심한 혈소판 감소증을 동반한 복합 교원성 질환 1예

두은영,주영빈,엄완식 대한내과학회 2011 대한내과학회 추계학술대회 Vol.2011 No.-

대장 외에 다발성 종양이 발생한 가족성샘종폴립증 1예

두은영,김동찬,정혜미,윤준식,김정은,최경수,최호순 대한내과학회 2013 대한내과학회지 Vol.84 No.4

Most patients with familial adenomatous polyposis (FAP) undergo prophylactic colectomy. As a result, extracolonic manifestations including benign and malignant tumors are more common in patients with FAP, and duodenal cancer is now the main cause of death. However, duodenal adenomas and carcinomas are detected less frequently in Korea and Japan than in Western countries, and gastric cancer is more prevalent than in Western countries. In the present case, a 63-year-old man, who had undergone a total colectomy and an ileostomy 14 years previously, presented at our outpatient clinic complaining of discomfort at the ileostomy site. The patient had adenomas in the gallbladder and ileum, and adenocarcinomas in the duodenum and stomach. The interval between development of duodenal cancer and stomach cancer was only 4 months. Therefore, we suggest that more frequent endoscopic surveillance may be needed for these cases. 저자들은 가족성샘종폴립증 환자가 대장 외 증상으로 회장과 담낭에 용종이 있었고, 짧은 간격의 추적 상부위장관내시경 검사를 시행했음에도 불구하고 십이지장 유두부 선암종과 위의 바닥샘종과 연관된 위 선암종이 발생한 증례를 경험하였다. 과거와 비교하여 가족성샘종폴립증 환자들이 선암종이 발생하기 전에 예방적으로 대장 절제술을 받는 경우가 증가하면서 대장 외 증상으로 인한 사망률이 점차 증가하고 있다. 내시경과 초음파를 이용한 주기적인 추적검사가 필요할 것으로 생각한다.

New Nurses' Work Adaptation Experience

두은영,서형은,김미영 기본간호학회 2022 기본간호학회지 Vol.29 No.1

Purpose: This study aimed to explore the work adaptation experiences of new nurses who underwent stress whiletransitioning into the workforce. Methods: In-depth semi-structured group and individual interviews wereconducted with 18 nurses working at a general hospital from December 2018 to February 2019. Colaizzi’sphenomenological approach was followed for the data analysis. Results: Four clusters of themes were drawn frommeaningful data regarding the nurses’ adaptation experience: “Weakened mind and body”, “Reaching one’smental and physical limits”, “Fighting back against work stress”, and “Assuming the role of a nurse”. The newnurses were the most stressed during the three to six months following independence from the preceptor, andafter seven months on the job, they experienced some resolution by adapting to human relationships with theircolleagues. Conclusions: This study suggests a broad and longer perspective to which new nurses need to adapt,both at work and in human relationships, to overcome their difficulties.

간호사가 지각하는 내부마케팅활동 정도가 간호사의 이직의도, 간호업무수행 및 간호업무생산성에 미치는 영향

두은영,임지영,서문경애,김인아 대한간호행정학회 2005 간호행정학회지 Vol.11 No.1

The purpose was to analyze the effects of internal marketing activity factors on nurse's turnover intention, nursing task performance and nursing productivity. Methods: The subjects were 355 nurses who were working at the 3 universities hospital over 1 year. The instruments were used of internal marketing activity factors(Lee, 2001), turnover intension(Lee, 1995), nursing task performance(Park, 1988) and nursing productivity(McNeese-Smith, 1996). Results: The mean score of internal marketing activity factors was 2.79, education and training 2.97, individualization 2.93, communication 2.87, promotion 2.76, work environment 2.63, reward system 2.62, and management vision for employee 2.61. The turnover intention was 3.12, nursing task performance 3.49, and nursing productivity 3.38. The internal marketing activity factors were negatively correlated with turnover intention(r=-0.37, p<0.0001), and positively correlated with nursing task performance(r=0.29, p<0.0001) and nursing productivity(r=0.30, p<0.0001). The key predictor of turnover intension was reward system, education and training, communication, and salary. They explained 35.0% of the total variance. In nursing task performance, communication, management vision for employee, salary and unit explained 26.0% of the total variance. In nursing productivity, communication, reward, education and training, salary, and position explained 24.0%. Conclusions: To increase nurse's nursing task performance and nursing productivity and to decrease turnover intention, it is necessary to concentrate on improving communication and reward system in the internal marketing activity factors. Through these activities, the effectiveness of internal marketing strategies will be enhanced and finally, nursing organizational outcome will be increased.

