뇌졸중 노인을 돌보는 주 간호제공자의 안녕감 예측 요인

박연환 서울대학교 간호과학연구소 2006 금요학술세미나 Vol.2006 No.-

일개 군 지역 노인의 가정간호요구에 대한 조사연구

박연환,송미순 서울대학교 간호대학 간호과학연구소 1995 간호학 논문집 Vol.9 No.1

This study was accomplished to attain basic data to establish Korean Home Care Model through the investigation of prevalence of chronic disease and frequency, contents of home care needs of the elderly who were aged over sixty five in a rural county of Kunggi province, Korea. The number of subjects was 513 elderly who were selected by stratified cluster sampling from a county population. The data were collected during the period from July 26, 1993 to August 6, 1993. The data were collected through interviews with questionnaire, checking blood pressure and observation by trained senior nursing students who visited each household. Six out of seven criteria, which were selected by Seoul National University Community Health System Demonstration Project to investigate home health care needs in the area, were adapted in this study, to screen home care needs of the elderly. It was regarded that home care need is present if there is severe impairment on any one item of the questionnaire composed of eighty eight three point rating scale. The items of questionnaire consisted of symptoms of chronic illness, source of social support, functional capacity and demographic data. The data were analyzed with descriptive statistics and x²test by means of p/c SAS program. The results were as followings; 1) The prevalence of chronic illness in the elderly was 49.9%, and the number of chronic illness for each older person was .65. Neurological and joint disease(22%), and hypertensive disease(19.0%) were the most prevalent chronic illness. 2) The elderly who have more than one home care need were 61.0% of all subjects. There were 34% of the subjects who met more than two home care need criteria. The rates of home care need among subjects according to each home Care need criteria were as follows. (1)The subjects who impaired to control or recover from the chronic were 19.3%, and the subjects who had educational need were 40.7%. It means that major proportion of home care activities should be planned with appropriate education and management of chronic illness, which enhances ompliance, minimize complications and potentiate rehabilitational abilities. (2) The rate of recently discharged patients and the subjects with special medical appliance was under 1%. However they should be cared by the hospital based home care nurses who are familial with high technique nursing. (3) The subjects with insufficient health management abilities among elderly were 33.1%. Therefore, home care service for the elderly should not be limited to the extension of hospital care, but comprehensive health promotion services should be included. (4) The subjects who have insufficient familial support were 18.9%, It is suggested that social service should be included in home care service. 3) Followings are the result of chi square tests, examing difference in prevalence of home care needs among different characteristics of the subjects. (1) There were significant differences in prevalence of need for control or recovery from the chronic illness between sexes (P<.001), chronically ill and non-chronically ill(P<.001). (2) There were significant differences in prevalence of need for health management between sexes (P<.001), young-old and old-old age(P<.001), educational levels(P<.001), chronically ill and non-chronically ill(P<.001), and good and poor transportational convenience(P<.05). (3) There were significant differences in familial support need between sexes (P<.05), educational levels (P<.05), the number of family members (P<.05), chronically ill and nonchronically ill (P<.001), and rural and non-rural and non-rural residental area (P<.05). (4) There were significant differences in educational need between chronically ill and non chronically ill (P<.001), rural and non-rural residental area (P<.001), and good and poor transportational convenience (P<.001). In conclusion, above characteristics of home care needs of community elderly should be considered in development of Korean Home Care Model.

