치매의 행동심리증상관리를 위한 웹기반 요양보호사 교육 프로그램 개발 및 효과

송준아,김효진,김유경,박재원 한국노인간호학회 2013 노인간호학회지 Vol.15 No.3

Purpose: The purpose of this study was to develop and evaluate a web-based education program designed for nursing home caregivers to improve their management of behavioral and psychological symptoms of dementia (WebEd-BPSD) exhibited by residents. Methods: Four sessions of WebEd-BPSD were developed and operated through a web server for 4 weeks. Caregivers who had worked for more than one month in the study nursing homes (N=6) were randomly assigned to either the experimental (N=37) or control group (N=30). Pre and posttests were performed for both groups to assess participants’ knowledge, self-efficacy, and perceived problem solving abilities regarding BPSD management. Only the experimental group was evaluated for program satisfaction. The data were analyzed using descriptive statistics, χ2-test, t-test, paired t-test. Results: The WebEd-BPSD was effective in increasing participants’ knowledge about BPSD management (t=2.87, p=.006) and self-confidence about problem solving (t=-2.08, p=.045), though not for self-efficacy or overall perceived problem solving abilities. Participants’ overall satisfaction with the WebEd-BPSD was generally high. Conclusion: The results indicate that the WebEd-BPSD is useful for improving nursing home caregivers' knowledge and perceived ability in BPSD management. However, replication studies with larger random samples are necessary to confirm the findings obtained from this study.

치매의 행동심리증상이 요양시설 간호제공자의 부담감에 미치는 영향

송준아,박재원,김효진 노인간호학회 2013 노인간호학회지 Vol.15 No.1

Purpose: The purpose of this study was to identify the impact of behavioral and psychological symptoms of dementia (BPSD) on the burden of caregivers in nursing homes (NHs). Methods: The sample consisted of 145 dyads of persons with dementia (PWDs) (mean age=83.34±7.11; women 80.69%) and their caregivers (mean age=50.69±8.97; women 97.93%) conveniently selected from six NHs (≥50 beds). PWDs were evaluated using the Korean Mini-Mental Status Exam, Physical Activities of Daily Living, and Korean Cohen-Mansfield Agitation Inventory; and their demographic information was obtained by a chart review. Caregivers were asked to complete the Professional Caregiver Burden Scale and a questionnaire asking general characteristics. Data were analyzed using Pearson correlations, t-tests, ANOVAs, and hierarchical multiple regression analyses. Results: Multiple regression analyses revealed that caregivers’ age (β=-.27, p= .001), PWD’s length of stay in the facility (β=-.23, p= .006) and BPSD (β=.31, p<.001) significantly predicted caregiver burden (F=4.55, p<.001; adjusted R2=.18); and that BPSD was the strongest factor, independently adding 9% to total variance explanation power of the model. Conclusion: Replication studies using large random sample are necessary to confirm the findings of this study.

요양시설 치매노인의 배회행동

송준아,임영미,손귀령 한국간호과학회 2008 Journal of Korean Academy of Nursing Vol.38 No.1

Purpose: This study investigated various factors relatied to wandering behavior of Korean elders with dementia (KED). Methods: A sample of 160 ambulatory residents with dementia from 14 long term care facilities was used to examine demographic, individual, cognitive, physical health, and environmental characteristics by comparing wanderers (N=108) to nonwanders (N=52). Subjects were evaluated by Korean versions of the Mini-mental State Exam (K-MMSE), the Physical and Instrumental Activities of Daily Living (K-PIADL), and the Revised Algase Wandering Scale Nursing Home version (KRAWS-NH) along its six dimensions. Demographic and environmental data were also obtained. Independent sample ttests, Chi-square test, Fisher’ Exact tests, and ANCOVAs were used to examine differences between wanderers and nonwanders. Results: Wanderers were significantly (p

