• Journal of Korean Biological Nursing Science
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• 제1권1호
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• pp.100-114
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• 1999

This study was done to investigate the effects of rapidly-rotating shift work of two-day interval on fatigue level and the concentration of urinary 17-KS, $Na^+,\;Cl^-$. The subjects were 20 nursing college students(control group) and 15 nurses in a university hospital and the study was done from Apr. 21 to May 4th, 1999. In the test group, each 5 nurses were allocated to day shift(8 AM-4 PM), evening shift(4 PM-12 MN) and night shift(12 MN-8 AM) respectively. The fatigue level were measured 30 minutes after work start on the 2nd day of work shift. Urine specimens were collected at 8 AM, 4 PM and 12 MN on the 2nd day of work shift in the control group and 30 minutes before and after work on the 2nd day of work shift in the test group. The data were analyzed with SPSS(for Window, ver 7.5). Statistical analysis was performed by using t-test, paired t-test and ANOVA. The results were as follows. 1. The perceived fatigue level in shift work 1) The physical and mental fatigue level were significantly higher in night shift than that in day or evening shift(p<0.05). In the neuro-sensory fatigue level, night shift showed higher tendency than that in day or evening shift, but there were no significant differences between each shifts. 2) Comparison between the control group and the test group: Physical fatigue level was significantly higher in night shift than that in day or evening shift of the control group(P<.001). Mental fatigue level was significantly higher in day or night shift than that in evening shift of the control group(P<.05). In the neuro-sensory fatigue level, test group showed higher tendency than that in the control group, but there were no significant differences between two groups. 3) The total fatigue level was higher in night shift than that in day shift or evening shift(P<.05). In comparing with the control group, night shift and day shift showed higher total fatigue level than that in the control group(p<0.05). 2. The concentration of urinary 17-KS, $Na^+$ and $Cl^-$ In the control group, urinary 17-KS, $Na^+$ and $Cl^-$ showed higher level in afternoon that in morning and night. In the test group, cr in day and evening shift and $Na^+$ in evening shift showed higher level at the end of work. The 17-KS concentration at the begining and the end of work in three shift groups were lower than those in control group(p<0.05), however, $Cl^-$ concentration at the begining of work in day shift, and the end of work in day and evening shift were higher than those in control group(p<0.05). $Cl^-$ concentration at the begining and end of work in night shift were considerably higher than those in control group repectively(p<0.1, p<001). $Na^+$ concentration showed a higher tendency in three shift groups except at the begining of work in night shift, but there were no statistical difference. In comparing concentration of the 17-KS, $Na^+$ and $Cl^-$ among the shift groups, 17-KS concentration showed a lower tendency and $Na^+,\;Cl^-$ showed a higher tendency in night shift: The result of this study showes that biorhythm of shift work nurse was irregular. Fatigue level as the subjective index for evaluating the health problem concerning shift work was higher in night shift and proved to be in accordance with the concentration of urinary 17-KS, $Na^+$ and $Cl^-$ used as objective indices. Disturbation of biorhythm and work stress due to night shift seems to cause the health problem of nurses and decrease of work efficiency. It is considered that work regualtion is necessary for the rational management of the nursing administration.

• 한국산학기술학회논문지
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• 제16권4호
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• pp.2691-2703
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• 2015

본 연구는 중환자실 간호사들의 DNR에 대한 윤리적 문제의 인식과 태도를 파악하여 DNR 환자간호에 도움이 되는 기초자료로 활용하고자 시도하였다. G광역시 상급종합병원 1개소, 전라 남 북도 700병상이상 종합병원 각각 1개소 중환자실에 근무하는 간호사를 대상으로 2014년 8월 1일 부터 9월 5일까지 설문조사하여 154부를 최종분석 하였다. 첫째, DNR 결정 태도는 치료를 거부하는 환자의견에 반대, 예후가 좋지 않은 환자라도 생명의 연장에 찬성, 환자가 원했을 경우 어떠한 상태라도 DNR 미실시, 보호자의 요구에 의한 치료와 가망 없는 환자의 CPR실시에 반대하였다. 둘째, 환자가족에 의한 인공호흡기 및 다른 치료의 적극적 실시에 반대, 보호자의 중환자실 입실에 대립적인 입장을 보였다. DNR 환자에 대해 의사의 인공호흡기의 소극적 사용에 찬성, 환자의 신체적 심리적 안정을 위해 기본적인 간호도 줄여야 하고, 무균술을 지키지 않은 처치에 묵인하는 입장이며, 가족에 의한 환자의 상태변화를 주치의에게 여러 차례 보고하는 것에 반대하였다. 셋째, 의사의 관심감소를 인정하고, 이에 보호자의 항의가 있을 때 의료팀을 옹호하며, DNR 결정을 주치의가 내린 것에 대립적인 입장이며, DNR 지침에 따른 결정에 반대하였다. 예후가 좋지 않은 환자에게 그대로 설명하는 것에 반대 또는 중립적이며, 환자나 보호자에게 환자상태를 있는 그대로 설명하는 것과 사망에 가까운 경우 환자나 보호자에게 상태를 그대로 설명하는 것에 반대하였다. 결론적으로 DNR 주체는 환자이며, 환자의견이 충분히 반영 되어야 하며, 의료행위의 범위와 결정과정에서의 갈등을 최소화하고 환자중심의 윤리적 의사결정이 되도록 DNR 결정에 대한 표준과 지침이 필요하며, 충분한 설명을 근거로 한 동의가 이루어 져야하겠다.

