말기암환자의 섬망으로 인한 진정제 투약과 생존기간에 관한 후향적 코호트 연구

박형숙,김대숙,배은희,김정림,서정화,윤정미,Park, Hyoung Sook,Kim, Dae Sook,Bae, Eun Hee,Kim, Jung Rim,Seo, Jung Hwa,Yun, Jung Mi 한국호스피스완화의료학회 2016 한국호스피스.완화의료학회지 Vol.19 No.2

목적: 본 연구의 목적은 섬망이 있는 말기암환자에 있어 진정제의 투약 투약 관련 특성을 파악하고, 진정제 투약군과 비투약군 간의 생존기간의 차이를 확인하기 위함이다. 방법: 본 연구는 2012년 1월부터 2013년 12월까지 B 광역시 소재 P대학교병원에서 응급실과 수술실, 중환자실을 제외한 병동에서 임종한 암환자 900명 중 경과기록지, 간호기록지를 통해 섬망선별 도구인 Nu-DESC를 이용하여 섬망이 있었던 말기암환자 240명을 대상자로 선정하였다. 투약기록지를 통해 진정제인 haloperidol, diazepam, lorazepam을 정맥 또는 근육주사로 규칙적이거나 필요 시 투여한 횟수를 조사하였다. 결과: 연구 대상자의 섬망기간은 최소 1일에서 최대 61일까지 나타났고, 중앙값은 5일이었다. 연구 대상자에게서 나타난 섬망 특성은 부적절한 행동이 35.0%로 가장 많았다. 연구 대상자의 연령(F=3.96, P=0.021), 원발암의 종류(F=3.31, P=0.010), 항암치료 여부(t=-3.44, P=0.001)에 따른 섬망기간이 유의한 차이가 있었다. 연구 대상자가 진정제를 복용한 경우는 72.1%이었고, 투약된 진정제의 종류는 haloperidol이 59.6%로 가장 많았다. 진정제 투약군의 생존기간은 평균 16.85일, 비투약군은 9.37일로 나타났으나 이는 통계적으로 유의하지는 않아(t=1.766, P=0.079) 진정제 투약이 생존기간에 영향을 미치지는 않았다. 결론: 말기암환자의 섬망 발생 시 진정제 투약이 생존기간에 미치지 않았다. 이러한 결과를 바탕으로 생명단축의 윤리적 문제로 인해 진정제 사용을 꺼려하기 보다는 증상완화를 위한 진정제 치료를 적극적으로 권유할 수 있다. 또한 섬망은 가족이나 의료진과의 의사소통 장애를 유발할 뿐 아니라 환자나 가족들에게 스트레스로 작용하며 돌봄에 대한 부담감을 가중시키므로, 적절한 진정제의 투여는 말기암환자와 가족의 안위를 위해 적극적으로 추천하는 바이다. Purpose: This study analyzed the difference in survival time of patients with delirium according to sedative medication. Methods: From January 2012 through December 2013, a retrospective cohort study was performed using the electronic medical records (EMR) of Pusan National University Hospital. Among 900 patients who died from cancer, we selected 240 who suffered delirium based on the EMR. The Nu-DESC delirium screening test was used to diagnose delirium. Results: The median length of delirium period was five days. Delirium characteristics were dominated by inappropriate behaviors (35.0%). Sedatives were administered in 72.1% of the cases. The most frequently used sedative was haloperidol which was used in 59.6% of cases. The delirium period significantly differed by patients' age (F=3.96, P=0.021), cancer type (F=3.31, P=0.010), chemotherapy (t=-3.44 P=0.001). The average survival time was 16.85 days for the sedative medication group and 9.37 days for the non-medication group, which, however, was not significant (t=1.766, P=0.079). Conclusion: In this study, the use of sedatives did not affect patients' survival time. Thus, appropriate sedative medication can be positively recommended to comfort terminal cancer patients and their families.