치매노인 정신행동증상 관리에 대한 노인요양시설

송준아,김유경,김효진 노인간호학회 2012 노인간호학회지 Vol.14 No.3

Purpose: The purpose of this study was to evaluate the need for education on behavioral and psychological symptoms of dementia (BPSD) for certified nursing caregivers (CNCs) in nursing homes (NHs). Methods: A convenience sample of 134 CNCs (mean age=53.63±6.44; Female 97.8%) working for more than one month in NHs (N=6) located in Seoul City or Kyoungi Province was recruited. Participants were asked to complete a questionnaire about the necessity and the importance of education about BPSD on a scale of 1 (never) to 5 (very much). Results: Highest scores for the necessity and the importance of education were for understanding of BPSD (mean score=4.38±.54, 4.35±.53, respectively) followed by understanding dementia and general management approaches for BPSD. The most necessary and important BPSDs identified for education were aggression and depression. The degree of necessity and importance of education differed significantly (p<.10) according to frequency of CNCs’ participation in education programs on dementia. Conclusion: Findings of this study provide a useful basis as to which areas of education would be helpful for CNCs working in NHs. Development of educational programs with various educational methods targeted to satisfy the educational needs identified in this study would be valuable.

노인전문요양시설과 노인요양시설 치매노인의 환경적 특성과 배회 비교

송준아,임영미 노인간호학회 2009 노인간호학회지 Vol.11 No.1

Purpose: This study was done to compare wandering behavior of persons with dementia (PWDs) living in skilled (SNF) and general (GNF) nursing facilities. Methods: Ambulatory residents (N=160) with dementia were recruited from 6 SNF and 8 GNF and evaluated using the Korean Mini-Mental State Exam (K-MMSE), Korean Physical and Instrumental Activities of Daily Living (K-PIADL)and the Revised Algase Wandering Scale Nursing Home version (KRAWS- NH). Demographic and environmental data were obtained from a chart review. Chi-square tests, independent sample t-tests, and Mann-Whitney U tests were used to compare characteristics of residents, environment, and wandering behavior between SNF and GNF residents. Results: Except for use of antipsychotic drugs, there were no differences in demographic, cognitive, or physical characteristics between residents of SNF and GNF. For environmental characteristics, there were significant differences between residents of SNF and GNF for type and color of resident's room and living room, total number of residents and nurses in the facility, and total number of residents in a room. Overall and for six subscales of KRAWS-NH, higher scores were found for residents of GNF. Conclusions: Findings indicate a need to plan and establish nursing facilities that are eco-friendly to PWDs, especially those who exhibit wandering behavior.

요양시설 치매노인의 배회 관리를 위한 시설기반 그룹 걷기 프로그램의 효과: 예비연구

송준아,박재원 노인간호학회 2011 노인간호학회지 Vol.13 No.1

Purpose: The purpose of this study was to do a preliminary examination of effects of an Institution-based Group Walking Program (IGWP) on affect and depression, wandering and other behavioral and psychological symptoms of dementia (BPSD), and sleep in persons with dementia (PWDs) who wander. Methods: This study used an A (baseline measure)- B (treatment condition)- A (baseline measure)- B (treatment condition) single case research design (n=10). Participants (mean MMSE=11.11±7.56; mean age=81±6.27) were encouraged to walk in a group along the pre-planned path every evening after supper for 30 minutes from Monday to Friday. Data were collected for four weeks: every day for affect and sleep; every week for wandering, BPSD, and depression. Using repeated measure ANOVA, within-subject effects and within-subject contrasts were evaluated. Results: Within-subject effect was found on wanderer's affect (F=12.73, p =.001), depression (F=5.26, p =.005), neuropsychiatric symptoms (F=5.87, p =.016), hours of sleep (F=3.99, p =.018), sleep efficiency (F=3.99, p =.018), and frequency of wake-ups during sleep (F=5.05, p =.007). Conclusion: Results of this study imply that a regular group walking program may be beneficial for improving affect, mood, and night time behavior of wanderers. Further studies with larger samples and longitudinal design are necessary to confirm the findings obtained in this study.

