• 산업융합연구
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• 제22권5호
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• pp.117-125
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• 2024

자연 재해와 대규모 사회 재난발생으로 인해 체계적이고 전문적인 재난교육의 필요성이 증가하고 있다. 본 연구는 간호학생과 간호사를 대상으로 한 재난교육에서 교육적 개입의 효과를 종합적으로 분석한 체계적 문헌고찰 연구이다. 주요 한국 데이터베이스에서 재난, 교육 프로그램, 시뮬레이션 관련 키워드로 문헌을 검색하였으며, 재난교육 프로그램 중재를 제공한 국내 간호사 및 간호대학생을 대상으로 한 논문들이 분석 대상이었다. 대부분의 프로그램에서 이론 강의, 시뮬레이션, 디브리핑 방법이 사용되었으며, 중재 시간은 2시간 이하에서 40~56시간에 이르는 다양한 구성으로 진행되었다. 가장 많이 측정한 변수는 재난간호 준비도와 재난간호수행능력이었으며, 재난교육 프로그램의 효과로 재난간호 준비도, 재난간호수행능력, 재난태도, 재난지식, 재난인식, 학습 자기효능감, 실습만족도, 재난간호 자신감 변수에 긍정적인 영향을 미친 것으로 나타났다. 다양한 중재 시간과 방법을 고려하여 참여자들에게 실제적이고 현장감 있는 학습 경험을 제공할 수 있는 프로그램을 구성하고 효과를 검증하는 것이 중요하다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권21호
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• pp.9301-9305
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• 2014

Background: Pain is one of the most terrifying symptoms for cancer patients. Although most patients with cancer pain need opioids, complete relief of pain is hard to achieve. This study investigated the factors influencing persistent pain-free survival (PPFS) and opioid efficiency. Materials and Methods: A prospective study was conducted on 100 patients with cancer pain, hospitalized at the medical oncology clinic of Akdeniz University. Patient records were collected including patient demographics, the disease, treatment characteristics, and details of opioid usage. Pain intensity was measured using a patient self-reported visual analogue scale (VAS). The area under the curve (AUC) reflecting the pain load was calculated from daily VAS tables. PPFS, the primary measure of opioid efficacy, was described as the duration for which a patient reported a greater than or equal to two-point decline in their VAS for pain. Predictors of opioid efficacy were analysed using a multivariate analysis. Results: In the multivariate analysis, PPFS was associated with the AUC for pain (Exp (B)=0.39 (0.23-0.67), P=0.001), the cumulative opioid dosage used during hospitalisation (Exp (B)=1.00(0.99-1.00), P=0.003) and changes in the opioid dosage (Exp (B)=1.01 (1.00-1.01), P=0.016). The change in VAS score over the standard dosage of opioids was strongly associated with current cancer treatment (chemotherapy vs. others) (${\beta}=-0.31$, T=-2.81, P=0.007) and the VAS for pain at the time of hospitalisation (${\beta}=-0.34$, T=-3.07, P= 0.003). Conclusions: The pain load, opioid dosage, concurrent usage of chemotherapy and initial pain intensity correlate with the benefit received from opioids in cancer patients.

• 지역사회간호학회지
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• 제6권1호
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• pp.55-73
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• 1995

