• 제목/요약/키워드: interventions

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분자유전학적으로 진단된 가부키 증후군 1례 (A Case of Kabuki Syndrome Confirmed by Genetic Analysis: A Novel Frameshift Mutation in the KMT2D Gene)

  • 박수진;안문배;장우리;조원경;채효진;김명신;서병규
    • 대한유전성대사질환학회지
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    • 제17권3호
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    • pp.103-108
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    • 2017
  • 가부키 증후군(Kabuki syndrome)은 특징적인 얼굴(아치형의 넓은 눈썹, 낮은 코끝, 큰 귓바퀴, 아래 외측 안검 외전), 골격계 이상, 출생 후 성장 지연, 그리고 경도의 정신 지체를 특징으로 나타내는 선천성 이상 질환이다. 또한, 선천성 심장기형, 비뇨생식기 기형, 구개구순열을 포함한 위장관 기형, 안검 하수 등의 증상이 동반되기도 한다. 감염과 면역질환, 경련, 내분비 문제, 청력 손실이 나타날 수 있다. 가부키 증후군의 대부분은 12번 염색체의 장완에 위치한 KMT2D 유전자의 돌연변이에 의해 발병된다. KMT2D 유전자의 돌연변이로 생성된 비정상적인 KMT2D 단백질로 인해 신체의 여러 장기와 조직의 특정 유전자의 활성이 정상적으로 이뤄지지 못하여, 결과적으로 가부키 증후군의 특징적인 외형과 기능장애가 나타난다. 출생시 선천성 심장 기형, 갑상선 기능 저하 및 일과성 저혈당 과거력이 있던 환아가 만 4세경 성장 지연, 아치형 눈썹, 낮은 코끝, 아래 외측 안검 외전, 큰 귓바퀴 등의 얼굴 생김새를 보여 시행한 분자유전학적 검사에서 KMT2D의 exon 15에서 새로운 frameshift mutation이 발견되어 증례를 보고하는 바이다. 가부키 증후군은 성장 지연 뿐 아니라, 발달 장애 및 행동 장애, 사춘기 여아의 경우 조기 가슴 발육을 포함한 내분비적 문제, 사시, 안검하수 등의 안과적 문제, 만성 중이염, 청력 손실, 감염, 경련 등 다양한 증상을 나타낼 수 있기 때문에 조기에 질환을 진단하고, 임상증상에 따라 적절한 중재를 할 수 있도록, 정기적으로 신장, 몸무게, 머리둘레, 발달상태, 청각과 시각상태를 확인하는 것이 중요하다. 따라서 여러 장기의 선천 기형을 보이는 환아의 경우, 임상의는 출생 당시에는 두드러지지 않을 수 있는 특징적인 얼굴 생김새, 성장 지연, 정신 지체 등의 이상에 대해 유의하여야 한다. 분자유전학적 검사는 임상적으로 가부키 증후군이 의심되는 환아를 조기에 진단할 수 유용한 방법이며, 앞으로도 가부키 증후군과 연관된 유전자 변이에 대한 연구가 더욱 필요할 것으로 사료된다.

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Oxidative Stress Induced Damage to Paternal Genome and Impact of Meditation and Yoga - Can it Reduce Incidence of Childhood Cancer?

