성인간호학 영역에서의 간호중재논문 내용 분석

서문자,정재심,오효숙 대한기초간호자연과학회 2003 Journal of korean biological nursing science Vol.5 No.2

Purpose : This descriptive study was performed to analyse the trends of nursing interventional studies in adult nursing area. Method : All interventional studies of 'Journal of Korean Academy of Adult Nursing Society', fifty three articles, from 1989 to 2000 were collected and reviewed. Result : The research subject were patients in 38(66.7%) and 81.8% of researches was performed in hospital environment. There was only one true experimental design and most of articles(79.2%) were designed by quasi-experimental method. Only 17% of articles have theoretical framework and 73.6% of articles described research hypotheses. The data collection methods for variables were as follows : Psychosocial measurement 60.8%, physiological measurement 25.7%, and observation 13.5%, respectively. Lecture(16.7%), audio-visual(16.7%), and book, pamphlet, or leaflets(13.6%) were the most frequently used instniments of the interventions. Behavioral domain(60.3%) and Physiological : Basic domain(29.3%) were the most common, when the interventions were classified by Nursing Intervention Classification. Physiological(50.8%) and psychosocial variables(49.2%) were the two major dependent variables. Conclusion : Considering the above results obtained, the nursing intervention studies in adult nursing area have been tested with quasi-experimental studies through clinical trials. For the development of clinical nursing practice and advancement of nursing theories, the amount of interventional studies should be increased and the quality of research methods refined more to develop nursing science and practice in adult nursing area.

아동병동 간호사의 경력에 따른 아동 통증지식에 대한 연구

최선일,최명애 대한기초간호자연과학회 2005 Journal of korean biological nursing science Vol.7 No.1

Purpose : The purpose of this study was to identify pediatric nurses’s knowledge related to children's pain and pediatric nurses’ career including educational experience and to examine whether there is a difference of their knowledge according to their career. Method : Subjects of this study was 115 pediatric nurses of one university hospital who understood purpose of this study and accepted to participate in this study. Subjects responded questionnaire by self report. The data were gathered for 7 days during the period from October 20 to October 27, 2003. The pediatric nurses' knowledge and attitude survey regarding pain developed by Manworren(2001) was used to identify the knowledge related to children’s pain of pediatric nurses. Nurses’ career consisted of level of education, presently working ward, duration of experience at clinic, pediatric clinic and presently working ward and educational experience related to children's pain during undergraduate courses, ward orientation and continuing education. Educational experience regarding children’s pain was measured by whether they had education related to children’s pain during undergraduate courses, ward orientation and continuing education or not and their perception on the contents of education was measured by 5 point Likert type scale. SPSS Windows was used to analyze the data. Scores of the knowledge regarding children’s pain and career including educational experience of pediatric nurses were presented as mean and standard deviation. Mean percentage of correct answers responded by the subjects was presented under the category of introduction, assessment, pharmacological and nonpharmacological intervention for children’s pain. The difference of scores of the knowledge regarding children’s pain according to nurses’ career was analyzed using t-test, ANOVA and Tukey as a post hoc. Statistical significance was accepted at the level of p<.05. Result : Pediatric nurses had deficient knowledge related to children’s pain on the whole and did not trust pain complaint and underestimated the pain. They were short of concrete practical knowledge about pain assessment and pharmacological and nonpharmacological intervention for children’s pain. They were excessively concerned with side effect and addiction of analgesic drugs and had a negative view point on nonpharmacological pain intervention. About 50% of the subjects received education regarding children’s pain while their undergraduate courses. The number of nurses who received education regarding children’s pain while their undergraduate courses was found to be greater among the recently graduated nurses. In ward orientation and continuing education, only less than 10% of the nurses received education regarding children’s pain. Nurses perceived their experienced educational content deficient; experienced educational content consisted of pain introduction, assessment and pharmacological and nonpharmacological intervention for children’s pain while their undergraduate course, ward orientation and continuing education. There were no significant differences of the knowledge regarding children’s pain of pediatric nurses according to level of education, duration of experience at clinic, pediatric clinic and presently working ward. Scores of the knowledge regarding children’s pain of nurses at neonatal ward were significantly greater than those of nurses at pediatric intensive care unit. Scores of the knowledge regarding children’s pain of pediatric nurses who received education during their undergraduate course were significantly greater than those who did not receive it during their undergraduate courses. Also scores of the knowledge regarding children’s pain of pediatric nurses who received one kind of educational experience were significantly greater than those who had no educational experience. Conclusion : Pediatric nurses had deficient knowledge of children's pain and underestimated the pain of children. Also they were short of concrete practical knowledge on pain assessment and intervention for children’s pain.

