간호실무에서 신봉이론(Espoused theories)에 대한 탐색적 연구

서문자,김혜숙,이은희,박영숙,조경숙,강현숙,임난영,김주현,이소우,조복희,이명하,지성애,하양숙,손영희,권성복,김희진,추진아 성인간호학회 2001 성인간호학회지 Vol.13 No.1

As a nursing practice involves nurses' actions in a specific context of health care, this study has focused on exploring the espoused theories in nursing practice within the action science perspectives, Espoused theories are the belief, principles, and rationale expressed by the practitioner as guiding her/his actions in a situation of practice. The data were analysed qualitatively and 25 elements of espoused theories of nursing action were identified and clustered into 6 categories. The 25 elements of espoused theories are as follows: The clinical nurse worked in wholistic and individual nursing, focussed on the patient's needed, comfort and supportive nursing (5 theories of nursing goal) ; excellent skills, knowledge based, assessment and data collection, explaining, educating or a scientific basis(6 theories of nursing intervention): advocacy, value oriented, treatment, account- ability and commitment(4 theories of nursing ethics) ; human respect. partnership, trust(3 theories of patient-nurse relationship) : knowledgable, accumulated clinical experiences and personally lived experiences. positive perspectives(4 theories of nurse), role of intervention. rewarding peer relationship(3 theories of situations) The above mentioned espoused theories are similar to that of nursing textbooks which students learned through basic nursing education and almost the same as the Acts ofa Nurse in Korean. However, we are doubtful whether nurses actually do as they think. Therefore. it is recommended to review the theories-in-use in order to and any discrepancies between the espoused theories and the reality of nursing actions

바이오피드백 훈련이 만성 두통 환자의 임상 증상 및 스트레스 반응에 미치는 효과

장명선,하양숙,정진상,유범희 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.6

Objectives : This study aimed to examine the effect of biofeedback treatment on the clinical symptoms and stress responses in chronic headache patients. Methods : We recruited 18 chronic headache patients who were treated with 8 sessions of biofeedback treatment and 18 age and sex-matched control headache patients. All subjects consisted of patients with chronic tension headache and migraine hea-dache. Stress responses were measured using Symptoms of stress (SOS) inventory and all subjects performed Beck depression inventory (BDI), Spielberger state anxiety inventory (STAIS), and visual analogue scale (VAS). Biofeedback physiological vaiiables including frontal and forearm EMG, electrodermal response (EDR) and skin temperature at pre-and post-treatment were also measured in all subjects. Results : Compared with control patients, patients on biofeedback treatment showed significant reduction in scores of STAIS(t=3.705,P<.001),andVAS (t=3.392, p=.001) as well as SOS subscales ; peripheral manifestations (t= 1.788, P=.042), habitual pattems (t=2.008, P=.027), depression (t=2.081, P=.023), anxiety (t= 1.990, P=.028), and total score (t=2.045, p=.025). There was a significant increase of skin temperature (t= -1.835, P=.038) only in the biofeedback treatment group. Conclusion : These results suggest that biofeedback treatment may be effective in relieving chronic headache by reducing psychological and physiological stress responses.

