간호실무에서 신봉이론(Espoused theories)에 대한 탐색적 연구

서문자,김혜숙,이은희,박영숙,조경숙,강현숙,임난영,김주현,이소우,조복희,이명하,지성애,하양숙,손영희,권성복,김희진,추진아 성인간호학회 2001 성인간호학회지 Vol.13 No.1

As a nursing practice involves nurses' actions in a specific context of health care, this study has focused on exploring the espoused theories in nursing practice within the action science perspectives, Espoused theories are the belief, principles, and rationale expressed by the practitioner as guiding her/his actions in a situation of practice. The data were analysed qualitatively and 25 elements of espoused theories of nursing action were identified and clustered into 6 categories. The 25 elements of espoused theories are as follows: The clinical nurse worked in wholistic and individual nursing, focussed on the patient's needed, comfort and supportive nursing (5 theories of nursing goal) ; excellent skills, knowledge based, assessment and data collection, explaining, educating or a scientific basis(6 theories of nursing intervention): advocacy, value oriented, treatment, account- ability and commitment(4 theories of nursing ethics) ; human respect. partnership, trust(3 theories of patient-nurse relationship) : knowledgable, accumulated clinical experiences and personally lived experiences. positive perspectives(4 theories of nurse), role of intervention. rewarding peer relationship(3 theories of situations) The above mentioned espoused theories are similar to that of nursing textbooks which students learned through basic nursing education and almost the same as the Acts ofa Nurse in Korean. However, we are doubtful whether nurses actually do as they think. Therefore. it is recommended to review the theories-in-use in order to and any discrepancies between the espoused theories and the reality of nursing actions

2003년 국내 중증급성호흡기증후군 진료 현황 및 문제점 분석

이진수,김은실,정문현,백제중,정선화,안주희,최영화,이선희,고철우,김성범,김민자,박승철,기현균,송재훈,최상호,김양수,이상오,조용균,박영훈,정숙인,김연숙,이흥범,손창희,장성희,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

목적 : 2002년 말 중국에서 SARS가 발생한 이후 국내에서도 2003년 10월까지 총 3명의 추정환자, 17명의 의심환자가 보고되었다. 향후 추가적인 SARS의 유행이 우려되는 상황에서, 그간의 SARS 환자 진료에 있어서의 실질적인 준비사항, 진료 현황 등에 대한 조사를 통해 문제점을 파악하여, 향후 더 나은 대비가 될 수 있도록 개선점을 제시하고자 하였다. 재료 및 방법 : SARS로 의심되는 환자를 진료 경험이 있는 병원의료진을 대상으로 2003년 10월에 설문조사를 실시하였다. 설문에는 SARS 환자 진료 시의 실질적인 조치, 진료 현황, 병실, 응급실 및 외래에서의 격리 시설과 준비사항, 보건당국의 관리와 지원에 관한 사항을 포함하였다. 결과 : 대상이 되는 22개 병원 중 17개(17/22, 77.2%) 병원이 설문에 응하였다. SARS 환자를 위한 격리실은 응급실, 외래, 일반병실 및 중환자실에서 각각 9개(9/17, 52.9%), 5개(5/17, 29.4%), 15개(15/16, 93.7%), 4개(4/16, 25%) 병원에서 음압처리가 되어있지 않은 일인실 혹은 다인실이 사용되었고, 1개(1/16, 6.3%) 병원에서만 일반병실에서 음압격리실이 운영되었다. 입원환자의 진찰 시 개인보호구의 착용은 거의 모든 의료기관에서 이루어졌다. 보건당국에서 SARS지정병원의 시설 등을 사전에 확인한 곳은 1곳(1/12, 8.3%)이였고, 14개 병원(14/15, 93.3%)에서는 보건당국에 의뢰한 검사결과를 통하 받지 못하였다. 결론 : 의료기관에서 SARS 환자용 격리실뿐만 아니라 기존의 격리실 설비 등이 미흡하였으며, 특히 중환자실 및 외래의 준비가 더욱 부족하였다. 보건당국의 의료기관에 대한 종합적인 지원이 부족하였고, 병원과의 원활한 연계가 잘 이루어지지 않았다. SARS 만이 아닌 격리를 필요로 하는 질환의 적절한 진료를 위해 향후 병원 시설의 정비와 정부차원에서의 보다 구체적이고 실질적인 대책마련이 필요하다. Background : There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. Materials & Methods : Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. Results : The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. Conclusions : The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.

