• 간호행정학회지
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• 제6권1호
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• pp.135-146
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• 2000

The purpose of this study was to develope, based on the Nursing Intervention Classification (NIC) system. a set of standardized nursing interventions which had been validated. and their associated activities. for use with nursing diagnoses related to home health care for women who have had a caesarian delivery and for their newborn babies. This descriptive study for instrument development had three phases: first. selection of nursing diagnoses. second, validation of the preliminary home health care interventions. and third, application of the home care interventions. In the first phases, diagnoses from 30 nursing records of clients of the home health care agency at P. medical center who were seen between April 21 and July 30. 1998. and from 5 textbooks were examined. Ten nursing diagnoses were selected through a comparison with the NANDA (North American Nursing Diagnosis Association) classification In the second phase. using the selected diagnoses. the nursing interventions were defined from the diagnoses-intervention linkage lists along with associated activities for each intervention list in NIC. To develope the preliminary interventions five-rounds of expertise tests were done. During the first four rounds. 5 experts in clinical nursing participated. and for the final content validity test of the preliminary interventions. 13 experts participated using the Fehring's Delphi technique. The expert group evaluated and defined the set of preliminary nursing interventions. In the third phases, clinical tests were held at in a home health care setting with two home health care nurses using the preliminary intervention list as a questionnaire. Thirty clients referred to the home health care agency at P. medical center between October 1998 and March 1999 were the subjects for this phase. Each of the activities were tested using dichotomous question method. The results of the study are as follows: 1. For the ten nursing diagnoses. 63 appropriate interventions were selected from 369 diagnoses interventions links in NlC., and from 1.465 associated nursing activities. From the 63 interventions. the nurses expert group developed 18 interventions and 258 activities as the preliminary intervention list through a five-round validity test 2. For the fifth content validity test using Fehring's model for determining lCV (Intervention Content Validity), a five point Likert scale was used with values converted to weights as follows: 1=0.0. 2=0.25. 3=0.50. 4=0.75. 5=1.0. Activities of less than O.50 were to be deleted. The range of ICV scores for the nursing diagnoses was 0.95-0.66. for the nursing interventions. 0.98-0.77 and for the nursing activities, 0.95-0.85. By Fehring's method. all of these were included in the preliminary intervention list. 3. Using a questionnaire format for the preliminary intervention list. clinical application tests were done. To define nursing diagnoses. home health care nurses applied each nursing diagnoses to every client. and it was found that 13 were most frequently used of 400 times diagnoses were used. Therefore. 13 nursing diagnoses were defined as validated nursing diagnoses. Ten were the same as from the nursing records and textbooks and three were new from the clinical application. The final list included 'Anxiety', 'Aspiration. risk for'. 'Infant behavior, potential for enhanced, organized'. 'Infant feeding pattern. ineffective'. 'Infection'. 'Knowledge deficit'. 'Nutrition, less than body requirements. altered', 'Pain'. 'Parenting'. 'Skin integrity. risk for. impared' and 'Risk for activity intolerance'. 'Self-esteem disturbance', 'Sleep pattern disturbance' 4. In all. there were 19 interventions. 18 preliminary nursing interventions and one more intervention added from the clinical setting. 'Body image enhancement'. For 265 associated nursing activities. clinical application tests were also done. The intervention rate of 19 interventions was from 81.6% to 100%, so all 19 interventions were in c1uded in the validated intervention set. From the 265 nursing activities. 261(98.5%) were accepted and four activities were deleted. those with an implimentation rate of less than 50%. 5. In conclusion. 13 diagnoses. 19 interventions and 261 activities were validated for the final validated nursing intervention set.

