胃內視鏡 檢査時 患者의 反應

鄭福禮 慶北大學校 醫科大學 1980 慶北醫大誌 Vol.21 No.2

1978年 4月 20日부터 同年 8月 7日 사이에 慶北大學校 醫科大學 附屬病院 胃鏡室에 胃內視鏡 檢査를 받으러 온 患者 200名을 對象으로 患春의 身體約, 또는 環境上의 條件 및 胃內視鏡檢査에 대한 사전 理解 등과 患者가 느끼는 苦痛 및 反應과의 關係를 檢討하여 다음과 같은 成績을 얻었다. 性別로는 女子가 男子보다 더 不安하고 또 더 苦痛을 느꼈으며 敎育程度別로는 敎育程度가 높을수록 적게 느끼는 傾向이 있었으나 有意的인 差는 없었다. 飮酒習性과 느끼는 著痛 사이에는 별 關聯性이 없었고 腎內視鏡檢査에 대해 事前 情報를 들은 일이 있는 群이 苦痛을 적게 느꼈고, 이 檢査에 대해 不安을 많이 느낄수록 더 若痛을 느꼈으며 患者의 體格과 느끼는 苦痛과의 사이에는 別 關聯性이 없었다. 檢査直後 檢査所感은 敎育程度가 높을수록, 診察頻度가 낮을수록, 不安感을 적게 느낄수륵 檢査를 잘해 보았다고 辰應하였다. 患者의 脈搏, 呼吸, 血壓은 檢査가 進行될수록 上昇하고 있었다. 入院患者의 경우 外來患者의 경우보다 檢査에 대한 看護員의 事前敎育이 잘되어 었었고, 不安感도 入院患者에서 적게 느끼는 傾向이 었었다. The purpose of this study was to investigate the degree of pain, anxious feeling, and changes in vital signs of patients in the course of gastroduodenofiberscopy and to discuss their reactions in connection with their personal back grounds, particularly their sex, ages, level of education. Two hundred patients were interviewed, and their vital signs were checked three times in the process of the examinations. This study was conducted from April, 20, 1978. to August 7, 1978. No significant results were noted in relation to ages and educational backgrounds. Most of the patients felt very anxious and experienced pain. The female patients reported more pain and were more anxious because of examinations than the male patients. The more anxious the patient felt, the greater the pain. The well-informed patients felt less than the uninformed patients. The inpatients were bettr informed than the outpatients. Vital signs of all patients were considerably increased just before and directly after the examination than just before the pretreatment for endoscopy. Most of the patients replied that they were satisfied to have the oppotunity to receive this examination.

