• Tuberculosis and Respiratory Diseases
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• 제56권1호
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• pp.85-90
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• 2004

Rasmussen 동맥류는 공동성 폐결핵에 동반되어 종종 대량객혈을 일으킬 수 있어 임상적으로 중요하다. 그동안 이의 존재나 치료에 대한 보고는 간헐적으로 있어왔으나 본 증례와 같이 기관지내시경으로 직접 병변을 관찰하고 나선식 CT로 Rasmussen 동맥류의 존재를 확인한 경우는 없어 이에 보고하는 바이다. 또한 기관지 내시경 검사시 발견되는 종양 형태의 병변에는 이와 같은 혈관성병변도 있을 수 있으므로 생검 등의 침습적 검사시에 보다 신중해질 필요가 있으며, 기존 질환이 진행된 공동성 폐결핵일 경우에는 더욱 주의를 필요로 한다.

• 한국사회복지학
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• 제58권3호
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• pp.341-370
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• 2006

본 연구는 부 모 노동력의 탈상품화 가족화와 상품화 탈가족화 정도를 반영하는 부모권과 노동권 지원수준을 통해 OECD 21개국을 비교분석하여 몇 가지 중요한 결과를 도출하였다. 첫째는 남성생계 부양자에 근거한 주류 복지국가 논의에 대한 대안적 논의의 가능성을 열어 놓았다는 점이고, 둘째는 사민주의 4개국은 구사회위험 뿐만 아니라 신사회위험에 대해서도 (상대적으로) 적절한 대응을 하고 있다는 점이다. 셋째는 부모권의 지원 문제, 즉 가족정책의 가족화 수준이 반드시 탈가족화 수준과 일치하지 않을 수도 있다는 것이다. 프랑스, 오스트리아의 예에서 보듯 두 국가 부모휴가제도의 탈상품화 수준은 낮지만 가족화 수준은 상대적으로 높게 나타났기 때문이다. 이러한 결과에 근거해 한국가족 정책에 대한 몇 가지 주요한 함의를 정리하였다. 첫째, 가족정책과 관련된 정책목표의 달성은 단순히 제도도입 여부와 같은 형식적 문제가 아니라 부모휴가(육아휴직)제도 등이 실제적으로 부 모의 실제적 이해와 요구를 반영하는 수준의 지원이 이루어져야한다는 점이다. 둘째, 한국가족정책에서 높은 수준의(탈)상품화 (탈)가족화를 제도화할 수 있는 힘은 한국사회의 여성유급노동에 대한 객관적 필요에 의해 결정될 것이므로, 여성의 유급고용 확대를 위한 시장과 비시장부분에서의 충분한 정책적 노력이 진행되어한다. 셋째, 임신, 출산, 양육이라는 신사회위험에 대한 가족정책의 대응을 위해 계급과 계층을 가로지는 새로운 사회연대를 모색해야 한다.

• 한국보육지원학회지
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• 제9권5호
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• pp.335-355
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• 2013

본 연구는 아동권리 존중 측면에서 어린이집에서의 휴식 및 낮잠에 대한 유아들의 인식과 요구는 무엇인지 알아보는 것이 목적이다. 연구대상은 서울시 국공립 B어린이집 원아 만4세 20명, 만5세 20명으로 총40명이다. 연구방법은 면담조사와 프로젝트활동 중에서 참여관찰로 이루어졌으며 이 과정에서 수집한 관찰기록, 녹음자료, 동영상자료의 전사본을 내용분석 하였다. 연구결과로 첫째, 유아가 인식하는 휴식의 의미는 가족과 함께 하는 시간, 재미있는 놀이하는 시간, 힘들고 화날 때 필요한 시간, 맛있는 음식을 먹는 시간으로 나타났으며 둘째, 어린이집에서의 낮잠에 대해 유아들은 자기 싫은데도 자야하는 시간, 조용한 음악 듣는 시간, 자고나면 기분이 좋아지는 시간으로 인식하였으며 셋째, 어린이집에서의 휴식 및 낮잠에 대해 유아들은 친구들이 귀가 후 종일반에 모였을 때 쉬고 싶어 하였으며, 교실 외 별도의 공간을 필요로 하고, 휴식할 때 친숙한 성인의 보호를 요구했다. 이 결과를 통해 유아들의 휴식 및 낮잠을 즐길 수 있는 권리를 존중하는 측면에서 향후 연구방향을 제안하였다.

