신규간호사와 프리셉터 간호사의 의사소통에 대한 내용분석

정연옥 ( Yeon Ok Jeoung ),박성철 ( Song Chol Park ),진정근 ( Jeong Kun Jin ),김주영 ( Joo Young Kim ),이지언 ( Ji Uhn Lee ),박순영 ( Soon Young Park ),석소현 ( Sohyune Sok ) 한국간호과학회 정신간호학회(구 대한간호학회정신간호학회) 2014 정신간호학회지 Vol.23 No.2

This study was done to explore communication between nurses during preceptorship. Methods: A qualitative study, using content analysis was conducted. Semistructured interviews were held with 10 nurses working in urban hospitals. Results: A total of 226 significant statements were selected from the data and classified into 4 categories and 23 subcategories. Communication experiences of new nurses’ own performance were responses to reproach - acceptance and apology, and unresponsiveness due to feeling small and uncomfortable; responses to questions - misanswer; responses to directions - unconditional acceptance. Communication experiences of new nurses’ performance by nurse preceptors were kindness, stigmatization, talking behind one’s back, criticism and reproach, impolite words, and emotional expression. Communication experiences of nurse preceptors’s own performance were directives, sympathy, reproach, unkindness, authoritative strictness, and nonverbal expression: being cold, and lessening of tension. Communication experiences of nurse preceptors’ performance by new nurses were response to criticism - recognition and apology for mistakes, evasion of responsibility, and excuses; responses to explanations-active acceptance, and difficulty with communication due to lack of comprehension. Conclusion: These results provide deep understanding of nurses’ communication during preceptorship and should help in developing comprehensive education programs for preceptor nurses and new nurses.

간호사의 인수인계 의사소통 교육 방법론

정연옥 ( Jeoung Yeon Ok ),박용익 ( Bak Yong Ik ) 한국텍스트언어학회 2016 텍스트언어학 Vol.41 No.-

The aim of this article is to introduce a teaching program for the nurse`s handover communication. The goal of handover communication is not only to transfer correctly and clearly the informations about the patients but also to build the cohesiveness and to promote the solidarity among the team members. For this goal the handover communication should be two-way exchange of information between outgoing and oncoming staff. In addition, the team members should respect, support and empathize with each other. This article will show how the dialog pattern, the communicative norms, and the evaluation sheet of the handover communication containing the elements of the two-way and emphatic communication can be used in the teaching handover communication.

간호사의 인수인계 대화 원형

정연옥 ( Yeon Ok Jeoung ),석소현 ( So Hyune Sok ),박용익 한국외국어대학교 언어연구소 2015 언어와 언어학 Vol.0 No.69

의료인의 경청과 공감 능력 향상을 위한 정밀읽기의 원리와 방법론

정연옥 ( Yeon Ok Jeoung ),박용익 ( Yong Ik Bak ) 대한의료커뮤니케이션학회 2021 의료커뮤니케이션 Vol.16 No.2

Background: Close reading is used in medical education to improve doctors’ listening, empathy and relationship-building ability, but no method for close reading has been suggested yet. In order to efficiently use close reading in medical education, it is essential to present concrete methods of close reading. Methods: The development of the Close Reading methods is based on the basic principles of text interpretation, resources of knowledge in the evaluation process and the theory of variation analysis presented by Lucius-Hoene and Deppermann. Results: The basic principles of text interpretation include data-orientedness, reconstructive attitude, prerequisites for meaningfulness, multilevel consideration, sequence analysis and contextuality, circularity and coherence, explicativity and argumentativity. As knowledge resources there is everyday knowledge, ethographic-historical knowledge, knowledge about linguistic-communicative phenomena, theoretical knowledge. Variation analysis includes substitution, deletion, permutation, insertion. Conclusion: The basic principle of text interpretation is worth using as guidelines for text interpretation that readers of close reading should pay attention to. Knowledge resources can be used as the resources and argument for text interpretation. And the Variation analysis can be used to verify the validity of the close reading results. All of these can also be used for teachers in assessing and providing feedback to learners.

