노인의 삶의 질 예측모형 구축

박은숙(Park Eun Sook),김순자(Kim Soon Ja),김소인(Kim So In),전영자(Chun Young Ja),이평숙(Lee Pyoung Sook),김행자(Kim Haeng Ja),한금선(Han Kuem Sun) 한국노년학회 1998 한국노년학 Vol.18 No.3

본 연구는 노인의 삶의 질에 영향하는 변수와 이들 변수간의 관계를 파악하여 노인의 삶의 질을 예측하는 모형을 구축함으로서 노인의 삶의 질 향상을 위한 프로그램 개발에 기초로 제공하고자 시도되었다. 이를 위하여 기존의 문헌 고찰과 선행연구를 기초로 노인의 삶의 질에 영향하는 요인으로 연령, 결혼 상태, 경제상태, 교육정도, 건강개념, 지각된 건강상태, 내적 건강통제위, 자아존중감, 자기효능감, 건강중진 행위로 개념적기틀을 구성하였으며 공변량 구조 분석을 이용하여 총34개에 이르는 가설 경로들을 검증하였다. 연구대상은 서울시 8개구에 거주하는 571명의 65세이상 노인이었으며 연구자료 수집 기간은 1997년 11월부터 1998년 1월까지였다. 연구도구는 삶의 질을 측정하기 위해 노유자(1988)가 개발한 도구를 사용하였고, 건강증진 행위를 측정하기 위해 Walker등(1987)이 개발한 건강증진 행위 척도, 건강개념은 Laffrey(1986)의 도구를, 지각된 건강상태는 Lawston 등(1982)의 도구를, 건강통제위는 Wallston (1978)의 도구를, 자아존중감은 Rogenberg(1965)의 도구, 자기효능감은 Sherer(1982)의 도구를 노인에게 예비조사하여 문구를 수정, 보완한 후 신뢰도와 타당도를 검증한 후 사용하였다. 가설 모형의 검증 결과 모형의 부합도가 주어진 자료와 잘 맞지 않아 자유 특징수들을 추가하고 유의하지 않은 경로중 3개의 경로를 삭제하여 수정모형에서의 부합도와 설명력을 높였다. 노인의 삶의 질 예측 요인으로는 연령, 교육정도, 경제상태, 건강개념, 지각된 건강상태, 내적 건강통제위, 자아존중감, 자기효능감, 건강증진 행위가 유의한 것으로 나타났으며, 자아존중감이 가장 큰 영향을 미치는 것으로 나타났다. 노인의 건강증진 행위 예측 요인으로는 연령, 교육정도, 건강개념, 지각된 건강상태, 내적 건강통제위, 자아존중감, 자기효능감으로 나타났으며 건강개념이 가장 큰 영향을 미치는 것으로 나타났다. 즉 노인의 연령이 낮을수록, 교육 정도가 높을수록, 건강 개념이 포괄적일수록, 지각된 건강 상태가 높을수록, 내적 통제위 성향이 높을수록, 자아존중감, 자기효능감이 높을수록, 건강증진 행위가 높을수록 삶의 질이 높게 나타났다. 이상의 결과로 연령, 경제 상태, 교육 정도 등의 인구사회학적인 변수와 건강증진 행위 및 건강 개념, 자아존중감, 내적 건강통제위, 자기효능감 등의 변수가 노인의 삶의 질을 예측하는 변수임을 알 수 있으며 이에 따라 노인의 삶의 질을 향상시키기 위해서는 이상의 관련 변수를 고려한 지역사회 중심의 포괄적인 건강 증진 프로그램의 개발과 효과 검증이 필요하다고 본다. 이상의 결과로 다음과 같이 제언하고자 한다. 1. 본 연구에서는 서울시내 노인대학과 경로당을 중심으로 대상자를 선정하였으므로 연구의 제한점이 있고, 가정내 거주 노인 및 농촌 지역의 노인을 대상으로 대상자 확대 및 반복 연구가 요구된다. 2. 노인의 삶의 질을 증진시키기 위한 프로그램 개방 및 효과 검증이 요구된다. 3. 