Evaluation of skin surface dose for head and neck cancer patients treated with intensity-modulated radiation therapy using in vivo dosimetry

김연실,이동수,강영남,유미나,홍주영,윤세철,장홍석 대한방사선방어학회 2011 대한방사선방어학회 학술발표회 논문요약집 Vol.2011 No.04

간호간병통합서비스병동 간호사와 일반병동 간호사의 업무스트레스, 소진 및 간호업무성과 비교

김연실,박정애,서은경 대한스트레스학회 2019 스트레스硏究 Vol.27 No.1

Background : The purpose of this study was to compare job stress, burnout and nursing performance between nurses who work in comprehensive nursing care service wards and general wards. In addition we identified a correlation among job stress, burnout and nursing performance. Method : The participants were 80 nurses(comprehensive nursing care service ward: 40, general wards: 40) and the data were collected using structured questionnaires to assess job stress, burnout and nursing performance. Results : There was no significant difference in general characteristics between comprehensive nursing care service wards nurses and general ward nurses. Comprehensive nursing care service wards nurses were statistically significantly higher in job stress and burnout than general ward nurses. While there was no difference in nursing performance. There was a positive correlation between job stress and burnout in comprehensive nursing care service wards. Conclusion : In order to establish a comprehensive nursing care service system with high patient satisfaction, it is necessary to study strategies to solve job stress and burnout of nurses and to improve job satisfaction and nursing performance. 본 연구는 보호자가 없는 간호•간병통합서비스병동과 일반병동의 간호사를 대상으로 업무스트레스, 소진 및 간호업무성과를 비교하였으며, 각 요인의 관계를 확인하였다. 간호•간병통합서비스병동과 일반병동 간호사 총 80명을 대상이었고, 두 집단의 일반적 특성은 모두 동질하였다. 간호•간병통합서비스병동 간호사의 업무스트레스 및 소진이 일반병동 간호사에 비해 유의미하게 높게 나타났다. 간호•간병통합서비스병동 간호사의 업무스트레스와 소진은 정적 상관관계를 보였다. 본 연구 결과는 환자의 만족도가 높은 간호•간병통합서비스 제도의 안정적인 정착 및 확대를 위해 간호•간병통합서비스병동에 근무하는 간호사의 업무스트레스와 소진을 해결하기 위한 적극적인 전략 개발 연구에 근거자료로 활용될 수 있을 것이다.

UAM 추락 시 인구 밀접 지역 지상 인명피해 분석

김연실,최인호,Kim, Youn-sil,Choi, In-ho 한국항행학회 2022 韓國航行學會論文誌 Vol.26 No.5

This study quantitatively analyzed the human casualties that can occur when a multicopter-type Urban Air Mobility (UAM) with a weight of about 1 ton and a speed of about 100 km/h falls in an urban area. Based on the population density and building database in Seoul, the population exposed to collisions in the event of a UAM crash was derived. Through the ballistic descent model, the accident impact radius of the UAM fall was calculated. In addition, the change in human casualties on the ground was analyzed when the accident impact radius increased. Finally, the ground risk map was created for Seoul, and it was confirmed that about 1 to 10 people could be injured when a UAM crash.

Reirradiation of head and neck cancer in the era of intensity-modulated radiotherapy: patient selection, practical aspects, and current evidence

김연실 대한방사선종양학회 2017 Radiation Oncology Journal Vol.35 No.1

Locoregional failure is the most frequent pattern of failure in locally advanced head and neck cancer patients and it leads to death in most of the patients. Second primary tumors occurring in the other head and neck region reach up to almost 40% of long-term survivors. Recommended and preferred retreatment option in operable patients is salvage surgical resection, reporting a 5-year overall survival of up to 40%. However, because of tumor location, extent, and underlying comorbidities, salvage surgery is often limited and compromised by incomplete resection. Reirradiation with or without combined chemotherapy is an appropriate option for unresectable recurrence. Reirradiation is carefully considered with a case-by-case basis. Reirradiation protocol enrollment is highly encouraged prior to committing patient to an aggressive therapy. Radiation doses greater than 60 Gy are usually recommended for successful salvage. Despite recent technical improvement in intensity-modulated radiotherapy (IMRT), the use of concurrent chemotherapy, and the emergence of molecularly targeted agents, careful patient selection remain as the most paramount factor in reirradiation. Tumors that recur or persist despite aggressive prior chemoradiation therapy imply the presence of chemoradio-resistant clonogens. Treatment protocols that combine novel targeted radiosensitizing agents with conformal high precision radiation are required to overcome the resistance while minimizing toxicity. Recent large number of data showed that IMRT may provide better locoregional control with acceptable acute or chronic morbidities. However, are required before a definitive conclusion can be drawn on safety and effectiveness of IMRT.

