Summary/Keyword: Psychological support system

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Ethnography of Caring Experience for the Senile Dementia (노인성 치매 환자의 돌봄경험에 대한 문화기술지)

  • 김귀분;이경희
    • Journal of Korean Academy of Nursing
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    • v.28 no.4
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    • pp.1047-1059
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    • 1998
  • Senile Dementia is one of the dispositional mental disorder which has been known to the world since Hippocratic age. It has become a wide-spread social problem all over the world because of chronic disease processes and the demands of dependent care for several years as well as improbability of treatment of it at the causal level. Essentially, life styles of the older generation differ from those of the younger generation. While the fomer is used to the patriarchal system and the spirit of filial piet and respect, the latter is pragmatized and individualized under the effects of the Western material civilization. These differences between the two generations cause conflict between family members. In particular, the pain and conflict of care-givers who take care of a totally dependent dementia patient not only is inciting to the collapse of the family union, but is expanding into a serious social problem. According to this practical difficulty, this study has tried to compare dementia care-givers' experiences inter-culturally and to help set up more proper nursing interventions, describing and explaining them through ethnographies by participant observation and in-depth interviews that enable seeing them in a more close, honest and certain way. It also tries to provide a theoetical model of nusing care for dementia patients which is proper to Korean culture. This study is composed of 12 participants (4 males, 8 females) whose ages range from 37-71 years. The relations of patients are 5 spouses(3 husbands, 2 wives), 4 daughters-in-law, 2 daughters, and 1 son-in-law. The following are the care-givers' meaning of experiences that results of the study shows. The first is "psychological conflict". It contains the minds of getting angry, reproaching, being driven to dispair, blaming oneself, giving up lives, and being afraid, hopeless, and resigned. The second is "physical, social and psychological pressure" . At this stage, care-givers are shown to be under stress of both body and soul for the lack of freedom and tiredness. They also feel constraint because they hardly cope with the care and live through others' eyes. The third is "isolation". It makes the relationship of patient care-giver to be estranged, without understanding each other. They, also, experience indifference such as being upset and left alone. The forth is "acceptance" They gradually have compassion, bear up and then adapt themselves to the circumstances they are in. The fifth is "love". Now they learn to reward the other with love. It is also shown that this stage contains the process of winning others' recognition. The final is "hope". In this stage they really want situations to go smoothly and hope everything will be O.K. These consequences enable us to summarize the principles of cue experience such as, in the early stage, negative response such as physical·psychological confusion, pain and conflict are primary. Then the stage of acceptance emerges. It is an initial positive response phase when care-givers may admit their situations. As time passes by a positive response stage emerges. At last they have love and hope. Three stages we noted above : however, there are never consistent situations. Rather it gradually comes into the stage of acceptance, repeating continuous conflict, pressure and isolation. If any interest and understanding of families or the support of surrounding society lack, it will again be converted to negative responses sooner or later. Otherwise, positive responses like hope and love can be encouraged if the family and the surroundings give active aids and understanding. After all, the principles of dementia care experiences neither stay at any stage, nor develop from negative stages to positive stages steadily. They are cycling systems in which negative responses and positive responses are constantly being converted. I would like to suggest the following based on the above conclusions : First, the systematic and planned education of dementia should be performed in order to enhance public relations. Second, a special medical treatment center which deals with dementia, under government's charge, should be managed. Third, the various studies approaching dementia care experiences result in the development of more reasonable and useful nursing guidelines.