지역사회 노인 인구의 건강 요구를 평가하고 실제 건강관리를 전담하기 위한 노인 건강 관리전문가의 교육이 요구된다. This study was conducted to a structural model for explaining the quality of life in the elderly. The conceptual model was constructed based on the findings from studies on the elderly. Data were collected by self-reports questionnaires from 571 elderly living in Seoul, from Nov. 1997, to Jan. 1998. Data analysis was done with SAS 6.12 for descriptive statistics and PC-LISREL 8.12 program for Covariance Structural analysis. The findings as follow; 1. The fit of the Hypothetical model with 21 paths and the empirical were low, thus it was modified by excluding 4 paths and adding free parameter to it. The Modified Model with 17 paths showed a good fitness to the empirical data (x2 =1162.76 (df=182, P=0.0), GFI=0.95, AGFI=0.92, NNFI=0.97, NFI=0.97, RMSR=0.07, RMSEA=0.09). 2. Age(r ₄₁=-0.03 ), Educational level(r ₄₄=0.04), Health concept(r ₄₅=0.59), Perceived health status(r ₄₆=0.16), Internal locus of control(r ₄₇=0.11), self esteem(β ₄₁=0.32), self efficacy(β ₄₂=0.13), health promoting behavior(β ₄₃=0.20) have significant effects on quality of life in the elderly of these variable, self esteem was the most essential factor. All predictive variable of quality of life altogether explained 79% of variance. 3. Age(r ₃₁=-0.01), Educational level(r ₃₄=0.11), Health concept(r ₃₅=1.33), Perceived health status(r ₃₆=0.15), Internal locus of control(r ₃₇=0.02), self esteem(β ₃₁=0.12), self efficacy(β ₃₂=0.38) have significant effect on health promoting behavior in the elderly. All predictive variable of health promoting behavior altogether explained 69% of variance. In conclusion, the derived model in this study was confirmed to be proper in explaing and predicting on quality of life in the elderly. From the result of the study, it is suggested to develop health promoting program for improving quality of life in the elderly.