  • Dada, Rima;Kumar, Shiv Basant;Chawla, Bhavna;Bisht, Shilpa;Khan, Saima
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권9호
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    • pp.4517-4525
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    • 2016
  • Background: Sperm DNA damage is underlying aetiology of poor implantation and pregnancy rates but also affects health of offspring and may also result in denovo mutations in germ line and post fertilization. This may result in complex diseases, polygenic disorders and childhood cancers. Childhood cancer like retinoblastoma (RB) is more prevalent in developing countries and the incidence of RB has increased more than three fold in India in the last decade. Recent studies have documented increased incidence of cancers in children born to fathers who consume alcohol in excess and tobacco or who were conceived by assisted conception. The aetiology of childhood cancer and increased disease burden in these children is lin ked to oxidative stress (OS) and oxidative DNA damage( ODD) in sperm of their fathers. Though several antioxidants are in use to combat oxidative stress, the effect of majority of these formulations on DNA is not known. Yoga and meditation cause significant decline in OS and ODD and aid in regulating OS levels such that reactive oxygen speues meditated signal transduction, gene expression and several other physiological functions are not disrupted. Thus, this study aimed to analyze sperm ODD as a possible etiological factor in childhood cancer and role of simple life style interventions like yoga and meditation in significantly decreasing seminal oxidative stress and oxidative DNA damage and thereby decreasing incidence of childhood cancers. Materials and Methods: A total of 131 fathers of children with RB (non-familial sporadic heritable) and 50 controls (fathers of healthy children) were recruited at a tertiary center in India. Sperm parameters as per WHO 2010 guidelines and reactive oxygen species (ROS), DNA fragmentation index (DFI), 8-hydroxy-2'-deoxy guanosine (8-OHdG) and telomere length were estimated at day 0, and after 3 and 6 months of intervention. We also examined the compliance with yoga and meditation practice and smoking status at each follow-up. Results: The seminal mean ROS levels (p<0.05), sperm DFI (p<0.001), 8-OHdG (p<0.01) levels were significantly higher in fathers of children with RB, as compared to controls and the relative mean telomere length in the sperm was shorter. Levels of ROS were significantly reduced in tobacco users (p<0.05) as well as in alcoholics (p<0.05) after intervention. DFI reduced significantly (p<0.05) after 6 months of yoga and meditation practice in all groups. The levels of oxidative DNA damage marker 8-OHdG were reduced significantly after 3 months (p<0.05) and 6 months (p<0.05) of practice. Conclusions: Our results suggest that OS and ODD DNA may contribute to the development of childhood cancer. This may be due to accumulation of oxidized mutagenic base 8OHdG, and elevated MDA levels which results in MDA dimers which are also mutagenic, aberrant methylation pattern, altered gene expression which affect cell proliferation and survival through activation of transcription factors. Increased mt DNA mutations and aberrant repair of mt and nuclear DNA due to highly truncatred DNA repair mechanisms all contribute to sperm genome hypermutability and persistant oxidative DNA damage. Oxidative stress is also associated with genome wide hypomethylation, telomere shortening and mitochondrial dysfunction leading to genome hypermutability and instability. To the best of our knowledge, this is the first study to report decline in OS and ODD and improvement in sperm DNA integrity following adoption of meditation and yoga based life style modification.This may reduce disease burden in next generation and reduce incidence of childhood cancers.

보호시설 가출청소년의 정신병리에 대한 평가와 분류 (THE CLASSIFICATION OF ADOLESCENTS IN RUNAWAY SHELTERS BY THE EVALUATION OF THEIR PSYCHOPATHOLOGY)

