노인의 영적 간호요구

최미혜,김경희,김귀옥,김기숙,김수강,김정신,김춘숙,노흥진,박지연,성혜연,오명선,이선희,이원옥,이윤영,이현수,장명재,차혜경,채정선,홍상희 중앙대학교 의과대학 간호학과 간호과학연구소 2001 중앙간호논문집 Vol.5 No.1

This study was designed to exam the aged's needs for spiritual nursing care. The purpose was to serve as a basis for the development of spiritual nursing practice. The major findings are as follows : 1. The degree of needs for spiritual nursing care as area was that needs of love and relationship mean 22.0, needs of meaning and object mean 28.2, needs of forgiving mean 13.5. Total needs for spiritual nursing care mean 63.7, which was on the upper middle level. The needs of meaning and object was rated highest. 2. Among the general characteristics of the subjects, needs of love and relatiohship wasn't significanlty different. 3. Among the general characteristics of the subjects, needs of meaning and object was significantly different according to two factors : age(F=7.260, p=0.001), religion(F=5.275, p=0.001). Higher needs of meaning and object was possessed by the older than the younger, by the one who have religion than the other. 4. Among the general characteristics of the subjects, four factors made a significantly difference to needs of forgiving : sex(t=-2.851, p=0.006), age(F=8.201, p=0.001), religion(F=6.928, p=0.000), disease(t=2.327, p=0.024). Higher needs of forgiving was possessed by man than woman, by the older than the younger, by the one who have religion than the other, by the one who have disease than the other.

초등학교 교사들의 직무스트레스와 건강 수준

조현숙,이종태,손혜숙,박진국 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.5

Objective : The purpose of this study was to assess the effect of job strain on stress and health status among elementary school teachers. Methods and Material : The subjects in this study were 300 teachers who were selected from among 588 teachers in 13 out of 42 elementary schools in the city of Gimhae. Through the questionnaire, demographic characteristics, Karasek's Job Content Questionnaire(JCQ) and the Psychosocial Well-being Index (PWI) to assess their occupational characteristics and psychosocial stress level were surveyed. Medical checkup results of them were adopted to measure their Health status. Results : 24.9 percent of the general teachers were low strain group, and 16.3 percent of them were high strain group. In the senior teachers, 19.7 percent belonged to a low strain group and 21.3 percent belonged to a high strain group. In regard to health status, more senior teachers than junior teachers suffered from obesity(24.6%) and diabetes(11.5%) (p<0.O5), and they also were higher in DBP(p<0.057), total cholesterol(p=0.039) and blood sugar level(p=0.000), the low strain group perceived more social support(p=0.000), and the high strain group felt bigger physical overload(p=0.000). Concerning psychosocial stress, the low strain group was more aware of teacher social role and put more confidence in themselves(p=0.004). The high strain group was more depressed(p=0.001), but no difference was detected in health status. The health status difference between the high strain and low strain groups was significant in depression of psychosocial stress(OR=3.823, 95%CI=1.584-9.224). Conclusion : The senior teachers group was more morbid to obesity, diabetes and hyperlipidemia, which implies that some measure should be studied to help senior teachers manage those diseases properly. The high strain group suffered more from physical overload and was high 'Social support'. Therefore it's required for high strain group to be given more support from colleagues and supervisors, and a stress management program should be implemented to reduce their psychosocial stress.

