• 제목/요약/키워드: physical and mental health care

검색결과 322건 처리시간 0.024초

재가 만성 뇌졸중 편마비 환자의 가정 재활운동 프로그램의 효과 (The Effect of Home Rehabilitation Exercise Program of Home Stayed Chronic Hemiplegic Stroke Patients)

  • 노국희
    • 한국보건간호학회지
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    • 제16권1호
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    • pp.77-94
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    • 2002
  • This study was a quasi-experimental study of nonequivalent control group pretest- posttest design to investigate the effect of home rehabilitation exercise program on the physical and psychological functions of home stayed chronic hemiplegic stroke patients. The data were collected during the period of May 20th to August 15th, 200l. The subjects for this study were 40 hemiplegic stroke patients with the experimental group consisting of 19 patients and the control group being composed of 21 patients. The patients selected for this study were: (a)living in J city who had been diagnosed with stroke and at home after being discharged from the hospital, (b) suffering from stroke for 6 months to 5 years, (c) without recognition disorder with the MMSE-K(Mini-Mental State Examination-K)score above 25, (d) below 2 on the modified Ashworth scale, (e)free from heart and pulmonary disease, (f)able to walk beyond 15 minutes for themselves, (g) not taking regular exercises. The program for the experimental group provided 8 weeks' home rehabilitation exercise, two times of group education during the first week and individual education and supportive care after the second week through home visiting and telephoning more than once a week. The amount of time spent on rehabilitation exercise by the experimental group was 35 to 50 minutes a day, three times a week. In order to understand the effects of experiment the two groups were compared and verified by measuring the physical and psychological functions of both groups. The data were analysed by $\chi^{2}-test$, paired t-test and unpaired t-test and ANCOVA through SAS/PC program. The results of the study were as follows: 1. In terms of physical variables: grip strength. lower extremity muscle strength, walking time, ADL and serum lipid levels 1) There was no significant difference in the unaffected and affected grip strength between the two groups, even though the unaffected and affected grip strength was more improved in the experimental group than in the control group. 2) There was no significant difference in the unaffected lower extremity muscle strength between the two groups, even though the unaffected lower extremity muscle strength was more improved in the experimental group than in the control group. There was no significant difference either in the affected lower extremity muscle strength between the two groups, even though the affected lower extremity muscle strength was more improved in the experimental group than in the control group. 3) There was significant difference in walking time between the two groups. Walking time was significantly reduced in the experimental group whereas it increased in the control group. 4) There was significant difference in ADL score between the two groups. ADL score was significantly increased in the experimental group, but it significantly decreased in the control group. 5) There was significant difference in serum total cholesterol level between the two groups. After experiment the serum T-C level became lower in the experimental group whereas it became sigficantly higher in the control group. 2. In terms of psychological variables: depression and self-esteem 1) There was no significant difference in the depression between the two groups, even though the depression showed constant in the experimental group, but it showed a significant increase in the control group. 2) There was no significant difference in the self-esteem between the two groups, even though the self-esteem showed some increase in the experimental group, but it significant decrease in the control group. As shown above, the results of 8 weeks' home rehabilitation exercise program for chronic hemiplegic stroke patients produced positive effects on walking time, ADL score and serum T-C level, shortening walking time, improving activities of daily living(ADL) and lowering serum total cholesterol level.

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대학생의 약물 사용 실태.지식 및 태도(서울 및 경기 북부지역) (The Survey on the Drug use status, Knowledge and Attitude of College Students (Seoul and Northern Part of the Kyunggi-do))