  • 이종성;곽영숙
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제12권2호
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    • pp.192-217
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    • 2001
  • 연구목적:기존 가출청소년 보호시설에 거주하거나 입소하는 청소년에 대한 자아능력과 가출원인에 내재하는 정신병리 조사를 통하여 가출청소년의 특성을 파악하고 다양한 유형으로 분류해냄으로써, 청소년 가출에 대한 예방 대책 수립은 물론, 궁극적으로 가출청소년을 개개인의 다양한 문제에 따라 적합한 보호시설로 의뢰할 수 있도록 보호시설을 다양화하는데 필요한 기초자료의 확보를 목적으로 한다. 방 법:본 연구는 청소년 보호시설에 수용 중인 만 12세에서 21세까지의 남녀 청소년 128명을 대상으로 하였다. 보호시설 전문 상담원의 상담 기록 및 대상자 자신의 기록을 통해 연구대상자의 사회인구학적 특성에 대한 기초설문조사를 실시하였다. 아동행동증상목록표(CBCL), 미네소타 다면적인성검사(MMPI), 벤더-게슈탈트 검사(BGT), 한국웩슬러지능검사(K-WAIS), 간이정신진단검사(SCL-90-R) 등을 실시하여 가출청소년들의 자아능력 평가와 함께 가출의 원인에 기여하는 내재된 정신병리를 조사하였다. 결 과:본 연구대상인 보호시설 가출청소년의 사회인구학적 특징과 임상소견은 다음과 같다. 대상 청소년의 나이는 15세가 가장 많았고, 중기 청소년기에 있는 청소년들이었으며 학교는 중학교 때 중단하고 가정생활은 중간 정도이며, 부모 학력은 고졸인 청소년이 가장 많았다. 가출과 관련된 특징은 첫 가출이 중학교 때 가장 많았고, 가출횟수는 10회 이상이 가장 많았으며 대부분 재가출자였다. 약물을 한 경우는 10%정도였고 술을 한 경우는 80%정도였다. 37%에서 법을 어긴 경험이 있고 돈을 받고 성행위를 한 경우가 약 10%에서 있었다. K-YSR 결과 95명(83%), SCL-90-R 결과 42명(36%), MMPI 결과 70명(69.3%)에서 임상수준을 보였다. 지능검사 결과 22명(22%)에서 정신지체 수준을 보였다. BGT에서 35명(39.4%)이 뇌기능장애 소견을 보였다. 결 론:시설의 가출청소년들은 가출이라는 행동 밑에 다양하고도 심각한 정신건강문제를 지니고 있으며, 그 문제의 종류에 따라 다음과 같이 분류할 수가 있었다. 주의력결핍장애를 포함한 행동장애군, 불안/우울 등의 정서장애군, 신체증상을 호소하는 신체화장애군, 심한 정신병리의 가능성이 있는 정신병위험군 등이다. 따라서 가출청소년에 대한 정신의학적 평가는 매우 중요하며 이에 따른 특성화된 치료적 개입이 필요하다.

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암환자의 요구 조사 도구 개발 (Development of Needs Assessment Instrument for the Patients with Cancer)

  • 김기연;최상순;박소미;송희영;허혜경
    • Journal of Hospice and Palliative Care
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    • 제5권2호
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    • pp.136-145
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    • 2002
  • 목적 : 본 연구는 암환자의 요구를 포괄적으로 포함하면서 실용적으로 측정할 수 있는 도구를 개발하기 위해 시도되었다. 방법 : 기존의 문헌들과 함께 Wingate와 Lackey(1989)의 내용분석 결과를 근거로 정보요구, 이용가능한 자원, 신체적 요구, 정서적 요구, 영적 요고, 그리고 법적/경제적 요구의 6개 영역을 선정하였고, 각 영역에 대한 문항 내용은 암환자 대상의 요고, 조사연구들를 참고로 하여 작성한 후 간호학 교수 3인의 자문을 받아 문항의 내용을 수정, 추가 또는 삭제하면서 예비문항을 작성하였다. 이를 통해 정보요구 7문항, 이용가능한 자원 5문항, 정서 요구 4문항, 영적요구 5문항, 법적/경제적 요구 4문항, 신체적 요구 7문항의 총 32문항의 예비도구를 작성하였다. 예비 도구의 내용 타당도를 확인하기 위해 강원도 소재 대학병원의 간호사 중 평균 경력 10년 이상인 암환자를 간호하고 있거나 간호한 경험이 있는 수간호사와 책임 간호사 9명을 대상으로 실시하였고, 구성타당도와 신뢰도를 검증하기 위해서는 강원도 충정도 및 경기도 소재 종합병원에 근무하고 있는 간호사 116명을 편의표출하였다. 수집된 자료를 SPSS 10.0 WIN을 이용하여 요인분석 및 Cronbach ${\alpha}$값을 구하였다. 결과 : 1) 내용 타당도 분석 결과, 전문가 합의률이 55.4%로 낮은 '유언장 쓰는 방법을 알고싶다'는 문항이 삭제되어 31문항이 선정되었다. 2) 요인분석을 실시한 결과 신체적 요구, 정보 요구, 영적 요구, 정서 요구, 이용가능한 자원, 그리고 법적/경제적 요구의 6요인이 추출되었고 전체 설명력은 61.840%였다. 제 1요인인 신체적 요구와 제 2요인의 정보요구는 각각 25.354%와 10.903%의 설명력을 나타내어 암환자 요구의 주요 영역으로 규명되었다. 3) 도구의 신뢰도는 내적 일관성을 나타내는 Cronbach ${\alpha}$값은 .90이었다. 결론 : 본 연구에서 개발된 도구는 간호사로 하여금 암환자의 요구를 포괄적으로 사정할 수 있게 하고 궁극적으로는 암환자의 요구에 맞는 총체적이며 포괄적인 간호중재를 마련하는 근거로 활용될 것이다.