대화 분석적 인수인계 의사소통 교육 프로그램이 임상간호사의 인수인계 수행능력, 자기효능감, 대인관계 스트레스에 미치는 효과: 예비연구

정연옥 ( Jeoung Yeonok ),박용익 ( Bak Yong Ik ),이정우 ( Lee Jeongwoo ),박성철 ( Park Songchol ),진정근 ( Jin Jeongkun ),이혜용 ( Lee Hyeyong ),강승혜 ( Kang Seung Hae ),석소현 ( Sok Sohyune ) 한국간호과학회 정신간호학회(구 대한간호학회정신간호학회) 2016 정신간호학회지 Vol.25 No.3

Purpose: The purpose of this study was to examine the effects of an education program for effective nursing intershift handoff communication (NIHC) on nursing intershift performance, self-efficacy, and interrelationship stress among clinical nurses. Methods: The study was a pilot study using a one-group pretest-posttest design. Participants were 40 clinical nurses from Seoul/ Gyeonggi Province. The handoff dialogue pattern was developed by three professors and one doctoral student in 2014, and was based on an education program for effective (NIHC) from dialogue analysis. The education program as an experimental treatment was provided for 3 1/2 hoursto clinical nurses. Measures included nursing intershift performance scale, self-efficacy scale, and interrelationship stress scale. Collected data was processed and analyzed with SPSS PC+ Version 21. Results: There were significant differences in nursing intershift performance (hand over: t=-12.18, p<.001; undertaking: t=-6.88, p<.001), self-efficacy (hand over: t=9.42, p<.001; undertaking: t=8.13, p<.001), and interrelationship stress (hand over: t=11.46, p<.001; undertaking: t=10.49, p<.001) between pre and post-test. Conclusion: Findings indicate that this education program can be utilized as a manual, and can be applied to improve nursing intershift performance and self-efficacy, and to decrease interrelationship stress for effective (NIHC) among clinical nurses. Findings will also help to reduce incorrect performances and increase work efficiency in clinical practice for nurses.

효율적인 인수인계 대화 수행을 위한 의사소통 규범

정연옥 ( Yeon Ok Jeoung ),박용익 ( Yong Ik Bak ) 한국텍스트언어학회 2015 텍스트언어학 Vol.38 No.-

The purpose of this article is to establish the communicative norms in nursing handover which are positively necessary for the improvement of nurses`` communicative competence during the handover. This research is based on the preceding qualitative research on the nurses`` experience about the handover communication. The communicative norms are inferred from nurses`` notions about the positive and negative elements of nurses`` handover communication reported in the qualitative research. As a result, 39 communicative norms were found in total, and each of those norms could be applied for the information giver, the information recipient, or in both-information giver and information recipient. The norms are classified into 6 categories according to the functions and the meanings: (1) preparing condition and establishment of a relaxed atmosphere for communication, (2) communicative attitudes, (3) arrangement of modes of communication, (4) performance methods of communication, (5) contents of handover, (6) expression modes. These norms couldbe used as guidelines for the effective communication or the criteria for evaluating the performed communication during the handover.

텍스트언어학 밖에서의 텍스트 분석 -의학교육에서 텍스트 정밀읽기-

정연옥 ( Jeoung Yeonok ),박용익 ( Bak Yongik ) 한국텍스트언어학회 2021 텍스트언어학 Vol.51 No.-

One purpose of this article is to introduce close reading, which is practiced as a type of text analysis outside of text linguistics and used as an educational method in narrative medicine. Another aim is to discuss the possibilities and tasks of text linguistics for close reading. Narrative medicine, which aims to improve doctors' attentive listening and empathy skills, is introduced into medical education to overcome “cold” and “inhuman” modern medicine. Close reading, which means attentive, critical, careful reading, is considered to be the best means of realizing the purpose of narrative medicine. The attentiveness improved by close reading can be used to develop the attentiveness, listening and empathy skills of doctors. However, the concrete method of Close Reading has not yet been precisely demonstrated. Text linguistics, which has a tradition of precise and detailed text analysis, has a great opportunity to contribute to the development of the methodological foundations of close reading.

간호사의 인수인계대화 평가 도구 개발

정연옥 ( Yeon Ok Jeoung ),박용익 ( Yong Ik Bak ),석소현 ( So Hyune Sok ),이정우 ( Jung Woo Lee ) 서울대학교 인문학연구원 2015 人文論叢 Vol.72 No.2