• 임상간호연구
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• 제14권2호
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• pp.127-138
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• 2008

Purpose: To examine the effects of the environmental nursing intervention using eye-shields and earplugs on the incidence of delirium, environmental stress and sleep among the patients with open-heart surgery in the post-cardiac ICU(intensive care units). Method: This study was a non-equivalent control group non-synchronized design. The subjects consisted of 93 patients who received ICU care after the cardiac surgery. Among those, 32 subjects was assigned in one experimental group with eye-shields, 31 in the other experimental group with earplugs, and 30 in the control group. ICU delirium was measured by CAM-ICU, environmental stress by ICUESS, and sleep by two sleep scales developed by Oh, et al. and Kim. The data were analyzed by the SPSS 13.0 program including frequency, percentage, t-test, $x^2$ test, ANOVA and ANCOVA. Results: There are no statistically significant differences in the incidence of delirium among three groups (p=.139). The ICU environmental stress scores from the subjects of two experimental groups demonstrated lower (F=6.731, p=.002) than the control group. Also, the degrees of sleep pattern (p=.000, p=.000) and sleep satisfaction (p=.000, p=.000) were greater than those of the control group. Conclusion: Although the environmental nursing intervention using eye-shields and earplugs did not demonstrate the effects in decreasing the incidence of ICU delirium, it has affirmative effects in decreasing environmental stress and improving the quality sleep among the patients with open-heart surgery while they stay in ICU. Further nursing implications are discussed.

• 기본간호학회지
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• 제19권1호
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• pp.87-97
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• 2012

Purpose: This study was done to evaluate nursing guidelines for patients with acute stroke, developed by adapting the guidelines of Registered Nurses Association of Ontario, Canada to clinical settings on a large scale and evaluating the effectiveness as a research study. Method: The general characteristics of the 319 patients and the effectiveness of guideline application were evaluated in terms of structure, process, and outcome using questionnaires on the guidelines application with reference to the medical records of patients with acute stroke hospitalized on a ward of the stroke center of S General Hospital in Seoul. Results: Structures as a guidance system for assessment were consistent with the recommendations. With respect to the process of the guidelines, for items on nursing assessment, improved performance was found to be statistically significant. For outcomes of the guidelines, complications occurred in 8 patients (5.3%) prior to application of the guidelines and 11 patients (6.5%) after application of the guidelines, but this result was not statistically significant (p=.841). Conclusion: The results of the study indicate that for the effectiveness of the guidelines, accessibility to the guidelines and effectiveness of quality improvement need to be evaluated, in addition to complications of a stroke.

• 임상간호연구
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• 제20권3호
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• pp.326-336
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• 2014

Purpose: The purpose of this study was to compare the effectiveness of heparin and 0.9% normal saline solution flushing for maintaining patency of non­tunneled central venous catheters in patients with surgery. Methods: A randomized controlled clinical trial was performed. Fifty­eight patients were prospectively enrolled and fifty-four patients were completed the study. The heparin group consisted of 30 patients given 100u/ml diluted heparin flushing and the normal saline group consisted of 24 patients with 0.9% sodium chloride flushing. Results: There was no significantly difference in occlusion between the heparin group and the normal saline group in non­tunneled central venous catheters' occlusion. Also there was no difference between these two groups in catheter­related infections. Conclusion: Flushing with 0.9% normal saline is as effective as flushing with heparin solution in maintaining the patency of non­tunneled central venous catheters. In this study, however, the duration of central line use was short and the infection occurrence was little. Further studies are warranted with a larger sample size at multiple centers.

