제2형 당뇨병 환자의 당뇨식이 관리 행동에 영향을 미치는 요인

진소현 忠南大學校 大學院 2020 국내석사

This study was conducted to identify the factors that type 2 diabetes affects diabetic dietary behavior by identifying the socio-demographic characteristics, diabetes-related characteristics, autonomous motivation. The subjects of this study were 96 nursing patients who diagnosed with Type 2 diabetes registered with the Center for the Hypertension and Diabetes Registration in S City, Korea. Data was collected by using questionnaires from August to September, 2019. For the data analysis, this study conducted descriptive statistical analysis, t-test, ANOVA, Sheffé test, correlation analysis and regression analysis using SPSS 24.0 program. The results of this study are summarized as follows. 1. The subjects of this study were a total of 96 persons, 5 0 (52.1%) women and 46(47.9%) men. The subjects were 44(45.8%) people aged 70 or older, 41(42.7%) in their 60s and 11(11.5%) in their 50s or younger. The marriage status of the subjects was 81(84.4%) married and 15(15.6%) divorced or widowed. The education level of the subjects were 64(66.7%) or below high school graduates and 32(33.3%) or above college graduates. 44(45.8%) people were generally satisfied with their income, while 38(39.6%) were satisfied and 14(14.6%) were dissatisfied. 67(69.8%) subjects had no jobs and 29(30.2%) subjects had jobs. The period of diagnosis for diabetes was 45(46.9%) patients for more than 10 years, 26(27,1%) patients for three to six years, 20(20.8%) patients for less than one year, and 5(5.2%) patients for one to three years. 84(87.5%) subjects did not have diabetes complications, while 12(12.5%) had diabetes complications. 52(54.2%) subjects took a blood glucose test on their own, while 44(45.8%) did not take a blood glucose test on their own. 68(70.8%) subjects had a diabetes education attendance, while 28(29.2%) subjects had no experience attending. 50(52.1%) subjects attended a nutrition education program, while 46(47.9%) had no experience. 46(47.9%) people did not attend the sessions, 44(45.8%) in 1 to 3 sessions, and 6(6.3%) more than 4 times. 88(91.7%) subjects currently smoke, while 8(8.3%) did not smoke. 63(65.6%) of the subjects drink the alcohol while 33(34.4%) do not drink. 2. For each of the three areas of treatment self-regulation, the average point autonomous motivation was 37.05, controlled motivation was 22.25 and amotivation was 13.92. The diabetic diatary behavior was 16.69. 3. Autonomous motivation showed that the significantly differences in diabetes education attendance, the nutrition education attendance, and the number of nutrition education attendance. Controlled motivation showed significant differences in level of education. Amotivation showed significant differences in level of education and drinking. Diabetic dietary behavior showed significant differences in the nutrition education attendance, the number of nutrition education attendance, and drinking. 4. Subjects showed correlation between diabetic dietary behavior and autonomous motivation, nutrition education attendance, the number of nutrition education attendance and drinking. There was a correlation between autonomous motivation and nutrition education attendance, the number of nutrition education attendance. It has been shown that amotivation and drinking, controlled motivation, controlled motivation and amotivation correlation between. There was correlation between the diabetes education attendance and the nutrition education attendance, the number of nutrition education attendance and drinking. There was a very high correlation between the number of nutrition education attendance and the nutrition education attendance were higher than other variables. 5. To identify the factors affecting diabetes dietary behavior, a stepwise regression analysis was performed with variables diabetes education attendance, nutrition education attendance, number of nutrition education attendance, drinking, autonomous motivation, controlled motivation and amotivation. The suitability of the regression model was appropriate(F=6.548, p=.002), and drinking(B=-2.452, SE=1.006, p=.017) and the number of nutritional education attendance(B=1.785, SE=.787, p=.026) was shown to be a significant factor. These variables accounted for 12.3% of the subjects’ diabetes dietary behavior. In conclusion, the diabetes dietary behavior of type 2 diabetes needs discussion and efforts on the implementation and direction of the nation's alcohol policy to alleviate alcohol-related problems and improve the quality of life in order to promote self-care management behavior. Further research will also need to be consider to help prevent blood sugar control and diabetes complications through self-care enhancement, such as development, repeated education, an application of continuous diabetes nutrition education programs for each patient, and dietary management of the diabetic patients. Key words:diabetic diet, diet management