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A Study on the Perception of Concurrent Use of Western and Korean Medicine Care and Integrated Medical Service in Korea - Targeting tertiary hospital users - (의-한의 동시 진료 및 통합의료서비스에 대한 인식조사 - 3차 상급종합병원 이용자를 대상으로 -)

  • Seo, Sangwoo;Kim, Hyungsuk;Lee, Seung Hyeun;Kong, Moonkyoo;Lee, Beom-Joon;Heo, Sung Hyuk;Kwon, Seung-won;Park, Bong Jin;Yun, Dong Hwan;Lee, Euiju;Oh, Hyunjoo;Kim, Sung-Bum;Choi, Hye-Sook;Kim, Kwan-Il;Chung, Won-Seok
    • The Journal of Korean Medicine
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    • v.43 no.2
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    • pp.51-60
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    • 2022
  • Objectives: Currently, Korea's medical services are divided into Western medicine and Korean medicine, and people who are not satisfied with the existing treatments are looking for complementary and alternative medicine(CAM). Therefore, this study attempted to confirm patients' perception of the ongoing collaborative treatment and integrated medical service that added CAM to collaborative treatment based on tertiary hospital users. So that we can confirm the expected advantage and disadvantage of integrated medical service system and the necessity of supporting medical expenses for it. Methods: The survey was conducted on 100 people who experienced tertiary hospital treatment and other 100 people who experienced both tertiary hospital treatment and Korean medicine treatment at the same period. The survey was conducted until the number of respondents in both group reached 100. The survey was conducted through e-mail and was conducted from September 27, 2021 to October 8, 2021. Results: For the advantages of collaborative treatment 'increased in psychological stability,' and for disadvantages 'longer time spent for treatment' were the most common. If integrated medical services are implemented in the future, expected advantages include 'consideration of various treatments.' and expected disadvantages include 'increased medical cost.' The needs to expand support for health insurance for integrated medical services were 75.5% among responders. Conclusions: We were able to find out the (expected) advantages and disadvantages of the collaborative medical care and the integrated medical system that medical users experienced or expected, also confirmed positive answers to the expansion of health insurance support for the integrated medical system.

A Clinical Study for Promoting Quality Nusing Care in a University Hospital (질적 간호제공을 위한 간호단위 시범 운영 효과에 관한 임상적 연구)

  • Lee, A.J.;Kim, S.H.;Seong, Y.H.;Yoo, S.A.;Kwon, I.G.;Jeong, Y.I.;Nam, H.K.;Kwon, E.J.
    • The Korean Nurse
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    • v.32 no.5
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    • pp.66-77
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    • 1994
  • The purpose of this study was to develop a new nursing unit which can meet changing health care needs, enhance patients' satisfaction and nurses' job satisfaction, and finally guarantee quality nursing care with present manpower. For this, one medical unit was selected as a unit for quality care. And one medical unit which is similar in staffing and patients' characteristics was selected as a control unit. To assess present problems and identify the remedies to the problems a hospital-wide survey and a workshop were performed. According to the survey results, educational programs and improvement of the facilities and equipment supply system, managereal support for interdepartmental cooperation and intensification of bed-side nursing care were adopted as main principles for operating model unit, This model unit was operated for 3 months from Sep. 1, 1992 to Nov. 30, 1992. To evaluate the effectiveness of the model unit, derect/indirect nursing care hours, patients' satisfaction to nursing care, nurses' job satisfaction, and quality care index were measured. Direct/indirect nursing care hours were compared with that of the control unit, and patients' and nurses' satisfaction and quality care index were measured before and after operating model unit and compared with each other. The results of the study were as follows; 1. In the model unit mean direct nursing care hours per cach shift was 146.88 minutes and indirect nursing care hours was 354.72 minutes. The ratio of the direct nursing care hour to indirect nursing hour was 29.6 ; 70.4 and that of the control unit was 26.9 : 73.1. Direct nursing care hour in model unit was longer than that of the control unit. But, the difference was not significant. In subcategories of direct nursing care, the time spent in mobility and exercise, conservation of body temperature, hygiene, and communication and health education were longer than that of the con" trol unit. 2. Indirect nursing care hour in model unit was shorter than that of the control unit. But, the difference was not significant. In subcategories of indirect nursing care, the time spent in drug management and ward arrangement was shorter than that of the control unit. 3. Patients' satisfaction to nursing care was increased significantly after operating the model unit (T=-3.48, P=-0.002) and satisfaction to subcategories of physical comfort measure, psychological cate, and unit management components were significantly higher than before. 4. In the model unit, nurses' total job satisfaction was increased significantly after operating the model unit(Z=2.1004, P=.0357) and satisfaction to subcategory of satisfaction to administration was significantly higher than before (Z=-2.0732, P=.0382). 5. After operating the model unit, quality care index was increased from 89 to 93. With this results, it can be summarized that all the measures tried for quality care, such as educational programs, managereal support for interdepartmental cooperation, and improvement of the equipment and facility provision resulted in partial increase in direct nursing care hours, nurses satisfaction to their job and patients' satisfaction to nursing care. In can be postulated that managereal support and motivation without proper staff supplementation is not enough for increasing direct nursing care hours. And for the enhancement of the level in clinical nursing, and staff supplement must be considered sincerely and the measures for reducing indirect nursing care hours, such as computerization of nursing care activities, improvement of facilities and equipment and facilities supply system, must be instituted in addition.