• 성인간호학회지
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• 제19권4호
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• pp.556-566
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• 2007

Purpose: This study attempted to analyze problems of informed consent in the clinical setting and appraise ethical aspects inherent in such issues in order to boost awareness of informed consent and its implementation among healthcare professionals. Methods: Study methods included identifying ethical meanings of informed consent in the clinical setting based on the principal ethics, and exploring the process of informed consent utilizing communicative ethics and feminine care ethics Results: The ethical basis of informed consent encompasses not only respect for autonomy but also prohibiting malice, practicing beneficience, and establishing justice. These principles, however, are limited in illustrating the ethical aspects of communicative ethics and care ethics that are entailed in informed consent within clinical settings. The ethical meaning of informed consent involves a communicative and caring process between healthcare professionals, patients, and family built on mutual respect. Conclusion: Healthcare professionals must fully understand the ethical meanings of informed consent and in turn respect and protect the clients' right to know and making decisions. Nurses especially, must take on the role of mediator and advocate throughout the process of obtaining informed consent, and practice ethical caring by facilitating communication grounded in mutual understanding among the physician, patient, and family members.

• 간호행정학회지
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• 제9권4호
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• pp.541-557
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• 2003

Purpose: This descriptive study was designed to explore the clinical nurse's ethical value regarding human life. Method: Data were collected from September to October, 2002. Study subjects were 527 clinical nurses working in General Hospital as tertiary located in Seoul. Ethical value was measured with questionnaire developed by researchers and consisted on items regarding ethical value on human life. Result: Among the items, most nurses highly agree with the item, "When a patient requests his/her health care provider to keep his/her personal secret, the health care provider is obliged to do so." and "When a patient asks for information on his/her medicinal and dietary contents, his/her wish must be granted." Most clinical nurses mainly agree with the item. "Health care providers must always be honest to the patient and/or his/her family". However, most nurses disagree with the item, "When a patient is on the verge of death after an accident, it is justifiable to soothe his/her family by saying 'he/she is OK' instead of telling them the truth, in order to avoid a sudden shock befalling on them". Most clinical nurses mainly disagree with the items, "When a patient is on the verge of death after an accident, it is justiable to soothe his/her family by saying 'he/she is OK' instead of telling them the truth, in order to avoid a sudden shock befalling on them" and "It is justiable that various new ways of treatment should be applied to patient at his/her terminal stage to prolong his/her life, even for the purpose of research". There were significant differences in some items of ethical value according by clinical nurse's age and professional experience, current position, religion, education, marital status, continued education on ethics, and the experience of holing on life saving treatment. Conclusion: It is intensifying the notion of ethical underpinning for human rights, truthfulness is essential to a trust relationship under what circumstances. Also most clinical nurses agree with that It is essential to trust in the nurse-patient relationship, patients have the right to know and it is the ethical thing to do as health care provider.

• Journal of Hospice and Palliative Care
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• 제26권2호
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• pp.80-94
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• 2023

Purpose: This study aimed to identify attitudes toward advance directives (ADs) among female cancer patients and factors related to ADs. Methods: The study was conducted at a university hospital in Seoul from September 19, 2020, to January 20, 2021. The participants were 153 patients diagnosed with gynecological cancer or breast cancer. Data were collected using questionnaires and included general characteristics, disease- and AD-related characteristics, knowledge and attitudes about ADs, and attitudes about dignified death. Data were analyzed using the t-test, analysis of variance, and multiple regression analysis. Results: Only 2% of the participants completed ADs. The mean score for attitudes toward ADs was 3.30, indicating a positive knowledge and attitude toward dignified death. The factors related to attitudes toward ADs were attitudes toward dignified death (𝛽=0.25, P=0.001), experience discussing life-sustaining treatment (𝛽=0.17, P=0.037), preferred time to have a consultation about ADs (𝛽=0.19, P=0.046), intention to write ADs (𝛽=0.15, P=0.038), and Eastern Cooperative Oncology Group Performance Status (𝛽=-0.37, P<0.001). The explanatory power of these variables for attitudes toward ADs was 38.5%. Conclusion: Overall, patients preferred to have a consultation about ADs when they were still active, mentally healthy, and able to make decisions. Education about ADs should be provided to patients on the first day of hospitalization for chemotherapy or while awaiting treatment in an outpatient setting so patients can write ADs and discuss them with family and friends.

