환자간호 개선방안

박혜자,Park, Hye-Ja 대한병원협회 1995 대한병원협회지 Vol.24 No.12

인사의글-호스피스 환자의 생존 예측은 가능한가?

박혜자,Park, Hye-Ja 한국가톨릭호스피스협회 2002 호스피스 Vol.24 No.-

팀 기반 학습을 적용한 응급중환자간호 시뮬레이션 교육이 간호대학생의 문제해결능력, 비판적 사고능력 및 임상판단력에 미치는 효과

박혜자(Park, Hye-Ja),홍세훈(Hong, Sehoon),박정아(Park, JungAh) 학습자중심교과교육학회 2019 학습자중심교과교육연구 Vol.19 No.5

본 연구는 팀 기반 학습을 적용한 응급중환자간호 시뮬레이션 교육이 간호대학생의 문제해결능력, 비판적 사고능력, 임상판단력에 미치는 효과를 확인하기 위한 단일군 사전사후 유사실험설계 연구이다. 연구대상자는 경기도 소재 간호학과 4학년 44명이며, 팀 별로 1주간 참여하였다. 수집된 자료는 SPSS 23.0 프로그램을 이용하여 분석하였다. 대상자의 일반적 특성 및 학업특성은 빈도와 백분율, 평균과 표준편차 등을 사용하여 분석하였으며, 교육 전 후 문제해결능력, 비판적 사고능력, 임상판 단력의 차이는 t-test로 분석하였다. 분석결과 팀 기반 학습을 적용한 시뮬레이션 교육 후 간호학생은 문제해결능력(t=3.194, p=0.003)과 비판적 사고능력(t=2.282, p=0.028)이 유의하게 향상되었다. 본 연구를 통해 환자의 안전 및 권리보호 등으로 인해 간호대학생의 임상실습이 제한되어 부족할 수 있는 실무 간호능력을 향상시키기 위해서 임상환경을 반영한 지식, 기술 및 태도가 통합된 시뮬레이션 실습 교육을 확대할 것과 아울러 팀 기반 학습법 등 학습자 중심의 다양한 교수학습법 적용의 기초자료를 제공할 수 있을 것으로 생각된다. The purpose of this study was to examine the effect of simulation-based education for critical patient care by applying team-based learning on problem solving ability, critical thinking, clinical judgement of nursing students. The participants were 44 nursing students. The data was analyzed using descriptive statistics and t-test. After simulation-based education for critical patient care by applying team-based learning, the improvements of problem solving ability(t=3.194, p=0.003) and critical thinking(t=2.282, p=0.028) were statistically significant. Therefore, the simulation-based education for critical patient care by applying team-based learning has a positive effect on nursing students in terms of problem solving ability and critical thinking. Utilizing simulation-based education focusing on team-based learning for critical patient care may contribute to training more competent nurses in the area of critical care nursing. It may also serve to provide a better critical care environment for the safety and health of patients. And, more research and supports are needed to develop teaching and learning methods in nursing education.

