• 치위생과학회지
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• 제14권3호
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• pp.417-423
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• 2014

이 연구는 국민건강영양조사를 이용하여 우리나라 만 65세 이상 노인을 대상으로 보철 상태에 따른 건강관련 삶의 질을 조사하여, 노인의 구강건강증진의 기초자료를 확보하고자 하였으며, 다음과 같은 결론을 얻었다. 전체 연구대상자의 HRQoL은 0.86이었으며, 성별에 따른 HRQoL은 남자에서 0.90에 비해 여성에서 0.82로 남자가 유의하게 높았으며, 월 평균 소득이 증가할수록, 학력수준이 높을수록, 상실치아 개수가 낮을수록 HRQoL이 유의하게 높았다. 연구대상자 중 고정성 가공의치와 총의치 필요한 대상자는 HRQoL이 유의하게 낮았으며, 부분의치와 총의치를 장착하지 않은 대상자에서 HRQoL이 유의하게 높았다. EQ-5D의 현재의 건강 상태 5개의 항목에서 운동능력 항목은 부분의치 장착군에서 비장착군에 비해 어려움에 대한 응답한 비율이 높았으며, 자기관리 항목에서 총의치장착군에서 어려움이 있다고 응답한 비율이 높았다. 불안/우울 항목에서 총의치 장착군이 비장착군에 비해 어려움이 있다고 응답한 비율이 높았다.

• 대한간호학회지
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• 제20권2호
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• pp.153-173
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• 1990

One of the important tasks for new parents. especially mothers, is to establish warm, mutually affirming interpersonal relationships with the new baby in the family, with the purpose of promoting the healthy development of the child and the wellbeing of the whole family. Nurses assess the quality of the behavioral characteristics of the maternal-infant interaction. This study examined the relationships between primiparas pereptions of their delivery experience and their maternal infant interaction. It compared to delivery experience of mothers having a normal vaginal delivery with those having a casearean section. The purpose was to explore the relationships between the mother's perceptions of her delivery experience with her maternal infant interaction. The aim was to contribute to the development of theoretical understanding on which to base care toward promoting the quality of maternal-infant interaction. Data were collected directly by the investigator and a trained associate from Dec. 1, 1987 to March 8, 1988. Subjects were 3 random sample of 62 mothers, 32 who had a normal vaginal delivery and 30 who had a non-elective cesarean section (but without other perinatal complications) at three general hospitals in Seoul. Instruments used were the Stainton Parent -infant Interaction Scale(1981) and the Marut and Mercer Perception of Birth Scale(1979). The first observations were made in the delivery room (for vaginally delivered mothers only), followed by day 1, day 2, day 3, and 2 weeks, 4 weeks, 6 weeks and 8 weeks after birth, for a total of 7-8 contacts(Cesarean section mothers were observed on days 4 and 5 but the data not used for analysis). Observations in the hospital were made during the hour prior to scheduled feedings. The infant was placed beside the mother. Later contacts were made at home. Data analysis was done by computer using as SPSS program and indulded X² test, paired t-test, t-test, and Pearson Correlation coefficient ; the results were as follows. 1. Mothers who had a normal vaginal delivery tended to perceive the delivery experience more positively than cesarean section mothers(p＝0.002). The finding supported the hypothesis I that perception of delivery would vary according to the method of delivery. Mothers' perceptions of birth were classified into three dimensions, labor, delivery and the bady. There was a significantly different and positive perception by the vaginally delivered mothers to the delivery experience(p＝0.000) but no differences for labor or the bady according to the delivery method(p＝0.096, p＝0.389), 2. Mothers who had a normal vaginal delivery had higher average maternal-infant interaction scores(p＝0.029) than mothers who had a cesarean section. There were similar higher scores for the 1st day(p＝0.042), 2nd day (p＝0.009), and the 3rd day(p＝0.006) after delivery but not for later times. The findings supported the hypothesis Ⅱ that there would be differences in maternal-infant interaction for mothers having vaginal and cesarean section deliveries. However these differences deccreased section deliveries. However these differences decreased over time . by eight weeks the scores for vaginal delivery mothers averaged 8.1 and for cesarean section mothers, 7.9. 3. The more highly positive the pereption of the delivery experience, the higher the maternal-infant interaction score for all subjects(F＝.3206, p＝.006). The findings supported the hypothesis Ⅲ that there would be correlations between perceptions of delivery and maternal-infant interaction. The maternal infant interaction was highest when the perception of the bady and deliery was positive(r＝.4363, p＝.000, r＝.2881, p＝.012). No correlations between perceptions of labor and maternal-infant interaction were found(p＝0.062). 4. The daily maternal-infant interaction score for the initial contact after birth to 8 weeks postpartum had the lowest average score 5.20 and the highest 7.98(in a range of 0-10). This subjects group of mothers needed nursing intervention to promote their maternal- infant interaction. The daily scores for the maternal-infant over the period of eight weeks. However, there were significantly different increases in maternal-infant interaction only from the first to second day(p＝0.000) and from the fourth to sixth weeks after birth(P＝0.000). 5. When the eight items of maternal-infant interaction were evaluated separately, “Expresses feelings about her role as mother” had the highest average score, 1.64(ina range of 0-3)and “Speaks to baby” the lowest, 0.9. All items, with the possible exception of “Expresses feelings about her role as mother”, suggested the subjects' need of nursing intervention to promote maternal-infant interaction. 6. There were positive correlations between certain general charateristis, namely, both a higher economic status(p＝0.002) and breast feeding(p＝0.202) and maternal - infant interaction. There were positive correlations between a mother's confidence in her role as a mother and the perception of the birth experience(p＝0.004). For mothers who had a cesarean section, a positive perception of the birth experience was related to the duration of her marriage(p＝0.010), a wanted pregnancy (P＝0.030) and her confidence in her role as a mother(p＝0.000). Pereptions of birth for mothers who had a normal vaginal delivery were positive than those for mothers who had a cesarean section. The level of maternalinfant interaction for mothers delivered vaginally was higher than for cesarean section mothers. The relationship between perception of birth and materanalinfant interaction was confirmed. Cesarean section has an impact on the mother's perceived experience of birth which, in turn, is positively related to maternal-infant in turn, is positively related to maternal-infant interaction. Nursing intervention to enhance maternal-infant interaction should begin in prenatal classes with an exploration of the potential impact of cesarean section on the perceptions of the birth experience and continue throughout the perinatal and post-natal periods to promote the mother's ability to control with this crisis experience and to mobilize social support. Nursing should help transform a relatively negatively perceived experience into an accepted, positively perceived and self affirming experience which enhances the maternal-infant relationship.