입원환자의 TPN 투여전 영양상태 평가

박형숙,이수경,하미정,Park, Hyoung-Sook,Lee, Soo-Kyeong,Ha, Mi-Jeong 한국가정간호학회 2002 가정간호학회지 Vol.9 No.2

The purpose of this study was to assessment of hospitalized patients. Nutritional assessment was performed on 353 hospitalized patients before TPN support by ideal body weight. albumin, total lymphocyte count, cholesterol. The data analysis were performed on frequency, percentage, means and standard deviation. The major findings as follows: 1. Everage NPO duration was $6.77\pm5.39$day and $\geq5$days 48.9%, >5days 51.1%. NPO duration of 1M, NL, GS, Others prolonged. 2. %IBW was everge $94.86\pm17.21%$ 43.1% normal. 37.8% low weight. There were low weight IM 44.8%. TS 47.8%, Others 44.0%. 3. Albumin was everage $2.93\pm0.51$g/dl. moderate malnutrition 45.4%, mild malnutrition 30.9%. All session were malnutrition status. 4. Total lymphocyte count was ever age $960.41\pm721.32cell/mm^2$. severe malnutrition 43.9%. moderate malnutrition 29.0%, mild malnutrition 24.4%, normal 2.7%. All session were malnutrition status. 5. Cholesterol was everage $123.02\pm45.67$mg/dl 58.4% low level. 41.2% normal. 0.4% high level. 1M, GS and TS were low level. NL, NS, DR, Others were normal. It was very poor nutritional status before TPN support of patients. The malnutrition decrease immunity, slowly cure injury, cause abnormality organs, increase the complication and obstruct the recovery. Therefore, Evaluating and correcting are very important.

혈액투석환자의 자가간호 역량 및 자기효능감에 대한 연구

박형숙,조징림,Park, Hyoung-Sook,Cho, Jing-Lim 한국가정간호학회 2002 가정간호학회지 Vol.9 No.2

The purpose of this study was to identity degree on self-care agency & self efficacy of hemodialisis patients. The subjects for the study consisted of 260 hemodialisis patients and the data were collected from April 1st. 2002 to April 30. 2002. The instruments used for this study were the Self-carer As Inventory Scale(Genden & Taylor. 1998) and Concrete Self Efficacy Scale(Joo-Hyen Kim. 1995). The Self-carer As Inventory translated by So Hyang-Sook and was modified by auther of this study. The data were analysed by using SPSS/WIN program and included number. percentange. t-test, ANOV A and Pearson Correlation Coefficient. The results of the study are summarized as follows. 1. As the average score Self-care agency indicated $132.21\pm19.11$ points and Self efficacy showed $597.33\pm130.95$points. it can be said that Self-care agency and Self efficacy were high. 2. In the relationship between general and hemodialisis cure characteristics and Self care agency were significant difference in age(F=3.065. p=0.018). married(F=3.160. p= 0.029). religion(F=4.128. p=0.003). hemodialisis cure duration(F=2.615. p=0.049). 3. In the relationship between general and hemodialisis cure characteristics and Self efficacy were significant difference in age (F=2.992. p=0.019). married(F=4.427. p=0.013), job(before attack-F=1.926. p=0.044. after attack-F=1.784. p=0.048). incomes (F=2.235. p=0.041), hemodialisis cure frequency (F=1.718. p=0.042). diet practice (F=2.248. p=0.025). 4. Self efficacy was significantly related to Self-care agency(r=0.474. p<(0.001). That is the higher the self efficacy. the higher the level of Self-care agency. The result in the above showed that more concern and endeavors need to improve hope. medical support. self efficacy, self-care agency of hemodialisis patients.

OFDMA/TDD 시스템의 하향링크 빔형성 송신기 설계

박형숙,박윤옥,김철성,Park Hyeong-Sook,Park Youn-Ok,Kim Cheol-Sung 한국통신학회 2006 韓國通信學會論文誌 Vol.31 No.5a

논문은 OFDMA/TDD 시스템에서 하향링크 빔 형성 송신기의 효율적인 구조와 설계 변수의 최적화에 대하여 고찰하였다. 다수의 송신 안테나를 사용하는 하향링크 빔 형성 송신기 설계에 있어 다수의 사용자에 대한 효율적인 빔 형성 구조 설계와 송신기 블록의 word-length 는 송신기의 성능과 하드웨어 복잡도 측면에서 중요한 설계 변수가 된다. 본 논문에서는 기지국 수신에서 사용자 구분 없이 부반송파별 가중치만 메모리에 저장하고, IFFT 입력의 부반송파 단위에서 사용자에 따라 할당된 부반송파의 가중치를 고속으로 계산하여 적용하는 효율적인 빔형성기 구조를 제시하였다. 또한, 고정 소수점 시뮬레이션을 통하여 최적의 설계 변수를 분석하였다. 제시한 구조는 프레임 당 최대 사용자 수에 비례하게 메모리를 줄일 수 있으며, 또한 기지국 수신에서 사용자 제어 없이 FFT 출력을 바로 송신에 적용하여 OFDM 한 심볼의 처리 시간을 줄일 수 있고 송신기에서 빔 형성 계산은 별도의 처리 시간을 요구하지 않는 장점이 있다. This paper presents the efficient structure and parameter optimization of downlink beamforming transmitter in OFDMA/TDD system. To design downlink beamforming transmitter for multiple transmit antennas, an efficient beamforming structure for multiple users and the choice of word-length of each block are critical in the aspect of its performance and hardware complexity. We propose an efficient beamforming scheme, which stores the weights of subcarriers into memory without user identification at the receiver of base station and calculates the weights for corresponding user in a subcarrier unit of IFFT input at high speed. Also, we obtain the word-length of main data path and other design parameters by fixed-point simulation analysis. The proposed architecture could reduce the memory size proportional to the maximum number of users per frame, and the processing time of an OFDM symbol at the receiver of base station without the need of additional processing time for calculating the weights at the transmitter.

