뇌졸중 환자의 일상생활동작, 우울과 삶의 질의 관계

김원옥 ( Won Ock Kim ),강현숙 ( Hyun Sook Kang ),왕명자 ( Jmyung Ja Wang ),김정화 ( Jeong Hwa Kim ),최진이 ( Jin Yi Choi ) 경희대학교 동서의학연구소 2007 동서간호학연구지 Vol.13 No.2

본 연구는 뇌졸중 환자의 일상생활동작, 우울, 삶의 질의 관계를 파악하고자 하는 서술적 조사 연구로서 일상생활동작,’ 우울, 삶의 질 정효〉 관계가 있음을 확인하였다. 그러므로 본 안구의 주요한 결과를 중심으로 다음과 같이 고찰하였다. 뇌졸중 환자들의 일상활동 수행능력을 측정하는 도 구로 FIM, Modificd Barthel Index (MBI) 등이 많이 쓰 이고 있는데 FIM은 분야에 상관없이 표준화를 통한 높은 실용성,실행성, 이해도로· 인하여 널리 사. 하고 있는 도구로 이를 이용하여 측정한 본 연구에서는 872점으로 국내에서 만성 뇌졸중 환자와 퇴원 시 뇌졸중 환자를 대상으로 측정한 85. 9점 (Hw떼g, 2004) 과 85. 3점 (Kim, 2004) , 85. 8점 (Hong et al., 1998) 에 비하 여 약간 높아졌으나 비슷하였고, 일본 뇌졸중 환자를 대상으로 한 연구의 77. 1점보다는 높은 결과이었다 (Hama et al., 2007) . 특히 하부역역인 운동영역은 다 른 연구에 비해 높았으나 인지영역은 다른 연구에 비 해 낮은 편이었다 (Hwang, 2004二 Hama et al. , 2007, Hong 嫩 al. , 200긱 Kim, 2004) . 미국의 지역사회시설 에 있는 뇌졸중이 처음 발병한 환자들을 대상으로 재 활 후 5년간 환자를 추적한 연구에서 3년 후까지는 FIM점수가 상승하였으나 그 이후 감소되는 양상을 보였고 본 연구에서는 친단 후 경과 기간이 35.5개월 (87.2점)로 퇴원 후 3년 된 시점의 결과no도4점) 와 비교하였을 때 낮은 편이었다〈 Leonard, Mnler, Griffiths, Mcclatchie, & wherry, 1998) . 이러한 결과는 지역사 회와 집에서 간호를 받고 있는 뇌졸중 환자들에게 지속적인 재활 프로그램의 필요성이 높다는 것을 시사 한다고 볼 수 있다. 그러므로 입원을 한 직후부티 환 자에게 적절한 재활프로그램을 계획하여 시작하고 퇴원 후에는 연계되어 재활을 받을 수 있는 시설과 연결하여 환자가 지속적으로 재활을 할 수 있도록 돕는 병원과 지역사회가 공동으로 개발하고 시행하는 개활프로그램이 필요하다. 우울은 뇌졸중을 진단 받은 환자들의 급성기와 회 복기에 많이 동반되는 증상으로 본 연구에서도 CES- D를 이용하여 우울을 측정한 결과 23. 8점으로 Bak (2003) 의 연구와 비슷한 정도로 높게 측정되어 이 전의 연구결과와 같이 뇌졸중 환자의 가장 흔한 후유 증이 우울임을 다시 확인할 수 있었다 (Cho et al. 2003, `` Chon & Rhee, 1992, `` Kim, 2005, `` Kim, Seo, & Kang, 2000; singh et al. , 2000) . 그러므로 입원 시부터 신체적인 증상 뿐 아니라 우울도 같이 사정하고 우울이 진행되지 않도록 지속적인 관찰과 정서적인 간호가 뇌졸중 환자를 위한 재활프로그램에 포함이 되어야 한다. 삶의 질은 3 ``03점으로 뇌졸중 환자 l이명을 대상으로 한 chung (2000) 의 연구에서 의 3. 41점보다는 낮았으나 Kim과 Kim (2003) 의 연구의 3. 17점과는 비슷하였고 전체적으로 낮은 편이었다. 이런 결과는 최근 의학기술의 발전으로 뇌졸중으로 인한 사망률이 감소 되고 만성적인 뇌졸중 환자가 증가함에도 불구하고 재가뇌졸중 환자들에 대한 재활과 관리가 효과적으로 이루어지지 않고 있음으로 확인할 수 있었다. 따라서 뇌졸중과 삶의 질은 단기간에 향상되는 것이 아니므로 개활 프로그램이 단기적인 것보다는 체계적으로 계획되고 지속적으로 수행되어져 삶의 질을 관찰하는 연구가 필요할 것으로 생각된다. 또한 일상생활 동작을 잘 할수록 우울점수가 낮게 나타났고 삶의 질 정도가 높게 나타났다. 그리고 우 울 정도가 심할수록 삶의 질 정도가 낮은 것으로 나타났다. 뇌졸중 환자들에 대한 선행연구결과들을 살 펴보면 뇌졸중은 일상생활동작 수행과 같은 신체적인 문제, 우울, 대인관계 감소 등의 사회적 문제가 발생 되고 장기적인 치료와 간호를 요구하는 질병으로서 최종적으로. 삶의 질이 저하되는 것을 보고하고 있다 (Chung, 2000; Hama et al. , 2007, `` Ingrid, Kwakkel, Bruin, & Lindeman, 2007; Khan, 2004; Kim & Kim, 2003; singh et al. , 2007) . 