• 제목/요약/키워드: after-school science program

검색결과 1,144건 처리시간 0.026초

전인적 지지간호중재가 두경부암 수술환자의 절망감, 자아존중감 및 자아개념에 미치는 효과 (Effect of Supportive Nursing Intervention on Hopelessness, Self-Esteem, Self-Concept of Operative Patient with Head and Neck Cancer)

  • 석정희;강은실;최화숙
    • Journal of Hospice and Palliative Care
    • /
    • 제7권2호
    • /
    • pp.189-199
    • /
    • 2004
  • 목적: 본 연구는 전인적 지지간호중재가 수술한 두경부암 환자의 절망감, 자아존중감, 자아개념에 미치는 효과를 규명하기 위한 비동등성 대조군 전 후 시차 유사실험 설계연구이다. 방법: 연구대상은 P시에 소재한 K 대학교 부속 병원에서 두경부암으로 진단 후 수술을 받은 입원환자로써 대조군 20명, 실험군 20명으로 총 40명이었다. 자료수집 기간은 대조군이 1999년 12월 1일부터 2000년 2월 19일까지였고, 실험군은 2000년 2월 17일부터 4월 11일까지였다. 연구도구는 실험도구로서 전인적 지지간호중재 protocol은 연구자가 문헌고찰을 중심으로 전문가의 도움을 받아 제작한 것으로 신체적, 정서적, 정보적, 영적중재로 구성되어 있다. 측정도구는 절망감을 측정하기 위해 Beck(1974)의 절망감 측정도구를[15]이 번역한 척도를 사용하였다. 자아존중감에 대한 측정도구는 [29]가 개발하고 [41]가 번역한 도구를, 자아개념에 대한 측정도구는 [20] 등이 사용한 것을 [21]이 수정보완한 도구를 사용하였다. 자료처리는 SPSS/PC 9.0 프로그램을 이용하여 실수, 백분율, 평균, 평균평점, 표준편차, $x^2-test$, t-test로 분석하였다. 결과: 본 연구의 결과는 아래와 같았다. 1. 제 1가설 '전인적 지지간호중재를 받은 실험군은 받지 않은 대조군보다 절망감 정도가 낮을 것이다' 는 지지되었다(t=4.550, P=.000). 2. 제 2가설 '전인적 지지간호중재를 받은 실험군은 받지 않은 대조군보다 자아존중감 정도가 높을 것이다' 는 지지되었다(t=-6.442, P=.000). 3. 제 3가설 '전인적 지지간호중재를 받은 실험군은 받지 않은 대조군보다 자아개념 정도가 높을 것이다'는 지지되었다(t=-6.065, P=.000) 결론: 전인적 지지간호중재는 두경부암 수술환자의 절망감 감소와 자아존중감, 자아개념의 증진시키는데 효과가 있으므로, 두경부암 환자의 삶의 질을 위해 임상실무에 전인적 지지간호중재 프로토콜을 적용할 필요가 있으리라 사료된다.

  • PDF

3차원 유한요소법에 의한 임플란트 지지 3본 고정성 가공 의치의 부적합도가 인접골 응력에 미치는 영향 분석 (Finite Element Analysis of Bone Stress Caused by Horizontal Misfit of Implant Supported Three-Unit Fixed Prosthodontics)

  • 이승환;조광헌
    • 구강회복응용과학지
    • /
    • 제28권2호
    • /
    • pp.147-161
    • /
    • 2012
  • 본 연구에서는 유한요소해석 방법을 사용하여 임플란트 지지 3본 고정성 가공 의치에 수평적인 부적합이 존재할 때 그 정도가 임플란트 인접골 응력 발생에 미치는 영향에 대해 조사하였다. 3본 고정성 가공의치, 임플란트/악골 복합체로 구성된 해석 모델은 3차원으로 연구되었다. 3본 고정성 가공의치의 체결 간격은 하악 제2 소구치와 제2 대구치에 17.9mm 거리로 식립된 임플란트 간격에 비해 0.1mm 짧거나(17.8mm), 0.1mm 길게(18.0mm) 모델링하였다. 3본 고정성 가공의치와 임플란트 지대주 간의 체결은 총 6단계로 모사되었고 각 단계별로 가공의치가 하방으로 0.1mm 씩 변위되었다. 유한요소해석에는 PC용으로 출시된 DEFORM$^{TM}$ 3D 프로그램(ver 6.1, SFTC, Columbus, OH, USA)을 사용하였다. 3본 고정성 가공의치와 임플란트 사이의 응력은 von-Mises 응력, 최대 압축 응력, 필요한 경우 방사상 응력을 평가하였다. d=18.0mm인 모델에서는 가공의치와 지대주간의 체결이 이루어지지 않은 반면, d=17.8mm 인 모델에서는 성공적으로 체결이 가능했다. 체결 여부를 떠나 과도하게 높은 응력이 체결과정과 그 이후에 발생되었는데, 17.8mm 모델의 경우 체결완료 후에도 임플란트 주위 변연골에서 잔류하는 인장 및 압축 응력이 각각 최대 186.9MPa과 114.1MPa이었다. 이 경우 임플란트로부터 2mm 떨어진 부분까지 압축 응력이 골개조 장애 임계 응력인 55MPa($4,000{\mu}{\varepsilon}$과 같은 크기)보다 크게 측정되었다. 3본 고정성 가공의치의 0.1mm 크기의 수평적 부적합은 체결 과정뿐만 아니라 완료 후에도 인접 변연골에 높은 응력을 발생시킬 수 있다.

