• 제목/요약/키워드: Ward structure by observation

검색결과 5건 처리시간 0.023초

정신요양 병동에서의 관리영역과 환자의 요양 공간영역의 관찰적 시선에 따른 병동구조와 요양 공간환경의 특성에 관한 연구 (Characteristics of Spatial Environment in Psychiatric Wards through the Analysis by Patient's Preferred Healing Environment in Observational Ward Structure Dividing Staff Area and Patient Area)

  • 주용선
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제27권2호
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    • pp.57-64
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    • 2021
  • Purpose: The relationship between the staff area and the patient's private area is the key factor in designing the structure and the environmental characteristics of ward spaces in a psychiatric hospital. Recent research has found that for the purpose of treatment and securing privacy, psychiatric patients need to be in an open space of relief rather than closed confined environment and under the watch of nursing staffs. Methods: A survey at three kinds of wards in a private psychiatric hospital in Japan was conducted in October 2002. These wards include an acute ward, a psychiatric convalescence ward, and a stress care ward. All three kinds of wards have the same structure. At each ward, spatial preferences of the 145 psychiatric inpatients were surveyed and data concerning the patient's diagnostic category, symptoms, and activities of daily living were recorded. Results: The patients in the stress care ward prefer to stay in private spaces than public spaces. On the other hand, in the acute ward the patients seem to have a preference between managed public spaces where are monitored by nursing staffs and their private rooms where the nurse station is close. In addition, the patients in the psychiatric convalescence ward spend most of their time in the public space, such as the hallways or the day room. Implications: Base on this research, the spaces at the acute ward that could be monitored by the nursing station serves effectively as a safety space for patients was concluded. However, in the stress care ward, the patients may perceive the monitoring by the nursing staff as interruption or nuisance to their relaxation. In order to design an ideal healing environment for psychiatric patients in psychiatric ward, it is important to consider how environmental characteristics of space affect the environmental sense of patients in each ward.

만성 재가 기동장애자의 가정병실 모델 개발을 위한 현장 연구 (A Ethnographic Field Study for a Model Development of the Chronic Bed-ridden Patient s Home-ward)

  • 김태연;정연강
    • 대한간호학회지
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    • 제24권4호
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    • pp.597-615
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    • 1994
  • This study is designed to facilitate the creation of home environment conducive to the family taking care of chronic bed-ridden patients with more effective method. The need for this study has emerged against the background of marked changes in the structure of ailments and causes of death, resulting in the number and plights of chronic bed-ridden patients as well as of a rapid increase in demand for medical care and resulting premature discharge. Keeping these in mind, this study focused on home-wards where the majority of chronic bed-ridden patients are being cared for. Despite. their overriding importance, home-words are less than efficient in caring (or chronic bed-ridden patients. These circumstances require the designing of home-wards that can offer greater comfort to patients and at the same time make things easier for caregivers, on the basis of an overall analysis of patients' life and home - ward situation. According1y this study adopted a Participant Observation Method derived cultural anthropology, Toward this end, 3 patients were chosen as subjects of this study for intensive interviewing and participant observation. In the process of this field re-search efforts were made to collect emprical data, that is, to faithfully record the words of the subjects and their caregivers for analysis and interpretation. The findings of these analyses are as follows. Firstly, the chronic bed-ridden patients are mostly being taken care by close family members. Secondly, a room for the exclusive use of the patient, floor, kitchen, bathroom and multipurpose space were found to be necessary for proper caring of the patient. These spaces were respectively used with a view to 1) accomodating the patient as well as caregivers' activities, 2) keeping general and medical supplies and other appliances for patient's care and drying the patient's washing, 3) preparing and keeping the patient's foods and beverages, 4) keeping the supplies necessary for cleaning the patient's body and treating the patient's eliminations, 5) washing the patient's clothes, underwears and bedclothes. The patient's room in turn is subdivided into six portions in terms of uses : specifically the places for accomodating 1) the patient, 2) medical supplies, 3) medicines, 4) linens St clothes, 5) bedclothes and, 6) diapers. Thirdly, the activities of the caregiver are subdivided into seven key areas : hygiene, exercise, diet, elimination, therapeutic nursing, prevention of sore, and other activities. Each area is further classified into several different activities of caring. These activities we mainly carried out in the patient's room. Fourthly, the supplies for caring the chronic bed-ridden patient is divided into two large domains : medical and general supplies. Finally, three main problems areas were found in this study on the part of caregivers, that is, sore prevention, hygiene problem related frequent urination / defecation, the caregiver's physical, psych ological and emotional burden. In consideration of the aforesaid problem areas, a model home-ward was developed in this study. The newly-developed model has been found to have the following six advantages. Firstly, the time and effort required for maintaining the patient's hygiene are reduced, thus relievins the caregiver's physical and psychological bur-den. Secondly, the patient's hygiene can be maintained in satisfactory conditions, because the patient's eliminations are more easily removed. Thirdly, skin irritations caused by the patient's eliminations were remarkably reduced and so were the patient's sores due to moisture and bacteria. Fourthly, the home-ward have a tilt-table ef-fect thanks to the inclining room floor. This improves the patient's cardiovascular function as well as constantly changes pressed skin areas and thus prevents sores. Fifthly, improved shelf arrangements help make the best use of patient's supplies. Sixthly, the trouble of continuously changing clothes, underwears, diapers & bedclothes is remarkably reduced simply by covering the patient with cotton sheets when laid in bed. This is espected to cut down expenses by reducing the comsumptions of diapers and other disposable supplies.