간호사와 의사의 악성종양성 통증관리 실태

서순림,정복례,박진미 慶北大學校 醫科大學 1996 慶北醫大誌 Vol.37 No.3

목적 : 본 연구는 암환자의 통증사정과 관리에 대한 간호사와 의사의 지식을 파악하고 실제로 통증사정과 관리를 위해 실시한 방법을 분석하므로써 간호사와 의사를 위한 악성종양성 통증관리 교육프로그램 개발의 기초자료를 제공하기 위한 것이다. 대상 및 방법 : 연구대상은 대구시내 2개 종합병원에 근무하는 간호사 136명, 수련의사 46명이었으며 자료수집기간은 1995년 12월부터 1996년 3월까지였고 설문지를 사용하여 조사하였다. 연구도구는 June Dahl, McCaffery 등의 기존도구에 실제 수행하고 있는 통증사정과 관리에 대한 개방식 질문내용을 첨가하여 사용했으며 자료분석은 SAS program에 의해 두 집단간의 X^2 test를 하였다. 결과 : 암환자는 진단초기이던 진행된 상태이던 통증호소율이 상당히 높았다. 악성종양성 통증은 암자체로 인하며 통증을 가장 정확히 판단하는 사람은 환자자신이라고 하면서도 환자의 통증호소를 그대로 믿어야 한다는 관점에서는 간호사/의사 모두 지식정도가 낮았다. 또한 수면이나 안정을 통증완화와 동일시하거나 활력증상의 변화를 심한 통증때문으로 간주하는 등 잘못 알고 있었고 진통제사용에 대해서 간호사와 의사 모두가 어느 정도는 과소투약의 문제를 인식하고 있었으나 구강투여의 적절성이나 부작용, 최대용량 사용 시기 및 심리적 의존심 발생확률 등에 대한지식이 상당히 부족하여 마약성 진통제 사용에 대한 지나친 두려움이 있음을 볼 수 있었다. 현재 실무에서의 통증사정은 간호사와 의사 모두 환자행위 관찰을 위주로 하고 있고 통증관리는 대부분 진통제 사용에 의존하고있었다. 결론 : 악성종양성 통증 사정 및 관리에 대한 지식부족이 나타났으며 이로 인한 간호사 의사의 보수적인 태도와 편견이 있었으므로 이를 개선하기 위한 악성종양성 통증관리교육 프로그램을 실시하여 통증을 호소하는 암환자의 삶의 질을 높여야 할 것이다. The purpose of this study was to identify the knowledge and the parctice of cancer pain management in nurses and physicians. The subjects were 136 nurses and 46 residents working at two hospitals in Taegue from December, 1995 to march. 1996. The survey was done by self-reported method using questionnaires and data analysis by SAS. The results were as follows; 1. The rate of patients with pain was 39% by nurses and 42% by physcians perceived at the time of cancer diagnosis. Nurses and physicians reported that the incidence rate of pain was 90% respectively in the cases of advanced cancer. The rate of patients complaining pain during one month or more was 72% by nurses and 75% by physicians. 2. Nurses and physicians knew well the fact that 'pain is due to cancer itself' and 'patient with pain is the best one who judges accurately its intensity'. However, there was low level of such knowledge as that 'cancer pain with treatment is relieved well' and 'medical professional must believe patient's report of pain'. 3. There was prevailed some misconcept like that 'sleep and sedation can be equated with pain relief', 'observable changes in vital sign must be relied upon to verify a patients's statement that he has severe', and 'giving patient placebo is useful test to determine if the pain is real' in most nurses and physicians. 4. Most nurses and physicians responded that 'cancer pain of hospitalized patient is rarely or never relieved'. 5. 56% of nurses and 79.% of physicians agreed in terms of undermedication of cancer pain management. About 50% or more of nurses and physicians showed that 'pain is better controlled when analgesics are administer around the clock'. In terms of oral route as the preferred administration of analgesics, constipation occurred frequently after repeated administration of narcotics, and prognosis less than 24 months as appropriate time to receive maximal doses of analgesics, nurses and physicians didn't know well. 6. Nurses and physicians knew little about the fact that the incidence of psychological dependence as a result of the legimate use of narcotics in cancer pateints with pain was less than 1%. Most of them knew psychological dependence as one of frequent side effects in cancer patients with pain and concerned it with one of their family who receiving narcotics. 7. Few of nurses and physicians knew accurately having patient's request of increasing amounts of analgesia due to increasing pain. 8. At the current practice for pain management, nurses used to administer analgesics(45%) and listening/psychological support/giving good environment(31%) to patients, physicians used to prescribe analgesics(77%) mainly. 9. The behavioral change of patients due to pain was observed as the assessment of pain patients by nurses923%) and physicians(61%). As the above results, pain was not relieved completely although it was one of frequent symptoms in cancer patients at the clinical setting. Nurses and physicians had lack of knowledge of pain assessment and management. Particularly as the results of knowledge deficit for narcotic medication such as pharmacology, administration, side effect, psychological dependence and prescription about maximal doses, nurses and physicians had misconcepts and did misuse of analgesics besides they had conservative attitudes toward pain assessement and management. Therefore it is necessary for nurses and physicians to be given an appropriate in-service education for pain management in clinical setting. After this education done for them, it is recommanded evaluative research of education program for improving quality care of cancer patient with pain.