  • 한경순;문선영;박현옥;박은희
    • 한국간호교육학회지
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    • 제6권2호
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    • pp.376-389
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    • 2000
  • The Purpose of this study was to grasp the status of drug uses in college students, and to investigate the knowledge and attitude when they use it. We collected through questionnaires from Sep. 1 to Oct. 30 in 1999. The subjects were 490 college students in Seoul and northern of the Kyunggi-do. The data analysis was performed using SPSS (version 7.0) and ANOVA. The results of this study were as follows. 1. There was no correlation for all factors in the relationship between general characteristics of subjects and knowledge for drugs. On the contrary, in the relation of the general characteristics and attitude for drug of subjects, some factors are statistically significant e.g., department (F=3.049, p<.010), satisfaction for school life (F=6.167,p<.002), body shape(F=8.092, p<.000), and the relationship with ones parents (F=3.728, p<.005). 2. In the analysis of drug use status and knowledge, only in the factor of administration control was statistically significant(F=4.304, p<.014) and in the relation of attitude for drug uses, drug administration was statistically significant (F=4.521, p<.004). 3. In the mean scores for the drug knowledge analysis, the highest factor was 'A narcotic make deformed persons through poisoning of physical and mental' (M=4.14), the lowest factor was 'If catch the flu during the pregnancy, should be take drug as possible as quickly to reduce negative effect for fetal' (M=1.94). 4. In the analysis for drug attitude, the highest factor was 'A drug is alike a poison' (M=3.48), 'Should be keep the usage and dosage of drug' was the lowest (M=1.48). 5. From the investigation for status of drug use, it was revealed that the most subjects (73.6%) were purchase drugs after explain their symptoms to pharmacist. And they take drugs only when they felt painful in 43.1%. The most students (70.4%) were experienced control of drug administration. It was inquired that subjects were mainly obtained information about drugs from pharmacist and television (or radio) advertisement, 33.5% and 33.1%, respectively. In the examination for existence of long-term administrators in their family, 'none' and 'only parents' are 49.6% and 37.3%, respectively. When their parents have illness, the persons go to drugstore and hospital for heath-care, 47.8% and 44.3%, respectively. On the basis of results of this study, we suggest as follows. 1. This study was analyzed data from questionnaires for college students in a part of local areas, so we suggest that the next research should be perform for national-wide students as subjects to generalize the results. 2. It is need more intensive research methodologies such as interview and observation. 3. Additional research is required for knowledge and behaviors of drug uses that will how impact on ones health behavior.

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우리나라 노인 정책 방향 제언을 위한 탐색적 연구 : 노인 연령규범과 희망활동의 융복합적 관점을 중심으로 (A Study on Proposal to Develop Senior related Policies : Convergence Approach of both Age Norm and Hoping Activities)

  • 구혜경
    • 디지털융복합연구
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    • 제14권4호
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    • pp.101-110
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    • 2016
  • 본 연구는 노인복지법 제5조에 근거하여 3년마다 실시되는 노인실태조사의 2014년 결과를 토대로 우리나라 노인을 연령규범 인식에 따라 유형화 하고, 각 유형별 특성을 파악하고 이들의 삶의 만족도와 희망활동에 대한 요구도 차이를 분석하였다. 현재의 노인은 과거 20~30년 전의 노인과 건강, 교육수준, 경제수준 등이 더 높으며 과거 노인을 대상으로 수립한 노인 관련 정책들은 이제 사회, 문화, 산업, 복지, 고용, 참여 등 융합적인 관점에서 재논의 되어야 하는 시점으로 본다. 본 연구에서 분석한 결과 우리나라 노인은 크게 체념형, 진취형, 체면형의 3개 유형으로 구분되었다. 이는 노인의 연령규범 인식에 따른 구분이며, 이에 따라 삶의 만족도 및 희망하는 활동에 대한 차이가 확인되었다. 향후 우리나라 노인 관련 정책은 기존 취약노인을 대상으로 하는 복지적 관점만이 아니라, 고용, 사회참여, 생활 만족, 자원봉사 등 다양하고 융합적인 관점에서 고려할 필요가 있으며 특히 노-노 케어 및 친분이 있는 소규모 노인 집단을 대상으로 정책을 접목하는 시도 등도 필요할 것으로 본다.

해양 원격의료 지원 개선을 위한 응급처치 담당자의 교육요구도 분석 (Analysis of the Educational need of Vessel First Aid Managers for Improvement of Marine Telemedicine Service)

  • 서보휘;고대식
    • 보건의료생명과학 논문지
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    • 제11권1호
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    • pp.87-96
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    • 2023
  • 본 연구는 상급안전재교육을 받은 교육생을 대상으로 상급안전신규교육과 해양원격의료서비스의 중요도와 만족도를 파악하고 교육요구도 우선순위를 파악하는 서술적 조사연구이다. 한국해양수산연수원에서 상급안전재교육을 실시한 교육생 190명의 자료를 연구에 활용하였다. 연구결과 상급안전신규교육 교육요구도는 생명징후 측정법이 최우선 항목으로 선정되었고, 해양원격의료지도 유형별 교육요구도는 신경계, 순환기계, 외과계가 최우선 항목으로 선정되었다. 본 연구결과로부터 바다라는 시·공간적 제약과 선박이라는 한정된 공간에서의 응급상황 발생 시 환자의 전반적인 상태를 파악하여 적절한 응급처치를 결정하기 위해 생명징후 측정법에 대한 교육요구도가 높았던 것으로 생각되며, 장시간 근무 및 단조로운 일상생활이 정신적·육체적 스트레스의 원인으로 작용하여 신경계, 순환계 및 외과계의 환자 발생률이 높고 다른 계통에 비해 환자 발생 시 생명과 관련성이 높아 교육요구도가 높았던 것으로 판단된다.