이러한 연구 결과는 일상생활동작, 우울, 삶의 질이 단계적으로 순환되는 관계로 서 모두 뇌졸중환자를 위한 재활프로그램 내용에 포함되어야 함을 의미한다. 이런 연구결과들을 종합하여 볼 때 뇌졸중은 환자 의 뇌손상을 일으켜 장기적인 우울과 신체적인 기능 장애를 발생시킬 가능성이 높으므로 뇌졸중 환자의 재활프로그램은 입원을 하자마자 계획하여 치료와 동 시에 시작하고 특히 우울은 뇌졸중의 만성적인 건강 문제로 재활과정을 방해할 수 있으므로 신체적인 중 재와 더불어 정서적인 중재를 포함한 포괄적인 내용 의 프로그램이 바람직하고 장기적으로 삶의 질을 평 가함이 바랑직할 것이다. 또한 뇌졸중은 장기적인 재 활이 요구되는 질환이므로 단기간의 재활 프로그램을 병원에서만 시행하는 것이 아니라 퇴원 후 병원과 지 역 사회에서 연계하여 치료적인 연속성을 가지고 유지 할 수 있는 재활 프로그램의 개발이 반드시 필요할 것이 라고 본다. Introduction: The purpose of this study was to examine relationships among stroke patients`` activities of daily living(ADL), depression, and quality of life(QOL). Methods: Data were collected by questionnaires from 251 stroke patients at 5 hospitals and 2 public health centers in Seoul and Kyonggi-Do. The following Questionnaires were utilized for this study: Functional independence measure(FIM) from Grange, Hamilton, and Sherwin(1986), the Korean CES-D scale from Randloff(1977), and quality of life scale from Bang, Hwal-Lan(1991). Results: Data were analyzed using the pearson correlation, t-test, and ANOVA with SPSS/WIN 12.0. The results of this study were as follow; The subjects consisted of 110 females and 141 males. The mean score of activity of daily living was 87.2(range 18-126). Age, family history, comorbidity, paralysis site, and duration after diagnosis were significantly associated with activity of daily living. The mean score of depression was 23.8(range 11-44). Age, gender, education, and job were significantly associated with depression. The mean score of quality of life scale was 3.0(range 1-5). Gender, religion, education, job, economic status, and duration after diagnosis were significantly associated with quality of life. Relationships among activity daily living, depression, and quality of life scale: The activity of daily living had a negative relationship with depression score. The activity of daily living had a positive relationship with QOL score. The depression had a negative relationship with QOL score. Conclusion: Based on these results, it is necessary to run rehabilitation programs to improve stroke patients`` ADL, depression. Also, it research for of identifying stroke patients`` quality of life according to rehabilitation program.