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English Predicate Inversion: Towards Data-driven Learning

  • Kim, Jong-Bok;Kim, Jin-Young
    • 영어영문학
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    • 제56권6호
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    • pp.1047-1065
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    • 2010
  • English inversion constructions are not only hard for non-native speakers to learn but also difficult to teach mainly because of their intriguing grammatical and discourse properties. This paper addresses grammatical issues in learning or teaching the so-called 'predicate inversion (PI)' construction (e.g., Equally important in terms of forest depletion is the continuous logging of the forests). In particular, we chart the grammatical (distributional, syntactic, semantic, pragmatic) properties of the PI construction, and argue for adata-driven teaching for English grammar. To depart from the arm-chaired style of grammar teaching (relying on author-made simple sentences), our teaching method introduces a datadriven teaching. With total 25 university students in a grammar-related class, students together have analyzed the British Component of the International Corpus of English (ICE-GB), containing about one million words distributed across a variety of textual categories. We have identified total 290 PI sentences (206 from spoken and 87 from written texts). The preposed syntactic categories of the PI involve five main types: AdvP, PP, VP(ed/ing), NP, AP, and so, all of which function as the complement of the copula. In terms of discourse, we have observed, supporting Birner and Ward's (1998) observation that these preposed phrases represent more familiar information than the postposed subject. The corpus examples gave us the three possible types: The preposed element is discourse-old whereas the postposed one is discourse-new as in Putting wire mesh over a few bricks is a good idea. Both preposed and postposed elements can also be discourse new as in But a fly in the ointment is inflation. These two elements can also be discourse old as in Racing with him on the near-side is Rinus. The dominant occurrence of the PI in the spoken texts also supports the view that the balance (or scene-setting) in information structure is the main trigger for the use of the PI construction. After being exposed to the real data and in-depth syntactic as well as informationstructure analysis of the PI construction, it is proved that the class students have had a farmore clear understanding of the construction in question and have realized that grammar does not mean to live on by itself but tightly interacts with other important grammatical components such as information structure. The study directs us toward both a datadriven and interactive grammar teaching.

대퇴경부 골절 환자의 입원 생활 (The Hospital Life of the Patient with Femoral Neck Fracture)