베트남 농업구조개혁과 협동조합의 계약영농: 중부베트남의 농촌을 사례로 (Contract Farming Through a Cooperative to Boost Agricultural Sector Restructuring: Evidence from a Rural Commune in Central Vietnam)

  • 드응 티 투 하;김두철
    • 한국경제지리학회지
    • /
    • 제25권1호
    • /
    • pp.109-130
    • /
    • 2022
  • 베트남 정부는 농업구조개혁을 위해 새로운 협동조합을 통한 계약농업을 추진하고 있으며, 베트남 농민은 정책에 따른 구조 전환의 영향을 직접적으로 받고 있다. 따라서 정책 과정에 따른 농민들의 토지이용 및 생존전략을 이해하는 것은 이러한 농업개발정책에 있어 필수적이라 할 것이다. 이 연구는 중부 베트남의 전형적인 농촌 마을 중 하나인 빈다오사(社)(Binh Dao commune)를 대상으로 이루어졌다. 이 논문에서는 먼저 GIS을 이용한 토지이용 변화 분석 및 190명의 농민과의 심층 인터뷰를 통해 계약농업 도입 전후의 농촌 노동력 구조와 생업활동의 변화와 그 원인을 분석하였다. 그 결과, 새로운 협동조합을 통한 계약농업은 농민-협동조합-농산물판매회사로 이어지는 수직적 가치사슬을 형성하고, 기계화를 통한 효율적 토지이용에 기여하여, 생산성을 향상시키고 농산물 시장가격의 리스크로 부터 농민들을 보호하는 순효과를 가져왔다는 것이 밝혀졌다. 한편, 이러한 긍정적인 효과에도 불구하고, 베트남의 협동조합을 통한 계약농업은 애초에 의도했던 농촌 노동력을 비농업부문으로 재배치하지는 못한 것으로 나타났다. 오히려 빈다오사(社)의 농민들은 농업구조개혁 과정에서 경작면적을 늘리려는 경향이 있었다. 즉, 베트남 농촌지역의 제한적인 농외 취업기회로 인해, 빈다오사(社)의 농민들은 기계화와 생산성 향상으로 생긴 잉여 가족노동력을 역설적으로 농업부문에 집중시키는 생존전략을 선택한 것으로 보여된다. 그 결과 빈다오사(社)의 농민들은 협동조합의 계약농업을 통한 농업구조개혁에도 불구하고 여전히 가족노동력에 의존한 소농체제에 머물러 있다.

간호원의 환자교육 활동에 관한 연구 (Study of Patient Teaching in The Clinical Area)