두경부 암환자의 항암화학요법에 따른 삶의 질 변화

신혜숙,박혜자,박명희,연기순,김훈교,문한림,송혜향 가톨릭대학교 가톨릭대학교 간호대학 호스피스 교육연구소 1999 호스피스논집 Vol.4 No.-

The purpose of this study was to assess the changes in quality of life wish elapse of chemotherapy in head and neck cancer patients. This study was a longitudinal descriptive design. The subjects were 9 patients who had stage III and stage IV head and neck cancer and received neoadjuvant cisplatin and 5-fluorouracil chemotherapy. Linear Analogue Self Assessment Scale (LASA) of the QOL which it includes eleven items(seven physical items appetite, nausea/vomiting, physical well-being, vigor activity, energy, sleepiness, fatigue and four mental items anger, anxiety, depression & vital power) were used to assess the quality of life eleven times(once in the prechemotherapy period and from the 1st day to 10th day postchemotherapy). The means of scores at each time were analyzed by repealed measures of ANOVA and Bonferroni multiple comparison method. The results are as follows : 1. The degree of appetites decreased significantly on the period between third and sixth day compared with that of appetites on the prechemotherapy day (p<0.001). 2. The degree of physical well-being decreased significantly on the period between first and fifth day compared with that of physical well-being on the prechemotherapy day (p<0.001). 3. The degree of nausea/vomiting decreased significantly on the period between first and fourth day compared with that of appetites on the prechemotherapy day (p<0.001). 4. The degree of anger decreased significantly on the second, fourth, eighth and ninth day after chemotherapy compared with that of anger on the prechemotherapy day(p<0.001). 5. The degree of fatigue decreased significantly on the fourth day compared with that of fatigue on the prechemotherapy day(p<0.001). 6. The increment of nausea/vomiting and poor appetite started on the 2.89th day and 3.67th day after chemotherapy, respectively. 7. The increment of sleepiness started on the 2.56th day after chemotherapy. 8. The increment of depression and anxiety started on the 2.33th day and 3.33th day after chemotherapy, respectively. 9. The lowest degrees of nausea/vomiting and poor appetite were 37.00±17.9 % and 28.64±14.94 % after chemotherapy compared with those of nausea/vomiting and poor appetite on the prechemotherapy day, respectively. 10. The lowest degrees of anger and vigor activity were 48.12±28.3 % and 39.83±24.9 % after chemotherapy compared with those of anger and vigor activity on the prechemotherapy day, respectively. 11. The recovery rates of eight items of quality of life (appetite, vigor activity, energy, fatigue, anger, anxiety, depression & vital power) were shown to reach a peak on the tenth day after chemotherapy and be reached to almost 84 % compared with those of quality of life on the prechemotherapy day. 12. The recovery rates of physical well-being and sleepiness were shown to reach to 67.75 % and 95.68 % on the 10th day after chemotherapy compared with those of physical well-belong and sleepiness on the prechemotherapy day. 13. The recovery rates of seven physical items were faster than those of four mental items on the 10th day after chemotherapy. In conclusion, it is suggested that nursing care strategies to improve the quality of life in patients with chemotherapy would be established both physically and mentally, and be extended at least ten days when patients stayed their home after chemotherapy.

관상정맥동과의 연결이 없는 좌상대정맥의 CT 소견 : 1예 보고 case report

백상현,박재성,이혜경,홍현숙,김대호,조준희,박성진,차장규 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

A persistent left superior vena cava (PLSVC) is the most common thoracic venous anomaly. It is a persistent remnant of a vessel that is present as a counterpart of normal right-sided superior vena cava(SVC) in early embryological development but normally disappears later. Its diagnosis can be confirmed by many noninvasive and invasive tests, or it is incidentally diagnosed at insertion into the left subclavian or jugular vein or thoracic surgery. If it is not associated with other congenital cardiac anomalies, it is usually asymptomatic and hemodynamically insignificant. We describe the chest radiograph and CT findings of bilateral SVC with drainage to left superior intercostal vein, hemiazygos, azygos vein and right SVC, and no connection of coronary sinus.

고려수지요법을 이용한 손 마사지가 항암 화학요법을 받는 암 환자의 오심·구토 및 식욕부진에 미치는 효과

이현숙,성기월,손보경,김지선,이혜정,이순영 병원간호사회 2006 임상간호연구 Vol.11 No.2

Purpose: The purpose of this study was to examine the effect of hand massage through Korean hand acupuncture therapy on nausea, vomiting and anorexia induced by chemotherapy in cancer patients. Method: Subjects consisted of 40 patients with cancer who were hospitalized and had chemotherapy at D university hospital in D city, Korea. These subject were assigned randomly to a hand massage throght Korean Hand Acupuncture Therapy (experimental group: n=20, control group: n=20). The data were collected from April 1 to September 15 in 2005. All the patients were assessed for their nausea, womiting and anorexia; Nausea and vomiting were measured with Rhodes INVR(index of Nausea, Vomiting by Rhodes and McDaniel) and Anorexia was measured with VAS(Visual Analogue Scale). As an experimental treatment, the hand massage through Korean Hand Acupuncture Therapy was applied three times a day for three consecutive days. The data were collected at the time of 4 hours before the start of chemotherapy, 24hours and 48hours after hand massage respectively. The data were analyzed with SPSS/WIN 11.5 program using frequency, percentage, χ²-test, t-test, repeated Measures ANOVA. Reslt: Severity of nausea and vomiting in hand massage through Korean Hand Acupuncture Therapy group was significantly less than of control group(F=28.10, P=.000). Severity of anorexia in hand massage through Korean Hand Acupuncture Therapy group was also significantly less than that of control group(F=31.24, P=.000). Conclusion: Hand massage through Korean Hand Acupuncture Therapy is effective for relieving patients' nausea, vomiting and anorexia during chemotherapy. Therefore, it is proposed that hand massage through Korean Hand Acupuncture Therapy can be applied as a supportive as a supportive nursing arbitration method to relieve naussa, vomiting and anorexia in patients who are getting chemotherapy.

