소동맥 폐쇄증에서의 급성 반응성 단백

성영희 대한뇌졸중학회 2006 Journal of stroke Vol.8 No.2

Background:Inflammatory processes are implied in the pathogenesis of atherosclerosis and are a risk factor for myocardial infarction, stroke, and peripheral arterial disease. We assessed whether acute reactive protein such as C-reactive protein (CRP) and fibrinogen levels are related to small-vessel occlusion. Methods:Six hundred twelve patients with acute ischemic stroke and one hundred thirteen control subjects who visited Gil Medical Center between March 2004 and February 2005 were enrolled in this study. Acute ischemic stroke was classified by TOAST classification. Among these patients, large artery disease (LAD), small vessel occlusion (SVO) patients uncomplicated by infection were included, and cardioembolic (CE), stoke of others determined cause (SOD) and stoke of undetermined etiology (SUE) were excluded. CRP and fibrinogen were measured during the first 48 hours after stroke onset. We analyzed the risk factor and acute reactive protein in each group. Results:Among the 612 patients with acute ischemic stroke patients, 235 had LAA and 213 had SVO. There was no significant difference in clinical characteristics between groups. LAA group had higher CRP and fibrinogen levels than SVO or control group. The CRP level was higher in SVO group than control group (p=0.041), but the fibrinogen showed no significant difference between two groups (p=0.302). Conclusion:The CRP may be involved in the pathophysiology of small-vessel occlusion as well as large-artery atherosclerosis. (Korean Journal of Stroke 2006;8:187-190)

파킨슨병에서 안정시 진전의 도파민 치료에 대한 반응 예측 인자

성영희,정선주,김성렬,이명종 대한신경과학회 2007 대한신경과학회지 Vol.25 No.1

Background: The pathophysiology of resting tremor in Parkinsons disease (PD) remains unclear. Dopaminergic treatment provides variable effects on resting tremor in PD. We aimed to evaluate the predictable clinical factors for the levodopa responsiveness of resting tremor in patients with PD. Methods: Eighty-five PD patients with prominent resting tremor who visited Asan Medical Center between June 2004 and June 2005 were included. The prominent resting tremor was defined as tremor scoring more than 3 in at least one limb in the Unified Parkinsons Disease Rating Scale (UPDRS). Subjects were divided into the responsive group (RG) or non-responsive group (NRG) according to the responsiveness of resting tremor to dopaminergic treatment. Responsiveness was defined as a minimum 2 points reduction of UPDRS score for the resting tremor after dopaminergic treatment for more than 3 months. Results: Among the 85 patients, there were 35 men and 50 women ages 34-87 years (mean age, 67 years). Thirty-six patients (42.4%) were grouped into RG and 49 (57.6%) into NRG. Mean age of RG was significantly younger than that of NRG. RG showed significantly higher initial UPDRS part III subtotal score (p=0.015) and more severe Hoehn & Yahr stage (p=0.010) than those of NRG. UPDRS subscores for rigidity (p=0.012), bradykinesia (p=0.021) and postural impairment (p=0.018) were correlated with the responsiveness of dopaminergic treatment. Conclusions: Resting tremor in PD patients more favorably responded to dopaminergic treatment when it presented in combination with bradykinesia and rigidity suggesting dopaminergic role in the genesis of resting tremor in those PD patients.

일 병원 간호서비스 질에 대한 소비자와 제공자의 지각차이 비교

성영희,권인각,김미경 병원간호사회 2006 임상간호연구 Vol.12 No.1

Purpose: The purpose of this study was to examine the expectation, performance, and perceived clinical nursing service quality on the basis of the model of SERVQUAL at one of the tertiary hospitals, where the ratio of inpatients to nurses is 2:1, located in Seoul. Method: This study was cross-sectional survey. A convenience sample of 274 customers and 295 providers was obtained. Data were collected through self-reporting questionnaire in 2005. The questionnaire, 5 Likert scale, consists of 20 statements divided into 5 dimensions. The values of Cronbach's α appeared to be 0.98 at the both group. Result: Consumers' expectation of the nursing service was not met in most of service factors except empathy. But the differences between expectation and performances were not statistically significant. Consumers' perception on nursing service quality was significantly higher than that of the nurses. Reliability was perceived the most important dimension of nursing service by customers but tangibles was perceived less important than others. And the item of 'to provide nursing care promptly however busy nurses may be' was pointed as the most urgent item to be improved. Conclusion: To improve the quality of patient-centered nursing service, outstanding nursing service focused on reliability and assurance should be stressed.