애완견 매개활동이 노인의 자기존중감, 우울 및 인지기능에 미치는 효과 (The Effects of Pet Dog-Assisted Activities on Self-Esteem, Depression and Cognitive Function among Elderly People)

  • 신에스더;이성국
    • 농촌의학ㆍ지역보건
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    • 제35권3호
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    • pp.314-325
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    • 2010
  • 본 연구는 애완견매개활동이 양로원 노인들의 자기존중감, 우울 및 인지기능에 미치는 효과를 조사하기 위하여 대구광역시 소재의 1개 양로원의 90여명의 노인들 중 65세 이상의 노인들 22명을 선정하여 실험군으로 하고 대구광역시 소재의 또 다른 곳에 위치하고 있는 1개 양로원의 90여명의 노인 중 65세 이상의 노인들 22명의 노인들을 선정하여 대조군으로 하였다. 일반적 특성과 건강상태 및 행위에 관한 특성, 자기존중감, 우울 및 인지기능에 관한 특성이 동일한 자들로 실험군과 대조군을 선정하여 실험군에게는 주 1회 3 실험군간 12회기의 애완견매개활동에 참여하게 한 후 실험 전과 실험 후의 자기존중감, 우울 및 인지기능, 우울 및애완견매개활동을 하지 않고 정기적인 방문만을 한 대조군과 비교하여 분석하였다. 실험군 중 애완견매개활동 12회 중 10회 이상 참여한 19명과 대조군 중 실험 종료 1주 후 그리고 실험 종료 4주 후의 척도검사에 모두 응답한 20명을 최종분석 대상자로 하여 자기존중감, 우울 및 인지기능의 변화를 비교하였더니 실험군에서 자기존중감, 우울 및 인지기능의 점수가 긍정적으로 변화하였으며 이들의 변화는 통계적으로 유의하게 나타났다. 이상의 결과를 볼 때 애완견매개활동은 노인층인구의 증가, 이혼율의 증가, 출생율의 저하, 핵가족화, 개인화 및 디지털 문화의 확산 등으로 인해 소외감과 외로움을 느끼는 사람들이 늘고 있는 이러한 사회적 여건 속에서 애완견매개활동은 이들에게 정신적, 사회적으로 유용한 치료 및 긍정적 향상으로서의 역할을 할 수 있을 것이라 사료된다. 특히 신체적 정신적 사회적 능력의 퇴보로 심리 정서적인 문제들을 가지고 있는 노인들에게는 매우 효과적인 중재방안이 될 수 있으며 여러 종류의 의료 시설, Care시설 및 교화목적을 위한 시설 등에도 활발하게 적용 가능한 방안으로서의 관련프로그램 개발도 이루어져야 할 것이다.

일부 농촌지역 거주 노인들에 대한 포괄적 노인평가 (Comprehensive Geriatric Assessment for Community Living Elderly in a Rural Area)

