• 보건교육건강증진학회지
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• 제27권5호
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• pp.41-50
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• 2010

목적: 한국 농촌지역에 있는 보건진료소에서 수행하고 있는 고혈압 예방 및 관리 사업 평가도구를 개발하고, 이를 활용하여 현장에서 수행되고 있는 프로그램을 평가하고자 한다. 방법: 문헌고찰, 현장방문과 보건진료소에서 근무하는 보건진료원과의 심층면담을 통해 예비문항을 작성하고, 전문가(중앙기관의 업무행정담당자 5인, 보건진료원 6인, 이론과 연구전문가 5인)집단을 통해 2회 내용타당도 검정을 실시하였다. 전문가들에 의해 80%이상 동의한 항목만을 선정한 결과, 4개 영역, 12개 항목, 41개 세부평가 항목으로 구성된 평가도구가 완성되었다. 4개 영역은 고혈압 예방사업, 고혈압 관리사업, 사업여건조성, 자체평가로 분류되었고. 고혈압 예방사업 영역은 보건교육, 고혈압환자 조기발견 항목이 포함되었고, 고혈압 관리사업 영역은 고혈압환자 등록 및 관리사업, 교육 및 상담, 고혈압환자 치료 및 추구관리 항목이 포함되었다. 사업여건조성 영역은 지역주민의 접근성, 보건교육자료의 비치, 홍보 항목이 있고, 자체평가는 사업계획서 수립, 중간평가, 결과평가 항목으로 구성하였다. 영역별 가중치는 전문가타당도 검정을 통해 각기 다르게 설정하였으며, 연구대상은 전국 보건진료소를 모집단으로 비례층화추출법에 의해 700개소를 선정하였다. 연구의 윤리적인 측면을 고려하여 설문지 표지에 연구에 대한 구체적인 소개, 익명성보장과 자발성을 제시하고 자가 보고식의 우편설문조사를 실시하였다. 최종적으로 215개의 설문지를 자료 분석에 활용하였다. 결과: 영역별 평가결과에 의하면 고혈압 관리 사업이 평균 28.81점(72%), 고혈압 예방사업은 평균 23.44점(67%), 사업여건조성이 평균 4.29점(43%), 자체평가 5.10점(34%) 순으로 나타났다. 항목별 평가에서 가장 낮은 결과를 보인 것은 보건교육을 위한 교육매체 보유, 공식적인 연계망, 고혈압사업의 여건조성을 위한 물리적 환경조성과 사업결과로 나타났다. 결론: 보건진료소에서 실시하고 있는 고혈압 예방 및 관리 사업을 좀 더 효과적으로 수행하기 위해서는 사업여건 조성과 자체평가 영역을 향상시켜야 할 것으로 사료된다.

• 보건교육건강증진학회지
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• 제13권1호
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• pp.52-71
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• 1996

수술실에 근무하는 간호사들을 대상으로 일반적인 특성과 업무특성에 따른 스트레스의 정도와 스트레스에 관련이 있는 요인들을 파악하기 위하여 대구광역시 소재 4개 의과대학 부속병원 수술실에 근무하는 간호사 131명 대상으로 자기기입식 설문조사를 실시하여 그 결과를 분석하였다. 총 설문 60문항의 전체 스트레스 평균점수는 3.71점이었다. 가장 스트레스를 많이 받은 업무요인은 업무 외의 책임으로 4.01점이었으며, 그 다음이 의사와의 대인관계상 갈등, 의료한계에 대한 심리적 부담 순이었고, 가장 적은 스트레스를 받는 업무 요인은 대인관계상의 문제로 3.39점이었으며, 전문직으로서의 역할갈등, 간호업무와 관련된 사항 순이었다. 가장 스트레스를 많이 받는 업무의 내용은 간호업무 수행시 실수나 누락한 것을 발견했을 때로 4.47점이었으며, 근무중 물품파손 및 분실로 인한 책임을 져야할 때, 수술도중 기구가 갑자기 작동되지 않을 때의 순이었다. 가장 스트레스를 적게 받는 업무의 내용은 거즈를 재생하기 위하여 보푸라기를 제거할 때로 2.75점이었으며, 컴퓨터 조작을 잘못할 때, 간호조무사와의 관계가 좋지 않았을 때 순이었다. 연구대상자의 특성별 스트레스의 정도는 결혼 상태에 따라서는 기혼인 경우가 3.5점으로 미혼의 3.3점에 비해 다소 높았으며, 자녀수가 1명 있는 경우에 3.9점으로 자녀가 없는 경우 3.7점과 2명인 경우의 3.4점에 비해 유의하게 높았다. 현재 수술실내의 업무의 특성에 따른 스트레스의 평균 점수는 부소독 간호사업무가 3.8점으로 스트레스론 가장 많이 받았다. 간호 업무와 관련하여 스트레스를 특히 많이 받는 경우는 기혼, 1명의 자녀가 있을 때, 학력이 상대적으로 낮을 때 그리고 수술실 근무 경력이 3-6년 미만일 때였다. 따라서 수술실 근무 간호사들의 업무와 관련된 스트레스를 효과적으로 관리하기 위해서는 수술에 대한 충분한 사전준비과 간호업무에 대한 재교육이 철저하게 시행되고, 과로를 방지하며, 자녀양육에 관한 부담을 들어주면서 계속적인 교육의 기회를 보장해 줄 수 있는 방안이 마련되어야 한다.