진료협력간호사의 역할규명을 위한 직무분석 : 교육상담간호사와 진료코디네이터간호사 중심

성영희,임난영,박광옥,정정희,권인각,김을순,황문숙 병원간호사회 2009 임상간호연구 Vol.15 No.2

Purpose: The purpose of this study was to identify role through job analysis (duties and tasks) of nurses who work as clinical nurses with education and clinical nurse with patient coordination within the hospital. Methods: The DACUM committee was organized with 8 nurses each, clinical nurses with education and clinical nurses with coordination. The committee derived the duties and tasks of the two groups of clinical nurses from their actual work in the hospital through a DACUM workshop. Validity of the derived duties and tasks was tested by 12 nurses at each of 3 hospital. Results: For clinical nurse with education, 8 duties and 45 tasks were identified, which included patient education and consultation, patient advocacy, management of the therapeutic process, direct nursing care, activities work directed at improvement, management of health promotion events, administration work, and self-improvement. For clinical nurse with coordination, 10 duties and 54 tasks were identified, and included client consultation, client education, direct nursing care, coordination of therapeutic flow, employee education, public relations with the community, planning and operation of meetings, administration work, work directed at improvement, and self-improvement. Conclusion: The results of this study contribute to not only the work of the participants but also basic data for human resource management in the hospital.

일 종합전문요양기관 간호사의 핵심역량 도출 및 근무지 특성별 중요도 인식 비교

성영희,정정희 대한간호행정학회 2006 간호행정학회지 Vol.12 No.1

Purpose: The purpose of this study was to define the core components required of nurses to provide quality nursing care to patients and analyze the significance of these components in the hospital's various units to maintain a high level of competence among nurses. Method: The study evaluated 3 categories included 35 subcategories with 148 core components that were derived from literature review and interviews of nursing professionals. The nursing professional category included 18 subcategories with 98 components, the organizational culture category included 4 subcategories with 16 components, and the temperament attitude category included 13 subcategories with 34 components. The study included 335 nurses with more than one year of hospital experience and measured disparities among different hospital units. The data was analyzed with SPSS-Win 10.0, differing perceptions of the importance of general traits among the participants were measured using standard deviation, and differing perceptions of the importance of professional traits among the participants were assessed using ANOVA and subsequently with the Bonferroni Test. The reliability of the aforementioned research tools were evaluated using the Cronbach's α. Result: The results of the study were as follows: 1. Among the three categories, temperament attitude category was perceived to be the most important, followed by nursing professional category and organizational culture category. Among the ten most important subcategories within the three categories, safety and infection prevention as well as responsibility were perceived to be the most important, followed by promotion of physiologic adaptation, document management and presentation, self-control, ethics, observance law, coping with emergency, humanity, and medication. 2. The relative importance of category associated with the core competencies within the hospital unit were as follows : 1) The units that rated nursing professional category as being the most significant were: internal medicine, surgical unit, mother-child unit, emergency room, intensive care unit, and operating room, in that order. 2) The units that rated the organizational culture competencies as being the most significant were: mother-child unit, internal medicine, surgical unit, emergency room, operating room, and intensive care unit, in that order. 3) The units that rated temperament-attitude category as being the most significant were: internal medicine, surgical unit, emergency room, mother-child unit, operating room, and intensive care unit, in that order.