An Effect of Muscle Strength Training Program on Muscle Strength, Muscle Endurance, Instrumental Activities of Daily Living and Quality of Life in the Institutionalized Elderly Recent statistics shows that the aged are the fastest growing segment of our population by increasing life span. The age group of over 60 shows multiple health problems and the most serious handicapping problem of these. are related to the changes in muscular skeletal system. With aging, people lose. their muscle mass and muscle strength resulting from biological changes and physical inactivity. Studies documented a 30-50% loss of muscle mass in an advanced age and thus, ordinary life activities can be seriously affected due to weakened muscle strength. Preservation of muscle strength of lower limb is especially important in the aged. Since it is readily affected from reduced physical activity in old age, sometimes to the detriment of moving or walking. So muscle strength exercise program designed for the elderly to improve leg muscle strength and leg muscle endurance. The research design used was nonequivalent control group pretest - protest design. The purposes of this study were to test the effect of muscle strength exercise program utilizing Leg Press on muscle strength, muscle endurance, instrumental activities of daily living(IADL), cognitive perceptual variables and quality of life. Forty nine subjects participating in this study consisted of twenty four male and twenty five female. Twenty four experimental group subjects were selected from C-institution in Chung Buk province, and twenty five control group subjects were selected from O-institution in Chung Nam province. The mean age of subjects was 72.8 years. Muscle strength training program utilizing Leg Press for the experimental group was carried out three times a week for 9 weeks. The data was collected from August, 1993 to October, 1993. Data were analyzed with $X^2-test$, t-test, ANCOVA test, Kruskal Wallis 1-Way ANOVA test using SPSS PC program. Results were obtained as follows : 1) The experimental group showed significantly higher scores on muscle strength (leg lift strength, back lift strength and grip strength) and muscle endurance than control group after the experiment $\ulcorner$F=52.35(p=.001), F=54.07(p=.001), F=6.97(p=.011), F=18.17(p=.001)$\lrcorner$ 2) Experimental group were significantly higher scores on IADL than control group(F=7.51, p=.009). 3) Experimental group showed significantly higher scores on economical state and self esteem aspects of the quality of life scale than control group $\ulcorner$F=10.59(p=.002), F=6.97(p=.011)$\lrcorner$. But there were no differences in emotional state, physical and functional state and relationship with reatives in the quality of life between groups. 4) Scores on IADL showed a significant difference with the level of muscle strength and muscle endurance $\ulcornerx^2=7.73(p=.025),\;x^2=8.86\;(p=.011)\lrcorner$ 5) Scores on self esteem and physical and functional state aspects of the quality of life scale showed a significant difference with the level of IADL $\ulcornerx^2=11.39(p=.003),\;x^2=9.02(p=.011)\lrcorner$. 6) Scores of experimental group after the experiment in cognitive perceptual variables (perceived benefit on exercise, perceived health status, self efficacy, emotion on exercise) were significantly higher than those of control group $\ulcorner$F=32.09(p=.001), F=5.07(p=.029), F=20.63 (p=.001), F=30.38(p=.001)$\lrcorner$. As a result of this study, the effect of strength training exercise program with Leg. Press had improved muscle strength, muscle endurance, IADL, and the perception of self esteem, physical and funtional state, and economical state. Thus strength training program could be beneficially applied for the prevention of disablity and promotion of health and wellbeing in the aged easily and safely. The subjects in the experimental group have maintained their exercises till six months after the cessation of the experiment. This seem to illustrate that changes in cognitive perceptual variables and the improvement in health status have reinforced motivation for the continuation of voluntary exercises. A further study is necessary to determine the factors affecting maintainance of muscle strength exercise and to assess the effect of weight training program on bone density.

• 한국전문물리치료학회지
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• 제21권4호
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• pp.23-33
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• 2014

The aim of this study was to evaluate the effects of walking on a treadmill while using dynamic functional electrical stimulation (Dynamic FES) on functional ability and gait in chronic stroke patients. This was a prospective, randomized controlled study. Twelve patients with chronic stroke (>24 months) who were under grade 3 in dorsiflexor strength with manual muscle test were included and randomized into intervention (Dynamic FES) ($n_1$=7) and control (FES) ($n_2$=5). Both the Dynamic FES group and FES group were given a neuromuscular development treatment. The Dynamic FES group has implemented a total of 60 minutes of exercise treatment and gait training with Dynamic FES application. The FES group, with the addition of applying FES while sitting, has also implemented a total of 90 minutes of gait training on treadmill after the exercise treatment. Both two groups accomplished the program, twice a week, for a total of 24 times in a 12-week period. Exercise treatment, gait training on treadmill, and both Dynamic FES and FES were implemented for 30 minutes each. Korean version activities-specific balance confidence scale (K-ABC) was measured to determine self-efficacy in balance function. Timed up and go (TUG) test was performed to evaluate the physical performance. K-ABC, TUG, Berg balance scale (BBS), modified physical performance test (mPPT) and G-walk were evaluated at baseline and at 12 weeks. After 12 weeks, statistically significant differences (p<.05) were apparent in the Dynamic FES group in the changes in K-ABC and BBS. mPPT, TUG, gait speed, stride length and stance phase duration (%) were compared with the FES group. K-ABC had higher correlation to BBS, along with mPPT to TUG. Our results suggest that walking with Dynamic FES in chronic stroke patients may be beneficial for improving their balance confidence, functional ability and gait.