고위험 임신 및 분만과 모자의 상태와의 관계에 관한 연구

전영자 中央醫學社 1988 中央醫學 Vol.53 No.1

산욕기 초산모의 간호요구와 만족도에 관한 연구

전영자 여성건강간호학회 1997 여성건강간호학회지 Vol.3 No.1

This study was carried out to identify the difference between nursing needs and levels of satisfaction of primiparas during the early postpartum period. The goal of the study was to obtain data needed to develop maternal education programs and to improve the nursing quality for primipara. The subjects were 111 primiparas who had normal delivery at 2 general hospitals in the Seoul area. The data was gathered using an 81 items questionnaire which was developed by the researcher from Nov. 30, 1995 to Feb.5, 1996. Results found are as follows : 1. The characteristics of subjects The majority of subjects were aged 26-30yrs(60.4%), high school graduated(49.5%), jobless(52.3%), had no religion(49.5%), no antenatal(74.5%), and postnatal education on self and infant care(55.9%). A large proportion of primiparas intended to feed breast milk(49.5%) but in fact only 7.2% fed breast milk while in the hospital. Many subjects perceived that they had reasonable self confidence about self care(46.8%), and infant care(36%). 2. The level of nursing needs of overall nursing care was relatively high(Mn 3.98) but the level of atisfaction was of average level(Mn 3.09). Therefore, difference between the level of nursing needs and satisfaction was significant(p=0.0001). 3. The nursing needs by category of nursing care, the highest need was on the education of infant care(4.29), the lowest was on physical care(3.80). The level of satisfaction was higher on environmental care(3.40) and physical care(3.32). But the category that showed the lowest satisfaction was education of infant care(2.67). Hence, difference of categories between the level of nursing needs and satisfaction was significant (p=0.0001). 4. Among items of physical care, observation of primiparas' conditions(4.21), accurate medication and treatment(4.18), care of breast engorgement(4.07) and control of postpartal hemorrage(4.01) showed high nursing needs. On the other hand, only the level of satisfaction was higher on accurate medication and treatment(3.82). The rest of items revealed only average level of satisfactions. Difference of items between the level of nursing needs and satisfaction was significant(p=0.0001) except items of dietary care. 5. Among items of psychological care, 8 items of nursing needs were high(3.72-4.29), especially detailed explanation on which mothers want to know(4.29), treatment and nursing care they receive(4.23), kind and faithful care(4.22), early contacts with their baby(4.20) and adequate draping during the care and treatment(4.18). Among items of psychological care higher satisfactions were shown on items of kind and faithful care(3.80), personal treatment(3.70), and detailed explanation to mothers, but the least satisfied item was early contact with baby(2.13). Difference between the level of nursing needs and satisfaction was significant (p=0.0001). 6. Among items of environmental care, the highest level of need and satisfaction was on the items of neat bedding and pajamas(3.54). The difference was significant(p=0.0001). 7. Among the items of educational needs on self-care, all of 22 items revealed higher educational needs(3.50-4.33) but the levels of satisfaction varied with a range of 2.63-3.42. Among the items the satisfactions were high on items of breast care including massages(3.42), perineal care(3.36) and expression of breast milk(3.32). Less satisfied items were drugs not to be taken by breast milk feeder(2.63), maintenance of breast figure(2.76) and postpartum exercise(2.80) and so on. The difference was significant ( p=0.0001). 8. Among the items of educational needs on infant care, 19 items revealed higher educational needs(3.28-4.54). And the highest need were on the 3 items of normal growth and development of infant, safety and emergency care, symptoms of sick(4.54) and the meaning of crying of the baby(4.52). The level of satisfaction among items of education of infant care ranged from 2.47 to 3.16. Most satisfied items were burping(3.16), bathing(3.11) and diappering (3.09). The items of which the mother's needs were high revealed the lowest satisfaction level. The difference was significant(p=0.0001). 9. Relationship between nursing needs and levels of satisfaction among primiparas of different characteristics were as follows : 1) Nursing needs of physical and psychological areas were significantly different among different age levels but no relationship was found on other categories regardless of the level of satisfaction. 2) With regard to different levels of education, some relationship was found in nursing needs of psychological area (p=0.007), educational needs on infant care (p=0.04) and environmental care (p=0.01). Also, the difference of satisfaction level was significant. 3) Working mothers had higher nursing needs and were more satisfied on items of physical care (p=0.05), education on self care and infant care. Difference were significant between nursing needs and level of satisfaction. 4) With regards to different religion a moderate relation was found between nursing needs of environmental care and infant care education but no relationship was found on levels of satisfaction. 5) With regards to antenatal education, the mothers who have had no antenatal education revealed higher nursing needs on physical care but those who had antenatal education were more satisfied with education on self care and infant care. The difference was significant.( p=0.0001). 6) With regards to postpartum education, the mothers who have had some sort of postpartum education revealed higher nursing needs on physical and self-care. And they were more satisfied with nursing of every category except infant care than mothers who had not any postpartum education. Differences was significant between the nursing needs and levels of satisfaction. (p=0.0001). 7) With regards to breast feeding experience during the hospitalization, those who had no experience of breast feeding revealed higher nursing needs on physical care in contrast to breast feeders, who had higher educational needs on infant care. And breast feeder were more satisfied with all categories. Differences were significant (p=0.0001). 8) With regards to perception of self confidence on self care and infant care, no relationship was found on nursing needs and level of satisfaction in every category of nursing.

