간호학적 견지에서 본 심장맥관질환 환자의 통계적 고찰

This data to be presented was obtained from 9308 patients admitted to Ewha Womans University Hospital from .Jan. 1967 to June 1969 and also from 53 professional nurses who were working an the medical wards of 4 university hospita1s( Ewha, Yonsei, Seoul National, Catholic university Hospitals ) as well as Cho K.H. Private Hospital ( heart major)in Seoul, Korea. The prime purpose of this study was to investigate 9308 patients admitted in relation to the number of admissions to each department, the number of deaths and the actual nursing care of these cardiovascular disease patients. The aim of this study was to improve the special nursing care of patients with cardiovascular disease and this also will contribute to better health for the people as a whole. The results obtained from this study were as follows: 1. The number of admissions to the Obstetric & Gynecological Department was higher(55.6 %) -than the admissions to the Departments of Internal Me야cine(14.7 ％), Pediatrics (11.2 ％), Surgery(10.0 ％), Ortho-pedics(3.5 ％), E.N.T.(3.0 ％), Eye(1.O ％), Psychiatrics (0.8 ％),＆ Uro1ogy((0.2 ％). 2. Among the 9308 patients, the number of cardiovascular patients were 285(3.1 ％). There were more females.61.1 ％ (174) than males38.9 ％(111), It was interesting to notice that female 56-60 years of age(9.8 ％) showed the highest incidence, while male patients from 51-55years of age (6.3 ％) showed the heghest incidence. On the other hand in the case of males nonoccurence was noted in ages from 6-10 and 21-25. 3. The total number of deaths among the 9308 patients was 219(2.4 ％). It is important to point out that the most common couses of deaths were due to cardiovasular disease (20.5 ％). These findings indicate the great meed to emphasize the importance of preventing as well as reducing the death rate of these cardiovascular disease. The others couses of death were from hypertensive C.V.A.(42.3 ％), nonhypertensive subarachnoid hemorrhage (24.4 ％), heart failure (17.8 ％),essential eclampsia (6.7 ％), cerebralthrombosis (4.4 ％) and hypertension(4.4 ％). 4. The majority of nurses (66.1 ％) were gratuates of 4 year collegiate nursing schools in Korea and 33.9 ％ were graduates of 3 year diploma courses. 5. One half of the nurses (60.4 ％) had from 6 months to one and a half year of clinical experience on Medical Wards and the more experienced, the less in number. 6. It can not be ignored that the actual care practised by the nurses was mainly symptomatic care (55.2 ％), physical care (8.6 ％) and very little special cares was given (35.5 ％). 7. The major concerns expressed by more than half of the nurses in caring for the cardiovascular disease patients was to provide " the patients with rest both physical and mental" while 47.7 ％ of nurses cared for the patients according to the doctors order only. It is very evident that these nurses new better nursing care than they actually practiced and this behavior should be corrected. The majority of the nurses (68.0 ％) did patient teaching in terms of low salt diet, comfort measures, etc. However it seems significant that more broad and regular group patient teaching including every aspects of cardiovascular disease would be very effective.목차 = 0 - ABSTRACTS - = A Ⅰ. 서론 = 1 Ⅱ. 연구대상 및 방법 = 4 Ⅲ. 결과 = 5 1. 입퇴원환자 총 9308예의 과별분포와 사망자 수 = 5 2. 심장맥관질환의 진단별 분류 = 6 3. 심장맥관질환 환자의 성별 및 연령별 분류 = 9 4. 입원기간 및 사망원인 = 12 5. 기록상으로 본 진단별 간호 = 14 6. 조사대상 간호원의 졸업년도, 교육정도 및 내과병동 근무년한 = 16 7. 심장맥관질환 환자를 위한 간호기준 = 18 8. 환자교육의 실태 = 20 Ⅳ. 총괄 및 고찰 = 24 Ⅴ. 결론 = 40 참고문헌 = 4

