농촌지역 노인들의 우울증상에 관련된 요인들의 특성

송미숙,전기홍,송현종,김정은,박승구,신상건,이동훈,정성현,최연주,최완철,최민규,황재철,홍지만 아주대학교 1997 아주의학 Vol.2 No.2

This study was performed to identify risk factors for depression among the elderly in a rural area. A survey was done for the elderly living in Gosam-myenn, Ansung-kun during the period of July 28, 1997 and July 30, 1997. Demographic and sodoeconornic characteristics, and functional and health Status were assessed using a structured questionnaire, and the level of depression was measured by GDS score. The data obtained were analyzed by frequencies, percentage, t-test, ANOVA, and multiple regression, and the results were as follows: 1. The total sample consisted of 133 elderly. Of them, 47 elderly (35.4%) showed significant depressive Symptoms. 2. The GDS score was the highest for the group over 85 years of age (p < 0.05). Those living alone or widowed showed lower GDS score than those living with someone or married (p < 0.05). 3. The GDS score was the highest in the absolutely dependent group, followed by the partially dependent group, and the independent group (p < 0.01). The elderly who perceived their health Status as excellent showed the lowest GDS score. In contrast, those who had more than five chronic diseases showed the highest GDS score. 4. The elderly receiving financial and emotional support from their family or friends showed lower GDS score compared to those without any support. 5. The economically dependent group showed higher GDS score than that of independent group. 6. The elderly who involved in leisure activities showed lower GDS score than those without any involvement. 7. In terms of risk factors for depression, we found that perceived health Status, subjective economic Status, leisure activities, living arrangement and financial support were inversely associated with GDS score, whereas labor support was positively associated with GDS score. Based upon the above findings, this study suggests that these risk factors for depression in the elderly should be taken into consideration for a comprehensive mental health program for the elderly living in the rural area.