중환자실 간호사의 직무스트레스와 건강상태에 관한 연구

박형숙,조규영,강은희,Park, Hyoung-Sook,Cho, Gyoo-Yeong,Gang, Eun-Hee 한국중환자간호학회 2010 중환자간호학회지 Vol.3 No.1

Purpose: This study was to investigate Job Stress and the Health status of ICU Nurses. Methods: Data was accumulated from 230 ICU nurses serving at least more than one year in 500 bed order hospitals during the period of three months from June 1 to August 31, 2009. Results: The average job stress was $3.14{\pm}.59$ points, which was relatively high, The average health status was $1.52{\pm}.19$ points, There was significant difference according to religion and subjective health status in Job Stress, There was significant difference according to age, religion and subjective health status in Health Status, There was significant difference according to satisfaction of work, satisfaction of personal relations, impulse to give up duty and in service education in Job Stress, There was significant difference according to satisfaction of work. satisfaction of personal relations, and expectant nursing job in Health Status, There was significantly negative relationship between job stress and health status. Conclusion: Job stress has the most important impact on health status of ICU nurses, Based on the finding, we could conclude that job stress management of ICU nurses should be required to improve health status.

유방암 환자의 건강신념에 따른 운동계획 수립에 관한 연구

박형숙(Park, Hyoung Sook),정윤서(Jung, Yun Seo),김영미(Kim, Young Mi),황재현(Hwang, Jae Hyun) 기본간호학회 2020 기본간호학회지 Vol.27 No.1

Purpose: The purpose of this study was to identify the factors relating to commitment to a plan for exercise in the breast cancer patient following a mastectomy and to examine the relationship between these factors. Methods: This study was a correlational research and the participants were 152 patients with breast cancer. Data were collected using a structured questionnaire from June to October, 2015. Results: The final regression model showed that income, experience of exercise and current exercise were significant predictors related to commitment to a plan for exercise in patients with breast cancer and explained for 65.9% of the variance in commitment to a plan for exercise. Conclusion: The findings indicate that patients in breast cancer-oriented intervention programs have an enhancing experience of exercise. Current exercise should be provided for patients with breast cancer in order to promote health and quality of life.

간호학과 편입학생의 비판적 사고성향, 자아존중감 및 스트레스 대처간의 관계

박형숙(Park, Hyoung Sook),윤정미(Yun, Jung Mi),김영미(Kim, Young Mi),최인영(Choi, In Young),황재현(Hwang, Jae Hyun) 기본간호학회 2016 기본간호학회지 Vol.23 No.3

Purpose: The purpose of this study was to evaluate the effect of critical thinking and self-concept on stress adaptation in transfer nursing students. Methods: For this study, data were collected from 196 transfer nursing students from Busan and South Gyeongsang Province Data collection was done during the period from September to December, 2015. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson correlation coefficients and multiple regression. Results: The results showed that for critical thinking gender (t=2.48, p=.014), age (F=2.90, p=.044) and club activities (t=2.05, p=.041) were significant. Stress adaptation was significant according to academic year (F=3.81, p=.025). Critical thinking, self-concept and stress adaptation had positive correlations. Conclusion: Findings indicate that college adjustment for transfer nursing students could be enhanced through the development of programs to promote critical thinking and self-concept in the nursing curriculum.

