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호스피스 환자의 영적 요구 (Spiritual Needs of Hospice Patients)

  • 한영미
    • Journal of Hospice and Palliative Care
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    • 제3권1호
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    • pp.39-48
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    • 2000
  • 목적 : 본 연구는 호스피스 병동과 독립기관에 입원한 환자의 영적 요구를 알아보고자 실시하였다. 방법 : 대상자는 9개 기관에서 선정한 환자 49명과 보호자 40명이며, 자료수집 기간은 1999년 6월부터 8월까지였다. 결과 : 1) 일반적 특성에 따른 영적 요구는 환자의 경우 위암 환자 군, 여성 군, 대졸 이상군, 기독교군, 호스피스 간호기간 $8{\sim}14$일 군 및 신앙이 중요하다고 하는 군에서 유의하게 높았고, 보호자의 경우는 기타 종교를 가진 군, 투병기간 $3{\sim}5$년 미만인 군이 높았다. 2) 영적 요고, 전체 평균에서 환자가 $3.69{\pm}0.52$로 보호자 $4.06{\pm}0.42$보다 유의하게 낮았다. 영역별 순위는 환자가 삶의 의미와 희망영역에서, 보호자는 사랑과 관심영역에서 가장 높았고, 종교적 영역은 공통적으로 낮았다. 문항에서는 사랑과 관심영역에서 환자는 '부드럽게 말해주길 원한다'가, 보호자는 '슬프고 외로울 때 따뜻하게 질문에 대답해 주길 원한다'를 가장 많이 요구했고, 또한 환자는 '다른 환자보다 본인에게 신경 써 주길 원한다'와 보호자는 '환자는 부드럽게 말해주길 원한다'가 가장 요구가 낮았다. 종교적 영역의 문항 중 '모든 것에서 벗어나 마음이 평안해 질 수 있도록 도와주길 원한다'는 환자와 보호자 모두 요구가 높았으며, '신을 알 수 있는 책을 권유해 주길 원한다'가 가장 요구가 낮았다. 삶의 의미와 희망에 관한 영역의 문항 중 두 군 모두 '희망을 갖도록 해 주길 원한다'가 가장 많이 원했으며, '관계가 좋지 않은 사람과 화해할 수 있는 기회를 가지도록 배려해 주길 원한다'가 가장 낮았다. 결론 : 호스피스 환자의 영적 요구를 더 깊이 알고 이해하기 위해서는 개별적인 심층면담이 실시되어야 한다고 사료되며, 이를 통해 호스피스 팀은 환자가 원하는 영적 간호를 실시하도록 체계적인 접근 방법을 강구해야 할 것으로 사료된다.

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청금탕(淸金湯)의 효능(效能)에 관(關)한 실험적(實驗的) 연구(硏究) (Experimental Studies on the Effects of Chunggeumtang)

