• 한국산학기술학회논문지
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• 제22권5호
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• pp.229-240
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• 2021

본 연구는 입원환자를 대상으로 환자안전인식과 환자안전활동 수행 간의 관계를 확인하고 환자안전인식과 환자안전활동 수행을 증진시키기 위한 중재 프로그램을 개발하는데 기초자료로 제공하고자 수행하였다. 본 연구의 대상자는 D광역시 일 상급종합병원에 입원한 성인 환자 103명이었다. 자료수집은 2021년 2월 22일부터 3월 12일까지 이루어졌고, 환자안전인식과 환자안전활동 수행을 측정하기 위한 구조화된 설문지를 사용하였다. 입원환자의 환자안전인식은 5점 만점에 4.22±0.52점, 환자안전활동 수행은 4점 만점에 3.35±0.48점이었다. 환자안전인식은 환자안전교육 경험과 유의한 차이가 있었고(t=4.85, p<.001), 환자안전활동 수행은 결혼상태(t=2.75, p=.007), 환자안전교육 경험(t=3.88, p<.001)에 따라 유의한 차이가 있었다. 환자안전인식과 환자안전활동 수행은 유의한 상관관계가 있었다(r=.59, p<.001). 본 연구의 결과를 통해 임상에서 적용 가능한 입원환자의 환자안전인식과 환자안전활동 수행 증진을 위한 프로그램을 개발하고 시스템적으로 적용함으로써, 환자안전문화 향상을 도모할 필요가 있다.

• 한국산학기술학회논문지
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• 제21권6호
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• pp.127-136
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• 2020

본 연구는 만성질환자를 대상으로 건강관련 의사결정에 대한 참여 정도와 자가간호역량의 관계를 확인하고 자가 간호역량에 영향을 미치는 요인을 파악하기 위한 서술적 조사연구이다. 자료수집은 2018년 1월 1일부터 1월 31일까지 경기도 소재 보건소에서 만성질환으로 진료를 받는 만성질환자 518명을 대상으로 시행되었다. 자가 보고식 설문지를 사용하였으며, IBM SPSS/WIN 22.0을 이용하여 기술통계, t-test, ANOVA, Scheffé test, Pearson correlation coefficients, multiple linear regression으로 분석하였다. 연구결과 건강관련 의사결정에 대한 참여 정도와 자가간호 역량의 평균점수는 각각 3.62±0.20, 4.57±0.34였고, 건강관련 의사결정에 대한 참여 정도와 자가간호역량과 유의한 차이를 타나낸 주요 변수는 성별, 연령, 학력, 진단받은 질환명, 주관적 건강상태이다. 건강관련 의사결정에 대한 참여 정도와 자가간호역량 간에 유의미한 양의 상관관계(r=.66, p=.043)를 나타냈다. 대상자의 자가간호역량에 영향을 미치는 요인으로는 학력(β=-2.23, p<.001), 건강에 대한 관심정도(β=0.14, p=.003), 주관적인 건강상태(β=2.57, p=.011), 연령(β=-0.36, p=.048)으로 확인되었으며, 자가간호역량의 전체 설명력이 .56 으로 확인되었다. 이상의 결과는 만성질환자 간호 시 대상자 특성을 헤아려야 하며, 만성질환자의 자가간호역량을 높이기 위해 건강관련 의사결정 시 능동적인 태도를 독려해야 할 필요성을 제시하였다. 또한 추후 연구에서 만성질환자의 능동적인 참여를 이끌어낼 수 있는 가이드라인을 제시하는 연구를 시도해 볼 것을 제언한다.

• 한국융합학회논문지
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• 제10권6호
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• pp.365-379
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• 2019

본 연구의 목적은 환자-가족중심 의료서비스의 특성과 성과를 체계적 문헌고찰 방법으로 분석하여 서비스의 융합적 유효성을 평가하는 것이다. 15개 전자 데이터 베이스에서 환자-가족중심 의료서비스의 성과를 연구한 RCT 문헌 검색, 선정, 자료 추출, 질 평가를 시행하였다. 선정된 21편 문헌의 환자-가족중심 의료서비스의 공통적 특성은 정보제공과 교육, 의사소통, 가족 및 친구의 참여였다. 환자-가족중심 의료서비스의 성과 측정 변수는 89개였고, 환자 성과는 사망률, 재원기간 등으로 측정되었으며 18편의 문헌에서 환자 성과가 유의하게 향상되었다. 본 연구는 환자-가족중심 의료서비스의 성과를 통합적으로 제시하여 서비스의 유효성을 증명함으로써 의료기관과 지역사회의 지속적인 의료질 향상 활동을 위한 당위성을 제공하였으며 향후 의료의 질 향상과 환자안전을 위한 환자-가족중심 의료서비스의 융합적 적용과 이에 대한 근거기반 연구가 필요함을 제언한다.