재가노인의 우울예방을 위한 집단프로그램의 효과

김연실 한국농촌간호학회 2010 한국농촌간호학회지 Vol.5 No.2

본 연구의 목적은 지역사회 재가노인을 대상으로 집단 프로그램을 적용하여 우울과 생활만족도, 자아통합감에 미치는 효과를 검증하는 것이다.

모성건강관리프로그램이 임부의 우울, 모성역할자신감, 분만자신감에 미치는 효과

김연실,이윤정,박규희,Kim, Youn Sil,Lee, Yun Jeong,Park, Gyu Hee 경희대학교 동서간호학연구소 2017 동서간호학연구지 Vol.23 No.2

Purpose: The purpose of this study was to investigate the effects of the maternal health care program on pregnant women's depression, maternal role self-confidence and delivery self-efficacy in a public health center. Methods: This study used a non-equivalent control group quasi-experiment design attempted to verify the effectiveness of maternal health care program. In the experimental group (39 participants), maternal health care program was applied for 120 minutes for 8 weeks, and the control group (40 participants) was provided with a booklet for maternal health care. Data collection was conducted from September 20, 2015 to November 30, 2015. Data were analyzed using ${\chi}^2-test$, Fisher's exact test and t-test. Results: The maternal health care program showed a significant effect on maternal role self-confidence and delivery self-efficacy compared to control group. Conclusion: The maternal health care program conducted at the public health center was found to be effective in improving maternal role self-confidence and delivery self-efficacy. Further development of a program to mediate the depression of the expectant mothers is needed.

Radiation Therapy Combined with (or without) Cisplatin-based Chemotherapy for Patients with Nasopharyngeal Cancer: 15-years Experience of a Single Institution in Korea

김연실,김범수,정소령,이연수,김민식,선동일,유은정,문성권,윤세철,정수미,김훈교,조승호,강진형 대한암학회 2008 Cancer Research and Treatment Vol.40 No.4

Purpose: This retrospective study was carried out to evaluate the efficacy and toxicity of radiation therapy (RT) with/without cisplatin-based chemotherapy in nasopharyngeal cancer (NPC). Materials and Methods: One hundred forty six patients with NPC received curative RT and/or cisplatin-based chemotherapy. Thirty-nine patients were treated with induction chemotherapy (IC), including cisplatin and 5-fluorouracil followed by RT. Another 63 patients were treated with concurrent chemoradiotherapy (CCRT) using cisplatin, and 22 patients were treated with IC followed by CCRT. The remaining 22 patients were treated with RT alone. Results: One hundred four (80.0%) patients achieved complete response (CR), and 23 (17.7%) patients achieved partial response (PR). The patterns of failure were: locoregional recurrences in 21.2% and distant metastases in 17.1%. Five-year overall survival (OS) and progression free survival (PFS) were 50.7% and 45.0%, respectively. Multivariate Cox stepwise regression analysis revealed CR to chemoradiotherapy to be a powerful prognostic factor for OS. CR to chemoradiotherapy and completion of radiation according to the time schedule were favorable prognostic factors for PFS. A comparison of each treatment group (IC → RT vs. CCRT vs. IC → CCRT vs. RT alone) revealed no significant differences in the OS or PFS. However, subgroup analysis showed significant differences in both OS and DFS in favor of the combined chemoradiotherapy group compared with RT alone, for stage IV and T3-4 tumors. Grade 3-4 toxicities were more common in the combined chemoradiotherapy arm, particularly in the CCRT group. Conclusions: This study was limited in that it was a retrospective study, much time was required to collect patients, and there were imbalances in the number of patients in each treatment group. Combined chemoradiotherapy remarkably prolonged the OS and PFS in subgroup patients with stage IV or T3-4 NPC.