• 간호행정학회지
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• 제11권2호
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• pp.195-207
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• 2005

Purpose: The purpose of this study was to confirm the change of nursing organizational characteristics and to define the difference of organizational outcome by measuring the organizational commitment and job satisfaction perceived by nursing staffs and patient satisfaction before and after organizational redesign. Method: The structured questionnaires of which contained organizational characteristics, organizational commitment and job satisfaction were developed from previous published studies after modification by researcher. The questionnaires were distributed to 1,200 and 679 nurses before and after nursing organizational change. patient satisfaction were measured before and after organizational change by direct interview with structured questionnaire from 1,566 and 1,291 patients. Results: 1. The organizational characteristics were significantly increased and the leadership of team leader and head nurse was significantly increased among the factors of organizational characteristics. 2. Organizational commitment was showed decreased tendency, but the difference was not significant. Job satisfaction was increased significantly and administration, autonomy, and job tasks were increased significantly in the factors of job satisfaction. Patient satisfaction was also increased significantly. 3. There was significant positive correlation between organizational commitment and job satisfaction and also job satisfaction and nursing organizational characteristics. All factors of organizational characteristics and satisfaction in present working unit were major factors to influence organizational commitment and explained 43.8% in a significant level by multiple regression analysis. The major factor which affect job satisfaction were the factors of nursing organizational characteristic except 'interaction with team leader' and satisfaction in present working unit among general characteristics and these factors explained 58.8% of job satisfaction. Conclusion: In conclusion, the nursing organizational change was very effective to bring about desirable change in nursing organizational characteristics and also to improve job satisfaction and patient satisfaction. Therefore the nursing productivity and comparability would be increased when the nursing organizational change is accomplished by the way of improving the factors of organizational characteristics and it would be followed by the promotion of job satisfaction and organizational commitment.

• 대한지역사회영양학회지
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• 제6권2호
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• pp.227-233
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• 2001

The purpose of this study is to verify nutrient intake status and prevalence of obesity in vegetarians non-vegetarians and non-vegetarians. The vegetarian subjects consisted of 127 Buddhist nuns(age:23-79 yrs) from Oonmoon Temple on the Choungdo District of Gyeongsang Bookdo Province and 118 Buddhist nuns practicing Zen meditation at Soodeok Temple in Yeosan District of Chongcheong Namdoo Province. Control subjects were 235 healthy female adults aged from 23 to 79 years old. They were teachers and nurses at the hospital of Gyeongsang National University and housewives living in Chinju, Gyeingsang Namdoo Province. The study was conducted from October 1996 to February 1997, and consisted of a survey and anthropometric measurement. The results are summarized as follows : The average age of the subjects was 44.2 yrs for vegetarians and 40.5 yrs for non-vegetarians. The average body mass index(BMI) of vegetarians and non-vegetarians was 22.4 and 21.0, the waist hip ratio(WHR) was 0.8 and 0.8, and the percentage of body fat was 28.7 and 26.5 respectively. The average duration of vegetarian diet among vegetarians was 13.1 years. The nutrient intakes of vegetarians were above the RDA for all the nutrients expect calcium and vitamin A. The intakes of fat, cholesterol, saturated fatty acid and the energy ratio from fat among the vegetarians were significantly lower than those of the non-vegetarians(p〈0.01). However, the vegetarians consumed significantly higher amounts of fiber and vitamin C compared to the non-vegetarians(p〈0.01). Also, the ratio of dietary polyunsaturated fatty acid/saturated fatty acid was significantly higher in vegetarians. The prevalence of obesity was 13.9% for vegetarians and 11.9% for non-vegetarians by criteria of BMI 25 as obese.