• 수면정신생리
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• 제20권1호
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• pp.15-21
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• 2013

목 적: 하지불안증후군에서의 인지기능 저하는 흔히 동반되는 수면박탈, 불안, 우울 등에 의해 영향을 받는다. 본 연구의 목적은 투약 받지 않고 있는 한국 노인 인구에서 하지불안증후군과 인지기능 저하와의 관련성을 동반 증상의 영향을 배제하고 살펴보는 것이다. 방 법: 연구대상은 25명의 투약 받고 있지 않은 한국 노인 하지불안증후군 환자군과 나이, 성별, 교육연한에 따라 짝지은 50명의 대조군이다. 모든 연구대상에 대해 CERAD-K 신경심리평가, 중증인지감퇴평가 척도, 전두엽 기능 평가, 그리고 시계 그리기 검사(CLOX)를 포함한 광범위한 인지기능 평가를 시행하였다. 또한 수면의 질 평가를 위해 피츠버그 수면의 질 지수(Pittsburgh Sleep Quality Index, PSQI), 우울증의 평가를 위해 노인우울척도(Geriatric Depression Scale, GDS)를 사용하였다. 결 과: 환자군과 대조군 사이의 PSQI와 GDS 점수의 차이는 없었다. 구성 재인 검사에서 환자군이 대조군에 비해 더 낮은 점수를 보였으며(t=-2.384, p=0.02), 이를 제외한 모든 영역의 인지기능 평가에서 환자군과 대조군의 유의미한 차이는 관찰되지 않았다. 우울감이 있는 대상($GDS{\geq}10$)은 그렇지 않은 군에 비해 언어 유창성, 간이 정신상태 검사, 단어목록기억, 길 만들기 검사, 전두엽 기능 평가의 영역에서 유의한 인지기능 저하를 보였다. 수면의 질이 낮은 대상(PSQI>5)은 그렇지 않은 군에 비해 인지기능 평가의 전 영역에서 차이를 보이지 않았다. 결 론: 본 연구에서 하지불안증후군 환자군을 대조군과 비교한 결과 환자군은 불면과 우울의 영향을 배제하면 비교적 인지기능이 보존된 것으로 관찰되었다. 환자군에서 관찰되었던 시각 인지 영역의 저하는 하지불안증후군에서의 도파민 신경전달계의 장애와 연관하여 해석해 볼 수 있다.

• 한국산학기술학회논문지
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• 제18권9호
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• pp.203-215
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• 2017

본 연구는 요양병원 입원 노인환자를 대상으로 섬망예방을 위한 안위증진 프로그램이 섬망발생, 섬망지속정도, 섬망위험요인을 감소시키는데 효과가 있는지 검토하기 위한 비동등성 대조군 전후 설계의 유사실험연구이다. 자료수집 기간은 2016년 7월 3일부터 8월 20일까지 이루어졌으며 연구 대상은 요양병원에 입원중인 65세 이상의 노인 환자로 실험군 34명, 대조군 34명이었다. 자료분석은 IBM SPSS 21.0 Program을 이용하여 independnet t-test, repeated measures ANOVA를 이용하여 분석하였다. 섬망예방을 위한 안위증진 프로그램은 Kolcaba이론을 바탕으로 개발하였고, 개발된 프로그램의 효과는 다음과 같다. 섬망발생률은 실험군 2.9% (1/34명), 대조군 14.7% (5/34명)로 실험군에서 통계적으로 유의하게 낮았으며($x^2=3.98$, p=.047), 섬망심각도는 실험군(0.24)이 대조군(5.1)에 비해 통계적으로 유의하게 낮았다(t=2.27, p=.027). 섬망지속시간은 실험군(2일)이 대조군(2~10일)보다 통계적으로 유의하게 짧은 것으로 나타났다($x^2=3.22$, p=.043). 시간의 변화에 따라 실험군에서 안위는 증가하였으며(F=108.85, p<.001), 불안(F=63.39, p<.001)과 우울(F=89.78, p<.001)은 감소하였다. 수면의 질은 실험군이 대조군에 비해 높았고(F=63.63, p<.001), 통증은 실험군이 대조군에 비해 낮았다(F=93.64, p<.001). 결론적으로 요양병원에 입원한 노인환자의 섬망예방을 위해서 신체, 심리 영적, 사회 문화적, 환경적 접근을 한 Kolcaba이론에 근거한 섬망예방을 위한 안위중재예방프로그램의 효과가 있는 간호중재임이 확인되었다. 따라서 요양병원 입원 노인환자들의 섬망예방을 위해서 신체, 심리 영적, 사회 문화적, 환경적 맥락에서의 섬망예방을 위한 안위중재프로그램을 확대 시행할 필요가 있음을 제언한다.

