• Journal of Hospice and Palliative Care
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• 제19권3호
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• pp.233-239
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• 2016

목적: 말기암환자 가족간병인의 사별가족 연구참여와 관련된 요인에 대해서는 알려진 바가 적다. 본 연구에서는 사별가족 연구에 실제 참여를 예측하는 임종 전 요인에 대해 살펴보고자 한다. 방법: 임종 전과 사별 후에 시행된 다기관 조사연구 자료를 이용하여, 전향적 관찰연구를 진행하였다. 사별가족 연구 참여와 관련된 요인을 추출하기 위해, 단계적 다변량 로지스틱 회귀분석을 이용하였다. 결과: 185명의 사별가족 중, 30명이 사후조사에 참여하였다(응답률: 16.2%). 사후조사 참여군과 비참여군은, 종교, 경제적 상태 그리고 임종 전 인지되었던 돌봄의 질에서 차이를 보였다. 최종 다변량 모델에 의하면, 종교를 가지고 있던 가족(adjusted odds ratio [aOR]=5.01, P=0.008), 높은 경제수준을 가진 가족(aOR=4.86, P=0.003) 그리고 가족 내 관계형성에 대한 돌봄에 만족했던 가족(aOR=4.49, P=0.003)이 그렇지 않은 가족에 비해 더 사후 연구에 참여를 하였다. 결론: 본 연구에 의하면, 임종기 돌봄의 질을 향상시키는 것은 사후 고통을 줄임으로써 사별가족연구에의 참여를 촉진시킨다. 사별가족 연구참여를 망설이는 사별가족들의 특성에 관심을 가질 필요가 있다.

• 대한물리의학회지
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• 제13권1호
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• pp.27-38
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• 2018

PURPOSE: The purpose of this study was to find out the treatment patterns of Children with cerebral palsy, and to analyze the effect of physical function level and treatment intensity on improvement of physical function in children with cerebral palsy for six months. METHODS: Participants were 126 children (boys 83, girls 43) diagnosed cerebral palsy that the mean age was at 33months, ranged from 8 months to 77 months. We collected data related on demography and disable characteristic, treatment pattern using by questionnaire constructed ourselves for six months on caregivers. The treatment pattern includes, type, frequency, and institute of treatment. We performed the evaluation of Gross Motor Function Measurement (GMFM) and Pediatric Evaluation of Disability Inventory (PEDI) between pre and post for six months in order to find out improvement of physical function. We analyzed the effect of physical functional level measured by Gross Motor Functional Classification system, age, treatment intensity on physical function using by repeated measures ANOVA for SPSS PC ver. 22.0. RESULTS: The average of treatment frequency for physical therapy was 5.74 times per week, occupational therapy was 3.96 times, speech therapy was 2.96 times, treatment for accompanying disability was 3.12 times. Physical function level and age was significantly factors affecting improvement of physical function, there was no significant difference according to treatment intensity. CONCLUSION: We suggest that physical function and age might be important factors on improvement of physical function and professional rehabilitation team must consider the appropriate treatment type customized to each children.

• 한국사회복지학
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• 제57권2호
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• pp.185-204
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• 2005

본 연구는 계속 증가하고 있는 케어 수요를 충당하기 위해 영국 정부가 시행해 온 정책과 제도를 살펴보았다. 영국 정부는 최근 케어 수요와 공급 간의 불균형이 초래할 문제를 심각하게 인식하고, 가족과 시장의 적극적인 참여를 유도하고 있다. 이 두 영역에 대해 초기의 의도와는 달리 점차 국가의 적극적인 개입이 이루어지고 있는데, 비공식적 보호자인 케어러에 대해서는 보상과 인정을 주는 형태로, 공식적 보호자인 유급 케어워커에 대해서는 규제와 감독 강화를 통한 질적 통제라는 형태로 정부 기능은 점차 확대되고 있다. 케어러의 지위와 권리 향상을 위해 3가지 법률이 제정되었으며, 유급 인력의 자격 강화를 위해 케어기준법과 그에 기반 한 5가지 공식 기구가 발족되었다. 이러한 제도적 정비 과정에서 영국은 비공식적 보호자에 대해서는 적극적 시민권이란 새로운 이념으로, 유급 케어워커에 대해서는 사회서비스의 현대화 가치라는 이념으로 그 기반을 다지고 있다. 그러나 영국의 케어 정책은 점차 혼자서 살아가기 어려운, 시장에서 케어를 사적으로 구입하기가 어려운 보다 열악한 환경에 놓인 서비스 이용자들을 외면하는 방향으로 나아가고 있다는 비판에 직면하고 있다.

