A Prediction Model of Fear of Falling in Older Adults Living in a Continuing-Care Retirement Community(CCRC) in United States

정덕유(Jung, Dukyoo) 한국노년학회 2009 한국노년학 Vol.29 No.1

배경: 낙상은 노인의 가장 일반적이고 심각한 건강문제로 대두되고 있다. 낙상은 중요한 신체적 심리적 영향을 주며 결과적으로 신체적 행동약화나 기능의 위축, 사회적 기능 약화 등을 야기시킨다. 하지만, 상대적으로 낙상 후의 심리적, 정신적 부분은 간과되어져왔다. 낙상 후 노인들이 심리적 또는 정신적으로 보고하는 대표적인 증상으로는 다시 낙상을 할 것이라는 두려움으로 나타났다. 목표: 이 논문은 노인의 낙상에 대한 두려움에 영향을 주는 요인에 대한 모델을 테스트하는데 있다. 또한, 낙상에 대한 두려움에 영향을 주는 중요한 요인 중 하나인 노인의 운동과 운동에 대한 신념, 운동에 대한 기대감의 관계를 연구함에 있다. 방법: 미국 메릴랜드 주 볼티모어시 지역에 거주하는 노인149명을 대상으로 2004 11월부터 2005년 3월까지 수집된 2차 자료를 이용해서 결과가 분석되었다. 참가 가능 노인으로는 본 연구에 참여하기로 동의한 노인을 대상으로, 노인요양시설에 거주하며, 인지적으로 이상이 없고 (MMSE>20), 65세 이상의 나이를 가진 노인을 대상으로 한다. 자료 수집은 구조화된 설문지를 통해서 이루어졌다. 자료 분석을 위해, SPSS 12.0을 통해 빈도분석과 상관분석 등이 사용되었고, 모델 평가를 하기 위해서 AMOS프로그램을 통해 path analysis를 시행하였다. 결과: 모델 내 49개의 path중에 13개의 path가 유의하게 나타났고 모델의 22%가 설명되어졌다. 모델의 확실성은 chi-square를 통해서 조사되었고 결과 모델의 확실성이 입증되었다. 또한, CFI 는 0.99 RMSEA는 0.00으로 모델을 지지하는 결과가 나타났다. 특히, 성별, 과거 낙상경험, 운동은 노인의 낙상에 대한 두려움을 설명하는 중요한 변수로 나타났다. 논의: 본 연구는 노인의 낙상에 대한 두려움을 총체적으로 설명하기 위한 모델을 제시한다. 또한, 운동에 대한 신념과 결과에 대한 기대치가 노인의 운동을 설명하는 직접적 변수로, 낙상에 대한 두려움을 설명하는 간접적인 변수로 나타났다. 이 연구는 노인들이 낙상의 두려움을 줄이기 위해 적극적으로 운동에 참여하도록 하는데 중요한 이론적 근거를 제공한다. Background: Falls are among the most common and serious health problems of older people. The psychological symptoms of falling have received relatively little attention compared to physical problems. Objective: The purpose of this study is to test a model to explain the factors that influence fear of falling among older adults living in a continuing care retirement community (CCRC) in Baltimore city, United States. Methods: A secondary analysis was conducted using data obtained from a Health Promotion Survey done on 149 older adults living in a CCRC. Data was originally obtained during face to face interviews with each participant. Descriptive statistics and bivariate correlations were used to describe the sample and evaluate simple correlations. A path analysis was done using the AMOS 4.0 statistical program. Results: Of the 49 hypothesized paths, 13 were statistically significant, and the model accounted for 22% of the variance in fear of falling among the elderly. There was support for the fit of the model to the data with a nonsignificant chi square at 0.478 (df=2, p=0.79), and the ratio of chi-square to degrees of freedom was 0.24, a CFI of 0.99 and RMSEA of 0.00. In particular, gender, a history of falling, and exercise were significant predictors of fear of falling. Conclusions/Implications: As anticipated, exercise is an important factor to prevent fear of falling. As a modifiable variable, self-efficacy and outcome expectation indirectly influence fear of falling through exercise.

