정신질환자 가족의 부담감과 치료자의 전문적인 지지

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(A) study of the attitudes of nursing students toward their clinical affiliation in a mental hospital

간호학과/석사Today, over seventy five percent of the schools of nursing in Korea provide a psychiatric experience in the basic curriculum. The psychiatric affiliation presents numerous major problems of adjustment to the student. The importance of positive attitudes toward the nursing care of psychiatric patients is recognized by the nursing profession. The purpose of this study was to determine the expressed attitudes of fifty-three nursing students toward their psychiatric affiliation. An attempt, also, was made to determine what implications these attitudes revealed relative to future program planing for students during the psychiatric nursing affiliation. A questionnaire, a Korean translation of the "psychiatric Nursing Attitude Questionnaire" by Mildred Elizabeth Fletcher, was administered to fifty-three nursing students form three schools of nursing in Seoul, Who had completed a four-week psychiatric affiliation in a large mental hospital during Mar.19,1997 to May 19,1973. The questionnaire of 100 statements was administered in the following way; (!) Part Ⅰ, Preconceptions, was given in individual conferences with each subject, during the first few days of their affiliation, and again duing the final week of the affiliation. The responses to Part Ⅰ were oral. (2) Part Ⅱ, Expectations, Part Ⅲ, Personal Relations, Part Ⅳ, Personal Feelings, and Part Ⅴ, Attitudes and Activities of Patients were given to all of the subjects in a group meeting during the second week of the affiliation, and again, during the fourth week at the termination of the affiliation,. Responses to Parts Ⅱ, Ⅲ, Ⅳ, and Ⅴ were written. Each of the 100 statements of the questionnaire was considered to be either Positive or Negative. A favorable response was assigned the Positive value of +1, and an unfavorable response was assigned the Negative value of 0. The coefficient of correlation was computed between the two sets of scores for the fifty-three nursing students. The mean score, the standard deviation, and the differences in the means on each of the five parts of the questionnaire were computed and the relationships calculated by a t-test. The results of the study were as follows : 1. There was no significant correlation between the two sets of scores for the fifty-three nursing students during the four-week psychiatric affiliation.(r=.573) 2. There was no significant difference in the mean scores between the first and final tests for any of the five parts of the questionnaire. 3. The PartⅠ, Preconceptions, data indicated nursing students enter the psychiatric affiliation with certain attitudes and preconceptions toward the psychiatric affiliation which affect their psychiatric nursing experience. 4. The PartⅡ, Expectations, data indicated inappropriate expectations of students related to lack of experience, lack of pre-psychiatric affiliation orientation, lack of social understanding, and feelings of insecurity. 5. The PartⅢ, Personal relations, data indicated some students have negative attitudes in personal relations with normal people in respect to psychological security and social responsibilities. 6. The Part Ⅳ, Personal feelings, data indicated nursing students have psychological insecurity & inappropriateness. 7. The PartⅤ, Attitudes and activities of patients, data indicated nursing students have negative attitudes of feer and frustration due to the psycholtic behavior of certain patients in certain situations. 8. The data indicated preconceptions are predominate in unfavorable attitudes of students toward psychiatric nursing affiliation. Further research is indicated in the following areas : 1. Because of the limited number of students in this study, similar studies should be performed with larger groups for further validation of the results. 2. Because of the findings concerning the influence of the opinions of people in close contact with the students, similar studies of the attitudes of the staff in nursing schools, attitudes of graduate nurses and attitudes of the public should be done to determine weakness and strengths of present programs.restrictio

Clinical Competency for Directing of Registerd Nurses' National Examination.- focused on Fundamental, Medical-Surgical, Psychiatric, Women's health, Community, Pediatric, and Administrative Nursing -

For producing large numbers of professional nurses who could manage 21th century's human health, it is necessary to review the direction of registered nurses' national examination which evaluates the nursing education and is granted a licence. For adapting to social expectation of the nurse, we have to nurture the nurses' problem solving capability in clinical setting. Seven divisions of Korean Academy of Nursing suggested clinical competency according to their categories. This paper was presented in the workshop for setting up direction of registered nurses' national examination. We expect that this paper would be more refine and confirm through reviewing subdivisions' learning obectives and discussing clinical minimum level of competence contents with clinical leaders.ope

Behavior Problems, Self-Esteem, Social Skills, and Depression in Middle School Male Students