보건교사의 천식 및 알레르기질환에 대한 지식, 관리, 교육 요구도

김희선 충남대학교 교육대학원 2016 국내석사

연구 목적: 본 연구는 보건교사의 천식 및 알레르기 질환에 대한 지식, 관리, 교육 요구도를 파악하여, 보건교사 대상 천식 및 알레르기 질환 교육 자료 및 학교 대응 프로토콜 개발을 위한 기초자료를 제공하기 위하여 시도한 서술적 조사연구이다. 연구 방법: 2015년 11월 1일부터 12월 10일까지 대전광역시 초등학교에 근무하고 있는 96명의 보건교사에게 질문지법을 이용하여 수행하였다. 연구 결과: 천식 및 알레르기 질환 관련 지식점수는 20점 만점에 평균은 16.63점, 총 정답률은 83.12%으로 나타났다. 천식 및 알레르기 질환 관리 정도는 4점 만점 중 평균 2.44점으로 나타났다. 천식 및 알레르기 질환 관련 교육 요구도는 4점 만점 중 평균 3.39점으로 나타났다. 대상자의 일반적 특성에 따른 천식 및 알레르기 질환 관련 지식은 통계적으로 유의한 차이가 없었다. 대상자의 일반적 특성에 따른 천식 및 알레르기 질환 관리는 가족 중에 천식 및 알레르기 질환 여부에 대해서는 통계적으로 유의한 것으로 나타났으며(t = -2.94, p < .01), 질환이 없는 집단의 평균값(M=2.64)이 더 높은 것으로 나타났다. 재직기간동안의 천식 및 알레르기 질환 학생 경험 여부에 대해서는 통계적으로 유의한 것으로 나타났으며(t = -3.21, p < .01), 경험이 없는 집단의 평균값(M=3.22)이 더 높은 것으로 나타났다. 연령, 결혼여부, 보건교사의 천식 및 알레르기질환 여부와는 통계적으로 유의한 차이가 없었다. 일반적 특성에 따른 천식 및 알레르기 질환 교육 요구도는‘식이’에 대한 교육 요구도만 교육 경험여부에 대해서 통계적으로 유의한 것으로 나타났으며(t = 2.09, p < .05), 교육경험이 있는 집단의 평균값(M=3.56)이 높았다. 결론: 본 연구 결과를 토대로 보건교사의 천식 및 알레르기질환에 대한 교육 요구도를 반영한 교육 자료 개발과 학교 대응 프로토콜 개발을 통해 관리 정도를 높이는 방안을 모색하는 것이 필요하다. 또한 개발된 교육 자료와 학교대응 프로토콜을 적용하여 효과를 검증해 볼 필요가 있다.