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The Operation Plan of the Community-Linked Extracurricular Education program for Lifelong Education for the Persons with Disabilities Based on the Memorandum of Understanding (MOU) of Extracurricular Education between Chosun University and Daegu University (조선대학교-대구대학교 비교과 교육 업무협약(MOU) 기반 지역 연계 장애인평생교육 비교과프로그램 운영 방략)

  • Kim, Young-Jun;Kim, Wha-Soo;Rhee, Kun-Yong
    • The Journal of the Convergence on Culture Technology
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    • v.8 no.2
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    • pp.273-280
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    • 2022
  • Based on the MOU between Chosun University and Daegu University, this study was conducted with the aim of exploring the operation strategy of a extracurricular education program on the theme of lifelong education for the disabled in community connection. In front-line university sites, extracurricular education programs are often recognized as forms and procedures to assist in subject learning at the major or liberal arts level, but they have a very important status and identity considering that they are classified as "learning competency reinforcement support", "career psychological counseling support", "employment and start-up support", "subject-linked extracurricular education". Accordingly, the extracurricular education programs has the nature and advantage of covering not only the level of the one-time trend program itself, but also various community -linked problem-solving learning, including students' major learning and employment linkage. As part of the above, this study aims to present a strategy for the operation of a extracurricular education programs with the main theme and content of "lifelong education for the disabled" by viewing Chosun University and Daegu University. The contents of the study were largely presented as "organizational operation strategy between two universities," "operation strategy of curriculum between two universities," and "comprehensive system for extracurricular education programs operation of lifelong education for the disabled between the two universities". First, the first research content, "Organized Operation Strategy between Two Universities," was schematized in detail the process of collaborating and communicating with Chosun University's center of extracurricular activities, Daegu University Lifelong Education Center, and other committees and departments. The second research content, "The Curriculum Operation Strategy between Two Universities", is a detailed schematic diagram of the learning contents, methods, and procedures to be organized in the extracurricular education program. The third study, "Comprehensive System of extracurricular education program Operation for Lifelong Education for the Disabled between Two Universities," presents the results of synthesizing the basis elements essential for operating the extracurricular education program at the level of a roadmap. As a result of the study, it was possible to see the project tasks that could be promoted in-depth through the operation of a extracurricular education program on lifelong education for the disabled through the MOU between the two universities.

A Shared Electronic Medical Record for Lung Cancer Clinic (폐암 클리닉을 위한 공유 전자의무기록)