Adolescency is a period of change physically, psychologically, and socially. Adolescents experience a lot of stress from these changes. If they cannot cope effectively with changes, it can lead to adolescent depression, delinquency, and other problems. Adolescence depression can produce low academic achievement, low self-esteem, and antisocial behavior. The purpose of this study was to determine the relationship among the variables, ’behavior problems’, ’self-esteem’, ’social skills’ and ’depression’. An exploratory descriptive design was used to describe and examine the relationship between the variables of behavior problems, self-esteem, social skills, and depression in a convenience sample of 131 middle school male students. Data were collected through the use of ’Social Skill Inventory’, ’Self-esteem Inventory’, ’Behavior problems’ and ’CES-D’ instrument to measure depression. The data collection period was from April 16 to April 23, 1998. Correlational analysis and multiple analysis were used to identify the relationship among the variables. Correlational analysis revealed a negative relationship between depression and social skills, depression and self-esteem. On the other hand there was a positive relationship between depression and behavior problems. Regression analysis revealed that these variables accounted for 46% variance of the depression and added significantly to the model. Results from this study may be used for informational purpose for nurse educators, researchers, and teachers as they teach, work, and develop programs for adolescents. Information from this study indicated that low social skills, low self-esteem, and behavior problems were related to depression. Therefore, strategies and interventions to increase self-esteem and social skills could be carried out in the school and appropriate treatment and counselling needs to be given to students who are depressed.ope

Current Situation and Perspectives for Home Care Nursing Research In Korea

This study was conducted to identify the current situation of home care nursing research and to propose future research in the area of home care nursing in Korea. The design was a retrospective descriptive study based on 171 studies. The studies were collected from nursing academic magazines, the national library web site and dissertations on home care. The data were classified according to the independent and dependent variables which were represented in the research title. The final category classification was defined by considering the research objectives and content as found in the 171 studies. Eight categories were created to describe the results of home care nursing research in Korea. They included: home care needs. home care services. home care costs. development of home care programs and equipment. management of home care services. effectiveness of home care services, development of an educational curriculum for home care, and recognition of home care services. Based on our research we have identified other future research areas that need to be developed such as community needs assessment, standards and guidelines for home care nursing, quality assurance and quality improvement for controlling home care quality, home care informatics. and a system of home care cost and ethics.ope

A Case Study of Home Care Nursing for People with Chronic Mental Illness

This study was conducted to identify the basic data necessary to develop a home care protocol for people with chronic mental illnesses and to develop various psychosocial rehabilitation programs. The subject of this study was a 29 year old divorced female diagnosed with schizophrenia, paranoid type. She was hospitalized and discharged from the psychiatric ward of S General Hospital for the second time. A home care nurse assessed the client's psychosocial functions, identified mental problems, planned nursing interventions, performed nursing activities, and evaluated the outcomes. The results were then reflected in the nursing interventions that followed. This study was a case study that reporting recovering process from the mental illness. The data was collected through the in-depth interviews with the subject. The home care nurse visited the client's home eight times. During the first and second sessions, the nurse made assessments and plans, during the third to seventh sessions nursing interventions were made and the eighth session was the termination session. The main nursing problems of the client were the lack of communication skills, social support and insight into the disease, ineffective drug management, the absence of a caregiver, social maladaptation, ineffective stress-coping skills and conflicts with other family members. Focusing on these problems, the nu ovided counseling, psychoeducation, role modeling of social skills and stress coping strategies. The results showed that the client expressed feelings of satisfaction to the home care nursing she received. There were also a decreased number of family conflicts, fewer difficulties at work and increased effective stress coping skills, a greater knowledge of drugs and their side effect, a decrease in noncompliance of drugs, and insight into the mental disease.ope

The development of schoolbased adolescent smoking

Adolescent smoking is increasing continuously in Korea. Since most of the adolescent are belong to school in Korea, it is desirable to conduct a smoking prevention program at school. The smoking prevention programs, also need to be done continuously. Most of the former programs, however, are focused on one-time class so have no continuity. The purpose of the study was to develop school-based comprehensive smoking prevention program and to test its effectiveness. As a study frame work, the Prochaska's transtheoretical model which explains stage of change behavior was used. Study design was quasi-experimental with pre and three post test. Total 41 high school students participated in the study, 22 in experimental group and 21 in control group. To see the long-term effectiveness of the program, participants were followed after 3 and 6 month. The program was made up total 9 sessions, took 60-70 minutes for one session and provided twice a week. The experimental group was devided into 3 small groups and three trained researchers leaded the group. To test the effectiveness of the program, nicotine dependency, urine cotinine level, self-efficacy, stage of change of smoking behavior, stress level were tested as dependent variables. Only urine cotinine level showed significant differences after the program. The cotinine level and self-efficacy, cotinine level and stress were significantly correlated in experimental group. Since it is very difficult to decrease adolescent smoking, small group intervention strategies and continuous follow-up was successful to decrease smoking amount. It is suggested that further research needs to be done to test effectiveness of the program with large study samples.ope