家庭 環境이 좋지 않은 한 어린이의 境遇

田英子 이화여자대학교 사범대학 교육심리학과 1964 心理硏究 Vol.- No.5

초임부의 교육 요구와 만족도에 관한 연구

전영자 여성건강간호학회 1998 여성건강간호학회지 Vol.4 No.2

This study was carried out to identify the difference between educational needs and levels of satisfaction of primigravida during the antepartum period. The goal of the study was to obtain data needed to develop educational programs and to improve the nursing quality for antepartal clients. The subjects were 106 primigravida who attend antenatal clinic at 3 general hospitals in the Seoul area. The data was gathered using a questionnaire which, consist of 71 items, was developed by the researcher from May 4 to June 3, 1998. Results found are as follows : . 1. The characteristics of subjects : The majority of subjects were aged 25-29years(73.6%), college graduates(61.3%), jobless(68.9%), had no religion(38.7%), attended antenatal clinic regularly(91.5%), duration of pregnancy was 38-39 weeks(49.06%), pregnancy was planned(67%), and 42.5% have had some sort of prenatal education. 2. Over all level of educational needs was relatively high(Mn. 3.97) but the level of satisfaction was of average level(Mn. 3.01). Therefore, differences between the level of educational needs and satisfaction was significant (P=.0001) . 3. The educational needs by category, the highest need was on birth preparation(Mn. 4.18), self care of the mother and infant care(Mn 4.10), health maintenance and promotion(Mn. 3.79), the lowest was care of discomfort(Mn 3.66). The level of satisfaction was higher on postpartum self care(Mn 3.15), but the lowest was infant care(Mn 2.84). Differences between educational needs and satisfaction by categories was significant(P=.0001). 4. Relationship between educational needs and levels of satisfaction among primigravida of different characteristics were as follows : . 1) Educational needs of minor discomforts areas were significantly high among age of 25-29 (P=.010%), and over 35years of age, was satisfied on preparation of labor & delivery, postpartum self care(P=.036, .02). 2) With regard to different level of education, middle school graduates had higher educational needs on discomfort care and postpartum self care(P=.0014, .014). College graduates have had higher educational needs on health maintenance(P.008) and were more satisfied on preparation of birth(P=.0025). 3) With regard to whether pregnancy was planned or not, no difference was found on educational needs. But the levels of satisfaction was significantly higher in the group of planned pregnancy(discomfort care P=.0454, birth preparation P=.0256, postpartum self care P=.0092). 4) with regard to antenatal education, those who have had some sort of antenatal education, educational needs on birth preparation(P=.0345) was significantly high. And also the levels of satisfaction were significantly higher on every category (P=.0004-.0001) . 5) No difference was found on educational needs or level of satisfaction by Job, religions, regularity of antenatal care and complication of pregnancy.