문화행정에 있어 분권화와 정부간 기능배분에 관한 연구

박혜자(Park Hye Ja),오재일(O Jae Il) 한국정부학회 2003 한국행정논집 Vol.15 No.4

코로나바이러스 감염증(COVID-19) 전담병원 중환자실 간호사의 외상 후 스트레스 장애 영향 요인

정현옥,박혜자,Jeong, Hyun Ok,Park, Hye-Ja 경희대학교 동서간호학연구소 2022 동서간호학연구지 Vol.28 No.2

Purpose: This study aimed to identify the factors influencing post-traumatic stress disorder in intensive care unit nurses in dedicated hospitals for coronavirus disease of 2019 (COVID-19) during the peak of the outbreak. Methods: This study used a cross-sectional correlational design. A total of 100 participants completed questionnaires comprising the Impact of Event Scale-Revised (IES-R), coping strategy indicator, social support, and post-traumatic growth. Post-traumatic stress disorder was classified as normal, mild risk, and high risk. Data were analyzed using 𝛘² test, Fisher's exact test, Kruskal-Wallis test with multiple comparison analysis, Pearson correlation coefficient, and multinominal logistic regression analysis. Results: Fifty seven nurses (57.0%) had a high risk of post-traumatic stress. Higher levels of post traumatic stress were associated with higher levels of social support seeking, and higher levels of avoidance, and lower levels of social support from supervisors. Higher post traumatic growth was correlated with higher social support for seeking coping, and problem solving coping strategies, and social support from supervisors and colleagues. Post-traumatic stress risk was associated with social support seeking and supervisors' social support. In addition, a higher risk of post-traumatic stress was related to COVID-19 work duration and supervisors' social support. Conclusion: Supportive programs, including increasing social support and building coping skills, may be suggested to safeguard the mental health of critical care nurses during the pandemic.

병원간호사의 소진 및 소진 영향 요인

이경애 ( Kyeoung Ae Lee ),박혜자 ( Hye-ja Park ) 한국보건정보통계학회 2023 보건정보통계학회지 Vol.48 No.2

Objectives: This study identified the associated factors with burnout among hospital nurses. Methods: In this cross-sectional correlational study, 208 nurses working at two university hospitals completed questionnaires on burnout, conflict management style with physician, resilience and organizational commitment. A transformed standardized burnout score of ≥56 was defined to be high. Data were analyzed with χ²-test, Mann-Whitney U test, Pearson correlation analysis and logistic regression. Results: Fifty-nine nurses (28.4%) had a significantly high burnout. The mean T scores of burnout were 61.84±3.89 and 45.31±7.48 in the high and low burnout group. The mean scores of resilience were 3.26±0.35 and 3.70±0.37 in the high and low group (p<0.001). The mean scores of organizational commitment were 2.51±0.48 and 3.30±0.51 in the high and low group (p<0.001). Nurses with high burnout managed conflict with physicians using the styles of collaboration (20.9%), competition (36.2%), avoidance (30.8%), accommodation (33.3%), and compromise (20.9%). Higher burnout was correlated with lower resilience (r=-0.62, p<0.001) and lower organizational commitment (r=-0.58, p<0.001). Lower burnout was associated with higher accommodation conflict management (B=-1.14, OR: 3.13, 95% CI: 1.11-8.85), higher dispositional and higher philosophical resilience (B=-1.31, OR: 3.72, 95% CI: 1.44-9.62; B=-2.29, OR: 9.90, 95% CI: 3.80-25.64). Lower burnout was associated with higher continuance of organizational commitment (B=-1.23, OR: 3.41, 95% CI: 1.80-6.49). Conclusions: Supportive strategies to enhance resilience, organizational commitment, and proper conflict management could be suggested for ameliorating burnout among hospital nurses.

임신성 당뇨병 임부의 정서명확성과 모성정체성 및 태아애착과의 관계

이수민 ( Lee Su Min ),박혜자 ( Park Hye-ja ) 여성건강간호학회 2017 여성건강간호학회지 Vol.23 No.2

Purpose: The purpose of this study was to examine the relationship among emotional clarity in emotional intelligence, maternal identity, and fetal attachment to measure how emotional clarity and maternal identity impact on fetal attach-ment and to determine mediating effects of maternal identity in pregnant women at the time of diagnosis with gesta-tional diabetes mellitus (GDM). Methods: This study used a correlational survey design. 88 pregnant women with GDM completed a study questionnaire of emotional clarity, maternal identity, and fetal attachment immediately after the diagnosis of GDM. Data were analyzed Mann-Whitney U test, and ANOVA with Duncan test, Pearson correlation, three-step regressions to test mediating effect, and Sobel test. Results: The emotional clarity was positively related with maternal identity and fetal attachment. It affected maternal identity with 21.9% of explained variance. The emo-tional clarity and the maternal identity were significant predictors of fetal attachment by 57.7% of explained variance. The maternal identity mediated the relationship between emotional clarity and fetal attachment. Conclusion: The results suggest that a nursing program to enhance the emotional clarity and the maternal identity needs to be devel-oped as an effective strategy to improve fetal attachment.