• 지역사회간호학회지
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• 제11권1호
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• pp.127-145
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• 2000

The objectives of this study are to identify health behaviors and health problems. and the relations between health behaviors and health problems of female workers in the retail business. The number of subjects were 200 female workers of 6 department stores in Seoul and Kyonggi area, whose jobs last more than 6 months as retail employees. The data was collected during 2 months from July 1 to August 30, 1998. The Cornell Medical Index Health Questionnaire(CMI) was used to measure their health problems, while health behaViorn were investigated in terms of 'smoking', 'alcohol', exercise', 'diet', and 'sleeping'. The data were analyzed with frequency. percentage, t-test, ANOVA test, and $X^2-test$ by SPSS PC+ program. The results of this study are as follows: 1. Out of health problems. Digestive symptoms occupied the highest percent number. nervous ones the second and cardiovascular ones the third among physical health problems of retail female workers. The most frequent mental health problem was 'adequacy' and the next, 'tension' and 'anger', 2, Health problems according to general characteristics of subjects were shown that the younger or the unmarried complained more than the older or the married, especially in the items of 'eye and ear', 'respiratory system', 'cardiovascular system', 'digestive tract', 'nervous system', 'adequacy', and 'depression'. The longer working duration they have had, the more they complained of 'respiratory system' and 'adequacy'. The lower academic careers complained of 'nervous' than the higher ones with statistical significance. 3. The analysis of daily health clinic notes showed that respiratory complaints were the highest percent, successively followed by digestive tract, nervous one, external injury, musculoskeletal system, urinary-reproductive system and others. 4. The level of their health practice was generally low in smoking, diet habit and alcohol intake, exercise, sleeping, very low especially in smoking, diet, alcohol intake, and exercise among them all. 5. Present smokers and ones with past experience complained of physical and mental health problems of 'respiratory system', 'digestive tract', 'skin', 'nervous', 'urinary-reproductive system', 'fatigability', adequacy', 'depression', 'anxiety', 'anger' and 'tension', than non smokers, with statistical difference. Workers without having breakfast and with irregular diet had more complaints on 'digestive tract', 'adequacy' and 'tension', than those who had regular dietary habit. The less the subjects slept, the more they complained of eye and ear, cardiovascular system. The subjects who drank alcohol complained more digestive problem. However, whether they exercise or not did not affect physical and mental health problems in a significant manner. 6. The subjects' age and marital status were statistically significant relating to health behaviors, as the younger or unmarried recorded a low level of health practice in smoking, drinking, dietary habit. Based on the results, the suggestions are made as follows: 1. Health education program on smoking, alcohol intake, diet habit is needed to improve health problems and health behavior of female retail workers. 2. The unmarried workers of late teen and twenties, who are transitional period from teenagers to adulthood are important targets for health promotion program especially for maternal health. 3. Better working environment with sufficient time and facilities for workers to relax is required to promote female sales workers' health. 4. Further research is required to identify the relation between workers' visual fatigue and intense lights for the display of goods.

• 인간행동과 음악연구
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• 제4권2호
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• pp.1-17
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• 2007