  • 이정애;신희영;정은경;신준호
    • 농촌의학ㆍ지역보건
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    • 제27권1호
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    • pp.21-31
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    • 2002
  • 일부 농촌 지역사회 거주 노인들의 신체적, 정신적, 기능적, 사회환경적 상태를 포함하는 포괄적 노인평가를 시행하여 지역사회 중심 노인보건사업의 기초자료를 얻고자 하였다. 전라남도 일개 군에서 층화 집락추출한 지역사회 거주 65세 이상 노인 388명을 대상으로 조사를 하였다. 조사내용은 노인들의 인구사회학적 특성, 현병력, 신체적, 정신적 건강상태, 일상생활활동(ADL), 도구적 일상생활활동(IADL) 및 대상노인들의 사회적, 환경적 평가를 포함하였다. 주요 연구결과는 다음과 같다. 1. 전체 388명 중 남자가 169명(43.6%)이었고 여자가 219명(56.4%)이었으며, 평균연령은 남자 $73.5{\pm}6.4$세, 여자 $74.0{\pm}6.2$세였다. 2. 조사노인 1인당 평균 1.6개의 질환을 가지고 있었으며, 3개 이상의 질환을 가지고 있는 노인들은 약 19%나 되었다. 3. 신체적 건강상태는 시각기능의 감소가 남녀 각각 50.9%, 65.3%로 다른 기능에 비해 가장 많았고, 씹거나 삼키는 데 어려움이 있는 구강기능의 감소도 34.3%, 39.3%로 그 다음을 차지하였으며, 상대적으로 상지, 하지 기능의 감소는 1-6% 정도로 적은 편이었다. 4. 정신적 건강상태는 단기 기억력으로 살펴 본 인지기능의 감소가 33.7%, 44.7%로 적지 않았고, 노인우울 평가를 이용하여 우울증 여부를 조사한 결과 남자에서 19.1%, 여자에서 24.9%이었다. 5. 일상생활활동(ADL) 평가 결과 6가지 모두 독립적으로 수행할 수 있는 노인이 남자 72.2%, 여자 58.9% 이었으며, 도구적 일상생활활동(IADL)은 식사준비하기가 가능한 경우가 남자에서 81.1%로 여자의 92.7%에 비해 낮았고, 반대로 금전관리가 가능한 경우는 여자에서68.9%로남자의 83.5%에비해낮았다. 6. 사회적 지지체계의 평가에서는 도움이 필요할 때 제공할 수 있는 수발자가 있는 경우가 26.3%이었고, 수발자와의 관계는 배우자가 가장 많고 다음은 며느리 였다. 가족과의 거주형태별로는 49.5%가 노부부만 사는 경우였고, 다음은 노인 혼자 사는 경우로 22.9%를 차지하였다. 환경적 평가에서는 위험요소 네 가지 중 하나이상을 가진경우가83.5%나되었다. 따라서 농촌지역 거주 노인들에 대한 포괄적 평가는 지역사회 중심 노인보건프로그램을 개발하기 위한 기초자료를 제공하였다.

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금원사대가의학(金元四大家醫學)이 조선조의학(朝鮮朝醫學) 형성(形成)에 미친 영향(影響) (The influence of the four noted physicians of Geum-Won era on the completion of the medicine in the Chosun dynasty)