기관절개술 환자의 Povidone 소독에 따른 포도상구균의 양상

홍해숙,김윤경 대한기초간호자연과학회 2001 Journal of korean biological nursing science Vol.3 No.2

본 연구는 기관절개술을 받은 환자의 기관절개부위에서 발견되는 포도상구균에 대해 povidone의 살균효과와 소독제 사용 횟수, 경과일수에 따른 변화를 관찰하는 것을 목표로 하고 있다. 연구대상은 2001년 1월 16일부터 2001년 2월 26일까지 D시내에 소재한 2개 종합병원의 신경외과 중환자실에 입원한 35명의 기관절개환자였으며, 수집된 자료는 SAS를 이용하여 백분율, t-test로 분석하였다. 연구결과는 다음과 같다. 포도상구균에 대한 povidone의 살균효과는 농도와 시간에 관계없이 강하게 나타났다. 1일 1회 소독 후 3일째부터 Staphylococcus aureus균이 검출되었고, 6일째에 가장 많이 검출되었다. Coagulase negative Staphylococcus균은 1일부터 3일까지는 거의 검출되지 않았으나, 4일째에 가장 많이 검출되었다. 소독횟수에 따른 균집락화 양상은 1일 1회 소독할 때보다 2회 소독시 황색포도상구균이 현저히 감소하였다. 항생제에 대한 Staphylococcus aureus와 Coagulase negative Staphylococcus의 내성검사를 한 결과 Staphylococcus aureus는 Methicillin에서 72.7%, Imipenem에서 63.6%가 내성을 나타냈으며, Coagulase negative Staphylococcus는 Methicillin에서 37.5%, Imipenem에서 12.5%가 내성을 나타내었고, Vancomycin에는 모두 내성을 나타내지 않았다. 이상의 본 연구결과로써 기관절개환자의 절개부위에 대한 철저한 소독을 통해 병원감염을 예방할 수 있는 기초자료가 될 수 있는 것으로 사료되며, 다음과 같은 제언을 하고자 한다. 앞으로 더 많은 소독제와 다양한 균종과의 관계에 대한 연구가 시행되어야 할 것이며, 모든 의료인은 철저한 병원감염예방에 힘써야 할 것이다. 또한, 병원감염 예방과 간호 발전을 위한 소독전문인력을 양성하여 활성화시키는 것이 필요할 것으로 사료된다. The object of this study was to measure the biocidal effect of povidone on staphylococcus found in tracheal incision site, changes following the disinfection frequency and duration, and tolerance to the antibiotics. The data was analysed by percentage and t-test using SAS program. The subjects of this study are 35 tracheostomy patients in an Intensive Care Unite of the hospital located in Daegu city and analysing term was from January 16 to February 26, 2001. The results of this study were as follows. The biocidal effect of povidone on Staphylococcus was strong regardless of time and concentration. Staphylococcus aureus was found on third day and found to be highest concentration on 6th day after disinfection of once/a day. Coagulase negative Staphylococcus was not found from 1st to 3rd day and highest on 4th day after disinfection of once/a day. As to bacteria colonization following the disinfection frequency, twice per day of disinfection was more effective on Staphylococcus aureus than once a day. In tolerance test of Staphylococcus aureus and Coagulase negative Staphylococcus, 72.7% of Staphylococcus aureus showed tolerance in Methicillin, 63.6% in Imipenem, and 37.5% of Coagulase negative Staphylococcus showed tolerance in Methicillin, 12.5% in Imipenem. Bothof them do not have any tolerance in Vancomycin. The results of this study can be used as the basis for protection against hospital mediated infection through thorough disinfection. With above results, I suggest the following. First, we should research relation between antiseptics and fungi, virus more deeply. Secondly, all medical personnel should try to protect against the hospital mediated infection. Thirdly, there is a need of training professional disinfection personnel for preventing hospital mediated infection and the progress of nursing science.

