뇌동맥류 환자간호의 질평가 도구 개발

신용순 한양대학교 대학원 1999 국내석사

포괄수가제의 도입과 양질의 전문적 간호에 대한 사회적 요구에 부응하기 위해서는 간호서비스의 질관리를 할 수 있는 표준화된 평가도구가 필요하다. 특히 개별 환자군을 대상으로 하는 간호의 질평가 도구는 실제 임상에서 활용 가능한 것으로서 다양한 측면의 도구개발이 요구된다. 본 연구는 뇌동맥류 환자간호의 질평가 도구의 개발을 목적으로 시행되었다. 먼저 뇌동맥류 환자 간호의 질평가 접근법으로는 과정평가의 틀을 선택하였으며, 본 도구의 질평가 대상은 뇌동맥류 파열로 인한 지주막하 출혈이 발생하여 개두술을 받은 환자였다. 본 연구의 과정은 도구의 문항개발을 위한 두 단계와, 개발된 도구의 신뢰도, 타당도 검증을 위한 단계 등 크게 세 단계로 나뉘어진다. 도구의 개발과정은 1) 도구문항의 예비항목 작성, 2) 도구의 표준 및 기준 개발, 3) 표준 및 기준의 내용타당도 검증의 단계로 이루어졌다. 첫째 단계에서는 연구자가 작성한 예비항목을 13명의 1차 임상간호 전문가집단에서 수정 보완하였고, 6명의 2차 전문가 소집단에서 도구의 표준 및 기준을 개발하였다. 두 번째 단계에서는 전국의 종합병원 및 대학병원에 근무하는 총 26명의 전문평가단이 도구의 내용타당도 검증과정에 참여하였다. 세 번째 단계에서는 개발된 도구의 구성타당도와 신뢰도 검증을 위하여 서울시내 일개 3차 의료기관 신경외과에서 뇌동맥류로 개두술을 시행받고 입원치료 중인 환자 38명을 대상으로 하였다. 개발된 표준과 기준의 내용타당도를 조사하기 위하여 4점 척도로 구성된 설문지를 이용하였으며, 개발된 도구의 구성타당도 및 신뢰도 검증을 위하여 환자 38명의 의무기록 검토 및 간호직원 면담 및 관찰법으로 자료수집을 하였다. 자료수집 기간은 1999년 9월 2일부터 1999년 11월 6일까지였다. 자료분석은 Cronbach's α reliability와 구성타당도 검증을 위해 Item-total correlation을 이용하였다. 본 연구의 결과는 다음과 같다. 1. 1차 임상간호 전문가집단에서 작성한 예비항목은 모두 134개의 문항으로 구성되었고, 2차 전문가 소집단에서 개발한 표준은 15문항, 기준은 134문항이었으며, 4점 척도로 구조화되었다. 2. 타당도 및 신뢰도 검정을 통해 15개의 표준과 130개의 기준이 최종 선정되었다. 15개의 표준은 뇌동맥류 환자의 수술전 간호영역에 5개 표준과 수술직후 간호영역에 3개의 표준, 그리고 수술후 간호영역에 7개의 표준으로 구성되었다. 이중 수술전 간호영역의 표준은 30개의 기준을 포함하고 있으며, 수술직후 간호영역의 표준은 28개, 수술후 간호영역의 표준은 72개의 기준을 포함하고 있다. 3. 뇌동맥류 환자간호의 질평가 점수는 3점 만점에 평균 2.38±0.24점으로 나타났으며, 이중 수술전 간호의 평균점수는 2.18±0.32점, 수술직후 간호의 평균점수는 2.33±0.28점, 수술후 간호의 평균점수는 2.63±0.19점으로 나타났다. 4. 본 연구에서 최종적으로 개발된 평가도구의 평균내용타당도지수(CVI)= .95로 나타났으며, 수술전 간호 CVI= .97, 수술직후 간호 CVI= .98, 수술후 간호의 CVI= .97로 나타났다. 평균내용타당도 점수는 4점 중 3.67점으로 나타났다. 5. 각 표준별 내적일관성 신뢰도 검정에서 Cronbach's α 계수는 .2960~.9463으로 나타났다. 97개 기준의 Item-total correlation의 범위는 .0113~.8924였다. 이상의 결과를 볼 때 본 도구의 신뢰도와 타당도를 비교적 수용할만한 수준의 것으로 임상실무에 실제로 활용될 수 있을 것으로 기대한다.