대중잡지『불꽃(Огонёк)』에 나타난 소비에트 병사 이미지의 정치적 함의, 1944-1953

송준서(Song Joon Seo) 한국노어노문학회 2009 노어노문학 Vol.21 No.3

본 연구는 전후 스탈린 정권이 예술을 통해 어떻게 인민들의 전쟁에 대한 기억을 통제하고 조종하려 했는지를 소련의 대표적 대중잡지『불꽃』에 실린 소비에트 병사 이미지와 그에 담긴 정치, 사회적 의미의 분석을 통해 밝히고자 하였다. 제2차 세계대전 직후 스탈린 정권은 전쟁동안 엄청난 인적, 물적 희생을 당하고 육체적, 정신적 고통을 겪은 소련 인민들의 전쟁 기억을 정권에 유리한 방향으로 재구성하기 위해 노력하였다. 스탈린 정권이 두려워했던 것은 인민들이 전쟁의 아픔을 되새기면서 전쟁 초기 나치 독일의 공세에 적절한 대응을 하지 못했던 정부를 비난하게 되는 것이었다. 또한 스탈린은 전쟁의 승리가 인민들의 영웅적이고 희생적인 헌신보다는 자신의 뛰어난 지도력의 결과로 인식되기를 바랐다. 1946년 중반을 기점으로『불꽃』지에서 병사의 영웅적인 모습, 부상당한 모습이 평온하고 낙관적이며, 스탈린에 종속된 병사의 이미지로 대체된 것은 스탈린 지도부의 전쟁 기억 재구성 의도가 반영된 결과인 것이었다. After World War II, the images of Soviet soldiers presented in Ogonek, a Soviet popular magazine, began to change. During the war and immediately after, that is, up to the mid 1946 soldiers were frequently portrayed as heroic warriors in intense battlefields, or liberators who saved Soviet citizens from German occupation. At the same time, the hardship of the soldiers during the war was to be expressed in the magazine. Ogonek presented paintings portraying wounded war heroes. However, the images of the soldiers as war heroes, or as war victims gradually disappeared from the magazine from mid 1946 and replaced with those of soldiers with new images-i.e., peaceful, happy, humane new and warm images of soldiers who were loyal to Stalin. Examining the reason why those images of soldiers changed and what the political and social implications in the new images were, this article explores the ways that the Stalin leadership manipulated the popular memories of the war. Because Stalin wanted to be the only postwar hero after the war, he attempted to play down the status of war heroes. In addition, he did not want Soviet citizens to remember the tragic wartime episodes which could remind them of the Soviet government's mistake especially during the first stage of the war that caused a great loss of Soviet people. Reenforcement of socialist realism from the mid-1946 was another reason that the grime images of soldiers, such as those of wounded or dead soldiers, were to disappear in Ogonek. According to socialist realism, the hardship of the present day was not allowed to be presented; only a bright, conflict-free, optimistic future was to be presented.