노인의 스트레스원과 스트레스 인지정도에 관한 연구

서현미,하양숙 서울대학교 간호대학 간호과학연구소 1997 간호학 논문집 Vol.11 No.1

The purpose of this study was to identify stressors and perceived stress level experienced by elderly. And the intent of this investigation is to suggest nursing intervention for care of the elderly. A convenient saplling of 331 elderly who lives in Seoul, Kwang-Ju, Yang-Ju Gun-Kyung-Ki Do, Ui-Jong Bu, and Young-Am Kun, Jeun-Ra Nam Do was done. The period of collection was from January in 1996 to May in 1996. The constructing process of Seo's Elderly Stress Scale(SESS) were as follows; 1) Make preliminary items which related to stress and stressor of the elderly that was based upon review of literature and unstructured interview with 45 elderly. 2) Modification of items and pilot study were performed to determing the stressors. Consequently, 64 stressors were identified. The SESS was composed of 3-areas(1. If you experienced the following stressors in the past one years, Please mark "0" on the "yes" column 2. How many frequently occurred the experienced stressors you felt.; "1=seldom", "2=sometimes", "3=often", "4=always", 3. How much stressful the experienced stressors you felt. The degree of stressfulness is 0-10 and it was a ladder scale. ). The total score of perceived stress level was calculated from frequency score by stressfulness score. The range of total score is 0-2,560. Internal consistency of SESS was Cronbach's α=0.9060. SPSS/PC?? program was used for statistical analysis and the data was analyzed in terms of frequency (percentile score), mean (SD), t-test, F-test and the reliability coefficient. The results of this study were as follows: 1. Most frequently experienced stressors by elderly were ranked 'decreased eyesight'(86.1%), 'decreased strength'(83.1%), 'change of dental condition'(82.5%), 'decreased memory'(81.0%), 'sleep change'(76.7%), 'thinking about own death'(72.2%), 'loneliness'(69.5%) and 'decreased hearing'(69.2%). 2. Always experienced stressors by elderly were ranked 'change of dental condition'(40.2%), 'decreased eyesight'(40.2%), 'south and north Korean unification'(31.4%). 3. Most stressfulness stressors experienced by elderly were ranked 'death of your children'(9.83), 'death of your spouse'(9.62), 'divorce of your children'(8.67) and 'infertility of your children'(8.55) 4. Total mean (SD) score of perceived stress level is 431(218), maximum score is 992 and minimum score is 4 by subjects, 5. Compared the perceived stress level of subjects with sex, live together children, disease, and perceived health status were significantly differences. In conclusion, most frequently experienced stressors by elderly which was changed of physical function according to aging process. And most stressfulness stressors which was death of family members.

Influencing Factors of Psychosomatic and Psychological Symptoms of Stress in Korean Adults

Yang-Sook Hah,Sunhee Cho,Myungae Choe,Keum-Soon Kim,Myungsun Yi,Soyeon Cho 대한스트레스학회 2012 스트레스硏究 Vol.20 No.3

우리나라 건강한 성인들의 신체적ㆍ심리적 스트레스 증상에 영향하는 요인을 파악하기 위해 횡단적 서술조사 연구를 시행하였다. 전국에 거주하는 성인 남성 815명, 성인 여성 1,554명을 편의 표집하여 일반적 특성, 건강상태, 스트레스 정도, 스트레스 증상, 스트레스 대처 유형을 조사한 후 다중회귀분석을 이용하여 자료를 분석하였다. 응답자의 스트레스 증상에 영향하는 요인은 다음과 같이 도출되었다. 주관적 건강 상태, 질병 유무, 인지된 스트레스 수준은 전체 11개 스트레스 증상의 유의한 영향요인이었다. 문제 중심적 대처 유형은 심리적 스트레스 증상의 유의한 영향 요인이었다. 감정 중심적 대처 유형은 신체적 및 심리적 스트레스 증상의 유의한 영향요인이었다. 연령, 성별, 주관적 건강 상태, 질병 유무, 인지된 스트레스 수준, 감정 중심적 대처 유형은 신체적 스트레스 증상의 유의한 영향요인 이었다. 결론적으로, 자신의 건강상태를 긍정적으로 인지하고 스트레스 수준이 낮을수록 신체적 스트레스 증상이 더 적은 것으로 예측되었다. 반대로, 감정 중심적 대처 유형은 신체적 스트레스 증상과 더 많은 관련이 있었다. 이러한 결과는 지역사회 건강 전문가들이 스트레스로 인하여 신체적 증상을 호소하는 대상자들에게 자신의 스트레스 대처 유형을 파악하고 문제 중심적 대처 기술을 강화하도록 하는 프로그램을 개발하기 위한 근거 자료로 사용될 수 있을 것이다. The purpose of this study was to examine predictors of somatic symptoms and psychological symptoms of stress among Korean adults. A cross-sectional descriptive survey was conducted. A sample size of 815 male and 1,554 female adults residing in South Korea completed the instruments of perceived stress, symptoms of stress, and way of coping. Data was analyzed by multivariate regression. Influencing factors for eleven symptoms of stress were as follows: a) subjective health status, having disease, perceived stress level were significant influencing factors for all symptoms of stress; b) problem-focused coping was a significant influencing factor for psychological symptoms of stress; c) emotional-focused coping was significant influencing factor for both psychosomatic and psychological symptoms of stress; d) age, gender, subjective health status, having disease, and perceived stress level were significant influencing factors for psychosomatic symptoms of stress; e) emotion-focused coping predicted psychosomatic symptoms of stress. Feeling healthier and perceiving a lower stress level predicted more psychological symptoms of stress. In contrast, using more emotion-focused coping was significantly associated with more psychosomatic symptoms of stress. The findings suggest that community health providers need to develop interventions to aware coping strategies and to enforce problem-focused coping skills for community-dwelling Korean adults with psychosomatic complaints. (Korean J Str Res 2012;20:179∼186)

