• 농촌의학ㆍ지역보건
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• 제17권1호
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• pp.34-45
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• 1992

In this county, the gap between the urban 'haves' and the rural 'have-nots' continues to be an increasing problem. WHO and UNICEF see primary health care(PHC) as the key to achieving an acceptable level of health throughout the world as a community development. PHC is essential health care made accessible to individuals and families in the community by means acceptable to them. It is the first level of contact of individual, the family, and community with the national health system. It includes at least education on health system. It includes at least education on health problems, promotion of food supply, MCH including family planning, immunization against infectious diseases, control of endemic diseases, treatment of common diseases and injuries, promotion of mental health, and provision of essential drugs. However, of the aboves, education concerning of mental health problems and the methods to identify, prevent, and control them is the principal step of establishment. In Korea, the category of PHC worker includes the physician as public doctor and nurse as primary health care practitioner and community health leader as village health worker. PHC workers of the aboves will thus function best if they are appropriately trained to respond to the health needs of the community. However in this country, since the national PHC service project launched in 1980, the government has not developed and performed appropriate and enough education and training activities. In light of above reasons, several categories of health education activities had been planned and performed being aimed at above specific target groups and the main focus was on the village health workers for about one year from July 1991 to July 1992 in Yeoju Kun of Kyonki Province. At the end of the period, evaluation of education input was carried out to measure the improvement of healthful life of people in terms of awareness, attitude, and practice. At the end of the period, evaluation of education input was carried out to measure the improvement of healthful life of people in terms of awareness, attitude, and practice. The totals of 80 village health workers, 13 public health practitioners and 9 public docters took in the course of health education for a few hours at every month and the evaluation works of educational effect were taken. The results the study were as follows. 1) Number of persons who realized the maxim "health care of the people is a duty of the government" increased after the education course, On the other hand, the rate of satisfaction on the effort of government for health promotion of the people decreased. 2) Public doctors and primary health care practitioners(nurses) liked and enjoyed the education schedule as a meeting of peer group. It provided chances of communication with staffs of Korea University Hospital. It was said that lectures covered great deal of knowledge and technic they urgently needed in the field. 3) After finishing the education course, more of village health workers(VHW) thought they adapted themselves to their roles and functions showing increased number of home visit and contact with primary health care practitioners by month. 4) In case of patient refer, VHW preferred primary health care practitioners to public doctors. 5) Capability of VHWs in most of their functions increased dramatically after when the education course finished except tuberculosis control.

• 정신신체의학
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• 제28권2호
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• pp.168-176
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• 2020

연구목적 외로움과 수면의 질 저하는 노인에게서 흔히 나타나는 증상이다. 하지만 우리나라에서 노인의 외로움과 수면의 관계에 대해서는 연구된 바는 거의 없다. 본 연구는 독거노인의 외로움과 수면의 질의 연관성을 보고자 하였다. 방 법 본 연구는 천안 지역에 거주하는 독거노인 1,090명을 대상자로 시행되었다., 훈련된 간호사의 면담과 외로움 척도, 피츠버그 수면의 질 지수(Pittsburgh Sleep Quality Index, PSQI), 인구사회학적 정보, 신체 건강상태(Cumulative illness rating scale, CIRS), 인지기능, 단축형 노인우울척도 등의 자가설문지를 통해 조사하였다. 통계분석은 인구학적 변인과 외로움 척도 간의 관계를 탐색하기 위해 기술적 통계분석을 시행하였으며 외로움과 수면의 질의 연관성을 확인하기 위해 단변량 및 다중회귀분석을 사용하였다. 결 과 외로움군의 평균 PSQI 점수(9.2±4.2)는 정상군(7.3±3.7)에 비해 통계적으로 유의하게 높았다(student-t test, p<0.001). 성별, 기분장애 및 상관분석에서 유의성을 보인 변수를 통제한 다중회귀분석에서 외로움은 전체 PSQI 총점(standardized β=0.065, p=0.025), 수면방해(standardized β=0.086, p=0.005), 수면제 사용(standardized β=0.065, p=0.034)과 유의한 연관성을 보였다. 결 론 외로움은 수면문제와 연관성을 보였으며 이는 독거노인의 수면의 질 저하에 외로움이 위험요인이 될 수 있음을 의미한다. 독거노인의 외로움을 줄이기 위한 개입은 수면의 질을 호전시키고 신체 및 정신 질환을 줄일 수 있을 것이다. 따라서 독거노인의 외로움을 예방하고 줄일 수 있는 지역사회 기반의 보건복지 정책이 필요함을 시사한다.

