암 환자의 통증과 통증완화에 대한 간호사의 지식에 관한 연구

양미라,최길순,정영 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.1

Objectives: This study is a descriptive research designed to provide basic materials for developing clinical nurses' ability to make more active observation and correct report of cancer patients' pain for advanced pain palliation by examining their knowledge of cancer patient's pain and pain-palliation. Method: Data were collected from 247 clinical nurses serving for the Veterans general hospital in Gwangju and Daegu City from Sep. 1 to 15, 2005. Results: 1. Average rate of correct answer on pain was 79.88% and that of knowledge on pain-palliation was 56.80%. 2. Difference in knowledge of pain-palliation by general characteristics showed statistically significant difference in clinical nursing experience of cancer patients (t=1.978, p=.049) and type of degree (F=5.380, p=.005) 3. As a result of comparing knowledge of pain depending on presence and absence of experiences of pain-palliation education, scores of group without having pain education (t=-3.130, P=.002) were higher and statistically significant. 4. As a result of comparing knowledge of pain-palliation depending on presence and absence of experience of pain-palliation education, scores of group having pain education (t=2.049, p=.042) were higher and statistically significant, Conclusion: Accordingly, this study finds out that educational contents of cancer patients' pain showed no difference in knowledge level between the groups with and without education and thus a new program which has new content and new approach for education on pain and pain- palliation knowledge in cancer patients is needed.

소아(小兒) 재발성(再發生) 삼출성(渗出性) 중이염(中耳炎)에서 가미형개연교탕(加味荊芥連翹湯)의 치료효과(治療效果)에 대한 임상적(臨床的) 연구(硏究)

양미라,진경선,이해자,권미원,박은정,Yang Mi-Ra,Jin Kyong-Son,Lee Hai-Ja,Kwon Mi-Won,Park Eun-Jeung 대한한방소아과학회 2001 대한한방소아과학회지 Vol.15 No.2

Otitis media with effusion(OME) is the second most common disease in childhood after upper respiratory tract infection. Antibiotic treatment and ventilation tube insertion are the common treatment. The emergence of drug-resistant streptococcus pneumoniae (DRSP) has implications for the primary care provider who treats acute otitis media(AOM) in children. OME need not be treated with antibiotics unless the effusion has been present for 3 to 4 months. Tympanostomy tubes are an effective treatment for both chronic OME and recurrent AOM. But the complications of tympanostomy tubes are serious Kamihyunggyeyungyotang is known to have antiinflmmatory and antiallergic effect. In this study, we investigated the clinical efficacy of the Kamihyunggyeyungyotang on recurrent otitis media with effusion prospectively by using pneumatoscopy, tympanogram, pure tone audiometry, and radiologic study. The patients who had treated by antibiotics was used as control. The statistical analysis was done by Mann-Whitney test and the significance was considered when the p value was less than 0.05. The general outcome was significantly higher in Kamihyunggyeyungyotang group than in antibiotic group. The recovery rate from grade 3 to 0 in pneumatoscopy was 42.5% but the control was 6%. Hearing gain was improved 71% and pnuematization was returned 70%.