생리신호를 이용한 음의 감성 및 수면평가

신용순 공주대학교 대학원 2005 국내석사

소의 임신초기 황체, 태반 및 자궁내막에서 세포사멸 기전과 20α-HSD에 관한 연구

신용순 韓京大學校 2009 국내박사

성서번역에 있어서의 이해용이도 : 개역한글판을 중심으로

신용순 숭전대학교 대학원 1981 국내석사

We who live in the 20th century have to get new information from the books written in foreign languages. But the gap between the language of the original text and the language into which one translates it provides difficulty to the readers of the translated text. So the task of translating is a difficult oner and the services of a translator are called in to bridge tile barrier or gap. We can say that there has never been a time in the human history when translation has been more necessary. Therefore we should manipulate language accurately. Finally (1971) said that translating is both a craft and an art. In other words, the art of the translator is to conceal the translation. The reader should experience the same impression as if he were reading a document in his own language. 1 . Theoretical Background Translation means the process to shift the communication in the source language to the commnication in the target language. By the way, communication can be established by the process of encoding and decoding (Langacker 1973:21-27). In decoding the message, the cultural context must be shared. In short, translation can he defined as the communication between two languages(Nida 1966:16) ◁그림 삽입▷(원문을 참조하세요) In figure 1, the translator (S_(2)) who is a bilingual person must fulfill a dual role, and he must understand the two cultural contexts. When the cultural contexts are ignored, the communication is impossible. An adequate translation has to convey the perfect meaning of the source language to the receptors. Pike( 1980 ) has same view as Kida's eaning, in part, the abstraction of the intent of the speaker: hence if the translation does not reproduce this intent, the translation is inadequate. Disjunctively, however, meaning is definable as also including the impact on the hearer -- on his understanding and on his behavior. Hence the adequate translation should ideally elicit from the hearer the kind of understanding ( and, when appropriate, the kind of behavior ) which the original source document elicited from its hearer. In addition, an adequate translation should retain the focus of attention of the speaker. (1.388) So, first, a translator must know a knowledge of the original language, such that he can understand fully linguistic level. That is to say, he should have a full knowledge of the grammar of the source language as well as of the vocabularies. Secondly he should present an accurate account of the contents of the original, omitting nothing and adding nothing. The third criterion of a good translation is thus it should capture the style and atmosphere of the original. This is more important in the case of literary texts. But putting an emphasis on the fact that the reader must gain the same impression of the text as they would if it gad. been written in his native language. The investigator propose that th translator should be able to reconstitute the text in the target language. When the text is reconstituted well, we can read a good translation. And good translation depends upon comprehensibility. But comprehensibility varies by the class of the readers. When the question: For whom is tile translation intended?, can be answered, we can answer this question : Is this a correct translation? The investigator thinks that the higher comprehensibility the translation involves, the better it is. But comprehensibility is an aspect of the informative function of language, and the purpose of this thesis is to test comprehensibility of some sentences in Matthew, and analyse them in terms of vocabulary, grammatical structures, and cultural context. And then the investigator suggests good model of translation of his own. Especially in Bible translation, the most important criterion is holt readily and correctly and ordinary reader or hearer is likely to understand Biblical passages. So the translator should eliminate the expression which is likely to be misunderstood, and the expression so difficult and heavy as to discourage the roader from attempting to comprehend the content of the message. To satisfactorily achieve this purpose the translator has to "Paraphrase "his target language well. Back-transformation of a surface structure to the underlying kernels may be regarded as a form of paraphrase. "Paraphrase" as we are using it at this point in referring to back transformation, is a technical term from linguistics and related disciplines, and is characterized by three specific features: (1) it is intralingual rather than interlingual, ie, it is another tray of saying the same thing in the same language; (2) it is rigorous, in that there are no changes in the semantic components: no addition, no deletions, no skewing of relationships, only a different marking of the same relations between the same elements: (3)specifically as it relates to back-transformation, it is aimed at restatement at a particular level, that of tile kernels. (P.47) So I would like to frame my of own conclusion that good paraphrasing can bear a good translation. This time I will introduce the new system of translation. Nida (1974) named it three-stage translation. The first stage is "analysis", in which the surface structure is analysed in terms of the grammatical relationships and the referential meaning of words. The second one is "transfer", in which the analyzed material is transferred in the mind of the translator. The Last one is "reconstituting", in which the transferred material is restructured in order to mite the final message fully acceptable in the practical circumstances. But especially in Bible Translation, we should establish certain fundamental sets of priorities. Nida(1974) suggested four sets of priorities in translating Biblical