• 대한한의진단학회지
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• 제16권3호
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• pp.49-58
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• 2012

Objectives: This research was designed to study the characteristics of heart rate variability in acute dyspepsia patients compared with normal group. Methods: The testing of HRV was carried out at Oriental Medical Center of ${\bigcirc}{\bigcirc}$University with the participation of 94 acute dyspepsia patients and 85 control group people. We checked HRV of the 2 groups that were checked on the first visit day and compared HRV index between groups. Results: In the frequency domain analysis, HF, LF, VLF, LF/HF ratio, TP were significantly lower than control group on acute dyspepsia patient group. HF, LF, VLF, LF/HF ratio, TP were not significantly associated with age. Conclusions: According to this study, autonomic nerve system was more decreased on the acute dyspepsia patient group compared with the control group. Though further studies will be needed, the present finding provide us the possibility that stress is a major cause of the acute dyspepsia along with food factor.

• 대한간호학회지
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• 제29권4호
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• pp.892-902
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• 1999

The purpose of this study was to investigate the ethical values of senior students in nursing (N＝111) and in medicine(N＝82). The data were collected through self-reported questionnaires in April, 1999. Categories for classifying used in the content analysis of the responses were : (1) human life (2) patient relationship (3) task relationship and (4) co-worker relationship. The results of the study are as follows ; 1) The ethical values of students in nursing and medicine were in the direction of utilitarian in the area of human life. The ethical values of students in nursing and medicine were in the direction of a deontological position in the area of patient relationship. The mean score for students in nursing was significantly higher than for those in medicine(P＜0.01) The ethical values of students in nursing and medicine was in the direction of utilitarian in the area of task relationship. The mean score for students in medicine was significantly lower than that of students in nursing(P＜0.01). The ethical values of students in nursing and medicine was definitely in the direction of a deontological position in co-worker. The mean score for students in nursing was significantly higher than that of students medicine (P＜0.05). 2) A positive correlation was found between the area of human life and patient relationship(P＜0.05), patient and task relationship(P＜0.01), and task and co-worker relationship(P＜0.05) for students in nursing. On the other hand, the area of human life was positively correlated with patient, task and co-worker relationship area(P＜0.05) for students in medicine. The area of patient relationship was also positively correlated with co -worker relationship for the students in medicine(P＜0.01). 3) The ethical values of students in nursing were related to demographic characteristics ; degree of participation in religion(P＜0.01)and degree of recognition of an ethical codes(P＜0.05), on the other hand, the ethical values of students in medicine showed no significant differences according to demogrephic variables.

• The Journal of Korean Physical Therapy
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• 제36권1호
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• pp.33-38
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• 2024

Purpose: This study investigated the effect of proprioceptive neuromuscular facilitation (PNF) on gait speed in a stroke patient with genu recurvatum. Methods: The subject was a 52-year-old female diagnosed with stroke. Information on health was collected through client Interview based on the International Classification of Functioning, Disability and Health (ICF). The ICF was used to identify connections between functional problems, and for diagnosis, and functional problems were described using ICF terms. For prognostic purposes, comprehensive goals for functional activity and participation level are presented as long- and short-term goals. Intervention was performed using an exercise program composed of techniques and principles based on PNF concepts for 50 minutes a day, 3 times a week, for 6 weeks. Gait speed and lower limb strength before to after intervention differences were used as study outcomes. Results: Clinical advantages were observed in body function (3.6kg increase in knee extension strength, 1.4kg increase in knee flexion strength, 0.9kg increase in hip abduction). Gait speed, which was the patient's primary limitation, was improved by 0.2m/sec. Conclusion: Based on the results of this study, application of the PNF concept would appear to improve gait speed and genu recurvatum in stroke patients.

• 종양간호연구
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• 제2권1호
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• pp.36-49
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• 2002

The purpose of this study was to evaluate the effects of the pain management education on pain of the terminal cancer patients at home. For evaluating the effectiveness of the intervention modified Patient Outcome Questionnaire (APS, 1995) including patients concerns with cancer pain management, pain intensity, and interference of daily activities related to pain were measured before and after the education in control group and experimental group and the differences were compared with each other. Satisfaction with pain management was measured after the intervention. Pain management education was delivered to 16 experimental group patients by home care nurses, who were provided with 3-hour education on cancer pain management by one of the researchers. Pain management education included common misconceptions about cancer pain control and pharmacological and non-pharmacological interventions and emphasis was put on the importance of pain reports and patients' active participation in pain management. The results of the study were as follows. Patients concerns with pain management were decreased more greatly in the experimental group than those of the control group. The worst, average, and present pain intensities during the last 24 hours were decreased more greatly in the experimental group, and total score and each subcategory of the interference of daily living, except walking, were decreased more greatly in the experimental group. And satisfaction score with total pain management and nurses response to the pain reports were higher in the experimental group. The results of this study suggest that pain management education given to the patients by home care nurses is a very useful intervention to improve pain of the cancer patients at home. This positive result is thought to derive from patients' active pain report and participation in pain control and the use of powder form sustained release morphine for breakthrough pain control in part. Further studies with increased sample size from more institutions are recommended and early introduction of short acting morphine is strongly suggested for effective cancer pain control.