조혈모세포이식 후 골성장인자의 변화 및 골대사에 미치는 영향 : Impact on Bone Mineral Metabolism

백기현,오은숙,오기원,이원영,김혜수,권순용,한제호,강무일,차봉연,이광우,손호영,강성구,김춘추 대한내분비학회 2002 Endocrinology and metabolism Vol.17 No.5

연구배경: 각종 장기이식의 시행이 많아지고 이식 후 생존율이 증가함에 따라 이식 후 합병증에 대한 관심 또한 높아지고 있다. 조혈모세포이식 후에도 다양한 내분비적 합병증이 발생할 수 있으며 골격에 대한 합병증도 문제점으로 대두되고 있다. 조혈모세포 이식 후 발생하는 골소실에는 이식 후 초기의 골형성 저하와 골흡수 증가가 중요한 역할을 담당하리라고 추측되는데 이러한 골재형성불일치(biochemical uncoupling)에 골 성장인자들이 미치는 영향에 대해서는 알려진 바가 없다. 본 연구에서는 조혈모세포이식 전, 후로 말초 혈액에서 IGF-I, FGF-2, M-CSF같은 성장인자의 변화를 알아보고, 이들 성장인자의 변화가 조혈모세포이식 후의 골형과 골흡수에 미치는 영향 및 이식 후 발생되는 골량 소실과의 연관성을 확인해 보고자 하였다. 방법: 여러 가지 혈액질환으로 인해 동종 골수이식을 시행 받은 환자들을 전향적으로 관찰하였으며 이식 전 및 이식 후 1주, 2주, 3주, 4주 및 3개월, 6개월 1년에 말초 혈액에서 골교체표지자를 측정하였다. 이식 전 및 이식1년 후에 요추골 및 대퇴골 골밀도를 측정할 수 있었던 36명의 환자들을 대상으로 냉동 보관되어 있던 혈청을 이용하여 IGF-I, FGF-2 및 M-CSF를 시기별로 측정하였으며 이들 성장인자와 골교체표지자의 변화 및 골밀도 변화 사이의 상관관계를 확인하였다. 결과: 골흡수 표지자인 혈청 ICTP는 이식 전에 비해 이식 후 4주까지 점차 의의 있게 증가하다가 이후 6개월까지 더욱 증가한 후 감소하였다. 골형성 표지자인 osteocalcin은 이식 후 3주까지는 점차 감소하다가 이후 증가하여 이식 후 3개월 및 6개월에 기저치보다 통계적으로 유의하게 증가한 후 감소하였다. 혈청 IGF-I과 FGF-2는 각각 이식 후 3주 및 1주까지 의미있게 감소하다가 이후 증가하였으며 혈청 M-CSF는 이식 후 1주째에 기저치에 비해 의미 있게 증가하였다가 이후 기저치로 회복되었다. 이식 1년 후 평균 요추부 골밀도는 5.2% 감소하였고 평균 근위대퇴골 골밀도는 11.6% 감소하였다. 이식 전 및 이식 후 3주에 측정한 IGF-I과 같은 시기에 측정한 오스테오칼신 사이에 유의한 상관관계가 관찰되었으며 이식 후 3주째의 M-CSF와 골흡수표지자인 M-CSF 사이에서 의미 있는 양의 상관관계를 관찰할 수 있었다. 이식 후 3주 및 3개월에 IGF-I이 낮은 환자일수록 이식 1년 후 근위대퇴골에서의 골소실이 많은 것으로 분석되었다. 결론: 조혈모세포이식 후 발생하는 골소실에는 기존에 알려진 기저질환의 영향, 성호르몬의 감소, 면역억제의 투여, 골수기질세포와 조골세포의 손상 및 이식초기 사이토카인의 변화이외에도 골성장인자가 관련이 있음을 확인하였고, 이는 이식 후 발생되는 골량소실에 중요한 역할을 할 것이라고 사료된다. Background: A loss of bone mass is usually detected after a bone marrow transplantation (BMT), especially during the early post-transplant period. We recently reported that enhanced bone resorption following a BMT was related to both the steroid dose and the increase in IL-6. We also suggested damage to the marrow stromal microenvironment, by myoablation, partly explains the impaired bone formation following a BMT. It is well known that some growth factor play important role in bone growth and osteogenesis. However, the pathogenetic role of bone growth factors in post-BMT bone loss is unknown and data on the changes in the growth factors, in accordance with bone turnover markers and bone mineral density (BMD) changes are scarce. We investigated changes in bone growth factors such as IGF-I (Insulin-like growth factor-I), fibroblast growth factor-2 (FGF-2) and Macrophage colony stimulating factor (M-CSF), during the post-BMT period, and assessed whether the growth factor changes influenced the bone turnover and post-BMT bone loss. The present study is the first prospective study to describe the changes in bone growth factors following a BMT. Methods: We prospectively investigated 110 patients undergoing a BMT, and analyzed 36 patients (32.4±1.3 years, 17 men and 19 women) whose BMDs were measured before, and 1 year after, the BMT. The serum biochemical markers of bone turnover were measured before, 1, 2, 3 and 4 weeks, 3 and 6 months, and 1 year, after the BMT. The serum, FGF-2, IGF-I and M-CSF levels were measured before and 1 and 3 weeks, and 3 months after the BMT. The correlation between the changes of growth factors and various bone parameters was analyzed. Results: The mean bone losses in the lumbar spine and total proximal femur, calculated as the percentage change from the baseline to the level at 1 year, were 5.2(p<0.05) and 11.6%(p<0.01), respectively. the serum type I carboxyterminal telopeptide(ICTP), a bone resorption marker, increased progressively until 6 months after the BMT, but thereafter decreased, to the base value after 1 year. Serum osteocalcin, a bone formation marker, decreased progressively, until 3 weeks after the BMT but then increased transiently, and finally returned to the base level at 1 year. The serum IGF-I and FGF-2 also decreased progressively until 3 weeks 1 week after the BMT, respectively, then increased to the base values at 3 months. The serum M-CSF increased briskly at 1 week post-BMT, then decreased to the base level. There were positive correlations between the percentage changes from the baseline proximal femur BMD and the IGF-I levels 3 weeks and 3 months (r=0.52, p<0.01, r=0.41, p<0.05) post BMT. A significant correlation was found between the IGF-I and osteocalcin levels pre-BMT, and 3 weeks after the BMT. Another positive correlation was found between the M-CSF and the ICTP levels at 3 weeks post BMT (r=0.54, p<0.05). Conclusion: In conclusion, there were significant changes in the serum IGF-I, FGF-2 and M-CSF levels in the immediate post-BMT period, which were related to a decrease in bone formation and loss in the proximal femoral BMD during the year following the BMT (J Kor Soc Endocrinol 17:664∼674, 2002).