제2형 당뇨병 환자에게 적용한 표준진료지침이 혈당, 당화혈색소, 당뇨지식 및 재원일수에 미치는 효과

김희승,윤건호,유양숙,오정아,송민선,신미옥,김경희,송복례 대한당뇨병학회 2002 임상당뇨병 Vol.3 No.1

연구배경 : 당뇨병 환자의 평균 재원기간을 단축시키고, 제한된 입원기간 내에서 질적인 면과 비용효과성을 고려한 총체적인 건강관리체계의 필요성이 요구됨으로써 생겨난 것이 당뇨병 표준진료지침(Critical Pathway: CP)이다. 현재 개발된 당뇨병 CP를 통한 진료가 환자의 당뇨병에 관한 지식을 개선시키고 이에 따라 장기적으로 당뇨병 환자의 혈당조절이 개선되었다는 과학적인 검증은 당뇨병 CP를 여러 병원에 정착시키기이전에 반드시 선행되어야 할 과제이다. 이에 본 연구는 2000년 3월부터 1년간 강남성모병원에 입원하는 당뇨병 환자를 대상으로 현재 개발된 1주일 CP를 적용한 실험군의 혈당, 당뇨병 관련 지식 및 재원일수가 대조군에 비하여 차이가 있는지를 조사하였다. 방법 : 1주일 CP를 적용한 실험군은 내과병동에 입원한 당뇨병 환자 89명이었고, 대조군은 기타병동에 입원한 당뇨병 환자 22명이었으며 CP를 적용하지 않았다. CP를 적용하기 전인 입원시에 실험군과 대조군의 공복혈당, 식후 2시간혈당, 당화혈색소 및 당뇨관련 지식을 측정하였고, 퇴원 시에 실험군과 대조군에게 공복혈당과 당뇨관련 지식을 재측정하고 재원일수를 파악하였다. 그리고 두 군에게 퇴원 3개월 후의 공복혈당, 식후 2시간 혈당 및 당화혈색소를 조사하였다. 결과 : 1) 실험군의 공복혈당은 입원 시 238.7: 1) 실험군의 공복혈당은 입원 시 238.7mg/dL에서 퇴원 시 139.4mg/dL로 감소하는 경향이었으나 퇴원 3개월 후에는 150.6mg/dL로 약간상승하는 경향을 보였다. 대조군은 입원 시 251.5mg/dL에서 퇴원 시 136.2mg/dL로 감소하는 경향이었으나, 퇴원 3개월 후에는 219.3mg/dL로 현저히 증가하는 경향이었다. 2) 실험군의 입원 시 식후 2시간 혈당은 312.5mg/dL에서 퇴원 3개월 후 248.5mg/dL로 감소하는 경향이었다. 대조군도 입원 시 식후 2시간 혈당이 300.1mg/dL에서 퇴원 3개월 후 262.5mg/dL로 감소하는 경향이었으나 실험군보다 감소의 폭이 적은 경향이었다. 3) 실험군과 대조군의 입원 시 당화혈색소는 각각 10.3%와 9.7%로 유의한 차이가 없었으나,퇴원 3개월 후 실험군은 7.5%로 대조군의 9.1% 보다 유의하게 감소하였다. 4) 실험군의 입원 시 당뇨지식 점수는 실험군이 12.1점 대조군은 12.0점으로 유의한 차이가 없었으나 퇴원 시는 실험군이 15.5점으로 대조군의 14.6점 보다 높은 경향이었다. 5) 재원일수는 실험군이 8.4일로 대조군의11.0일 보다 유의하게 적었다. 결론 : 따라서 당뇨병 환자를 위한 CP는 재원일수의 감소뿐만 아니라 환자의 자가관리에 대한 체계적인 교육과 개선의 기회를 가짐으로써 장기적인 혈당 조절의 향상을 도모할 수 있는 효과적인 방법이라고 생각한다. Background: The aim of this study was to examine the effects of the critical pathway for the admitted patients with type 2 dia betes me llitus on glycemic control, the knowledge on the disease, and the length of hospital stay. Methods: 89 diabetic in-patients were applied with the 1 week critical pathwa which was consisted of intensive education program for self-management of diabetes me llitus such as glucose monitoring, excercise prescription, diet control, self-a djustment of the drugs and so on. The results were compared with 22 diabetic inpatients who were treated with conventional way. We assessed the effects of critical pathway on the degree of glycemic control, the knowledge on the disease, and the length of hospital stay. Results: Although fasting and postprandial 2 hours blood g lucose levels did not showed sta tistically significantd ifference between critical pathway group and conventional group on discharge , HbA1c was significantly decreased in critical pathwa group compared with the conventional group (7.5±1.8% vs 9.1±2.6%) on 3 months after discharge . Knowledge on the disease tended to increase in critical pathway group compared with the conventional group on discharge. The Length of hospital stay was significantly decreased in critical pathway group compared with the conventional group (8.4±2.8day vs 11.0±3.9da ) Conclusion: These results showed that critical pathway for the patients with diabetes mellitus might be a usefulway for improving the long term glycemic control through motivation, enhancing the knowledge on the disase as well as reducing the length of hospital stay.

한의진단명과 진단요건의 표준화 연구 III : 3차년도 연구결과 보고

최선미,양기상,최승훈,박경모,박종현,심범상,김성우,노석선,이인선,정진홍,이진용,김달래,임형호,김윤범,박성식,송태원,김종우,이승기,최윤정,신순식 한국한의학연구원 1997 한국한의학연구원논문집 Vol.3 No.1

The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the third year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows : - analyzing and differentiating of epidemic febrile disease - analyzing and differentiating in accordance with the Sasang constitution medicine based on four-type recognition - differentiation of disease according to pathological changes of Chong and Ren channels - standards for diagnosis of women's disease - standards for diagnosis of children's disease - standards for diagnosis of motor and sensor disturbance (-muscle. born, joint, etc.) - standards for diagnosis of neuropsychiatric disease - standards for diagnosis of five sense organ disease - standards for diagnosis of external disease The indivisual diagnosis pattern was arranged by the diagnostic requirements in the following order : another name, notion of diagnosis pattern, index of differentiation of symptoms and signs, the main point of diagnosis, analysis of diagnosis pattern, discrimination of diagnosis pattern, prognosis, a way of curing a disease, prescription, herbs in common use, disease appearing the diagnosis pattern, documents. The standards for diagnosis of each disease was arranged by the diagnostic requirements in the following order : another name, notion of disease, the main point of diagnosis, analyzing and differentiating of disease, analysis of disease, discrimination of disease, prognosis, a way of curing and prescription of disease, disease in western medicine appearing the disease in oriental medicine, documents.

