한국 호스피스의 현황과 전망에 관한 연구

노유자,이선미,김남초 성인간호학회 1996 성인간호학회지 Vol.8 No.2

There has been a growing interest and concern to Hospice in Korea since 1965, which was started by Catholic sisters for the first. In Korea, however, hospice is still infant stage, also there has been no report summarizing about the present status of hospice. The authors interviewed people in charge of thirty-nine hospice centers, and also reviewed thirty-four papers published between 1984 and 1995. This study was carried out from March 4th to April 27th,1996. The results of the interviews revealed 1.Hospice services were spread nationwidly and at least one hospice center is active in each province of Korea. 2.Most of hospice services were established in the 1980s and 1990s. 3.Type of hospices are :7 Hospice Units are hospital based. There are scattering hospices in 16 hospitals. There are 5 hospital based home hospices and 7 independent home hospices. Occupation of people in charge of hospice services were :nurses 15, priest, ministers, catholic brothers & sisters 12, doctors 9. Religious background of hospice were :catholic 25, protestant 8. 4.Hospice services were supported by personal funds in 12, personal and administration funds in 9 hospices. 5.Hospices have been running by a team approach all but 9 of the 39 centers. Twenty one centers had education/intervention programs, bur only eight of these centers had a bereavement programs. Thirteen centers published an introductory brochure for public relations. The results of the review of the papers revealed 1.Among thirty four papers, twenty papers were published between 1991-1995, showing a gradual increase in the study of hospice in recent years. 2.The content of the papers were :research 19, article 13, case report 2. 3.The subject of these studies were : cancer patients who were in the terminal stage and their families in 9, hospice care in 14. Problems suggested by people in charge of hospice were ;lack of concern about hospices among doctors, patients and their families and administration officials, poor facilities, financial deficit and a lack of man power. It has been proposed that governmental financial support as well as regulatory is necessary. Enhancement of public relations is also proposed for the development of hospices in Korea. Problems that was found in papers were: lack of Public Relations, financial deficits, meagerness of research and of personnel. Financial and regulatory support from the government was strongly suggested. Other proposals were similar to the results from interviews with person in chrage of hospice service. Above results showed that there has been a consensus about the problems and proposals among the members of hospice services in Korea. And also improvement in understanding of hospice services as well as financial and regulatory support from the government is necessary for the development of hospice in Korea.

인공호흡기 튜브교환주기에 따른 인공호흡기 관련 폐렴발생률

김남초,김양리 성인간호학회 2003 성인간호학회지 Vol.15 No.3

Purpose: This study was aimed at providing scientific evidence for minimizing ventilator-associated pneumonia (VAP) by identifying appropriate timing of exchange of circuit for mechanical ventilator that is well suitable for the medical environment of intensive care units of hospitals in Korea. Method: This was quasi-experimental study with a convenience sample of 19 adult subjects aged over 18 years who were admitted to the NS ICU of C university hospital, and placed on mechanical ventilator. The subjects were placed in two groups, compared on the incidence rate of VAP after they received exchange of circuit either at 1-week interval (N=10) or 2-week interval (N=9). Result: 1) When considering 1000 days as the standard unit of analysis fro incidence, the incidence rate of VAP was 7.19 cases at the 1-week cycle exchange group and 15.23 at the 2-week cycle exchange group, showing no statistically significant difference between the two groups. 2) There were a total of 3 types of bacteria isolated from the patients with VAP, including 2 cases with P. aeruginosa, 1 case with Streptococcus group F and A. baumannii. Conclusion: With thorough hand washing and strict management of tracheal tube of mechanical ventilator as well as use of tracheal intubation techniques, exchange cycle of circuit of mechanical ventilator by nurses may be changed from 1-week to 2-week interval.

