소생 불가능한 환자에 대한 간호 행위를 찾기 위한 탐색적 연구

김달숙,이혜경 충남대학교 의과대학 지역사회의학연구소 1984 충남의대잡지 Vol.11 No.1

This study was advanced with a view to identify the most desired nursing behaviors of patient's family for almost dying, through this, and to explorate appropriate nursing action intervend in patients almost dying. The 26 family members whose patients were cancers were interviewed at Chung-Nam national University Hospital, Dae-Jeon Eul Ji Hospital, and Dae Jeon Sun Hospital with questionaire which included 52 nursing behaviors items each having 10 grade scale and classified with psychosocial, environmental psychosocial, physical aspects and is generated through in depth literature review from April 15 to May15. he results were analyzed by basic descriptive statistics and were as follows: 1. The ten most desired nursing behaviors by family members were the nurse 'do not abandon patient', keep comfortable positon and change position frequently', `eliminate urine and feces as usual', have humorous talks to the patient frequently' `keep the patient out of suffering (cough, nausea, vomiting)', try to keep the patient to eat his favorite foods, `keep the patient rest appropriately', `ventilate the room and keep the patient inspire fresh air', try for the patient to meet the medical personnel when she or he want', keep the environment out of noise', 2. The ten least desired nursing behaviors were the nurse `act religious rituals with the patient', 'crywith the patien when the cry', `talk to the patient honestly when he keep him informed of his lab data and his condition', `administrate sedatives to the patient to keep him sleep', `try for the patient to take part in a sort of nursing action as much', 'encourage the patient I his grief', 'allow the patient to cry when he want to cry' 'keep and assist the patient his mouth cleaning', 'give the pain medications as often as possible as ordered by doctor', 3. Nursing behaviors of psychological aspects for almost dying patient showed the least quanti-

소생 불가능한 환자 가족의 안락사에 대한 의식 구조

김달숙,서문자 충남대학교 의과대학 지역사회의학연구소 1983 충남의대잡지 Vol.10 No.2

The purposes of this study were to identify the attitudes of family members whose patients were confined in bed with almost dying conditions and to identify and test various factors which are closely related to attitudes of family members toward euthanasia for their almost dying patients. This study hypothesized that age, religion and education of the family members, monthly house hold income, methods of supplying medical expenses, the role of this particular patient in family, family member's awareness about the death expectation of his or her patient, hospitalization duration and frequency, the harmonic adjustment of family members would be related to the attitudes of family members toward euthanasia for the almost dying patient. The thirty-five cases were interviewed with questionaire whose patients were critically ill and considered almost dying at Chungnam National University Hospital, Chungnam Seung-Mo Hospital and Seoul National University Hospital at the period from August 17 to October 20, 1983. The findings obtained from this study were as follows: 1. Euthanasia attitude scale and family environmental scale showed high internal consistency reliability. 2. Attitudes of family members of this particular patient toward euthanasia were approximately to positive direction. 3. Monthly household income, methods of supplying medical expenses, family relation between the family member and patient, hospitalization duration and frequency and the harmonic adjustment of family members were identified as significantly related to attituds of family members toward euthanasia and the amount of variance of each variable or total variance accounts significantly. 4. The rest of the factors such as age, religion, education, awareness of death expectation and the role of the particular patient in family did not consistently influence the attitude toward euthanasia in this particular case at significant level. In the view point of the results from this study, it could be recommended for nurses to consider the above mentioned significant factors influencing the attitude toward euthanasia when they administer 'nursing process' for the almost dying patient and his or her family members.

대전 일부 종합 병원 간호원의 소진 경험에 대한 연구

김달숙 충남대학교 의과대학 지역사회의학연구소 1985 충남의대잡지 Vol.12 No.2

The purposes of this study were to find out the stressors that affected the staff nurse burnout experience and to provide the basic datas for the nurses to be prevented and to be treated from burn out. This study hypothesized that age, educational back ground, career, working parts, attitudes toward nursology in nursing school age, motives of choicing nursing department, expected working period on nursing, marriage, religion, working period with head nurse, work situation, amity oriented leader-ship style of head nurse, task oriented leadership style of head nurse would be correlated with burn out experience. The 217 cases were studied with questionaire at Chungnam National University Hospital, Chungnam Seung-Mo Hospital, and Taejeon Eul Ji Hospital at the period of July 29 to August 5, 1985 The findings were as follow: 1. Crohnbach's Alpha of work situation scale, of leader ship style scale, of burnout experience scale were each 0.6846, 0.8751, 0.8609. 2. The mean point of work situation, of amity oriented leadership-style, of task oriented leadership style, of burn out experience which the staff nurses perceived, were each 2.6, 3.2, 3.6, 2.5 for 5. among these the mean point of amity oriented leadership style: 3.2 and of task oriented leadership style: 3.6 showed a modality of effective leadership style of head nurse by Halpin's leadership assesment method. 3. The most predicting factors that affected burn out experience were motives of choicing nursing discipline, work part, task oriented leadership style, work situation, expected working period on nursing. The amount of variance of 13 independent variables that affected burnout experience is 13.3% 4. The motives of choicing nursing discipline (p<0.01), work part (p<0.01), expected working period on nursing (p<0.05), work situation (p<0.05), task oriented leadership style (p<0.05), were correlated with burn-out experience statistically In the view point of the results, it could be recommended to managers or peernurse to consider the predicting stressors at once to intervene burn out and to prevent, treat it.

