향기요법이 스트레스에 미치는 효과에 대한 메타 분석

김경덕,서순림,Kim, Gyung-Duck,Suh, Soon-Rim 한국호스피스완화의료학회 2008 한국호스피스.완화의료학회지 Vol.11 No.4

목적: 본 연구의 목적은 향기요법이 스트레스에 미치는 효과에 대하여 메타분석 방법을 이용하여 연구결과의 정도를 종합, 분석하기 위함이다. 방법: 2000년 1월부터 2008년 2월까지 이루어진 연구를 대상으로 하여 국내 학위논문과 주요 학술지를 중심으로 추출하였으며, 향기요법이 스트레스에 미치는 효과를 연구한 45편의 논문 중 분석대상 기준에 적합한 논문 21편을 대상으로 하였으며, 자료분석은 통계프로그램인 SAS 9.1/PC을 이용하여 분석하였다. 결과: 최종 선정된 21편의 연구물로부터 58개의 효과 크기가 산출되었으며, 58개의 효과크기를 바탕으로 전체 효과, 종속변수의 지표별 효과, 연구대상 및 중재 방법에 대한 효과, 중재시간에 따른 효과를 산출하였다. 향기요법이 스트레스에 미치는 전체 효과크기는 .593으로 보통 효과크기로 나타났다. 스트레스의 지표별 효과 크기는 생리적 지표에서 보다 심리적 지표에서 훨씬 큰효과를 보였으며, 심리적 스트레스에서는 주관적 스트레스에 효과가 가장 컸고($\bar{d}$=.983), 생리적 스트레스에서는 코티졸($\bar{d}$=.648)과 맥박($\bar{d}$=.515)에서는 중간정도의 효과크기가 나타났으나, 수축기 혈압($\bar{d}$=.490)과 이완기혈압($\bar{d}$=.401), 에피네피린($\bar{d}$=.334)에서는 중재효과가 작은 것으로 나타났다. 대상자별 효과에서는 노인집단에서 .706으로 가장 큰 효과를 나타내었고, 암환자($\bar{d}$=.337)에게 가장 작은 효과로 나타나 집단간 유의한 차를 보였다(F=2.271, P=.043). 중재방법에 대해서는 향기요법과 마사지요법을 병행한 경우($\bar{d}$=.590) 가장 큰 효과로 나타났으나 중재시간별 효과크기의 차는 없었다 (F=.495, P=.687). 중재시간에 대해서는 $20{\sim}30#분의 중재를 한 경우 .730으로 가장 높게 나타났으나, 역시 통계적 유의한 차는 없었고, 중재 회기 수와 효과크기와의 상관관계는 r=.349로 나타나 통계적으로 유의한 차를 보였다(P=.007). 결론: 본 연구 결과 향기요법은 대상자의 스트레스를 감소시키는데 효과가 있는 것으로 나타났으므로 향기요법을 이용한 간호중재 프로토콜의 개발과 그 실제 적용이 요구된다할 수 있겠으며, 프로토콜 개발 시 대상자의 특성과 중재 시간이 고려되어야 하겠다. Purpose: The purpose of this study was to analyze the effects of aromatherapy on stress using meta-analysis. Methods: Meta-analysis was done with 21 published studies, and data were analyzed with the SAS 9.1 program. Results: Fifty eight effect size was estimated with data from 21 published studies. Overall mean effect size (ES), and mean effect size of dependence variables according to the type of intervention and subject and according to the total amount of time spent in aromatherapy were estimated. Overall mean effect size of the effects of aromatherapy was .593, and the subjective stress (.983) was most effective in the physiological faculty, followed by mean effect size of cortisol (.648) and pulse (.40). On the other hand, mean effect size of systolic blood pressure (.490) was moderate, and that of diastolic blood pressure (.401) was not large. Mean effect size of elderly (.706) cancer patients was considerable(.337). There were significant differences depending on the subjects. With regards to the types of aromatherapy, the effect size of aroma massage combined with inhalation therapy was .590, and there were no significant differences between the intervention methods. With regards to the time of intervention, $20{\sim}30$ minutes spent in aromatherapy was .730, and there were no significant differences between the times of intervention. The relationship between the effect size and intervention frequency was r=.349 and showed significant difference. Conclusion: This result suggests that aromatherapy is an effective intervention to reduce stress for subjects. Nursing intervention protocol by using aromatherapy should be developed and applied in clinical and community settings. Further studies on the effects of aromatherapy on stress should be done by using meta-analysis.