혈액투석 환자의 신체수행능력, 운동효능감, 의사결정균형, 삶의 질이 허약에 미치는 영향

김선기(Kim, Sun-Ki),박혜자(Park, Hye-Ja),양동호(Yang, Dong Ho),정혜윤(Jeong, Hye Yun) 한국성인간호학회 2018 성인간호학회지 Vol.30 No.2

한국어판 파킨슨병 삶의 질 축약형 도구의 신뢰도와 타당도

김세현 ( Sehyun Kim ),박혜자 ( Hye-ja Park ),박민정 ( Min Jung Park ),김현숙 ( Hyun Sook Kim ) 한국보건정보통계학회(구 한국보건통계학회) 2020 보건정보통계학회지 Vol.45 No.2

목적: 파킨슨병 환자를 위한 건강관리 전략을 개발하고 증진하는데 건강 관련 삶의 질 측정은 매우 중요하다. 8개의 항목으로 구성된 파킨슨병 삶의 질 도구(PDQ-8)는 39개 항목으로 개발된 파킨슨병 삶의 질 도구(PDQ-39)의 축약형으로 파킨슨병 환자의 건강상태를 측정하는데 유용하다. 본 연구는 한국어판 축약형 파킨슨병 삶의 질 측정도구의 신뢰도와 타당도를 확인하고자 한다. 방법: 80명의 파킨슨병 환자가 자가보고형으로 PDQ-39와 PDQ-8 설문지에 무작위 순위로 응답하였다. PDQ-39 응답점수와 PDQ-8 응답점수를 이용하여 건강상태지수를 환산하였다. 파킨슨병 중증도 점수, 운동능력, 간이정신건강, 몬트리올 인지평가, 임상치매척도, 국제치매척도를 이용하여 임상지표 자료를 수집하였다. 결과: 축약형 파킨슨병 삶의 질 도구의 천장효과 2.5%와 바닥효과 1.3%는 적절하였고 내적일관성 신뢰도 계수(α = 0.88), 문항-총점 상관계수(0.48-0.77), 카파상관계수 0.53은 적절하였다. 축약형 파킨슨병 삶의 질 문항은 하나의 요인에 적재되었고(고윳값= 4.35, 분산설명력 =54.51%) 요인적재량은 만족되었으며(0.585-0.847), 확인적요인분석의 모형은 적합하였다(GFI= 0.932, NFI= 0.914, TLI= 0.973, IFI= 0.981, CFI= 0.981, RMSEA= 0.056). 축약형 파킨슨병 삶의 질 도구는 문항 간 유의한 상관관계를 보였고(p <0.05), PDQ-8 건강상태지수는 PDQ-39 건강상태지수와 유의한 상관관계를 보여(r= 0.91, p <0.001) 수렴타당도는 만족되었다. 축약형 파킨슨병 삶의 질의 건강상태 지수는 레보도파민 복용량(r= 0.28, p = 0.028), 파킨슨병 중증도(r= 0.44, p = 0.001), 운동능력(r= 0.45, p = 0.007), 간이정신검사(r=-0.28, p = 0.047), 몬트리올 인지평가(r=-0.49, p = 0.006), 임상치매척도(r= 0.33, p = 0.025), 국제치매척도(r= 0.40, p = 0.007)와 유의한 상관관계를 보여 준거타당도를 만족하였다. 결론: 한국어판 축약형 파킨슨병 삶의 질 도구는 파킨슨병 환자가 지각하는 건강상태를 측정할 수 있는 신뢰도와 타당도가 높은 도구로 간호실무와 연구 수행에 유용한 도구로 사용할 수 있을 것이다. Objectives: This study aimed to determine the reliability and validity of the Korean Parkinson’s disease questionnaire (PDQ-8) using a standard short-form validation approach. Methods: This cross-sectional psychometric study evaluated 80 outpatients with PD who completed the Korean 39-item Parkinson’s disease questionnaire (PDQ-39) and PDQ-8 tools in random order. The summary index (SI) was calculated for the PDQ-39 (PDQ-39SI) and PDQ-8 (PDQ-8SI). A neurologist performed evaluations using the Hoehn and Yahr (HY) scale, unified Parkinson’s disease rating scale (UPRDS motor), mini-mental state examination (MMSE), Montreal cognitive assessment (MoCA), the clinical dementia rating (CDR), and global deterioration scale (GDS). Results: The PDQ-8SI exhibited appropriate floor effect (2.5%) and ceiling effect (1.3%), with acceptable internal consistency reliability (Cronbach’s α=0.88), item-total correlations (0.48-0.77), and inter-rater reliability (Kappa coefficient=0.53). The PDQ-8 loaded one factor (Eigen value=4.35, 54.51% of the variance) and had broadly similar factor loadings (0.585-0.847). The PDQ-8 had mostly goodness of fit (GFI=0.932, NFI=0.914, TLI=0.973, IFI=0.981, CFI=0.981, and RMSEA=0.056). The PDQ-8SI and PDQ-8 items exhibited good correlations with each other (all p<0.05) and the PDQ-39SI (r=0.91, p<0.001). The PDQ-8SI was correlated with levodopa dose (r=0.28, p=0.028), HY score (r=0.44, p=0.001), UPRDS motor (r=0.45, p=0.007), MMES (r=-0.28, p=0.047), MoCA (r=-0.49, p=0.006), GDS (r=0.33, p=0.025), and CDR (r=0.40, p=0.007), respectively. Conclusions: The PDQ-8 appears to be reliable and valid. It may be useful for quickly and easily evaluating the patient’s perspectives regarding the disease’s impacts, which may guide nursing practice and future research.