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산전 진단된 수신증의 임상 경과 - 단일 기관의 경험 - (Outcome of Prenatally Diagnosed Hydronephrosis - One Center Experience -)

  • 김연희;김병주;박문성;양정인;김행수;김병길;배기수
    • Childhood Kidney Diseases
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    • 제6권2호
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    • pp.178-187
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    • 2002
  • 목적: 산전 초음파가 널리 이용되면서 태아기의 선천성 요로계의 이상이 발견되는 경우가 점차 증가하고 있다. 수신증의 대부분은 출생 후 1년 내에 자연스럽게 없어지는 생리적 수신증이지만 수술적 교정을 요하는 병적 수신증과의 감별이 쉽지 않다. 본 연구에서는 산전 수신증이 의심되는 환아에서 출생 후 수신증을 확진하여 산전 진단과의 연관성을 비교 분석하고, 산전 수신증의 원인과 자연경과를 이해하여 출생 후 수신증에 대한 대처에 도움을 주고자 본 연구를 시행하였다. 방법: 1994년 9월부터 2001년 8월까지 아주대학교 병원 산과에 등록되어 산전 초음파 검사상 태아 수신증이 의심되었던 환아 119명 중 출생후 실시한 신 초음파 검사에서 수신증이 확진된 91명(121 신단위)을 대상으로 수신증의 원인과 자연경과를 신 초음파 검사와 배설성 신주사 검사로 추적 관찰하였다. 결과: 산전 초음파 검사에서 수신증이 의심되었던 119명의 신생아 중 출생 후 수신증이 확진 되었던 환아는 91명으로 76%였다. 수신증의 원인으로 요관 신우 이행부 협착이 57례(47%)로 가장 많았으며 그 다음으로는 다낭성 이형성신이 12례(10%), 요관 방광 이행부 협착 5례(4%), 방광 요관 역류 5례(4%), 후부요도 판막 2례(2%)등의 눈이었으며 원인을 찾을 수 없었던 경우도 38례(31%)였다. 추적검사에서 47%가 수신증의 완전소식 혹은 호전소견을 보였으며 총 121개의 신 단위 중 10단위가 수술을 받았으며 진단에서 수술까지는 평균 7.2개원이 걸렸다. 결론: 산전 초음파로 발견된 수신증의 대부분은 출생후 수신증으로 확진되었으나 정상인 경우도 있었다. 산전 수신증의 원인으로 요관 신우 이행부 폐쇄가 가장 많았으며 대부분은 비폐색성 수신증이었고, 추적 검사에서 호전되는 경우가 많았다. 그러나 아직까지 신생아 수신증은 정확한 감별진단이 어렵기 때문에 신장기능의 보전을 위해서는 수신증의 정도에 따라 적절한 간격으로 지속적인 관찰을 하는 것이 필요할 것으로 사료된다.

