당뇨병 환자의 당뇨지식, 자가간호활동과 자기효능감의 관계 - 일 종합병원 환자를 대상으로 -

이미화,김은영,Lee, Mee-Hwa,Kim, Yeun-Young 한국가정간호학회 2003 가정간호학회지 Vol.10 No.1

This study provides some basic information on the improvement of diabetics' self-care activities through examining the patients' knowledge on diabetes, self-care activities, and how much they feel those activities are effective and through studying the correlation among the three factors. One hundred and fifty four patients were subjected to this study, who were treated or hospitalized in a hospital in Pusan. Researches were conducted from October 21 to November 9, 2002, and information were gathered by questionnaire and direct conversation with the patients. The data was processed through SPSS WIN 10.0 program. The Date were analyzed by descriptive statistics, ANOVA, t-test, Pearson correlation coefficient and Spearman rank correlation coefficient. The results of this study was the followings; 1) The subjects' knowledge on diabetes ranged from 6 to 23 points with a mean of 17.01 points. 2) The subjects' self-care activities ranged from 21 to 103 points with a mean of 67.72 points. That of the patients with regular treatments appeared to have the highest points (3.51) and the lowest points appeared in the measurement of sugar level in blood (2.60) 3) The subjects' feelings of effectiveness ranged from 21 to 103 points with a mean of 70.01 points. Drug therapy had the highest point (3.94) and diet showed the lowest (3.37) 4) In the general characteristics of the subjects, the more education a subject had, the more knowledge on diabetes he or she appeared to have (F=3.36, p=0.012). The self-care activities were significantly high among non-alcoholic subjects (F=4.301. p=.016). The subjects' feelings of effectiveness were higher in female patients than in male patients(t=2.132 , p=.035), and those in the ages between 51 and 60 felt more effectiveness (F=4.198. p=.003). In addition, married subjects felt more effectiveness than the unmarried (t=2.856, p=0.005), and the more education a patient had. the more effectivess he or she felt (F=2.879, p=.025). 5) In the subjects' pathological characteristic, the subjects who experienced diabetes education showed more knowledge on diabetes, more self-care activity, and more effectiveness than those without the education (t=3.193, p=.002; t=2.299, p=.023; t=2.128, p=.035). 6) As the results of the analyses of correlations among knowledge on diabetes, self-care activity, and effectiveness, the more knowledge on diabetes a patient had, the more self-care activity and the more effectiveness he or she showed (p=0.283. p=0.002; p=0.182, p=0.036). Self-care activity became higher as the feeling of effectiveness appeared higher (r=.550, p=.000). Based on the results above, several suggestions were made; 1) This study was conducted in one hospital, so it is difficult to generalize the results. It is necessary to gather more information from more patients through repeated researches. 2) The study on the other factors which can affect a patient's self-care activity is required. 3) The development of a program which improves a patient's self-care activity, knowledge on diabetes. and effectiveness is needed.

Pediatric Vulvovaginitis: A Study of Clinical and Microbiologic features and the Efficacy of Perineal Hygienic Care

이미화 ( Mee Hwa Lee ) 대한산부인과학회 1999 대한산부인과학회 학술대회 Vol.84 No.-

최신임상강좌 : 한국 청소년 여성에서의 비정상 사춘기 발달

이미화 ( Mee Hwa Lee ) 대한산부인과학회 2009 Obstetrics & Gynecology Science Vol.52 No.12

사춘기는 생식 능력을 처음으로 획득하는 시기로 이차성징의 완성과 함께 여성에서는 초경을 경험하게 되는 시기이다. 사춘기의 시기와 속도는 주로 유전적 요인에 의해 결정되며, 영양상태, 생활환경, 지리적 특성 등 다양한 환경적 요인에 의해서도 영향을 받기 때문에 인종, 성별 및 개체 간에 차이가 나타난다. 비정상 사춘기 질환인 성조숙증과 사춘기 지연은 이차 성징발현의 평균 연령을 기준으로 2 표준편차를 벗어나는 경우로 정의되기 때문에 한 국가의 비정상 사춘기 질환의 추이를 확인하기 위해서는 정상 사춘기의 특성을 이해하여야 한다. 서구 여러 나라의 사춘기 연구에서 첫 이차 성징 발현 시기가 대부분 8세에서 13세 사이인 것과 유사하게 한국 여성 청소년의 이차 성징 발현의 2 표준편차 연령도 8.7세와 13.9세로 보고되었다. 본 종설에서는 한국 여성 청소년의 정상 및 비정상 사춘기 발달에 관한 최근의 문헌을 고찰하여 우리나라 여성에서의 사춘기 질환 특성을 분석하고자 한다. Puberty is the period of first attaining capability of reproduction, and is signed by the appearance of secondary sex characteristics and the occurrence of menarche in females. The timing of puberty is ethnically, sexually and individually variable and is influenced by both genetic and environmental factors. The diagnosis of precocious or delayed puberty is considered when signs of puberty develop before or after 2 standard deviation of the mean age for the onset of puberty. Consequently, a comprehensive understanding of the normal progression of puberty is vital in the evaluation of abnormal pubertal development. In most western countries, the first signs of puberty occur between 8 and 13 years of age. Correspondingly, the recent Korean data have shown that puberty begins in most Korean girls with breast development at the age between 8.7 and 13.9 years. This article reviewed lately published literatures on normal and abnormal pubertal development in Korean adolescent females to delineate features of pubertal disorders in this population.

