동정맥루 천자를 위한 드레싱 준비 방법의 개선에 따른 업무효율 및 비용절감활동

원삼순,이지숙,지미경,박영희,백경원,조성이 한국의료QA학회 2008 가을학술대회 Vol.2008 No.3

혈액투석환자 배우자의 스트레스와 대응에 관한 연구

원삼순,권혜진 중앙대학교 의과대학 의과학연구소 1992 中央醫大誌 Vol.17 No.4

This descriptive study designed to identify stress factors and level and helpful coping methods of hemodialysis patient's spouse. Data were collected from 60 subjects who were spouses of hemodialysis patient of conveniently selected 4 Hemodialysis Units in the city of Seoul. The Collection of data it was carried out by the researcher from the 7th of Octobor to 20th of October, 1992. Two instruments were used to collect the data ; 1. Stress questionaire was developed by researcher which was combined review of literature and the result of interviewer, consisted 30 stress factor items and measured by five point Likert scale. The items were categorized physical, psychological and socioeconomic area. 2. Helpful coping questionaire developed by investigator through literature review and result of interviewer, included 50 items and measured by five point Likert scale. Helpful coping items were classified into two categories, the problem oriented and the affective oriented. Data was analyzed by S.A.S. computer porgram using percentile, means and standard deviation, t-test and Pearson correlation coefficient. The results of this study are summerized as follows 1. The spouses of hemodialysis patient were found to be stressful in general and the items with high stress were "To be treated indefinite period of time", "Uneasiness of trevel", "To be say with their spouse who suffer pain", "To ingest medication continuously", "Financial burden", "No treatment except kidney transplantation", "Anxious about disease transmission due to transfusion" and the highest stress category was physical. 2. The spouses of hemodialysis patient were shown to be helpful by the coping methods and the most helpful coping items "To accept as a fate" and "Self condolence comparing others who were in a more serious rather than thier sitution" and the higher helpful coping method was affective oriented. 3. The result of the analysis of the relationship between scores of stress categories and general characteristics was as follows : Spouse's sex, house shape, and occupational status before the patient got illness showed a statistically significant difference in score of stress categories(P<0.05) 4. The result of the analysis of the relationship of the relationship between helpful coping methods and general characteristics was as follows : The number of family, the state of medical insurrance, spouse's disease, the number of hemodialysis, and having or not having complication related with hemodialysis showed a statistically significant differance in helpful coping methods(P<0.05) 5. There was significant differance among stress categories and coping methods.(P<0.01)

외래환자의 병원이용 경험에 관한 연구

원삼순,지희영,이소연,김복순,현신숙,홍상희,윤정인,김정애,지성애 중앙대학교 의과대학 간호학과 간호과학연구소 1999 중앙간호논문집 Vol.3 No.2

An objective hospitals of today should pursue is to maintain a comfortable environment for medical examinations, including medical technologies in order to provide patients with high quality medical services. The objective of this research is to examine factors, which affect the degree of contentment in outpatient medical services, remove any inconveniences or remedy them. Therefore, it eventually makes a good impression to people and makes them wish to revisit the hospital when medical services are needed. Research was conducted in a hospital attached to C University through content analysis by observation and interview. Thirty patients were interviewed from Oct.1, 1999 through Oct. 19 and data were collected, analyzed and interpreted by examinig in clinic areas. Results found by interpreting the date are as follows: 1. Need of a guideboard was found regarding finding the hospital. 2. They were classifies into three types regarding registration: confusion, unkindness and inconvenience. 3. They were classified into three types regarding receipt: unkindness, narrowness and inconvenience. 4. They were classified into three types regarding medical examination: unkindness, wait and inconvenience. 5. In finding either inspecting rooms or consultation rooms, confusion and inconvenience were pointed out but employees' kind guidance was important. 6. The waiting rooms for medicine showed that a long-waiting problem is the first thing to be solved. 7. With regard to parking, more parking space, signboards (entrance/exit), and changing parking ticket size were requested. 8. They were classified into three things regarding rest rooms: cleanness, shortage and atmosphere. 9. With respect to overall environment, two things were pointed out: one is the distinct difference between the first floor and the second floor due to repair work and the other is difficulties of depositing one's belongings. In terms of notices and other things on notice boards, it was proven that patients do not draw attention to their size, color, and design but their overall atmosphere affects the patients. Based on the results analyzed, the research has come up with plans for improvement. 1. Things can easily improved Employee's unkindness, payphone location, reservation activation for medical examination, variety in books and magazines for waiting people, guiding lines on the floor, change in numbered tickets for medicine, signboards (entrance/exit) in the parking lot, change in parking tickets, a signboard for the parking ticket booth and solving a problem of getting a stamp on a parking ticket, cleanness of rest rooms and making them no smoking area, placing potpourris, hooks and shelves in the rest rooms, strengthened visitor control, more water dispensers. 2. Things to be added or altered Subway station. bus stop. guideboards to show the location of our hospital, earlier start of medical examination, breakup special examination mainly provided in the morning and provide it even in the afternoon, providing patients with more medical examination services by specialists - currently 3~4 times per week - to let them have more opportunities to enjoy the services, examination at night, change in location and size of signboards, repairing the pole in the waiting room for medicine, change in size on electric bulletin board and waiting time reduction in the medicine room, playing programs on hospital introduction or on health instead of cable TV for those waiting for their medicine, creating comfortable atmosphere for the rest rooms, making a notice board for PR, difficult of using the (convenient) store (distance, location, difficulty of recognizing products displayed) 3. Things to add new functions or spaces Computerization in information process, more and larger booth for receipt, installation of electric board that shows charges and waiting ticket issuer, more space for people waiting in the medicine room - more space between chairs and more chairs, more space for parking lot and rest room, repair work on the second floor, placing lockers, installations of more elevators and its functional improvement, providing patients with resting place(room), store and facilities - need of cafeteria, facilities for day-care center and playing kids, shuttle bus service Regarding facilities, which are difficult to be repaired, the reserchers hope that the data on the facilities will be used as basic data when MC the is built. Also the researchers wish that modification, improvement, and repair will be made soon to make people revisit our hospital and reuse medical services and facilities it offers.