청소년 부모의 음주행태와 문제음주 관련요인

김남초,박호란,이소영,유소영 한국아동간호학회 2004 Child Health Nursing Research Vol.10 No.1

Purpose: This study aimed to identify the alcohol drinking pattern of parents and to analyze drinking related factors in problem drinking among adolescent's parents. Method: This study was conducted through a structured questioning from November 5th to 22th in 2002. Those are 2,522 parents of the students of the 1st and 2nd grade who were selected randomly among 26 middle and high schools located in Socho-gu, Seoul. Data was analyzed using SAS program that included descriptive statistics, Chi-square test, and multiple logistic regression analysis. Result: 1. For frequency of drinking, 33.1% of the subjects responded to drink two-four times a month, 26.0% drink more than two times a week. 2. For the amount of drinking, 29.6% drink one or two glasses while 9.4% drink over ten glasses at a time. 3. The mean AUDIT score was 8.27± 7.02(score of range: 0- 40). 4. Based on AUDIT score, drinkers with less than eight point from AUDIT(normal group) were 55.1%, from more than eight point to less than twelve point from AUDIT(problematic drinker) were 16.3%, and more than twelve point from AUDIT(alcohol abuse and dependency) were 28.6%. 5. Based on more than twelve point from AUDIT, female(mother), high school and, have religion, housekeeper were the significantly higher score than counter parts. Conclusion: Alcohol drinking pattern and level of drinking of their parents links to their children's drinking and results in family, social, and national loss. Active prevention is needed. Specially, pertinent education about drinking and public education for mothers who are housekeepers should be carried out with concentrated intervention programs for the problematic drinker so alcohol abuse and dependency can be reduced.

손씻기 교육이 간호사의 손씻기 행위와 중환자의 호흡기로의 MRSA 분리율 감소에 미치는 영향

김남초,최경옥 성인간호학회 2002 성인간호학회지 Vol.14 No.1

Purpose: This is a clinical experimental study aimed to provide basic data to ensure quality care. The propose of this study is to increase nurses hand washing behavior and decrease respiratory isolation rate of MRSA. Method: This study was conducted in Kangnam St. Marys hospital. The subjects included 5 nurses working at the NS ICU and 165 specimen for nasal swabs and 46 specimen for sputum cultures from 106 patients admitted to the NS ICU. The data were collected from June to September 2000. Results: 1. The percentage of the nurses hand washing was 15.6percent but was improved to 46.5 percent after the educational intervention. In particular, hand washing behavior was increased in situations such as after suctioning, before parenteral nutrition, and after providing hygiene care. 2. Results of nasal swab showed that MRSA isolation rate was reduced from 42.8 percent before the education to 18.6percent after the education. The sputum culture results also showed that the MRSA rate was reduced from 40.7percent before the education to 34.6percent after the education. Conclusion: The findings showed the nurses' strict hand washing behavior and use of disposable gloves and paper towers as well as use of hand sterilization spray by visitors or families can decrease the MRSA isolation rate in the NS ICR patients. Since the NS ICU patients may have respiratory complications due to long-term hospitalization, the nurses regular hand washing is important enough to be emphsized. Future research should be focused on the impact of nurses' hand washing behavior on the incidence of pneumonia, an iatrogenic infection.

호스피스 전문 간호사의 역할과 기본능력

김남초,유소영 가톨릭대학교 간호대학 호스피스 교육연구소 2003 호스피스논집 Vol.7 No.-

수술환자에게 적용한 간호중재효과 분석

김재옥,송혜향,김남초 성인간호학회 1998 성인간호학회지 Vol.10 No.3

A meta-analysis of 13 quasi-experimental studies was conducted to determine the magnitude of the effect of various nursing interventions applied to surgery patients. The studies were selected from dissertations done between 1982 to 1996 and had randomized or nonequivalent control groups in a pretest-post test design. The studies were classified according to three criteria: 1) types of surgery 2) types of nursing interventions 3) types of respondent variables. The following analysis was done : 1) Determination of usefulness of nursing interventions for surgery patients. 2) The magnitude of effect for each study was tested for different types of surgery, nursing interventions and outcome variables. 3) For a group of homogenious studies, the weighted mean effect size and standard error were estimated. Some findings are summarized as follows : Nursing interventions on relaxation effect applied to surgery patients have resulted in a significant effect size on pain, anxiety, and BP stabilization. Relaxation and music therapy were more effective on surgery patients than either education, heat therapy, or purposeful touch. It was impossible to identify which type of surgery was more effected by these interventions. On the basis of these findings, the following recommendations were made : 1) Many studies on the same kind of intervention applied to similar surgery patients should be accumulated continuously to identify factors that affect the effect size. 2) the detailed explanation of research process, such as, assignment method to experimental and control groups, starting points, duration and frequency of nursing interventions, and estimation of the outcome variables should be described in other to be utilized for further research and practice.