북한에 있는 어린이에게

양미라 한국국어교육학회 1995 세계가 한동네 Vol.1995 No.-

한방병원 산후조리센터 내 신생아의 한방적 처치에 대한 임상적 고찰

양미라,김선미,Yang, Mi-Ra,Kim, Sun-Mi 대한한방소아과학회 2004 대한한방소아과학회지 Vol.18 No.2

Objective : The aim of this study is to investigate the effects of oriental medical treatments for neonates in the Postpartum care center. Methods : This clinical study was carried out with the 186 neonates who admitted to the Postpartum Care Center of Conmaul Oriental Medicine Hospital, from November, 2003 to May, 2004. The data of sex, delivery method, gestation age, birthweight, symptoms, herbal prescription, improved condition and other treatments was collected via the medical charts. Results : Among 186 newborn babies, 48 cases had diarrhea. We used Gwakhyangjeonggi-san for 31 cases, Bulwhangumjeongnggi-san for 5 cases, compound prescription of the two for 8 cases. The effect of treatment was excellent for 25 cases, good for 11 cases, not good for 8 cases. In fever, there were 39 cases. We used Gwakhyangjeonggi-san and venesection of blood for 17 cases, only venesection of blood for 20 cases, and only Gwakhyangjeongg-isan for 3 cases. The effect of treatment was excellent for 37 cases, good for 3 cases. In cold, there were 4 cases. We used Samsoum for 1 case, Socheongryong-tang for 3 cases. The effect of treatment was excellent for 2 cases, good for 1 case, not good for 1 case. Conclusions : This study shows oriental medical treatments like acupucture, herbal medicine, and venesection of blood for neonates have significant effects. we will need further prospective studies about effects of these oriental medical treatments.

Involvement of Kupffer Cell in $CCl_4$ induced Liver Injury: The Role of Calcium

양미라,Yang, Mie-Rha The Korean Society of Pharmacology 1996 대한약리학잡지 Vol.32 No.1

사염화 탄소에 의한 과산화 지질 증가 및 간 손상에 calcium 및 Kupffer cell의 역할 및 calcium channel blocker의 간 손상에 대한 방어 효과를 연구하였다. 사염화 탄소는 (1 gm/kg, ig) 간의 malondialdehyde (nmole/gm liver) 및 혈중 AST와 ALT (lU/ml) 활성도의 현저한 증가를 나타내었다. 고 농도의 Retinol (250,000U/kg/day)로 인한 Kupffer cell의 활성 증가는 사염화 탄소에 의한 간 과산화 지질 증가 및 간 손상에 상승 작용을 나타낸 반면, $GdCl_3$ 전처리는 $CCl_4$로 인한 ALT의 증가를 감소시켰다. 한편 Retinol 처치군에 Diltiazem (10mg/kg/day)을 병행하여 처치한 결과, 사염화 탄소에 의한 혈중 AST 및 ALT의 증가를 Retinol 단독 처치군에 비하여 현저하게 억제시킬 수 있었다. 이 결과들이 Retinol 혹은 Diltiazem의 투여에 의한 사염화 탄소가 cytochrome P450에 의한 대사 활성 또는 GSH와 관련된 항산화 기전에 미치는 영향에 기인한 것인가를 규명하기 위하여 cytochrome P450, cytochrome P4502El 활성도, GSH reductase 및 GSH peroxidase 활성도를 측정하였다. 그 결과, Retinol 및 Diltiazem의 전처리는 이들 효소의 활성도에 미치는 영향은 대조군에 비하여 유의한 차이가 없었다. 이상의 실험 결과를 종합하여 보면, 사염화 탄소의 투여에 의한 간 손상은 세포내 calcium의 증가를 가져오며, 이는 이차적으로 Kupffer cell을 활성화 시켜 이미 손상된 간세포의 독성을 증가시켰으며, calcium channel blocker인 Diltiazem의 투여는 사염화 탄소의 간독성을 현저하게 감소시키는 효과를 나타내었다. The hypothesis that calcium provoke $O_2^-$ formation by Kupffer cells and may contribute to carbon tetrachloride $(CCl_4)$ induced liver injury was studied in SD rats. In $CCl_4-treated$ animals, hepatic malonaldehyde (nmole/gm liver) and plasma ALT (IU/ml) levels elevated significantly from $119.63{\pm}13.00$ to $268.97{\pm}14.82$ and from $17.3{\pm}0.18$ to $806.08{\pm}37.63$, respectively, compared to those in controls. Activation of Kupffer cells with high dose of retinol (250,000 IU/kg/day, po, for 7 day) significantly enhanced ALT levels, while inactivation of Kupffer cells with gadolinium chloride (7.5 mg/kg/day, ip, for 2 day) attenuated the increase of serum ALT level following $CCl_4$ treatment. Diltiazem (10 mg/kg/day, ip for 2 day) given in combination with retinol led to a marked decrease in ALT levels compare to the level in rats treated only with retinol against $CCl_4$ treatment. In order to determine any alterations in cytochrome P450 activities, the P450 content and the CYP2E1 activity were measured and all $CCl_4-treated$ rats showed significantly lower levels compared to those in controls and vehicle-treated animals. There were significant increases in glutathione peroxidase in all $CCl_4-treated$ rats except diltiazem treated groups. No difference was found among untreated and vehicle-treated rats. It is concluded that Kupffer cells contribute to $CCl_4-induced$ liver injury and that calcium antagonist attenuated the increased $CCl_4-induced$ liver injury due to activation of Kupffer cells.