중·고등학교 교사의 당뇨에 대한 지식과 태도 및 교육요구도 조사

김지윤 충남대학교 교육대학원 2016 국내석사

이 연구는 중·고등학교 교사를 대상으로 당뇨에 대한 지식과 태도, 교육요구도를 파악하여 교사 대상 당뇨병 교육 자료 개발을 위한 기초자료로 제공하는데 그 목적이 있다. 연구설계는 중·고등학교 교사의 당뇨에 대한 지식과 태도 및 교육요구도를 파악하기 위한 서술적 조사연구이다. 연구대상은 대전광역시에 위치한 중학교, 고등학교 각 2곳의 교사 92명이었고, 자료수집은 2015년 11월 1일부터 12월 10일까지 이루어졌다. 수집된 자료는 IBM SPSS 21.0 프로그램을 이용하여 분석하였다. 연구결과, 중·고등학교 교사의 당뇨에 대한 지식 평균평점은 19점 만점에 9.83점, 당뇨에 대한 태도의 평균평점은 5점 만점에 3.84점, 당뇨에 대한 교육요구도는 4점 만점에 평균평점 3.17점으로 나타났다. 당뇨 관련 교육을 받은 경험은 5.4%이었다. 대상자의 일반적 특성에 따른 당뇨에 대한 지식과 태도, 교육요구도는 통계적으로 유의한 차이가 없다고 나타났다. 이상의 연구 결과에서 중·고등학교 교사가 당뇨에 대해 중간수준의 지식과 긍정적인 태도, 약간 높은 교육요구도가 있음을 알 수 있었다. 최근 당뇨병이 있는 아동․청소년이 점차 증가하고 있으나 관련 교육을 받은 경험은 별로 없었다. 그러므로 체계적인 학생 관리를 위해 교사 대상 당뇨병 교육이 요구되며 연구 결과를 반영한 교육 자료 개발이 필요하다. The main purpose of this study is to investigate the level of knowledge, attitude and educational demand concerning diabetes of middle and high school teachers, and finally, to be used as basic information in developing educational materials for those educators. A descriptive survey was designed to investigate the level of knowledge, attitude, and educational demand concerning diabetes of middle and high school teachers. Overall, 92 teachers of 2 middle and 2 high schools in Daejeon Metropolitan City were recruited as subjects and finally participated in this survey from November 1st to December 10th, 2016. Collected data were statistically analyzed using IBM SPSS version 21.0. The average score of knowledge, attitude, and educational demand concerning diabetes of middle and high school teachers were 9.83, 3.84, and 3.17, while total score for each aspect were 19, 5, and 4, respectively. Only 5.4% of our subjects had experiences of any diabetic education. Knowledge, attitude and educational demand of study subjects concerning diabetes did not show any statically significant correlation with their general characteristics. From this study, middle and high school teachers showed considerably strong educational demands and positive attitudes, not high level of knowledge related to diabetes. Despite the fact that the number of diabetic children and adolescents are recently increasing, teachers for those young students did not seem to be sufficiently educated, especially considering their number of contacts with diabetic education. Therefore, training materials reflecting these results related with diabetes should be developed and provided to teachers for systematic management of students.

당뇨병 환자의 자가관리행위별 사회 연결망 분석

고금보 忠南大學校 大學院 2020 국내석사

The purpose of this study is to identify the characteristics of structured and interactive social networks that can explain the health status of diabetics, to identify the types of social networks, and to identify social networks by self-management behaviors of diabetics. The data collected from this study were analyzed for general characteristics, diabetes-related characteristics, and diabetes self-management behavior using the SPSS 24.0 program. Social Network Analysis by Self-Management Behavior is NetMiner 4.0, an analysis tool that can analyze the network that can represent the influence of network members by visualizing the relationship between each Node and Link based on Excel. According to the analysis of the social network that affects the support of diabetes management in the type of social network according to the use of diabetes self-management behavior resources, the degree centralization index, closeness centralization index, and betweenness centralization index of the In-degree centralization index in B village were the highest at 21.26%, 37.43%, and 7.10%, respectively. The social network analysis results that affect diabetic diet cooperation showed a similar pattern, indicating 27.32% and 44.39% of the connection between B villages compared to the other two villages, and the social network analysis results that affect the diabetic exercise showed 26.80% and 43.75% respectively. In particular, the Betweenness centralization Index of village B was 9.69%, which was higher than the other two villages. On the other hand, the social network analysis results that affect daily information showed that the degree centralization index, closeness centralization index of the C village were 27.92% and 50.36%, respectively, which were higher than the other two villages. In addition, the social network analysis results that affect blood glucose level test showed the degree centralization index, closeness centralization index of the village C were 37.28% and 66.15%, respectively. This study applied social network analysis to find cooperation and differences in community villages, and examines the overall level of participation and specific patterns of participation within the network. Therefore, the results and approach of this study may influence the evaluation of other collaborative networks aimed at promoting population health at the local and national levels. It is possible to measure the key characteristics between groups of various sizes, showing that it can be used for further research on the formation and outcome of the network of community diabetes self-management.

제2형 당뇨병 환자의 자가관리에 대한 미래 가치지향적 조절 개념분석

보사드경희 忠南大學校 大學院 2020 국내박사

Purpose: The purpose of this work was to analyze Type 2 Diabetes patients’ self-management behavior control based on perceived future value concept. Method: The hybrid concept analysis model was used to analyze Type 2 Diabetes patients’ self-management control behaviors. Theoretical review of 54 research studies were analyzed and results were obtained through an in-depth interview of 11 diabetic patients. Results: The research found four categories and 12 attributes related to future-value oriented behavior control of Type 2 Diabetes patients. The following categorically summarizes each dimension discovered through the research; Time: Preparation for Future, Subjectivity of Time Reward: Material Rewards (time/money), Complication Prevention, Blood-Glucose Control. Value: Functional Value, Social Value, Conditional Value, Emotional Value Control: Ambivalence of Self-Care, Choosing Preferred Self-care, Willingness to Practice. Conclusion: Future-value oriented control is defined as the intention of Type 2 diabetes patients to select and control current self-management behavior to achieve personally perceived future results (reward). The categories and attributes of future-value oriented behavior controls and associated concepts presented in this work can be used to enhance development of nursing intervention programs to improve the self-management behavior of Type 2 diabetes patients.