심한 혈소판 감소증을 동반한 복합 교원성 질환 1예

두은영,주영빈,엄완식 대한내과학회 2011 대한내과학회 추계학술대회 Vol.2011 No.1

서론: 복합 교원성 질환에서는 전신성 홍반성 루프스와는 달리 항인지질 항체가 양성이더라도 항인지질항체 증후군이 동반되는 경우가 드물다. 그리고 복합 교원성 질환에서 나타나는 혈소판 감소증은 대부분 경미한 것으로 알려져 있다. 이에 저자들은 복합 교원성 질환에서 항인 지질항체가 양성을 보이면서 심한 혈소판 감소증이 동반되었던 1예를 경험하였기에 보고하는 바이다. 증례: 68세 여자. 2년 전부터 레이노 증후군, 구강 및 안구건조증으로 타원에서 스테로이드, pilocarpine을 복용중이었다. 최근 멍이 쉽게 드는 증상을 주소로 내원하였다. 흉부 진찰에서 양측 하엽에서 수포음이 들렸다. 근골격계 진찰에서 양측 손끝이 부어 있었다. 말초혈액검사에서 백혈구 2,500/mm3, 혈색소 11.6g/dL, 혈소판 11,000/mm3이었다. 면역학적 검사에서 항핵항체 양성(>2,560, speckled pattern), 항 SnRNP 항체 양성이었고, 항 dsDNA 항 체, 항 Sm 항체, 항 Ro 항체, 항 La 항체, 항 Scl-70 항체, 항 Jo-1 항체는 음성이었다. 류마티스인자는 28 IU, 항 CCP 항체는 음성이었다. C3 93.7 mg/dL, C4 9.0 mg/dL로 정상 범위 안에 있었다. 항인지질항체 중 루푸스 항응고인자 양성, 항카디오리핀 항체 중 Ig M 항체가 20 MPL(참고치: 0~7 MPL)으로 양성, Ig G 항체는 음성이었으며 항 β2-glycoprotein 1 항체 중 Ig M 항체가 양성으로 역가는 55.5 Unit (참고치: 0~20 Unit), Ig G 항체는 음성으로나왔다. 감염의 증거는 없었다. 골수천자생검에서 혈소판은 감소되어 있었으나 거대핵세포의 수는 정상이 었다. 폐기능 검사에서 DLCO는 66.3%로 감소되어 있었고흉부방사선검사 및 전산화단층촬영에서 간질성 폐질환이 관찰되었다. 골수천자 시행 당일 혈소판은 10,000/mm3로 출혈 예방 위해 혈소판을 수혈하였고, 골수천자생검 시행 후 methylpredisolone 125 mg을 정맥주사하였다. 그 다음날부터 prednisolone 1 mg/kg, cyclosporine 3 mg/kg를 경구 투여하였다. 이후 혈소판 감소증은 호전 중이며 외래에서 추적 관찰 중이 다. 고찰: 본 증례는 Kasukawa criteria에 따라 복합 교원성 질환을 진단하였으며, 항인지질항체 양성을 보이는 심한 혈소판감소증을 면역억제 제로 성공적으로 치료한 예이다. 본 증례는 항인지질항체와 혈소판 감소증의 상호관계를 확인하기 위해 항인지질항체 역가의 추적이 필요하며, 전신성 홍반성 루푸스가 발생하는지 추적 관찰이 필요하다. 복합 교원성 질환에서도 심한 혈소판 감소증이 생길 수 있고 항인지질항체와 의 관련성이 보고되고 있으므로 이를 인지하고 적극적인 면역억제제 치료가 필요하다고 생각되어 본 증례를 보고하는 바이다.