  • 김경자;지성애
    • 간호행정학회지
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    • 제2권1호
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    • pp.35-56
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    • 1996
  • Nowerdays, the increase of traffic accidents and old age population make the Femoral Neck Fracture(FNF) patients increase. By the improvement of education and standard of living the patients demand better medical service than before. This study is designed to give practical help for the FNF patients by observing their hospital life and establish practical nursing strategies for the FNF patients. For these purposes the Ethnographic Participant Observation was adopted. By this study is focused on the hospital life patient's view. For this end, the field study adopted orthopedic ward in the C University Hospital with 400 beds in Seoul. The object patients of the study were twelve patients. The patients experienced five stages : Embarrassment, Conflict, Stability, Independent, and Extension Stage. The findings and prepared nursing strategies are stated as follows. First, in the Embarrassment Stage they suffered embarrassment, anxiety, pain, they could not do ordinary things. The patients who accidental fractures had anxiety from unfamiliar tests and from hospitalization itself. They lamented that they could not ordinary things, and do nothing but obeying the hospital, and endure the pain. They recognized the changed environment and resigned themselves to life in the ward. In this stage, full openness by the nurses is needed. Second, the attribute of the Conflict Stage were conflict, fear, curiosity, belief, reflection. When they sign the consentment form, they experience conflicts about the possibility of complication, fear of recovery from anesthesia, curiosity about the operation procedure, post - operation state, reflection on their past life, and promise to care for their family members after discharge and keep their religious life faithfully. And they accepted the operation depending on God, believing in modern medicine, and the surgeon. Asking for their changed informations, they expected positive results from the operation. In this stage, an empathic attitude by the nurses is needed. Third, the attribute of the Stability Stage were relief, gratitude, difficulty with excretion, and pain. When they awoke from anesthesia, they felt relief because of a the end of the operation, but they experienced extreme pain, difficulty of excretion in bed. They accepted the changed environment and expected recovery. In this stage, support by the nurses is needed. Fourth, the attributes of the Independence Stage were freedom, exercise, nurturing, anxiety, and discomfort. When they ambulated and exercised, they experienced freedom. They showed exhibited weakness of the digestive organs and discomfort hospital's space, structure, and facilities, the delay of medical certificate issue the lack of prompt response by the medical agents. They ate nurturious food and felt anxiety on the end of hospital life and returning to their ordinary life. They showed the independence of overcoming their environment by increasing exercise and expected their discharges. In this stage, respect by the nurses is needed for the patients to, overcome their environment and prepare for their independence. Fifth, the attributes of the Extension Stage were pessimism, isolation, dissatisfaction, and pain. Accompanied injury and old age made their ward life extend to over seven weeks. They exhibited weariness, melancholy, skeptisis, general pessimistic feeling, and desperation caused by their isolated life. They experienced the digestive discomfort caused by the prolonged medication and psycological pain caused by long-time hospitalization. As a, result, their dissatisfaction on the human, physical, and systematic environments had been increased. They acquired critical power and sought for something to do spending their time. They expected vaguely about the returning of their ordinary life. In this stage, counseling is needed by the nurse to overcome positively their psychological, social, and physical problems. The process of the FNF patient's ward life starts from the dependent state, when they are hospitalized, and gradually progresses to self-fulfillment in order to keep independent life. As a result, the FNF patients showed "Response in Challenge" or "Adaptation in Conflict" through their experiences of social, physical, and psychological difficulties.

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의대생들의 과제해결기반 병원 내 진료지원부서 현장체험에 관한 현상학적 분석 (Phenomenological Analysis of the Task-Based Field Experience for Medical Students: Focusing on the Medical Care Support Department in the Hospital)

  • 박귀화
    • 한국콘텐츠학회논문지
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    • 제20권8호
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    • pp.152-161
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    • 2020
  • 본 연구의 목적은 의과대학 1학년을 대상으로 병원 내 진료지원 부서에 대한 과제해결 기반의 현장체험 프로그램을 운영한 후, 학생들의 경험과 그 의미를 현상적으로 분석하는 것이다. 병원 내 진료지원 부서로 간호부(병동과 외래, 중환자실), 인공신장실, 의무기록실, 약제부, 진단의학검사실, 영상의학실, 원무팀, 고객상담센터, 장기이식센터, 국제의료센터를 선정하였다. 학생들은 부서를 방문하여, 인터뷰, 관찰, 직접 시행 등의 다양한 방법을 활용하여 주어진 과제를 해결하고, 프로그램 만족도와 자기성찰 에세이를 작성하였다. 그 결과 프로그램 만족도에서, 학생들은 병원 내에 많은 직종과 역할이 있고, 보건의료 직종의 역할을 이해하게 되었다는 것을 가장 높게 평가하였다. 학생들이 작성한 성찰일지에 나타난 현장체험학습 경험에 대한 본질적 주제는 현실을 인식에서는 '체험이 주는 이상과 현실의 괴리'로 나타났으며, 존중과 협력에서는 '다른 직종의 전문성 인정과 존중', '팀이라는 인식 형성'이 나타났으며, 경험으로부터의 자기성찰에서는 '내면의 변화'가 나타났다.