• Journal of Hospice and Palliative Care
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• 제11권1호
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• pp.42-50
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• 2008

목적: 통증은 암환자가 지각하는 가장 고통스러운 증상으로 가족간호자와의 부적절한 의사소통은 암환자의 통증관리에 영향을 미치는 중요한 요인 중 하나이다. 따라서 본 연구는 국내에서 암환자와 가족간호자의 부적절한 의사소통이 효과적인 암성통증관리에 문제가 되는 지를 살펴보기 위하여 지각하는 통증강도에 있어서 암환자와 그 가족간호자의 차이가 존재하는 지를 파악하여, 효과적인 암성통증관리를 위한 기초자료를 제공하기 위하여 실시되었다. 방법: 본 연구는 6개월 동안 서울에 소재한 1개 암 전문 병원에서 입원 또는 외래로 치료를 받고 있는 암환자와 그 환자의 가족간호자 127쌍을 대상으로 하였다. 연구도구는 간이통증척도(BPI-K)의 통증강도 항목과 선행연구를 참고하여 연구자들이 구성한 환자용 설문지 및 가족용 설문지였으며, 훈련된 연구보조원이 일대일로 자료를 수집하였다. 그리고 암환자의 임상적 자료는 의무기록 열람을 통해 수집하였다. 결과: 가족간호자들이 지각한 환자들의 '지난 24시간 동안 가장 심한' 그리고 '바로 지금' 통증강도 평균점수는 암환자들의 통증강도 평균점수에 비해 통계적으로 유의하게 높았다. 통증강도 범주별 일치도는 '지난 24시간동안 가장 심한' 통증의 경우, 암환자의 통증강도가 '심한 통증' 범주인 경우 78.7%의 가족간호자가 같은 범주로 지각하고 있었고, '통증없음'의 경우는 40%의 가족간호자가, '경미한 통증'인 경우는 27.5%의 가족간호자가, 그리고 '중등도 통증'인 경우는 22.9%의 가족간호자가 암환자와 같은 범주의 통증정도로 지각하고 있었다. 그리고 '지금 바로' 통증의 경우, 암환자의 '지금 바로' 통증강도가 '심한 통증' 범주인 경우 50.0%의 가족간호자가 같은 범주로 지각하고 있었고, '경미한 통증'인 경우는 47.2%의 가족간호자가, '통증없음'의 경우는 46.3%의 가족간호자가, 그리고 '중등도 통증'인 경우는 26.3%의 가족간호자가 암환자와 같은 범주의 통증정도로 지각하고 있었다. 결론: 본 연구결과 암환자와 가족간호자가 지각하는 환자의 통증강도 범주의 일치도는 '심한 통증' 범주를 제외하고 절반 미만으로 나타났다. 그러므로 암환자가 '심한 통증'을 경험 할 때보다 '중등도 통증' 또는 '경미한 통증'을 경험할 때 암환자와 가족간호자가 지각하는 통증강도 범주가 다를 가능성이 높으며, 암환자의 통증을 과대평가하는 가족간호자가 과소평가하는 가족간호자보다 더 많을 가능성이 높다. 이에 본 연구에서 나타난 차이를 줄이기 위해 암환자와 가족간호자를 대상으로 간단한 통증척도를 이용하여 통증을 객관적으로 사정하여 보고하도록 교육하여야할 것이다. 또한 본 연구에서 나타난 암환자와 가족간호자의 차이를 규명하는 반복연구를 통해 확인이 필요하며, 암환자와 가족간호자의 통증강도 차이에 영향을 미치는 변수들이 어떤 것인지를 밝히는 연구가 필요하다.