  • 김응식;이시형
    • 대한한방내과학회지
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    • 제18권2호
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    • pp.1-26
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    • 1997
  • Chunggeumtang has been used in Korea for many centuries as a treatment for respiratory disease. The effect of Chunggeumtang on tracheal smooth muscle is not konwn. The purpose of the present study is to determine the effect of Chunggeumtang on histamine and acetylcholine induced tracheal smooth muscle contraction in rats and guinea pigs. Guinea pig(500g, male) and Sprague Dawley rats (250g, male) were killed by $CO_2$ exposure and a segment (8-10mm) of the thoracic trachea from each rat and guinea pig was cut into equal swegments and mounted 'in pairs' in a tissue bath. Contractile force was measured with force diplacement transducers under 0.5g loading tension. The dose of histamine (His) and acetylcholine (Ach) which evoked 50% of maximal response ($ED_{50}$) was obtained from cumulative dose response curves for histamine and acetylcholine($10^{-7}{\sim}10^{-4}M$). Contractions evoked by His ($ED_{50}$) and Ach ($ED_{50}$) were inhibited significantly by Chunggeumtang. In guinea pig tracheal smooth muscle, the mean percent inhibition of acetylcholine induced contraction was $6.1%after\;30{\mu}l/ml$ Chunggeumtang, and 49.4% (p<0.01) after $100{\mu}l/ml$ Chunggeumtang. In rat tracheal smooth muscle, the mean percent inhibition of acetylcholine induced contraction was $6.7%\;after\;30{\mu}l/ml$ Chunggeumtang, and $54.2%\;(p<0.01)\;after\;100{\mu}l/ml$ Chunggeumtang. Also, in guinea pig tracheal smooth muscle, the mean percent inhibition of histamine induced contraction was $30.6%\;(p<0.05)\;after\;30{\mu}l/ml$ Chunggeumtang, and $53.0%\;(p<0.01)\;after\;100{\mu}l/ml$ Chunggeumtang. In rat tracheal smooth muscle, the mean percent inhibition of histamine induced contraction was $24.1%\;(p<0.05)\;after\;30{\mu}l/ml$ Chunggeumtang, and $55.3%\;(p<0.01)\;after\;100{\mu}l/ml$ Chunggeumtang. Propranolol and indomethacin($10^{-7}M$) slightly but significantly attenuated the inhibitory effects of Chunggeumtang. Following treatment with propranolol, the mean percent inhibition caused by $100{\mu}l/ml$ Chunggeumtang fell to 27.6% in guinea pig induced by acetylcholine contraction and by $100{\mu}l/ml$ Chunggeumtang fell to 28.7% (p<0.05) in rat induced by acetylcholine contraction and the mean percent inhibition caused by $100{\mu}l/ml$ Chunggeumtang fell to 16.2% in guinea pig induced by histamine contraction and by $100{\mu}l/ml$ Chunggeumtang fell to 28.7% (p<0.05) in rat induced by histamine contraction. Indomethacin, the mean percent inhibition caused by $100{\mu}l/ml$ Chunggeumtang fell to 20.0% in guinea pig induced by acetylcholine contraction and by $100{\mu}l/ml$ Chunggeumtang fell to 16.9% (p<0.05) in rat induced by acetylcholine contraction and the mean percent inhibition caused by $100{\mu}l/ml$ Chunggeumtang fell to 16.4% in guinea pig induced by histamine contraction and by $100{\mu}l/ml$ Chunggeumtang fell to 23.1% (p<0.05) in rat induced by histamine contraction. Methylene blue($10^{-7}M$) did not significantly alter the inhibitory effect of Chunggeumtang. Also, I could find the effects of Chunggeumtang and Chunggeumtanggamorphine on the tracheal smooth muscle in guinea pig and rat did not change significantly. These results indicate that Chunggeumtang can relax histamine and acetylcholine-induced contraction of guinea pig and rat tracheal smooth muscle, and that this inhibition involves sympathetic effects and the release of cyclooxygenase products.

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전산화단층촬영 소아 흉부검사에서 관전압의 변화에 따른 화질변화에 관한 연구 (A Study on the Change of Image Quality According to the Change of Tube Voltage in Computed Tomography Pediatric Chest Examination)

  • 김구;김경립;성순기;곽종혁
    • 한국방사선학회논문지
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    • 제13권4호
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    • pp.503-508
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    • 2019
  • 흉부 CT 검사의 스캔 기법의 하나인 VOLUME AXIAL MODE를 이용하여 관전압의 변화에 따라 진단적으로 가치가 높은 영상을 얻기 위하여 화질을 평가하고 적절한 관전압을 제시하고자 한다. CT 장비는 GE사의 Revolution(GE Healthcare, Wisconsin USA)모델을 이용하였으며, Phantom은 Pediatric Whole Body Phantom PBU-70을 사용하였다. Heart의 SNR 평균차이분석에서는 70 kvp에서 $-4.53{\pm}0.26$ 이었고 80 kvp는 $-3.34{\pm}0.18$ 이었으며 100 kvp는 $-1.87{\pm}0.15$이었고 70 kvp가 100kvp 보다 약 -2.66정도 SNR이 높았으며 통계적으로 유의하였다.(p<0.05) Lung의 SNR 평균차이분석에서는 70 kvp에서 $-78.20{\pm}4.16$이었고 80 kvp는 $-79.10{\pm}4.39$이었으며 100 kvp는 $-77.43{\pm}4.72$이었고 70 kvp가 100 kvp 보다 약 -0.77정도 SNR이 높았으며 통계적으로 유의하였다.(p<0.05). Lung의 CNR 평균차이분석에서는 70 kvp에서 $73.67{\pm}3.95$이었고 80 kvp는 $75.76{\pm}4.25$이었으며 100 kvp는 $75.57{\pm}4.62$이었고 80 kvp가 70 kvp 보다 약 20.9정도 CNR이 높았으며 통계적으로 유의하였다.(p<0.05) 관전압 100 kvp에서는 70 kvp와 80k vp를 비교 했을 때 심장 영상의 질을 유지하면서 SNR이 1에 가까웠다. 하지만 70 kvp와 80kvp에서는 SNR 차이가 없어 70 kvp 로 소아 흉부 CT 검사를 하여 방사선량을 줄일 수 있을 것이다. 반면에 CNR은 70 kvp에서 가장 1에 근사치를 나타냈었으며 80kvp와 100kvp에서는 차이가 없어 80 kvp로 소아 흉부 CT 검사를 하여 방사선량을 줄일 수 있을 것이다. 또한 Volume Axial mode 검사 시 0.3초의 짧은 scan time으로 검사 할 수 있어서 움직이거나 진정이 필요한 소아환자에게 유용할 것으로 사료된다.