• 대한감각통합치료학회지
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• 제13권2호
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• pp.31-41
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• 2015

목적 : 본 연구의 목적은 만 3~5세 아동의 감각처리 문제를 선별할 수 있는 아동감각처리척도(Sensory Processing Scale for Children: SPS-C)를 개발하여 타당도를 검증하는 것이다. 연구방법 : 아동감각처리척도를 개발한 뒤, 만 3~5세 아동 138명의 보호자를 대상으로 평가를 시행하였다. 평가도구의 구성타당도를 검증하기 위해 수집된 자료를 대상으로 라쉬분석을 통해 단일차원모형의 적합성과 평정척도의 적합성을 분석하였다. 결과 : 라쉬분석 결과 총 56개 항목 중 6개 항목(10.7%)이 부적합한 것으로 나타났다. 또한 평정척도 분석 결과 5점 척도보다 3점 척도가 더 적합한 것으로 나타났다. 결론 : 본 연구를 통해 아동감각처리척도의 구성타당도를 검증하였으며, 추후 연구에서는 최종적으로 수정 보완된 한국형 감각처리척도를 대상으로 신뢰도와 기타 타당도 검증을 하여야 할 것이다.

• 성인간호학회지
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• 제13권2호
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• pp.209-222
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• 2001

The environment in the ICU leads to negative changes in a patient's usual sleep pattern and so contributes negatively to the patient's health condition as compared to patients in general wards. Therefore, it is thought that an important nursing intervention would be to identify the relation between noise and sleep patterns which play an important role in illness recovery. The purpose of the present study was to explore the relationship between noise in the ICU and the sleep pattern of patients admitted to the ICU. A descriptive correlation design was used to examine the relationship. Thirty-four subjects were recruited from a Medical ICU (MICU), Surgical ICU (SICU) and Coronary Care Unit (CCU) at a large university hospital in Suwon. Data were collected from September 28 to October 31 in 1999. In the present study, noise was categorized into noise level and patients' perception of noise. The objective noise level was measured using the A-Weighted Sound Level Meter. The patients' preception of noise was measured using a self-reported questionnaire developed by the researcher. Sleep patterns in this study includes both quantity and quality of sleep. These were measured using open ended questionnaires and the 'Korean Sleep Scale A' developed by Oh, Song, Kim(1998). The data was analyzed using the SPSS-WIN to test the research question, Pearson product moment correlation coefficient was run. Ancillary analysis were conducted with demographic variables to determine their relation to the main study variables. For the ancillary analysis, t-test and one-way ANOVAs were performed. The results of the present study are summerized as follows : 1. The total mean of objective noise level (10pm-6am) was 56.2dB. The means for night time noise level in individual ICUs for the SICU, MICU and CCU, were 58.7dB, 58.6dB and 48.3dB, respectively. The total mean for patients' noise perception was 42.8 out of a maximum possible score of 76. For item means of noise perception, the one ranked highest was "conversations between doctors and nurses" (3.2). The one ranked lowest was "noise from the radio" (1.2). Regarding the degree of perception for each type of noise source, the one ranked highest was "equipment noise" (2.6), the second was "conversation between medical staff" (2.4), the third was "conversation between patients, caregivers and visitors" (2.3), and the one ranked lowest was "environment noise" (1.8). 2. Looking at quantity of sleep of ICU patients, the mean nocturnal sleep time was found to be 4.9 hours. The total mean of sleep quality for ICU patients was 21.0 out of a maximum possible score of 40. 3. The relationship between perception of noise and quantity of sleep was statistically significant(r= - .41, p<.05). The relationship between perception of noise and quality of sleep was also statistically significant(r= - .47, p<.01). The results of the study indicate that personal perception of noise is related to sleep patterns. Therefore, it is suggested that nursing interventions be developed to reduce the degree of personal perception of noise and, thus, decrease sleep pattern disturbances in patients in the ICU.