한국 노인과 뉴질랜드 노인의 우울, 불안 및 스트레스 비교 연구

김경덕(Kim, Gyung-Duck),김경혜(Kim, Kyung-Hae) 한국산학기술학회 2015 한국산학기술학회논문지 Vol.16 No.9

본 연구의 목적은 한국과 뉴질랜드 노인의 국가 간 우울, 불안, 스트레스 정도의 차이를 파악하기 위한 서술적 조사연 구이다. 연구 대상은 60세 이상의 남녀 재가노인으로 뉴질랜드 55명과 성별로 짝짓기를 하여 한국 55명으로 총 110명을 분석 하였다. 자료 수집은 2013년 1월 24일부터 2월 10일까지 구조화된 설문지로 직접 면접을 통하여 수집하였다. 연구 결과, 우울 정도는 한국 13.67/42점으로 뉴질랜드 4.70/42점보다 높았다. 불안 수준은 한국 11.42/42점으로 뉴질랜드 4.92/42점보다 높게 나타났다. 또한 스트레스 수준은 한국 13.54/42점으로 뉴질랜드 5.40/42점보다 높게 확인되었다. 노인의 우울, 불안 및 스트레 스 간의 상관관계는 우울은 불안과 스트레스와 순 상관관계를 보였으며, 불안 또한 스트레스와 순 상관관계를 보였다. 본 연구를 통하여 한국 노인의 노년기 삶의 질 향상을 위해서 우울, 불안 및 스트레스를 감소시키는 프로그램의 개발 및 적용되 어야 할 것으로 사료된다. This study was done to identify differences in depression, anxiety, and stress in Korea elders (n=55) and New Zealand elders (n=55). Methods: This study was conducted from January 24th, 2013 to February 10th, 2013. We individually matched Korea elders to New Zealand elders based on age and sex, and assessed a questionnaire regarding depression, anxiety, and stress. Results: The average depress score for the Korea elders (13.67/42) was significantly different to the average for the New Zealand elders (4.70/42). The average anxiety score for the Korea elders (11.42/42) was significantly different to the average score for the New Zealand elders (4.92/42). The average stress score for the Korea elders (13.54/42) was significantly different to the average score for the New Zealand elders (5.40/42). The depression score showed a significant relationship with anxiety and stress. There was significantly positive correlation between anxiety and stress. The study suggests that should be considered in developing nursing intervention to manage depress, anxiety, and stress of the Korea elderly people.

항암화학요법을 받고 있는 유방암 환자의 증상 클러스터와 삶의 질

김경덕(Kim, Gyung Duck),김경혜(Kim, Kyung Hae) 한국성인간호학회 2011 성인간호학회지 Vol.23 No.5

유방암 생존여성의 갱년기 증상과 피로가 삶의 질에 미치는 영향

김경덕(Kim, Gyung Duck) 대한종양간호학회 2014 Asian Oncology Nursing Vol.14 No.2

Purpose: The purpose of this study was to test hypothetical model of quality of life (QOL) in breast cancer survivors and to test the mediating effects of cognitive dysfunction. Methods: This study was conducted from December 1st, 2013 to February 28th, 2014. 164 breast cancer survivors were recruited from A, D, and Y city in Korea. The instruments used in this study were climacteric symptoms, fatigue, cognitive dysfunction, and the QOL scales. Data were analyzed using descriptive statistics, correlation, and pathway. Results: Cognitive dysfunction was directly affected by climacteric symptoms and fatigue. QOL was directly affected by fatigue, However climacteric symptoms and cognitive dysfunction did not effect on QOL directly. Impact of climacteric symptoms on QOL, mediating effect of cognitive dysfunction was not confirmed. In addition, effect of fatigue on the QOL, the mediating effect of cognitive dysfunction was not. Conclusions: Effects of climacteric symptoms on QOL was not mediated by cognitive dysfunction, Furthermore effects of fatigue on QOL was not mediated by cognitive dysfunction.