• Journal of Dental Anesthesia and Pain Medicine
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• 제24권2호
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• pp.109-117
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• 2024

Background: Dental fear and anxiety are significant challenges in managing behavior in children. Oral administration of sucrose or sweet-tasting solutions has shown effectiveness in reducing procedural pain in infants and neonates. This study aimed to investigate whether pre-application of sucrose solution had an effect on minimizing pain perception during injection and to assess the potential impact of the child's age and sweet preference. Methods: A randomized control clinical trial was conducted on 60 children aged 3-9 years requiring buccal infiltration injections. Following parental consent, demographic data of the children were recorded. Sweet preferences was assessed using a modified forced-choice test. Children were equally and randomly allocated into study (sucrose) and control groups using a lottery method. Sucrose solution or distilled water, respectively, was applied to the lateral surface of the tongue for 2 min. Topical anesthetic was applied at the site of injection, followed by local anesthesia administration. The children rinsed their mouths thrice with water immediately after anesthetic injection. A video was recorded during injection which was then scored by three blinded examiners on the Sound Eye Motor (SEM) scale. The children also self-evaluated using Wong-Baker Faces Pain Rating Scale (WBFPS). Results: The mean SEM scores and WBFPS scores were analyzed using the Kruskall-Wallis test. The mean SEM score in the study group was 1.37 ± 0.61, compared to 3.17 ± 0.87 in the control group, showing a statistically significant difference (P < 0.001). Mean pain scores assessed by WBFPS in the study group were 0.60 ± 1.4, while in the control group, they were 6.27 ± 2.33, also showing a statistically significant difference (P < 0.001). Children with a sweet preference demonstrated a subjective reduction in pain perception. Conclusion: Application of sucrose before dental injections in children helps to minimize pain upon injection across all age groups.

• Korean Journal of Health Education and Promotion
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• 제2권1호
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• pp.31-61
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• 2000

Introduction. Despite the fact that half of premature deaths are caused by unhealthy lifestyles such as smoking tobacco, sedentary lifestyle, alcohol and drug abuse and poor nutrition, there are no theoretical models which accurately explain these health promotion related behaviors. This study tests a new model of health behavior called the Model of Health Promotion Behavior. This model draws on elements and frameworks suggested by the Health Belief Model, Social Cognitive Theory, the Theory of Planned Action and the Health Promotion Model. This model is intended as a general model of behavior but this first test of the model uses amount of exercise as the outcome behavior. Design. This study utilized a cross sectional mail-out, mail-back survey design to determine the elements within the model that best explained intentions to exercise and those that best explained amount of exercise. A follow-up questionnaire was mailed to all respondents to the first questionnaire about 10 months after the initial survey. A pretest was conducted to refine the questionnaire and a pilot study to test the protocols and assumptions used to calculate the required sample size. Sample. The sample was drawn from 2000 eligible participants at two blue collar (utility company and part of a hospital) and two white collar (bank and pharmaceutical) companies located in Southeastern Michigan. Both white collar site had employee fitness centers and all four sites offered health promotion programs. In the first survey, 982 responses were received (49.1％) after two mailings to non-respondents and one additional mailing to secure answers to missing data, with 845 usable cases for the analyzing current intentions and 918 usable cases for the explaining of amount of current exercise analysis. In the follow-up survey, questionnaires were mailed to the 982 employees who responded to the initial survey. After one follow-up mailing to non-respondents, and one mailing to secure answers to missing data, 697 (71.0％) responses were received, with 627 (63.8％) usable cases to predict intentions and 673 (68.5％) usable cases to predict amount of exercise. Measures. The questionnaire in the initial survey had 15 scales and 134 items; these scales measured each of the variables in the model. Thirteen of the scales were drawn from the literature, all had Cronbach's alpha scores above .74 and all but three had scores above .80. The questionnaire in the second mailing had only 10 items, and measured only outcome variables. Analysis. The analysis included calculation of scale scores, Cronbach's alpha, zero order correlations, and factor analysis, ordinary least square analysis, hierarchical tests of interaction terms and path analysis, and comparisons of results based on a random split of the data and splits based on gender and employer site. The power of the regression analysis was .99 at the .01 significance level for the model as a whole. Results. Self efficacy and Non-Health Benefits emerged as the most powerful predictors of Intentions to exercise, together explaining approximately 19％ of the variance in future Intentions. Intentions, and the interaction of Intentions with Barriers, with Support of Friends, and with Self Efficacy were the most consistent predictors of amount of future exercise, together explaining 38％ of the variance. With the inclusion of Prior Exercise History the model explained 52％ of the variance in amount of exercise 10 months later. There were very few differences in the variables that emerged as important predictors of intentions or exercise in the different employer sites or between males and females. Discussion. This new model is viable in predicting intentions to exercise and amount of exercise, both in absolute terms and when compared to existing models.