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장중첩증에서 비수술적 정복의 실패 위험인자 (Risk Factors for the Failure of Non-operative Reduction of Intussusceptions)

  • 고광민;송영우;제보경;한재준;우찬욱;최병민;이정화
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제11권2호
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    • pp.110-115
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    • 2008
  • 목 적: 장중첩증의 일차적인 치료로 사용되는 비수술적 관장 정복은 장천공, 쇼크 그리고 복막염 등과 같은 심각한 합병증과 불필요한 스트레스 및 과도한 방사선 노출의 위험이 있다. 본 연구에서는 무리한 비수술적 정복의 시도를 피하기 위하여 장중첩증 환자의 임상 양상 및 검사 소견 중 비수술적 정복 실패를 예측할 수 있는 인자를 파악하고자 하였다. 방 법: 고려대학교 의료원 안산병원에서 1998년 3월에서 2006년 7월까지 장중첩증으로 진단되어 치료받았던 환자 314명 중 비수술적 정복이 시도되었던 300명을 대상으로 하였다. 비수술적 정복의 성공 군과 실패군으로 나누어 성별, 연령, 임상증상 및 이학적 소견 그리고 증상의 시작에서 비수술적 정복술을 시도하기까지의 시간과 비수술적 정복 실패와의 연관성을 분석하였다. 결 과: 비수술적 정복 실패 군의 경우 성공 군에 비해 연령이 어렸고(12.3${\pm}$17.2개월 vs 18.0${\pm}$15.8개월, p=0.03), 정복 시도까지의 시간 경과가 길었으며(33.6${\pm}$29.0시간 vs 21.5${\pm}$20.3시간, p<0.01), 구토, 기면은 많았음(p<0.01)에 비해 복통이나 보챔은 적었다(p<0.01). 이러한 인자들의 다중회귀분석에서 비수술적 정복 실패와 연관된 인자는 6개월 미만 연령(odds ratio: 2.5, 95% confidence interval: 1.2~5.2, p=0.01), 24시간 경과(odds ratio: 2.1, 95% confidence interval: 1.2~4.2, p=0.03), 혈변(odds ratio: 4.8, 95% confidence interval: 1.9~12.2, p<0.01), 기면(odds ratio: 3.4, 95% confidence interval: 1.1~10.4, p=0.04), 복통 또는 보챔(odds ratio: 0.2, 95% confidence interval: 0.1~0.4, p<0.01)이었다. 결 론: 장중첩증에서 6개월 미만 어린 연령, 혈변이나 기면의 소견, 증상 시작 24시간이 경과된 경우 비수술적 정복 실패의 가능성이 많으므로 이러한 사항을 충분히 고려하여 시행 여부를 결정하는 것이 좋겠다.

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뇌졸중환자의 자가간호 수준과 가족구성원의 간호요구 (A Study on the Care Needs of Family-Caregivers and the Level of Self Care for Patients of Cerebral Vascular Accident(CVA))