기초간호자연과학의 인체구조와 기능 내용별 필요도에 대한 연구

최명애,변영순,서영숙,황애란,김희승,홍해숙,박미정,최스미,이경숙,서화숙,신기수 대한기초간호자연과학회 1999 Journal of korean biological nursing science Vol.1 No.1

The purpose of this study was to define the content of requisite human structure and function knowledge needed for clinical knowledge of nursing practice. Subjects of human structure and function were divided into 10 units, and each unit was further divided into 21 subunits, resulting in a total of 90 items. Contents of knowledge of human structure and function were constructed from syllabus of basic nursing subjects in 4 college of nursing, and textbooks published by nurse scholars prepared with basic nursing sciences. The degree of need of 90 items was measured with a 4 point scale. The subjects of this study were college graduated 136 nurses from seven university hospitals in Seoul and three university hospitals located in Chonnam Province, Kyungbook Province, and Inchon. They have been working at internal medicine ward, surgical ward, intensive care unit, obstetrics and gynecology ward, pediatrics ward, opthalmology ward, ear, nose, and throat ward, emergency room, rehabilitation ward, cancer ward, hospice ward, and their working period was mostly under 5 years. The results were as follows : 1. The highest scored items of human structure and function knowledge necessary for nursing practice were electrolyte balance, blood clotting mechanism and anticoagulation mechanism, hematopoietic function, body fluid balance, function of plasma, and anatomical terminology in the order of importance. The lowest scored items of human structure and function knowledge necessary for nursing practice was sexual factors of genetic mutation. 2. The highest order of need according to unit was membrane transport in the living unit, anatomical terminology in movement and exercise unit, mechanism of hormone function in regulation and integration unit, component and function of blood in oxygenation function unit, structure and function of digestive system in digestive and energy metabolism unit, temperature regulation in temperature regulation unit electrolyte balance in body fluid and electrolyte unit, concept of immunity in body resistance unit, and genetics terminology in genetics unit. The highest order of importance according to subunit was membrane transportation in cell subunit, classification of tissues in tissue unit, function of skin and skin in skin subunit, anatomical derivatives of the skeleton subunit, classification of joints in joint subunit, an effect of exercise on muscles in muscle subunit, function of brain in nervous system subunit, special sense in sensory subunit mechanism of hormone function in endocrine subunit, structure and function of female reproductive system in reproductive system unit, structure and function of blood in blood unit, structure of heart, electrical and mechanical function in cardiovascular system unit, structure of respiratory system in respiratory system subunit, structure and function of digestive system in digestive system subunit, hormonal regulation of metabolism in nutrition and metabolism subunit, function of kidney in urologic system subunit, electolyte balance in body fluid, electolyte and acid-base balance subunit. 3. The common content of human structure and function knowledge need for all clinical areas in nursing was structure and function of blood, hematopoietic function, function of plasm, coagulation mechanism and anticoagulation mechanism, body fluid, electrolyte balance, and acid-base balance. However, the degree of need of each human structure and function knowledge was different depending on clinical areas. 4. Significant differences in human structure and function knowledge necessary for nursing practice such as skin and derivatives of the skin, growth and development of bone, classification of joint, classification of muscle, structure of muscle, function of muscle, function of spinal cord, peripheral nerve, structure and function of pancrease, component and function of blood, function of plasma, structure and function of blood, hemodynamics, respiratory dynamics, gas transport, regulation of respiration, chemical digestion of foods, absorption of foods, characteristics of nutrients, metabolism and hormonal regulation, body energy balance were demonstrated according to the duration of work. 5. Significant differences in human structure and function knowledge necessary for nursing practice such as classification of tissue, classification of muscles, function of muscles, muscle metabolism, classification of skeletal muscles, classification of nervous system, neurotransmitters, mechanism of hormone function, pituitary and pituitary hormone, structure and function of male reproductive organ, structure and function of female reproductive organ, component and function of blood, function of plasma, coagulation mechanism and anticoagulation mechanism, gas exchange, gas transport, regulation of respiration, characteristics of nutrients, energy balance, function of kidney, concept of immunity, classification and function of immunity were shown according to the work area. Based on these findings, all the 90 items constructed by Korean Academic Society of Basic Nursing Science should be included as contents of human structure and function knowledge.