• Journal of Hospice and Palliative Care
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• 제18권1호
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• pp.35-41
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• 2015

목적: 본 연구는 항암치료 단계 유방암 환자의 PTSD, 대처방식, 사회적 지지의 관계를 파악하여 암환자의 PTSD에 관한 효과적인 간호중재의 기초자료를 제시하기 위함이다. 방법: J시 소재 G지역암센터 외과 외래를 방문한 만 30세 이상이며, 항암치료단계인 유방암 환자134명을 대상으로 조사하였다. 수집된 자료는 SPSS WIN 18.0프로그램을 이용하여 서술통계, ANOVA, Pearson correlation coefficients 등을 실시하였다. 결과: 항암치료 단계 유방암 환자의 외상 후 스트레스 장애는 26.9%가 PTSD 고위험군, 17.9%가 PTSD 위험군에 속하는 것으로 나타났다. 대상자의 PTSD 그룹(고위험군, 위험군, 정상)의 대처방식(적극적 대처, 소극적 대처), 사회적 지지의 상관관계는 PTSD 고위험군인 경우 적극적 대처와 소극적 대처가 유의미한 정적 상관관계를 가지는 것으로 나타났으며, PTSD 고위험군에서 사회적 지지와 적극적 대처는 유의미한 정적 상관관계를 가지고 있는 것으로 나타났다. 결론: 항암치료 단계 유방암 환자 중 26.9%가 PTSD 증상을 보이는 것으로 나타났으며, PTSD 고위험군에서 사회적 지지가 증가할수록 적극적 대처가 증가하는 것으로 나타났다. 암은 평생 자기관리가 필요한 질병임을 고려할 때 높은 사회적 지지는 자신의 건강관리 능력을 증진시킬 수 있는 계기가 될 수 있을 것이며, 더 나아가 PTSD 고위험군에게 있어 높은 사회적 지지는 환자의 스트레스를 줄이고 삶의 질을 높이는데 효과적인 역할을 할 것이라 여겨진다.