보육교사의 수요 전망

이미화(Mee Hwa Lee),신나리(Na Ry Shin),김현철(Hyun Chul Kim),김문정(Moon Jeong Kim) 한국아동학회 2007 아동학회지 Vol.28 No.5

자궁내 병변을 치료하는데 있어서 양극성 전극시스템 (Versapoint Bipolar Electrosurgical System)의 유용성

이미화 ( Mee Hwa Lee ),심성신 ( Sung Shin Shim ),차선희 ( Sun Hee Cha ),강석호 ( Suk Ho Kang ),조진호 ( Jin Ho Cho ),한승일 ( Seung Il Han ),김현철 ( Hyeon Chul Kim ) 대한산부인과학회 2004 Obstetrics & Gynecology Science Vol.47 No.12

목적 : 자궁경 수술 clinic에서 자궁내 병변을 치료하는데 있어서 양극성 전극시스템 (Versapoint Bipolar Electrosurgical System)의 유용성에 대해 살펴보고자 하였다. 연구 방법 : 1999년 8월부터 2003년 8월까지 분당차병원 산부인과를 내원하여 자궁내 병변으로 자궁경 수술을 시행받은 388명의 여성을 대상으로 하였다. 자궁내 병변의 진단은 경질초음파 또는 경질초음파 자궁조영술을 시행하여 자궁내 병변의 크기와 위치 Objective : The aim of this study was to evaluate the efficacy and feasibility of the Versapoint bipolar hysteroscopic instrument in the surgical treatment of intrauterine pathology in an outpatient setting. Methods : A prospective study of 388 women (age

보육교사와 시설장의 보수교육에 대한 인식 및 요구 조사 연구

이미화 ( Mee Hwa Lee ),김경회 ( Khyung Heo Kim ),김문정 ( Moon Jeong Kim ) 미래유아교육학회 2010 미래유아교육학회지 Vol.17 No.1

본 연구는 보육시설장과 교사를 대상으로 보수교육에 대한 요구를 조사하여 이를 바탕으로 보수교육의 개선방안을 제시하기 위한 것이다. 이를 위해 시설장 374명과 교사 894명을 대상으로 설문조사를 실시하였다. 설문조사 결과를 바탕으로 제시한 개선방안은 첫째, 대체교사 문제 해결, 둘째, 수요자의 요구에 맞게 교육내용 개선, 셋째, 적절한 교수방법과 다양한 강사진의 선정, 넷째, 보수교육기관의 다양화, 다섯째, 보수교육 참여 증진을 위한 동기화 방안 마련 등이다. The purpose of this study was to analyze the demand of directors and teachers at child care center for in-service education and discuss about the way to increase the efficiency of in-service education. To achieve this purpose, the demand for in-service education was examined using questionnaires from 374 directors and 894 teachers. The main findings were as follows. Almost directors and teachers at child care center perceived that in-service education was necessary. And they demanded improvement of schedules, rewards, programs of in-service education more than other things such as lecturer, subsidy, place, etc. The counterplan according to the findings of this study could be summarized as follows: resolving the insufficiency of substitution teacher, improving in-service education program according to demand of directors and teachers, devising appropriate teaching method and selecting appropriate lecturer, variating institutions giving in-service education, devising policy for enhancing participation in in-service education.

