• 대한지역사회영양학회지
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• 제19권3호
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• pp.241-249
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• 2014

합병증으로 당뇨병성 족부질환을 가진 환자와 그렇지 않은 당뇨병 환자에서 DFS를 조사하고 이것이 생활습관, 식습관 및 당뇨병 자가 관리와 상관관계가 있는지 규명하고자 하였다. 1) 당뇨병성 족부질환군 69명(남/녀 48/21)과 일반당뇨군 59명(남/녀 33/26)으로 구성되었고, 당뇨병성 족부질환군이 일반당뇨군에 비해 당뇨병 유별기간이 유의적으로 길었으며(각각 $17.3{\pm}11.0$년, $11.3{\pm}9.46$년, p<0.01), 연령이 유의적으로 낮았고(각각 $51.2{\pm}11.6$세, $64.2{\pm}12.6$세, p<0.01), 기혼자의 비율이 유의적으로 낮았다 (p<0.05). 2) 당뇨병성 족부질환군은 일반당뇨군에 비해 부정적인 식사 특히, 패스트푸드, 배달음식, 인스턴트식품 및 편의점 음식의 섭취 빈도가 유의적으로 높은 반면(각각 $1.37{\pm}1.02$일/주와 $0.91{\pm}0.85$일/주, p<0.01), 긍정적인 식사 빈도와(각각 $2.74{\pm}1.76$일/주와 $3.61{\pm}2.05$일/주, p<0.01), 발 관리, 특히 발 씻기와 씻은 후 말리기의 빈도는 유의적으로 낮았다(각각 $4.61{\pm}1.97$일/주와 $5.53{\pm}2.22$ 일/주, p<0.05). 3) 12 항목으로 된 DFS의 Chronbach's ${\alpha}$는 당뇨병성 족부질환군에서 0.614로 매우 낮고, 자아효능감 관련 하부 영역의 세 항목은 제거되었을 때 내적일치도가 증가하였다. 따라서 당뇨병의 자가관리를 예측하는 인자로서 DFS의 유용성은 적어도 당뇨병성 족부질환 환자에서, 현재 12 항목의 DFS 도구로는 제한적임을 시사한다. 4) 당뇨병성 족부질환 합병증이 없는 일반당뇨군의 경우 12 항목 DFS는 Chronbach's ${\alpha}$가 0.869로 높고, 음주(r=0.247, p=0.059)와 부정적인 식사(r=0.241, p=0.066)와는 양의 상관관계가, 긍정적인 식사(r=-0.227, p=0.083)와는 음의 상관관계의 경향이 있었다. 자아효능감과 관련된 DFS와의 양의 상관관계는 음주(r=0.257, p<0.05), 흡연(r=0.350, p<0.01) 및 부정적 식습관(r=0.295, p<0.05)과 유의적이었고, 운동 (r=-0.224, p<0.088) 및 발 관리(r=-0.247, p<0.059)와는 경향이 있었다. 따라서 DFS는 적어도 당뇨병성 족부질환이 없는 환자의 경우에 특히 자아효능감 관련 항목에서 생활습관, 식습관 및 발 관리 충실도를 예측할 수 있는 도구로서의 잠재적 유용성을 있음을 제시한다. 본 연구에서는 당뇨병성 족부질환으로 족부 절단 위험에 처한 당뇨 환자가 그렇지 않은 당뇨 환자에 비해 식생활이 바람직하지 못할 뿐 아니라 발 관리가 잘 되고 있지 않음을 보여주어 비록 그 인과관계가 밝혀지지는 못했지만 당뇨병성 족부질환의 예방과 관리에서 당뇨 환자를 위한 식생활과 발관리 교육의 중요성이 확인되었다. 또한 이 연구는 우리나라에서 당뇨환자의 생활습관, 식습관 및 당뇨 자가관리를 예상할 수 있는 척도로서 미국에서 최근 개발된 DFS가 사용될 수 있는지 알아보는 첫 시도로 의미가 있는데 연구 결과는 종교, 당뇨병 형태, 심각한 합병증 유무에 따른 당뇨병 환자군별로 그 유용성을 규명할 필요성을 제시하였다.