  • 조영희
    • 기본간호학회지
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    • 제7권2호
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    • pp.239-255
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    • 2000
  • The purpose of this study was to explore the care needs of family-caregivers caring for patients with a CVA and the level of self care of the patients. The subjects for the study were 112 patients with a CVA and their caregivers. These patients were seen in a hospital or out-patient-department(OPD) at two oriental medical hospital in Jeonbuk province. The survey instruments used in this study were Kang's ADL checklist for self care of patients and Kim's Likert-style checklist for care needs of family-caregivers to patient with CVA. The survey was conducted from July 4 to August 30, 1999. Internal validity by calculation of Cronbach's alpha was 0.95, which was regarded as high. The survey results were analyzed using the SPSS program, with percentages, means, t-test, ANOVA and Pearson's correlation coefficients. The results of this study are as follows : 1. The level of self care for patients with a CVA was : 1) complete dependence(M=14.9, 13.1%), 2) complete independence(M=23.6, 20.9%), 3) incomplete independence(M=23.9, 21.0%), 4) incomplete dependence(M=26.6, 25.0%), 5) dependence and independence(M=23.0, 20.0%). The items for which there was a high level of self care were : 1) drinking(M=3.62), 2) eating (M=3.25), 3) position returning(M=3.18) : and the items for which there was a low level of self care were : 1) ascending and descending stairs(M=2.08), 2) walking(M=2.47). 3) putting on and taking off trousers(M=2.55). 2. The mean score of the sum of the care needs of the family-caregivers was : 1) need for immediate care and help: 2) need of the way to communicate with patient: 3) need for education and assistance related to physical functional level: 4) need to be informed about the disease, treatment and care: 5) need for social support and consultation: 6) need for appreciation: 7) need for management of nursing problems related to immobility. The highest meed factor was the need for immediate care and help(M=3.47): and lowest need factor was the need for management of nursing problems related to immobility(M=2.80). 3. There were significant differences between the level of care need and general characteristic of the caregivers, there were family-caregivers age(P=0.001), marital status (P=0.276), occupation (P=0.006), monthly income(P=0.000), Patient's relationship to caregivers(P=0.004) and health(P=0.000). 4. There were significant differences between the level of self care and general characteristic of the patients, there were patient paralytic condition(P=0.01), blood pressure(P=0.01), and length of suffering(P=0.03). 5 There were significant differences between the level of care need and the general characteristic factors, which were CVA patient's blood pressure (P=0.05), problem of medical fee (P=0.05). 6. There was significantly correlation with the family-caregivers care need and the level of self care in the CVA patient(r=0.300, P=0.000). As a result, need to promote the level of self care in patients and to meet the care need of family-caregivers for more efficient nursing of CVA patients, is emphasized. Therefore more study is needed on an efficient way to provide rehabilitation and quality nursing interventions for family-caregivers and patients with CVA.

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암환자의 희망 예측요인 (Predictive Factors of Hope in Patients with Cancer)

  • 이화진;손수경
    • 성인간호학회지
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    • 제12권2호
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    • pp.184-195
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    • 2000
  • It has been believed that cancer is an omnious factor threatening the future and life itself. Patients having the disease experience anxiety, fear, feeling of weakness, depression and feelings of uncertainty and hopelessness. Most cancer patients, however, have expectations of possible recovery and a better future, very different from the patients who feel hopeless. Therefore. hope allows people to respond effectively to the fatal disease they have and prevents them from detoriorating physically and spiritually, positively influencing their survival, response to treatment and sense of security. Studies previously performed showed that hope is positively correlated with social and family supports, self-esteem, spiritual well-being, responsive action, health promotion behavior and quality of life. Thus, the study attempted to provide basic information on nursing cancer patients by investigating their levels of hope and determining predictive factors which influence hope. For the study 200 cancer patients in two university hospitals located in Pusan were sampled as subjects. Data were collected for twenty nine days from Feburary 1, 1999 to March 1. Instrumets for the study included 10 items from the self-esteem scale by Rosenberg (1965), 39 hope measurements by Kim and Lee(1965), 16 of the social support scale by Tae(1986) and 16 of the general characteristics scale, all of which totaled 81 items. The data were analyzed using the SPSS program. General characteristics of the investigated based on numbers and percentage. Hope, self-esteem and social support were analyzed using means, minimum, maximum and standard deviation. Relations among the foregoing three factors were analyzed using Pearson' correlation coefficient. Levels of hope in cancer patients were determined using t-test, ANOVA and Scheffe test. Predictive factors influencing hope were investigated using multiple stepwise regression analysis. Results of the study are summarized as follows: 1. An average level of hope was $185.55{\pm}23.39$ points(96 min. and 234 max.) 2. Levels of hope showed a significant difference among them according to sex (t=-3.69, P=.000), age(F=4.714, P=.000), job(F=3.247, P=.008), monthly income (F=6.113, P=.003), treatment charge (F=3.796, P=.011), supportive resources (F=10.554, P=.000), diagnosis(F=2.287, P=.029), perceived health status(F=22.184, P=.000), level of pain(F=3.334, P=.021), religion (F=4.911, P=.001) and religion's effect in life (F=11.706, P=.000), 3. For the subjects, self-esteem and social support were $38.32{\pm}7.21$(13 min, and 50 max.) and $52.97{\pm}8.49$points(28 min, 80 max.). Concerning social support, average levels of family support and medical support were found $35.95{\pm}6.05$(18 min, and 40 max) and $27.02{\pm}4.99$ points(20 min and 40 max). The hope the cancer patients showed significant correlations with self-esteem (r=.588, P=.000), family support(r=.224, p=.001) and medical support(r=.221, P=.002). 4. The five variables related to hope (self-esteem, religion's effect in life, perceived health status, social support and age) accounted for 54.2 percent of the hope level; especially, self-esteem was the highest at 34.6%. As shown in the above results, predictive factors which most influence hope in cancer patients were self-esteem and religion's effect of life. Therefore, nursing interventions to increase self-esteem should be developed. Regarding religion's effects, studies on spiritual aspects should be carried out in a way that contributes to promotion of hope.