간호대학생의 정신간호학 실습이 요중 Na^(+), Cl^(-), K^(+), Ca^(++)에 미치는 영향

나현주,한유정 대한기초간호자연과학회 2001 Journal of korean biological nursing science Vol.3 No.2

This study was done to investigate the effect of the first experience of the clinical experience for psychiatric nursing on urinary Na^(+), Cl^(-), K^(+), Ca^(++) of the nursing students. We analyzed the urine of 36 students on curriculum who were students of D college in K city. The data were analyzed with SAS Statistical analysis was performed by using paired t-test, GLM. The second day group increased 18.56 at 8AM, 31.90 at 4PM in a case of Na^(+)(p=0.004). The second day group increased 27.61 at 8AM, 43.53 at 4PM in a case of Cl^(-)(p=0.009). The first day group increased 2.62 at 8AM, 7.09 at 4PM in a case of K^(+)(p=0.018). The second day group increased 3.69 at 8AM, 5.19 at 4PM in a case of K+(p=0.013). The second day group increased 20.65 at 8AM, 14.07 at 4PM in a case of Ca^(++)(p=0.033). There was a significant difference in Na^(+) according to group at 8AM(F=4.17, p=0.024) and 4PM(F=3.58, p=0.040). There was a significant difference in Cl^(-) according to group at 8AM(F=4.38, p=0.020) and 4PM(F=6.29, p=0.003). There was a significant difference in K^(+) according to group at 8AM(F=5.03, p=0.012). In conclusion, Na^(+), Cl^(-), K^(+), Ca^(++) may be used as a indicator of the amount of stress to improve the educational environment for the students.

지시적 심상요법이 혈압과 맥박에 미치는 효과 : 간호대학생을 대상으로 In Nursing Students

최은옥,이동숙 대한기초간호자연과학회 2003 Journal of korean biological nursing science Vol.5 No.2

The purpose of this study was to test the effect of guided imagery on blood pressure and pulse rate. The subjects were thirty-nine nursing students in I university located in Busan, Korea. To enhance the effect of treatment, they were trained getting themselves absorbed in guided imagery on three different occasions before the study. Actually in the study, the subjects were given instruction in Mason's guided imagery for 19 minutes and 58 seconds. Blood pressure and pulse rate were measured before and after guided imagery application. The data were analyzed through paired t-test. The Results were as follows : 1) There was a significant decrease in systolic blood pressure after the use of guided imagery. 2) There was no significant decrease in diastolic blood pressure after the use of guided imagery. 3) There was a significant decrease in pulse rate after the use of guided imagery. These results indicate that guided imagery is a helpful technique for decreasing blood pressure and pulse rate, which are increased in stress condition.

웹 기반의 기초간호자연과학 멀티미디어 콘텐츠 개발 : 심장의 구조와 기능을 중심으로 Centered on Structure and Function of Heart

유지수,황애란,박지원,김춘자 대한기초간호자연과학회 2000 Journal of korean biological nursing science Vol.2 No.2

This study was conducted to develop web-based distance learning program of basic nursing physical science which was composed of a multimedia contents such as documents, voices and pictures. This was to advance curriculum of basic nursing physical science based on a proper nursing characteristics related to other major nursing subjects and induce a new and creative method to gain a knowledge. Based on a general learning design model, distance learning program was developed centered on a structure and function of heart among contents which got a consensus in the conference of academy of basic nursing physical science in 1999. The stages of development were like this. Firstly, at the analytic stage, specific units and contents for developing multimedia contents were decided and presentation methods for each item were designed and then the evaluation items were developed. Secondly, at the design stage, the most effective design of multimedia construction was selected and interfaces, basic frames, and presentation elements were chosen. Thirdly, at the developmental stage, internet files were designed using Namo web editor 4.0 and this files were modified with Adobe Photoshop.

중환자실 간호사의 기초간호과학 지식의 필요성 분석

변영순,최명애,김희승,박미정,서화숙,이경숙,최스미,홍해숙 대한기초간호자연과학회 2002 Journal of korean biological nursing science Vol.4 No.1