  • Kim, Kyu-Sik;Park, Eun-Sun;Kim, Seung-Seok;Kim, Hyung-Woo;Kim, Young-Chul;Bom, Hee-Seung;Ahn, Sung-Ja;Na, Kook-Joo;Kim, Yun-Hyeon;Kim, Yu-Il;Lim, Sung-Chul;Moon, Jai-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.5
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    • pp.480-486
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    • 2005
  • Since the year 2000, lung cancer has become the leading cause of cancer death in South Korea as in many other parts of the world. The current multidisciplinary approach for lung cancer includes a wide range of modalities, not only surgery, radiotherapy, medical drug therapy but also pain control, as well as social and psychological support. Therefore, thoracic surgeons, radiologists, nuclear medicine specialists, anesthetists, psychologist, nurses and social workers as well as medical doctors care for lung cancer patients. Sharing a common treatment protocol and optimal communication are vital aspects of shared care both from a medical and cost-effectiveness point of view. We developed a shared electronic medical record (SEMR) for treating patients with lung cancer in a university hospital to facilitate the sharing protocols and communications between doctors involved in a lung cancer clinic. A SEMR system was developed within a order communication system(OCS) for a lung cancer clinic. The records of radiological, laboratory and pathological studies as well as the records of surgery, chemotherapy, and radiotherapy were stored and presented to all doctors who treat the same patient. Every doctor was allowed to change his/her own records. They could review other doctor s records but could not alter them. With the SEMR, it was expected that the time to complete the medical records for one patient could be reduced because it was easy to review all the data from the other doctors who share the same patient. In addition, the confidence of the doctors who share a common treatment protocol would be higher. Therefore, a shared electronic medical record is expected to improve the quality of patient care.

A Study on the Problems and Improvement of Long-Term Care Insurance for the Elderly (노인장기요양보험제도의 문제점 및 개선방안에 관한 고찰)

  • Ahn, Myung-Sun;Park, Joo-Hyun
    • The Journal of the Korea Contents Association
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    • v.19 no.8
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    • pp.525-534
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    • 2019
  • Korea is facing one of the fastest aging population problems in the world due to the extension of life expectancy and low birth rates due to economic development and the development of health care. It has become difficult to take care of elderly people in need of long-term care at home, and social problems such as dementia and the increase in stroke cases are serious problems. The government is enacting and implementing the Long-Term Care Insurance Act for the purpose of improving the quality of life for senior citizens subject to long-term care and alleviating the burden of family support in order to solve such social structure and problems for senior citizens. However, as a result of the implementation of the long-term care insurance system for the elderly, the privatization of the facilities and the disorder are causing widespread requests for public accountability of the services and the enhancement of the quality of the facilities. In addition, various arrangements are needed for the production of low-wage medical care workers, tasks for quality improvement, problems regarding financing methods, and so on. In order to maintain and develop the long-term care insurance system for the elderly, the government will consider seeking ways to improve the legal and institutional aspects according to changes in the social environment of the age, as well as seeking mental and psychological measures for the stabilization of old life as well as physical health.

A Study on the recognition and Attitude of Home Health Nursing System (가정간호사 제도에 대한 인식 및 태도 조사연구)