사무 자동화에 따른 사무직 근로자의 건강과 연관된 자각 증상에 대한 조사연구 (An Investigation on the self-consciousness Symptoms of the Clerical Workers attendant upon Office Automation)

  • 정미화
    • 한국직업건강간호학회지
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    • 제3권호
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    • pp.54-70
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    • 1993
  • According as the automation of clerical work(OA ; Office Automation) develops, the use of VDT(Visual or Video Display Terminal) is increasing suddenly. But, in proportion to the spread of office automation(OA tendency), the self-conciousness syptom attendant upon the work is appearing also (Kim, Jung Tae, Lee, Young Ook, 1990). The apparatuses of office enable the clerical workers to be convenient and perform mass businesses. But, they are increasing the opportunity to be exposed to VDT syndrom, techno stress, computer terminal disease, pain by muscle strain(RSI), bradycausia of noise nature, and electromagnetic waves, etc. which are referred to as the new type of occupational diseases to the workers. It is the real situation that the workers to use VDT is complaining of the physical inconvenience sense in the recent newspaper and literature, it is the point of time that the sydrome to come from VDT use and computer terminal disease, etc. must be classified into the occupational disease(Lee, Kwang Young 1990, Lee, Kyoo Hak 1990, Lee, Won Ho 1991, Lee, Si Young 1991, Lee, Joon 1991, Choi, Young Tae 1991, Heo, Seung Ho 1989). In addition, it is the real situation that the scientifitic study result about the scope that electromagnetic waves has influence on the human body has not been suggested yet, and criticism on the stable exposure permission standard about electromagnetic waves to be emitted from VDT and on the problem in the health about electromagnetic waves is continuing. (IEEE Spectrum, 1990). In addition according to the experience of nursery business of industry field, it is the real situation that the patients who consult complaining of physical and mental inconvenience sence, among the users of apparatus of office automation, are reaching 10% of the patients coming to doctor's room. Therefore, it is necessary to confirm the self-consciousness symptom that the clerical workers complain of multilaterally with the actual state examination about the use of the apparatuses of offices automaton. Thus, this study was tried as th basic data for the cosultation and education for the maintenance and furtherance of the health of workers as the nurse of industry field, by confirming the contents of self-consciousness symptom attendant upon the use of the apparatus for office outomation making the financial institution in which the spparatus for office automation in most frequently used as the subject, and by examining whether there is the difference according to the subject of study, the data were collected, by using the questionnaire method, making 200 workers who consented to the study participation as the subject, among the persons who have spent over 3 months since they used the apparatuses for office automation and didn't receive the treatment in hospital due to the clerical disease for recent 3 years. The period of data collection was from Oct. 9, 1991 to Oct. 12. As for the measurement instrument about the complaint if self-consciousness symptom attendant upon the use of apparatuses fo office automation, the question item on the complaint symptom of health problem attendant upon the treatment of VDT that Kim(1991) developed and on CMI health problem and the question items on the fatigue degree due to industry were used by previous examination to 25 persons. Collected data were analyzed with the statistical method such as percentage, arithmetic mean, Person correlation coeffient, Kai square verfication, t-test, ANOVA, etc. by using SPSS/PC+ program, and the result is as follows : 1. The self-consciousness symptom that the clerical workers complained of most frequetly appeared high in 'My eyes are tired'(99.4%), 'I feel fatigue and weariness'(99.4%), 'I feel that my head is heavy5(90.0%), 'eyesight fell'(88.8%), 'I have a stiff neck'(88.8%), 'I fell pain in the shoulder'(85.0%), 'I feel cold and painful in the eyes'(76.9%), 'I feel the dry sense of eyeball'(76.2%), 'My nerves are edgy, and I an fretful, (75.6%), 'I feel pain in the waist'(73.2%) and 'I fell pain in the back'(72.8%). It emerged that the subject use the apparatuses for office automation complained of self-consciousness symptoms related to visual symptoms and musculoskeletal symptoms. 