• Journal of Acupuncture Research
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• 제21권4호
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• pp.107-124
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• 2004

Objective : This The purpose of this study is to find out the effects of the Taeguk Gi Gong Exercise program on physical and physiological functions. Methods : The study is performed with one group pretest-posttest design. A total of 20 subjects are selected by convenience sampling, which are comprised of 11 researchers of a research center, and 9 nurses of a general hospital. The average age of the subjects is 26.3 years old. The Taeguk Gi Gong Exercise program is consisted of 30-minute main exercise and 10-minute finishing exercise. During the first two weeks, the 40 minute program was conducted in a group, 5 times per week. From the third week, it was conducted 3 times per week, twice in a group and once individually by watching video. All of the subjects were examined for the vital signs, blood sugar, body weight, and the flexibility of joint before and after conducting the program. Results : The results of the study are as follows: 1. After the Taeguk Gi Gong Exercise, the systolic blood pressure increased, and there is no change in the diastolic blood pressure, but all of them are not significant. 2. After the Taeguk Gi Gong Exercise, the pulse decreased, but not significant. 3. After the Taeguk Gi Gong Exercise, the blood sugar increased, but not significant. 4. After the Taeguk Gi Gong Exercise, the body weight reduced significantly. 5. After the Taeguk Gi Gong Exercise, the flexibility of waist significantly increased. 6. After the Taeguk Gi Gong Exercise, the flexibility of arm significantly increased(Left : t=-4.219, p=.000, Right : t=-2.74, p=.013). Conclusion : Based on the results described above, it is considered that the Taeguk Gi Gong Exercise program is clearly effective in decreasing body weight and flexibility of joint.

• 간호행정학회지
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• 제7권3호
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• pp.473-485
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• 2001

This study is intended to develop a reliable and appropriate instrument of the clinical nursing education. This research consisted of 4 steps. First step is construction of the content validity by 1 Korean literature professor and 1 teaching professor in Ga Chon Gil College, the pilot study for the content validity by 14 professors and survey with four points Likert Scale, which includes from the point 'strongly valid' to the point of 'strongly non-valid', by 113 head nurses who guide and evaluate the students in clinical practice. The third step is the test of validity and reliability of the preliminary evaluation tool. The fourth step is the test of validity and reliability of the developmental evaluation tool. The data were collected from Sep. 10th, 2001 to Sep. 28th, 2001. This study was analyzed by SPSS PC+ for descriptive statistics, factor analysis and Cronbach's Co-efficient Alpha of the collected data. The results of these analysis are like as follows. 1. Evaluation tool of Clinical practice consists of 16 items including four categories : factor 1 was labeled 'desirable attitude'(5 items), factor 2 was labeled 'correctly judgement and nursing problem solving'(4 items), factor 3 was labeled 'adaptive ability of nursing knowledge and skill'(4 items), factor 4 was labeled 'desirable human relationship'(3 items) and these contributed 71.992% of the variance in the total score. 2. Cronbach's Co-efficient Alpha for internal consistency was .9128 for the total 16 items. For further research, it need to develop a variable and reliable instrument of the student self-evaluation and instrument that based on community.

• 간호행정학회지
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• 제10권1호
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• pp.83-96
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• 2004

Purpose: The purpose of this research is, by investigating organizational characteristics, types of nursing organizational culture and team effectiveness in ICU, to ascertain the type of nursing organizational culture and the organizational characteristic that can improve the team effectiveness. Method: The research targeted 427 nurses from 33 ICUs of 14 general hospitals which have more than 250 beds and the data were gathered by using self-report questionnaires from April 10, 2003 to April 24, 2003. For this research, the following tools were used; the tool for measuring organizational characteristics and organizational cultures and the tool for measuring team effectiveness. Result: The most significant nursing organizational characteristic in ICU is the centralization. The organizational culture in ICU is generally rank-oriented culture. There was a significant difference (p<.01) in four types of organizational cultures; relation-oriented, innovation-oriented, rank-oriented and task-oriented. Verifying influence power of organizational cultures upon team effectiveness of ICU, relation-oriented culture had 49.2% of an influence upon team effectiveness, innovation- oriented and relation-oriented culture had 60.4% of an influence, and rank-oriented, innovation-oriented and relation-oriented culture had 61.2% of an influence. The organizational culture profiles according to the types of nursing organizational cultures in 33 ICUs were found by a cluster analysis. They were classified into five culture profiles; strong balance culture profile, weak balance culture profile, innovation-oriented and task-oriened culture profile, strong relation culture profile and strong rank culture profile(p<0.5). According to me organizational culture profiles, a significant difference of team effectivenesses(coworker satisfaction, team performance perception, team satisfaction and team commitment) was found(p<.01). The strong balance culture profile had the best team effectivenesses. Conclusion: For nursing culture management, a nursing administrator should identify the relevant nursing organizational culture at first by utilizing an innovative team-leader. After identifying the organizational culture, the administrator should make strategic plans and practices that can distinguish good organizational cultures to be expanded from ones to be sublated so that a strong balance culture can be developed.