폐 활성 슬러지의 납 흡착에 따른 기초 요소의 영향

강미영,서정호,이창한,이송우,나영수,송승구 부산대학교 환경문제연구소 1998 環境硏究報 Vol.16 No.-

본 연구에서는 하수 처리장에서 발생되는 상당량의 폐 슬러지를 전처리 없이 중금속 제거에 사용하였다. 본 연구의 목적은 폐 슬러지를 이용하여 중금속을 제거하는 것이다. 온도와 pH, 초기 농도의 영향과 보관 시간에 따른 납 흡착량의 영항을 흡착등온 모델과 흡착속도 모델에 적용시켜 활성슬러지의 납 흡착 특성을 고찰하였다. 납, 카드뮴, 크롬, 니켈 중 슬러지는 납을 가장 많이 제거하였고, pH 4.5~5.5에서 최대의 흡착량을 나타냈으며, 온도가 증가할수록 흡착량은 증가하였고, Langmuir model에 잘 적용되었으며, 초기 최대 흡착속도도 Michaelis-Menten 형태 식으로부터 구하였다. In sewage treatment plant, waste sludge was one of bothering thing to be treated. The objective of this study was to examine the removal of heavy metal by waste sludge. The effect of factors such as temperature, pH, storage time, initial concentration of lead, and initial amount of biomass on adsorption of lead was investigated. And the biosorption model, adsorption isotherm, and initial adsorption rate model were evaluated. Waste sludge was proved to have an excellent ability to remove lead than other heavy metals such as cadmium, chromium, nickel in pure and mixed solution. The optimum pH of biosorption with waste sludge was 4.5~5.5, and the amount of adsorption was increased with increasing temperature. The adsorption isotherm of lead to waste sludge followed to Langmuir model. The initial adsorption rate of lead to waste sludge followed to Michaelis-Menten type kinetic.

제2형 당뇨병 동물모델인 OLETF 쥐에서 장기간 라미프릴 투여가 내당능 및 췌도 베타세포에 미치는 효과

고승현,윤건호,김명미,안유배,송기호,유순집,손현식,차봉연,이광우,손호영,강성구 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.25 No.6

연구배경:최근 소개된 HOPE(Heart Outcomes Prevention Evaluation)study의 결과에 의하면, 심혈관질환이나 이에 대한 위험인자가 1가지 이상인 9,541명을 대상으로 안지오텐신 전환효소 억제제의 일종인 라미프릴을 투여하여 사망율과 뇌졸증, 심부전, 당뇨병 합병증이 개선되었을 뿐 아니라 다른 항고혈압제에 비해 새롭게 당뇨병으로 진단되는 환자가 줄었음을 보고한바 있다. 이에 저자들은 라미프릴(ramipril)을 제2형 당뇨병 동물모델에 장기간 투여함으로써 당뇨병을 예방하거나 고혈당 상태 또는 인슐린 감수성을 개선시킬수 있는지를 알아보고자 하였다. 방법:생후 24주된 체중 400∼450g의 OLETF와 LETO 쥐를 대상으로 6개월간 라미프릴 경구투여 하였고 혈압, 24시간 단백뇨 및 인슐린 내성검사를 시행하였다. 6개월 이후로는 8주간 투여군과 대조군의 체중을 비슷하게 맞추어 내당능 상태를 평가하였고 이후 다시 8주간 고농도 포도당을 투여하였다. 경구당부하검사를 시행한 후 희생시켜 조직표본을 만들어 guinea pig anti­human insulin 항체로 염색후 DAB로 발색하여 point count 법으로 베타세포를 정량하였고, 면역염색으로 췌도의 변화와 섬유화의 정도를 관찰하였다. 결과:라미프릴을 6개월간 투여하였을 때 OLETF 쥐에서 1)체중 증가가 적었으며 2)경구 당부하검사시 포도당하 면적은 의미있게 감소하였고 3)인슐린 내성검사상 Kitt가 증가되는 경향을 보였으며 4)수축기, 이완기 혈압과 24시간 단백뇨양이 의미있게 감소하였고 5)체중을 맞추면 내당능 상태가 비슷해졌다가 고농도 포도당 주입시 다시 포도당하 면적이 대조군에서 더 증가되었다. 라미프릴 투여군에서 췌도변형 및 파괴와 탈과립, 췌도내 섬유화가 감소하였다. 결론:본 실험에서는 인슐린 비의존성 당뇨병 동물 모델인 OLETF 쥐에서 당뇨병 발생 이전 단계부터 장기간 라미프릴을 투여할 경우 체중증가가 적었고, 투여군과 대조군의 체중을 맞추었을 때는 내당능상태의 차이가 없아가 고혈당 투여시 다시 투여군과 대조군에서 의미있는 차이를 보였다. 라미프릴 투여가 베타세포의 기능면에서 이로운 효과를 보일 것으로 생각되었다. 따라서 비만한 환자에서 안지오텐신 전환효소 억제제의 장기투여는 단백뇨 감소, 혈압강하 효과 이외에 체중증가의 억제 및 당뇨병 발생을 억제할 가능성을 시사한다. Background : In a Heart Outcomes Prevention Evaluation HOPE study, ramipril, a long-acting angiotensin-converting enzyme (ACE) inhibitor, significantly reduced the death rates the number of myocardial infarctions, strokes, heart failure as well as the risk of complications related to diabetes and of diabetes itself. However, it is known that ACE inhibitors improve glucose tolerance or insulin sensitivity or reduce the incidence of diabetes. Methods : 24 week-old OLETF (Otsuka Long Evans Tokushima Fatty) rats weighing 400 ~ 450 g were used in this study. 4 groups of rats were examined in parallel for 40 weeks. The OLETF rats were randomized for treatment with an aqueous solution of ramipril (5 mg/Kg) daily [OL (RMP), n=10)] and with saline [OL (CON), n=10)]. The LETO rats were also randomized in the same was as the OLETF rats (LT(RMP), n=10, LT (CON), n=10). The blood glucose level, body weight, systolic and diastolic blood pressure was assessed every month. At 3 and 6 months, the 24hrs urinary protein concentration was measured, and as insulin tolerance test and oral glucose tolerance test were conducted in all experimental groups. After 6 months, the body·weight was matched for 2 months in each corresponding group. Subsequently, a 15% sucrose loading was done for 2 months. After the glucose tolerance test, the pancreas was excised and immuno histochemical staining was conducted for insulin to quantify the beta cell mass by a point-counting method. In addition, the islet morphology was evaluated in the pancreas. Results : Ramipril treatment for a period of 6 months improved the 2hr blood glucose level, the area under the glucose curve in the oral glucose tolerance test, insulin sensitivity in addition to lowering significantly systolic and diastolic blood pressure and 24hrs urinary protein level significantly in OLETF rats. Of note, a lower weight gain was observed in both the ramipril-treated animals at 6 months. After weight matching, the AUC g and 2hr blood glucose level values were similar between the corresponding groups, but a 15% sucrose loading worsened the AUC g value. Histologically, the islets were less disorganized and the extent of fibrosis was lower in the ramipril-treated OLETF rats in the trichrome stain. Conclusion : Long-term treatment of ramipril, a long acting angiotensin-converting enzyme inhibitor may be useful for suppressing weight gain and proteinuria in addition to having a protective effect on the islet to harmful stimuli such as hyperglycemia (J Kor Diabetes Asso 25:469~482, 2001).