• 한국보건간호학회지
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• 제17권2호
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• pp.255-265
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• 2003

This study was conducted to provide a baseline data for hospice nurses to improve their practices for the spiritual wellbeing of their clients. Analysis of the spiritual wellbeing status of hospice patients was conducted from April 20 to June 20, 2002. A total of 59 cancer patients who admitted to hospice care units of one university medical center, and who have alert mental status were recruited for the study. Paloutzian and Ellison (982) spiritual wellbeing scale and Jungho Kang (996) scale, which was modified for the cancer patients, were used as the study instruments, ANOVA and T-test were applied using SPSS win 10.0 for statistical analysis. The results are as follows : 1. The mean spiritual wellbeing score of the hospice patients was $49.76(SD\pm7.95)$. When it was converted into 4 point scale, the mean score for the spiritual wellbeing was 2.49. The mean religious wellbeing score was $24.17 (SD\pm5.56)$ and that of the existential wellbeing was $25.59 (SD\pm3.10)$. 2 The mean score for the total spiritual wellbeing was $52.54 (SD\pm8.12)$ for female, and $47.86 (SD\pm6.95)$ for male and the difference was statistically significant (t=-2.305, p=.025), 3. In testing the spiritual wellbeing, there was significant difference according to the religion (F=28.931, p=.000). 4. In testing the religious wellbeing, the mean score was $22.77 (SD\pm5.35)$ for male, and $26.20 (SD\pm5.32)$ for female and the difference was statistically significant (t=-2.430, p=.019). 5. In testing the religious wellbeing, there was significant difference according to the religion (F=37.522, p=.000). However, the religious wellbeing was not different according to the age, occupation, marital status and education level. 6. In testing the existential wellbeing. there was significant difference according to the religion (F=8.147, p=.000). However, mean score for the existential wellbeing was not significantly different according to sex, age, occupation, marital status and education level. 7. In testing the existential wellbeing, there was significant difference according to the level of vigor (F=3.662, p=.032), while no difference was observed in the existential wellbeing according to the general health status, degree of pain, and diagnosis. From the results described above it can be concluded that : To improve the spiritual wellbeing status of hospice patients, hospice nurses should identify spiritual needs of the patients according to the religion. gender and the level of vigor.

• 지역사회간호학회지
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• 제7권2호
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• pp.183-202
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• 1996

This study was designed out to develop a home health care service for nurses working in community care services. This study investigates actual conditions at welfare institutions related to health needs the demands of clients, and the state of home health care services we hope that this study will improve upon the current service system. In Korea home health care services are still developing and only new becoming a part of the health care supply system. The data was collected by recording the client home nursing assessments modified to the situation of UTMB home health agency. In this study 107 clients were selected for home care who needed care for physical and mental deficits. The study lasted from March to November of 1995 at one of the welfare service institutions in Chunchon city. The results show that those who most frequently needed care services were over 50 years old with a health deficit of 80.3%, followed by sex as women who needed care at 59.8%. 50.5% of the clients had very little education. 99.1% of the clients live with their family, and a medical diagnostic analysis reveals that 73.9% of the 5 year period of illnesses were the following : 38.8% - muscular -skeleton system disorder, 24.4% - hypertension and stroke, 25.7% sole disease of arthritis. For behavioral conditions 43.3% of the patients were without care services, 56.6% of the patients were taking treatment that 73.5% of those were taking medication. The most main complaint of patients were 22.4% of pain in the extremities, next were 16.8% of a limitation of body activities, 15.0% was lumbo-sacralgia. According to the investigator who was a senior student nurse, the following suggestions were made: 32.7% for curative medical services, 29.9% for physical exercise, 19.6% for emotional support. Consultation nursing services consisted of 67.2% for physical therapy, 11.2% for the maintaining healing, 9.4% for counseling. The patients at home, required assistance most frequently for muscular-skeleton problems under the category of physical systems (33.3%). But, on the other hand, 49.5% of the patients required care givers at home, 28.2% had a knowledge deficit, 21.0% had malnutrition, 18.4% had bad impaired communication. The character of health problems were devided into chronic disease(67.0%), accidents(I3.1%), and general disease(15.9%). 86% of the disabled client had an impairment of the physical system. Eating (86.9%) , Toileting(77.6%), and personal care showed much the same of ADL condition, the level and range of achievement of mobility, the most frequently self performed was 81.3% only in a room size area, and 40.2% were completely dependent when going out. Although there were a large number of home care services in th community at these welfare institutions, many clients needed a variety of curative services. As policy changes have gathered momentum, responsibility for the development of a more suitable program was demanded by the clients from the community.