• 근관절건강학회지
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• 제27권3호
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• pp.229-237
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• 2020

Purpose: This paper aims to clarify the concept of well-dying in the sociocultural context of Korea. Methods: Walker and Avant's method was chosen for the concept analysis. Through a literature review of 36 papers, the attributes and definition of well-dying were derived. Results: The literature revealed that in Korean society, well-dying is defined as the process of actively preparing for death throughout life. The attributes of the concept are a reflection on death, death acceptance, searching for meaning, transcendence, advance decision-making, and sharing values with family. The motivation for thinking about death, the hope of dying with dignity, and the Korean cultural view of death precede the concept, followed by dying with dignity, personal and family happiness, and improved quality of life and death. Conclusion: This study may lead to the unification of concept use based on mutual understanding, thus enabling effective communication in research, education, and clinical settings. This can be the rationale for the development of tools and educational programs as well as establishing policies related to well-dying in Korea.

• 가정간호학회지
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• 제8권2호
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• pp.148-158
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• 2001

Purpose: This study is to investigate the attitudes on the Home Health Care among the physicians and nurses in P University. Method: Data were gathered from 71 physicians and 264 nurses. working at P University Hospital. from May 1 to May 15, 2001 and analyzed using descriptive statistics and Fisher exact test. Results: 1) As to the previous information about home health care program, those who have been familiar to it were 100% of physicians, and 99.6% of nurses, and 39% of the physicians and 66.1% of the nurses. were found to have responded with right answers, 2) As to the acceptance of the home health care program, 87% of physicians and 98.5% of nurses were found to be positive and there showed a significant difference(p= .019), 3) The main reasons for accepting the system were: the alleviation of the family burden of time, the maintenance of continuity of care, and the reasons for opposing the system were incomplete legal assurance. the possibility of providing illegal medical services. 4) The physician's intention rate of patient referrals to home care program reveled 49.2%. 5) According to the services related to Home Health Care. the orders of acceptance rates were medical tests related services (77.8%, 92%); therapeutic nursing interventions(69.0%, 88.2%): and services for medication(68.3%, 82.5%) among physicians and nurses. respectively. Conclusion: For the stabilization and successful implementation of home health care system. it should be accompanied with education for physicians about home care. setting specific laws and regulations for home care. legal assurance of home care business. outcome research for home care recipients. and support systems of hospital administration.

• 간호행정학회지
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• 제5권2호
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• pp.337-353
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• 1999

This study is to provide the basic sources to develop educational data that can establish ethical values with research on the interrelation between moral development and ethical values of nurses. The subjects of this study are the convenience sample from 111 nurses working in clinical settings from 5 general hospitals located in Pusan area. The questionnairs for this study are comprised two parts: Part 1 is SRM-SF(1995) guestionnaire, and translated by Kil, 1m Ju(1997): Part 2 is the guestion papers about the ethical values, and disigned by Jung, Hee Ja. The data were collected from June lth to 31th, 1997 and analyzed by S.A.S(Statistical Analysis System) Package for frequency, percent, and Pearson's correlation coefficient. The results of the study is as the followings: 1) According to the moral development. the nurses are in the levels of Stage3 or Transition3/4, which are generally focused on the personal relations or personality. Thus, nurses are considered to need to get the stage4 of education that helps them recognize a person as a member of society. a family as an unit of society, and human life as the values of human dignity. 2) According to the ethical values, nurses have the positive ethical values of respecting the right of the patients, providing information, keeping the secret, truth. and credit of patients. But they also experience some troubles by the patients to care and the clinical situation. Thus, to overcome the problems, nurses are considered to need to get the education that establishs the right ethical values. 3) The analysis result on the interrelation between moral development level and ethical values shows as r=0.28 and p=0.003. This indicates that the interrelation between them is low. In conclusion, it is considered that the moral development level is viewed broadly from a person and family to a society, and then it can affect to the ethical values positively.