전국 10개 종합병원 중환자실 환자의 직장내 Vancomycin-resistant Enterococci(VRE) 보균율, 보균의 위험요인 및 유전적 다양성 조사

정희진,송준영,엄중식,김우주,최선주,최정현,이혁,정문현,이광미,신동현,손보라,최종성,우흥정,권정아,이경원,최강원,박승철 대한감염학회 2002 감염 Vol.34 No.5

간호사의 통증관리에 대한 주관성 연구

박경숙,송미승,김경희 성인간호학회 2001 성인간호학회지 Vol.13 No.1

The purpose of this study is to analyze the structural pattern of nurses' pain management with patients who experience pain. As a research method, the Q methodology, which is useful for an objective view of a highly abstract concept, was applied. The data collecting activity of this study was from August, 21st, 2000 to November, 24th 2000 The Q-population. the previous thesis and a literature review were done. Questions about pain management by the nurse on the patients. caregivers, nursing students, doctors, nurses, and others were asked in documentary work and in-depth interviews. In all. 223 units of the Q-population were formed, and the last 35 units of the Q-population were extracted. The data on the P-sample was collected from 41 nurses who worked in the medical and surgical units of a hospital that belonges to C university in Seoul. The research results were constituted in 3 types. Type I was the 'pattern of judging by objectivity'. The statement on which most of the People highly agreed for those patterns was shown by 'If patients said that they are suffering from pain, we sufficiently performed an assessment about the etiology, location, duration and degree'. For type I, the same pain was found in different locations according to the patients. so the etiology of the pain should be identified first place Since ways of coping are different according to pain etiology, it was thought that it is important to assess sufficiently the pain etiology, location, duration, and degree Therefore. when patients complain of pain, the pain etiology should be identified and assessed; according to the result, pain management should be performed systematically. Tyre II was the 'pattern of accepting by subjectivity'. The statement on which most of the people highly agreed for those patterns was shown as 'If patients said that they are suffering from pain, the medical treatment should be performed rapidly and speedily. 'For type h. when the patient complains of pain. treatment should be performed quickly in order to prevent the condition getting worse. and it is thought that activity is a reasonable duty Further, by trying to show empathy after pain is admitted and by understanding and coping rapidly with the pain of patients, an attitude which matched the altruistic morals of nurses is being shown. Type III was the 'pattern of worrying about', and the statement on which most of the people highly agreed for those patterns was shown is 'When there is a pain. to help patients to tolerate the pain to the highest degree. 'In type III, the pain is a subjective expression, so there is a difference according to every individual. Therefore, actually if there is no measurement of pain, it could be exaggerated so nurses should help patients to tolerate it to the utmost. Even if there is a way to remove pain without an analgesic drug, nurses were reluctant to perform pain management as they possibly could. Through these research results, pain management of nurses was classified in 3 types, and structural characteristics in each type were discovered. Based upon the characteristics according to the type, an individualized pain management intervention strategy should be established and the follow up work performed