  • Lee Sung Ja
    • Journal of Korean Public Health Nursing
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    • v.12 no.1
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    • pp.132-146
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    • 1998
  • This Study was attempted to provide the basic data necessary in the development and introduction of Home Health Nursing System by investigating the recognition and attitude level of Home Health Nursing System. The data were collected by means of questionaires presented to 74 patients who had been admitted in C general hospital in Chon Ju, from June 30, 1997. As the tool for this study, the questionares developed by Kim Yong. Soon, et al (1990) and Han Bok Hee(1993) were modified and supplemented for the aim of this study. The computer was used for data analysis. The items about the charateristics of the subjects and the attitude to the management plan of Home Health Nursing System were represented as the frequency and percentage. The standard deviation and calculation average were produced on the items related to definition, recognition, necessity, expected effect of the attitude of Home Health Nursing System and the items related to admission. The ANOVA test was .used according to the characteristics of variables to analyze the necessity and difference of Home Health Nursing System. The results of this study were as follows 1) The general characteristics of the subjects were as follows ; for sex, man, $58.1\%$ ; for age, 50-59 years, $29.7\%$ ; for the level of education, high school, $51.4\%$ ; $79.7\%$ of them were married; for the family forms, small family, $73.0\%$ ; and $68.9\%$ of them take the monthly income over 100 million won. 2) The characteristics related to admissions of the subjects were as follows ; for clinic, surgical department, $78.4\%$ ; addmission not more then 7days, $47.3\%$ ; for the operation-performance $71.6\%$ of them were experienced; for the admission route, via outpatients clinic, $54.1\%$ ; for waiting period to the admission day, 1-2 days, $71.6\%$. 3) The difficulties comming from the hospitalization were related mostly to the factor that they felt hospital life more inconvenient than home.(3.66) The reasons for the difficulties in the admission which was due to insufficient beds in the hospital was related to the concentration to the general hospital because of 'The Whole National Medical Insurance System'(4.05). 4) On the previous informations about the Home Health Nursing System, those who have heard of only the name were 42 $(56.8\%)$, and on the recognition of it, they thought that it is periodic treatment by the licenced nurses for the recovering pateints after early discharge(3.73). On the attitude about the necessity of Home Health Nursing System, they thought that it is necessary because of the increasing trend of a psychological disease by the change of environment and complexity of the social structure(4.24). On the expected effect of Home Health Nursing System, they answered that it is convinient for the family of the patient to take care of them(4.l8). 5) On the attitude to the management plan of the Home Health Nursing System, those who had intention to participate in the system in the case of systemic support were 42(56.8). In the visiting time, 'visit periodically' and 'visit when the patient needs' were $28(37.8\%)$ respectively. For the application of medical insurance, if possoble, they will use $(91.9\%)$; for the method of payment for the treatment, 'pay by the time required' was $23(31.1\%)$, for the subject of management, 'National public institute must operate' was $33(44.6\%)$. 6) The relationship between the general characteristics of the subjects and the necessity of Home Health Nursing System showed the notable difference in the age (F=3.508, P<0.05) and marrage state (F=5.402, P<.023).

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The Hope of the Stroke Patients (뇌졸중환자의 희망)

  • 김이순
    • Journal of Korean Academy of Nursing
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    • v.27 no.1
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    • pp.212-227
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    • 1997
  • Cerebrovascular diseases in Korea is an important health problem since mortality and mobidity have been increased rapidly. It marked the 2nd cause of specific death rates in 1993. The stroke causes physical function disorder due to hemiparalysis and emotional disorder, and stroke patients experience helplessness, powerlessness. sense of alienation and loss of hope. These feelings make the rehabilitation difficult because they lose the will of life. The subjects of the study were seven citizens who live in Pusan, are over 50 years old and belong to low income-level. The data were collected from Jan. to Sep. 1995. The researcher as a caregiver and volunteer made confidence of them and asked for their agreement on the purpose of the study. The subjects expressed their experience as openheartedly as possible. The analysis of the data was made through the phenomenological analytic method suggested by Giorgi, which is as follows ; as an unit of description which include the subject' expressions and the researcher's observation, it is examined the theme that express the hope experience with the subject's language(underlining), and the focal meanings are identified. The focal meaning is the crystalization of the theme, which is written in the language of the researcher. After intergrating the focal meaning and make the situated structural description as the meaning of the hope experience identified on each subject's point. After intergrating the situated structural description and make the general structural description as the meaning of the hope experience identified on total subject's point then the systemizing of the structure of the hope experienced phenomena and the flowing of the conciousness was researched. The conclusions of this study was as follows : The ten sources of hope which the subjects experienced were sorted as under 〈mutual relations to others : spouse, children, relatives, fellow believer. health professioner. associate patient group〉, 〈spiritual dependence〉. 〈recovery of physical function〉. 〈rumination of the past life〉, 〈expectation of the future〉. 〈economic power〉, 〈belief〉, 〈ability〉. 〈spontaneous participation〉 and 〈recovery of roles〉. Their hope was spoken out by the following two kinds of linguistics. First. the hope was expressed in the affirmative expression as follows : 〈 to be dependable〉, 〈to make efforts〉, 〈to keep under control〉, 〈to desire〉, 〈to be pleasant〉, 〈to be peaceful〉, 〈to be grateful〉, 〈to give help〉, 〈self-confidence. Courage〉, 〈to be happy〉, 〈to satisfy oneself〉, 〈to share with others〉, 〈to understand〉 and 〈to be affected, be impressed〉 Second, the hope was expressed in the negative on pression as under : 〈to be distressed〉, 〈to be uneasy〉, 〈to be sorry, be unsatisfied〉 〈despair〉, 〈to abandon〉, 〈to be fearful〉, 〈to suffer〉, 〈to bear a burden〉 〈to be confused〉, 〈to be solitary〉, 〈chest trouble〉, 〈to feel heavy〉 〈grief〉, 〈to be daunted〉, 〈to get angry〉, 〈to be uncomfortable〉, 〈to have something regretable〉 and 〈to feel guilty〉. And their hope was expressed by the following four behavioral expressions : 〈physical sphere〉, 〈psychological sphere〉, 〈social support sphere〉 and 〈spiritual sphere〉. The reaction patterns of their hope experience appeared in the following 4 coping method : 〈conquest type〉, 〈dependence type〉, 〈adaptation type〉 and 〈fate type〉. Finally, in the hope structure the sense of certainty don't always coexict with the sense of uncertainty, When the stroke patients try to search for the best quality of life, the senses of certainty and uncertainty make a continual cyclic system in the hope structure.