모유수유에 영향하는 요인에 관한 연구

전영자 고려대학교 의과대학 1993 고려대 의대 잡지 Vol.30 No.2

The infants first year of life are crucial in laying the foundation on good health and improving the quality of life. Hence, the nature provided breast milk for the infant as it can adequately meet ail the nutritional needs of baby, especially up to 4-6 month of age. And over yeas it has become more and more evident that it is the most ideal, safe and complete food for babies. Regretably, despite all known facts on the value of human milk, the practice of breast feeding is decreasing in Korea in contrast to its increasing in the western society. Therefore, this research was undertaken to find out the factors which influenced on prevalence and duration of breast feeding. The subjects were 337 mothers of infants whose age was 6-12 month and of attended out patient clinic of 3 general hospitals and 2 wellbaby clinic of health center in Seoul area. The data were collected with questionaire which was developed by researcher from August 16-30, 1992. Results were founded as follows: 1. Majority of respondants were aged between 25-29 (51.6%), college graduates (48.6%), Jobless (67.4%), neucleic family structure (83.1%), primiparous (61.7%), attended antenatal clinic regularily (94.0%), nipple is normal (82.5%), delivered baby normally (73.0%) at general hospital (53.1%) or private physicians clinic (46.9%) 2. Majority of respondants infants were aged 6-7 month (36.8%), Male(54.6%) and their birth weight was in normal range (87.96). And the infants whose mother had job were cared by their grandmother (mother of father and or mothers 68.2%) but they live separately from the respondants (60.0%) 3. Among the respondants, 76.9% have fed breast initially but only 18.4% continued it up to 6 month. The reset were discontinued breast feeding at 1-4week (25.8%), 2-3month (15.7%) and within a week (9.28%), 23.1% of mothers had never feed breast milk for their baby. 4. The prevalence and duration of breast feeding were different significantly by the presence of motheres job (P<.01), have had breast care during the antenatal period (P<.01), planned to feed breast milk exclusively (P<.001) for longer than 6 month (P<.001), had breast massage during the postpartal period (P<.001), rooming in (P<.001), delivered at private physicians clinic (P<,001) and started breast feeding earlier while they stay in the hospital (P<.001). 5. No relation was found on prevalence and duration of breast feeding by age, educational level, parity, antenatal care recieved, conditions of nipples, mode of delivery and type of family structure. 6. The subjects yield the reasons for not feed breast milk to their baby were because of bottle feeding have started at the hospital (19.9%), C / S(18.5%), of no secreation of breast milk (12.3%) 7. The reasons of discountinued breast feeding prior to 6 month of infants age were insufficient breast milk (33.8%), mothers job (19.0%) and for the baby's health (10.6%). 8. Percieved mean scores on the factors influenced on breast feeding were attitude toward breast feeding 3.95, knowledge 3.49, health status of mother 3.24, nutritional conditions 3.04, level of stress 2.71, breast feeding methods 3.01, amount of breast milk 3.58, hospital practices 2.25 and social structure 2.32. 9. Mean scores on the influedcing factors were differed significantly by age, educational level, parity and presence of mothers job, (p<05-01). Mean scores on the knowledge was lower in the less educated group, on the health status was worse in the jobless mothers, on the nutritional condition was worse in the less educated group, on the breast feeding method was lower at age of 20-24, less educated, primipara and working mothers. Mean scores on amount of breast milk was lower in the less educated group but higher educated group showed lowest score on hospital practice. Social structure were low scored by less educated and working mothers. 10. Relationship between prevalence, duration of breast feeding and mean scores of related factors revealed significant differences on breast feeding methods (P<.01), hospital pracitce (p<.01) and social structure (p<.05) that higher scored group feed longer meanwhile lower scored group feed shorter and or not feed ever. 11. In the cases of those did not feed breast milk due to no secreation of breast milk, correlation was relatively high between the factors, such as health and nutritional status (r. 40), feeding methods ((r.42), levels of stress (r.-43) and social structure (r.47) Amounts of breast milk and feeding methods (r.80) hospoital practices (r.44) and social structure (r.56) 12. In the cases of discontinued breast feeding prior to 6 month of infants age because of infufficient breast milk, revealed a significant correlation between the factors ; the amount of breast milk and health status (r.18), levels of stress (r.22), breast feeding method (r.38) and social structure (r.26). In conclusion, this study revealed that hospital practices, social structure, breast feeding method are most important factors for breast feeding practices.

초임부의 교육 요구와 만족도에 관한 연구

전영자 고려대학교 1999 간호학논집 Vol.1 No.-

腹式分娩産母의 臨床看護學的 分析 硏究

전영자 간호사 1980 월간 看護 Vol.1980 No.9

Changing Family Patterns and Their Influence on the Child's Health and Development