뇌성마비 아동의 통합치료교육 사례 연구

한경임,송미승,박철수 한국특수아동학회 2003 특수아동교육연구 Vol.5 No.1

본 연구는 한 뇌성마비 아동의 언어치료와 물리치료의 통합치료교육에 대한 사례 연구이다. 연구대상은 전남 D대학교 언어ㆍ청각임상 센터에서 치료를 받고 있는 아동으로 치료를 시작하기 전 언어장애 진단과 발달 영역별 진단 결과 스스로 신변자립이 불가능하고, 호흡도 스스로 조절하기가 어려운 상태였다. 또한 머리 조절이 불가능하여 사물을 주시하거나 손을 움직여 지적하기도 어려운 상태였다. 치료 초기에는 호흡과 인지 능력의 개선을 위한 지도에 중점을 두었다. 그러나 머리 조절이 어려운 관계로 호흡 훈련에 큰 진전이 없어 물리치료적인 측면에서의 진단을 통해 언어치료와 물리치료에서 통합적인 치료가 이루어지도록 수행하였다. 그러한 통합치료적인 접근을 수행하여 현재 치료가 이루어지고 있으며, 머리조절 개선과 함께 호흡조절과 발성 시간의 증가가 향상되고 있음을 알 수 있었다. 향후 치료에서도 통합적인 관점에서 치료교육이 수행될 수 있도록 계획하고 지속적으로 학생의 발달 진전 사항을 관찰할 예정이다. This study is a case study on the interdisciplinary team approach for therapeutic education of a child with severe cerebral palsy. The subject is a female elementary school student being registered in a Language & Audilogy Center, Chonnam province. She is a non-ambulatory and nonverbal student. Before starting therapeutic education it was impossible for her to control of her head, respiratory and had movement. Because of non-control of her head she can not move her arm and hand freely and control the visual-movement coordination. In the beginning of therapeutic education, it was focused to the speech therapy composed to respiratory and voice production. But it was not effective. After interdisciplinary team approach including speech therapy as well as physical therapy, she was able to control her head movement, respiratory and voice production a little. According to control her head movement she can control her hand movement a little and accept the possibility of Augmentative and Alternative Communication intervention. In Conclusion, this results represent the importance of interdisciplinary team approach in the therapeutic education for children with cerebral palsy. Based on the above conclusion, it is need for following studies to develop transdisciplinary team approach program for therapeutic education and adapt it to the field of special education. And following studies need to include more various therapeutic education area and include more subjects.