• 한국융합학회논문지
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• 제9권6호
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• pp.77-88
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• 2018

신종 감염병에 직면하고 있는 의료종사자들을 보호하고, 모든 의료 환경에서 전염병 전파를 막기 위한 표준주의는 미래의 간호사가 될 간호대학생들에게 감염병 전파를 예방하기 위해 중요하다. 이에 간호대학생들의 표준주의에 대한 태도에 미치는 영향을 조사하였다. 연구시기는 2016년 5월부터 6월까지이며, 연구대상자는 D시에 소재한 대학의 간호대학생 291명이다. 연구결과는 간호대학생의 건강신념 하위요인 중 지각된 이익(4.26)이 가장 높게 나타났고, 표준주의 지식점수는 정답률 78.9%이었고, 태도 수준(4점 척도)은 평균 3.63점 이었다. 지각된 민감성, 지각된 이익, 지각된 장애, 자기효능감, 표준주의에 대한 지식이 표준주의에 대한 태도와 유의한 상관관계를 보였다. 건강신념의 하위요인 중 지각된 민감성(${\beta}=.152$, p<.05)과 지각된 장애(${\beta}=-.125$, p<.05)가 간호대학생의 표준주의에 대한 태도(F= 5.680, p<.001)에 영향을 주는 것으로 나타났다. 이에 따라 간호대학생의 표준주의에 대한 태도 수준을 높이기 위해 간호대학생에게 건강신념을 향상 시킬 수 있는 융합적 교육프로그램이 필요하다.

• 재활치료과학
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• 제6권1호
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• pp.45-54
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• 2017

목적 : 본 연구는 주의력결핍 과잉행동장애(ADHD) 아동들의 집중력 향상과 충동성 조절에 상호작용식 메트로놈(IM) 훈련이 효과가 있는지 알아보고자 한다. 연구방법 : ADHD 아동 1명을 대상으로 2016년 5월부터 7월까지 개별 실험 연구(single-subject experimental research design) 중 ABA'디자인을 적용하여 실시하였다. 총 21회기로 기초선 3회기, 중재기 15회기, 추적기 3회기를 시행하였다. 중재는 IM 훈련이었으며 매 회기마다 IM의 SFA(Short Form Assessment)와 집중력 측정과제를 수행하였다. 또한 기초선, 중재기, 추적기 때 각 한번씩 IM의 LFA(Long Form Assessment)와 자기통제력 검사(SCRS) 평가를 진행하였다. 매회기 SFA와 집중력 측정과제의 결과를 시각적 그래프로 나타내었으며 LFA와 SCRS의 값은 표로 제시하였다. 결과 : 기초선과 비교하여 IM 훈련 중재 후에 대상자의 집중력은 향상되었으며 충동성은 감소하였다. 중재가 끝나고 한 달 후인 추적기에도 그 효과가 유지되거나 향상됨을 확인 할 수 있었다. 결론 : 본 연구는 IM이 ADHD 아동의 집중력 향상과 충동성 조절에 긍정적인 영향을 미친다는 것을 확인하였고 ADHD 아동의 중재방법으로써 임상적 근거를 제공하는데 의의가 있다.