제7차 「기술 · 가정」 교과에 대한 학생의 인식

최지혜,장현숙 경북대학교 사범대학 부속 중등교육연구소 2005 중등교육연구 Vol.53 No.2

본 연구는 2001학년도부터 시행되어 온 제7차 교육과정에서 「기술 · 가정」 교과에 대한 학생의 인식을 알아보는 데 목적이 있으며, 이를 위해 2004학년도 12월 현재 대구광역시에 소재한 7학년부터 10학년까지의 학생 1065명을 조사한 결과 다음과 같이 결론을 내릴 수 있다. 첫째, 「기술 · 가정」 교과에 대한 학생의 인식에서 성별에 따라서는 여학생이 남학생보다 「기술 · 가정」 교과를 더 실용적으로 인식하고 있었으며, 학년에 따라서는 9학년 학생이 다른 학년의 학생보다 「기술 · 가정」 교과에 대한 흥미도, 중요도, 실용도가 낮게 나타났고, 운영형태에 따라서는 7학년 학생이 전담지도보다는 분담지도의 경우 더 흥미있어하고 덜 어려워하는 것으로 나타났다. 둘째, 학생의 흥미도, 중요도, 실용도, 난이도의 상관관계를 살펴보면, 실용적인 것을 중요하게 여기고, 흥미가 있으면 중요하게 여기고 중요한 것에 흥미를 나타내며, 실용적인 것에 흥미를 나타내는 것으로 나타났으며, 어려울수록 흥미를 잃는 것으로 나타났다. The purpose of this research was to find the perception of students on the subject 「technology and home economics」 in the 7th national curriculum. For this research, questionnaires were sent by post to middle school students and first graders in high school. Then they were collected. The number of students' questionnaires was 1082 and 1065 questionnaires were used for being analyzed. The results of this research were summarized as follows. 1) Students' perception about the subject, technology and home economics, was affected by sex, grade, and implementation types. Girls' perception on the subject was more practical than boys'. Students in the 9th grade showed lower interest, importance, practicality on the subject than those in the other grades. According to implementation types, students in the 7th grade showed more interests in the partial charge than in the whole charge. 2) Considering correlation among interest, importance, practicality and difficulty, they thought of practical things as important and when they were interested in some things, they thought them important. They got interested in what they thought important and practical. And the more difficult the subject was, the less interested they were in it.