• 대한간호학회지
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• 제29권4호
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• pp.880-891
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• 1999

The purpose of this study was to describe nursing decision tasks, their characteristics, and problems associated with decision making. The subjects were 32 nurses who had at least one-year nursing experience and worked on medical-surgical units or intensive care units(ICU). They were asked to describe their decision making experiences in patient care situations and to identify the characteristics of each decisions. They were also asked to describe perceived problems associated with decision making in nursing. The responses on nursing decision tasks and problems were analyzed with content analysis and the decision characteristics were identified by statistical analysis of variance. It was found that there were 16 nursing decisions which are as follows : decisions related to interpreting and selecting appropriate strategies for pain management(6.6%) ; decisions related to providing emotional support (0.7%) ; decisions related to explaining the patient's condition and rationale for procedures(1.1%) ; decisions related to assisting patients to integrate the implications of illness and recovering into their lifestyles(2.9%) ; decisions related to detecting significant changes In patients and selecting appropriate intervention strategies (17.2%) ; decisions related to anticipating problems and selecting preventive measures(4.2%) ; decisions related to identifying emergency situations(0.4%) ; decisions related to effective management of patient crisis until physician assistance becomes available(2.8%) ; decisions related to starting and maintaining intravenous therapy(2.6%) ; decisions related to administering medications(8.1%) ; decisions related to combating the hazards of immobility(7.3%) : decisions related to treating wound management strategies(5.5%) ; decisions related to relieving patient discomfort(13.9) ; decisions related to selecting appropriate strategy according to the changing situation of the patient(18.2%) ; decisions related to selecting the best strategy for patient management(5.3%) ; and decisions related to coordinating, ordering, and meeting the various needs of the patient (3.1%). The nurses reported the fellowing problems in decision making : difficulties due to lack of knowledge and experience (18.6%) ; uncertainty and complexity of decision tasks(15.2%) ; lack of time to make decisions(2.9%) ; personal values which conflict with other staff(15.7%) ; lack of selection autonomy(30.0%) ; and organizational barriers(7.6%). Continuing education programs and decision support systems for frequent nursing decision tasks can be established on the basis of these results. Then decision ability in nurses will increase through the education programs and decision support systems, and then quality of nursing service will be better.

• 한국산학기술학회논문지
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• 제20권12호
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• pp.212-223
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• 2019