Chun, Young-Ja 고려대학교 의과대학 1979 고려대 의대 잡지 Vol.16 No.2

가정은 어린이가 태어나면서부터 최초로 접촉하는 사회이며 그 가족으로부터 보호와 애정을 받으면서 신체적 정서적 및 사회적으로 성장 발달하게 된다. 특히 가정에서 어린이는 비공식적 교육을 통해서 어린이가 속해있는 사회가 요구하는 생활방식과 규범을 습득하고 다른 사람과 상호작용하는 방법을 습득함으로 사회의 일원으로 성장하게 된다. 특히 어린이의 성격형성의 기틀이 잡혀지는 유아기에 있어서 가정의 환경 즉 부모의 정서상태, 부모자녀관계, 훈육방법, 가족구성원의 됨됨이와 가정의 도덕적 규준은 어린이의 성장발달에 직접적으로 영향을 준다. 그러나 현대사회는 사회 경제적 발달, 산업의 발달, 서양문화의 유입, 친족관념의 희박등으로 가족의 형태가 대가족제도에서 핵가족화되고 있으며 이러한 변화는 가족의 형태면 뿐 아니라 가족의 역할 및 기능면에 까지 많은 변화를 초래케 되었다. 특히 모성의 직장진출로 인해 자녀 양육방법의 양상이 변화되어 어머니가 아닌 가정부나, 형제 또는 탁아소 등 전문가의 손에 맡겨지고 또한 모유 대신 우유로 양육되고 있으며 조기에 이유를 해야하는 실정이어서 어린이는 정서적으로 스트레스를 받게된다. 또한 급격한 산업화로 대부분의 아버지들은 그들의 사업에 얽매여 가족과의 상호작용할 시간이 없고 아울러 아버지의 고유 역할을 충분히 이행할수 없는 상태이므로 어린이는 가정에서 습득해야할 가치관 확립이 어렵고, 어린이들이 갖는 여러 가지 갈등과 문제점을 충분히 해결 할 수 없게 되어 심리적 갈등 뿐 아니라 탈선의 요인도 되고 있다. 결혼과의 변화로 인한 이혼문제 및 미혼모 문제로 파생되는 어린이의 안녕문제는 날로 심각해 지고 있다. 이러한 시대적인 변화 상황에서 보다 어린이가 건강하고 건전하게 성장발달 하도록 돕는데 있어서 일차적인 책임은 부모가 부모의 역할과 기능을 충실히 이행함으로 어린이는 보다 건강하게 성장할 수 있을 것이며 사회 역시, 어린이의 건강과 건전한 성장발달을 위해서 필요한 정책의 결정과 수행을 보다 적극적으로 해야 할 것이다. The influences of the family, including family-life patterns, upon the child's health and development, especially in the formative years of young childhood have been briefly discussed. As the major responsibility for the health and development of the child lies with the parents and the society, inorder to meet the child's needs, it is essential to strengthen the roles and functions of the family and of child social services.

노인운동의 변화단계에 따른 의사결정 균형에 대한 연구

김소인,전영자,박은숙,김순용,장성옥,이평숙,이숙자 성인간호학회 2000 성인간호학회지 Vol.12 No.1

Purpose : This study was carried out to identify the factor of decisional balance for exercise. This was composed of a set of variables at the level of decision making when the elderly decide to do exercise. It was used to classify and identify the characteristics of the stages of change for exercise to which the elderly belong, and was used to identify the variables of decisional balance which influence the stage of change for exercise in the elderly. Methods : Convenient samples of 198 subjects over age 60 in Seoul(mean age=70) were selected from community living, mentally competent older adults and the data was collected from April 1, 1999 to May 31, 1999. The research instrument was the Decisional Balance Measure for Exercise(Marcus & Owen., 1992), Stage of Change Measure(Marcus et al, 1992). The data was analyzed by SAS Program. Results: 1. According to stage of change measure, without missing data, 191 subjects were distributed in each stage of change for exercise : 50 subjects(26.1%), 7 subjects(3.6%), 52 subjects(27.2%), 4 subjects(2%), and 78 subjects(40.8%) belonged to the pre-contemplation stage, contemplation stage, preparation stage, action stage and maintenance stage. 2. Factor analysis identified 3 factors of decisional balance as appropriate factors for excise of the elderly and named by researchers; 1)'Perceived Physical-psychological benefit', 2)'Perceived Physical-psychological burden', and 3)'Perceived time burden'. 3. The analysis of variance showed that the two components Perceived Physical - psychological benefit(F=45.95, p=.0001), and Perceived Physical-psychological burden(F=26.52, P=.001) were significantly associated with stage of change. 4. Through the discriminant analysis, it was found that both 'Self Perceived Physical-Psychological benefit' and 'Perceived Physical-Psychological burden' were the influential variables in discriminating the three stages of change(pre-contemplation, preparation, and maintenance). Conclusion: Results are consistent with the application of the Transtheoretical model, which has been used to understand how people change health behaviors. Even though this study is a cross-sectional, not a longitudinal study, the findings of this study give useful information for exercise intervention about especially the factors relating to decision making for exercise of the elderly in the different stages of change of exercise.