당혹감(embarrassment) : 개념분석 a concept analysis

정은정,정복례 성인간호학회 2002 성인간호학회지 Vol.14 No.2

Purpose: The concept of embarrassment as an unpleasant emotion is important in caring for those who are in the continuum of illness and health requiring body care and facing sexual problems. In spite of its nursing implication, embarrassment has not been focused in nursing research. Therefore, the purpose of this paper is to develope a conceptual analysis of embarrassment. This analysis would help to understand comprehensively an embarrassing situation in which an intimate relationship between nurse and patient regarding body care of the patient could develope. Futhermore, it would be a basis for developing strategies for prevention of embarrassment which could lead for both patient and nurse to emotionally vulnerable situation because of their failure of self-presentation (impression management). Method: The concept analysis model suggested by Walker and Avant (1988) is used to clarify what is meant by the term embarrassment'. Result: This analysis defines the attributes of embarrassment such as follows. First, embarrassment is often attributed to situational factors interrupting a smooth interaction such as intimacy, confusion, vulnerability, exposure of interaction and characteristics of audience. Second, embarrassment is closely related with cognitive factor such as fear of losing face resulted from a behaviour being out of line. Third, embarrassment is closely associated with dispositional factor such as embarrassability. Fourth, embarrassment is an unpleasant and unwanted emotion arising reactively after an interaction had occurred. Fifth, embarrassment encloses physical, physiological and behavioral aspects such as a variety of unique and easily noticeable reactions and a pattern of verbal and non-verbal behaviour for coping in an embarrassing situation. The antecedents were normally socialized adolescents with normal cognitive ability, concern of losing face, embarrassability, embarrassing events related with situational intimacy, confusion, vulnerability, exposure of interaction and characteristics of audience, physical, behavioral blunders resulting in a failure of impression management. The consequences were an emotional coping behaviour, audience's embarrassment responses, and verbal and non-verbal coping strategies of interactional participants. Conclusion: It is hoped that this analysis will stimulate further exploration of this concept and study for developing systematic assessment and nursing practice that diminishes embarrassment of interactional participants.

청소년, 성인, 노인의 수면의 질과 수면 방해 요인 비교

박현숙,김경덕,김경혜,정복례 대한간호학회정신간호학회 2000 정신간호학회지 Vol.9 No.4

The purpose of this study is to search for sleep quality and factors which are influenced on sleep among adolescents, adults and elderly Subjects were 108 adolescents, 85 adults and 114 elderly who live around Taegu city. The data were collected from August 10, 1998 to January 20, 1999. A self-rating questionnaire was used to collect data. Data were analysed in frequency, percentage, X^2 -test, means, standard deviation, t-test, ANOVA, and Scheffe test by SAS computer programme. The results of this study were as follows : The mean score on quality of sleep was 4.57 in adult, 5.79 in adolescents, and 6.71 in elderly. There were statistically significant in quality of sleep among three groups. The mean score of quality of sleep in adults was the highest compared to others. The subjective quality of sleep in elderly was poorer than adults. Quality of sleep in elderly was characterized by prolonged sleep latency, reduced sleep duration, lowered habitual sleep efficiency. Adolescents had the highest level of daytime dysfunction among the three groups. Factors which were influenced on sleep in daily life were investigated. Adolescents were disturbed by 'nocturia(4.6%)', 'feeling too cold(4.6%)', and 'dreams(4.6%)'. Adults were disturbed by 'nocturia(7.1%)', 'other reasons(5.9%)', and 'cough and loud snoring(2.4%)'. And the elderly were disturbed by 'nocturia(75.5%)', 'other reasons(7.9%)', 'shortness of breath(4.4%)', and 'cough and loud snoring(4.4%). Nocturia was the common disturbing factor which was influenced on sleep in the elderly.

성인 암환자의 질병 특성에 따른 증상발생 정도

허혜경,이은현,이원희,소향숙,정복례,강은실 성인간호학회 2002 성인간호학회지 Vol.14 No.3

Purpose: This study was to investigate symptom occurrence related to the disease characteristics of patients with cancer. Method: A total of 301 patients with cancer participated in this study. The participants were recruited from University Hospitals located in Seoul, Wonju, Kwangju, Daegu, and Pusan. Data collection was performed by using a questionnaire on symptom occurrence. The obtained data was analyzed using SPSS computer program that included descriptive statistics, Pearson correlation, one-way ANOVA, and t-test. Result: The mean score of fatigue was the highest (3.24), followed by loss of appetite, lack of concentration, change in appearance, pain, insomnia, change in bowel pattern, nausea/vomiting, coughing, and dyspnea. Most symptoms were significantly correlated with each other. The level of symptom occurrence in patients with lung cancer or cervix cancer was significantly higher than the level in patients with stomach cancer. Patients receiving radiation therapy or a combined therapy of radiation therapy and chemotherapy experienced significantly higher level of symptom occurrence significantly higher level of symptom occurrence than those receiving chemotherapy only. Also, female patients experienced higher level of symptom occurrence than male patients did. Conclusion: The sites of cancer, types of treatment, and gender influence the level of symptom occurrence of patients with cancer. Thus, these variables should be considered when assessing and planing for symptom occurrence of patients with cancer.