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조기진통 산부의 간호 요구에 대한 산부와 간호사의 지각 차이에 대한 연구 (A Study of Mothers' and Nurses' Perception of the Nursing Needs of Women Experiencing Premature Labor)

  • 한경려
    • 여성건강간호학회지
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    • 제1권1호
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    • pp.97-118
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    • 1995
  • The purpose of this study was to compare the nurses' perceptions with the women's about the women's needs in premature labor and to find out how to accomplish effective nursing intervention for the women to cope with their crises in premature labor. The objects of this study consisted of 33 hospitalized mothers in post partum because of premature labor, who were delivered of new born, in four university hospitals, a general hospital and a lower general hospital which has a neonatal intensive care unit in Seoul during 17 days(Oct. 4, 1994 to Oct. 20, 1994) and 32 nurses who have worked at delivery rooms in the hospitals above for 6 months or more, accomplishing nursing intervention. The results of this investigation were as follows : 1) General characteristics of women : Their mean age was 29.4 years(SD 4.37) and the mean of their gestational periods 3 days over 34 weeks(SD 2.48). Most of them were the married(93.9%) and held high school degree or more(93.9%). And some of them were the deligious(68.7%), multiparae(59.4%) and had their jobs(21.2%). The also had hospitalized experience due to premature labor(51.5%), experienced in premature delivery(33.3%), the prental care(78.6%), cesearean section(63.6%), and pregnancies less than twice(62.5%). The most mothers were included in 34 weeks and a day to 37 weeks(60.6%). It was also confirmed that most of the sustaining presences in labor were their husbands(81.2%). 2) General characteristics of nurses : Their mean age was 27.6 years(SD 4.50), and their carrier with the service on the average 6 months over 3 years long(SD 3.63). Numbers of them were staff nurses(84.4%), maiden ladies(71.9%), graduated from junior colleges of nursing(71.9%), and had no experiences in delivery(78.1%).Besides, none of them had experiences in premature labor. 3) The whole mean of needs perceived by pregnant women was identified as 3.086 points and the degree of their perception was given much weight in order of interdependence need(3.14), self concept need(3.11), physical physiologic need(3.09), and role function need(2.74). So it was proved that they regarded interdependence need as being the most important need in crises caused premature labor. 4) The whole mean of needs felt by the nurses was 3.092 points and the degree of their feelings was given much weigh in order of physical physiologic need(3.22), self concept need(3.15), interdependence need(3.06) and role function need(2.75). So it was ascertained that they felt physical physiologic need the most important, differing from the women in it. 5) There were few differences on the degrees of the perceptions that the nurses and the women showed on each of the four parts. 6) On each part of the questionnaires, it was examined that the women felt the need for the fetus to be the most important generally while the nurses perceived the need with the women to be more important than that. 7) The primiparae(40.6%) felt role function need be more important than multiparae(59.4%) (p<0.05), and the women from universities and above(39.4%) perceived self concept need to be more important than those holding the high school degrees and below(60.6%). (p<0.05) 8) The nurses having experience in delivery(21.9%) perceived interdependence need and role function need to be more important than important than those having no experiences(78.1%). (p<0.05) So far most of the nurses have concentrated their efforts on nursing for safety for the women in premature labor hospitalized in delivery rooms. But the women are not satisfied with just it because of having perceived the need for the fetus more important above all. In nursing for the future, therefore, every nurse caring for the women should offer them all the informations that they will want for their fetuses to adapt them to the crises effectively, understanding such their needs and making most of honest and simple terms for them, I insist. Through this study, I'm sure that inquiring into the need of women in premature labor minetely will show the way of more effective nursing interventions in clinic. And I suggest that the various kinds of studies about the more objects be done for the generalization of the results of this study in the future.