General Gynecology : Abnormal pubertal development in Korean female patients

이미화 ( Mee Hwa Lee ) 대한산부인과학회 2009 서울심포지움 Vol.14 No.-

유아와 초등학생 간 책읽기 버디프로그램이 친사회적 행동과 언어 이해력에 미치는 효과

이미화(Lee, Mee-Hwa),이진희(Lee, Jin-Hee) 한국열린유아교육학회 2012 열린유아교육연구 Vol.17 No.6

본 연구는 핵가족화와 저출산이라는 사회적 현상 속에서 서로 다른 연령 간의 교류를 통하여 사회적 학습과 상호작용의 맥락을 제공하는 책읽기 버디프로그램이 가지는 가능성을 살펴보는 것을 목적으로 하였다. 구체적으로 유아와 초등학생이 버디를 맺어 함께하는 책읽기 버디프로그램이 이들의 친사회적 행동과 언어 이해력에 미치는 효과가 어떠한지 알아보았다. 초등학교 3학년 34명, 만 4, 5세 유아 36명을 대상으로 연구를 실시하였다. 총 16회에 걸쳐 유아와 초등학생 버디가 함께 책을 읽는 활동을 한 결과 책읽기 버디프로그램을 실시한 유아와 초등학생은 적용하지 않은 유아와 초등학생보다 친사회적 행동이 유의미하게 증진되었다. 언어 이해력은 유아들의 경우 실험집단과 통제집단 간의 유의미한 차이가 없었던 반면, 실험집단 초등학생의 언어 이해력은 통제집단에 비하여 유의미하게 증진되었다. 본 연구결과를 토대로 책읽기 버디프로그램이 다양한 연령간의 공유된 책읽기라는 의미 있는 경험을 통해 친사회적 행동 및 언어 발달을 포함한 다양한 교육적 효과를 가질 수 있도록 교육현장에서 더 활발하게 실시될 것을 제안한다. The purpose of this study was to explore the possibilities of a reading buddy program as a context for social learning and interaction through cross-age transaction as an attempt to overcome the contemporary social phenomena caused by the increasing number of nuclear families and low birth rate. Specifically, it examined the effects of a reading buddy program to young children and elementary students on their pro-social behaviors and linguistic comprehension. The subjects of this study were 34 third grade students in an elementary school and 36 4- and 5-year-old children in 2 public kindergartens. With 16 sessions in which a young child and a 3rd grader paired up as buddies and read books together, pro-social behaviors of both young children and the elementary students improved significantly. In terms of the linguistic comprehension, there was no significant group difference for the young children but the reading buddy program had significant positive effects on the linguistic comprehension of the elementary students in the experimental group. Based on the results, it is suggested that reading buddy programs should be implemented more actively in educational scenes to provide invaluable educational experiences that encourage learners" pro-social behaviors and language development through meaningful shared reading experiences between cross-age buddies.

유소아 외음부 질염의 임상적 특성과 외음부 위생관리의 치료적 효과

김현철(Hyun Chul Kim),이미화(Mee Hwa Lee),홍성근(Sung Gun Hong) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.12