욕창(褥瘡)환자를 활석분(滑石粉)으로 치료(治療)한 치험 2예

양미라,최진영,신학수,정용준,김관식,서관수,김동웅,신선호,조권일,Yang, Mi-Ra,Choi, Jin-Young,Shin, Hak-Soo,Jung, Yong-Jun,Kim, Kwan-Sik,Seo, Kwan-Soo,Kim, Dong-Woung,Shin, Sun-Ho,Cho, Gwon-Il 대한한방내과학회 2001 大韓韓方內科學會誌 Vol.22 No.4

Pressure sore(Decubitus ulcer) is an area of ulceration and necrosis of the skin and underlying tissues occurring over the body prominence such as the sacrum, greater trochanter, scapula, lateral malleolus, thoracic spine and heels after prolonged or often repeated pressure. These days incidence of pressure sore have been increased because of the many population of the old, traffic accidents and cerebral vascular disease. But the treatment was not confirmly established. As for treatment, we used Talcum powder for 10 days in case 1 and 6 days in case 2. The patients were improved within 14 days after treatment in case 1 and 10 days in case 2.

고당 수련원과 화암사

양미라 열린전북 2002 열린전북 Vol.2002 No.8

음낭수종 환자 치험 1례

양미라,나원경,박은정,이지연,Yang, Mi-Ra,Na, Won-Gyung,Park, Eun-Jung,Lee, Ji-Yeon 대한한방소아과학회 2002 대한한방소아과학회지 Vol.16 No.1

Hydrocele is commonly found clinically and it is associated with patent processes vaginalis. The exact causes of this disease have no been proved up to now however monthly this disease disappears in twelve months after birth but some cases remain. For the treatment we do hydrocelectomy and although the rate of complications were low, sometimes the complications result in reoperations of children. Form the view of oriental medicine, hydrocele is included in susan(水疝) and this treatment originated from naekyung(內經). In this case, we got good results after treating a boy at the age of twenly-five months by bojungikitanggamibang therefor we want to annoume this.