간동맥 화학색전술을 받은 간세포암 환자의 삶의 질 영향요인

박형숙(Park, Hyoung-Sook),이현주(Lee, Hyun-Ju),하재현(Ha, Jae-Hyun) 기본간호학회 2015 기본간호학회지 Vol.22 No.1

Purpose: The purpose of this study was to examine the relationship among family support, self-care and quality of life(QOL) in Patients with hepatocellular carcinoma receiving transarterial chemoembolization, including the effects of these variables on QOL. Methods: The research was a cross-sectional, descriptive design. Participants were 103 patients with hepatocellular carcinoma who were receiving transarterial chemoembolization. Data were analyzed using descriptive statistics, t-test, one way ANOVA, and hierachial multiple regression analysis with SPSS 18.0 program. Results: QOL had a significant correlation with family support(r=.60, p<.001) and self-care(r=.38, p<.001). Family support had a significant correlation with self-care(r=.41, p<.001). Hierarchial multiple regression analysis for QOL revealed that the most powerful predictor was family support followed by self-care. Family support, self-care, gender, and occupation explained 50% of the variance in quality of life. Conclusion: These results indicate that various factors are related to the quality of life of these patients. Further, nursing strategies to improve the family support and self-care of patients with hepatocellular carcinoma are needed.

남성 간호사의 성 역할정체감, 성 고정관념, 직무만족 및 이직의도의 관계

박형숙(Park, Hyoung-Sook),하재현(Ha, Jae-Hyun),이미헌(Lee, Mee-Hun) 한국산학기술학회 2014 한국산학기술학회논문지 Vol.15 No.5

본 연구는 남성간호사의 성 역할정체감,성 고정관념,직무만족 및 이직의도의 관계를 파악하기 위해 시도한 서술적 조사연구이다.연구대상은 부산?경남지역 의료기관에 근무 중인 남성간호사 86명이였으며 자료수집기간은 2012년 8월부터 12월까지이다.자료분석은 SPSSwin18.0프로그램을 사용하였다.연구결과 남성간호사의 성 역할정체감은 양성성(33.7%), 미분화(30.2%),여성성(19.8%),남성성(16.3%)순 이였고 직무만족은 양성성 유형의 직무만족이 높았다(χ2=12.80p=.005).성 고정관념과 직무만족 및 이직의도의 상관관계는 성 고정관념이 높을수록 이직의도가 높고(r=.22,p=.044)직무만족이 높을수 록 이직의도가 낮았다(r=-.36,p<.001).따라서 간호현장에서 직무만족이 낮은 성 역할정체감 유형의 남성간호사들의 직무만 족을 높이고 이직의도를 줄이는 전략이 필요하다. This study was conducted to investigate of gender-role identity, gender stereotype, job satisfaction and turnover intention in male nurses. The data were obtained from 86 male nurses with from August to December 2012.The data were analyzed by SPSS/WIN 18.0 program. The results showed that gender-role identity types were androgyny(33.7%), Undifferentiated(30.2%), feminity(19.8%) and masculinity(16.3%). Androgyny style was appeared that higher job satisfaction(χ2=12.80 p= .005) than other. There were statistically significant correlation between gender stereotype and turnover intention(r=.22, p=.044), job satisfaction and intention(r=-.36, p<.001). It is needed to improve their job satisfaction about that low gender-role identity type of male nurses and reduce employee turnover in the field of nursing.

기본간호학 교수의 간호교육인증평가에 대한 인식, 직무만족도 및 전과의도

박형숙(Park, Hyoung Sook),정승교(Chaung, Seung Kyo),양영옥(Yang, Young-Ok),양진향(Yang, Jinhyang),김명수(Kim, Myoung Soo),신용순(Shin, Yong Soon),김동희(Kim, Dong-Hee),김현주(Kim, Hyun-Ju),원종순(Won, Jongsoon),조복희(Cho, Bok-Hee 기본간호학회 2017 기본간호학회지 Vol.24 No.2

Purpose: This study was done to explore recognition of accreditation for nursing education, job satisfaction and intention to change teaching area for faculty in Fundamentals of Nursing. Methods: Participants were 104 faculty members teaching Fundamentals of Nursing. Each participant responded to a questionnaire. Data were collected from June 25 to October 25, 2016, and analyzed using SPSS 23.0 for descriptive statistics, t-test, ANOVA, and Pearson correlation coefficient. Results: The participants’ recognition of accreditation in nursing education was 3.45±0.81 out of 5 and in the sub-items, the score for quality improvement in professors in Fundamentals of Nursing was lowest at 3.21±1.03. Job satisfaction was 3.30±5.30, and intention to change teaching area was 2.62±1.00. Attributes related to practice appear to be major reasons why participants intended to change their teaching area and scores for intention to change teaching area were medium or higher. Conclusion: Results indicate that it is necessary to develop strategies to improve job satisfaction and reduce intention to change teaching area for faculty with less experience in Fundamentals of Nursing education. Development of strategies, management and support are needed to improve young professors" job satisfaction and reduce intention to change teaching area.