messages. (1) contextual consistency has priority over verbal consistency (or word-for-word concordance), (2) dynamic equvalence has priority over formal correspondence, 1 (3) the aural (heard) form of language has priority over the written form, (4) forms that are used by and acceptable to the audience for which a translation is intended have pririty over forms that may be traditionally more prestigious. (F.14) As each language covers the totality of experience with symbols and has its own systems of symbolizing meaning, it is natural that we should choose the right word in the receptor language on the context rather than upon a fixed system of vrbal consistency. The second is based. upon the reactions of the receptors. This response should be analysed in the three respects: the informative function, the expressive function, and the imperative function. When the translator is a bilingual person who understands a language-culture relationship between M_(1) and M_(2) (see fig.1), his readers can react dynamically to M_(2). The third deals with the typical circumstences of communication. I think that this set of priority has to do with the reason for ambiguity and vagueness, for many people hear the Scriptures read. The last priority consists of more complex factors: age, sex and education. So the bible should be translated in the common or popular language. 2. Comprehensibility The investigator made up some questions using some sentences in Matthew and tested the readers' comprehensibility. That is to say, I selected 14 Biblical passages and evaluated how readily and correctly to understand them. The results of the most difficult questionaires to about 250 readers, including Christians and non-christians, are as follows: " 조상의 양을 채우라" (Matt 23:32) : 15.5% " 저희는 자기 상을 이미 받았느니라" (Matt 6:2) : 24.8% " 돈을 바꾸는 자들 " (Matt 21:12) : 33.9% " 이혼 증서를 써 줄 것" (Matt 5:31) : 48.3% This result shows that some Hankul sentences in Matthew are problem sentences. On other words, the comprehensibility curve of the sentences is very low. The fig. 2 shows that about 85% of the readers ◁그림 삽입▷(원문을 참조하세요) understood the question 12 correctly, and about 16% of the readers, the question 14. Here I call the curve CD the Comprehensibility Curve, and the territory A is the territory of Comprehension. When tile comprehensibility curve remains on the line 100, the readers are believed to read a completely correct translation. So I analyzed the reason for the low comprehensibility curve, and I was able to conclude that the unsatisfactory result was produced by two types of expressions:(1) ambiguity and (2) vagueness. Some sentences in Matthew have very vague terms that may be interpreted variously, and others are misunderstood. (1) The reason for vagueness is that the meaning itself of an item seems indeterminating and that the meaning is only generally specified. The following words and phrases belong to this category: "돈 바꾸는 자"(Matt. 21:12) C.C: 33.9% "자기 상"(Matt. 6:2) C.C: 24.8% "있는 자 없는 자"(Matt. 13:12) C.C: 63.4% "조상의 양을 채우라"(Matt. 23:32) C.C: 15.5% "길에 있을 때에"(Matt. 5:25) C.C: 73.8% "평안하기를"(Matt. 10:12) C.C: 57.6% "누구든지 아내를 버리거든 이혼 증서를 줄 것"(Matt. 5:31) C.C: 48.3% cf.; C.C=Comprehensibility Curve (2) The reason for ambiguity is that some items can be read with different meaning in various stress and intonation. The concrete examples taken in this category are as follows: "건너가 본 동네"(Matt. 9:1): 63.8% "와서 먹지도 않고 마시지도 아니하매"(Matt. 11:18): 54.2% "한편 손"(Matt. 12:10): 60.1% "말 아래서"(Matt. 5:15): 82.3% The most difficult sentences to Korean ordinary readers, including Christians and non-christians, are "너희가 조상의 양을 채워라" (Matt. 23:32) and "저희는 자기상을 이미 받았느니라"(Matt. 6:2) These sentences are not understandable, that is to say, not informative. They realize that "조상의 양" means something good, and that the hypocrites were rewarded by God. If the readers tend to misunderstand, the expression must be changed. When a translation is not informative, it can be neither impressive nor imperative. If communication is to be established successfully between the source and the recentor, a translation must fulfill its informative function. And another important reason for the low comprehensibility was that the cultural gap is deep. 3. Conclusion The purpose of translation means to communicate. Therefor R_(2) must be able to respond to M_(2) in ways similar to those in which R_(1) responds to M_(1.) By Nida(1974:12), translation, especially Bible Translation, was defined as "Translating consists in reproducing in the receptor language the closest natural equivalent of the source-language message, first in terms of meaning and secondly in terms of style." So the translator has to eliminate (1) the expressions which are likely to he misunderstood ana (2) the expressions so difficult old heavy as to discourage the readers from attempting to comprehend the content of the message. 1. Ambiguity of a vocabulary and of a sentence causes the low comprehensibility. The translator has to analyse the part of speech correctly, and put an emphasis on pronunciation of words, especially on homonyms. 2. Another reason for the low comprehensibility level is vagueness of a word or a sentence. A sentence is vague when it gives no information. So the translator should emphasize two important factors: (1) the essential difference between the source language and the target language, and (2) the relationship of the two languages to their respective cultural contexts. 3. In reconstituting the message, the translator consider the needs of the readers. When a translation is reconstituted in the common or popular language, their comprehensibility ascends. In conclusion, (1)"Korean Revised Hankul Version" still has the vestiges of Chinese culture, and (2) the sentences were reproduced in terms of style. Therefore, the readers reacted inversely or misunderstood some of the messages.