청소년기는 성장과 발달의 과도기적 단계로 모든 영역에서의 발달과 새로운 역할 수행, 학업수준의 향상으로 인한 부담감 등 커다란 변화를 겪게 된다. 이 시기의 청소년은 발달 과제를 해내지 못하거나 변화로 인한 좌절이나 갈등을 반복하는 경우 스트레스와 우울 같은 심리적 어려움을 토로하게 되고, 성숙한 대처를 못하거나 극복하지 못하는 경우 우울이나 불안 같은 정신장애를 얻기도 한다. 오늘날 현대 사회의 청소년을 위한 실질적인 정신건강이나 정신장애에 대한 대응과 예방은 미비하며, 이에 청소년을 위한 상담이나 심리치료 프로그램의 개발이 절실히 요구되고 있다. 그러므로 본 연구에서는 우울 성향을 가진 여중생에게 블루스 음악형식을 활용한 자기효능감 증진 연주활동을 시행하여 참여자들의 우울과 자기효능감에 대해 미치는 영향과 대상자들이 연주를 통해 어떠한 경험을 했는지에 대해 살펴보고자 하였다. 연구 참여자는 서울시 소재 D중학교 1학년에 재학 중인 여자 중학생 3명으로 연구자가 70여명의 학생들에게 아동우울척도(CDI)와 자기효능감척도 검사를 실시하여 선별한 여학생들이다. 실시된 10회기의 연주활동은 3단계로 나누어지는데, 1단계에서는 자기소개와 라포형성, 블루스 음악소개와 블루스 음악형식 연주를 통한 활동에 대한 흥미 유발을 목표로 진행하였다. 2단계에서는 블루스 음악에서 자주 볼 수 있는 특징적인 부분인 부점, 셋잇단음표, 엇박자를 활용한 블루스 음악형식을 연주해 익히고, 5회기 동안 각 회기에서 수행하는 음악과제의 난이도를 달리하여 음악연주과제(즉흥연주 포함)를 수행하도록 하였다. 3단계에서는 전 단계에서 배워 연주했던 곡들을 정리하고 각 대상자들이 곡을 선택하거나 새로운 곡을 창작하여 연습한 뒤 음악연주 발표시간을 가짐으로써 완수경험의 극대화로 음악연주에 대한 경험을 확장하는 시간으로 활용하고자 하였다. 연구결과는 첫째, 연주활동에 참여한 참가자들의 우울 점수는 유의미한 차이를 보이진 않았으나 우울과 자기효능감이 부적상관관계가 있음을 볼 수 있었다. 둘째, 연주활동에 참여한 참가자들의 자기효능감에 미친 영향으로는 자기효능감의 세 가지 하위영역 중 과제난이도선호에서 유의미한 차이를 보여주었다. 셋째, 연주활동에 참가자들의 음악연주에 대한 자기효능감의 세 가지 하위영역 중 과제난이도 선호에서 유의미한 차이를 보여주었다. 넷째, 사후 인터뷰 질문지의 내용과 대상자들의 각 회기 세션 내용을 질적으로 서술하고 분석해 본 결과 대상자들은 블루스 음악형식 연주활동을 통해 과제난이도를 달리하여 연주활동을 했을 때, 자신감을 경험하고 긍정적인 정서를 경험했으며 대상자들에게 의미 있는 경험이었다는 것을 알 수 있었다. 마지막으로 본 연주활동의 효과와 대상자들의 음악경험의 결과와 의미를 볼 때에 블루스 음악형식을 활용한 연주활동이 치료적인 중재 도구로서의 가능성이 있음을 시사한다.

• 초등상담연구
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• 제5권1호
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• pp.227-253
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• 2006

It seems common for students living at a small county and islands to experience psychological conflicts and be unaccustomed in the peer society because they are not familiar with peer interaction and social skills. This is a case study of L (hereinafter called L) who was grown up in the sheltered school at a small county. L was psychologically disturbed because he couldn't get along well in the transferred school. It is the reason why he had lived in the sheltered school at a small county, so he had not enough exposure to interact with peer and social skills. Sometimes he was obstinate irrationally and when he had trouble with friends, he threw something out or went out of school and tricked juniors dangerously. The fact of disperse with families, parent's indifference, and hate of older brother made L to have ill feeling against family. He had low motivation and low self confident in learning because of short attention time and accumulated poor learning progress. In this study, he was evaluated at various area, such as, intelligent, affective, personal and inter-personal, before counselling. To evaluated the effect of the counselling, K-WISC-III, KPRC, sentence filling test, social adaptation ability test, etc, were administered right after the counselling was over and 8 weeks later. For specific information gathering and analysing, observation diary and deepen counselling were accomplished by homeroom teacher, his mother, and his peers. To correct his problematic behaviors, 13 counseling sessions were accomplished for 6 months and those counselling sessions were recorded and analysed definitely. Followings are the result of this case study. First, he was recovered from the anxiety of inter-personal interaction and he started to interact with peers. The result of sac scale score of KPRC profile was lower than before as much as average student after counseling and 8 weeks later. This reveals that the distress against interpersonal relation have settled. Especially, through the result of sentence filing test, he seemed to feel attachment to peers and be positive, active in the relation of peer. For instance, he was active in the open class lesson and interacted well with peers. It could be said that he overcame the psychological distress comparing with previous time. Second, he could apologize to his peer and juniors for his fault. His attitude were well shown in the letter from an old friend at the sheltered school, average KPRC profiling score comparing with previous counseling time, and remarkable decrease of attack scale score of teacher and peer. Third, his view toward family turn out positive. He recognized his situation that he lived apart from family and even worried about his parent's financial difficulty. Through solving the confliction with his older brother, he could acquire the feeling of family reunion. Fourth, his learning motivation and self-confidence were increased. He confirmed his future positively and he might be judged more attentive because his intelligence index was higher than before as much as average student. With the main goal of this study, verification for effectiveness of counseling. understanding and helping problematic students such as L who lives at a small county and island through investigation of their real situation and problems with the method of counseling and socio-cultural analysis is worthwhile. Identification of ideal relationship with peer is related with positive self-conception, harmonic social adaptation and development of child. It is time to investigate easy adaptive in classroom and well-organised program to acquire general social skills for sheltered school students at a small county and islands.