• 한국산학기술학회논문지
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• 제17권1호
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• pp.664-675
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• 2016

본 연구의 목적은 간호사의 시간선택제 근무에 대한 인식을 조사하고 활성화를 위한 합리적인 근무방안을 제시하는 것이다. 자료는 무작위 할당표출법을 이용하여 전국의 532명의 간호사를 대상으로 2015년 2월 10일부터 24일 까지 설문조사를 하였다. 자료 분석을 위해 SPSS 21.0 프로그램을 사용하였다. 본 연구의 결과에서 시간선택제 근무 중 단축시간제에 대한 필요성($M=3.89{\pm}0.87$)과 지원 의향(46.2%)이 가장 높게 나타났으며, 야간전담제, 휴일전담제, 2교대제 순이었다. 지원 선택의 이유로는 교대근무의 힘든 업무와 육아 병행의 어려움이 가장 높게 나타났다. 시간선택제 근무시행에 따른 긍정적인 영향으로는 자기계발 활동이나 여가활동의 증가로 삶의 질을 높일 수 있고, 육아와 일-가정 양립이 가능한 점이었으며, 부정적인 영향으로는 비정규직으로 채용될 우려와 급여가 감소할 것이라는 의견이 가장 높게 나타났다. 본 연구의 결과를 토대로 시간선택제 근무를 시행하기 위한 선결조건으로 시간선택제 근무 유형에 따른 보상과 근무조건에 대한 표준화된 운영 지침을 제시함으로써 추후에 시간선택제 간호사의 균등한 근무조건을 마련하는데 기여할 수 있다.

• 한국보건간호학회지
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• 제7권1호
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• pp.31-48
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• 1993

Nowaday, there have a lot of changes in the demands of the aged persons. Their problems also came to the fore with diverse forms under the influences of industrialization, urbanization and nuclear family. To make the matter worse, the aged population is mounting rapidly. Also, such structure as nuclear family is widely disseminating uncomfortable to the aged. People is mainly being guided by self interest above everything else. Indeed, they had, all together, bad effects on our traditional value system regarding 'respect for the aged and devotion to patients'. It seems unfortunately obvious that the family responsibility is gradually weakening to support the old who is a dependent family. The result is that the aged must have suffered all sorts of hardships in lightenning psychological, physical and economical difficulties. First, to grasp the situations and conditions supporting for single aged persons from each view of psychological, emotional, family-relational, healthy, social and economical standpoints, and second, to analyze their own recognition levels thinking of their health conditions and the relationships between the supporting environments of old family dependants and their psychological healths and then finally, to propose suggestions being able to be helpful for living comfortably in an old age and thereby, building up good family relation. The statistical techniques used to analyze 115 respondents living in Puchun city are frequency, $x^2$ test, t-Jest, ANOVA, Pearson's Correlation Coefficiency and Regression analysis (SPSS package), pertnent to prove the hypothesis suggested in this paper. Of course, it is needless to say that more data are needed on this point. However, several main research findings can be summarized as follows: First, the better single aged persons may be in the habit of eating a meal and the higher they may think of their physical health conditions and movement, the more they want to participate in economic activities to be free from economical dependence upon their children and to overcome lonliness. Second, single aged women appear to have had higher ability to take care their health for themself than single aged men do. It is why signle aged women do not, in general, have big problems to manage their health. But, as shown in this paper, single aged person"s were more liable to the diseases of the aged and, thereby, requiring special medical treatment badly to be healthy. Third. single aged persons revealed potential desires to free themself from socio economic dependence upon their children even in simple labor Job which can draw a monthly salary of about W200, 000. Fourth, they are generally satisfied with their children's filial piety toward them. Nonethless, most of them appear to be reluctantly dependent upon their children and live lonly lives very much. Fifth, they seem to have some hesitation in expressing their candid opinions as that then are some others along with family environmental factors for psychological and emotiona stability. Accordingly, it is safe to conclude by saying that much attention should' be paid no only to socio-economic supports and better medical services for the aged but also to political supports of the society and towards their children for the aged's emotiona support, for improving the quality of their lives in old age and promoting efficiency in suporting for old family dependants.