간호조직에서의 억압에 대한 개념분석

두은영(Eun Young Doo),최수진(Sujin Choi) 한국콘텐츠학회 2021 한국콘텐츠학회논문지 Vol.21 No.4

본 연구의 목적은 간호조직에서의 억압에 대한 개념의 속성을 파악함으로써 억압에서 벗어나기 위한 교육개발에 기초자료를 제공하고자 함이다. 간호조직에서의 억압에 대한 속성, 선행요인, 결과요인을 밝히고자 Walker와 Avant의 방법을 이용하였고 2006년부터 2020년까지 발표된 국내 및 국외 선행연구 최종 17편을 선정하여 분석에 이용하였다. 개념의 속성은 낮은 자아존중감, 권한의 부족, 수평적 폭력이었다. 선행요인은 억압자, 위계적인 조직구조, 주변화이었으며, 결과는 직무만족도, 조직침묵, 환자안전 및 간호의 질로 나타났다. 연구 결과를 고려해보면, 간호조직 내의 억압을 벗어나기 위해서 간호사는 병원의 위계적인 근무환경 개선과 전문 간호사로서의 자기 인식이 중요하다. 따라서 간호사의 근무환경과 자기인식을 개선하기 위한 효과적인 교육 프로그램 개발이 필요하다. This study was to identify the concept of oppression in nursing organization thereby providing basic data on nursing education to improve oppression in nursing organization. Using Walker and Avant’s criteria to identify attributes, antecedents, and consequences of oppression in nursing organization, 17 research articles published from 2006 to 2020 were reviewed. The defining attributes of oppression in nursing identified in this study were low self-esteem, lack of authority, and horizontal violence. The antecedents to oppression in nursing organization were oppressors, hierarchical organizational structure, and marginalization. The consequences of oppression in nursing organization included job satisfaction, organizational silence, patient safety and quality of nursing. Considering the findings, improvement of the hierarchical working environment in hospitals and self-awareness as professional nurses are important for nurses to overcome oppression in nursing organization. Therefore, effective educational programs should be developed to ameliorate working environment and self-awareness of nurses.

일 종합병원 신규간호사의 예술치료 프로그램 효과

두은영(Doo, Eun-Young),서형은(Seo, Hyung-Eun),최수진(Choi, Sujin),장보경(Chang, Bo-Kyung),김미영(Kim, Miyoung) 한국간호행정학회 2018 간호행정학회지 Vol.24 No.2

Purpose: This study was done to evaluate the effects of group art and music therapy on decreasing job stress and increasing resilience of newly hired nurses. Methods: A mixed method design was used. Quantitative data (N=35) were collected through questionnaires from November 2 to December, 5, 2016 and were analyzed using a one-tailed paired t-test by SPSS/WIN 22.0 program. Qualitative data (N=18) were collected through group and individual interviews from November 10, 2016 to February 3, 2017 and were analyzed using a qualitative thematic analysis. Results: The first hypothesis “participants will have lower job stress after the art and music therapy” was not statistically supported (t=-1.12, p=.270). The second hypothesis, “participants will have higher resilience after the art and music therapy” was supported (t=-2.13, p=.041). Four main themes were derived from the interviews: ‘looking into myself’, ‘feeling a camaraderie’, ‘healing of my mind and body’, ‘change in the intimidated self,’ Conclusion: The findings indicate that art and music therapy for newly hired nurses may positively influence resilience. Hospital organizations should utilize the therapy for newly hired nurses to improve their resilience so that they can realize their own values and increase positive emotion despite job stress.