냉요법이 개두술 후 통증 및 안검 부종, 반상출혈에 미치는 효과

신용순 한양대학교 2007 국내박사

개두술 후 많은 환자들이 수술 후 통증과 안검 부종, 안면 반상 출혈 등과 같은 예상치 못한 불편감을 경험하고 있다. 간호사는 이러한 문제를 예방하는 데 중심 역할을 담당해야 할 것이다. 이에 개두술 후 환자에게 적용한 냉요법이 수술 후 통증과 안검 부종, 반상출혈에 미치는 효과를 알아보기 위하여 본 연구를 시행하였다. 2005년 11월부터 2006년 9월까지 서울시내 일개 종합 병원에서 개두술을 받은 환자 97명을 대상으로 하였으며, 모든 환자로부터 서면 동의 및 기관연구윤리위원회(IRB)의 승인을 얻어 연구를 진행하였다. 대상자는 블록 무작위법에 의해 각각 실험군48명, 대조군 49명으로 배정하였다. 실험군은 수술 후 3시간째부터 3일째까지 원형 얼음 주머니는 수술 부위에, 안경형 냉장 젤 팩은 눈 위에 각각 한 시간 간격으로 20분씩 동시에 냉요법을 적용하도록 하였다. 통증은 시각상사척도(VAS)로 측정하였고, 안검 부종은 Kara와 Gokalan의 도구에 의해 사정하였으며, 반상출혈은 그 넓이에 따라 분류하였다. 통증 점수는 냉요법 종료 후인 수술 후 3일(p=.021)에 실험군이 대조군 보다 낮았으며, 공변량 분석으로 진단명을 통제하고 냉요법만의 효과를 분석한 결과 통증 점수에 미치는 영향은 유의하지 않았다(p=.173). 혼합 선형 모형에서의 ANOVA 결과, 냉요법을 시행한 실험군의 통증이 시간의 흐름에 따라 더 급격히 감소한 것으로 나타났다(p=. 047). 수술 후 3일의 안검 부종도 대조군 보다 현저히 낮았고(p<.0001), 냉요법이 안검 부종 정도에 미치는 영향은 유의한 것으로 나타났다(p<.0001). 실험군은 수술 후 1, 2일까지 미약한 안검 부종을 보이다가 수술 후 2일 이후부터는 감소한 반면, 대조군은 수술 후 3일까지 급격히 증가하다가 서서히 감소하는 양상을 보였다 (p<.0001). 수술 후 3일째에 반상출혈이 나타난 비율은 각각 대조군이 53.1% (26/49), 실험군이 22.9% (11/48)였다(p=.003). 로지스틱 회귀분석 결과, 실험군에서 반상 출혈이 발생할 위험은 대조군의 약 1/5 이었다(adjusted OR, .211; 95% C.I., .082-.542; p=. 001). 이상과 같이 개두술 후 3일간 지속적으로 적용한 냉요법이 수술 후 통증 및 안검 부종, 반상 출혈을 줄이는 효과가 있는 것으로 나타났다. Background: Many patients have suffered from unexpected discomforts such as postoperative pain, eyelid edema, and facial ecchymosis after craniotomy. Nurses should take part in preventing such uneasiness. Objective: The aim of the study was to identify the effects of cryotherapy on pain, eyelid edema, and ecchymosis after craniotomy. Methods: After receiving Institutional Review Board’s (IRB) approval and written consent from patients, 97 of those who underwent elective craniotomy from November 1, 2005 to September 8, 2006 participated in the study. Participants were divided into two groups by block randomization: The cryotherapy group and the control group. In the cryotherapy group, ice bags were applied to surgical wounds while cold gel packs were used to periorbital areas. During the post-surgery phase, starting from 3 hours to 3 days, cryotherapy was applied for 20 minutes per hour. The level of pain was measured using visual analogue scale while the eyelid edema was measured utilizing Kara & Gokalan’s scale. Also, ecchymosis was classified by the extents. Results: The pain scores of the cryotherapy group were significantly lower than the control group (3^(rd) day, p=. 021). In covariate analysis for control diagnosis, the effects of cryotherapy on pain scores were not significant. The cryotherapy group had less eyelid edema during the postoperative period than the control group (3^(rd) day, p<. 001). In the analysis using linear-mixed effect model, trends of pain & eyelid edema reduction from two groups were significantly different (p=. 047, p<. 001). On the 3^(rd) day of surgery, 22.9% of the cryotherapy group showed facial ecchymosis while 53.1% of the control group (p=. 003) showed the symptom. In logistic regression analysis, cryotherapy was the only factor affecting ecchymosis (adjusted OR, .211; 95% C.I., .082-.542; p=. 001). Conclusion: Cryotherapy is a useful method in preventing acute pain, eyelid edema, and facial ecchymosis after craniotomy.