• 한국산학기술학회논문지
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• 제19권8호
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• pp.482-491
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• 2018

본 연구는 간호사의 태움 개념분석연구로 개념의 속성을 확인하고 명확한 개념 정의를 내리고자 시도되었다. Walker and Avant의 개념분석 방법을 사용하였다. 간호사의 태움의 속성은 조직문화, 피해자인 미숙한 신규 간호사, 가해자인 선임 간호사, 가르침의 변질, 언어적, 신체적 폭력경험, 심리적, 신체적 증상으로 도출되었다. 간호사의 태움의 선행요인은 간호업무 과다, 높은 노동 강도, 직무 스트레스, 인력 부족, 열악한 근무 환경, 신규 간호사의 업무 능력이 기대에 미치지 못함, 조직의 위계질서, 힘의 불균형이었으며 결과는 신체적, 심리적 증상, 간호업무 효율 저하, 불신 증가, 이직의도 증가, 환자 간호의 질 하락으로 나타났다. 간호사의 태움의 선행요인을 해결하기 위해 활동 간호인력 확충을 위한 근로조건 개선, 사회적지지 프로그램 제공, 의사소통과 상호협력 관계를 지향하는 공동체 문화가 조성되어야 한다. 이후 간호사의 태움에 대한 더 많은 질적 연구와 태움의 속성이 잘 반영된 도구개발 연구, 태움 문화 개선을 위한 프로그램 개발 연구를 제언한다. 본 연구는 태움의 선행요인을 제시하여 해결방안을 제안함으로써 신규간호사 적응 프로그램을 위한 이론적 근거를 제공했다는 점에서 의의가 있다.

• 한국산학기술학회논문지
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• 제17권7호
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• pp.410-419
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• 2016

본 연구는 스마트폰 사용자의 일반적 특성과 스마트폰 및 헬스케어 애플리케이션 이용 특성에 따른 헬스케어 애플리케이션의 인지도, 정보품질, 용이성 측면에서의 만족도 차이를 파악하기 위해 시도되었다. 자료 수집은 2014년 9월 17일부터 21일까지 헬스케어 애플리케이션 사용 경험이 있는 193명을 대상으로 이루어졌으며, 수집된 자료는 SPSS WIN 20.0을 이용하여 기술통계, t-test, One-way ANOVA, Kruskal-Wallis test로 분석되었다. 연구 결과, 일반적 특성 중 연령, 교육수준, 경제수준에 따라, 스마트폰 및 헬스케어 애플리케이션 이용 특성 중 스마트폰 운영체계, 스마트폰 사용기간, 설치된 헬스케어 애플리케이션 수 및 주요 정보 출처, 사용 빈도와 사용하지 않는 이유에 따라 헬스케어 애플리케이션 만족도는 유의한 차이를 나타냈다. 모바일 헬스케어의 효과적 확산과 헬스케어 애플리케이션의 개발 및 배포 전략을 수립하기 위해서는 스마트폰 이용자의 특성과 요구를 확인하고 이를 반영해야 한다. 또한 개발된 헬스케어 애플리케이션의 지속적인 이용을 위해서는 사용자의 이용 동기를 지속적으로 유발하고 만족도를 향상시킬 수 있는 다양한 전략들이 함께 적용되어야 한다.

• 한국산학기술학회논문지
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• 제17권2호
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• pp.479-488
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• 2016

본 연구는 간호사가 경험하는 직장 내 괴롭힘의 영향을 측정하기 위한 도구를 개발하고, 개발된 도구를 검증하려고 하였다. 간호사의 직장 내 괴롭힘 관련 문헌과 간호사 심층면담을 통해 28문항의 직장 내 괴롭힘 결과의 초기문항을 개발하였고, 내용타당도와 안면타당도의 확인과정에서 14개 문항을 도출하였다. 2013년 10월 21일부터 2013년 10월 28일 수도권의 의료기관에 근무하는 경력 6개월 이상의 간호사 458명을 대상으로 도구에 대한 신뢰도와 타당도를 평가하였다. 연구결과인 간호사 직장 내 괴롭힘 결과 측정도구(WPBN-CI)는 신체적 심리적 위축, 간호의 질 저하 및 불신 증가로 구성된 총 13개 문항, 3개 요인이 62.9%를 설명하였고, 수렴타당도 및 판별타당도는 각각 100%, 89.7%이었다. 우울점수가 높은 집단일수록 괴롭힘의 결과점수가 높아 집합타당도가 입증되었고, 우울척도와의 상관관계가 .70이상으로 준거타당도를 보였다. 이 도구의 Cronbach's alpha는 .90이다. 본 도구는 간호사들의 직장 내 괴롭힘으로 인한 결과 를 사전에 파악하고, 이를 통해 조기예방 및 해결방안을 모색하는 데 도움을 제공할 것이다. 또한, 직장 내 괴롭힘을 경험한 대상자들을 위한 프로그램 실시 효과성을 입증하는 도구로 사용가능할 것이다.