A Factor Analysis of The Stress of Hospitalization

Hah, Yang Sook,Lee, So Woo,Park, Eun Sook 서울대학교 간호대학 간호과학연구소 1986 간호학 논문집 Vol.1 No.1

본 연구자들은 1985년에 미국의 Volicer와 Bohannon이 개발한 입원스트레스척도(Hospitalization Stress Rating Scale)를 이용하여 한국환자에게 적합한 입원스트레스척도를 재구성한 바 있다. 본 연구에서는 이 입원스트레스척도를 가지고 입원스트레스를 구성하는 요인을 규명하기 위하여 요인분석의 통계 방법과 이론적 타당성을 조사한 바 Voliceer의 연구에서와 같이 9개의 요인으로 분류되었다. 연구방법과 결과를 구체적으로 설명하면 연구기준에 맞는 내외과 환자 104명에게 49개 항목의 입원스트레스 척도를 자세히 읽고 각 요인점수와 입원스트레스척도 점수를 얻기위하여 카-드분류방법으로 순위를 결정하게 하였다. 여기서 얻은 자료를 가지고 Varimax회전방법으로 상관계수행렬식(factor-variable correlation matrix)을 구한 결과 특정치(eigen value) 1.0이상인 요인이 16개로 나타났다. 다시 N Factor Parameter를 이용하여 요인의 수를 줄여 9개의 요인으로 확정하였다. 9개의 요인은 불편감, 정보결여, 중병에 대한 압박감, 낯선환경, 투약문제, 고립감, 자율성상실, 경제적문제, 배우자와의 별거 순으로 분류되었다. 각 요인의 명칭이 그 요인속에 포함된 항목을 대표하는지 또는 한 요인속에 있는 각 항목이 유사한 성격으로 집약되어 그 요인을 나타내고 있는지에 대한 일치성을 알아보고자 실습을 통하여 임상경험이 있는 80명의 간호대학 4학년학생을 대상으로 타당성 조사를 하였다. 그 결과를 환자를 대상으로 한 통계분석 결과와 비교하면 49개 항목중에서 36개 항목은 각 요인과 일치하였고, 13개의 항목이 통계분석에서 나온 결과와 일치하지 않았다. 환자를 대상으로한 통계분석결과는 13개의 항목이 그 항목을 대표하는 요인과 개념적으로 불일치를 보이는 것이었다. 따라서 타당성 조사 결과 나온 추후분석에 따라 13개 항목에 대한 재배치를 하여 그것으로 최종요인의 항목으로 결정하였다. 각 요인점수와 전체 입원스트레스척도 점수와의 상관관계는 높은 것으로 나타났다(r=.5276~8847). 결론적으로 Volicer의 연구와 본 연구의 결과를 비교하여 보면 요인수는 9개로 같지만 한개의 요인성격이 다르게 나타났다. 즉, 본 연구에는 "불편감"의 요인이 있으나 Volicer의 연구에서는 없으며 그 대신에 "타인과의 이별" 요인이 있다. 그리고 각 항목의 집약이 몇몇 요인에서 각기 다르게 나타났다. In a previous study, we explored the rank order of the intensity of the stressful events related to the experience of hospitalization using Volicer's HSRS with Korean subjects(1985). It was found that the rank order of the item's mean was different from Volicer's. The purpose of this study was to identify meaningful clusters of stressful events of stress factors of this HSRS. The study subjects included 104 patients who were able to complete the interview. Because the nature of the events in the stress scale pertain primarily to short-term hospitalizations, patients in the rehabilitation and psychiatric units were excluded. The patients were interviewed on the third or fourth day of hospitalization. To obtain the correlation coefficient between a variable and a factor, 4 Likert scale was used. The varimax rotated factor matrix was produced by the factor analysis with 9 N factors parameter according to the result of scree test. The result indicated that 49 items can be categorized into nine factors. In our study, the order of the nine factors was as follows: factor 1-discomfort, factor 2-lack of information, factor 2-threat of severe illness, factor 4-unfamiliarity of surroundings, factor 5-problems with medication, factor 6-isolation, factor 7-loss of independence, factor 8-financial problems, factor 9-separation from spouse.