간호사의 소진, 우울, 불안, ADHD, 충동성에 관한 대조군연구

김연실,임명호,김남희,위지희,장백희,박정애 대한스트레스학회 2019 스트레스硏究 Vol.27 No.1

Objective: This study aimed to evaluate the relationship of exhaustion, ADHD, self-esteem, impulsivity, suicidal tendencies and quality of life as well as depression and anxiety in nurses in Korea. Methods: This study was undertaken for the first time in Korea, from September 2017 to December 2017. A set of questionnaires was provided to a total of 97 nurses and 310 other participants as a comparison group. All subjects were evaluated using the Beck’s Depression Inventory, Beck’s Anxiety Inventory, Malach Burnout Inventory, Korean Adult Attention Deficit Hyperactivity Disorder Scales, Rosenberg‘s Self-esteem Inventory, Baratt’s Impulsivity Scale, Beck's Scale of Suicide Ideation, and Quality of Life Scale. Furthermore, the significant odds ratio of exhaustion, ADHD, self-esteem, and suicidal idea were correlated with the nurse group through logistic regression analysis. Result: The results of this study indicated that the nurses were more likely to show depression, anxiety, exhaustion, impulsivity, and quality of life. In the multiple regression analysis, nurses group was the most correlated factor in exhaustion. In addition, anxiety, depression, impulsivity, ADHD, self-esteem, and life satisfaction were also correlated to exhaustion. Conclusions: Timely and effective evaluation and treatment of impulsivity, as well as depression and anxiety were required for nurses. 본 연구는 간호사에서 소진, ADHD, 자존감, 충동성, 자살 사고와 삶의 질, 우울, 불안이 소진이 대조군에 비해 유의한 차이를 나타내는 지를 알아보았다. 2017년 9월부터 2017년 12월까지 한국에서 처음 시행되었으며 총 97명의 간호사와 비교집단으로 310명의 대조군에게 각각 자가설문지를 수해하였다. 평가도구로는 벡 우울척도, 벡 불안 척도, 소진척도, 한국판 성인 ADHD평가 척도, 로젠버그 자아존중감 척도, 바렛 충동성 척도, 벡 자살사고 척도 및 삶의 만족도 척도를 사용하였다. 또한 다중회귀 분석을 통해 소진과 간호사직업군, 우울, 불안, 소진, ADHD, 자존감, 충동성, 자살 사고 및 삶의 질의 연관성을 평가하였다. 연구결과에서 간호사군이 대조군보다 우울, 불안, 소진, 충동성, 삶의 질에서 유의한 차이가 나타났다. 또한 다중회귀분석에서 소진에 연관성이 가장 높은 요인은 간호사직업군이었으며, 그 외에 불안, 우울, 충동성, ADHD, 자존감, 삶의 만족도도 연관성을 나타내었다. 그러므로 간호사에게 우울, 소진뿐만 아니라 충동성에 대한 효과적이고 적절한 평가와 치료가 필요하다.

간호대학생의 임상수행능력과 핵심간호술 수행자신감이 간호전문직관에 미치는 영향

김연실,이윤정,박정애,Kim, Youn-Sil,Lee, Yun-Jeong,Park, Jung-Ae 경희대학교 동서간호학연구소 2023 동서간호학연구지 Vol.29 No.1

Purpose: This study aims to examine factors affecting nursing professionalism among nursing students. Methods: Data were collected using a structured questionnaire from July to August, 2022. The participants were a total of 266 students in the 3^rd and 4^th grades located in A and C cities. T-test, ANOVA, Scheffe' test, Pearson's correlation coefficient and multiple regression were used for data analysis using SPSS 24.0 program. Results: The average score for clinical competency was 4.05±0.59 (out of 5), confidence in essential nursing skill was 3.52±0.64 (out of 5), and nursing professionalism was 4.11±0.52 (out of 5). There was a positive correlation between clinical competency and confidence in essential nursing skills with nursing professionalism. The factors influencing nursing professionalism were clinical competency and grade, which explained 30% of nursing professionalism. Conclusion: The results of this study may be used as basic data for developing educational methods to improve nursing professionalism.

纖維工業 女從業員의 活動空間(action space)에 關한 硏究

金姸實,장혜정 효성여자대학교 사범대학 학도호국단 1983 師大論壇 Vol.2 No.-