  • 정면;홍원식
    • 대한한의학원전학회지
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    • 제9권
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    • pp.432-552
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    • 1996
  • The influence of the four noted physicians of Geum-Won era(金元代) on the completion of the medicine in the Chosun dynasty(朝鮮朝) can be summarized as follows. 1. The four noted physicians of Geum-Won era were Yoo-Wan-So(劉完素), Jang-Jong-Jung(張從正), Lee-Go(李杲), Ju-Jin-Heung(朱震亨). 2. Yoo-Wan-So(劉完索) made his theory on the basic of Nae-Kyung("內經") and Sane-Han-Lon("傷寒論"), his idea of medicine was characterized in his books, for exemple, application of O-Oon-Yuk-Ki(五運六氣), Ju-Wha theory(主火論) and hang-hae-seng-je theory(亢害承制論). from his theory and method of study, many deviations of oriental medicine occurred. He made an effort for study of Nae-Kyung, which had been depressed for many years, on the contrary of the way old study that Nae-Kyung had been only explained or revised, he applied the theory of Nae-Kyung to clinical care. The theory of Yuk-Gi-Byung-Gi(六氣病機) and On-Yeul-Byung(溫熱病) had much influenced on his students and posterities, not to mention Jang-Ja-Wha and Ju-Jin-Heung, who were among the four noted physicians therefore he became the father of Yuk-Gi(六氣) and On-Yeul(溫熱) schools. 3. Jang-Jong-Jung(張從正) emulated Yoo-Wan-So as a model, and followed his Yuk-Gi-Chi-Byung(六氣致病) theory, but he insisted on the use of the chiaphoretic, the emetic and the paregoric to get rid of the causes, specially he insisted on the use of the paregoric, so they called him Gong-Ha-Pa(攻下派). He insisted on the theory that if we would strenthen ourselves we should use food, id get rid of cause, should use the paregoric, emetic and diaphoretic. Jang-Jong-Jung'S Gang-Sim-Wha(降心火) theory, which he improved Yoo-Wan-So's Han-Ryang(寒凉) theory influenced to originate Ju-Jin-Heung'S Ja-Eum-Gang-Wha(滋陰降火) theory. 4. Lee-Go(李杲) insisted on the theory that Bi-Wi(脾胃) played a loading role in the physiological function and pathological change, and that the internal disease was originated by the need of Gi(氣) came from the disorder of digestive organs, and that the causes of internal disease were the irregular meal, the overwork, and mental shock. Lee-Go made an effort for study about the struggle of Jung-Sa(正邪) and in the theory of the prescription he asserted the method of Seung-Yang-Bo-Gi(升陽補氣), but he also used the method of Go-Han-Gang-Wha(苦寒降火). 5. The authors of Eui-Hak-Jung-Jun("醫學正傳"), Eui-Hak-Ib-Moon("醫學入門"), and Man-Byung-Whoi-Choon("萬病回春") analyzed the medical theory of the four noted physicians and added their own experiences. They helped organizing existing complicated theories of the four noted physicians imported in our country, and affected the formation of medical science in the Choson dynasty largely. Eui-Hak-Jung-Jun("醫學正傳") was written by Woo-Dan(虞槫), in this book, he quoted the theories of Yoo-Wan-So, Jang-Jong-Jung, Lee-Go, Ju-Jin-Heung, especially, Ju-Jin-Heung was respected by him, it affected the writing of Eui-Lim-Choal-Yo("醫林撮要"). Eui-Hak-ib-Moon("醫學入門"), written by Lee-Chun(李杲), followed the medical science of Lee-Go and ju-jin-heung from the four noted physicians of Geum-Won era. Its characteristics of Taoism, idea of caring of health, and organization affected Dong-Eui-Bo-Kham("東醫寶鑑"). Gong-Jung-Hyun(龔延賢) wrote Man-Byung-Whoi-Choon("萬病回春") using the best part of the theories of Yoo-Wan-So, Jang-Jong-Jung, Lee-Go, Ju-Jin-Heung, this book affected Dong-Eui-Soo-Se-Bo-Won("東醫壽世保元") partly. 