연구 목적: 본 연구는 우리 나라 유소아 외음부 질염에 대해 임상적 특징, 위험 요인, 미생물학적 특성을 알아보고자 하였으며 모든 환아에서 일률적으로 시행한 외음부 위생 관리의 치료적 효과를 고찰하였다. 연구 방법: 1997년 8월부터 1999년 9월까지 분당차병원 산부인과 성장기 클리닉에 내원한 외음부 질염의 증상이나 징후를 갖는 42명의 유아기 및 학동기 어린이를 대상으로 임상 증상, 위험 요인, 이학적 검사, 질 분비물의 미생물학적 검사를 시행하였고 20예에 대해 요충란에 대한 셀로판 테입 검사를 시행하였으며 전체 대상 환아에 대해 일률적인 외음부 위생 관리 원칙을 적용하여 이의 치료 효과를 전향적으로 고찰하였다. 결과: 대상 환아의 연령 중앙값은 4.8세로 연령분포는 2.9세에서 10.9세였다. 질염의 증상은 질분비물(79%), 외음부 통증(31%), 악취(17%), 소양감(14%), 질출혈(7%)의 순 이었으며 외음부 이학적 검사 상 외음부 발적(52%), 질분비물(40%)등이 관찰되었다. 질분비물의 세균 배양 검사 상 42명 중 24예(57%)에서 질 내 정상 균주 이외의 세균이 검출되었으며 소아 질염의 특이성 균주는 42명 중 9예(21%)에서 검출되었다. 검출된 균주는 H.influenza(3예), S.pyogenes(2예), K.pneumonia(2예), N.gonorrhea(1예)등이었으며 요충 감염이 1예에서 확인되었다. 확인된 위험 요인 중 가장 많은 것은 수영(14%)이었으며 그 외에 거품 목욕, 성학대, 손상, 이물질 등이 확인되었다. 2주간의 외음부 위생관리의 치료 성공률은 62%였으며 비특이성 질염(79%)이 특이성 질염(0%)에 비하여 유의하게 높은 성공률을 나타내었다.(p<0.05) 결론: 상당수(62%)의 외음부 질염 환아가 항생제 투여 없이 외음부 위생 관리만으로 증상이 소실되었으며 특히 비특이성 질염인 경우 그 치유율은 79%로 매우 높게 나타났다. 따라서 세심한 이학적 검사와 적절한 미생물학적 검사 그리고 이를 바탕으로 한 외음부 위생 관리에 대한 교육이 경험적인 항생제 투여보다 우선되어야할 것으로 사료된다. Objectives: The purpose of this study was to assess the clinical features, microbiologic results, and the efficacy of perineal hygienic care of pediatric vulvovaginitis. Methods: Forty-two unselected premenarcheal patients with symptoms or signs of vulvovaginitis who were attended the outpatient pediatric and adolescent gynecology clinic at Pundang CHA General Hospital from August 1997, to September 1999 were systematically interviewed and examined using a standardized format, studied microbiologically, and followed the efficacy of perineal hygienic measures prospectively. Results: The median age of the patients was 4.8 years (range 2.9 years to 10.9 years). Vaginal complaints of 42 patients were discharge(79%), genital pain or irritation(31%), odor(17%), pruritus(14%), and vaginal bleeding(7%). On physical examination, vaginal discharge and vulvar erythema were noted in 17(40%) and 22(52%) patients, respectively. Aerobic bacteria or yeast excluding vaginal normal flora were found in 24 of 42 patients(57%). Convincing evidence of specific pathogens was found in 9 of 42 patients(21%) including one case of pinworm infestation. Isolated pathogens were H. influenza(3), S. pyogenes(2), K. pneumonia(2) and N. gonorrhea(1). No patients were found to have chlamydial infection or trichomoniasis. In 14 patients, risk factors were identified such as swimming(14%), bubble bath(5%), sexual abuse(5%), genital trauma(5%) and foreign body(2%). After two weeks instructions of perineal hygienic care, 26(62%) of 42 patients revealed complete resolution of symptoms and signs of vaginitis without antibiotics. Efficacies of perineal hygienic care were 94%(17/18) in the patients with normal flora alone, 60%(9/15) in the patients with organisms suspected for nonspecific infection and 0%(0/9) in the patients with specific pathogens(p<0.05). Conclusion: Majority(62%) of the pediatric patients with symptoms or signs of vulvovaginitis were cured with perineal hygienic care alone. And the efficacy of hygienic measure were higher in the patients without specific pathogens(79%, 26/33). Therefore, proper physical examination, microbiologic study and appropriate instructions of perineal hygienic care were more important than empirical antibiotic treatment in initial management of pediatric vulvovaginitis.

복강경하 난관복원수술 후 임신율에 관한 임상연구

이위현(Wee Hyun Lee),차선희(Sun Hee Cha),이미화(Mee Hwa Lee) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.3

N/A Objective: Our purpose was to evaluate the pregnancy outcome and the advantages of laparoscopic tubal reanastomosis. Method; During 16 months, January 1996 to April 1997, thirty-two patient had underwent laparoscopic tubal reanastomosis in Pudang CHA General Hospital. The mean age of the patients was 36.1+-4.3 years(mean+-SD; range 26 to 47 years). Result: The intrauterine pregnancy rate of laparoscopic tubal reanastomosis was 72.4%(21/29). Data comparing laparoscopic procedure retrospectively to tubal reversal by laparotomy was also evaluated. The mean interval from operation to pregnancy was similar in the two groups (p=0.9). The operation time was sigoificantly longer for laparoscopy (215.3+-35.5 minutes) than for laparotomy(159.7+-52.3 minutes). Nevertheless, the intensity of postoperative pain was lower (p<0.05) in patient who underwent laparoscopy than in patient who underwent laparotomy. Also, the mean hospital stay (3.6+-2.3 days for laparoscopy, 6.1+-0.5 days for laparotomy) was shortened(p<0.05) after laparoscopy compared with laparotomy. Conclusion: Laparoscopic tubal reanastomosis may offer the benefits of lower postoperative pain and shorten recovery time in comparison with laparotomy. Therefore, considering the high pregnancy rate in minimal follow up period of 6 month, laparoscopic tubal reanastomosis could be an alternative procedure to microsurgical laparotomy in patients requesting reversal of sterilization.