대학생의 생활습관 요인과 비만과의 상관성: 경기도 지역 1개 대학교를 중심으로

정진희 ( Jin Hee Jeong ),박혜자 ( Hye-ja Park ) 한국보건정보통계학회 2021 보건정보통계학회지 Vol.46 No.4

Objectives: This study examined the associations between lifestyle factors and obesity among university students. Methods: In this cross-sectional correlational study, 671 students completed measures of lifestyle factors (dietary habit, exercise, smoking, and alcohol drinking), health concern, academic stress, and anthropometric indices. Obesity was classified by body mass index (BMI) and abdominal circumference (AC). The data were analyzed with χ² test, Mann-Whitney U test and logistic regression. Results: The frequencies of obesity and abdominal obesity were higher in male students than in female students (17.6% vs. 3.4% by BMI, 18.9% vs. 5.9% by AC). Abdominal obesity in students with diabetic parent was higher (16.8%) than in students without diabetic family history (9.2%). Obesity of BMI≥25 kg/m² associated with breakfast absence of 5-7 times/week (odds ratio, OR: 1.98, 95% confidence interval, CI: 1.05-3.71). Abdominal obesity associated with instant foods intake of 5-7 times/week (OR: 2.65, 95% CI: 1.14-6.17), fast foods intake of 3-4 times/week (OR: 2.87, 95% CI: 1.48-5.56), snacks of 3-4 times/wk (OR: 2.15, 95% CI: 1.15-4.00), and consumed alcohol of ≥1 glass a day (OR: 2.11, 95% CI: 1.19-3.73). Conclusions: Breakfast absence is associated with obesity. Instant foods, fast foods, snacks, and alcohol consumption are the associated factors with abdominal obesity among university students.