• 여성건강간호학회지
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• 제18권1호
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• pp.1-16
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• 2012

Purpose: The purpose of this study was to describe the experiences of the process of the change in cognitive function for women treated with chemotherapy for breast cancer. Methods: There were ten participants in total in this study. Data were gathered utilizing in-depth interviews over 3 times from September 2010 to January 2011. Data were analyzed by employing Strauss and Corbin's (1998) grounded theory methodology. Results: Findings indicate that causal conditions of these results were 'side effects of chemotherapy' and 'menopausal state', including contextual conditions as, 'mental fatigue' and 'anxiety about recurrence'. The core category was identified as 'confronting with unexpected chaos'. Intervening conditions were 'support from other people', 'lack of information on cognitive impairment'. Interaction strategies were 'changing the habit of life', 'making efforts for living life' and 'seeking for medical information'. Consequences of the process were 'physical restriction', 'difficulty in social life', 'disturbed working ability' and 'psychological distress'. Conclusion: The results of this study show that nurses should recognize there is a notable difference between individual patient's contextual conditions and interactive strategies. Furthermore educational information and individualized intervention should be provided to improve cognitive function for women with breast cancer.

• 근관절건강학회지
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• 제9권2호
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• pp.187-202
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• 2002

This study was aim to provide rheumatoid arthritis patients the basic data of development of nursing intervention to help psychosocial adaptation of rheumatoid arthritis patients as exploring the relationship among causal perception, coping pattern, psychosocial adaptation of rheumatoid arthritis. As the results of this study the mean score of causal perception of the subjects was 3.37. The score of the internal-unstable was the highest. which was followed by extra-stable, internal factor, internal-stable, external factor and external-unstable in order among the factor of causal perception. The mean score of coping pattern was 2.64. The type of coping patterns the score of the receptive coping was the highest, which was followed by wishful coping active coping and negative coping in order among the type of coping pattern. The mean score of psychosocial adaptation was 3.28. The subconcept of psychosocial adaptation the score for personal relationship was the highest, which was followed by role function and mental state in order among the psychosocial adaptation. The analysis of the relation among causal perception, coping pattern and psychosocial adaptation showed significant negative correlation between causal perception and psychosocial adaptation(r=-0.3219, P=0.002). The analysis of the relation between the type of coping pattern and psychosocial adaptation showed significant negative correlation between psychosocial adaptation and active coping(r=-0.3210, P=0.002), negative coping(r=-0.2296, P=0.032). Only causal perception(-.36) and period of illness(-.26) effected on the psychosocial adaptation were shown to the negative direction significantly. The psychosocial adaptation was explained the 17% by these two variables. Based on this study results the factor of causal perception and the type of coping pattern of rheumatoid arthritis were shown significant relations between psychosocial adaptation. We suggests that nurses in practice apply to assessing the factor of causal perception of individuals illness and the type of coping patterns when nursing interventions in rheumatoid arthritis patients.

• Journal of Korean Biological Nursing Science
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• 제1권1호
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• pp.100-114
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• 1999