(A) STUDY ON THE FIGURATION OF FLOWER'S IMAGE

예술가들이 자연에 대한 끊임없는 동경과 열망을 가지고 관찰하면서 그 자연의 미를 여러 가지 방법과 양식으로 표현해 왔으며, 자연은 예술에 있어서 가장 많은 관심과 표현의 대상이 되어 왔다. 이러한 조형활동은 작가가 자연을 보는 시각적인 척도나 미의식에 따라 다양하게 표현하는 것이 현대미술의 추세이며, 오늘날 염색공예에서도 실용성은 물론 조형성을 추구하는 조형예술의 한 영역으로서 그 위치를 굳혀가고 있다. 따라서 본 연구는 도시공간의 창(窓)밖에 보이는 꽃의 이미지 (Image)를 재구성함으로써 염색공예에서의 조형적 표현의 가능성을 모색하는 데에 연구목적이 있다. 이를 위한 이론적 배경에서는 표현과 대상, 표현과 양식에 대해 문헌을 통해 고찰해 보고 작품제작을 위해 표현소재, 재료와 기법. 작품의 형성을 연구하며, 이러한 이론적 연구를 바탕으로 작품제작과 분석을 통해 다음과 같은 결론을 얻었다. 첫째, 조형예술의 대상이 되어온 자연에 대한 연구는 의식의 변천과 함께 다각적인 측면에서 행해지고 있으며. 작가 나름대로의 미의식에 따라 변형 표현함을 알게 되었다. 둘째, 꽃의 이미지를 연구자의 주관적 체험에 따라 변형하며 초방염법으로 표현하는데 적절한 소재였다고 생각된다. 셋째, 염료와 섬유의 특성파악이나 형태의 변천과정에서의 어려움이 따르지만 염색공예만이 지닐 수 있는 독특한 기법상의 표현 가능성을 알 수 있었다. 작품제작 과정에서 소재에 대한 충분한 연구와 즘 더 폭넓은 감각적인 세계를 표현하지 못한 데 대한 아쉬움과 색조의 배색에서 오는 단조로움을 느꼈으나 앞으로의 계속적인 연구로 보다 나은 염색 공예로의 조형세계를 구축할 수 있도록 노력하고자 한다.;Artists have been observing the "nature" with their longings and eagerness toward the "nature" and they have been expressing the beauty of "nature", with various methods and styles. As far as the "art" is concerned, the "nature" has been the greatest concern to us and the most important objective of our expressions. In the field formative arts, the current trend of the modern art is that artists express the nature variously, according to their visual cirterion or aesthetic perception, and today also in the field of dying arts, its position as one field of formative arts, which pursues formativeness as well as practicality, becomes firm and assured. Accordingly in this study, through restructuring the image of flowers which can be seen outside the windows of urban spaces, I tried to figure out the possibility of formative expressions in the field of dying art. As theoretical backgrounds of the study, expressions and targets and expressions and styles have been observed and examined through literatures, and for the production of works, expression-materials, materials ＆ method and formation of works have been studied. Based on the theoretical studies as mentioned above, and through the production ＆ analysis of the works, following conclusions could be made; Firstly, the study on the nature, which has been the objective of formative arts, is being made from various angles in accordance with the changes in perceptions, and it becomes expressed after being transformed according to the aesthetic perception of the artists. Secondly, the image of flowers has been transformed according to the subjective experiences of the researchers, and it was thought to be an appropriate material to be expressed through the "Chobang" dying method. Thirdly, even if there existed difficulties in understanding the characteristics or in the form-changing process of dying materials ＆ babrics, there was an expression-possibility through a unique method, which only the dying art could have. I regret that during the process of work-production, more thorough studies on the materials ＆ wider range of expressions about the sensuous world could have been passible and I felt a sense of monotony coming from the arrangement of colors, however, I will try every effort possible to construct a better, formative world of dying art, through continuous and further studies.논문개요 = ⅴ Ⅰ. 서론 = 1 A. 연구목적 = 1 B. 연구내용 = 2 C. 연구방법 = 2 Ⅱ. 이론적 배경 = 3 A. 표현과 대상 = 3 B. 표현과 양식 = 7 Ⅲ. 작품제작 및 분석 = 13 A. 작품제작 = 13 B. 작품분석 = 17 Ⅳ. 결론 = 29 참고문헌 = 30 ABSTRACT = 3