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Postoperative Quality of Life in Patients with Papillary Thyroid Cancer (갑상선 유두암환자의 수술 후 삶의 질)

  • Kim, Ju-Sung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.3
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    • pp.1260-1269
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    • 2011
  • The purpose of this study was to determine postoperative quality of life(QoL), thyroid specific symptoms(TSSs), self care compliance, anxiety and depression in patients with papillary thyroid cancer and to identify factors influencing their postoperative QoL. 154 patients were surveyed using structured questionnaires and data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation, and multiple regression with SPSS/WIN 18.0 program. The mean score of postoperative QoL in the subjects was 2.72 and the postoperative QoL score of social/family well being subscale showed the lowest score. Most of the subjects suffered from TSSs such as fatigue, cold intolerance, and mood swings. The most frequent activity for self care compliance was taking thyroid hormone(100%) and OPD follow up was the second activity(99.4%). Anxiety score was 45.3 indicating a medium level however 63% of the subjects were evaluated as depression status. Postoperative QoL in thyroid papillary cancer patients showed significantly negative correlations to TSSs, anxiety, and depression (r=-.573, p<.001; r=-.739, p<.001; r=-.742, p<.001). The factors influencing postoperative QoL were TSSs, anxiety, and depression, which explained about 64.9% of the variance. Thus to improve postoperative QoL in patients with papillary thyroid cancer, health care providers should relieve negative emotions related to long term cancer management, develop the support system and provide practical information to apply patients' physical, and psychological symptoms control.

The Grounded Theoretical Study on Negative Emotion Recovery Process of Female College Students Through Bibliotherapy (독서치료를 통한 여대생의 부정적 정서 회복과정에 대한 근거이론적 연구)

  • Kim, Kil-Ja
    • Journal of the Korean Society for Library and Information Science
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    • v.42 no.3
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    • pp.103-131
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    • 2008
  • Today. the mental health has a great deal of impact on individuals and the society surrounding. Therefore. this research is to propose a way of bibliotherapical intercession by stages and patterns as to examine the recovery process of students with negative emotion by using the grounded theoretical method. This research collected materials through focus-interview, participant observation and book reports of 4 experiments involving female college students aged from 21 to 23, all having emotional and psychological difficulties. The recovery process of female students with negative emotion involved causal factors such as "recognition of hidden wound" "Sense of inferiority", and "difficulty in forming relationships", as well as contextual factors like "sympathetic attitude". which altogether brought about the core phenomenon. "pursuit for healthy ego". This core phenomenon induced to recovering the bright and positive attitude through using the strategies of 'self insight' and application of 'management plan', influence by such incoherent conditions as 'intimate surroundings' and $\setminus$ 'support system patterns'. And as time passed. the recovery process appeared tin four stages: 'issues recognition'. 'emotional responses', 'issue solution' and 'self application'.