Validation of the Korean Version of the Scales for Outcomes in Parkinson's Disease-Sleep

성영희,김희진,고성범,김중석,김상진,천상명,조진환,김윤중,마효일,박미영,백종삼,이필휴,정선주,김종민,송인욱,김한준,김지영,권도영,이재혁,이지영,김지선,윤지영,홍진용,김미정,윤진영,김지선,오응석,양희준,윤원태,유수연,권겸일,박형은,이수윤,김연수,김희태,안태범 대한의학회 2018 Journal of Korean medical science Vol.33 No.2

Background: Sleep problems commonly occur in patients with Parkinson's disease (PD), and are associated with a lower quality of life. The aim of the current study was to translate the English version of the Scales for Outcomes in Parkinson's Disease-Sleep (SCOPA-S) into the Korean version of SCOPA-S (K-SCOPA-S), and to evaluate its reliability and validity for use by Korean-speaking patients with PD. Methods: In total, 136 patients with PD from 27 movement disorder centres of university-affiliated hospitals in Korea were enrolled in this study. They were assessed using SCOPA, Hoehn and Yahr Scale (HYS), Unified Parkinson's Disease Rating Scale (UPDRS), Parkinson's Disease Sleep Scale 2nd version (PDSS-2), Non-motor Symptoms Scale (NMSS), Montgomery Asberg Depression Scale (MADS), 39-item Parkinson's Disease Questionnaire (PDQ39), Neurogenic Orthostatic Hypotension Questionnaire (NOHQ), and Rapid Eye Movement Sleep Behaviour Disorder Questionnaire (RBDQ). The test-retest reliability was assessed over a time interval of 10–14 days. Results: The internal consistency (Cronbach's α-coefficients) of K-SCOPA-S was 0.88 for nighttime sleep (NS) and 0.75 for daytime sleepiness (DS). Test-retest reliability was 0.88 and 0.85 for the NS and DS, respectively. There was a moderate correlation between the NS sub-score and PDSS-2 total score. The NS and DS sub-scores of K-SCOPA-S were correlated with motor scale such as HYS, and non-motor scales such as UPDRS I, UPDRS II, MADS, NMSS, PDQ39, and NOHQ while the DS sub-score was with RBDQ. Conclusion: The K-SCOPA-S exhibited good reliability and validity for the assessment of sleep problems in the Korean patients with PD.

응급실의 환자분류체계 확립을 위한 결정지표 개발 연구

성영희,성일순,이승자,이지향,김정하,문유정,최영미 대한간호행정학회 2006 간호행정학회지 Vol.12 No.3

Purpose: The purpose of the study was to identify critical indicators for the development of efficient patient classification system in a emergency room. Method: This study involved following five steps. Step 1. Selection of the lists direct nursing services in the ER. Step 2. Measurement of the time of direct nursing services from Aug. 31st to Nov. 30th, 2005. Step 3. Classification of the patients according to the nursing care time. Step 4. The determination the critical indicators for different patient classes. Result: Determinate indicators were as follow: 3 items in the first group (vital sign checking, Ⅳ route starting, blood sampling), 3 items in the second group (vital sign checking, fluid infusion, blood sampling), 9 items in the third group (I/O checking, O₂ inhalation, suction, fluid infusion, Ⅳ bolus, Central catheter preparation & management, blood sampling, intubation preparation & management, postmortem management), 7 items in the fourth group (EKG monitoring, BP monitoring, O₂ inhalation, fluid infusion, using the specific drugs, CPR, postmortem management). Conclusion: This study can help future studies which measure nursing services standard time or assigns value to emergency nursing services.