요양시설 요양보호사의 낙상관련 지식, 태도, 자기 효능감에 관한 연구

정덕유(Dukyoo Jung),김혜진(Hyejin Kim),변진이(Jinyee Byun) 대한여성건강학회 2013 여성건강 Vol.14 No.1

노인의 낙상, 낙상에 대한 두려움, 우울, 지각된 건강상태에 관한 연구

정덕유(Jung Dukyoo),신경림(Shin Kyung-Rim),강윤희(Kang Younhee),강지숙(Kang Ji-Sook),김건희(Kim Kon-Hee) 한국성인간호학회 2008 성인간호학회지 Vol.20 No.1

장기요양시설 치매노인의 식사어려움에 대한 주제범위 문헌고찰: 국내 연구를 중심으로

정덕유(Jung, Dukyoo),이규리(Lee, Kyuri),최은주(Choi, Eunju) 기본간호학회 2021 기본간호학회지 Vol.28 No.4

Purpose: This study synthesized the literature on eating difficulties among older adults with dementia in long-term care facilities. Methods: A scoping review, using the framework proposed by Arksey & O’Malley (2005) and supplemented by Levac et al. (2010), was conducted. Literature was searched from RISS, KISS, DBpia, PubMed, and CINAHL. Two reviewers independently selected studies and extracted their characteristics, using pre-tested forms to determine final inclusion. In total, 1283 articles were identified, and 13 articles were used for the final analysis. Results: The Eating Behavior Scale and the Edinburgh Feeding Evaluation in Dementia scale were the most widely utilized measurement tools. The most common factors related to eating behavior in older adults with dementia were cognitive and physical functions in the individual domain, the caregiver’s attitude toward eating in the inter-individual domain, and meal type in the environmental domain. Conclusion: Measurement tools reflecting the eating behavior of older adults with dementia must be developed to obtain a comprehensive understanding of this issue and create effective interventions for the specific context of long-term care facilities in Korea. The results of this study are intended to serve as a basis to develop meal support programs for older adults with dementia.

한국판 기능유지간호에 대한 간호사의 자기효능감 및 결과기대감 측정도구의 타당도와 신뢰도

정덕유(Dukyoo Jung),변진이(Jinyee Byun),이민경(Minkyung Lee),김혜진(Hyejin Kim) 한국콘텐츠학회 2015 한국콘텐츠학회논문지 Vol.15 No.9

본 연구는 요양시설 직접돌봄제공자의 기능유지간호에 대한 자기효능감 및 결과기대감 도구를 번역한 한국판 기능유지간호에 대한 자기효능감 및 결과기대감 도구의 타당도 및 신뢰도 분석을 통해 문화적인 차이가 있는 원 도구를 한국의 노인 요양시설에 근무하는 간호사에게 적용할 수 있는지 검증하는데 그 목적이 있다. 본 연구의 대상자는 전국 69개의 요양시설에 근무하는 간호사 187명으로 자료수집은 구조화된 설문지를 이용하였다. 수집된 자료는 SPSS/WIN 21.0과 AMOS 22.0을 이용하여 분석하였으며 구성타당도 검정은 확인적 요인분석으로 시행하였고, 준거타당도 검증을 위해 기능유지간호에 대한 자기효능감 및 결과기대감과 기능유지간호에 대한 지식, 직무만족과의 상관관계를 이용하였다. 연구결과 확인적 요인분석을 통해 구성타당도가 입증되었고, 준거타당도가 검증되었다. 또한, 신뢰도 분석을 통해 도구의 신뢰도가 확인되었다. 본 연구를 통해 번역된 한국어판 기능유지간호에 대한 자기효능감 및 결과기대감 도구가 국내에서 사용할 수 있는 도구임이 검증되었고, 추후 시설 입소노인의 기능유지간호를 위한 초석이 될 것으로 사료된다. The purpose of this study is to measure the validity and reliability of the Korean version of the self-efficacy for restorative care activity (K-SERCA) scale and the outcome expectations for restorative care activity (K-OERCA) scale. Psychometric testing was given to 187 nurses who have worked in 69 long-term care facilities in South Korea via post service and personal visit. Data were collected via structured-questionnaire and analyzed using SPSS/WIN 21.0 and AMOS 22.0. Content, construct validity using confirmatory factor analysis (CFA), criterion validity and internal consistency reliability were conducted. The K-SERCA scale had factor loading of the 10 items ranged from .74 to .87, and was validated by confirmatory factor analysis (CFI=.96, NFI=.94, RMSEA=.10). The K-SERCA scale was also a significantly positive correlation with ‘Job satisfaction’ (r=.32, p<.001). There was a reliable internal consistency with a Cronbach’s α =.94. The K-OERCA scale had factor loading of the 9 items ranging from .38 to .95, and was validated by confirmatory factor analysis (CFI=.98, NFI=.96, RMSEA=.09). The K-OERCA scale was also a positive correlation with ‘Knowledge (r=.26, p<.001)’, and ‘Job satisfaction (r=.30, p<.001)’. There was a reliable internal consistency with a Cronbach’s α =.89. The results demonstrate that the K-SERCA and K-OERCA scales had satisfactory validity and reliability to measure self-efficacy and outcome expectations for restorative care activities among nurses who have worked in long-term care facilities in South Korea.