This study was done to investigate the effects of rapidly-rotating shift work of two-day interval on fatigue level and the concentration of urinary 17-KS, $Na^+,\;Cl^-$. The subjects were 20 nursing college students(control group) and 15 nurses in a university hospital and the study was done from Apr. 21 to May 4th, 1999. In the test group, each 5 nurses were allocated to day shift(8 AM-4 PM), evening shift(4 PM-12 MN) and night shift(12 MN-8 AM) respectively. The fatigue level were measured 30 minutes after work start on the 2nd day of work shift. Urine specimens were collected at 8 AM, 4 PM and 12 MN on the 2nd day of work shift in the control group and 30 minutes before and after work on the 2nd day of work shift in the test group. The data were analyzed with SPSS(for Window, ver 7.5). Statistical analysis was performed by using t-test, paired t-test and ANOVA. The results were as follows. 1. The perceived fatigue level in shift work 1) The physical and mental fatigue level were significantly higher in night shift than that in day or evening shift(p<0.05). In the neuro-sensory fatigue level, night shift showed higher tendency than that in day or evening shift, but there were no significant differences between each shifts. 2) Comparison between the control group and the test group: Physical fatigue level was significantly higher in night shift than that in day or evening shift of the control group(P<.001). Mental fatigue level was significantly higher in day or night shift than that in evening shift of the control group(P<.05). In the neuro-sensory fatigue level, test group showed higher tendency than that in the control group, but there were no significant differences between two groups. 3) The total fatigue level was higher in night shift than that in day shift or evening shift(P<.05). In comparing with the control group, night shift and day shift showed higher total fatigue level than that in the control group(p<0.05). 2. The concentration of urinary 17-KS, $Na^+$ and $Cl^-$ In the control group, urinary 17-KS, $Na^+$ and $Cl^-$ showed higher level in afternoon that in morning and night. In the test group, cr in day and evening shift and $Na^+$ in evening shift showed higher level at the end of work. The 17-KS concentration at the begining and the end of work in three shift groups were lower than those in control group(p<0.05), however, $Cl^-$ concentration at the begining of work in day shift, and the end of work in day and evening shift were higher than those in control group(p<0.05). $Cl^-$ concentration at the begining and end of work in night shift were considerably higher than those in control group repectively(p<0.1, p<001). $Na^+$ concentration showed a higher tendency in three shift groups except at the begining of work in night shift, but there were no statistical difference. In comparing concentration of the 17-KS, $Na^+$ and $Cl^-$ among the shift groups, 17-KS concentration showed a lower tendency and $Na^+,\;Cl^-$ showed a higher tendency in night shift: The result of this study showes that biorhythm of shift work nurse was irregular. Fatigue level as the subjective index for evaluating the health problem concerning shift work was higher in night shift and proved to be in accordance with the concentration of urinary 17-KS, $Na^+$ and $Cl^-$ used as objective indices. Disturbation of biorhythm and work stress due to night shift seems to cause the health problem of nurses and decrease of work efficiency. It is considered that work regualtion is necessary for the rational management of the nursing administration.

• 농촌의학ㆍ지역보건
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• 제38권2호
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• pp.85-96
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• 2013

간호대학생의 아동학대에 대한 인식과 관심 및 경험실태를 파악하고, 이와 관련된 요인을 검토하고자 2개 간호학과 임상실습을 경험한 3-4학년 학생을 대상으로 아동학대인식 측정도구를 번안한 44항목으로 구성된 설문지를 전문조사자에 의해 실시한 결과 370명을 최종 분석대상으로 하였다. 분석은 관련요인 특성 별 아동학대 인식 비교는 독립표본 t-검정 방법을, 관련 요인 파악은 후진제거방식 회귀분석을 이용하였다. 간호대학생들은 아동학대에 대한 관심은 있었지만 법에 대해서 잘 모르고 있었으며, 교육이나 연수를 받은 경험도 상당히 낮은 것으로 조사되었다. 그러다 보니 아동학대에 대한 신고경험도 거의 전무하였다. 교육이나 훈련경험, 법에 대한 인지도는 고학년이 더 높은 것으로 나타났는데, 이는 아동간호학에서 일부 다루어지기 때문인 것으로 보인다. 전체적으로 아동학대 인식은 3.01점으로 도구에 포함된 행동을 '가끔'이라도 하면 학대로 인식하는 수준이었다. 하부 영역에서는 성적 학대에 대한 인식이 가장 높았으며, 신체학대, 심리적 학대가 그 다음 이었고, 방임에 대한 인식은 아주 낮은 수준이었다. 또한 평소 아동학대에 관심이 있거나, 학대가 의심될 때 관심이 있는 학생의 인식 점수가 유의하게 높았다. 간호대학생은 미래 신고의무자가 될 의료인으로서 아동학대에 대한 관심과 인식수준을 높이기 위한 방안으로 교육을 강화하여 아동학대에 대한 전문성을 높여야 할 것이다.