An Approach to Clinical Instructor Development

Chung, Bok Yae 慶北大學校 醫科大學 1994 慶北醫大雜誌 Vol.35 No.4

베트남 결혼이주여성의 임신과 출산 경험

정복례(Bok Yae Chung),유광자(Kwangza Yu),김지숙(Ji Suk kim) 한국가족학회 2014 가족과 문화 Vol.26 No.2

본 연구는 심층적인 면담을 근거로 다문화가정 결혼이주여성의 임신과 출산 경험을 이해하고자 한다. Giorgi(2004)의 자료수집과 순환적 분석 방법을 적용한 기술적 현상학적 연구이다. 참여자는 총 5명이었으며, 31개의 의미단위와 14개의 주제를 묶어 6개로 범주화하였다. ‘임신을 기다림’,‘도장 찍음’ 주제를 묶어 ‘가족의 신뢰감 얻기’로 범주화하였다. ‘가족의 지지’, ‘고향친구와 도움주고 받기’의 주제를 ‘도움 주고받기’로 범주화시켰으며, ‘태교하기’ 그리고 ‘공부하기’ 주제는 ‘좋은 엄마가 되기 위해 노력하기’로 범주화하였다. 다문화 가정 이주여성들의 ‘말 못하는 답답함’ ‘서운함’, ‘힘겨움’ 그리고 ‘도와주는 사람 없음’에 대한 주제들을 ‘참고 견디기’로 범주화하였고, ‘역할획득’ ‘위안 받음’은 ‘자식을 위해 살아가기’로, ‘아기양육에 대한 걱정’, ‘남편의 불 건강에 대한 걱정’은 ‘삶에 대한 걱정’으로 범주화하였다. 본 연구결과 베트남 결혼이주여성은 결혼에 대한 의미를 임신으로 여기고 임신을 기다리고 확인하면서 좋은 엄마가 되고자 노력하고 한국 사회와 문화에 적응하기 위해 스스로 노력하고 견디면서 살아가고 있었다. 본 연구는 베트남 여성만을 대상으로 그들의 삶의 경험을 분석한 바, 차후에는 베트남 외에 중국, 일본, 필리핀 등 각 나라에 따른 그들의 임신출산 경험을 깊이 있게 분석･연구하고, 이를 토대로 각 나라별 임신출산 문화를 인정하고 존중할 수 있도록 교육 책자와 홍보에 필요한 정보를 제공할 것을 제언한다. The purpose of this paper is for us to understand the experience of pregnancy and postpartum experiences of migrant women in a vietnam in korea. This study is based on in-depth interviews in accordance with the procedures of the Giorgi(2004).The participants of this study were consists of five members and then 31 meaning units and 14 theme were categorized into six. First, ‘Get the confidence of the family’ was categorized into ‘Waiting to see the pregnancy’, and ‘Taken painting’. Second, ‘Giving and receiving help’ was categorized into ‘Family support’, ‘Sending and receiving home help friend’ Third, ‘Good mother’ was categorized into ‘Guidance to’ and ‘Study’. Forth, ‘Hold on and withstand’ was categorized into ‘Tightness dumb’, ‘disappointment’ ‘Feels stuffy’ and ‘Can anyone help’ Fifth, ‘For the child to live’ was categorized into ‘Role Attainment’, ‘Comfort’. Finally, ‘worry about life’ was categorized into Worried about baby parenting and her husband’s ill. Therefore, marrid migrant women think that the meaning of marriage is pregnant and waiting for the Get the confidence of the family. She trying to become a good mother in the Korea Society and endure themselves while trying to adapt in the Korea Society and Culture. It is necessary to understand and analyze of the tough learning experience of migrant women while pregnant and giving birth in Korea, which will make a new family with the multi-cultural families and solve social problems and conflicts in the future.