• 대중서사연구
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• 제27권1호
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• pp.227-264
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• 2021

본고는 본격적인 게임 비평의 영역에서 발생한 루도내러티브 부조화의 개념을 정리하고 최근작 <더 라스트 오브 어스 파트2>를 대상으로 이를 구체화한다. 그 과정에서 이 게임이 루도내러티브 부조화를 적극적으로 활용하여 그동안의 게임성에 대한 정의를 넘어서는 인지적 경험을 플레이어에게 전달하고 있음을 살핀다. AAA급 게임의 전방위적인 발달과 함께 루도내러티브 부조화는 각각의 게임들이 극복해야 하는 중요한 과제로 나타나고 있는 중이다. 그러나 <더 라스트 오브 어스 파트2>는 루도내러티브 부조화를 극복하는 것보다는 더욱 드러내는 방식으로 새로운 효과를 발생시키고 있음에 주목해야 한다. <더 라스트 오브 어스 2>가 전달하는 루도내러티브 부조화에는 아이러니한 해석적 가능성의 효과들이 있다. 본고는 크게 두 가지 차원에서 부조화를 살피는데, 첫 번째는 게임 내부의 플레이-서사 구조 사이의 부조화다. <더 라스트 오브 어스 파트2>는 두 구조 사이에서 발생하는 부조화를 플레이어에게 환기시킴으로써, 플레이어가 그러한 부조화를 인지하고 전체 게임의 의미를 능동적으로 재구성할 수 있도록 유도한다. 두 번째로 게임의 내적 구조를 넘어서 게임을 플레이하는 플레이어 내부에 존재하는 인지적 부조화를 자극한다. 바로 게임성이라는 개념을 확장하여, 게임이 편의적인 자기효능감을 위한 도구 이상의 기능을 할 수 있는 가능성을 환기하는 것이다. 이처럼 루도내러티브 부조화는 게임성에 대한 더 근본적인 재정의 및 변화 가능성에 대한 문제의식의 표현이 될 수 있다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제22권5호
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• pp.323-338
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• 2022

Burning mouth syndrome (BMS) is a chronic oral disorder of unknown etiology which presents therapeutic challenges. Alpha-lipoic acid (ALA) has been studied as a potential treatment for BMS. The objective of this systematic review and meta-analysis was to evaluate the effectiveness of ALA compared to that of placebo or other interventions in individuals with BMS. Randomized controlled trials (RCT) using ALA to treat BMS were identified from MEDLINE, Cochrane Library, EMBASE, and Web of Science up to February 3, 2021. The assessment of the risk of bias in the included studies was based on the Cochrane guidelines. The primary outcome evaluated was the visual analog scale (VAS) pain intensity. ALA was compared with placebo, clonazepam, gabapentin, pregabalin, ALA plus gabapentin, capsaicin, Biotène^®, and laser therapy. Altogether, 137 records were scanned for inclusion/exclusion, and nine RCTs (two unclear and seven at high risk of bias) were included in the qualitative and quantitative analyses, with a total of 594 patients with BMS included in this review. All studies reported an improvement in VAS pain scores ranging from -0.72 to -2.77. Meta-analysis results showed a non-significant reduction in pain intensity for ALA (P = 0.616) compared to that of placebo on a VAS of 0-10. Patients taking ALA were 1.923 times more likely to show an improvement in self-reported BMS symptoms (P = 0.031) than those in the placebo group. Clonazepam and pregabalin showed a significant VAS pain reduction of 4.08 and 4.68 (P < 0.001), respectively, compared to that with ALA. Although ALA intervention provided a non-significant improvement in the pain score and was more likely to produce a reduction in BMS symptoms, the evidence was of low quality. Further research is needed to establish clear guidelines for the use of ALA for BMS treatment.