본 연구는 계획된 행위이론에 근거하여 태도, 주관적 규범, 지각된 행위통제가 종합병원 간호사의 욕창예방 행위에 미치는 영향을 규명하기 위하여 수행되었다. 서울과 경기도의 4개 종합병원에서 총 111명의 간호사가 연구에 참여하여 욕창예방에 대한 태도, 주관적 규범, 지각된 행위통제 및 욕창예방 행위와 관련된 설문조사에 응답하였다. 수집된 자료는 전체 대상자뿐만 아니라 대상자를 각각 학력수준, 근무병동 및 병원규모로 나누어 집단별 다중 회귀분석을 시행하여 분석하였다. 전체 대상자에 대한 연구결과에서는 욕창예방에 대한 태도가 긍정적이고 주관적 규범에 대한 인식이 높을수록 간호사의 욕창예방 행위의 수준이 높았다. 반면에 집단별 분석 결과에서는 '학사이상'이거나 '3차 종합병원'에 근무하는 간호사는 임상경험이 많을수록 행위 수준이 높았고, '외과병동 및 중환자실'에 근무하는 간호사는 태도 점수가 높을수록 욕창예방 행위의 수준이 높았다. 또한 '학사이상'인 간호사는 주관적 규범에 대한 인식이 높을수록 욕창예방 행위의 수준이 높았다. 따라서 간호사의 욕창예방에 대한 태도, 주관적 규범의 수준을 개선함으로써 욕창예방 행위를 증진하기 위해서는 간호사의 교육수준, 근무부서, 병원규모를 고려한 개별화된 맞춤형 중재가 제공되어야 한다.

• 임상간호연구
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• 제18권2호
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• pp.228-238
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• 2012

Purpose: The purpose of this study was to examine how an Advanced Cardiac Life Support (ACLS) simulation application via smartphone effects nurses' ACLS knowledge and learning satisfaction. Methods: The participants were selected from nurses in medical Intensive Care Unit (ICU), surgical ICU and emergency room. The experimental group consists of fifty nurses who were self-learned with ACLS simulation application via smartphone and the control group of seventy-one nurses who used traditional learning materials. Outcome variables included nurses' knowledge and learning satisfaction which were collected before and after the intervention. Results: The scores of ACLS knowledge were higher in the control group compared to the experimental group (p=.001) while learning satisfaction showed no statistical difference (p=.444). In learning satisfaction, the experimental group showed higher interest than the control group (p=.019) while the control group rated higher on the item, 'the contents of education was reliable' (p=.007). Conclusion: ACLS knowledge score was graded higher in control group that used traditional learning method than the experimental group that used the smartphone application. This study showed that training with the new material significantly increased nurses' interest in ACLS education. Hence, more applications for smartphones should be developed to provide self-learning environment for nurses and improve care quality.

• Journal of Hospice and Palliative Care
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• 제16권2호
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• pp.108-117
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• 2013

목적: 본 연구의 목적은 1) 죽음에 대한 태도와 대처정도, 생애 말기환자 간호인식 및 간호수행 정도를 파악하고, 2) 그들 간의 상관관계를 살펴보고, 3) 생애 말기환자 간호수행에 영향을 미치는 요인을 파악하고자 함이다. 방법: 3개 대학병원의 임종 다빈도 부서인 종양내과병동, 중환자실, 응급실에 근무하는 187명의 간호사를 대상으로 하였다. 연구 도구로는 '다차원 죽음에 대한 태도 척도', '죽음에 대한 대처정도 척도', '생애 말기환자 간호에 대한 인식 척도', '생애 말기환자 간호에 대한 수행 척도'를 사용하였다. 자료는 기술 통계, 상관관계, 다중 회귀분석을 수행하였다. 결과: 첫째, 생애 말기환자 간호수행은 결혼 유무, 종교, 근무 부서, 말기환자 간호에 대한 교육 참여 여부에 따라 의미 있는 차이를 보였다. 둘째, 생애 말기환자 간호수행은 죽음에 대한 태도(P=0.014), 죽음에 대한 대처(P=0.003), 생애 말기환자 간호인식(P<0.001)과 양의 상관관계를 보였다. 셋째, 생애 말기환자 간호수행이 근무부서(P<0.001), 생애 말기환자 간호인식(P<0.001)에 영향을 받는 것으로 나타났다. 결론: 생애 말기환자 간호수행이 근무 부서, 생애 말기환자 간호인식에 영향을 받으므로, 근무 부서에 따라 차별화된 생애 말기환자 간호인식을 향상시킬 수 있는 교육이 필요하다.