간호 임상 현장에서 효과적인 인수인계를 위한 간호사의 커뮤니케이션 능력에 대한 중요성이 점점 증가하고 있다. 이러한 맥락에서 간호 커뮤니케이션에 대한 연구와 교육이 활발하게 이루어지고 있다. 그러나 좋은 커뮤니케이션이 무엇인지, 커뮤니케이션을 어떻게 해야 하고 이를 교육할 것인지에 대해서는 논의가 활발하게 이루어지지 않고 있는 실정이다. 이 연구의 목적은 간호사의 인수인계 커뮤니케이션을 평가하기 위한 평가 도구를 개발하기 위한 것이다. 평가 도구의 개발을 통해 좋은 인수인계 커뮤니케이션이 무엇이고, 이를 어떻게 적용하고 교육할 것인지에 대한 자료를 마련할 수 있을 것이다. 이 연구의 결과로 제시한 평가 준거는 인수인계 대화 경험을 가진 간호사의 관점을 토대로 체계화된 질적 연구를 통해 개발된 것이다. 간호사가 인수인계를 할 때 좋은 커뮤니케이션이 되기 위한 의사소통 행위나 의사소통의 규범들을 평가 도구로 개발하였다. 개발한 평가 항목들은 두 가지 영역으로 구성하였다. 한 영역은 인수인계대화 원형의 개별 단계에 해당하는 항목들이고, 다른 한 영역은 인수인계대화 전체에 해당하는 평가 항목들이다. 또한 개발한 평가 항목들에 대해 내용타당도 조사를 실시하여 평가 도구를 보다 정밀하게 확정하였다. 이 연구에서 개발한 평가 도구는 간호사의 인수인계 커뮤니케이션 교육에 유용하게 활용될 수 있다. 또한 이 평가표를 활용하여 자신의 인수인계대화를 점검하고, 커뮤니케이션 능력을 향상시키기 위한 지속적이고 장기적인 노력을 기울일 수 있을 것이다. The necessity of effective communication in the handover between nurses is increasing in clinical practice. Feedback on what is good communication and how to communicate better is required. The purpose of this study is to develop an evaluation tool of handover communication between nurses. The establishment of evaluation criteria based on the perspectives of the staff nurses was systemized in a preceding qualitative research on the nurses’ experiences of handover communication. The communicative acts and norms that make good communication during nursing handover are based on this research. The evaluation items consist of two types of evaluation sections. One type of the criteria examines if necessary communicative acts are performed according to the individual communication phases. The other type of criteria is related to the overall evaluation of the whole handover communication. And these evaluation tools are generally verified through a content validity index by experts. This evaluation tool can be used for the education of nursing handover communication, and also as a tool for the repetitive estimation of their own handover communication, which is the presupposition for their long-term and continuous improvement of communication.