촉진적 관계형성교육이 간호원의 돕는 행위와 환자의 자기노출행위에 미치는 영향

간호는 환자와 간호원이 서로의 요구를 해결하는 일련의 돕는 관계를 통해 이루어 지는 것이다. 따라서 돕는 전문직인으로서의 간호원은 환자에게 성장을 촉진하는 지지나 도움을 제공할 수 있어야 함이 자명하다. 그러나 간호원과 환자와의 만남이 환자에게 도움을 주지 못하는 경우가 있으므로 돕는 관계의 의미나 돕는 행위를 교육할 수 있는 방법을 연구할 필요가 있다. 따라서 본 연구자는 공감, 존중, 온정 세 조건이 기본을 이루는 촉진적 관계 형성에 관한 간호원 교육을 통해 환자의 호소를 정확하게 지각하고 반응하는 능력을 증진시킴으로써 간호원의 돕는 행위를 향상시킬 수 있다고 본다. 본 연구의 목적은 간호원을 대상으로 간호원과 환자간의 촉진적 관계 형성에 관한 교육을 실시하고 간호원의 돕는 행위와 환자의 자기노출 행위를 평가함으로써 그 효과를 확인하는 것이다. 연구 방법은 본 연구자의 편의상 1984년 3월 18일부터 28일까지 서울 시내 2개 병원에서 근무하는 간호원 120명과 그 간호원에 의해 간호를 제공 받는 환자 120명을 선정하여 실험군, 대조군으로 나누어 질문지를 통해 자료를 수집하였다. 연구 도구는 간호원의 언어적 반응행위를 측정하기 위해서 Carkhuff의 Index of Communication을 수정 보완하였으며, 간호원의 경청행위를 측정하기 위해서는 Henderson의 Irritating Listening Behavior를 수정 보완하여 환자가 지각한 간호원의 경청 행위를 측정하도록 하였으며 환자의 자기문제 이해행위 척도와 간호원 신뢰행위 척도를 측정하기 위해서 본 연구자가 문헌을 통해 개발한 도구를 사용하였다. 도구를 사용하기 전에 신뢰도와 타당도를 확인하였다. 실험장치를 위한 촉진적 관계 형성에 관한 교육 내용은 Gazda의 인간관계 지침서를 간호상황에 적합하도록 수정 보완하여 사용하였다. 수집된 자료는 t검정, 분산분석, X2 검정, Pearson Correlation Coefficient, Interrater’s Reliability와 Cronbach’s Alpha를 통해 분석하였다. 분석 결과를 요약하면 다음과 같다. 1) 촉진적 관계 형성에 관한 교육의 효과와 분석 결과 간호원을 대상으로 실시한 촉진적 관계 형성에 관한 교육의 효과를 분석하기 위해서 실험처치 후 두 집단의 돕는 행위와 자기노출 행위의 측정치로 가설 검정한 결과는 다음과 같다. 제1가설인 e촉진적 관계 형성에 관한 교육을 받은 간호원의 돕는 행위정도 (언어적 반응행위정도, 경청 행위정도)는 촉진적 관계형성에 관한 교육을 받지 않은 간호원의 돕는 행위 정도보다 높을 것이다u는 지지되었다(언어적 반응행위 t=-16.248 df=118 P.0001, 경청행위t=-10.771 df=118 P.001). 제2가설인 e촉진적 관계형성에 관한 교육에 참여한 간호원에 의해 간호를 받은 환자의 자기노출 행위정도(자기문제 이해 행위정도, 간호원 신뢰행위정도)는 촉진적 관계형성에 관한 교육에 참여하지 않은 간호원에 의해 간호를 받은 환자의 자기노출 행위정도보다 높을 것이다u는 지지되었다(자기문제 이해행위t=-9.842 df=118 P<.0001, 간호원 신뢰행위 t=9.604 df=118 P<.0001). 제3가설인 e간호원의 언어적 반응행위, 경청행위, 환자의 자기문제 이해행위 및 간호원 신뢰행위 정도간에는 순 상관관계가 있을 것이다u는 지지되었다 (P<.0001). 이상의 결과를 종합할 때 간호원의 돕는 행위는 환자의 자기노출행위를 변화시킬 수 있는 변수임이 확인되었고 특히 간호원과 환자간의 촉진적 관계형성에 관한 교육은 간호원의 돕는 행위는 물론 환자의 자기노출 행위에 긍정적인 변화를 주었다. 따라서 교육을 통해 간호원의 돕는 행위를 계속 증진시킬 수 잇는 것으로 나타났다. 본 연구 결과를 토대로 다음과 같은 제언을 하고저 한다. 1) 한국 간호원의 돕는 행위 정도를 확인하기 위해서 좀 더 확대된 집단을 대상으로한 연구가 필요하다. 2) 촉진적 관계 형성에 관한 교육의 효과는 교육 즉시에 국한하였으므로 그 전이력을 비교하여 측정할 수 있는 연구가 필요하다. 3) 간호원의 돕는 행위가 대상자인 환자의 일반적 특성, 진단명, 또는 근무하는 장소의 물리적 환경에 따라 영향을 받는지 여부를 확인하는 연구가 필요하다. 4) 간호원의 촉진적 관계 형성에 관한 교육이 보수 교육 내용으로 활용되어 실제 간호업무에 적용될 수 있어야 하겠다. ; Nursing is defined as an interpersonal helping relationship concerned to meet the needs between patients and nurses. Nurses as one of the helping professionals should be supposed to provide patients growth-facilitating support and adequate assistance. But there are many occasions appeared in the interaction between nurses and their clients often do prove it harmful rather than helpful. Therefore, it is strongly needed to find a way education for the meaning and behavior of the helping relationship. This study was done for the improvement of nurses helping behavior through the facilitative relationship training as one of the nurse development programs, and the purpose of the study was to examine the effects of facilitative relationship training. The subjects, consisting of 120 adults in-patients who had less acute physical problem and 120 registered nurses working on those wards in E. Womans Hospital and S. Hospital, were divided into Experimental and Control Groups. The data was collected in the dates from March 18 to March 28 through descriptive responds and self-reported questionaires. The instruments used for this study were Carkhuff’s Index of Communication, Henderson’s Irritating Listening Behavior, revised by the researcher and patients problem understanding scale, patients trust scale on nurse, developed by the researcher. Teaching contents for the facilitative relationship training were designed specifically by the researcher, based on the Gazada’s Human Relationship manual to increase nurses helping abilities to perceive and respond with Respect, Empathy and Warmth. Analysis of the Data was done by use of t-test, X2 test, Pearson Correlation Coefficients, Cronbach’s Alpha Reliabilty Test and Interrater’s Reliability. The results of study are summarized as follows: 1. The results from analyzing the effect of facilitative relationship training: Comparative analysis of the measurement of the variables between the experimental and the control group after the treatment to confirm the effect of the facilitative relationship training in a significant difference. The hypothetical test resulted in the following: The first hypothesis that the nurse’s helping behavior who had taken the facilitative relationship training course will show a higher score than the nurse’s helping behavior not taken the same training course was supported. (P<.0001) The second hypothesis that the patients self-exploration behavior in the experimental group will show a higher score than the patients self-exploration in the control group was supported (P<.001). The third hypothesis that the positive relation between nurse’s verbal response behavior, attending behavior and patients self understanding behavior on his problems and trusting behavior on nurses were supported at the .0001 level. 