2. As for the general feature of examination subjects, the result to see the distribution by classifying into sex, age, school career, use career of apparatuses for office automation, skillfulness degree of the use of apparatus for office automation, use hours of the apparatuses for office automation per 1 day, type of business of the apparatus for office automation, rest hours during the use of apparatus for office automation, satifaction degree of business of office automation, and work circumstance, etc. emerged as follows : As for the sex of subjects, the distribution showed that men were 58.8% and women were 41.3%, Age was average 26.9. As the distribution of school career, the distribution showed that4below the graduation of high school' was 58.8%, 'graduation from junior college-university' was 35.0%, and 'over graduate school' was 6.3%. In the question to ask the existence or non-existence of experience of health consultation in connection with the work of office automation, the response that I had the consultation exprience and I feel the necessity emergerd as 90.1% And, the case that the subject who didn't wear the glasses or lens before using the OA apparatus wear glasses or lens after using OA apparatus emerged as 28.3% of whole. As for the existence or non-existence of use career of OA apparatus, the case under 3 years was highest as 52. 7%. As for the skillfulnness degree about the use of apparatus for office automation, most of them are skillful with the fact that 'common' was 44.4%, 'skill' was 42.5%, and 'unskillful' was 13.1% As for the use average hours of the apparatus for office automation per 1 day, the distribution showed that the case under 3-6 hours was 33.1%, the case under 6-9 hours was 28.1%, the case under 3 hours was 30.6%, and the case over 9 hours was 8.1% Main OA business and the use hours for 1 day showed in the order of keeping and retrieval, business of information transmission(162min), business of information transmission(79.3 min), business of document framing(55.5 min), and business of duplication and printing(25.4min). as for the rest during the use of apparatus for affice automation, that I take rest occasion demands the major portion, but that I take after completing the work emerged as 33.8%. Though the subiness gets to be convenient by the use of the apparatus for of office automation, respondents who showed the dissatisfaction about the present OA business emergd high as 78.1%. The work circumstances of each office was good with the fact that the temperature of office was 21.8, noise was average 42.7db, and the illumination was average 364.4 lx, in the light of ANSi/HFS 100 Standard. 3. Sight syptom, musculoskeletal symptom, skin and other symptoms showed the significant difference according to the extent of skillfulness of the apparatus for office automation. All the symptoms exept skin symptom showed the difference according to the use hours of the apparatus for office automation. All the question items exept the sytoms of digestive organs and the rest hours during the apparatus for office automation showed the signicant difference. The question item which showed the signicant difference from the satisfaction degree of present OA business showed the significant difference from all the question item classified into 6 groups. But, age and school career didn't significant difference from the complaint of any self-consciousness symptoms.

    . In conclusion, the self-consciousness symptoms of the subjects to use OA apparatus appeared differently, according to sex distiction, skillfull degree of OA apparatus, use hours of OA apparatus, the rest hours during th use of OA apparatus, and the satiafaction degree of persent business. Therefore, it is necessary that the nurse in the inuctry field must recognize to receive the education about the human technological physical condition which is most proper for te use of OA apparatus and about the proper rest method until they get accustomed to the use of OA apparatus. In addition, the simple exercise relax the tention of muscle due to the repetitive simple movement, and the education for the protection of eyesight are necessary.

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