6. our medical science was developed from the experience of the treatment of disease obtained from human life, these medical knowledge was arranged and organized in Hyang-Yak-Jib-Sung-Bang("鄕藥集成方"), medical books imported from China was organized in Eui-Bang-Yoo-Chwi("醫方類聚"), which formed the base of medical development in the Chosun dynasty. 7. Eui-Lim-Choal-Yo("醫林撮要") was written by Jung-Kyung-Sun(鄭敬先) and revised by Yang-Yui-Soo(楊禮壽). It was written on the base of Woo-Dan's Eui-Jung-Jun, which compiled the medical science of the four noted physicians of Geum-Won era. It contained confusing theories of the four noted physicians of Geum-Won era and organized medical books of Myung era, therefore it completed the basic form of Byun-Geung-Non-Chi (辨證論治) influenced the writing of Dong-Eui-Bo-Kham("東醫寶鑑"). 8. Dong-Eui-Bo-Kham("東醫寶鑑") was written on the base of basic theory of Eum-Yang-O-Haeng(陰陽五行) and the theory of respondence of heaven and man(天人相應說) in Nae-Kyung. It contained several theories and knowledge, such as the theory of Essence(精), vitalforce(氣), and spirit(神) of Taoism, medical science of geum-won era, our original medical knowledge and experience. It had established the basic organization of our medical science and completed the Byun-Geung-Non-Chi (辨證論治). Dong-Eui-Bo-Kham developed medical science from simple medical treatment to protective medical science by caring of health. And it also discussed human cultivation and Huh-Joon's(許浚) own view of human life through the book. Dong-Eui-Bo-Kham adopted most part of Lee-Go(李杲) and Ju-Jin-Heung's(朱震亨) theory and new theory of "The kidney is the basis of apriority. The spleen is the basis of posterior", so it emphasized the role of spleen and kidney(脾腎) for Jang-Boo-Byung-Gi(臟腑病機). It contained Ju-Jin-Heung's theory of the cause and treatment of disease by colour or fatness of man(black or white, fat or thin). It also contained Ju-Jin-Heung's theory of "phlegm break out fever, fever break out palsy"(痰生熱 熱生風) and the theory of Sang-Wha(相火論). Dong-Eui-Bo-Kham contained Lee-Go's theory of Wha-Yu-Won-Bool-Yang-Lib (火與元氣不兩立論) quoted the theory of Bi-Wi(脾胃論) and the theory of Nae-Oi-Sang-Byun(內外傷辨). For the use of medicine, it followed the theory by Lee-Go. lt used Yoo-Wan-So'S theory of Oh-Gi-Kwa-Keug-Gae-Wi-Yul-Byung(五志過極皆爲熱病) for the treatment of hurt-spirit(傷神) because fever was considered as the cause of disease. It also used Jang-Jons-Jung's theory of Saeng-Keug-Je-Seung(生克制勝) for the treatment of mental disease. 9. Lee-je-ma's Dong-Eui-Soo-Se-Bo-Won("東醫壽世保元") adopted medical theories of Song-Won-Myung era and analyzed these theories using the physical constitutional theory of Sa-Sang-In(四象人). It added Dong-Mu's main idea to complete the theory and clinics of Sa-Sang-Eui-Hak(四象醫學). Lee-Je-Ma didn't quote the four noted physicians of Geum-Won era to discuss that the physical constitutional theory of disease and medicine from Tae-Eum-In(太陰人), So-Yang-In(少陽人), So-Eum-In(少陰人), and Tae-Yang-In(太陽人) was invented from their theories.