2. The results from analyzing homogeneous in experimental and control group: There was no significant differences of demographic characteristics except religions (X2=6.44 df=1, P=.0399) but there was not only significant relationship between nurse’s verbal responds behavior and religions (F=0.56 P=.4581) but also between nurses attending behavior and religions (F=0.417 P=.2471). There was no significant difference of the score of nurses verbal response behavior, attending behavior, patient self-understanding behavior on his problem and trusting behavior on nurses between control group and experimental group. In conclusion, nurses helping behaviors and patients self-exploration behavior could change through the systematic and scientific approach to facilitative relationship training. Therefore, the nurse’s helping behavior is needed to improve through facilitative relationship training as a postgraduate course of refreshment in-serve education course. Also further studies are necessary to determine long term effects of a short-term training program.논문개요 ------------------------------------------------------------- ix Ⅰ. 서론 ------------------------------------------------------------- 1 1. 연구의 필요성 ---------------------------------------------------- 1 2. 연구의 목적 ------------------------------------------------------ 5 3. 가설 설정 -------------------------------------------------------- 6 4. 용어 정의 -------------------------------------------------------- 7 Ⅱ. 이론적 배경과 선행연구 ------------------------------------------- 9 1. 인간행위 체제 ---------------------------------------------------- 9 2. 상호작용 --------------------------------------------------------- 11 3. 전문적 돕는 관계 ------------------------------------------------- 16 1) 상담자의 돕는 행위 ---------------------------------------------- 19 2) 촉진적 관계형성을 위한 중심조건 --------------------------------- 21 （1）공감 --------------------------------------------------------- 22 （2）존중 --------------------------------------------------------- 25 （3）온정 --------------------------------------------------------- 26 3) 내담자의 자기노출 행위 ------------------------------------------ 28 4. 인간행위 체제, 상호작용, 전문적 돕는 관계와 간호이론과의 관계 ---- 30 Ⅲ. 연구 방법 -------------------------------------------------------- 35 1. 연구설계 및 방법 ------------------------------------------------- 35 2. 연구도구 개발과정 ------------------------------------------------ 38 3. 촉진적 관계형성을 위해 개발된 교육내용의 구성 및 그 합리성 ------- 42 4. 평가자 훈련과정 -------------------------------------------------- 44 5. 연구진행 절차 ---------------------------------------------------- 49 6. 자료 분석 -------------------------------------------------------- 54 7. 연구의 한계 ------------------------------------------------------ 55 Ⅳ. 연구 결과 -------------------------------------------------------- 56 1. 촉진적 관계형성에 관한 교육의 효과 분석 결과 --------------------- 56 1) 제1가설 검정 ---------------------------------------------------- 56 2) 제2가설 검정 ---------------------------------------------------- 57 3) 제3가설 검정 ---------------------------------------------------- 58 2. 실험군과 대조군의 동질성 검정 ------------------------------------ 59 1) 일반적 특성에 관한 실험군과 대조군의 동질성 검정 ---------------- 59 2) 실험군과 대조군 두 집단간의 주요변수에 관한 분석 ---------------- 61 Ⅴ. 논의 ------------------------------------------------------------- 62 1. 촉진적 관계 형성에 관한 교육의 효과 분석에 관한 논의 ------------- 62 2. 주요변수의 관계분석에 관한 논의 ---------------------------------- 71 3. 간호에의 의의 ---------------------------------------------------- 73 Ⅵ. 결론 및 제언 ----------------------------------------------------- 77 1. 결론 ------------------------------------------------------------- 77 2. 제언 ------------------------------------------------------------- 79 참고문헌 ------------------------------------------------------------- 80 부록 -----------------------------------------------------------------101 영문초록 -------------------------------------------------------------15