유방수술환자의 자아개념에 대한 적응

소희영,김달숙 충남대학교 의과대학 지역사회의학연구소 1990 충남의대잡지 Vol.17 No.1

This study was undertaken to investigate the influence of breast surgery on self concept by Roy's adaptation model, and to intervene on self concept for improving adaptation process by nurse. Self concept is the one of 4 adaptation form and involve physical, personal and interpersonal self. The subject in this study were 45 patient being operated at general surgery department of C. Uni. hospital in Daejeon and 47 woman from general population. For the measurement of self concept, Beck's depression inventory, Zung's SRAS, Osgood's Semantic Differential method was used. The analysis of data was done by use of freguency t-test, pearson Correlation coefficient, ANOVA and scheffe test of SPSS program. The results of the study were as follows. Hypothesis 1. There will be difference of degree of depression between the breast surgery group and general population was not supposed (t=1.08, p=0.285). Hypothesis 2. There will be difference of degree of anxiety between the breast surgery group and general population was not supposed (t=1.00, p=0.321). Hypothesis 3. There will be difference of degree of body image between the breast surgery group and general population was not supposed (t=1.71, p=0.090). In conclusion, proper intervention of nursing for adaptation/ self concept is to be more needed before surgery/biopsy/diagnosis than after operation of breast. It is surely regarded as necessary to have proper investigation the right timing on adaptation of patient and also to intervene highly of nurse for patient adaptation for whom need follow up care at the OPD after one two-three months after of surgery.

치료 효과 감지정도와 신체적 고통 감지정도가 수술직후 암환자의 희망에 미치는 영향

안성윤,김달숙 성인간호학회 2003 성인간호학회지 Vol.15 No.1

Purpose: The purposes of the study were 1) to examine what relationships exist between PTE(perceived treatments effect) and PPS(perceived physical suffering) as the independent variables and hope as the dependent variable and 2) to examine whether PTE and PPS predict hope in cancer patients in their post-operative period within the Stotland's hope theory. Method: The Visual Analog Scale was used for measuring PTE and PPS and the Kim & Lee's Hope Scale which had acceptable reliability and validity was used for measuring hope. The data was collected from 38 hospitalized cancer patients who were in the post-operative period with a convenient sampling method. Result: There was a significant positive relationship between hope and the PTE in the low PTE group. There was a significant negative relationship between hope and the PPS in the low PPS group. There were no significant relationships between hope and the PTE in the high PTE group, and between hope and the PPS in the high PPS group. And the PTE explained hope with 71.2% of the variance in the low PTE group. Conclusion: PTE in the low PTE group and PPS in the low PPS group were identified as the factors to explain hope.

산과력에 따른 통증반응 고찰

이혜경,김달숙 충남대학교 의과대학 지역사회의학연구소 1984 충남의대잡지 Vol.11 No.1

The purpose of this study was to determine how childbirth pain and childbirth experience differ according to the parity. Independent variable was parity and Dependent variables included knowledge about pregnancy & delivery, mothers, attitude toward pregnancy & delivery family members attitude toward pregnancy & delivery, pain self-report, and overt pain reaction. VAS(Visual Analogue Scale) and OPRRS(Overt Pain Reaction Scale) used as a study tool for measurement childbirth pain and 60 subjects were stlrveied. The following were the statistical findings in this study. 1) Knowledge about pregnancy & delivery was not different from the parity. 2) Mothers attitude toward pregnancy & delivery was significantly different from the parity. 3) Family attitude toward pregnancy & delivery was significantly different from the parity. 4) Pain self-report at the admission was significantly different from the parity. 5) Pain self-report at the labor was significantly different from the parity. 6) Overt pain reaction at the admission was significantly different from the parity. 7) Overt pain reaction at 7∼8 cm cervical dilatation was not different from the parity. 8) Overt pain reaction at 10cm cervical dilatation was significantly different from the parity. 9) Overt pain reaction at the birth of head was significantly different from the parity.