양로시설 입소노인의 수면의 질에 관한 연구

김경덕(Gyung Duck Kim) 한국노인복지학회 2000 노인복지연구 Vol.10 No.-

한국보건사회연구원의 치매 mapping 연구결과(1997)에 따르면 우리나라 65세 이상 노인의 치매 유병률은 8.3%로 2005년 35만1천명, 2010년 43만4천명, 2020년 61만9천명이 될 것으로 추정되고 있다. 정부는 치매관리에 대한 문제의 심각성을 깨닫고 치매노인문제를 사회적으로 해결하기 위해 1996년도에 `치매대책 10년 계획`을 수립해 전국 진료권역별로 치매 전문 진료기관을 1개소씩 설치를 추진 중이지만 치매환자가 증가하는 추세를 따라잡지 못하고 있다. 물론 국가적인 차원에서 치매노인을 위한 시설 및 시설에 대한 적정 인력지원, 치매관리에 소요되는 경비에 대한 특수 보험 수가화, 치매복지노인에 대한 법적 제도를 마련해야 될 것이다. 그리고 현장에서는 치매 노인의 기능을 증진시킬 수 있는 각종 프로그램의 개발 또한 필수적이다. 이에 대한 대책으로 생활시설 및 가정에서 적용 가능한 프로그램으로 본 치매노인을 위한 몬테소리 프로그램을 개발 하게 되었다. 본 연구는 치매노인의 인지기능 및 일상생활수행능력에 긍정적인 변화를 가져올 수 있는 몬테소리 프로그램 프로그램을 개발하고 그 효과를 파악하기위해 2003년 3월 16일에서 동년 6월 4일까지 충북 청원군 현도면 소재 은혜의 집에 거주하는 치매를 가진 노인 20명을 대상으로 수행되었다. 본 연구자가 개발한 치매노인을 위한 몬테소리 프로그램은 Myers Research Institute에서 개발된 치매노인을 위한 몬테소리에 기초를 둔 활동들을 모티브로 하여, 국내에서 유아를 대상으로 실행되었던 몬테소리 프로그램과 시설에서 노인들이 즐겼던 프로그램을 고려하여 한국 노인들에게 맞게 20회기 프로그램으로 구성하여 실행했으며 각 회기별 프로그램 실시 후 이해력, 감각, 소근육, 흥미 영역으로 나누어 몬테소리 프로그램의 효과성을 평가하였다. 본 프로그램을 통해 인지기능 및 일상생활 능력 변화에서 대상자 20명의 평균점수가 중재 전` 후에 통계적으로 의미 있는 변화는 없었으나 높아지는 경향은 보였다. 이와 같이 본 연구에서 통계적으로 유의한 결과가 나타나지 않은 이유는 본 연구의 대상자들이 평균연령 86.8세의 고령이며, K-MMSE 평균 점수가 10.95인 중증 치매노인들로 단기간의 프로그램으로 효과가 나타나지 않는 대상자들이었기 때문일 수도 있고, 장기간에 걸쳐 변화되는 변수를 택하였기 때문일 수도 있을 것이다. 그럼에도 불구하고 더 악화되지 않고 향상되는 경향을 보였으므로 본 프로그램은 치매노인의 인지기능과 일상생활 수행능력을 유지시키는 데 효과적인 프로그램으로 판단된다. The propose of this study was to identify sleep patterns, sleep disturbing factors and quality of sleep in the institutionalized elderly. The subjects were 72 elderly persons living in the elderly institution in Taegu city. The data were collected through interviews with unstructured questionnaires from August 9 to August 14, 1999. Analysis of data was done through the frequency, percentage, means, t-test and ANOVA with the SAS program. The results of this study were as follows ; 1. sleep patterns - going to bed time was 21.38, waking up time was 5.10, sleep latency was 66 min., sleep efficiency was 84% 2. Regarding sleep disturbing factors - use the bathroom(81.9%), pain(20.8%) were reported. 3. The mean score of quality of sleep was 6.9. The sleep quality(1.22) was the highest score and the use of sleeping medication(0.11) was the lowest among the domains of the quality of sleep. 4. The distribution according to the quality of sleep showed 43.9% good sleeper and 56.1% poor sleeper. 5. The demographic characteristics of the subjects, perceived health status, present illness, numbers of bed partner, type of institution were related to the quality of sleep.

호스피스 병동 실습 교육이 간호대학생의 영적안녕, 죽음에 대한 태도 및 호스피스 인식에 미치는 효과

김경덕(Kim, Gyung Duck) 대한종양간호학회 2016 Asian Oncology Nursing Vol.16 No.4

Purpose: The purpose of this study was to examine the effect of hospice unit practice education on spiritual well-being, attitude to death, and hospice awareness of nursing students. Methods: This study used a one group pre-posttest research design. The participants were 29 nursing students attending D university located in Y City. All students participated in 2 weeks of hospice unit practice education. The hospice unit practice education program consisted of 90 hours. Data collection was performed from March 2 to April 30, 2015. 2 weeks. The data were analyzed using frequency, and paired t-tests, with the SPSS 21.0 program. Results: The results of this study were as followings; the score of existential well-being, attitude to death, necessary of pain and symptom control were significantly increased after hospice unit practice education. Conclusion: Based on these results, hospice unit practice education is effective for improving spiritual well-being, attitude to death, and hospice awareness of nursing students. These results provide basic data to develop future nursing practice curriculum.