중환자실 의료장비 알람에 대한 간호사의 인식과 알람위해 조사

박미영 忠南大學校 大學院 2016 국내석사

The purpose of this study was to survey the alarm perception of nurses, alarm hazards on clinical alarms in intensive care units (ICU). A cross-sectional study was performed with 261 ICU nurses in 7 hospitals. The research aims and procedures, including voluntary participation, withdrawal, as well as anonymous data collection, and collection for the sole intention of research were explained. Data collected from August to September in 2015. ICU nurses's clinical alarm perception, alarm fatigue and alarm hazards were analyzed by frequency, percentage, and Chi-square test using SPSS 22.0. The study result were as follows : 1. More than 90% of nurses answered “agree” or “strongly agree” to the questions ‘The purpose of clinical alarms is to alert nurses of an existing or potentially patients condition’, ‘Alarm sounds visual display should differentiate the priority of alarm’, ‘Alarms should impact multi sense(audible, visual, etc.)’. 2. The question 'The number of times that the working hours of medical equipment due to alarms interfere with the work' was responded as 108 nurses(41.4%) were interfered by clinical alarm 6∼10 times in a shift, even in 23 nurses(8.8%) answered as more than 20 times. 3. Less than 20% of nurses answered “agree” or “strongly agree” to the questions ‘Policies and procedures exist within the facility to regulate alarms and ’ the question ‘There is a requirement in your institution to document that the alarms are set and are appropriate for each patient’ as followed. 4. As a result of measuring the alarm fatigue for nurses, about 70% of nurses answered “agree” to the questions ‘Have you experienced alarm fatigue in the past 6 months?’ and ‘False alarms occur frequently in my practice’. 5. The most important concerning issue for alarms, ranked by nurses, was ‘Frequent false alarms reducing attention/response to alarms that occur’. In conclusion, there are a variety of medical equipment and alarms used in the intensive care unit. The alarm perceptions of nurses were high, and the most important thing they perceived was a false alarm that can cause significant alarm fatigue during their managing the alarm in this study. Lots of hospital did not include medical equipment management system which related to the alarm. Moreover, little protocol for regulating the appropriate alarm settings was found in each medical equipment. It should be necessary to provide an alarm management guidelines and to consider ways to keep the alarm manager in the intensive care unit so that the safe working environment can be secured.