병원정보시스템 교육컨텐츠 개발

문원희,김달숙 충남대학교 간호과학연구소 2001 충남대 간호학술지 Vol.4 No.1

The study developed a E-Learning Program to use an effective informational technique for a hospital information system for new nurses. The contents of the Program include basic computer, hospital information system and Intranet communication of CNUH. The E-Learning Program is organized in web document through HTML(Hyper Text Markup Language) and designed as a self-learning type document which enables learners to do self-study of the contents of study from the web with her cognitive process. The development model of the E-Learning Program has four steps, Analysis, Production, Application and Evaluation. The E-Learning Program has been developed in the subject of the new 21 nurses who attend the orientation of CNUH on March 2001. The Program developed in this study is a positive teaching strategy in that it supplies materials to new nurses for individual study and guides learners and makes it possible to study repeatedly. In the future, the study will be used for the development of a larger variety of contents to develop a E-Learning Program related to nursing education.

혈액투석 환자의 적응 상태와 관련요인에 대한 분석적 연구

안희원,김달숙 충남대학교 의과대학 지역사회의학연구소 1989 충남의대잡지 Vol.16 No.2

This study has attempted to identify the relating factors and adaptive state among hemodialysis patients, in order to provide baseline data for effetive nursing. The survey was based on data of 86 patients collected through the guestionnaires including personal characteristic, stressor, health locus of control, self-esteem and through chart review of the interdialysis wt. gain, predialysis Na^+, K^+, BUN level by specialized hemodialysis nurse. The survey was performed from FEB. 25th to Mar. 20th, 1989 at three general hospital and a hemodialysis clinic in Taejon area. The results were analyzed by spss-x computer progrem and summerized as follows: 1. The cronbach’s alpha reliability test among measurement tools were as follows: The cronbach’s alpha of stress scale in 0.9038, health locus of control is 0.6818 and self-esteem is 0.6047. 2. The results of adaptive state among hemodialysis patients were as follows: The interdialysis average wt. gain is 2.46㎏, average predialysis Na^+, level is 138.4mEq/L average predialysis K^+ level is 5.1mEq/L and average predialysis BUN level is 75.95mg%. 3. There was not significant relationship between total stressor(physical & psychococial0 and physical adaptive state(interdialysis wt. gain, predialysis Na^+, K^+ and BUN level)(P>.05). There was significant negative relationship between total stressor and self-esteem(psychological adaptive state)(r=-0.4939, P<.001). 4. a)There were not significant differences in the physical adaptive state(interdialysis wt. gain, predialysis Na^+, K^+ and BUN level) and psychological adaptive state(self-esteem) according to age, education level and occupation(P>.05). b) There was significant difference in the interdialysis wt. gain, according to partner helping (P<.05). c) There was significant difference in the predialysis Na^+ level according to religion and marital state (P<.05). d) There was significant in the predialysis K^+ level according to parent helping (P<.05). e) There was significant difference in the predialysis BUN level according sex, hemodialysis period and partner helping(P<.05). f) There was significant difference in the self-esteem according to monthly income(P<.05). 5. There was significant negative relationship between health locus external-control and self-esteem(r=-0.2514, P<.05).

당뇨 교육에 있어 조력자 치료원칙(Helper therapy principle)적용이 환자의 자아상(self-image) 수정에 미치는 효과에 대한 연구

한영숙,김달숙 충남대학교 의과대학 지역사회의학연구소 1990 충남의대잡지 Vol.17 No.1

This study examined whether diabetic patients who functioned as teachers, demonstrated a greater level of disease-acceptance, self-acceptance, self-worth than diabetic patients who did not serve in the teacher role. A Quasi experimental research was designed and conducted a national university hospital(20 patients) and two clinics (40 patients) in Daejon. Date was collected from June to September, 1989, using the questionnaire method and by the use of the descriptive statistics, paried t-test, Coefficient of correlation, ANOVA, ANCOVA, scheff;e test. The results of the study were as follows; 1. The first hypothesis, "the Exp. G. participated in diabetic education as a teacher will have a greater level of disease-acceptance than the Cont. G. participated in diabetic education as a learner" was supported. 2. The second hypothesis, " the Exp. G. will have a greater level of self-acceptance than the Cont. G." was supported. 3. The third hypothesis, "the Exp. G. will have a greater level of disease-acceptance than preeducation" was supported. 4. The fourth hypothesis, "the Exp. G. will have a greater level of self-acceptance than preeducation" was supported. 5. The fifth hypothesis, " the relationship of disease-acceptance and self-acceptance will be a positive relationship " was supported. 6. The sixth hypothesis, " he Exp. G. will have a greater level of knowledge of DM than preeducation" was supported. 7. According to self-worth measurement, the Exp. G. wanted to be a responsible, accurate, and normal person, and the Count, G. wanted to be normal, helpful, competent person after education. In conclusion, serving in the teacher role contributed significantly to predicting higher levels of disease-acceptance, self-acceptance, self-worth.

Inoue Balloon을 이용한 PMV의 장·단기 결과 분석

진은선,이연아,전숙,김현숙,정승묵,박상선,최락경,임달수,홍석근,황흥곤 대한순환기학회 2003 Korean Circulation Journal Vol.33 No.11