매개모델을 이용한 유방암 환자의 증상클러스터 검증

김경덕(Kim, Gyung Duck),장현진(Jang, Hyun Jin) 대한종양간호학회 2012 Asian Oncology Nursing Vol.12 No.4

Purpose: This study was conducted to test whether sleep disturbance mediates the effect of pain on fatigue, whether fatigue mediates the effect of pain on depression, and whether fatigue mediates the effect of sleep disturbance on depression. Methods: This study was conducted from September 12th to December 20th, 2011. One hundred eighty-eight breast cancer patients were recruited from D city and S city in Korea. The instruments used in this study were the pain, sleep disturbance, fatigue, and depression scales. Data were analyzed using descriptive statistics, Pearson correlation coefficients, and mediation pathway with the SPSS 12.0 and AMOS 20.0 programs. Results: There was correlation among pain, fatigue, sleep disturbance, and depression. Mediation analyses indicated that pain influences fatigue. sleep disturbance, and depression directly as well as indirectly. Sleep disturbance influences fatigue and depression directly, also fatigue influences depression directly. But sleep disturbance had no direct effect on depression. Conclusion: Significant correlations among the four symptoms supported the existence of the symptom cluster. Effects of pain on fatigue was partially mediated by sleep disturbance, also effects of pain on depression was partially mediated by fatigue. However, the effects of sleep disturbance on depression was fully mediated by fatigue.

재가노인(在家老人)의 수면(睡眠)의 질(質)과 수면방해(睡眠妨害) 요인(要因)에 관한 연구(硏究)

김경덕(Gyung Duck Kim) 한국노인복지학회 2000 노인복지연구 Vol.7 No.-

The purpose of this study was to identify quality of sleep and sleep disturbing factors among healthy community dwelling elderly. The subjects were 114 healthy elderly persons over the of age 65, living in Taegu city. The data were collected through interviews With unstructured questionnaires from August 10 to September 10, 1998. Analysis of data was done through the frequency, percentage, means, x2, t-test and ANOVA with the SAS program. The results of this study were as follows : 1. The mean score of quality of sleep was 6.9. The sleep latency(1.48) was the highest score and the use of sleeping medication(0.10) was the lowest among the domains of the quality of sleep. 2. Regarding sleep - disturbing factors, use the bathroom(2.84) was reported. 3. The distribution according to the quality of sleep showed 43.9% good sleeper and 56.1% poor sleeper. 4. The demographic characteristics of the subjects, age, sex, married status, yes or no of bed partner, perceived health status, present illness, activity of day tame and exercise state were related to the quality of sleep.

유방암 생존자의 증상, 불확실성이 삶의 질에 미치는 영향

김경덕 ( Gyung Duck Kim ) 경북대학교 간호과학연구소 2021 경북간호과학지 Vol.25 No.2

Purpose: This study was to identify the effect of symptom experience and uncertainty on the quality of life in breast cancer survivors. Methods: Data were collected from 151 breast cancer survivors who participated actively in a self-help group from May 1st to 30th, 2015. Data were analyzed using Pearson correlation and stepwise multiple regression. Results: The severity of symptom experience, uncertainty, and quality of life of breast cancer survivors were moderate. Symptom experience, uncertainty, and quality of life showed a significant correlation. The most influential factor on quality of life was symptom experience which showed 66.0% of explanatory power. When uncertainty was added, the explanatory power increased to 74%. Conclusion: The finding showed the symptom and uncertainty affected the quality of life of breast cancer survivors. In order to improve the quality of life of breast cancer survivors, it is necessary to develop an intervention program that can reduce uncertainty and the symptoms experienced by breast cancer survivors.

항암화학요법으로 인한 유방암 환자의 인지기능 측정도구 사용 실태 분석

김경덕(Kim Gyung Duck),정복례(Chung Bok Yae),김경혜(Kim Kyung Hae),변혜선(Byun Hye Sun),최은희(Choi Eun Hee) 대한종양간호학회 2011 Asian Oncology Nursing Vol.11 No.3

Purpose: This study analyzed recent trends of instrument usage assessing cognitive function of breast cancer patients undergoing chemotherapy. Methods: The researcher collected 64 studies outside the country that were published between January 1996 and August 2010. Results: There was no study on the instrument assessing all domains of cognitive function in breast cancer patients undergoing chemotherapy. Most instruments assessing cognitive function of breast cancer patients have been used for patients with dementia depression and/or organic brain damage. Also the objective neuropsychological tests such as the grooved pegboard for the psychomotor area RCFT copy in visuospatial skill area and the WAIS-III block design have low sensitivity for measuring cognitive function in breast cancer patients thus they are not good for applying to breast cancer patients. Conclusion: There is a need to develop an instrument which has good sensitivity and specificity for measuring the cognitive function of the breast cancer patients who experienced cognitive impairment after chemotherapy treatment. In addition the developed instrument needs to be accessible and feasible in any nursing clinical setting for the purpose of accurate assessment and evaluation of the cognitive function among breast cancer patients.