근막 결손의 복원과 자궁천골인대 고정을 통한 전자궁적출술 후 질탈출의 성공적 교정

문화숙(Hwa Sook Moon),최진국(Jin Koo Choi),김경서(Kyung Seo Kim),박근식(Kyun Sik Park),황지영(Ji Young Hwang),문성은(Sung Eun Moon),한지원(Ji Won Han),김상국(Sang Gook Kim),김상갑(Sang Gap Kim) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.7

목적 : 본 연구는 전자궁적출술 후 질탈출을 부위-특이적인 결함의 개념에 입각하여 치골경부 근막과 직장질 격막의 연결을 통한 골반내 근막의 복원과 자궁천골인대 고정술을 이용한 질탈출의 성공적인 수술적 교정의 방법과 결과를 보고하고자 한다. 연구 방법 : 1999년부터 2001년 8월까지 자궁적출술 후 질궁탈출 증상으로 문화병원 산부인과를 내원, 탈출된 질의 근막을 재건시킨 다음, 이를 자궁천골인대에 고정시킴으로써 질의 부위-특이적인 교정술을 받은 3명의 환자를 대상으로 하였다. 3명중 1명은 개복술을 하였고 2명은 내시경 수술을 하였다. 결과 : 환자의 연령 분포는 49-67세였으며, 수술시간은 평균 113분 (105-125)이었다. 세 환자 모두 수술 후 질의 상태가 해부학 및 기능적으로 정상이었으며, 9일째 특이사항 없이 퇴원하였다. 수술 후 HRT를 시행한 1명을 포함한 3명 모두 각각 24개월, 12개월, 7개월간의 추적 검사에서도 특이한 합병증이나 재발 없이 좋은 경과를 보였다. 결론 : 골반 근막 결손의 복원과 자궁천골인대 고정술은 전자궁적출술 후 질탈출의 교정에 매우 안전하고 효과적이며, 기능적인 방법으로 사료되며, 자궁천골인대를 질탈출 교정에 이용한 연구는 본 연구가 국내에서 처음이다. Objective : To report the method and efficacy of the site specific-defects repair in the endopelvic fascia and uterosacral ligament suspension for the correction of posthysterectomy vaginal vault prolapse. Methods : This study was performed in 3 patients with posthyterectomy vaginal vault prolapse who underwent the surgery for the reconstruction of endopelvic fascia and the correction of vault prolapsed vagina by using uterosacral ligament suspension at the department of Obstetrics and Gynecology in Moon-Hwa Hospital. Among them, 1 patient was treated by laparotomy, and 2 patients were treated by laparoscope. Results : The age of patients ranged from 49 to 67 years. The mean operation time was 111 minutes (105-120 minutes). The status of postoperative vagina was normal in all 3 patients, who were discharged 9 days after operation without symptoms. No complication or recurrence were found in them despite long-term follow-up for 24 months, 12 months, 7 months, respectively after operation. One patient has been treated with HRT therapy. Conclusion : The reconstruction of the defect of endopelvic fascia and uterosacral ligament fixation may be very safe, effective, and functional in the correction of vaginal vault prolapse. This study reports the treatment of vaginal vault prolapse using uterosacral ligament within Korea for the first time.

신규간호사와 프리셉터가 인지하는 프리셉터의 교수효율성 비교

김지양,김영선,김춘실,박현숙,신미영,윤연숙,조유숙,박미미,유문숙 한국간호과학회 간호행정학회 2009 간호행정학회지 Vol.15 No.2

Objective: The purpose of this study was to compare preceptors and new graduate nurses on their perception of preceptor teaching effectiveness. Methods: The participants were 90 new nurses and 90 preceptors who worked in A medical center. The data were collected from July 1 to September 30, 2008. A cross-sectional descriptive survey was done using a structured questionnaire. Results: New nurses' perception (4.07±.44) of the preceptor teaching effectiveness was significantly higher than perception of the preceptors (3.57±.37). Fifty five percent of new graduate nurses reported a lack of coherence in the preceptor's practice guidelines. For 5 causal factors classified on the teaching effectiveness, the factor of 'Professional knowledge and ability' showed the highest score, but 'Interpersonal and communication skill' got lowest score for both group. Preceptors responded that they did not have enough time to teach well because of their heavy workloads. Conclusions: These results suggest that the preceptors need appropriate compensation and education opportunities, and new graduate nurses need consistent education by the teaching professionals. Therefore, it is important to give preceptors full charge of the preceptorship. Also, it will be necessary to develop education programs to enhance interpersonal and communication skill for preceptors and new nurses.

이미지 데이터베이스를 위한 정보 검색 시스템의 설계 및 구현

김만순,오세봉,김미연,민은미,박미영,정문숙,문현수,김상욱 강원대학교 정보통신연구소 2002 정보통신논문지 Vol.6 No.-

This paper presents design and implementation of an information retrieval system for a large volue of an image database. Our system supports three kinds of queries: attribute-based queries, keyword-based queries, and color-based queries. The attribute-based query is the most-typical query that finds target images based on their attribute values. The keyword-based query is to find target images by referring to their description information their attribute values. Finally, the color-based query is to search for target images by comparing the colors of a query image with those of images in the database. In this paper, we presents the system architecture and approaches adopted in our system for supporting the above three queries effectively and efficiently. We also discuss the user interface of our system that enables users to manipulate our system easily and conveniently.