• 대한유전성대사질환학회지
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• 제16권1호
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• pp.18-23
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• 2016

TMS가 확산되고 검사가 많아짐에 따라 위양성 건수도 증가하고 있다. 본 연구에서는 2012년 1월 1일부터 2014년 12월 31일까지 단일 기관에서 출생한 신생아를 대상으로 시행한 TMS의 위양성율을 조사하고 관련된 요인들을 분석하였다. 총 검사 대상자 중 남아는 8,942명(51.7%), 여아는 8,350명(48.3%)이었고, 평균 제태연령은 $38.6{\pm}1.7$주 였다. 평균 출생 체중은 $3,155.6{\pm}502.4g$, 평균 출생 신장은 $49.1{\pm}2.9cm$, 평균 체질량지수는 $13.0{\pm}3.8kg/m^2$ 이었다. 질식 분만은 9,713 (56.2%)건, 제왕절개는 7,579 (43.8%)건이었다. 평균 검사 시행일은 $2.8{\pm}1.1$일이었다. 위양성을 포함하여 TMS에서 양성으로 확인된 224명은 전체 대상자의 1.3%였다. 다중 로지스틱 회귀분석을 통해 분석한 결과 27주 이하의 초미숙아에서 위양성으로 나타날 odds ratio가 6.957 (95% CI: 1.273-38.008), 1,000 g 이하의 극저체중아에서 5.616 (95% CI: 1.134-27.820)로 나타났다. 위양성 대상자들 중에서는 지방산 대사이상 질환(fatty acid oxidation dis-orders)이 104명(47%), 아미노산 이상질환(amino-acidopathy)가 75명(34%), 유기산 이상 질환(organic aciduria)가 43명(19%)이었다. 전국적인 자료를 모아 평가한다면 국내 발생률에 대한 정확한 평가 및 접근이 가능할 것으로 생각한다.

• 한국방사선학회논문지
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• 제9권7호
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• pp.529-533
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• 2015