국내 경북지역 소에서 분리된 브루셀라 분리주의 생물학적 특성

김정화,임정주,김동혁,이진주,김대근,전무형,김상훈,장홍희,이후장,민원기,김석,Kim, Jeong-Hwa,Lim, Jeong Ju,Kim, Dong Hyeok,Lee, Jin Ju,Kim, Dae Geun,Jun, Moo-Hyung,Kim, Sang Hun,Chang, Hong Hee,Lee, Hu Jang,Min, Won-Gi,Kim, Suk 대한수의학회 2010 大韓獸醫學會誌 Vol.50 No.2

Members of the genus Brucella are facultative intracellular bacteria and cause brucellosis, a chronic disease in humans and abortion in animals. In this study, we tested sera for brucellosis of 15 Hanwoo farms in the western part of Gyeong-buk province, resulting 5 farms were brucellosis positive in 2008. We collected blood from 277 heads in the brucellosis positive 5 farms, and performed serological diagnosis, brucella positive cattle which had shown higher than 200 antibody titer in tube agglutination test were slaughtered, supramammary lymph nodes were collected, and Brucella spp. wild type isolation and identification were performed. From these results, 15 of Brucella spp. wild type strains were isolated and all strains were identified as B. abortus biotype 1 by biological and molecular analysis. In the antimicrobial susceptibility test, all 15 strains had a similar susceptibility and resistance pattern. This study may be useful for bacteriological and epidemiological understanding of cattle brucellosis in Korea.

〈교녀가〉연구

김정화(Kim, Jeong-Hwa) 한국어문학회 2014 語文學 Vol.0 No.125

〈Gyonyoga〉 is a kind of genyoga, which was written by father for daughters who lost their mother early. The author is conjectured to be Lee Jungen who also wrote 〈Bukgeongga〉. This is the first study on 〈Gyonyoga〉. There are 4 editions of 〈Gyonyoga〉 among which 〈Gyonyoga〉 possessed by Yangju Song is the complete work. 〈Gyonyoga〉 contained various contents focusing alert about wrong doing and discipline about well doing as two pillars. It warns wrong doing, and behavior focusing on Genyoga item. In well doing, it is based on theory of Taeguk, the basic of Confucianism explaining the origin of all things in the universe. And, as for behavior of women, it focused on sewing and spinning and the proprieties of food. While 〈Gyonyoga〉is a full-length work, it has outstanding structural unification overall. 〈Gyonyoga〉 not only deals with the warning against evil and admonition for good behavior as the broad structure, but also have structural density shown in ‘sewing and spinning songs’, which demonstrated the characteristics of male writer pursuing organized writing from the first. And ‘sewing and spinning songs’ in 〈Gyonyoga〉 connected to the recommendation on the mind of women. Father as the author of 〈Gyonyoga〉 regarded the mind ruling important based on the Confucian view of the world precedent to the importance of behavior. While it is positive to explain difficult issues easily for the understanding of daughters, it stresses the didactic purpose too much, which could be a limit of literature for women. Meanwhile, ‘Bettle song as a folk song is a work song composed by women. Accordingly, it contains emotion and suffering of women’s life. But, ‘Bettle song’ in 〈Gyonyoga〉 was composed by a man. Accordingly, emotion and suffering of women’s life was not the subject of consideration to the author of 〈Gyonyoga〉. Narrativity of ‘Bettle song’ is also closely related to the fact that it is song of women. Narrative story itself stirs curiosity of women, and women can be comforted regardless of its reality. To the contrary, ‘Bettle song’ in 〈Gyonyoga〉 completely excluded narrative story and did not include any emotional expression on the life of women. That is because ‘Bettle song’ was used for the didactic purpose from the perspective of male as a part of 〈Gyonyoga〉 regardless of the authorship of the song.

청간소요산으로 호전된 설통 환자 3례

김연진,양승보,김정화,이상화,조승연,박성욱,박정미,고창남,Kim, Yeon-jin,Yang, Seung-bo,Kim, Jeong-hwa,Lee, Sang-hwa,Cho, Seung-yeon,Park, Seong-uk,Park, Jung-mi,Ko, Chang-nam 대한한방내과학회 2017 大韓韓方內科學會誌 Vol.38 No.4

Objectives: This clinical study reports the effects of Cheonggansoyo-san (CSS) on three patients with glossodynia. Methods: Three patients with glossodynia were treated with CSS (i.e., an herbal medicine) and acupuncture. Numeric rating scales (NRSs) for glossodynia and dry mouth and hwa-byung questionnaire scores were evaluated, and the results from heart rate variability (HRV) evaluations were analyzed. Results: After treatment with CSS, three patients' glossodynia symptoms, such as burning sensations, tingling, and numbness of the tongue, were improved. NRS ratings for glossodynia and dry mouth and the hwa-byung questionnaire scores also improved, and HRV parameters were closer to the normal range. Conclusion: Cheonggansoyo-san could be used to treat glossodynia.