  • 강규숙
    • 대한간호학회지
    • /
    • 제2권1호
    • /
    • pp.3-33
    • /
    • 1971
  • Nursing of today has as one of its objectives the solving of problems related to human needs arising from the demands of a rapidly changing society. This nursing objective, I believe, can he attained by the appropriate application of scientific principles in the giving of comprehensive nursing care. Comprehensive nursing care may be defined as nursing care which meets all of the patient's needs. the needs of patients are said to fall into five broad categories: physical needs, psychological needs, environmental needs, socio-economic needs, and teaching needs. Most people who become ill have adjustment problems related to their new situation. Because patient teaching is one of the most important functions of professional nursing, the success of this teaching may be used as a gauge for evaluating comprehensive nursing care. This represents a challenge foe the future. A questionnaire consisting of 67 items was distributed to 200 professional nurses working ill direct patient care at Yonsei University Medical Center in Seoul, Korea. 160 (80,0%) nurses of the total sample returned completed questionnaires 81 (50.6%) nurses were graduates of 3 fear diploma courser 79 (49.4%) nurses were graduates of 4 year collegiate nursing schools in Korea 141 (88,1%) nurses had under 5 years of clinical experience in a medical center, while 19 (11.9%) nurses had more than 5years of clinical experience. Three hypotheses were tested: 1. “Nurses had high levels of concept and knowledge toward patient teaching”-This was demonstrated by the use of a statistical method, the mean average. 2. “Nurses graduating from collegiate programs and diploma school programs of nursing show differences in concepts and knowledge toward patient teaching”-This was demonstrated by a statistical method, the mean average, although the results showed little difference between the two groups. 3. “Nurses having different amounts of clinical experience showed differences in concepts and knowledge toward patient teaching”-This was demonstrated by the use of a statistical method, the mean average. 2. “Nurses graduating from collegiate programs and diploma school programs of nursing show differences in concepts and knowledge toward patient teaching”-This was demonstrated by a statistical method, the mean average, although the results showed little difference between the two groups. 3. “Nurses having different amounts of clinical experience showed differences in concepts and knowledge toward patient teaching”-This was demonstrated by the use of the T-test. Conclusions of this study are as follow: Before attempting the explanation, of the results, the questionnaire will he explained. The questionnaire contained 67 questions divided into 9 sections. These sections were: concept, content, time, prior preparation, method, purpose, condition, evaluation, and recommendations for patient teaching. 1. The nurse's concept of patient teaching: Most of the nurses had high levels of concepts and knowledge toward patient teaching. Though nursing service was task-centered at the turn of the century, the emphasis today is put on patient-centered nursing. But we find some of the nurses (39.4%) still are task-centered. After, patient teaching, only a few of the nurses (14.4%) checked this as “normal teaching.”It seems therefore that patient teaching is often done unconsciously. Accordingly it would he desirable to have correct concepts and knowledge of teaching taught in schools of nursing. 2. Contents of patient teaching: Most nurses (97.5%) had good information about content of patient teaching. They teach their patients during admission about their diseases, tests, treatments, and before discharge give nurses instruction about simple nursing care, personal hygiene, special diets, rest and sleep, elimination etc. 3. Time of patient teaching: Teaching can be accomplished even if there is no time set aside specifically for it. -a large part of the nurse's teaching can be done while she is giving nursing care. If she believes she has to wait for time free from other activities, she may miss many teaching opportunities. But generally proper time for patient teaching is in the midmorning or midafternoon since one and a half or two hours required. Nurses meet their patients in all stages of health: often tile patient is in a condition in which learning is impossible-pain, mental confusion, debilitation, loss of sensory perception, fear and anxiety-any of these conditions may preclude the possibility of successful teaching. 4. Prior preparation for patient teaching: The teaching aids, nurses use are charts (53.1%), periodicals (23.8%), and books (7.0%) Some of the respondents (28.1%) reported that they had had good preparation for the teaching which they were doing, others (27.5%) reported adequate preparation, and others (43.8%) reported that their preparation for teaching was inadequate. If nurses have advance preparation for normal teaching and are aware of their objectives in teaching patients, they can do effective teaching. 5. Method of patient teaching: The methods of individual patient teaching, the nurses in this study used, were conversation (55.6%) and individual discussion (19.2%) . And the methods of group patient teaching they used were demonstration (42.3%) and lecture (26.2%) They should also he prepared to use pamphlet and simple audio-visual aids for their teaching. 6. Purposes of patient teaching: The purposes of patient teaching is to help the patient recover completely, but the majority of the respondents (40.6%) don't know this. So it is necessary for them to understand correctly the purpose of patient teaching and nursing care. 7. Condition of patient teaching: The majority of respondents (75.0%) reported there were some troubles in teaching uncooperative patients. It would seem that the nurse's leaching would be improved if, in her preparation, she was given a better understanding of the patient and communication skills. The majority of respondents in the total group, felt teaching is their responsibility and they should teach their patient's family as well as the patient. The place for teaching is most often at the patient's bedside (95.6%) but the conference room (3.1%) is also used. It is important that privacy be provided in learning situations with involve personal matters. 8. Evaluation of patient teaching: The majority of respondents (76.3%,) felt leaching is a highly systematic and organized function requiring special preparation in a college or university, they have the idea that teaching is a continuous and ever-present activity of all people throughout their lives. The suggestion mentioned the most frequently for improving preparation was a course in patient teaching included in the basic nursing program. 9. Recommendations: 1) It is recommended, that in clinical nursing, patient teaching be emphasized. 2) It is recommended, that insertive education the concepts and purposes of patient teaching he renewed for all nurses. In addition to this new knowledge, methods and materials which can be applied to patient teaching should be given also. 3) It is recommended, in group patient teaching, we try to embark on team teaching.

  • PDF