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병원 간호사의 선호근무시간대에 관한 연구 (A Study on Hoslital Nurses' Preferred Duty Shift and Duty Hours)

  • 이경식;정금희
    • 대한간호
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    • 제36권1호
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    • pp.77-96
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    • 1997
  • The duty shifts of hospital nurses not only affect nurses' physical and mental health but also present various personnel management problems which often result in high turnover rates. In this context a study was carried out from October to November 1995 for a period of two months to find out the status of hospital nurses' duty shift patterns, and preferred duty hours and fixed duty shifts. The study population was 867 RNs working in five general hospitals located in Seoul and its vicinity. The questionnaire developed by the writer was used for data collection. The response rate was 85.9 percent or 745 returns. The SAS program was used for data analysis with the computation of frequencies, percentages and Chi square test. The findings of the study are as follows: 1. General characteristics of the study population: 56 percent of respondents was (25 years group and 76.5 percent were "single": the predominant proportion of respondents was junior nursing college graduates(92.2%) and have less than 5 years nursing experience in hospitals(65.5%). For their future working plan in nursing profession, nearly 50% responded as uncertain The reasons given for their career plan was predominantly 'personal growth and development' rather than financial reasons. 2. The interval for rotations of duty stations was found to be mostly irregular(56.4%) while others reported as weekly(16.1%), monthly(12.9%), and fixed terms(4.6%). 3. The main problems related to duty shifts particularly the evening and night duty nurses reported were "not enough time for the family, " "afraid of security problems after the work when returning home late at night." and "lack of leisure time". "problems in physical and physiological adjustment." "problems in family life." "lack of time for interactions with fellow nurses" etc. 4. The forty percent of respondents reported to have '1-2 times' of duty shift rotations while all others reported that '0 time'. '2-3 times'. 'more than 3 times' etc. which suggest the irregularity in duty shift rotations. 5. The majority(62.8%) of study population found to favor the rotating system of duty stations. The reasons for favoring the rotation system were: the opportunity for "learning new things and personal development." "better human relations are possible. "better understanding in various duty stations." "changes in monotonous routine job" etc. The proportion of those disfavor the rotating 'system was 34.7 percent. giving the reasons of"it impedes development of specialization." "poor job performances." "stress factors" etc. Furthermore. respondents made the following comments in relation to the rotation of duty stations: the nurses should be given the opportunity to participate in the. decision making process: personal interest and aptitudes should be considered: regular intervals for the rotations or it should be planned in advance. etc. 6. For the future career plan. the older. married group with longer nursing experiences appeared to think the nursing as their lifetime career more likely than the younger. single group with shorter nursing experiences ($x^2=61.19.{\;}p=.000;{\;}x^2=41.55.{\;}p=.000$). The reason given for their future career plan regardless of length of future service, was predominantly "personal growth and development" rather than financial reasons. For further analysis, the group those with the shorter career plan appeared to claim "financial reasons" for their future career more readily than the group who consider the nursing job as their lifetime career$(x^2$= 11.73, p=.003) did. This finding suggests the need for careful .considerations in personnel management of nursing administration particularly when dealing with the nurses' career development. The majority of respondents preferred the fixed day shift. However, further analysis of those preferred evening shift by age and civil status, "< 25 years group"(15.1%) and "single group"(13.2) were more likely to favor the fixed evening shift than > 25 years(6.4%) and married(4.8%)groups. This differences were statistically significant ($x^2=14.54, {\;}p=.000;{\;}x^2=8.75, {\;}p=.003$). 7. A great majority of respondents(86.9% or n=647) found to prefer the day shifts. When the four different types of duty shifts(Types A. B. C, D) were presented, 55.0 percent of total respondents preferred the A type or the existing one followed by D type(22.7%). B type(12.4%) and C type(8.2%). 8. When the condition of monetary incentives for the evening(20% of salary) and night shifts(40% of. salary) of the existing duty type was presented. again the day shift appeared to be the most preferred one although the rate was slightly lower(66.4% against 86.9%). In the case of evening shift, with the same incentive, the preference rates for evening and night shifts increased from 11.0 to 22.4 percent and from 0.5 to 3.0 percent respectively. When the age variable was controlled. < 25 yrs group showed higher rates(31.6%. 4.8%) than those of > 25 yrs group(15.5%. 1.3%) respectively preferring the evening and night shifts(p=.000). The civil status also seemed to operate on the preferences of the duty shifts as the single group showed lower rate(69.0%) for day duty against 83. 6% of the married group. and higher rates for evening and night duties(27.2%. 15.1%) respectively against those of the married group(3.8%. 1.8%) while a higher proportion of the married group(83. 6%) preferred the day duties than the single group(69.0%). These differences were found to be statistically all significant(p=.001). 9. The findings on preferences of three different types of fixed duty hours namely, B, C. and D(with additional monetary incentives) are as follows in order of preference: B type(12hrs a day, 3days a wk): day shift(64.1%), evening shift(26.1%). night shift(6.5%) C type(12hrs a day. 4days a wk) : evening shift(49.2%). day shift(32.8%), night shift(11.5%) D type(10hrs a day. 4days a wk): showed the similar trend as B type. The findings of higher preferences on the evening and night duties when the incentives are given. as shown above, suggest the need for the introductions of different patterns of duty hours and incentive measures in order to overcome the difficulties in rostering the nursing duties. However, the interpretation of the above data, particularly the C type, needs cautions as the total number of respondents is very small(n=61). It requires further in-depth study. In conclusion. it seemed to suggest that the patterns of nurses duty hours and shifts in the most hospitals in the country have neither been tried for different duty types nor been flexible. The stereotype rostering system of three shifts and insensitiveness for personal life aspect of nurses seemed to be prevailing. This study seems to support that irregular and frequent rotations of duty shifts may be contributing factors for most nurses' maladjustment problems in physical and mental health. personal and family life which eventually may result in high turnover rates. In order to overcome the increasing problems in personnel management of hospital nurses particularly in rostering of evening and night duty shifts, which may related to eventual high turnover rates, the findings of this study strongly suggest the need for an introduction of new rostering systems including fixed duties and appropriate incentive measures for evenings and nights which the most nurses want to avoid, In considering the nursing care of inpatients is the round-the clock business. the practice of the nursing duty shift system is inevitable. In this context, based on the findings of this study. the following are recommended: 1. The further in-depth studies on duty shifts and hours need to be undertaken for the development of appropriate and effective rostering systems for hospital nurses. 2. An introduction of appropriate incentive measures for evening and night duty shifts along with organizational considerations such as the trials for preferred duty time bands, duty hours, and fixed duty shifts should be considered if good quality of care for the patients be maintained for the round the clock. This may require an initiation of systematic research and development activities in the field of hospital nursing administration as a part of permanent system in the hospital. 3. Planned and regular intervals, orientation and training, and professional and personal growth should be considered for the rotation of different duty stations or units. 4. In considering the higher degree of preferences in the duty type of "10hours a day, 4days a week" shown in this study, it would be worthwhile to undertake the R&D type studies in large hospital settings.