Prevalence rate and associated factors of urinary incontinence among nursing home residents

The aim of this study was to estimate the prevalence of urinary incontinence among nursing home residents and to identify the factors associated with this condition. Method: The data were collected from 618 subjects (146 males and 472 females; mean age 79.9±8.4 yr; range 65-102 yr) of 30 nursing homes in Seoul, Gyeonggi-do and Gangwon-do in this cross-sectional study. The data were analyzed by chi-square test, t-test, and multiple logistic regression by using the SPSS/PC ver 12.0 program. Results: The prevalence of UI was 64.7% (64.6% in women; 65.1% in men). After adjustment for each of the variables considered in this study, six potential factors were strongly associated with UI: activities of daily living, comorbidity, age, cognition, specialty of the facility, and a bladder training program. Conclusion: Our finding suggests that it is necessary to develop a program for promotion of activities of daily living and to provide a bladder training program to prevent urinary incontinence among nursing home residents

The reasonable legal nursing manpower-staffing by using the system dynamics approach.

The Purpose of the study is to lay foundation for reasonable legal nursing manpower staffing by building the nursing manpower-staffing model. The System dynamics approach was adapted to build a simulation model. The model was built up on Vensim 5.0b DSS. In terms of economic efficiency on tertiary hospitals, the ratio of bed to nurse for the best reasonable legal nursing manpower-staffing is 3.0: 1(2.6:1 if calculating in terms of the ratio of patient to nurse) In terms of economic efficiency on secondary hospitals, the ratio of bed to nurse for the best reasonable legal nursing manpower-staffing is 3.5: 1(3.0:1 if calculating in terms of the ratio of patient to nurse)

Exercise self-efficacy, exercise benefits and barriers, and commitment to a plan for exercise among Korean women with osteoporosis and osteoarthritis

This study compared perceived exercise self-efficacy, exercise benefits, exercise barriers, and commitment to a plan for exercise between Korean women with a diagnosis of either osteoporosis or osteoarthritis. The influence of exercise self-efficacy, exercise benefits and barriers on commitment to a plan for exercise was also assessed in each group. Participants in the study were 154 Korean women over 40 years of age who were recruited from hospitals, health centers or a nursing home. The two groups differed on commitment to a plan for exercise with commitment greater among women with osteoporosis. Exercise self-efficacy was the most influential variable on commitment to a plan for exercise accounting for 27% of the variance in commitment among osteoporosis patients and 53% of the variance among osteoarthritis patients. This study generated information relevant to tailoring exercise interventions to the differing needs and perceptions of Korean women with osteoporosis and osteoarthritis. © 2004 Elsevier Ltd. All rights reserved

Korean adolescents' experiences of smoking cessation: A prelude to research with the human becoming perspective

Smoking cessation has been identified as an important factor for health and quality of life in Korean society. This article explicates Korean adolescents' experiences of smoking cessation from the perspective of Parse's human becoming theory, as a prelude to conducting research. A nurse was truly present with individual students as they shared their experiences of trying to stop smoking. Interpreted through the principles and concepts of Parse's theory, the experience of quitting smoking is elucidated as a struggle of choosing one's value priorities amid the opportunities and limitations inherent in this decision, while moving with unique patterns of relating. Staying with the commitment to stop smoking is changing one's health and quality of life. The authors briefly discuss the implications of this perspective for nursing practice, and identify struggling to change as a phenomenon for future research. © 1998 Chestnut House Publications