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노인층과 청·장년층 뇌졸중 환자가족의 건강상태·부담감 및 삶의 질과의 관계 (The Correlation Among Health Status, Burden and Quality of Life of the Adult Stroke Patient's Family and the Elderly Stroke Patient's Family)

  • 김귀분;이경호
    • 성인간호학회지
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    • 제13권2호
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    • pp.262-276
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    • 2001
  • The purpose of this study is to investigate the correlation among the stroke patient family's health, burden and quality of life which is based upon the comparative appreciation of the adult stroke patient's family and elderly stroke patient's family. For this purpose, data were collected from the family care-givers for two groups of stroke patients under sixty years old and over sixty years of age, admitted at K Hospital and H Hospital in Seoul. The instruments for this research are based on the tool for measuring physical health and psychological health developed by Yang, Young-hee(1992), the tool for measuring the sense of burden by Seo, Mee-hae and Oh, Ga-sil(1993), and the tool for the quality of life by Noh, Yoo-ja(1988). The sampling for this study was done from December, 2000 until February, 2001. Questionnaire data were drawn up by personal interviews aided by the staff nurses. The analysis of collected data are based on general characteristics calculated at the rate of 100 percent of the average, t-test, ANOVA(some difference on a level with p<.05 being subsquently confirmed by DMR) for Health Status, Burden, Quality of Life and Pearson Correlation to verify the hypothetical correlation among the subjects. The results of this study are as follows: 1. In the adult stroke patient family, the factors influencing the physical health proved to be age, present occupation and family-formation. Here, the factors influencing psychological health turned out to be age, matrimonial status, present occupation and family-formation. In the elderly stroke patient family, the factors influencing physical health proved to be age, gender, final academic status, matrimonial status, present occupation, and relation with the patient. Here, the factors influencing the psychological health were age, final academic status, matrimonial status, present occupation, relation with the patient and family-formation. In the former case, the influencing factors upon the burden were shown to be age, final academic status, matrimonial status, relation with the patient and family-formation. In the latter case, the influences upon the burden were age, gender, final academic status, matrimonial status, present occupation and relation with the patient. In the former case, the influences on the quality of life were gender, and economic situation. In the later case, the influencing factors on the quality of life were age, final academic status, matrimonial status, present occupation, and relation with the patient. 2. The rate of the physical condition in the former case turned out to be 2.83, and the psychological condition 2.37. The physical condition of the latter case was 2.76, and the psychological condition 2.46. The rate of the burden in the former case was 3.14, and that of the latter case was 3.04. The rate of quality of life in the former case proved to be 2.46, and that of the latter case 2.55. 3. The rate of correlation between the burden and the quality of life appeared to be the high counter-correlation (r= -.573). The rate of correlation between the psychological health and the burden of a simialr (r= -.565). The rate of correlation between the physical health and the psychological health proved to be a moderate correlation (r= .372), The rate of correlation between physical health and the burden turned out to be a low counter-correlation (r= -.276). According to this study, there proved to be a very close correlation among the stroke patient family's health, the burden and quality of life. Thus, it would be necessary to find out various nursing interventions in order to mitigate the stroke patient family's burden in the process of caring for the patients.

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