• 성인간호학회지
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• 제13권1호
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• pp.123-135
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• 2001

The purpose of this study is to analyze the structural pattern of nurses' pain management with patients who experience pain. As a research method, the Q methodology, which is useful for an objective view of a highly abstract concept, was applied. The data collecting activity of this study was from August, 21st, 2000 to November, 24th 2000. The Q-population, the previous thesis and a literature review were done. Questions about pain management by the nurse on the patients, caregivers, nursing students, doctors, nurses, and others were asked in documentary work and in-depth interviews. In all, 223 units of the Q-population were formed, and the last 35 units of the Q-population were extracted. The data on the P-sample was collected from 41 nurses who worked in the medical and surgical units of a hospital that belonges to C university in Seoul. The research results were constituted in 3 types. Type I was the 'pattern of judging by objectivity'. The statement on which most of the people highly agreed for those patterns was shown by 'If patients said that they are suffering from pain, we sufficiently performed an assessment about the etiology, location, duration and degree'. For type I, the same pain was found in different locations according to the patients, so the etiology of the pain should be identified first place. Since ways of coping are different according to pain etiology, it was thought that it is important to assess sufficiently the pain etiology, location, duration, and degree. Therefore, when patients complain of pain, the pain etiology should be identified and assessed; according to the result, pain management should be performed systematically. Type II was the 'pattern of accepting by subjectivity'. The statement on which most of the people highly agreed for those patterns was shown as 'If patients said that they are suffering from pain, the medical treatment should be performed rapidly and speedily.' For type II, when the patient complains of pain, treatment should be performed quickly in order to prevent the condition getting worse, and it is thought that activity is a reasonable duty. Further, by trying to show empathy after pain is admitted and by understanding and coping rapidly with the pain of patients, an attitude which matched the altruistic morals of nurses is being shown. Type III was the 'pattern of worrying about', and the statement on which most of the people highly agreed for those patterns was shown is 'When there is a pain, to help patients to tolerate the pain to the highest degree.' In type III, the pain is a subjective expression, so there is a difference according to every individual. Therefore, actually if there is no measurement of pain, it could be exaggerated so nurses should help patients to tolerate it to the utmost. Even if there is a way to remove pain without an analgesic drug, nurses were reluctant to perform pain management as they possibly could. Through these research results, pain management of nurses was classified in 3 types, and structural characteristics in each type were discovered. Based upon the characteristics according to the type, an individualized pain management intervention strategy should be established and the follow up work performed.

• 한국콘텐츠학회논문지
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• 제13권11호
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• pp.778-790
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• 2013

본 연구는 노인요양시설 노인에게 직접 돌봄을 제공하는 요양보호사가 시설노인의 낙상을 예방하고 낙상으로 인한 상해를 최소화하기 위해 노인요양시설의 요양보호사를 위한 낙상예방프로그램을 개발하였으며 낙상예방교육프로그램이 요양보호사의 낙상관련 지식, 낙상관련 부담감 및 낙상예방 돌봄행위에 미치는 효과를 검증하고자 하였다. 본 연구의 낙상예방교육프로그램은 4주 프로그램으로 주 1회 80분씩 총 4회 실시하였다. 프로그램 효과를 검증하기 위해 2012년 7월 16일부터 8월 31일까지 C지역의 A장기요양시설 요양보호사 실험군 24명, B장기요양시설 요양보호사 대조군 23명, 총 47명을 대상으로 프로그램 적용 전 후 사전 사후 조사를 실시하였다. 수집된 자료는 SPSS/Win 19.0 프로그램을 이용하여 실수와 백분율, 평균과 표준편차, ${\chi}^2$-test와 Fisher's exact probability test, independent t-test, ANCOVA로 분석하였다. 연구결과, 낙상예방교육프로그램을 받은 노인요양시설의 요양보호사는 교육을 받지 않은 요양보호사에 비해 낙상 예방교육프로그램 적용 후 낙상관련 부담감이 감소하였으며, 낙상관련 지식과 낙상예방 돌봄행위가 증가하였다. 따라서 본 연구에서 개발된 낙상예방교육프로그램은 노인요양시설 요양보호사의 낙상관련 지식과 낙상예방 돌봄행위를 증진하고 낙상관련 부담감을 완화하는 적절한 프로그램으로 노인노인요양시설 노인의 낙상예방을 위한 요양보호사의 교육자료로서 활용 가치가 있다 하겠다.

• Nutrition Research and Practice
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• 제9권3호
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• pp.278-287
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• 2015