기관내관을 적용중인 국내 중환자실 성인 입원환자의 구강간호에 대한 주제범위 문헌고찰

임정은,정덕유,유리호,Lim, Jungeun,Jung, Dukyoo,Yoo, Leeho 한국중환자간호학회 2024 중환자간호학회지 Vol.17 No.1

Purpose : This scoping review was designed to identify gaps in knowledge and guide future directions for clinical nursing practices and research on oral hygiene care for endotracheally intubated patients in Korean intensive care units. Methods : We conducted a scoping review using the methodological framework proposed by Arksey and O'Malley. PubMed, CINAHL, RISS, Science On, and DBpia databases were searched. Two reviewers independently selected the studies and extracted data. A total of 445 studies were identified, of which 17 were included in the final analysis. Results : No research has been conducted from 2021 to the present. A total of 12 instruments were utilized in 13 studies to assess the effectiveness of oral hygiene care. All studies investigating the effectiveness of oral hygiene care have consistently documented that chlorhexidine has the most significant effect. The frequency and time of oral hygiene care were each examined in one study. Conclusion : A research study is necessary to develop a measurement tool for assessing the effectiveness of oral hygiene care suitable for endotracheal intubated patients in intensive care units. Interventional studies should be conducted to determine the effects of chlorhexidine and the appropriate frequency and time of oral hygiene care. Thereafter, revision of domestic evidence-based clinical practice guidelines by integrating these results will be necessary.

입원 노인 환자의 추정 근감소증과 비만이 낙상 위험도에 미치는 영향

김가현(Kim, Kahyun),정덕유(Jung, Dukyoo) 한국재활간호학회 2023 재활간호학회지 Vol.26 No.1

자세안정성 원리에 기반한 환자이동기술 개발 및 효과검정

마예원(Ma, Ryewon),정덕유(Jung, Dukyoo) 한국간호과학회 2016 Journal of Korean Academy of Nursing Vol.46 No.1

Purpose: This study was done to develop a postural-stability patient transfer technique for care helpers in nursing homes and to evaluate its effectiveness. Methods: Four types of patient transfer techniques (Lifting towards the head board of the bed, turning to the lateral position, sitting upright on the bed, transferring from wheel chair to bed) were practiced in accordance with the following three methods; Care helpers habitually used transfer methods (Method 1), patient transfer methods according to care helper standard textbooks (Method 2), and a method developed by the author ensuring postural-stability (Method 3). The care helpers’ muscle activity and four joint angles were measured. The collected data were analyzed using the program SPSS Statistic 21.0. To differentiate the muscle activity and joint angle, the Friedman test was executed and the post-hoc analysis was conducted using the Wilcoxon Signed Rank test. Results: Muscle activity was significantly lower during Method 3 compared to Methods 1 and 2. In addition, the joint angle was significantly lower for the knee and shoulder joint angle while performing Method 3 compared to Methods 1 and 2. Discussion: Findings indicate that using postural-stability patient transfer techniques can contribute to the prevention of musculoskeletal disease which care helpers suffer from due to physically demanding patient care in nursing homes.

임상적 비판적 사고능력 검사도구 개발 및 평가

신수진,양은배,공병혜,정덕유,Shin, Su-Jin,Yang, Eunbae,Kong, Byunghea,Jung, Dukyoo 연세대학교 의과대학 2012 의학교육논단 Vol.14 No.2

This study developed a test entitled Clinical Critical Thinking Skills (CCTS) by using item response theory (IRT) and examined its validity. In the development stage, data obtained from a convenience sample of 627 undergraduate nursing students were analyzed using a discrimination and difficulty index with the TestAn 1.0 program. In the evaluation stage, data from a convenience sample of 284 nursing and non-nursing students were analyzed using a discrimination and difficulty index with the BILOG-MG program. Criterion validity was verified by the group comparison method. Five items received low discrimination index scores according to the IRT results. In terms of the criterion validity, CCTS scores differed according to major (t=2.21, p=0.028), location of high school (F=4.35, p=0.014), clinical experience (t=5.66, p=0.004), and grade point average (F=7.17, p< 0.001). The CCTS can be used to measure critical thinking skills in the clinical setting.

시뮬레이션 기반 응급기도관리 교육이 간호사의 자기효능감, 임상수행능력에 미치는 효과

이미자(Lee, Mi-Ja),정덕유(Jung, Dukyoo) 한국성인간호학회 2014 성인간호학회지 Vol.26 No.1