상실과 슬픔과정

김남초 대한간호협회 1995 대한간호 Vol.34 No.2

만성 폐쇄성 폐질환에 관한 환자의 교육요구와 간호사의 지각 비교

한숙정,박선남,정혜선,김남초 성인간호학회 1999 성인간호학회지 Vol.11 No.3

The purpose of the study was to investigate two areas as a basis for providing an educational program for pulmonary rehabilitation. A) the learning needs about chronic obstructive pulmonary disease in patients with chronic obstructive pulmonary disease and B) the perception of nurses of the same learning needs. The subjects consisted of 57 patients, with chronic obstructive pulmonary disease, at the general hospital in Seoul and 71 nurses, who were working in the medical ward. Data was obtained from a "learning need" questionnaire between October 29 and November 19. '99. Data was analyzed using SAS program for t-test. ANOVA, Scheffe test. The result were as follows : 1. The learning needs of the nurses(mean 4.36±.38) were higher than those of the patients (mean 3.56±.83). (t=6.78. P=.001) 2. The highest ranked patient education needs were as follows : a)"how to control dyspnea". b)"cause for activating dyspnea". and c)"how to minimize the necessity of oxygen in daily living" : and nurses' learning needs were : a)"how to cope with the risk situation", b)"management after discharge", and c)"how to control dyspnea". 3. In the patient group, those who had a college degree or higher education and paid their own hospital expenses were higher in the learning needs. According to the above results, we should consider an educational program which is realistic and effective for patients by evaluating the items the patients really want to learn about and how much they know about the evaluated items.

미혼모 사례에서 나타난 청소년의 성문제와 예방교육

김남초 가톨릭대학교 성평등연구소 2000 성평등연구 Vol.4 No.-

서울시내 1개 종합병원의 사망사례 조사연구

노유자,김남초 성인간호학회 1994 성인간호학회지 Vol.6 No.2

This study examined distributions of personal and physiological factors among those patients who died in a hospital located in Seoul. Three hundred thirty six cases were included in this study, excluding 74 cases whose information was incomplete among those 410 deaths occured during the entire years of 1982,1987, and 1992. Data were collected from medical records, death certificates and death confirmation notes. The results summarized as follows: 1. Those 410 deaths made up 1.3% of the hospitalized patients during those three years. Mortality rate was 0.9% for 1982, 1.2% for 1987, and 1.6% for 1992, showing the increasing tendency over the years. Of those 336 deaths included in this study, sex ratio during the three years was 1.1 to 1. Sex ratio by year was 1 to 1.1.19 to 1, and 1.08 to 1 for 1982, 1987 and 1992, respectively. 2. Deaths occurred most in December by the month, in the winter by the season, and between 8AM and 9AM during the day. 3. With regard to the leading causes of death, diseases of cerebrovascular system and diseases of circulatory system ranked the first and the second, respectively in 1982. However, the most frequent cause of death in 1987 and in 1992 was neoplasms, indicating a notable increase off deaths caused by neoplasms over these years. 4. Age- specific causes deaths showed prematurity as the most common among infants. Traffic accident ranked top cause of deaths in the twenties and seizure in the thirties, while neoplasm at such sites as stomach, lung, and liver caused deaths most frequently in the forties, fifties, and sixties. 5. As to changes in vital signs, abnormal patterns were most apparent between 2 and 1.5 hours before death: the average changes were from 81.56/46.14 mmHg to 62.54/ 36.16 mmHg for systolic/ diastolic blood pressure, from 96.79 to 82.28 for pulse rate per minute, and 21.69 to 16.91 for respiration rate per minute. 6. Unconsciousness was found before death among 76.8% of all deaths. The average interval between the loss of consciousness and death was 19.8hours with the range from 4 days to 1 hour or less. 7. Hematologic findings before death were below the normal levels. The average was 15.64x10³/㎣ for WBC count, 12.01g/㎗ among men and 11.29g/㎗ among women for Hb, and 36.9% among men and 34.4% among women for Hct. 8. As to the findings of serum electrolytes before death, Na was averaged 136.44mEq /L, which was below the normal level. The average scores of K (4.42㎎/㎗), cl(89.89mEq/㎗), Ca(8.23㎎/㎗) and P(4.46㎎/㎗) were within the normal ranges. The above findings indicate that some changes consciousness, vital sings, and hematologic an serum electrolyte findings would provide clues the imminent death among hospitalized patient who are faced with death. Furthermore, prediction of the occurrence of death based upon these kinds information would facilitate adequate nursing interventions in caring for them.