개별화된 투석액 나트륨 농도 조절이 투석환자의 혈압, 투석간 체중증가 및 갈증정도에 미치는 영향

원삼순;.윤현정;조성이;이세영;이경은;박미주 중앙대학교 의과대학 간호학과 간호과학연구소 2010 중앙간호논문집 Vol.14 No.-

Purpose: Current hemodialysis prescribing standards use dialysate sodium concenntration that are high relative to the patient's plasma sodium concentration. Generally each patient has a fixed osmolar set point. So, use of hypertonic sodium dialysate predispose to positive sodium balance, lead to higher blood pressure, interdialytic weight gain and thirst. Therefore, we designed a study to investigate the effects of individualized dialysate sodium concentration centration prescription based on pre-HD plasma sodium concentration on patient's blood pressure, interdialytic weight gain and thirst Methods: Thirty-eight HD patients were enrolled in this cross-over study. All the patients underwent nine consecutive HD sessions with the dialysate contained 138 mEq/L sodium (standard sodium HD), then concentrations of sodium were switched to match the patients average pre-HD plasrna sodium measured during the sodium standard phase (135mEq/L for patients with sodium levels less than 130mEq/L, 137mEq/L for patients with sodium levels over 138mEq/L). Results: Standard sodium dialysis and individualized sodium alignrnent of the physiological indices Hgb, Hct, Calcium. Kt / V, BUN, Cr and there were no differences, There was a significant decrease in the interdialytic weight gain (2.3 ± 0.8kg vs. 2.0±t 0.8kg, p <0.001). Alburnin 3.7±0.4 vs 3.8±0.3, plasma Na concentration of 137.8± 3.1 vs 136.1± 4.4. Blood pressure and pulse rate, weight gain between dialysis and hemodialysis blood pressure 140.9± 13.4 vs 131.8 ± 11.4, weight gain between dialysis 2.0± 0.8 vs 2.3± 0.8, systolic blood pressure after dialysis,. after dialysis, diastolic Blood pressure, pulse rate before and after hemodialysis, there was no difference in thirst. Conclusion: An individualized sodium dialysate based on predialysis plasma sodium levels decreases thirst, interdialytic weight gain, pre-HD SBP

가정간호 수혜자의 가정간호에 대한 인식조사 연구 : Q-방법론적 접근

김미숙,정연강,양갑필,원삼순,은미자,김복순,박현옥,양기우,윤정인 중앙대학교 의과대학 간호학과 간호과학연구소 1998 중앙간호논문집 Vol.2 No.2

The purpose of this study was to understand the pattern of the client's recognition on home nursing care system, individually, and then to provide some basic information that needed for establishment home nursing care system. The research had been proceeded as follows : 1. Delineation of the Q-population : the statements of Q-population had been derived from review of the related literature and open-ended questionare filled by Nurses, Doctors, general public, and outpatient. 2. Selection of the Q-sample : Among 452 concourse, those which was obscure or overlapped were deleted. 30 concourse were selected finally. 3. selection of the P-sample 27 subjects had been determined among the person who were provided home health nursing care after discharged from inpatient service in 1 university hospital. We visited at their home and collected data from 20th, Oct. to 5th, Nov. 1998. 4. Q-sorting : based on 1 to 9 point scale(forced normal distribution), the selected P-sample rated their operant definition of home health nursing care 5. Determination of Q-type : with Q-sorts, PC-QUANL program identified the three Q-types 6. Analysis of Q-type : the characteristics of three different recognition had been analyzed based on the typal array, extreme comments, and subject's demographic information The results revealed that there are three different pattern of recognition on home health nursing care system: certain type(recognition of effectiveness), deficiency of recognition type, uncertain type. As a view of summerized results the recognition of the home health nursing system had characteristics of 3 types with similarity but independency Accordingly, the means of this study was the facts discovered the characteristic 3 types that home health nursing subjects had thought. Because this 3 types are not fixed but changeable through each reaction and by their being conditions, we think that to build a practical and concrete home health nursing system and to utilize will be necessary.

혈액투석 환자에서 다리교차의 기립성 저혈압 감소 효과

김시숙(Kim, Si Sook),최경숙(Choi, Kyung Sook),원삼순(Won, Sam Soon),김인영(Kim, In Young) 대한근관절건강학회 2015 근관절건강학회지 Vol.22 No.3