The purpose of this study was to identify the knowledge contents of basic nursing sciences needed by nurses in the practices of the intensive care unit(ICU). To attain the goal of this study, the nurses working at 10 hospitals in the areas of Seoul and Kangwon Province were randomly selected. They were primarily interviewed, and the open question was secondarily put to them through the questionnaire. In the process of the 1st interview, the interviewees were asked of the question, “What is the knowledge of basic sciences such as anatomy, pathology, physiology. microbiology, pharmacology and the like thought to be lacking when you communicate with doctors in the ICU and when you carry out your nursing practices in it?” The contents of the interview were tape-recorded. The period of data collection ranged from May 1, 2001 to Sept 30. The interviews were conducted with total of 20 nurses. The open-end questionnaire was secondarily mailed to nurses. 113 questionnaires were returned. 100 questionnaires except 13 ones thought to be poorly completed in content were used for data analysis. Three coders classified data obtained from the interview and the questionnaire research into 5 detailed items relating to such as anatomical physiology, pathology, pharmacology. microbiology and basics of nursing. The three coders had experiences in nursing education of 18 years, 8 years and 6 years, respectively, and of them one coder was professor in basic nursing science. Data were statistically treated using frequency analysis and percentage by the SAS program. As a result, the following findings were obtained: It was found that the contents that ICU nurses responded were most needed in the field of Human structure and function were water and electrolytic balance(38%), blood and circulatory system(20%), changer in the patient’s skin(12%), the arrangement of the human body(10%) and the endocrine system(10%), nervous system(6%), and assessment of the state of the patient's consciousness(4%). It was found that the contents that ICU nurses responded were most needed in the field of pathology were found to be the process of the progress of the disease(32%), symptoms of the disease(27%), prognosis of the disease(22%), followed by the injury-healing process, clinical pathological examination, and examination by radiation. It was found that the contents that nurses responded were most needed in the field of pharmacology were the effect of drug(25%), the side effect of drug(22%), the relationship between diseases and drug(20%), the relationship between disease-causing bacteria and drug(20%) and chemotherapy(2%). It was found that the contents that ICU nurses responded were most needed in the field of microbiology were the relationship between diseases and disease-causing bacteria(45%), Kinds and characteristics of disease-causing bacteria(18%), infection control(16%), application of the aseptic technique(12%), isolation(9%) and the like. It was found that the basic knowledge that ICU nurses responded were needed were the identification of the patient’s current state(36%), understanding of the therapeutic process(22%), the operating principle of medical equipment and instrument(20%), medical terminology(9%), equipment and instrument management(7%), calculation of the dose of injection(2%) and the like.

정맥주입 전문간호사가 삽입한 말초삽입형 중심정맥관(PICC) 사용 결과에 대한 후향적 분석

박정윤,박광옥,백미경,김세라,권혜리,양수진 대한기초간호자연과학회 2004 Journal of korean biological nursing science Vol.6 No.1

Background : Intravenous(Ⅳ) access is becoming an increasingly important part of health care today. The current drive for clinical effectiveness and cost-effective health care serves to increase the need for reliable vascular access. Venous access devices were developed to overcome problems associated with limited peripheral access and frequent venipuncture in patients with long-term therapy. Although the peripherally inserted central catheter(PICC) have become popular during recent years in USA, its procedure is rare in Korea. Purpose : The goal of this study was to analyze the PICC inserted patient data by Ⅳ CNS intervention. Method : A Total of 62 PICCs were inserted into 51 patients by the Ⅳ CNS during a 10-month period form November, 14, 2002, to October 2, 2W2. Data was obtained retrospectively through chart review. Result : The patient population included 34(54.8%) men and 28(45.2%) women, with a mean age 50.6 years. The main indication for PICC placement was to access vein in poor peripheral venous status(40.3%). The mean served interval for PICC insertions was 16.7 days(range, 2~61 days). The reasons for removal were completed therapy in 18 cases(29.0%), patient death in 13 cases(21.0%), and mechanical or functional PICC problem in 10cases(16.1%). The three PICCs removed for presumed infection, and one had only positive tip cultures(0.2%). Conclusion : PICCs are rapidly growing popularity and required an extended course of Ⅳ therapy.

간호학생의 정신간호학 실습이 요중 17-Ketosteroid(KS), 17-Hydroxycorticosteroid(OHCS)에 미치는 영향

나현주 대한기초간호자연과학회 2000 Journal of korean biological nursing science Vol.2 No.1

The purpose of this study is to determine the effect of the first experience of the clinical experience for psychiatric nursing on the urinary 17-ketosteroid (KS) and 17-hydroxycorticosteroid (OHCS) of the nursing students. We analyzed the urine of fifteen students on curriculum who were students of D college in K city, compared with the control. In terms of 17-KS, at the end (4 PM) of the first day (p=0.00l) and the last day (p=0.003), there was statistically significant difference between the control and the experimental group. In terms of 17-OHCS, at the end of the first day, there was statistically significant difference between the control and the experimental group (p=0.005), and between at the beginning (8 AM) and at the end during the clinical experience (p=0.035). At the last day, also, there was significant difference on the statistics between at the beginning and at the end in both the control (p=0.018) and the experimental group (p=0.004). In conculusion, 17-KS and I7-OHCS may be used as a indicator of the amount of stress to improve the educational environment for the students.