VCUG 검사는 검사 중 배뇨를 해야 하기 때문에 하의를 벗은 상태에서 실시해야 해서 환자의 민망함과 불안감이 매우 큰 투시검사 중 하나이다. VCUG 검사는 배뇨 중 방광요관역류(VUR:Vesico Urthral Reflex)를 진단하기 위해서는 검사자와 의사가 배뇨의 전 과정을 지켜봐야 하고 환자가 직접 소변통을 들고 배뇨를 하면서 검사를 해야 하기 때문에 VCUG 검사 자체가 상당히 불편하다. 따라서 이러한 VCUG 검사는 환자의 인격을 고려한다면 향후 지양해야 할 검사이기도 하다. 그러나 이러한 VCUG 검사는 의료 비뇨기학적 진단에서 상당한 가치가 있고 아직까지 VCUG를 대체할 만한 검사법이 개발되지 않고 있다. 이에 VCUG 검사를 시행할 때 환자의 인격을 존중하고 환자의 민망함과 불안감을 감소시킬 수 있는 방안으로 VCUG 검사 팬티를 자체 제작하였고 VCUG 검사팬티를 사용한 실험군과 사용하지 않은 대조군들을 두 분류로 나누어 VCUG 검사 시간, 검사에 따른 환자가 받는 피폭 선량 그리고 환자 만족도를 비교 분석해 보았다. VCUG 검사 시간은 VCUG 팬티를 사용한 실험군이 27.8분, 대조군이 35.3분으로 실험군이 대조군에 비해 검사시간이 7.5분 단축되었다. 환자 피폭선량은 VCUG 검사 팬티를 사용한 실험군이 $3411.9{\mu}Gym^2$, 대조군이 $4566.6{\mu}Gym^2$으로 실험군이 피폭선량을 평균 $1154.7{\mu}Gym^2$를 감소시킬 수 있었다. 실험군과 대조군의 검사만족도 평가에서는 대조군 1.86에 비해 실험군 3.05로 실험군의 만족도가 매우 높았고 검사 중 수치심의 정도는 대조군 4.02에 비해 실험군 3.08로 수치심이 감소하는 것을 확인 할 수 있었다. 검사 중 불안감을 느끼는 정도는 대조군 3.45에 비해 실험군 2.51로 불안감을 적게 느끼는 것으로 나타났으며 배뇨가 잘 되는 정도는 대조군 1.90에 비해 실험군 2.84로 나타나 VCUG 검사 팬티를 사용함으로써 배뇨가 더 잘되는 것으로 나타났다. 따라서 VCUG 검사 팬티를 사용함으로써 검사시간과 환자의 피폭 선량이 단축되었으며 환자의 만족도 또한 향상되었다.

• 한국초등과학교육학회지:초등과학교육
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• 제40권2호
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• pp.239-252
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• 2021

본 연구에서는 STEAM 교육이 중시하는 과학에 대한 흥미와 과학적 창의성을 더 효과적으로 신장시키기 위해, 뇌기반 진화적 접근법에 따른 과학 교수·학습 모형(ABC-DEF)을 STEAM 교육에 적용하여, 새로운 '뇌기반 진화적 STEAM 교육' 교수·학습 프로그램을 개발하였다. 경기도 소재 S 초등학교 4학년 학생 90명을 대상으로 한 이 연구는, 비교반(45명) 학생들에게는 교과서·지도서 기반 STEAM 교육수업을, 실험반(45명) 학생들에게는 뇌기반 진화적 STEAM 교육 수업을 실시하였고, 수업 전후에 과학 흥미 검사와 과학 창의성 검사를 각각 시행하여 그 결과를 좌우·전후 비교분석을 통해 정량적으로 검증하였다. 또한, 정량적 검사로 드러나지 않는 특성들을 분석하기 위해 학생 관찰지, 면담일지를 추가로 분석하여 정성적 연구를 병행하였다. 본 연구의 주요 결과는 다음과 같다. 첫째, 과학 흥미 변인에 대하여 독립 표본 검증(좌우비교)을 시행한 결과, 뇌기반 진화적 STEAM 교육 프로그램이 교과서 기반 STEAM 교육 수업보다 상대적으로 과학 학습에 대한 흥미는 높이고, 불안을 감소시킨다는 것을 알 수 있었다. 둘째, 과학 흥미 변인에 대하여 종속 표본 검증(전후 비교)을 시행한 결과, 사전·사후 점수 간에 유의미한 차이가 없었던 교과서 기반 STEAM 교육에 반해, 뇌기반 진화적 STEAM 교육 프로그램은 수업 전후에 따라 과학에 대한 흥미가 향상되는 것을 알 수 있었다. 셋째, 과학 창의성 변인에 대한 독립표본 검증(좌우비교)을 시행한 결과, 뇌기반 진화적 STEAM 교육 프로그램이 교과서 기반 STEAM 교육수업보다 학생의 과학 창의성 점수와 독창성 점수를 높이는 데 더 효과적인 것으로 검증되었다. 넷째, 과학 창의성 변인에 대한 종속 표본 검증(전후비교)을 시행한 결과, 두 가지 교수·학습 방법 모두 수업 전후에 따라 학생의 독창성, 유용성, 과학 창의성 점수를 효과적으로 향상시킨 것으로 나타났다. 이러한 연구 결과를 토대로, 과학 교육과 STEAM 교육 연구에 관한 함의들을 논의하고자 한다.