제2형 당뇨병 환자를 위한 동기강화상담 프로그램의 개발과 적용가능성 평가

조정화 忠南大學校 大學院 2018 국내박사

The number of diabetes patients in Korea, who are over 30 years of age, is increasing. But diabetes awareness and the rate of glucose level by more than 7.0% of HbA1c. Hence, active diabetes control remains significantly low. Furthermore, the level of diabetes management is worse than before. It’s been reported that more than half of the diabetes patients are unable to control their care is needed. Since type 2 diabetes patients’ blood glucose management and complication prevention can’t be controlled through lifestyle habit modification and oral hypoglycemic agents, early insulin therapy is recommended. Diabetes patient’s decision to receive insulin therapy is determined by the patient’s intention to receive insulin treatment. Depending on the intention of insulin therapy, the diabetes patient’s decision factors to receive insulin therapy varies. Therefore, nursing intervention, in synch with the insulin therapy intention, is needed so that patients with type 2 diabetes can begin insulin therapy at the appropriate time. Motivational Interviewing is a client-centered counseling method aimed at enhancing the motivation to change within the patient. This is accomplished by considering the level of preparedness and motivation of the patient. Thus, Motivational Interviewing that are synchronized with the behavior change stages, help to solve the ambivalence toward change and enhance motivation for change. Therefore, to help type 2 diabetes patients with determining insulin therapy at the right time, it is necessary to develop and evaluate Motivational Interviewing Program in synch with the stages of intention of insulin therapy. It is also necessary to describe the development process and key decisions of the Motivational Interviewing Program and assess the feasibility of the program. The purpose of this study is to develop and apply Motivational Interviewing Program for patients with type 2 diabetes who require insulin therapy and to assess the effects of intention of insulin therapy, psychological insulin resistance. The intervention was developed and pilot tested for fidelity to protocol, for patient and interventionist feedback. The intervention was refined based in the results of the pilot study and delivered in the active arm of a prospective non-randomized study. In this study’s design, a non-equivalent pre-post test of quasi-experimental design was used. The study participants were recruited from endocrinology outpatients at two university hospitals in South Korea. In this study, 56 type 2 diabetes patients participated, with 28 in the experimental group and 28 in the control group. Motivational Interviewing based intervention took place for 6 weeks. Face-to-face interviews were conducted for the first and last sessions and telephone counseling was conducted during sessions 2 to 5. The nursing staff provided general care of the control group. Both the experimental group and the control group were followed up 12 weeks later. Data analysis was performed with paired t-test, t-test, χ²-test using the SPSS WIN 22.0 program. The results of this study are as follows; 1) Hypothesis 1: “After intervention, the intention of insulin therapy will be significantly improved in the experimental group versus the control group”was supported (p=.002). 2) Hypothesis 2: “After intervention, the Score of psychological insulin resistance will be significantly lower in the experimental group than the control group”was not supported (t=4.095, p=.051). In conclusion, the Motivational Interviewing Program for type 2 diabetes patients is effective in improving the intention of insulin therapy. Thus, this program can be recommended as an effective nursing intervention for type 2 diabetes patients who delay starting insulin therapy. The study suggested the fidelity of Motivational Interviewing Program and patient acceptability. This provides a very detailed description of the motivational interviewing development process for the specifics of training and delivering the intervention.

간호대학생의 정보윤리지수와 의료정보보호 인식도가 의료정보보호 실천도에 미치는 영향

차경인 忠南大學校 大學院 2017 국내석사

This study attempted to investigate the information ethics index and patients’ Health Information awareness and practice for nursing students who are practicing in medical institutions and to provide basic materials necessary for education of patients’ Health information protection to students in schools and/or medical institutions. The subjects of this study were 238 nursing students who experienced clinical practice at four universities in J province, and collected data by using questionnaires from April to June, 2016. For the data analysis, this study conducted descriptive statistical analysis, T-test, ANOVA, Sheffe test, correlation analysis and regression analysis using SPSS Windows for 21.0 program. The results of this study are summarized as follows. 1. The subjects of this study were a total of 238 persons, 210(88.2%) women and 28 (11.8%) men. 131 students(55.0%) had a religion, and 107 students(45.0%) had no religion. 