토막상식 : 러시아의 국가원형, 키예프 루시의 기원에 대하여

송준서 한국외국어대학교 러시아연구소 2010 Russia & Russian Federation Vol.1 No.2

Psychosomatic disorders in childhood : A focus on asthmatic disorders

宋俊萬 이화여자대학교 한국문화연구원 1977 韓國文化硏究院 論叢 Vol.30 No.-

精神的인 요인이 身體的인 障碍로 나타나는 精神-身體 疾患은 Freud에 의하여 1895년에 보고된 후 많은 사람들의 관심을 불러 일으켰다. Freud 전에도 정신적인 요인 특히 정서적인 요인이 신체적인 것에 영향을 미친다는 것은 이미 알려져 있었으나 Freud눈 實例를 들어서 精神的인 것이 身體的인 것에 作用하여 疾病을 유발시킨다는 理論을 제시함으로써 이 분야에 대한 硏究가 활발해진 것이다. 美國 精神科 醫師協會에서도 精神-身體 疾患을 情緖的 요인 때문에 일어나는 身體的인 疾患이라 定義하고 있고 本 論文에 예거한 여러 定義도 가튼 立場을 취하고 있다. 미국 정신과 의사협회에서는 精身-身體 질환을 피부질환, 호흡기계통 질환, 소화기 계통 질환, 性· 배설기 계통 질환 등으로 구분하고 있다. 本 硏究에서는 호흡기 계통 질환인 어린이 喘息을 살펴보았다. Wisdom(1961)은 천식의 決定要因을 어떤 위협에 대한 心理的 防禦機制의 反應으로서 설명하고 있으며 그밖에도 性格, 家庭環境要因 등을 들고 있다. 喘息兒童들의 일반적인 特徵과 發生原因에 대한 네 가지의 假說的 理論, 즉 特定要因 假說, 精神分析學的假說, 生物 遺傳 轉換 假說, 條件化 假說 등을 고찰한 바 천식아동들의 특징과 발생 원인 연구에 있어서는 硏究方法의 미숙과 長期硏究의 必要性이 문제점으로 대두되고 있음을 알 수 있었다. 어린이 천식의 治療方法은 心理的 접근 방법, 진정제와 催眼 접근 방법, 環境的 操作 접근 방법, 個人 心理 治療, 集團 治療의 다섯 가지 치료 방법을 고찰하였다. 이상의 考察에서 다음과 같은 結論을 내릴 수 있었다. 現在 사용되고 있는 다양한 치료 방법은 主觀的인 기준에 의한 치료 성과에 그치고 있어 좀 더 客觀的인 연구가 必要하며 각각 치료 접근 방법의 效果를 비교 할 수 있는 연구 방법의 改善이 시급한 상태이다. 앞으로의 치료연구에 있어서는 심리치료와 알레르기 치료의 效果를 비교할 수 있는 방법론상의 개선과 환자(피시험자) 선택에 있어서도 愼重性이 고려되어야 할 것이다. 그 밖에도 치료효과에 대한 분명한 根據가 없어 대부분의 硏究가 方法論上의 문제점을 가지고 있으며 대표적인 것으로 症狀이 나타난 때의 生活環境에 대한 적절하고 신빙성있는 情報를 수집하는데 커다란 문제점을 가지고 있다. 이 分野에서의 難點은 전문가들이 어떻게 그들이 漢 치료가 성과를 거두었다는 것을 發見하게 되었는가에 대한 明視的 근거가 결여되고 있다는 점이다.

생명과 장애

송준만 서강대학교 생명문화연구원 1997 생명연구 Vol.3 No.-

Once the value and sacredness of life is acknowledged, any act that intercepts life cannot be rationalized in any way. However, in real life, life-abusing acts like abortion are being practiced. Such behavior results from mechanical view of humanity and medical needs, without any regard to the value and sacredness of life but due to Amongst the views that attempt to rationalize life-abusing behavior, a view which suggests the possibility of physical and psychological disability is gaining considerable recognition. However, this view is based on the lack of objective understanding of disability. Taking of human life based on such mythical or visionary prejudice must be strictly forbidden. In this sense, instilling a proper understanding of disability could be the starting point in approaching the problems of human life. The phenomenon of rationalizing the destruction of life in the present society is evident in genetic counseling and euthanasia. Abortion through genetic counseling is rationalized by the suffering and burden brought about by the birth of a disabled child, and the low quality of life inflicted by disability. Likewise, euthanasia of the mentally-retarded is argued to rid the mentally-retarded of the suffering they must go through. Ohter euthanasia supporters pay more attention to the cost they must pay in society, and argue that they should be eliminated since they are useless in society. The rationale behind such life-destroying phenomenon - i.e. suffering brought on by disability-is merely a prejudice. This thinking is not based on factual information, but is merely a stereotype or myth. If a healthy (non-disabled) person commits a life-destroying behavior based on this kind of prejudice, it would pose a serious problem. Special education attempts to minimize this type of prejudice by developing the essential skills of the disabled, which minimizes the negative effects of disability; and gives the disabled person as well as the family some tangible hope by giving them some suitable skill to help them adjust to their role in society. Ultimately, special education attempts to eradicate life-threatening behavior on the grounds of burden and estimated suffering by eliminating the reasons behind the undervaluing of the importance of life on the basis of disability. This will eventually recover the belief in the valure of human life. The purpose of special education is to get rid of the prejudice that disability in some part of the body destroys the whole human being, and to form a society where the disabled people are treated and respected as ordinary human beings.