급성뇌경색 환자에서 국내 신경과 전문의의 정맥내 헤파린 투여 사용 실태

성영희 대한뇌졸중학회 2003 Journal of stroke Vol.5 No.2

Department of Neurology Hallym University College of MedicineBackground and Purpose: The use of intravenous(IV) heparin in acute ischemic stroke has been an area of great controversy. We sought to get the current practice patterns of Korean board certificated neurologists(KBCN) with regard to heparin use in acute ischemic stroke. Methods: A survey was taken of 657 KBCNs. The e-mail address and subspecialty were obtained from both the History of Korean Neurological Association(1982-2002) and the directory of Korean Stroke Society. Brief vignettes were presented via electronic mailing system for the following five scenarios: progressive stroke, cardiogenic embolism, posterior circulation, external carotid artery stenosis, repetitive TIA. For each vignette respondents were asked whether they would use IV heparin with response choice such as 'yes', may be’and ‘no’. Results: Two hundred and thirty three (46.5%) KBCNs returned a completed survey. In progressive stroke, 157 respondents (67.4%) replied ‘yes’, 48 (20.6%) replied ‘maybe’, and 28(12.0%) would not use I.V. heparin. In cardiogenic embolism, 169 respondents (72.5%) replied that they would use, 46 (19.7%) replied maybe, and 18(7.7%) would not use I.V. heparin. In posterior circulation stroke, 122 respondents (52.4%) would use I.V. heparin, 60 (25.8%) maybe use, 51(21.9%) would not use I.V. heparin. In ECA stenosis, 104 respondents (44.6%) would use, 70 (30.0%) maybe use, and 59 (25.3%) would not use I.V. heparin. In repetitive TIA, 173 respondents (74.2%) would use, 29 (12.4%) maybe use, and 31 (13.3%) would not use I.V. heparin. The usage pattern of I.V. heparin in each vignette was not affected by age, current teaching status and subspecialty of stroke. Compared to results found in American study in 2001, KCBNs were significantly more likely to use IV heparin in four clinical scenarios, except in cardiogenic embolism. Conclusion: Although most therapeutic guidelines for anticoagulants in acute ischemic stroke do not recommend IV heparin for any specific group of acute ischemic stroke that is based on any presumed stroke mechanism or location, Neurologists in Korea would use intravenous heparin in large numbers for these conditions.

전문간호사의 정서지능이 조직몰입과 이직의도에 미치는 영향

성영희,황문숙,김경숙,전나미 한국간호과학회 간호행정학회 2010 간호행정학회지 Vol.16 No.3

Purpose: The purpose of this study was to identify the influence of clinical nurse specialists' emotional intelligence on their organizational commitment and turnover intention. Methods: A descriptive study with second data analysis was conducted with permission. The original data was from the policy research on the status of clinical nurses with extended role hosted by the Hospital Nurses Association in 2007. Results: The mean score of emotional intelligence, organizational commitment, turnover intention were 58.66 (±6.63), 46,71 (±3.54), 12.87 (±3.98) respectively. Emotional intelligence had 40% positive influence on organizational commitment (F=50.58, p<.01, adj.R²=.16) and 24% negative influence on turnover intention (F=16.68, p<.01, adj,R²=.06). Conclusion: The results recommend to develop a program that enhances clinical nurse specialists' emotional intelligence. The program could be utilized as an institutional retention strategy to increase clinical nurse specialists' organizational commitment and decrease their turnover intention.

전문간호사의 성과지표 개발

성영희,이영희,임경춘,정재심,조명숙,김경옥,김명애,박광옥,김을순,황문숙 병원간호사회 2010 임상간호연구 Vol.16 No.3

Purpose: This study aims to develop, verify, and suggest outcome indicators for advanced practice nurses (APNs) in order to clarify their usefulness. Methods: To develop outcome indicators, the following methods were applied: reviewing literature intended to identify preliminary outcome indicators; surveying outcome indicators currently used for APNs and collecting the opinions from representatives of the professionals in clinical practice; verifying the content validity of preliminary outcome indicators by professionals and verifying the preliminary outcome indicators with 252 APNs. Results: Suggested outcome indicators are categorized into 84 items in total. Of these, the number of outcome indicators commonly appearing across disciplines was 18, mostly related to satisfaction and education. A majority of other outcome indictors exhibiting high relevance to individual disciplines are associated with care, including critical care (19 items), oncologic care (9 items) and emergency care (10 items). Conclusion: As the outcome indicators identified in this study are available to demonstrate the usefulness of APNs, it is recommended that future studies need to select and use appropriate outcome indicators according to characteristics and conditions of the discipline under examination. In addition, it is necessary to validate whether the suggested outcome indicators reflect adequately the practices of APNs.