• 대한후두음성언어의학회지
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• 제19권2호
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• pp.128-132
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• 2008

Background: Laryngeal contact granuloma is an inflammatory hypertrophic granulation tissue arising at around the vocal process of arytenoid cartilage. Various approaches are currently used for the treatment, but a solid guideline has not been established. Objectives: We aimed to compare the each treatment modality in the hope of suggesting a guideline for the successful management of laryngeal contact granuloma. Method: Eighty-seven treatment cases of 56 patients were analyzed. Cases having recent intubation history were excluded from the study. All patients received vocal hygiene education. Proton pump inhibitors (PPI, N = 33) or H2 receptor antagonists ($H_{2}RA$, N =26) were used as a first-line treatment. Among the non-responders to $H_{2}RA$, 11 cases received PPI as a second-line therapy. Eight cases received botulinum toxin injection and 9 cases had laryngomicrosurgical removal. Results: As an initial therapy, response rate to PPI and $H_{2}RA$ was 60.6% and 38.5% respectively, which was not statistically different (p=0.091). Response rate of PPI as the second-line therapy was 36.3% (p=0.162 when compared to that of first-line PPI therapy). Response rate of Botulinum toxin injection was 75%. All cases of surgical removal recurred in a relatively short period (mean 1.9months). Conclusion: In patients having laryngeal contact granuloma, combined therapy with vocal hygiene education and PPI medication would provide more than 60% of therapeutic response. Botulinum toxin injection is highly effective even in non-responders to antireflux therapy. The only indications of surgery are to resolve diagnostic doubt or to treat acute airway compromise.

• 간호행정학회지
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• 제3권2호
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• pp.123-136
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• 1997

The purpose of this study was to confirm the classification of nursing activity and to analyze the time of nursing workload in a new open hospital. The data were collected from 20 nurses working in 6 general nursing units by 4 trained observers. The tools used for this study were an observation recording sheet and a classification sheet of nursing activity. The classification sheet was constructed to be adaptable to each hospital system based on the instrument described in the literature. The results of the study are as follows : The direct nursing activities consisted of 6 sections, 33 subsections and the indirect nursing activities consisted of 14 sections, 53 subsections. The direct nursing activities included medication, measuring and observation, care of therapies, care of physical comfort, laboratory and treatment. The indirect nursing activities included preparation of medical utensils, collection of information and assessment, recording, phone communication, professional interaction related to patients, personal time, assigning work to staff, patient eaucation and training, interaction with lab, transfer of administration of utensils, checking physician's order, dietary service, management of pollution and contagion, guide direction. Nurses spent 127.6min for direct nursing activity during day duty. It was 24.5% of total nursing activity. Within that activity medication had the highest percentage of time(40.09%), followed by communication and education with patient(24.76%), measuring and observation (16.93%), laboratory and treatment (12.85%), care of therapies(3.21%) and care of physical comfort (2.16%). The time breakdown for indirect nursing activities is as follows ; the preparation of medical utensils 22.3%, collection of information and assessment 20.29%, recording 20.27%, phone communication 8.14%, professional interaction related to patients 7.33%, personal time 7.24%, with the remaining timeshared by staffing, patient education and training, interaction with lab, transfer of administration of utensils, checking physician's order, dietary service, management of pollution and contagion, guide direction. In the analysis of the relationships between the working time and the work allocation characters of the nurses(including nurse's experiences. nurse-patients ratio, nurse-rooms ratio, and character of nursing unit) ; There were no significant differences in direct-indirect nursing times between nurse's career years. There was significant difference in direct nursing time between assigned patient numbers. The nurses assigned larger number of patients spent significantly more time in direct nursing care than that of the smaller. On the other hand, there was no significant difference in indirect nursing workload between the assigned patient numbers. There were no significant differences in direct-indirect nursing time between an allocated patient's room numbers. There was significant difference in working time between working places. The nurse in the medical unit spent more time in direct nursing care than her counterpart in the surgical unit. However there was no difference in direct nursing time between two groups. The study results indicate that nurses spent less time in the direct nursing care than in the previous studies even though the hospital system has been modernized. On the other hand they spent much more time for the coordinating role within the interdisciplinary team and for the overlapping paperwork. Therefore it is recommended that patient oriented job description and more efficient usage of modernized utilities be made.