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'기(氣)' 현상에 대한 철학적 고찰 (Philosophic Investigation of the 'Ghi(氣)' Phenomena)

  • 이현주
    • 동서간호학연구지
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    • 제3권1호
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    • pp.50-67
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    • 1998
  • When recognition of the Ghi(氣) which exist in all things, is changed on the aspects of the science of nursing, the view of health and nursing will be more efficient and can be developed as the proper concept for Korean culture. I think it is nessary to confirm which philosophical basis of the will be applicable to nursing and how to it has to be developed. Therefore I can for the research of the Ghi phenomena to attain the Thoughts of philosophy that is appropriate to expound those phenomena. And I attempt to induct "the fusion of horizons" to unify the view of the I world between Korea and the West. The Ghi is very energetic and omnipresent among the universe, Nature, and the human being. So it can organize all the primary elements of mental and I physical function of human as like life, mind, breath, feeling, energy, etc. A general concept of the Ghi is described as follows ; (1) The Ghi is the origin and essence to organize the universe, Nature, and the human being. (2) It is the perpetually movable thing. (3) And there are continuous transmission between the Ghi of the universe and the human through 'body, mind, and soul. For review on the philosophic basis of the Ghi, I studied out the identity of the doctrine of Li and Ch'i(理氣論) in the field of philosophy of Korea and the West. In Korea, the concept of the Vigor is based on Ch'i monolism(기일원론) and Li Ch'i dualism (이기이원론) of Yul-gok Lee's, Toi-kye Lee's, Hwa-dam's, and/or Hekang's. These are indispensable for the view of the world of Korea as Metaphysical ideology, Concrete science, Materialism, Ontology, and Epistemology. From the viewpoint of the philosophy of the West, the doctrine of Li and Ch'i(이기론) of Korea is identical with the doctrine of Li and Ch'i(이기론) of Joo-ja, Idea of Plato, Metaphysics of Aristotle, World Spirit(Weltgeist) of Hegel, and Existentialism of Heidegger. In the nursing theory of the West, some of them referred to the Ghi as like Energy field theory of Rogers and Energy exchange of Neuman. Though there are different in terminology, "energy" and the "Ghi" are induced comparable therapeutic action between the human and the environments. With the nursing theory of Korea, I have made an attempt to compare the Ghi with metaparadigm of nursing-the human being, the environment, the health, and the nursing. For the most part, the alternative therapy is resonable to the frame of the nursing theory of Korea. It is easy to apply alternative therapy on the every spot of nursing. So this therapy could be a kind of forms as nursing therapy in the nursing centers where take the duties of supporting in local societies. In result, independent nursing intervention will be activated by the nurse who puts up with the major parts. It is available to apply this therapy to palliation of pain, insomnia of infant, Sanhujori (산후조리), pain of menstruation, arthritis. And the alternative therapy makes it possible to propose the nursing model which represent originality, tradition, and history of the nursing of Korea. Additionally, in the field of the nursing, it is indispensable to choose a suitable methodology which is considered whether it is matched with a theory of philosophy in the boundary and object of the research. Because there are many way to get the knowledge of nursing related to the Ghi. In the science of nursing, context of sociocultural background and frame are required to understand the person who need to take care of (nursing client). But the value systems of the West and the East are distinctive each other as well as the behavior of health persuance. Therefore it is the basic research data of great worth to review philosophical the Ghi phenomena which is well known to Korean.

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노인요양시설의 산림복지서비스 인프라 및 제공 실태 (An Analysis of Infrastructure and Provision of Forest Welfare Service in Nursing Homes for the Elderly)

  • 이인숙;김성재;방경숙;이윤정;김미주;문효정;연평식;하이얀;진영란
    • 한국산림휴양학회지
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    • 제22권4호
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    • pp.59-69
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    • 2018
  • 우리나라 노인요양시설의 산림복지서비스 인프라 및 서비스 실태, 관련 인식을 조사하여 산림복지서비스 활성화 방안을 제시한 횡단적 조사연구이다. 전국 노인요양시설을 대상으로 2016년 8월 한 달간 우편설문조사를 통해 수집한 123개 기관의 설문지를 분석하였고, 응답자는 대부분 원장 혹은 사무국장이었다(75.0%). 복합건물의 일부 층을 사용 중인 노인요양시설(16.3%)은 시설 내에 산림복지서비스 인프라를 갖추기 힘들 것으로 사료되고, 인근에 숲이 없는 경우(약 30%)와 숲이 있더라도 휠체어나 경사로가 없는 경우가 많아 이용에 제약이 많았다. 노인요양시설 운영자들도 산림복지서비스가 노인에게 긍정적인 효과가 있다고 인식하지만, 장기요양보험 급여의 필수항목은 아니고, 비용과 노력이 많이 소요되면서도 낙상, 이식증 등 사고위험이 있어 수행하지는 못하고 있었다. 국민건강보험공단이 노인요양시설을 평가할 때, 숲 등 산림치유적 요소를 갖추었는지를 평가할 필요가 있다. 시설 내 정원에 화장실 접근성을 높이고, 시설 인근 숲에 휠체어 진입이 가능한 통로와 리프트 이동로, 안전손잡이를 설치하는 등 산림복지서비스가 가능한 환경으로 조성할 필요가 있다. 또한, 정부는 노인요양시설 산림복지서비스 가이드라인을 개발 보급하여 시설 내외부에서 간편하게 따라할 수 있도록 지원할 필요가 있다. 이러한 노력을 통해 생의 마지막 단계에 있는 노인요양시설 입소노인에게 신체적 정신적 편안함과 적절한 인지자극을 줄 수 있을 것이다.