• 대한간호학회지
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• 제25권3호
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• pp.562-580
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• 1995

This research was an attempt to make it possible to provide nursing care and health education meet- ing the need not of care givers but of patients by identifying the nature of patients' self regulation experiences. The specific objective of this study was : 1) to explore self regulation experiences of patients with adult disease. The phenomenological approach in qualitative studies is used to serve this purpose. Colaizzi's method is used for the phenomenological analysis of the data in this study, which were collected from 25 patients hospitalized in the internal medical ward and oriental medical ward of a Seoul hospital, suffering from adult disease such as hypertension, arteriosclerosis and diabetes mellitus. The research was conducted over a period of March to September, 1994. The investigator conducted participated observations and in-depth unstructured interviews which were audiotaped under the permission of patients. The investigator read the data repeatedly to identify and categorize significant statements, formulating meanings, themes and theme clusters. The result is categorized as follows : Self regulation activities, their barriers and predisposing factors of a disease. Thirteen theme clusters of self regulation activities related to health identified were. “maintaining diet regimen”, “maintaining exercise regimen”, “maintaining medication regimen”, “maintaining oriental medical regimen”, “maintaining health monitoring regimen”, “maintaining self effort”, “maintaining religious life”, “maintaining social sup-port systems”, “maintaining peaceful mind”, “maintaining moderation in life”, “maintaining sincere attitude in life”, “maintaining natural life”, and “maintaining folk remedy” This findings confirm the fact that self regulation is complicatedly and diversely influenced by oriental medicine and folk remedy, and Korean traditional ideas melted in Confucianism, Buddhism, Taoism and Shamanism, and modern medical care and western culture. Seven theme clusters of self regulation barriers identified were : "lack of knowledge and self aware-ness", "lack of social supports", "lack of awareness of need in continuous regimen and treatment", "dissatisfaction with hospital and health care provider", "lack of self management ", "lack of will to combat illness", and "overconfidence in folk remedy" Four theme clusters of predisposing factors of a disease were : "cumulation of stressors", "fatalism", "careless life style", and "family history". In conclusion, this. study will prove helpful not only in understanding clients in light of our traditional culture but also in providing them with the kind of nursing care and health education satisfying their demands and particularly cultural needs.

• 사상체질의학회지
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• 제8권2호
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• pp.41-68
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• 1996

This thesis is a try for examining the historical characteristics of Constiutional medicine. For this purpose, I have examined their theory, and made a comparison carefully. Through this study, I have obtained several results as following. Both Chang and Lee lived in the time of change, which was unstable and uncertain. Under the condition, they both rejected following the existing trends of learned circles, and developed new thoughts and clinical techniques. They rejected superstitious beliefs and fatalism, and conducted the pursuit of experimental knowledge and rationale idea. Clinical experience was the very base of their study. They both criticized the bad habits of abuse of tonifing medication and health seeking. Especially Lee regarded control of emotion and regulation of a way of life as the best way for preservation of one's health. Chang regarded pathogenic factors as the ultimate factor of diseases, and strived for eliminating pathogenic factors, but L brought to a conclusion that the final factor of diseases was what is called "heart" itself, and emotional changes were the most essential causes of disease. It can be said that the pathogenesis insisted by Chang can be called The insistence that pathologic factors are the very etiology of all the disease (邪氣致病論), or all the diseases result from pathologic factors. And his whole remedy can be summarized as following, A study on the method of eliminating pathogenic factors. But the purpose of Constitutional medicine is to correct imbalance intrinsic to one's internal organs. In this aspect, Constitutional medicine is a "regulatory medicine". Depending on the classification of six vital substances, Chang classified all disease into six categories. These were based on symptoms and sings represented. While classification of diseases made by Lee was likely to rely upon constitutional characteristics. Chang thought that the three remedies made up of perspiration, purgation, vomiting were the most efficient way of eliminating pathogenic factors. Lee, however, thought those weren't methods of eliminating pathogenic factors but the best ways restoring one's self-regulation power. Chang thought that all the febrile disease essentially has a tendency in properties to belong to "heat", but Lee pointed out that pathologic processes are variable in accordance with constitutional features. They both regarded pathogenesis of diabetes as fire. That is to say, fire is the most essential factor of diabetes. And there are many risk factors such as inappropriate foods, drugs, climate, etc., but Lee thought what is most important is heart. Putting all accounts together, medical characteristics of Chang are similar to those of T aiyinjen and Shaoyangjen, and have no relation to those of those of Shaoyinjen. Therefore we can conclude that Chang understood pathologic processes of disease of T aiyinjen and Shaoyangjen, whether he knew about constitutional features or not.