• 대한간호학회지
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• 제13권3호
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• pp.1-33
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• 1983

The role and function of nursing care nowadays, tend to acquire sophisicated technology because specialization has expended due to increase of the medical population and the improvement of national health standards. To implement nursing care independently as a professional nurse, the apprehension of specific knowledge and skill should be acquired during basic nursing education. So it is important for nursing education not only to include theory and actual techniques, but also to strengthen the practical training in the actual clinical setting. This study was carried out with the following objectives; 1. To survey the detailed content and frequency of actual nursing students display during their clinical training. 2. To investigate the detailed content and frequency of actual nursing behavior which students display in each clinical a area. 3. To identify the motive for selection of nursing as their major and to determine the degree of self confidence, extent of knowledge and recognition of nursing responsibility. 4. To observe the relationship between actual nursing behavior and each of the following; 1) Motive for selecting nursing as a major 2) Self confidence 3) Knowledge of nursing care 4) Recognition of nursing responsibility The conclusions of this study were as follows; 1. Among the detailed nursing behavior which junior nursing college students carry out in clinical training; taking respiration's showed the highest frequency, and taking body temperatures, blood pressures, and pulses and making beds were next in frequency in this order. 2. In detailed nursing behaviors according to clinical area; taking vital signs showed the highest frequency in the emergency room, pediatric ward, orthopedic ward, general surgical ward and internal medicine ward. However, in the operating room, assisting with endotracheal tube insertion and sterile techniques were showen to have the highest frequencies. In nursery, umbilical cord care and the measurement of body weight were the highest in frequency In neurosurgical ward, the measurement of vital signs, changing position and tracheostomy care were the highest in frequency. In obstetric and gynecological ward and in the delivery room, checking duration, intensity and frequency of contractions was the highest in frequency. 3. In regard to the motive for majoring in nursing, the aptitude and interest of the student had the highest percentage(32.86%), and self-confidence in nursing activities (M=3.36), knowledge in nursing activities.(M=3. 09), and the recognition of the nursing activity (M= 3.76) wire in the middle range. 4. When the detailed nursing behaviors were compared with motive, self confidence, knowledge and recognition, it was found that when the nursing behavior was difficult and regarding much endeavor although the motive was high, the frequency of the nursing behavior was rather low. But in the cases in which there was much self confidence and a high level of skill was required, nursing behavior was carried more frequently. When there was muck self confidence and skill was not required, the frequency of nursing behavior was rather low. In the cases of a high level of knowledge, the frequency of nursing behavior was low and when recognition for nursing behavior was given the frequency of nursing behavior was low.

• Asian Pacific Journal of Cancer Prevention
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• 제17권4호
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• pp.1909-1915
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• 2016

Background: The purpose of this study was to determine the benefit of tertiary cytoreductive surgery (TC) for secondary recurrent epithelial ovarian cancer (EOC), focusing on whether optimal cytoreduction has an impact on disease-free survival, and whether certain patient characteristics could identify ideal candidates for TC. Materials and Methods: Retrospective analysis of secondary recurrent EOC patients undergoing TC at three Turkish tertiary institutions from May 1997 to July 2014 was performed. All patients had previously received primary cytoreduction followed by intravenous platinum-based chemotherapy and secondary cytoreduction for first recurrence. Clinical and pathological data were obtained from the patients' medical records. Survival analysis was caried out using the Kaplan Meier method. Actuarial curves were compared by the two tailed Logrank test with a statistical significance level of 0.05. Results: Median age of the patients was 49.6 years (range, 30-67) and thirty-eight (72%) had stage III-IV disease at initial diagnosis. Twenty six (49%) had optimal and 27 (51%) suboptimal cytoreduction during tertiary debulking surgery. Optimal initial cytoreduction, time to first recurrence, optimal secondary cytoreduction, time interval between secondary cytoreduction and secondary recurrence, size of recurrence, disease status at last follow-up were found to be significant risk factors to predict optimal TC. Optimal cytoreduction in initial and tertiary surgery and serum CA-125 level prior to TC were independent prognostic factors on univariate analysis. Conclusions: Our results and a literature review clearly showed that maximal surgical effort should be made in TC, since patients undergoing optimal TC have a better survival. Thus, patients with secondary recurrent EOC in whom optimal cytoreduction can be achieved should be actively selected.