공감이 의학에 끼치는 영향과 의미

정연옥 ( Jeoung Yeonok ),박용익 ( Bak Yongik ) 연세대학교 인문학연구원 2020 人文科學 Vol.120 No.-

Empathy는 130년 전 독일 철학에서 각인된 독일어 "Einfühlung"의 영어 번역어로서 1909년에 만들어진 개념이다. “Einfühlung”은 원래 예술 작품이나 자연의 형태에 관찰자의 감정이나 생각을 투사하는 것을 의미하였다. 그러나 심리학자 칼로저스의 개념을 토대로 하고 현재 보편적으로 널리 사용되고 있는 공감의 개념은 원래의 의미와 완전히 다르게 타자의 관점에서 타자의 생각이나 감정을 이해하고 존중하며 수용하는 것을 의미한다. 의학에 공감 개념을 본격적으로 도입한 사람은 헝가리 출신의 의사이자 정신분석가인 밸린트로 알려져 있다. 그는 1950년대에 공감을 토대로 하는 칼 로저스의 고객 중심 상담 개념에 착안하여 '환자 중심 의학'의 개념을 창안하였다. 그 이후로 공감은 의학에서 활발히 연구되고 교육되고 있다. 공감은 의학의 발달사와 직접적인 상호 관련성을 가지고 있다. 질병에 대한 과학적 진단이 이루어졌지만 특별한 약물이나 치료 수단이 없었던 근대 의학에서 의사들은 치료 수단으로 환자와의 친밀하고 공감적인 관계를 활용하였다. 그럼으로써 그들은 환자의 환대와 존경을 받았다. 제 2차 세계 대전 이후 본격적으로 시작된 현대 의학은 질병이 신체 조직 일부의 훼손 또는 기능적 장애라고 여기는 생의학적 모델로 발전하였다. 또한 현대 의학은 새로 개발된 치료제와 의료기기를 통해서 이전에는 치료할 수 없었던 다양한 질병을 치료할 수 있었다. 하지만 현대의학이 전적으로 자연과학적 지식과 치료제 및 기술에 의존함으로써 전인적 인격체로서의 환자와 그들의감정이 무시되었다. 이에대해서 환자들은의료인에 대해서 분노와 불신 그리고 낮은 순응도와 반감으로 반응하였다. 이 과정에서 의사의 직업 만족도와 삶의 질이 현격히 낮아지게 되었다. 이와 같은 현대 의학의 한계와 문제점에 대한 반작용으로 포스트모던 의학이 도입되었다. 포스트모던 의학에서는 환자에 대한 전인적 관념과 질병의 진단과 치료와 관련된 사회 심리적 요인 및 의사와 환자 간의 친밀하고 공감적 관계의 중요성이 강조된다. 인간은 사회적 존재로서 타인으로부터 이해되고 존중되며 수용되기를 바라는 인정과 공감의 욕구를 가지고 있다. 인간은 그러한 인정과 공감의 욕구가 충족될 때야 비로소 안정적으로 존재할 수 있고 행복하게 살 수 있다. 의사도 직업 만족도와 삶의 질을 위해서 특히 환자로부터의 인정과 공감을 받는 것이 매우 중요하다. 공감은 상호 호혜성의 원리를 기반으로 이루어진다. 다시 말해서 타자로부터의 공감은 타자에 대한 공감의 보상으로 이루어지는 것이다. 이것이 의사가 공감능력을 가져야하는 이유이다. The term "empathy" is the English translation of the German word "Einfühlung", coined in German philosophy 130 years ago. Einfühlung originally meant projecting the feelings or thoughts of the observer into the object like a work of art or shape in nature being observed. However, the concept of empathy, which is currently widely used, has developed a completely different meaning. The modern concept of empathy, based on the views of Carl Rogers, means understanding, respecting, and accepting others’ thoughts or feelings fromtheir point of view. It was Balint who introduced Carl Rogers' concept of “client-centered counselling derived from empathy” into medicine in the 1950s. He first introduced the term “holistic medicine,” as opposed to the contemporary trend of medicine, “disease-centered medicine.” Since then, empathy has been actively studied and taught inmedical education. The paradigms of medicine after the nineteenth century can be classified into modern medicine, contemporary medicine, and postmodern medicine. Such paradigms reflect the mutual relevance between empathy and medical care. In the era of modern medicine, in which a scientific diagnosis of the disease was made but there were no special medications, physicians used an intimate and empathetic relationship with the patients as a means of treatment. They were welcomed and respected by their patients. After the end of WorldWar II, during the era of contemporary medicine, the dramatic scientific and technological developments in medicine led to the paradigm of biomedicine. In contemporary medicine, due to the heavy reliance on science and medications, patients’ personhood and emotions came to be ignored, and the more patients depended on their physicians, the more they felt resentment and mistrust toward their caregivers. At the moment of the victory of medicine, physicians were criticized and scorned rather than respected, appreciated, or praised by their patients. Postmodern medicine began with the recognition of the limitations of biomedical science and the mutual distrust and dissatisfaction between patients and doctors. In postmodern medicine, the importance of empathy between physicians and patients, as well as socio-psychological factors related to diseases are emphasized. Humans, as social beings, have a constant desire for empathy. We want to be understood, respected, and accepted by others. Empathy is reciprocal. In other words, as the prerequisite and reward for empathy is empathy, physicians should have the ability to empathize.

간호사의 자리매김 행위에 나타난 의사의 정체성

정연옥 ( Jeoung Yeon Ok ),박용익 ( Bak Yong Ik ) 한국텍스트언어학회 2017 텍스트언어학 Vol.43 No.-

The purpose of this article is to investigate nurses positioning act with regard to the physicians. This research bases on 10 expert interviews with nurses about their experiences of communication with physicians and the positioning theory. This study tries to answer the following questions: how do the nurses position the physicians; how do the physician position the nurses in the nurses' notion?; what is important and valuable in the relation between nurses and physicians?; as whom do nurses want to be positioned and recognized by physicians? After introducing the positioning theory and term of position the mutual positioning acts of the nurses and physicians are analysed. According to the analysis the physicians are authoritative, self-oriented and selfish, impolite and shameless, unfair and inconsistent, half-hearted and careless, emotional and aggressive. These results implicate the following self positioning of the nurses: the nurse has the same dignity as doctor; the nurse performs independent and essential work for the treatment of a patient's illness; the nurse deserves the warm consideration and kindness of physicians; the nurse has to be treated with courtesy; the nurse is entitled to fair and equal rights; the nurse needs to be treated sincerely and seriously by physicians; the nurse needs to be treated kindly and polite by physicians.