203 students(85.3%) answered that they received education about patients’ Health information protection in the school, 35 students(14.7%) answered that they received no education about it, and 185 students(77.7%) responded to the questionnaire that they had education about patients’ Health information protection in the hospital and 53 students(22.3%) responded that they received no education about it. 2. The mean score of the information ethics index of the study subjects was with a full score 5 points out of 5 points for each domain, and in terms of the abstinence was 3.66 points for 12 items, in terms of respect was 4.06 points for 15 items, in terms of responsibility was 4.32 points for 16 items, and in terms of participation was 3.72 points for 12 items. The perception of the patients’ Health information protection awareness of the subjects was 23 questions. The mean score of the items was 4.38 points out of 5 points, and the mean score of the 23 items on patients’ Health information protection practice was 4.24 points out of 5 points. 3. In the information ethics index, the awareness and practice of patients’ Health protection according to the general characteristics of the subjects, it was found that nursing students with religion had higher patients’ Health information protection practice than nursing students without religion(t=2.50, p=.013). 4. To explore the relationship between the information ethics index and the patients’ Health information protection practice according to the patients’ Health information protection awareness of nursing students in this study, there was a positive correlation in the domains of temperance, respect(r=.440, p<.001), responsibility (r=.353, p<.001), and participation(r=.244, p<.001). The domains of respect, responsibility(r=.630, p<.001), and participation(r=.482, p<.001) were also found to have a positive correlation, and the domain of participation(r=.401, p<.001) was found to have a positive correlation with the domain of responsibility. The awareness on patients’ Health information protection was positively correlated with the domain of temperance(r=.196, p=.002) in information ethics index, and was positively correlated with the domains of respect(r=.511, p<.001) responsibility (r=.615, p<.001) and participation(r=.445, p<.001) in information ethics index. The patients’ Health information protection practice was positively correlated with the domain of temperance(r=.151, p=.020), and was positively correlated with the domains of respect(r=.417, p<.001), responsibility(r=.480, p<.001), and participation (r=.288, p<.001). The domains of awareness(r=.591, p<.001) and practice were also positively correlated with each other. 5. From the results of analyzing the regression model to explore the effects of general characteristics of nursing students in patients’ Health information protection practice and information ethics index and patients’ Health information awareness upon patients’ Health information protection practice, in Model 1, gender, age, religion status, education status were inserted to demonstrate that the fit of the regression model was not appropriate(F=1.560, p=.186) and that Religion status(B=.194, SE=.078, p=.014) were significant influencing factors. That is, nursing students with religion have higher practice for patients’ Health information protection than nursing students without religion. These variables accounted for 0.9% of the patients’ Health information protection practice. From the results of analyzing the regression model to explore the effects of general characteristics(sex, age, religion status, education status) of nursing students in patients’ Health information protection practice and information ethics index and patients’ Health information protection awareness upon patients’ Health information protection practice, in Model 2, the fit of the regression model was appropriate(F=16.709, p<.001), and religion status(B=.134, SE=.063, p=.033), responsibility(B=.233, SE=.104, p=.033) in information ethics index, and patients’ Health information protection awareness(B=.609, SE=.091, p<.001) were found to be significant influential factors. In other words, nursing students with religion have a higher level of patients’ Health information protection practice than nursing students without religion. The higher the patients’ Health information protection practice of nursing students with high awareness of the information ethics index and the patients’ Health information protection awareness, the higher the job satisfaction. These variables accounted for 37.4% of the patients’ Health information protection practice. In conclusion, as the information ethics index was higher, so there was a higher positive correlation between awareness and practice of patients’ Health information protection. This should be preceded by basic information ethics education prior to occupational patients’ Health information protection as a nurse, and it is necessary to develop a systematic and continuous education program including the necessity and importance of patients’ Health information protection in medical institutions as well as measuring the level of information ethics of nursing students before the practice of medical institutions, and which can help lay the groundwork to improve the patients’ Health information protection of practice students of medical institutions and improve the practice of patients’ Health information protection. Key words : nursing students, information ethics index, patients’ Health information protection awareness, patients’ Health information protection practice