일 지역 노인의 규칙적 운동수행에 영향을 미치는 요인

박연환,김주현,김희자 성인간호학회 2002 성인간호학회지 Vol.14 No.3

Purpose: The purpose of this study was to identify the factors influencing regular exercise of the elderly in discriminating regular exercise and non - regular exercise groups. Method: The subjects of this study were 167 elderly over the age of 60, living in a rural city in Korea. The data was collected by interview and self report questionnaire in 1999. The Cronbach 's alpha of scales used this study were .66 ∼.97. Result: 1. There were significant differences in doing regular exercise between the perceived importance of the health(p=021), the perceived health status(p=.050), the perceived need of the exercise(p=000), the perceived importance of the exercise(p=.000), the intent of participation in the exercise program(p=.000), IADL score(p=.022), the perceived benefits of exercise (p=.000), the emotion of exercise(p=.000), HPLP(p=.000), the self efficacy(p=.001), the perceived benefits of health promoting behaviors(p= .011), the perceived barriers of the health promoting behaviors(p=.002), and the Internal locus of control (p=.021) of the elderly. 2. Variables which showed significance for discriminating regular exercise of the elderly in this study were the perceived need of the exercise(p=.000) and the perceived benefits of the exercise(p=.000). By using the combination of these variables, the possibility of proper prediction for predicting regular exercise group was 84.8%, non - regular exercise group was 93.9%, and total Hit ratio was 89.4%. Conclusion: To improve exercise behavior in older adults, health care providers should focus of developing interventions to strengthen the perceived benefits, the perceived needs of the exercise.

Dysphagia Screening Measures for Use in Nursing Homes: A Systematic Review

박연환,방활란,한혜라,장희경 한국간호과학회 2015 Journal of Korean Academy of Nursing Vol.45 No.1

Purpose: The purpose of this study was to evaluate the psychometric quality and feasibility of measurements for screening dysphagia inolder adults to identify the ‘right tool’ for nurses to use in nursing homes. Methods: A systematic review was done. Electronic databaseswere searched for studies related to dysphagia screening measurements. A checklist was used to evaluate the psychometric quality andapplicability. Tools were evaluated for feasible incorporation into routine care by nurses. Results: 29 tools from 31 studies were identified. Dysphagia screening tools with an acceptable validity and reliability had sensitivity between 68% and 100% and specificity between 52%and 100%. The Gugging Swallowing Screen (GUSS) and the Standardized Swallowing Assessment (SSA) were the tools with high psychometricquality, especially with high sensitivity, that nurses could perform feasibly to identify the risk and to grade the severity of dysphagiaand aspiration of nursing home residents. Conclusion: Results show that GUSS and SSA are reliable and sensitive tools forscreening dysphagia which nurses can use in nursing homes. Further research is needed to examine feasibility of screening with identifiedtools, and also, to establish effective and standardized protocols for these tools so they can be effectively incorporated into routine care.

건강 임파워먼트 전략을 활용한 다학제적 장기적 자기관리 프로그램이 만성질환 노인의 건강임파워먼트, 운동관련 자기효능감, 신체활동량과 신체 기능에 미치는 영향

박연환,박초롱,송미순,조비룡,임재영,송욱,장희경 한국간호과학회 2014 한국간호과학회 학술대회 Vol.2014 No.10

뇌졸중 노인과 가족을 위한 주간보호사업의 효과 재가 노인 및 가족과의 비교

박연환 한국간호과학회 2003 Journal of Korean Academy of Nursing Vol.33 No.8

Purpose: The purpose of this study was to identify the effects of the day care service for the elderly and family with the stroke. Method: Data were collected from September 2002 to March 2003 by self report questionnaires and interview. 50 elderlies and families(Gr I) who used day care center were compared with 51 elderlies and families (Gr II) who didn't used. The data were analyzed using independent sample t test and chi square test. Result: The general characteristics, stressors, and situational variables related to outcome variables were homogeneous between two groups. The caregiver burden(t=-2.287, p=.024) score in the Gr I was significantly lower than in the Gr II. However there was no evidence of an effect day care center attendance on the depression of the elderly, the relationship between elderly and caregiver, and the family functioning. Conclusion: Findings indicate that day care service was effective in reducing the caregiver burden of the elderly, however more day care service programs(elderly health management, rehabilitation...)will be added.

뇌졸증 노인을 돌보는 주 가족간호자의 안녕감 예측 요인

박연환,유수정,김신미,이윤정 한국간호과학회 2006 Journal of Korean Academy of Nursing Vol.36 No.2

Purpose: The purpose of this study was to identify the factors related to the wellbeing of the family caregivers of the elderly with a stroke. Methods: The subjects of this study were 199 elderly treated in four oriental hospitals in Korea, and their primary family caregivers. The data was collected by interviewsand a self reported questionnaire, during the period from October, 2003 to April, 2004. Results: The results of this study were as follows. The mean score of wellbeing of family caregivers was 60.6412.63. The factors related to wellbeing of family caregivers were sex, age, education, depression, illness severity, ADL, paralysis, and speech disability in elderly characteristics. Among family caregivers characteristics, education, relation, and burden were significantly related. In situational variables, family income and the previous relationship between the elderly and family caregivers were related to wellbeing. Stepwise multiple regression analysis revealed that the most powerful predictor of wellbeing was the burden of family caregivers. A combination of the depression of elderly and age of family caregivers accounted for 50.3% of the variance of wellbeing. Conclusions: On developing the nursing intervention for improving wellbeing of family caregivers, many factors should be considered, especially caregiver burden, and elderly depression.