BACKGROUND/OBJECTIVES: Diet plays an important role in growth and development of children. However, dietary intakes of children living in either rural or urban areas can be influenced by household income. This cross-sectional study examined energy, nutrient and food group intakes of 749 urban children (1-10 years old) by household income status. SUBJECTS/METHODS: Children's dietary intakes were obtained using food recall and record for two days. Diet adequacy was assessed based on recommended intakes of energy and nutrients and food group servings. RESULTS: For toddlers, all nutrients except dietary fiber (5.5 g) exceeded recommended intakes. Among older children (preschoolers and school children), calcium (548 mg, 435 mg) and dietary fiber (7.4 g, 9.4 g) did not meet recommendations while percentage of energy from total fat and saturated fats exceeded 30% and 10%, respectively. The mean sodium intakes of preschoolers (1,684 mg) and school children (2,000 mg) were relatively high. Toddlers in all income groups had similar energy and nutrient intakes and percentages meeting the recommended intakes. However, low income older children had lowest intakes of energy (P < 0.05) and most nutrients (P < 0.05) and highest proportions that did not meet recommended energy and nutrient intakes. For all food groups, except milk and dairy products, all age groups had mean intakes below the recommended servings. Compared to middle and high income groups, low income preschoolers had the lowest mean intake of fruits (0.07 serving), meat/poultry (0.78 serving) and milk/dairy products (1.14 serving) while low income toddlers and school children had the least mean intake of fruits (0.09 serving) and milk/dairy products (0.54 serving), respectively. CONCLUSION: Low socioeconomic status, as indicated by low household income, could limit access to adequate diets, particularly for older children. Parents and caregivers may need dietary guidance to ensure adequate quantity and quality of home food supply and foster healthy eating habits in children.

• 한국산학기술학회논문지
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• 제17권2호
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• pp.649-656
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• 2016

본 연구의 목적은 대퇴부골절로 수술 후 섬망 발생군과 섬망이 발생하지 않은 군을 비교하여 수술 후 섬망 발생이 임상 예후에 미치는 영향을 파악하고 섬망의 위험요인을 규명하기 위한 후향적 조사연구이다. 자료수집은 2010년 7월 1일부터 2014년 1월 31일까지 대퇴부골절로 일 대학병원에서 수술한 65세이상 노인환자 68명의 의무기록지를 3년간 추적조사하였다. 연구결과 섬망발생군은 31명(45.6%), 섬망이 발생하지 않은 군이 37명(54.4%)이었으며, 섬망이 발생한 환자의 평균나이는 80.8세, 섬망이 발생하지 않은 군은 81.8세로 대부분 여성이었으며, 통계학적 유의성은 없었다. 섬망유무에 따른 특성은 5종류 이상의 약물복용, 혈중 크레아티닌 수치, 총 의료비용이 섬망 발생군과 섬망이 발생하지 않은 군에 따른 유의한 차이를 보였다. 또한 대퇴부 수술 후 주요 임상경과 발생에 예측요인을 확인하기 위해 Cox의 비례위험 모형(Cox's proportional hazard regression model)을 이용한 결과, 섬망, 5가지이상의 다중약물복용, 수혈경험이 유의한 예측요인으로 나타났다. 따라서, 대퇴부 수술 후 노인의 섬망발생은 환자와 보호자에게 부정적인 결과를 초래할 수 있으므로, 수술 전 섬망과 관련된 위험인자에 대한 평가 및 처치를 시행해야 한다.

• 대한지역사회영양학회지
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• 제14권5호
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• pp.521-530
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• 2009

This study was conducted to assess dietary pattern and dietary diversity of preschool children by investigating their food consumption. To accomplish this, dietary intake survey (24 hour-recall food diary) was administered to 508 children aged between 4 to 6 years old from 4 kindergartens in the Daegu area (415 were completed). By using CAN pro 3.0 for professionals, the dietary patterns and dietary diversity scores of each food group were examined by age and sex. Data were analyzed with SPSS 12.0, and $\chi^2$, t-test and Anova test, and Duncan's multiple range test used for verifying significance. For 4~5-year-old group, boys had significantly more fruit and meats than girls (p < 0.05), but girls had more dairy food than boys with no significance. For 6-year-old group, boys had significantly more foods, milk and dairy foods than girls (p<0.05), and also boys had more vegetables and fruit than girls with no significance. For DDS (Dietary Diversity Score), the score of 6-year-old group was significantly higher than that of younger children (p < 0.05) and the older the age was, the higher the score was. Dietary Pattern (GMVFD) was verified by 8 types, and the ratio of taking all five food groups (GMVFD = 11111) of the 6-year-old group was 48.8%. Children with older ages had more various foods than younger ones (p < 0.05). In addition, the ratio of taking less than the minimal intake of dairy foods of girls (48.1%) was higher than that of boys (41.3%). As results, unbalanced diet, overeating and not eating unbalanced diet were revealed as the problematic dietary habits among preschool children, and those habits may change positively with knowledge on nutrition grow on. Therefore, nutritional characteristics and importance of preschool children should be taught to parents and caregivers, and it must be practical and ready to use in cooking for these children to healthy dietary habits.