성인간호학회지 논문(1989-2000)의 내용과 경향 분석

서문자,김소선,송미순,이명선,오의금,신경림,김옥수,이숙자,이영자,오효숙,정재심,김철규 성인간호학회 2001 성인간호학회지 Vol.13 No.4

"Journal of Korean Academy of Adult Nursing" has been published since 1989 and more than 330 articles have been published up 2000. We reviewed all the articles published in this journal to analyze the contents and trend of published articles and to find out the way of improvement both in quantity and quality of studies in this area. The results are as follows : 1) Ninety percent of articles were quantitative studies. Experimental design was used in 16.1% and quasi-experimental design was adapted in 73.6% of articles. Qualitative research were 10.3% of total articles reviewed. 2) Only 5.1% of articles described theoretical framework and 73.6% of experimentally designed articles included research hypotheses. 3) Among experimental studies, only one was true experimental studie design. Eighty nine point three persent had descriptive survey method among non-experimental studies. Amog the thirty four qualitative studies, phenomenologic(73.5%), grounded theory(14.7%), and ethnographic (11.8%) design were used. 4) Most of research subject were patients and few healthy people, healthcare worker, and patient family. 5) Psychosocial data collection method which used questionnaire were 53.7% and interview. physical measurement, observation were used in 22.8%. 8.2% 5.4% of articles respectively. 6) Total number of keywords were 692, and average number of key words per article was 2.2. Health-related keyword was the most frequently used according to four metaparadigm of nursing (human, health, nursing, and environment). Environment related keyword was rarely appeared. The number and quality of nursing research in "Journal of Korean Academy of Adult Nursing" have been improved continuously. It is difficult to find out special trend or characteristics which is unique in this journal because of relatively short history of adult nursing studies. This review study was performed to analyze adult nursing studies only in the view of quantitative aspect, but it is needed to analyse qualitatively to find philosophical or theoretical trend in nursing.

척추관 협찬증 환자 진료 프로세스 개발

이환모,김호중,김긍년,안풍기,천자혜,김양수,신혜선,김인숙,정혜경,김영아,채형기,박인영 한국의료QA학회 2009 한국의료질향상학회지 Vol.15 No.2

연구배경: 수술적 치료가 필요한 척추관협착증 환자들은 주로 60세 이상의 고령환자로장기간의 입원 시 기회 감염의 증대와 불필요한 의료비의 증대를 가져오게 되며, 수술후환χ}들의 재원일수의 증가는병원의 병상가 동률을감소시키고, 전공의에게는불필요한 업무를 증가시킨다. 연구목적: 비용·효과면에서 최적화된 진료지침의 개발은 불필요한 의료비의 감소및 Hospital Induced Complication을 줄여 환자만족도를증진시킬 수 있으며, 각 환자에 대한전공의 업무를 줄일 수있다. 의료기관: 서울특별시에 소재한 2,075병상의 종합전문 요양기관 연구방법: 정형외과및 신경외과의 척추관협착증환자 의 처방을 비교하여 최적의 표준진료지침을 개발하고 최종적으로 CP Master Program (EMR 프로그램)에 입력하여 환자에게 적용하였다. 연구결과': CP 적용전, 후비교를통해 재원일수는 3.8일 이 감소하였으며, 이에 따라 병상가동률 및 진료수익이 증가했으리라고 예상되며 현재 비교검토중이다. 또한,CP 개발및 CP Master Program의 사용을 통한 전공의 업무감소에 대해 검토하고 있다.

세포브러쉬와 면봉도말법에 의한 부인과 세포학적 검사의 효율비교

김정란,김성숙,배한익,김용탁,심재철,임문환,윤혜원,이상식 동국대학교 경주대학 1993 東國論集 Vol.12 No.-

A study was undertaken to evaluate the efficiency of the sytobrush compared with the cotton swab for obtaining cells from the uterine cervix. In 300 patients, the cytobrush technique was employed and in control 300 patients was smeared by the cotton swab. In 12 out of 300 patients(4%) endocervical cells were found on the cotton swab technique. A total of 252 out of 300 cytobrush sampler specimen(84%) contained endocervical cells. With the X²method for statistical comparison, the difference in endocervical cell yield between the cotton swab and the cytobrush sampler was significantly different(p<0.01). This was particularly true in older patients. We conclude from study that the cytobrush sampler is of value for obtaining as adequate cervical cytologic specimen.

사회변화에 따른 빅토리언(Victorian)시대 여성 드레스의 특성 연구 : 1873-5년 산책용 드레스(Promenade dress)를 중심으로 On the 1873-5 Promenade Dress

김문숙,오현남,김현주,김현아,유진경,최은정,조정아,문신애,김완주,홍인숙 서울여자대학교 여성연구소 1999 여성연구논총 Vol.14 No.-

하위문화를 중심으로 현대패션에 나타난 크로스오버(Crossover)에 관한 고찰

김문숙,김현주 서울여자대학교 자연과학연구소 1997 자연과학연구논문집 Vol.8 No.-

Crossover is the coordination of a different items and the ideas of opposite elements from other themes and arts. This study examine a concept and existence factors of crossover through a social phenomenon, and look into a representative character of crossover on the sub-culture. The crossover at the end of 20th century of fashion is concerned with a repulsion of Modernism and a acceptance of Post-modernism. The crossover can be defined in many variables, such as a sex, area, nation and any other idea. The crossover in modern fashion reflects the spirit of 20th century society and culture, and performs various functions as follows, expression of fun, change in gender roles, expression of inner consciousness and pursuit of ideal human type.