• 한국병원경영학회지
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• 제22권4호
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• pp.74-86
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• 2017

Purposes: This study was performed to understand the recognition about accreditation motives, support within the hospital and accreditation survey process for the hospitals that participated in the accreditation program and to find out whether these factors are related to hospital management performances, so that the study can suggest plans for activation and development of the accreditation program. Methodology: This study was performed targeting 98 hospitals answered th the survey among 189 acute care hospitals that acquired accreditation from December 2010 to February 2014. For data analysis, frequency analysis, ${\chi}^2$-test, reliability analysis, ANOVA, Kruskal-Wallis H test and multiple regression analysis with SPSS 21.0 were used. Findings: The hospitals that had staff in charge of patient safety had bigger hospital culture change than those that didn't have(p<.05). In addition, the hospital culture change was bigger as internal motives were bigger, and as CEO's will was bigger(p<.05). Meanwhile, as maintenance rate of internal management after accreditation was higher, and as CEO's will was bigger, process improvement level was higher(p<.05). The quality improvement and patient satisfaction level were higher as CEO's will was bigger, and as suitability of survey process was recognized to be high(p<.05). As a result of analyzing the factors that affect hospital management performances with hospital culture change, process improvement and quality improvement combined, as internal management maintenance rate was higher, as CEO's will was bigger, and as suitability of survey process was higher, performances were higher(p<.05). Practical Implications: Hospitals need to reinforce internal motives to improve internal competences such as the whole system maintenance opportunity and staff training. In addition, the will of hospital director is most important, and if there is hospital director's interest in quality improvement and improvement intention definitely, employees voluntarily participate in and cooperate with the accreditation program, so that prompt medical service provision and high quality of medical services can be guaranteed, leading to hospitals' management performances.

• 한국콘텐츠학회논문지
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• 제15권1호
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• pp.286-299
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• 2015

본 연구는 의료기관 인증제의 의무 대상인 정신병원과 요양병원을 대상으로 환자안전 및 질 변화와 경영활동의 변화 간의 관계에 대해 의료기관 인증을 받은 5개 정신병원과 5개 요양병원에 근무하는 종사자들을 대상으로 조사 연구한 결과, 정신병원과 요양병원 종사자들의 인증업무 참여유무는 환자안전 및 질 관리 변화 측정내용 중 '안전보장활동 수행정도' '환자를 위한 양질의 의료서비스 제공정도' '환자의 권리와 책임에 대한 존중정도' '감염발생 위험예방 위한 감염관리활동 수행정도'의 향상 변화에 유의하게 긍정적인 상관관계를 보였다. 그리고 환자안전 및 질 관리 내용 중 안전보장활동 지속적인 질 향상 활동 환자의 권리와 책임에 대한 존중의 지속적인 발전적 변화를 추구하기 위해서는 교육훈련을 통해서 조직구성원들의 역량을 강화시키는 경영활동이 필요하며, 진료전달 체계와 평가의 관리 환자를 위한 양질의 의료서비스 제공의 지속적인 발전적 변화를 위해서는 고객지향성 업무프로세스를 사회 환경의 변화에 맞추어 추구하는 경영활동이 필요함을 알 수 있었다.

• 임상간호연구
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• 제28권3호
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• pp.223-232
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• 2022

Purpose: The purpose of this study was to apply patient-engaged bedside handoffs in comprehensive care units, and to evaluate the effects of bedsides to nurses and patients. Methods: This study employed a cluster randomized cross-over design.Electrical Medical Record (EMR)-based handoffs and patient-engaged bedside handoffs were alternatively applied to 104 patients, who were assigned to a total of 30 clusters (nursing handoff teams) in 4 comprehensive care units at the S medical center in Seoul, and the patients evaluated each type of handoffs. A total of 139 nurses were also participated in the same units and evaluated each type of handoffs. Data were analyzed using t-test, Wilcoxon rank sum test, ANOVA, and Kruskal-Walls test. Results: The patient's satisfaction of the patient-engaged bedside handoffs was higher than that of the EMR-based handoffs (Z=-5.16, p<.001). On the other hand, the nurse's satisfaction of the patient-engaged bedside handoffs was significantly lower than that of the EMR-based handoffs (t=13.21, p<.001). There were no differences in length of the reporting time between two types of handoffs (t=-0.48, p=.634). Conclusion: Patient satisfaction with the patient-engaged bedside handoffs was higher than that of EMR-based handoffs, and nurses' satisfaction with the patient-engaged bedside handoffs was significantly lower than that of EMR-based handoffs. Future studies are needed regarding the impacts of patient-engaged bedside handoffs on the quality of healthcare by identifying the benefits of the handoffs.