• 동서간호학연구지
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• 제1권1호
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• pp.22-39
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• 1997

Purpose: The purpose of this study is to evaluate the effect of rehabilitation education on the reduction of the stress of family members who have patients suffering from stroke and to find a new way to nurse the patients and their family. Subjects & Methods: The subjects were sixty-one family members with the patients who had been hospotalized in K hospital of oriental medicine from september the 9th, 1996 to september the fourteen, 1996. This study was performed by simulated control group pretest-posttest design; pretest was done on the control group through a questionnaire, counselling and observation while posttest was done on the experimental group 1-2 days after systemic rehabilitation education. To teach the patients and their family, the amended version of a book written by Lee Hae-jin was used as a tool for systemic rehabilitation education. As a method to estimate ADL score, modified Kang's method was applied and ADL score was measured by well-trained technician. As for the tool to estimate the degree of family stress, Choi's method adjusted to this study was applied. In the analysis of the data, social property of the patient and the characteristic of the disease were surveyed in $X^2$ examination to confirm the consistency between the experimental group and the control group. The diffrence in the degree of the stress, which is a dependent factor, was examined by t-test. The difference in ADL score between the experimental group and the control group was examined by t-test. The difference in the degree of the stress according to the general feature of the family with stroke patient, social property of the patients and the characteristic of the disease were surveyed by F examination. The difference in family stress according to the degree of ADL was surveyed by F examination. RESULTS: 1. After hypothetically-examined systemic rehabilitation education, the total of the score of family stress surveyed in 34 items of three domains was compared between the experimental group and the control group. There was no statistically significant difference between two groups; mean score of experimental group=2.28, that of control group=2.93(t=.17, df=59, p=. 66). 2. In the survey on family stress in 34 items, the items over mean score 3.0 were firstly the anxiety of possible disability and relapse of the disease and secondly to watch the patient's suffering without doing anything in the domain of the change of the disease and the difficulty in caring. And the items of the lowest stress with less than mean 2.0 score were little chance to meet the relative and friends, inconsistent treatment and attitude of the medical workers and the change of the attitude of the relative due to the patient orderly in the domain of social and personal relation and the responsibility as the family. The items which showed the difference between two groups were aggravation of neighboring patient(t=3.36, df= 59, p=.001) and the possibility of patient's death(t=2.19, df=58.38, p=.033) in the domain of the change of the disease and the difficulty in caring. 3. In the study on the stress difference according to general features of the family with the stroke patient, the score of family stress with the occupation was higher with mean 2.49 than that of the family stress without occupation with mean 2.16, but there was no significant difference. (F=5.21, df=1/59, p=.026). 4. In the study on the stress difference according to social property of the patient and the characteristic of the disease, there was significant difference in the age of the patients (F=2.98, df=3/57, p=.039). These results show that even if there is no statistically significant difference between two groups, sixteen of the experimental group are less than 3.0 in ADL score(standard 6 score)while eight of the control group are less than 3.0 and that ten of the experimental group are in the year range of 39-49 while four of the control group are in the year range of 39-49 which showed significant difference in family stress. These imply that there is a possibility that the experimental group have serious and fundamental stress resulting in high pretest stress compared with the control group. It might be due to the characteristic of simulated control group pretest-posttest design that the psychologic-supportive effect by the education was not observed. On the basis of these results, the followings are suggested. 1) A study on the nursing-mediated method to reduce the stress in the items which are not resolved by rehabilitation education, a study on nursing according to the patient's age and a study on the supportive nursing toward the family with occupation are required. 2) More than two times consecutive nursing-mediated rehabilitation education to measure the family stress is required. 3) Comprehensive and multilateral systemic education program including the instruction on western-eastern medicine, physical therapy, exercise and diet through collaboration of the experts in each field is required. 4) Family stress at home as well as in the hospital needs to be estimated and home rehabilitation and home-nursing needs to be continued.