상담자 자기효능감 관련 변인에 대한 메타분석

양미라,이영애 한국놀이치료학회 2019 한국놀이치료학회지(놀이치료연구) Vol.22 No.4

The purpose of this study is to classify variables related to counseling self-efficacy and to comprehensively analyze their effect size. A meta-analysis was performed with 69 studies published in Korea between 2001 and 2018 on topic of counseling self-efficacy. The results are summarized as follows. Firstly, a total effect size among the variables related with counseling self-efficacy was .357. This was a medium effect size. Second, the effect size of personal internal variables was .371 which is higher than the effect size of personal external variables which was .287. Thirdly, in terms of the personal internal variables, the effect size of counselor’s capability variables was .464 which again, is higher than the mid-range. Psychological variables was .334, and personality and attitude variables was .234 which again, is a mid-effect size. Fourthly, in terms of the personal external variables, effect size of counseling performance variables was .368, and the counselor’s capability facilitator variables was .267 which again, is mid, and relationship and organization variables was .181 which is lower than the mid-range. Fifthly, It can be seen that the moderating effects of publication type was significant in the whole of personal internal variables, with every subgroup of personal internal variables, and the whole of personal external variables. In the case of measurement instruments, It can be seen that the moderating effects of measurement instruments was significant in the whole of personal internal variables and personal external variables, counselor’s capability facilitator variables, counseling performance variables. 본 연구 목표는 상담자 자기효능감과 관련된 변인들을 체계적으로 분류하고 그 효과크기를 종합적으로 분석하는 것이다. 이를 위해 2001년도부터 2018년도까지 국내에서 발간된 학술지 논문과 석․박사 학위논문 중 상담자 자기효능감을 주제로 한 69편의 연구를 선정하여 메타분석을 수행하였다. 본 연구 결과를 요약하면 다음과 같다. 첫째, 상담자 자기효능감과 관련 변인들의 전체 효과크기는 =.357로 중간 효과크기를 나타냈다. 둘째, 개인내적 변인의 효과크기는 =.371, 개인외적 변인은 =.287 로 중간정도의 효과크기가 나타났으며, 개인내적 변인의 효과크기가 개인외적 변인의 효과크기 보다 다소 크게 나타났다. 셋째, 개인내적 변인의 상담자 역량 변인은 =.464로 중간이상의 효과크기가 나타났고, 심리적 변인은 =.334, 성격 및 태도 변인은 =.234로 중간정도의 효과크기가 나타났다. 넷째, 개인외적 변인의 상담자 성과 변인은 =.368, 상담자 역량 촉진 변인은 =.267로 중간정도의 효과크기가 나타났고 관계 및 직무 변인은 =.181로 중간이하의 효과크기가 나타났다. 다섯째, 관련 변인 전체를 대상으로 출판형태와 측정도구에 따라 효과크기가 변화하는지 검토한 결과, 출판형태는 개인내적 변인 전체와 내적변인의 각 하위변인 군, 개인외적 변인 전체에서 조절효과가 유의하게 나타났다. 측정도구는 개인내적 변인 전체, 개인외적 변인 전체, 상담자 역량 촉진 변인, 상담성과 변인에서 조절효과가 유의하게 나타났다.

팬데믹 상황(COVID-19)에서 사회적 지지가 불안에 미치는 영향: 사회신뢰의 매개효과

양미라,김해숙 한국융합학회 2020 한국융합학회논문지 Vol.11 No.11

본 연구에서는 팬데믹 상황(COVID-19)에서 일반인이 경험하는 불안, 사회적 지지, 신뢰 간의 관계가 어떠한지를 살펴보고, 사회적 지지와 불안의 관계에서 신뢰가 어떠한 영향을 미치는지 확인하였다. 첫째, 각 변인들 간 관계를 알아보기 위해 상관분석을 실시한 결과, 사회적 지지와 불안은 부적 상관관계를 보였고, 사회적 지지는 사회신뢰와 정적 상관을 보였으나, 정부신뢰와는 유의미한 상관을 보이지 않았다. 또한 정부신뢰와 사회신뢰 모두 불안과 부적 상관을 보였다. 둘째, 사회적 지지가 사회신뢰를 통해 불안에 영향을 미칠 것이라는 가설을 검증하기 위해 회귀분석을 실시한 결과, 사회적 지지와 불안 간의 관계를 사회신뢰가 부분 매개하는 것으로 나타났다. 이러한 결과를 토대로 논의 및 제안점을 제시하였다. In this study, we looked at the relationship among the anxiety, social support and trust experienced by the general public during the pandemic situation (COVID-19), and confirmed the effect of trust to the relationship between social support and anxiety. First, the correlations analysis that was performed to identify the relationship among the variables showed negative correlation between social support and anxiety. While it was also found that social support showed positive correlations with social trust, no significant correlations were shown with regards to government trust. Furthermore, government trust and social trust showed negative correlations with anxiety. Second, the regression analysis was conducted to verify the hypothesis that social support would affect anxiety through social trust. It showed that social trust partly mediated in the relationship between social support and anxiety. Based on the results above, the discussions and suggestions were presented throughout the study.