국내 수면장애 성인을 위한 비약물적 중재 효과에 대한 메타분석

정복례(Bok-Yae Chung),박현숙(Hyeon-Sook Park) 한국산학기술학회 2017 한국산학기술학회논문지 Vol.18 No.1

본 연구는 국내 수면장애를 가진 성인을 대상으로 비약물적 중재를 실시한 논문을 메타분석하여 중재 효과의 크기를 확인하고자 실시되었다. 본 연구의 자료검색은 국가과학기술정보 통합서비스 (NDSL), 한국교육학술정보원 (RISS), 한국학술정보원 (KISS), 학술데이터베이스서비스 (DBpia)에서 이루어졌으며, 검색된 2000년부터 2016년까지의 연구 1,334편 중 16편의 연구를 선정하였다. 분석은 메타분석 R(version 3.3.1)을 활용하였으며, 랜덤효과모형을 이용하여 비약물적 중재의 효과크기를 산출하였다. 메타분석 결과 수면장애가 있는 성인에게 수행된 비약물적 중재의 효과크기 Hedges" g는 2.36 (95% CI:1.44~3.28)로 큰 효과크기이었으며, 통계적으로 유의한 것으로 나타났다. 조절효과 분석에서 연령 집단, 중재방법, 입원유무 및 결과측정 도구에 따른 효과크기는 통계적으로 유의한 차이가 있었으나 연구설계 및 참여자 유형에 따른 효과크기는 유의한 차이가 없었다. 중재 중 이압요법이 가장 큰 효과크기를 보였고, 발반사 마사지, 아로마요법, 기타 및 웃음치료 순이었다. 연구결과는 수면증진을 위한 비약물적 중재가 수면에 효과적임을 확인하게 되었고, 실무에서 수면장애를 가진 성인을 위한 중재를 선택하고 실행하는데 객관적인 근거를 제공할 수 있을 것이다. The purpose of this study was to identify the effects of non-pharmacological interventions for Korean adults with insomnia. Literature review was performed for articles published between 2000 and 2016 in electronic databases. Sixteen articles met the inclusion criteria. Data were analyzed by R version 3.3.1 for windows. Meta-analysis was performed using the random effects model; the overall effect size of non-pharmacological interventions on sleep was significantly large (Hedges" g=2.36, 95% CI: 1.44~3.28). For heterogeneity, a moderator analysis was performed using the study design, participants, age group, intervention, presence of hospitalization, and sleep measurement. There was a statistically significant difference between the effects of moderator variables, except for the study design and participants. Of the interventions, auricular acupressure reported to have the largest effect size on sleep. The findings in this study indicate that non-pharmacological interventions have a positive effect on sleep, providing objective evidence to improve sleep in adults with insomnia using effective interventions.

Application of Nursing Conceptual Model to Nursing Education and Practice

Chung, Bok Yae 경북대학교 간호과학연구소 2000 경북간호과학지 Vol.4 No.1

Symptom Experience, Mood Disturbance, & Social Support in Breast Cancer Patients Undergoing Radiotherapy

Chung Bok Yae(정복례),Yu Xu,Lee Eun-Hyun(이은현) 대한종양간호학회 2006 Asian Oncology Nursing Vol.6 No.2

목적: 본 연구는 방사선치료를 받는 유방암 환자의 증상경험, 정서적 상태와 사회적지지 및 관련 변수간의 관계를 파악하기 위한 서술적 상관관계 연구이다. 방법: 연구대상자는 T시에 위치한 2개 대학병원에서 방사선 치료를 받는 유방암 환자 126명으로, 연구도구는 일반적 특성과 증상경험, 정서적 상태 및 사회적지지를 측정하기 위한 도구로 구성된 질문지이다. 결과: 연구대상자의 증상경험은 21.96(SD = 14.14), 정서적 상태는 110.95(SD = 100.92), 사회적지지는 3.70(SD = 0.98)로 나타났다. 증상경험과 정서상태는 유의한정 상관관계(r = .396, p = .001)를 나타내었고, 증상 경험과 사회적지지는 유의한 부적 상관관계(r = -.304, p = .003)를 나타내었다. 증상경험에 영향을 미치는 요인은 정서적 상태로 설명력이 16.5%이었다. 제언:이상의 연구결과 방사선치료를 유방암 환자의 증상경험과 환자의 정서적 상태가 관련이 됨을 알 수 있으나, 그 설명력은 약하므로 앞으로 더 연구하여야 할 영역이라 생각한다.