• Child Health Nursing Research
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• 제7권1호
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• pp.21-34
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• 2001

The impact of childhood experience has lifelong significance on subsequent health and development. Especially, the experience of infant is mostly affected by the quality of parental care and rearing environment. But the new mothers usually do not know what to do because of the lack of experience in these days. Therefore, an educational program regarding maternal role would be necessary. This study was conducted to evaluate the effectiveness of the maternal role education program for mother-infant interaction, child-rearing environment, and infant development. Non-equivalent control group time-series design was used, and Barnard's mother-infant interaction model was used as a conceptual framework of this study. The subjects were the healthy infants weighing over 2,500gm at birth, whose gestational age was more than 37 weeks, and their mothers. The final sample consisted of 19 mother-infant dyads for intervention group and 18 dyads for control group. Data were collected from March 15th to September 3rd in 1999. For the intervention group, programmed education which focused on mother-infant interaction, breast feeding, and infant care was provided before discharge. Telephone counselling was provided within one week after discharge. Home visiting for maternal role education was provided twice, one month and three months postpartum. For the control group, home visiting was also conducted but only for data collection. The data were analyzed using chi-square test and t-test to test the equivalence of two groups, and the effectiveness of intervention program was determined with repeated measure ANCOVA and t-test. The results were as follows: 1. Significant differences were found in mother-infant interaction between two groups(p=.000). It indicates that intervention program was effective in improving mother- infant interaction. In subscale analysis, four out of six subscale showed significant differences between the groups: sensitivity to cues (p=.000), social-emotional growth fostering (p=.000), cognitive growth fostering(p=.000) in mothers, and responsiveness to caregiver (p=.019) in infants. 2. The difference in the mean score of childrearing environment (HOME) between the intervention group and control group was significant(p=.003). When each subscale of HOME was examined individually, intervention group showed significantly higher scores in the diversity of stimulation(p=.000), and mother's involvement(p=.001). 3. Three-month-Infants of the intervention group showed higher GQ in the Griffiths mental development scale(p=.026). In subscale analysis, significant differences were found in the personal-social(p=.005), and the hearing and speech(p=.003). In conclusion, the maternal role education program proved to be effective in promoting the mother-infant interaction, organizing the childrearing environment, and fostering the infant development. These results are very meaningful that we found maternal role education necessary for normal infants' mothers, and that nurses can make a great contribution in promoting health of infants and mothers.

• 한국산학기술학회논문지
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• 제17권5호
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• pp.164-172
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• 2016

본 논문은 관상동맥우회술 대상자의 사회적지지, 우울, 건강관련 삶의 질의 관계를 규명하고자 하였다. 서울시 S 상급종합병원에서 관상동맥우회술을 받고 외래에 내원한 환자 134명을 대상으로 설문지를 이용하여 자료 수집하였고, SPSS WIN 21을 이용하여 통계 분석하였다. 신체적 건강관련 삶의 질은 연령(F=4.616, p=.004), 성별(t=3.657, p<.001), 교육정도(F=7.688, p=.001), 직업(t=-4.363, p<.001), 배우자(t=-3.065, p=.003), 기저질환(F=3.078, p=.030)에 따라 유의한 차이를 보였다. 정신적 건강관련 삶의 질은 성별(t=2.243, p=.027), 월수입(F=2.821, p=.041)에 따라 유의한 차이를 보였다. 사회적지지는 우울(r=-.415, p<001)과 통계적으로 유의한 부적 상관관계가 있었으며, 정신적 건강관련 삶의 질(r=.261, p=.002)과 유의한 정적 상관관계가 있는 것으로 나타났다. 우울은 신체적 건강관련 삶의 질(r=-.459, p<.001), 정신적 건강관련 삶의 질(r=-.554, p<.001)과 각각 통계적으로 유의한 부적 상관관계가 있었다. 관상동맥질환자의 신체적 건강관련 삶의 질 영향요인은 우울, 기저질환이었고, 설명력은 36.7%이었으며, 정신적 건강관련 삶의 질 영향요인은 우울이었고, 설명력은 34.1%이었다. 관상동맥우회술 후 최적의 건강관련 삶의 질을 위해 우울을 주요 요인으로 하는 표준화된 간호 중재를 개발할 필요가 있다.