Compliance with Respiratory Infection Preventive Behaviors and Its related Factors in Older Adults using a Senior Center

박연환,이성현,이유미,이지영,이민혜 한국지역사회간호학회 2018 지역사회간호학회지 Vol.29 No.3

Purpose: The purpose of this study is to identify factors related to compliance with respiratory infection preventive behaviors including hand washing, cough etiquette, and oral hygiene of older adults. Methods: A cross-sectional study was conducted with a convenience sample of 100 older adults (mean age: 76.11±6.35 years, female: 86.0%). Data were collected from a community senior center through face to face interviews by using instruments including measuring knowledge, perceived threat, self-efficacy, compliance with respiratory infection preventive behaviors. Results: The mean score of knowledge was 7.52 out of 13 in total. The compliance with hand washing with soap was 6.0% for 8 or more times per day. Among the participants, 12.0% adhered to the cough etiquette. Sixty-two older adults (62.0%) didn't use interdental brushes or floss at all. The stepwise linear regression indicated that age and self-efficacy for respiratory infection preventive behaviors were significant factors and explained 24.0% of the compliance with hand washing and the cough etiquette. Education level, cancer diagnosis, and self-efficacy for respiratory infection preventive behaviors were significant predictors of oral hygiene. The factor with the greatest effect was self-efficacy in the two models. Conclusion: The findings suggest that it is necessary to improve compliance with respiratory infection preventive behaviors among older adults using senior centers. In order to enhance the compliance, it is necessary to develop nursing programs based on the self-efficacy for respiratory infection preventive behaviors in the senior centers.

시민권을 누릴 권리가 있는 사회구성원으로서 노인의 수용

박연환 한국노년학회 2017 한국노년학회 학술발표논문집 Vol.2017 No.춘계

암환자 가족원의 부담감과 가족기능

박연환,현혜진 성인간호학회 2000 성인간호학회지 Vol.12 No.3

This study examined burdens of primary family caregivers, and family functioning of patients with cancer. In addition, the relationship between two concepts was assessed to develop nursing intervention to reduce the burdens of caregiving, and to improve family functioning. Ninety-two primary family care givers of patients with cancer at a general hospital in Seoul participated in this study. The patients with cancer aged from 19 to 84 yearn with a mean alee of 51 nears, and sixty-one percent were male. About 30 percent of the patients suffered liver and billiard tract cancer. Fifty-six percent of the primary family caregivers were spouses of the patients and 70.7 percent were women. Primary family caregivers' burdens were assessed by the Burden Scale originally developed by Zarit (1980) and Novak & Guest(1989) and modified by Jang (1975) for use in Korea. The instrument consists of six subscales: time-dependent burden, developmental burden. Physical burden, emotional burden, social burden, and financial burden. Family functioning was assessed by the Family APGAR developed by Smilkstein(1978). The results were as follows: 1.The average burden score was 86.1, indicating a moderate level of burden. The time-dependent burden scored highest followed by developmental physical, social, financial, and emotional burdens. The mean score of family APGAR was 9.71; among subjects 82.6% were included in dysfunctional families. 2.Of the characteristics of patients, age, gender, number of admissions, and job were found to be associated with the level of burden. There was no significant difference between patient characteristics and family functioning. Of the characteristics of primary family caregivers, caregiver's perception of patient prognosis was significantly related to the level of burden, and family functioning. Caregiver's sex and age were also related to family functioning. The quality of relationship between a patient and a caregiver was significant situational factors affecting the level of burden, and family functioning. In addition, the income of family. and help from other family members were related to the level of burden. Given the results, it is essential to develop nursing intervention to reduce burden and to improve family functioning, such as support groups.