기혼직장여성의 부부특성, 근로특성, 건강특성이 건강 관련 삶의 질에 미치는 영향요인

두은영(Eun-Young Doo),송혜영(Hye-Young Song),정명숙(Myung-Sook Jung) 한국콘텐츠학회 2022 한국콘텐츠학회논문지 Vol.22 No.9

본 연구는 기혼직장여성의 일반적 특성, 부부특성, 근로특성 및 건강특성이 건강관련 삶의 질에 미치는 영향을 파악하기 위하여 여성가족패널조사(KLoWF)자료를 활용하여 2차 분석을 수행한 서술적 조사연구이다. 본 연구는 7차년도(2017- 2018)조사에 참여한 기혼직장여성 총 2,060명을 대상으로 SPSS 25.0를 활용하여 분석하였다. 기혼직장여성의 일반적 특성, 부부특성, 근로특성 및 건강특성을 모두 투입한 결과, 가족의 경제상태, 진단받은 질환 유무, 스트레스 인지가 기혼직장여성의 건강 관련 삶의 질에 영향을 미치는 요인으로 나타났다. 이러한 연구결과를 토대로 기혼직장여성의 건강관련 삶의 질을 높이기 위해서는 가족의 경제 상태와 건강특성이 중요하고 이를 강화해야 할 방안 마련이 필요하다. 따라서 기혼직장여성의 건강 관련 삶의 질을 향상시키기 위하여 기혼직장여성 개개인의 건강특성을 고려한 맞춤형 건강 증진 프로그램 및 경제적 안정을 위한 다양한 정부 지원정책을 마련해야 함을 제언한다. The study aims to determine the factors associated with married working women’s health-related quality of life (HRQOL) in terms of general, marital, work, and health characteristics. In view of this, data was gathered from a total of 2,060 married working women who participated in the 7th wave (2017-2018) of the Korean Longitudinal Survey of Women and Family (KLoWF), which was conducted by the Korean Women’s Development Institute. The data was analyzed using SPSS 25.0. As a result of inputting the general characteristics, marital characteristics, working characteristics, and health characteristics of married women, family’s economic status, diagnosed disease, perceived stress were found to have a significant effect on married working women’s HRQOL. Based on the study results, educational programs and various policies to help married working women better manage their family-work conflict were proposed as a means to improve their HRQOL. This study is significant as it identified a wide range of factors that affect married working women’s HRQOL and discussed health and welfare measures to improve it.

The Increased Level of Depression and Anxiety in Irritable Bowel Syndrome Patients Compared with Healthy Controls: Systematic Review and Meta-analysis

이창현,두은영,최지민,장승호,류한승,이주엽,오정환,박정호,김용성 대한소화기 기능성질환∙운동학회 2017 Journal of Neurogastroenterology and Motility (JNM Vol.23 No.3

Background/AimsIrritable bowel syndrome (IBS) patients commonly experience psychiatric disorders, such as depression and anxiety. This meta-analysis sought to compare depression and anxiety levels between IBS patients and healthy controls. MethodsWe searched major electronic databases (PubMed, EMBASE, MEDLINE, and Cochrane library) to find comparative studies on IBS patients and healthy controls. The primary outcome was a standardized mean difference (SMD) of anxiety and depression levels; sub-group analyses were conducted according to IBS-subtypes. ResultsIn total, 2293 IBS patients and 4951 healthy controls from 27 studies were included. In random effect analysis, depression and anxiety levels were significantly higher in IBS patients (pooled SMD = 0.76; 95% CI, 0.62–0.90; P < 0.001; I2 = 77.2% and pooled SMD = 0.84; 95% CI, 0.67–1.01; P < 0.001; I2 = 85.6%, respectively). Both analyses’ funnel plots showed symmetry. In meta-regression analysis, heterogeneity was due to the studied region and questionnaire type for both depression and anxiety. In sub-group analyses of IBS-subtype, the pooled SMDs of depression and anxiety levels (IBS with predominant constipation: 0.83 and 0.81, IBS with predominant diarrhea: 0.73 and 0.65, and IBS with mixed bowel habits: 0.62 and 0.75; P < 0.001, respectively) were significantly higher in all IBS-subtypes. ConclusionsThe present meta-analysis showed depression and anxiety levels to be higher in IBS patients than in healthy controls, regardless of IBS-subtype. However, the gender effect on psychological factors among IBS patients could not be determined and should be evaluated in prospective studies.

내분비-대사 : 수술 이후 간질양 발작과 실신을 보인 뇌하수체 전엽 기능저하증 환자 (초)

박지훈,두은영,홍상모,박용수,김동선,최웅환,김태화,안유헌 대한내과학회 2010 대한내과학회 추계학술대회 Vol.2010 No.-