비타민 E 농도에 따른 마우스 면역능과 항산화 효소 활성도의 변화

이유숙,이지혜,김현숙 한국노화학회 2001 한국노화학회지 Vol.11 No.1

데이터마이닝을 이용한 의료의 질 측정지표 분석 및 의사결정지원시스템 개발

김혜숙,채영문,탁관철,박현주,호승희 한국의료QA학회 2001 한국의료질향상학회지 Vol.8 No.2

Background : This study presented an analysis of healthcare quality indicators using data mining and a development of decision support system for quality improvement. Method : Specifically, important factors influencing the key quality indicators were identified using a decision tree method for data mining based on 8,405 patients who discharged from a medical center during the period between December 1, 2000 and January 31, 2001. In addition, a decision support system was developed to analyze and monitor trends of these quality indicators using a Visual Basic 6.0. Guidelines and tutorial for quality improvement activities were also included in the system. Result : Among 12 selected quality indicators, decision tree analysis was performed for 3 indicators ; unscheduled readmission due to the same or related condition, unscheduled return to intensive care unit, and inpatient mortality which have a volume bigger than 100 cases during the period. The optimum range of target group in healthcare quality indicators were identified from the gain chart. Important influencing factors for these 3 indicators were: diagnosis, attribute of the disease, and age of the patient in unscheduled returns to ICU group ; and length of stay, diagnosis, and belonging department in inpatient mortality group. Conclusion : We developed a decision support system through analysis of healthcare quality indicators and data mining technique which can be effectively implemented for utilization review and quality management in a healthcare organization. In the future, further number of quality indicators should be developed to effectively support a hospital-wide Continuous Quality Improvement activity. Through these endevours, a decision support system can be developed and the newly developed decision support system should be well integrated with the hospital Order Communication System to support concurrent review, utilization review, quality and risk management.

일부 체육고등학교 학생의 자아개념 및 스트레스 요인과 대처방법에 관한 연구

오현이,김혜숙 朝鮮大學校 附設 醫學硏究所 1992 The Medical Journal of Chosun University Vol.17 No.1

The purpose of this study was tried to find out the students stressful life events, their methods to cope with them, and their self-concept effecting on the coping method, to analize the relationship among these three variables, and to provide basic data which maintain and promote student's adaptability and mental health. The data were collected from total 216 students of a physical education high school in Gwansg-ju. The Questionnair survey was done from June 25 to July 5, 1991. The instruments were composed of; 1. A part of Choi's perceptual orientation scale for measuring Self-Perception of students. 2. Rosenberg's Questionnair for measuring student's evaluation of self-esteem. 3. Modified McCubbin's Adolescent-Family Inventory of Life Events and Changes and Adolescent Life Change Event Questionnaire by Oh and Han's Stressful Life Events. 4. Modified Patterson's Adolescent Coping Orientation for Problem Experience by Oh and Han's coping method. The survey questionnaire consisted of 30 questions related to self-concepts, 47 questions related to stressful life events, and 44 questions related to coping method. The collected data were analyzed by descriptive statistics, frequency, ANOVA, t-test, and Pearson correlation coefficient. The results were summarized as follows; 1. The mean score of self concept was 10.58. 2. The mean score of stressful life events was 6.31. 3. The mean score of coping methods was 120.28. 4. The relationship between general characteristics and self-concept represented significant differences in sex(t=3.27, P=0.00), academic score(F=4.81, P=0.00), leisure time(F=4.32, P=0.00), reading(F=3.52, P=0.01), going to college after graduation(F=7.04, P=0.00), and health condition(F=6.39, P=0.00). 5. The relationship between stressful life events and general characteristics represented significant differences in presence or absence of parents (F=3.49, P=0.00), academic score(F=4.29, P=0.00), and family atmosphere(F=-2.74, P=0.01). 6. The relationship between general characteristics and coping methods represented significant differences in religion(F=3.11, P=0.02), educational level of father(F=2.57, P=0.03), and leisure time(F=3.98, P=0.00). 7. The relationship between self-concept and coping methods(r=0.30, P=0.00), and stressful life events and coping methods(r=0.30, P=0.00) represented correlation statistically significant.