우리나라 보건의료정책의 형평성 분석

신용순 가톨릭대학교 보건대학원 2021 국내석사

볏짚의 切斷길이가 韓牛의 採食과 反芻行動에 미치는 影響

신용순 建國大學校 農畜大學院 1995 국내석사

본 연구는 볏짚의 절단길이가 한우의 채식과 반추행동에 미치는 영향을 구명하기 위하여 실시하였다. 체중과 연령이 비슷한 한우 4두를 공시축으로 선발하여 채식, 반추 및 저작시간과 회수, 저작속도, 채식률, 반추와 저작효율, 반추시 bolus수 등을 구하여 얻어진 결과는 다음과 같다. 1. 채식과 총 저작시간은 절단길이가 길어짐에 따라 유의하게(P<0.05) 증가하였으며, 원형 볏짚에서 가장 길게 나타나는 경향을 보여주었다. 2. 1일 채식과 총 저작회수도 절단길이가 길어짐에 따라 유의하계(P<0.05) 증가하였으며, 원형 볏짚에서 가장 길게 나타나는 경향을 보여주었다. 3. 반추시 저작속도와 총 저작속도는 모두 15cm에서 가장 빠른 경향을 보여주었다. 4. 건물과 NDF함량에 따른 채식률과 저작호율은 길이가 짧아짐에 따라 높은 유의성을 나타내었다(P<0.01). 5. 일함 반추시 bolus수는 절단길이가 길어짐에 따라 유의하게(P<0.05) 증가하였으나, bolus당 저작시간과 회수는 9cm에서 가장 길게 나타났다. This experiment was conducted to determine the effect of cutting length of rice straw on the eating, ruminating, chewing time and numbers, eating rate, ruminating efficiency and chewing efficiency in Korean Native Cattle. Four Korean Native Cattle averaging 350 dy wei凉t were assisted to a 4×4 Latin square design by the cutting length of rice straw(3cm, 9cm, 15cm and long). The result are as follows: 1. Increasing cutting length of rice straw results in the prolongation of eating, ruminating and chewing time(P<0.05). Especially, eating time was increased from 0.06 to 0.08 min/g of neutral detergent fiber (NDF) (P<0.01). 2. Number of chews during ruminating and total chewing were increased (P<0.05) as the cutting length increased. Changes of eating and ruminating behaviour were also observed in eating chews from 2.93 to 3.86 chews/g of dry Hatter(DM)(P<0.01) and from 5.11 to 6.72 chews/g NDF(P<0.01), ruminating chews from 3.53 to 4.09 chews/g of DM(P<0.05) and from 6.17 to 7.12 chews/g NDF(P<0.05) if the cutting length of rice straw was longer. 3. The highest chewing speed 1 [Daily chewing numbers of ruminating/Daily ruminating time(sec)] and chewing speed 2 [Daily total chewing numbers/Daily total chewing time (sec)] were obtained from 15cm length. 4. Eating rate(P<0.01), ruminating efficiency and chewing efficiency (P<0.01) were increased significantly as the cutting length of rice straw was longer. 5. Increasing in cutting length of rice straw resulted in increased number of boluses per day(P<0.05). however, there was no di florence on chews per bolus and chewing time per bolus.

射出水에 依한 帶水層의 土質改良에 關한 基礎實驗

신용순 慶北大學校 1988 국내석사

지역경찰제도 운영개선방안에 관한 연구 : 순찰지구대를 중심으로

신용순 영남대학교 행정대학원 2004 국내석사

카르복시펩티다제 A 억제제의 합성 및 구조-활성 상관관계 관한 연구

신용순 포항공과대학 1990 국내석사