• 보건행정학회지
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• 제26권4호
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• pp.359-372
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• 2016

Background: The purpose of this study was to develop risk-adjustment models for acute stroke mortality that were based on data from Health Insurance Review and Assessment Service (HIRA) dataset and to evaluate the validity of these models for comparing hospital performance. Methods: We identified prognostic factors of acute stroke mortality through literature review. On the basis of the avaliable data, the following factors was included in risk adjustment models: age, sex, stroke subtype, stroke severity, and comorbid conditions. Survey data in 2014 was used for development and 2012 dataset was analysed for validation. Prediction models of acute stroke mortality by stroke type were developed using logistic regression. Model performance was evaluated using C-statistics, $R^2$ values, and Hosmer-Lemeshow goodness-of-fit statistics. Results: We excluded some of the clinical factors such as mental status, vital sign, and lab finding from risk adjustment model because there is no avaliable data. The ischemic stroke model with age, sex, and stroke severity (categorical) showed good performance (C-statistic=0.881, Hosmer-Lemeshow test p=0.371). The hemorrhagic stroke model with age, sex, stroke subtype, and stroke severity (categorical) also showed good performance (C-statistic=0.867, Hosmer-Lemeshow test p=0.850). Conclusion: Among risk adjustment models we recommend the model including age, sex, stroke severity, and stroke subtype for HIRA assessment. However, this model may be inappropriate for comparing hospital performance due to several methodological weaknesses such as lack of clinical information, variations across hospitals in the coding of comorbidities, inability to discriminate between comorbidity and complication, missing of stroke severity, and small case number of hospitals. Therefore, further studies are needed to enhance the validity of the risk adjustment model of acute stroke mortality.

• 여성건강간호학회지
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• 제7권3호
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• pp.271-283
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• 2001

The childbearing process is a sociocultural phenomenon of a woman who gives birth to a child as well as a biological phenomenon. The purpose of this ethnographic research study was to explore the experience of childbearing process of mothers with children from pregnancy to the 3 months postpartum in Korea and to understand deeply the perspectives of childbearing women reflected on Korean sociocultural values. A convenient sample of 10 childbearing women were observed from January to October 2000 through field work in Seoul, Korea. Data analysis was accomplished under ongoing process. The results of this study were as follows : The mothers with children experienced self-reflection, family relation, and physical adaptation during pregnancy. In self-reflection, all mothers experienced universality and diversity in their self-discovering process. The universal experiences were maturation, life with family and priority on maternal value between being a mother and a woman. The diverse experiences were taking a dual role of working mother, emotional drift of a resigned mother, and disheartened life of a mother who has two daughters. In family relation, the foundation of the new marital relationship were attained during childbearing process and sexual life were changed for the benefit of a healthy mother and a healthy baby. All mothers established friendly relations with their mothers, but established friendly or conflicting or constraining relations with their mother-in-laws due to husband based family culture. In physical adaptation, the informants endured well the physical discomfort and recognized general appearance change. Also maternal-fetal interaction occurred and mothers realistically felt motherhood and accepted themselves as mother-to-be. The mothers prepared for the best delivery, look for a safe childbirth center, newborn goods, endorsed family coping during hospitalization and responded labor pain to make it more endurable, less painful, fast passed owing to labor recognition of the natural process to be a mother. After childbirth, they felt emancipation, satisfaction, accomplishment, more easiness, actually feeling as mother-to-be, emptiness, and showed response to the sex of newborn. Their Sanhujori practice was different according to the Sanhujori environment including provider, place, time in postpartum and reflected on Sanhubyung. The mothers felt actually mother-to-be and happiness during lactation regardless of feeding pattern. These mothers had a different maternal image about rearing subjecthood through their child-rearing experience. But all mothers felt need for family support and social support. The universal rearing response were actual feeling of mother-to-be, a strenuous experience, a pride on child-rearing, confusion, reflecting marital relationship, and wondering rivalry among children. In conclusion, mother of all with children went through self-discovery, self-reflection and made connections with the family as a mother and as a woman simultaneously during the childbearing process. Therefore it is suggested when harmony and balance between a mother and a woman is accomplished, the woman will lead a healthy and high quality of life. Also, this study sought to confirm the sociocultural factors affecting the childbearing process from the perspectives of the women with children. Therefore health care providers must understand deeply the childbearing women with children based on this finding of and try a integrative approach with new ideology of maternity with biocultural perspectives in a clinical setting.