가미귀비탕을 포함한 한방치료로 회상기억이 향상된 뇌졸중 후 인지저하 환자 2례

김정화,이형민,신희연,김하리,양승보,조승연,박성욱,고창남,박정미,Kim, Jeong-Hwa,Lee, Hyeong-min,Shin, Hee-yeon,Kim, Hari,Yang, Seung-Bo,Cho, Seung-Yeon,Park, Seong-Uk,Ko, Chang-Nam,Park, Jung-Mi 대한중풍순환신경학회 2018 대한중풍.순환신경학회지 Vol.19 No.1

■ Objectives This case study is to report the two cases of Gami-Guibitang on cognitive impairment after stroke with improved recall memory. ■ Methods We used Korean medicine treatments including Gami-guibitang, acupuncture and moxibustion to treat patients who had cognitive impairment after stroke for at least two months. We observed the changes of symptoms by measuring Korean version of Mini-mental status examination (MMSE-K), Clinical Dementia Rating (CDR) and Global Detration Scale (GDS). ■ Results After treatment, the patient's symptoms were improved including MMSE-K, CDR and GDS. Improvement appeared to be prominent in recall memory. The general condition were also improved after treatment. ■ Conclusion This clinical case study suggests that Korean medicine including Gami-guibitang could be used to treat patients who had cognitive impairment after stroke especially suffering from degraded recall memory.

한국형 모빌리티 매니지먼트의 교통수단전환 영향분석

김정화,김숙희,류인곤,최기주,Kim, Jeong-Hwa,Kim, Suk-Hui,Ryu, In-Gon,Choe, Gi-Ju 대한교통학회 2015 교통 기술과 정책 Vol.12 No.3

반고형제제의 유동특성에 관한 연구 ( 제1보 ) : 치약의 정상전단 유동거동

김정화,송기원,이장우,이치호 ( Jeong Hwa Kim,Ki Won Song,Jang Oo Lee,Chi Ho Lee ) 한국약제학회 1995 Journal of Pharmaceutical Investigation Vol.25 No.3

The steady shear flow properties of six kinds of commercial toothpastes were measured using a concentric cylinder type rheometer. In this paper, the shear rate and temperature dependencies of their flow behavior were investigated and the validity of the Casson and Herschel-Bulkley models was examined. Further, the flow properties over a wide temperature range were quantitatively evaluated by calculating the various material parameters. Main results obtained from this study can be summarized as follows: (1) Toothpastes are plastic fluids with a yield stress and their flow behavior shows shear-thinning characteristics. (2) With increasing temperature, the degree of shear-thinning becomes weaker and the Newtonian flow behavior occurs at a lower shear rate range. (3) The Herschel-Bulkley model is more effective than the Casson model in predicting their flow behavior. (4) As the temperature increases, the yield stress, plastic viscosity and consistency index become smaller, on the contrary, the flow behavior index becomes larger.

PU-나노 웹과 필름 처리한 투습방수 자카드 직물의 성능

김정화,이정순,Kim, Jeong-Hwa,Lee, Jung-Soon 한국섬유공학회 2014 한국섬유공학회지 Vol.51 No.6

The aim of this study was to measure the functional properties of a nanofiber web laminate, microporous film laminate, and nonporous coating fabric and then compare their performances as a breathable waterproof fabric. We focused on the performance of the nanofiber web laminate as a breathable waterproof fabric. A PU nanofiber web was prepared by electrospinning. The measured functional properties included the water vapor permeability, air permeability, waterproofness, adhesive strength, and water vapor resistance, as well as the property of a warm/cool feeling. The measurement results showed that the nanofiber web laminate fabric provided excellent moisture permeability as well as sufficient waterproofness and water vapor resistance in comparison to the microporous film laminate and nonporous coating fabric. We concluded that the performance of the nanofiber web laminate is sufficient for use as cloth in outdoor wear if an optimum electrospinning and lamination process is used in its production.

새로운 직파재배기술 "무논골점파"

김정화,Kim, Jeong-Hwa 전국농업기술자협회 2008 농업기술회보 Vol.45 No.3

무논골점파 재배기술은 초기생육이 우수하고, 잡초성 벼 발생을 방지할 수 있으며, 특히 기계이앙과 비교하여 수량과 품질의 차이가 없는 새로운 직파재배기술이다.

뇌혈관질환의 재활간호

김정화,Kim, Jeong-Hwa 한국산업간호협회 2006 한국산업간호협회지 Vol.13 No.4