The Effect of Music Therapy on Anxiety in Neurotic Patients

The purpose of this study was to identify the effects of music therapy on anxiety in neurotic patients. The subjects of the study were 41 patients that had been diagnosed as having anxiety disorder, neurotic depression, or somatization disorder and were admitted to one general hospital in Seoul. The 41 research subjects were assigned to an experimental (22 clients) and a control (19clients) group. Data were gathered from September. 25, 1995 to December. 15, 1995 using a questionnaire and physiological measurement tool. Data were analyzed with the SAS package using frequency, t-test, paired t-test and Pearson correlation coefficients. The results of this study are as follows ; 1. There were significant differences between two groups on systolic and diastolic blood pressure, and pulse rate after treatment. In the experimental group, Systolic and diastolic blood pressure, and pulse rate decreased significantly after Music Therapy. 2. There were no significant differences between the two groups on the pre and post psychological anxiety score. But, after music therapy, experimental group had a lower psychological anxiety score than the control group. From these results, it is concluded that the music therapy can be effective in decreasing anxiety in neurotic patients.ope

Juvenile Delinquency and Drug Abuse

This study was designed to investigate the situation of drug abuse in delinquent adolecent, and to provide fundamental data about the relationship between drug abuse and delinquent behavior. The subjects for this study were 60 adolescents in Anyang and Daejon Juvenile Reformatories. The data was collected during the period from August 29-30, 1996 using individual interviews. The questionnaire developed by Kim et. al.(1996) to survey adolescent drug behavior was used. The data was analyzed using descriptive statistics, t-test and x -test with SPSS-WIN program. The results of this study were as follows 1) The education level of 48.2% of the respondents was 7-8 years. 2) Many had a past history of multiple delinquent behaviors : truency(98.2%), run away from home(91.15%), police report of fighting(73.2%), sexual intercourse(71.7%), stealing(63.6%). 3) In everyday life, 61% of respondents felt sadness, 51% felt fear, and 44% experienced loneliness. 4) Approximately 88% of reported their first age of unlawful behavior as 11-12 years old. 5) The family environment of respondents was perceived negatively and mother´ s substance use rate was high. 6) Most respondents had experienced substance abuse, especially, alcohol(94.6%), smoking(9 1. 1 %). bond(92.9%) and gas(75%). 7) The first age of their drug abuse was 13-15 years old. 8) They responded that habitual drug use caused health and law problems. 9) Most of their friend had experienced drug abuse. 10) It was easy to buy drugs except Marijuana and Pilophone. 11) According to gender analysis, there was a statistically higher tolerance of boys toward alcohol and smoking while girls were tolerant of the use of bond and gasoline.restrictio

Community-Based Mental Health Nursing Program Development For Rehabilitation of Home-Stayed Long-Term Psychiatric Patients in Seong-Buk Gu in Korea

Korean economic development has proceeded at the rapid rate of in the past two decades with neglect to some areas of human development, especially in the case of mental illness. But the government has belatedly recognized the importance and urgency of welfare and health programmes to cope with increasing problems. Mental health problems are more serious among the economically underprivileged than others. Because of large portion of mental patients from the economically underprivileged segment are at the without proper treatment or care. Thus it is imperative to develop easily assessible, cost-effective alternatives that would offer effective mental health care as well as useful social rehabilitation programmes. The government enacted the National Mental Health Law in December 1995. This project will assist to clarify the appropriate roles of the most effective care system. 20 nurse practitioners began a study on voluntary basis to assess the patients and their family with assessment tool which developed by research members. After that managed the 46 patients and their families through telephone or home-visiting, day care center programmes(such as social skill training, group therapy, movement therapy, art therapy) and counselling, refering hospital and family support group. The goals of research is to strengthen the capacity of psychiatric mental health nurse practitioners to undertake home and community-based mental health care services through various training programmes and expected outcome is this programme will be developed continuously and implemented to another community mental health center. Lastly, the cost-effective study of community-based mental health care will have been undertaken with realistic data provided by the pilot programme policy recommendations prepared for the Ministry of Health and Welfare.ope