미숙아의 구강수유 관련요인

박소연 忠南大學校 大學院 2021 국내석사

최근 미숙아 출생 비율이 증가되고 생존율 또한 이전에 비해 많은 향상을 보이고 있는 가운데 과학적이고 효과적인 미숙아 간호도 중요한 관심사가 되고 있다. 미숙아의 수유는 건강한 성장과 발달을 위한 기본적인 욕구로 구강수유는 퇴원을 위한 중요한 필요조건이기도 하다. 본 연구는 미숙아를 대상으로 구강수유 시작과 완전 구강수유 시기를 확인하고 구강수유 진행기간과 관련된 요인을 파악하고자 2018년 1월 1일부터 2019년 12월 31일까지 24개월 동안 D시에 소재한 C대학병원에서 출생한 미숙아 106명의 전자의무기록을 대상으로 후향적 조사연구를 실시하였다. 미숙아의 첫 구강수유 시기의 월경 후 연령은 평균 34.2주이며 구강수유는 완료한 시기의 월경 후 연령은 평균 35.7주이었다. 첫 구강수유에서 완전 구강수유까지의 구강수유 진행기간은 평균 11.51일로 나타났다. 미숙아의 구강수유 진행기간과 관련하여 상관관계를 분석한 결과, 출생시 재태연령(r=-.259, p<.001), 출생체중(r=-.362, p<.001)은 낮은 음의 상관관계를 보였으며, 입원일수(r=.561, p<.001), 호흡지지 기간(r=.510, p<.001), 위관삽관 기간(r=.636, p<.001)과 중간정도의 양의 상관관계를 보였다. 본 연구결과를 통하여 의학적 합병증이 있는 미숙아를 제외한 32주 미만 또는 1500g 미만으로 출생한 미숙아에게서 재태연령, 출생체중, 호흡지지 기간, 위관삽입 기간은 미숙아의 구강수유 진행 기간과 유의미한 연관을 가지며 미숙아의 구강수유 이행에 대한 간호사의 사정 및 평가와 기록의 필요성을 확인하였다. 또한 이러한 자료들은 구강수유 중재의 개발 및 평가에 적극 활용 될 것으로 기대되며 미숙아의 구강수유를 위한 중재의 개입은 완전 구강수유를 조기에 달성하게하고 이는 조기 퇴원을 가능하게 할 것이다. The purpose of this study is to determine the start of oral feeding and the timing of complete oral feeding in premature infants, and to identify factors related to the duration of oral feeding progress. The subjects of the study are 106 premature babies carrying with gastric tube feedings of less than 32 weeks or less than 1,500 grams, born and hospitalized at C University Hospital in D city for 24 months from January 1, 2018 to December 31, 2019, A retrospective study was conducted on the medical records of the babies including the general characteristics, respiratory support-related characteristics, and oral feeding progress-related characteristics. Data analysis was performed using descriptive statistics, t-test, Mann-Whitney U test, and Pearson's correlation according to the research purpose using the SPSS 24.0 program. The average postmenstrual age of premenstrual infants at the time of first oral feeding was 34.2 weeks, and the average postmenstrual age at the time of completion of oral feeding was 35.7 weeks. The average duration of oral feeding progress from the first oral feeding to complete oral feeding was 11.51 days. As a result of analyzing the correlation with the duration of oral feeding progress in premature infants, gestational age at birth (r=-.259, p<.001), birth weight (r=-.362, p<.001) showed a low negative correlation, and duration of hospital stay (r=.561, p<.001), duration of respiratory support (r=.510, p<.001), duration of gastric tube insertion (r=.636, p<.001) showed a moderate positive correlation. According to the results of this study, gestational age, birth weight, duration of respiratory support, and the number of days for gastric tube insertion in premature infants born less than 32 weeks or less than 1500g were significantly related to the duration of oral feeding progress of premature infants. (Premature infants with medical complications are excluded.) The necessity of the nurse's assessment and evaluation, and of the recording of oral feeding were confirmed. In addition, these data are expected to be actively utilized in the evaluation and the development of oral feeding interventions. The interventions for oral feeding of premature infants will achieve complete oral feeding early, which will enable to discharge earlier. just, Attention is required to generalize the results of this study and it is necessary to identify the study results of the study and previous studies. Key word: Premature infant, Oral feeding, Oral feeding progress, Respiratory support

제2형 당뇨병 환자의 당뇨병 자가간호 행위와 당뇨병 자기효능감 간의 관계 : 심리적 인슐린저항성의 매개효과

임안초 忠南大學校 大學院 2018 국내석사

The purpose of this study was to identify the role of Psychological Insulin Resistance (PIR) in the relationship between Diabetes Self-Efficacy (DSE) and Diabetes Self-Care management (DSC). This study used the data from the original study data on ‘Development and Evaluation for Korean version of Psychological Insulin Resistance’. The cross-sectional descriptive study was designed, and 992 type 2 diabetes patients were recruited from the endocrinology outpatient department. The Structural Equation Model (SEM) was performed to estimate direct and indirect effects of DSE on DSC when PIR was entered as a mediator. Date were analyzed using descriptive statistics, Pearson’s correlation, and path diagram were carried out using SPSS 24.0 program and AMOS 22.0 program. All hypothesis testing was 2-sided; type1 error was controlled at the 0.05 level. The results were as follows : 1. The mean scores of DSC, DSE, and PIR were 35.72 (±13.89) (range: 4~70 points), 70.79 (±15.59) (range: 18~180 points), and 59.95 (±16.19) (range: 18~90 points) respectively. 2. There was a significant negative correlation between DSE and PIR (r=−.11, p=0.001), and as well as between PIR and DSC (r=−.17, p<0.001). There was a significant positive correlation between DSE and DSC (r=.55, p<0.001). Therefore, the first prerequisite for mediation analysis was met three variables such as PIR, DSE, and DSC. 3. The DSE was significantly associated with DSC (β=.82, p=.013), wheres negatively associated with PIR was found (β=-.11, p=.017). PIR was negatively associated with DSC (β=-.11, p=.030). When PIR was entered as a mediator, the association between DSE and DSC was reduced (β=.02, p=.009). In conclusion, PIR was a mediator of relation between DSC and DSE. The results suggested that DSE and PIR should be considered as important factors for leading the successful DSC.