연마방법에 따른 탄성의치의 표면거칠기와 Candida albicans의 부착율 변화

오주원,서재민,안승근,박주미,강철균,송광엽 대한치과보철학회 2012 대한치과보철학회지 Vol.50 No.2

연구 목적: 본 연구는 탄성의치 제작 시 주로 사용되는 polyamide를 수종의 연마방법을 사용하여 처리 후 Candida albicans의 부착정도와 표면거칠기를 비교하고자 하였다. 연구 재료 및 방법: 25×15×2 mm 크기의 polyamide 시편을 4군으로 나누어 연마재를 사용하여 기공용 lathe 연마하는 방법(기공실내 연마방법)과 각기 다른 2종의 실리콘 포인트로 진료실내 연마하는 방법, 그리고 실리콘포인트 연마 후 pumice로 연마하는 방법으로 처리하였다. C. albicans의 부착성을 평가하기 위해 5×106 CFU/ml의 C. albicans 현탁액에 시편을 2시간 동안 침적하였고 5회 수세처리 후 한천배지에서 배양하였다. 그리고 주사전자 현미경(JSM-5900, JEOL LTd., Tokyo, Japan) 촬영을 시행하였다. Profilometer (Surf-pak; Kawasaki, Japan)를 이용하여 표면거칠기를 측정하였고 통계처리를 위하여 SPSS 18.0 프로그램을 사용하였다. 일원변량분석으로 비교 분석하였고 사후검증은 C. albicans의 부착성 검증을 위해 Scheffe test를 시행하였으며 표면조도검증을 위해 Tamhane’s T2 test를 시행하였다(α=.01). 결과: 최대 거칠기 값을 보인 군은 2단계의 연마용 버를 사용한 것으로 0.32 ㎛±0.10 값을 나타냈으며, 가장 낮은 거칠기 값을 보인 것은 tungsten carbide를 사용하지 않고 기공용 lathe로만 연마를 한 군으로 0.02 ㎛±0.00의 거칠기 값을 나타냈다. C. albicans 부착 실험에서는 기공용 lathe만을 이용한 연마방법이 가장 적은 부착수를 보였으며 다른 세 군과 유의한 차이가 발견되었다(P<.01). 결론: 표면거칠기 및 미생물 부착능 실험 결과 기공실 연마만을 시행한 경우 유의하게 낮은 거칠기 값과 부착율을 보였다. Pumice로 추가 연마한 군은 진료실연마를 시행한 군에 비해 낮은 거칠기 값을 보였으나 C. albicans 부착에 있어서는 유의한 차이를 보이지 않았다(P>.01). Purpose: The purpose of this study was to compare the effect of 3 chairside polishing methods and laboratory polishing methods on surface roughness and C. albicans adhesion of polyamide denture base. Materials and methods: Using contact profilometer, the surface of polyamide specimens (25×15×2 mm) was studied after conventional polishing without finishing and after chiarside polishing with 2 chiarside polishing kits and chairside-pumice polishing following finishing with tungsten carbide bur. To evaluate the adhesion of C. albicans, C. albicans suspension was overlayed on the test specimen. And the specimens were incubated for 2 hours. Imprint culture method was achieved and counted the colony on the agar plate. Polished polyamide were evaluated using a scanning electron microscope. The statistics were conducted using one-way ANOVA and in case of difference, Scheffe test and Tamhane’s T2 test were used. Results: Surface roughness (Ra) of surfaces polished with 2 chairside polishing kits had higher than conventional polishing and pumice polishing. The highest roughness value was 0.32 ± 0.10 ㎛, and the lowest was 0.02 ± 0.00 ㎛. The adhesion of C. albicans on the specimens polished with chairside polishing group and pumice polishing group were increased than conventional polishing group (P<.01). Conclusion: Conventional laboratory polishing was found to produce the smoothest surface and the lowest adhesion of C. albicans. Two groups polished with Chairside polishing kits were similar with respect to surface roughness. Surface of the specimen polished with pumice is significantly smoother than 2 chairside polishing groups, but the result of C. albicans adhesion is that group polished with pumice was similar with 2 chairside polishing groups (P>.01).

간호사의 이직의도 구조모형

김창희,양승순,김연자,손연정,유미애,송주은 대한간호학회 간호행정학회 2009 간호행정학회지 Vol.15 No.4

Purpose: The purpose of this study was to construct and test a structural equation model of nurses' turnover intention. Method: The participants were 716 nurses at 4 university hospitals. Data were collected by a self-report questionnaire in 2008 and analyzed using SPSS 12.0 and AMOS 4.0 Win program. Results: The fit indices of modified model were x²=285.928(p<.001),x²/df=1.958GFI=0.964, RMSEA=0.037, AGFI=0.944, NFI=0.947, NNFI=0.961, CFI=0.973, PNFI=0.658 and showed high compatibility with the empirical data. In the final model, job stress and satisfaction were found to have significant direct effects on nurses' turnover intention, while organizational culture and emotional labor were very important factors to have indirect effects on turnover intention via job stress and satisfaction. Nurses' turnover intention was accounted for 41.2% of covariance by these factors. Conclusions: Comprehensive nursing interventions for decreasing nurses' turnover intention should be focused on reducing job stress and increasing job satisfaction. Also, Nursing strategy for enhancing positive organizational culture and decreasing emotional labor would be helpful for decreasing nurses' turnover intention, too. Further studies are needed to prospectively conduct to verify these causal relationships with larger sample.