노인간호에 관한 연구

하양숙(Yang Sook, Hah) 한국보건간호학회 1990 韓國保健看護學會誌 Vol.4 No.1

Perceived Stress, Stress Symptoms, and Ways of Coping in Korean College Students

하양숙 ( Yang Sook Hah ),이지영 ( Jee Young Lee ) 한국간호과학회 정신간호학회(구 대한간호학회정신간호학회) 2010 정신간호학회지 Vol.19 No.4

Purpose: The purpose of this study was to identify perceived stress level, stress symptoms, and ways of coping and to examine the influences of perceived stress level and ways of coping on stress symptoms in Korean college students. Methods: A cross-sectional descriptive survey study design was used. A sample of 1,056 male and female college students completed the Brief Encounter Psychosocial Instrument, Symptoms of Stress Inventory, and the Ways of Coping Checklist. Data was analyzed by t-test, ANOVA, Pearson correlation coefficient and multiple regression analysis using SPSSIWIN 12.0. Results: The perceived stress level, stress symptoms, and ways of coping were found to be significantly positively correlated with one another. The perceived stress level and stress symptoms had a greater positive correlation with emotion-focused coping than problem-focused coping. Perceived stress, emotion-relieving coping, perceived health status, and wishful thinking coping accounted for 37.7% of the variance in college students` stress symptoms. Conclusion: The findings suggest that nurses, while developing and providing stress management programs, need to be aware of the perceived stress level, health perception, and the tendency to emotion-focused coping in Korean college students, as these factors all influence their total stress symptoms.

Flash를 이용한 스트레스관리 프로그램 개발

하양숙(Yang-Sook Hah) 대한스트레스학회 2010 스트레스硏究 Vol.18 No.4

본 연구의 목적은 한국의 20대∼50대 성인을 위한 웹기반 스트레스 관리프로그램을 개발하는 것이다. 대상자의 스트레스 관리프로그램 개발을 위해 사용자의 요구도 확인 및 개발과정과 검증 및 적용단계를 거쳤다. 문헌고찰을 포함하여 사용자의 요구도 확인을 위한 면담과 설문조사를 시행하였고, 사용자의 요구에 기초하여 [stressdown]프로그램을 개발하였다. 또한, 프로그램의 질을 평가하기 위해 전문가 평가와 프로그램 사용자들의 만족도 평가를 시행하였고, 수정보완 단계를 거쳤다. 개발된 프로그램은 크게 4개의 스트레스 관련 사전검사와 스트레스 관리 클리닉으로 구성하였다. 사전검사 부분은 사용자의 스트레스 정도와 증상, 대처방식, 스트레스 취약성에 대해 확인하는 과정이며, 스트레스 관리 클리닉은 사전검사 결과를 토대로 대상자에게 적합하고 유용한 관리방법이 소개되는 과정이다. 이 프로그램은 맞춤형 중재시스템을 활용하여 대상자에게 적합한 스트레스 관리방법을 추천해준다. 개발된 프로그램은 플래시 형태로 http://www.stressdown.net으로 접속하여 웹상에서 구현할수 있도록 하였다. 개발된 프로그램은 한국 성인의 스트레스관리와 정신건강 증진에 기여함은 물론 스트레스 관련 연구자와 전문가들에게 웹기반 스트레스 관리에 대한 정보공유에도 유용할 것으로 기대한다. The purpose of this study was to develop a web-based stress management system for 20"s∼50"s Korean adults. To identify user"s information needs, research process includes needs assessment analysis, design, development/testing, and application release. For needs assessment included literature review, interviews and surveys. Based on the user"s needs, a「Stress-down」program was developed. The program was evaluated by users for their satisfaction with the program and by experts for the quality of the program. 「Stress-down」 program was consists of 4 stress tests and stress management clinic. In the stress test section, 4 tests was used to find the user"s stress, symptom, coping style, and personal vulnerability to stress. In the stress management clinic, useful management method was introduced. This program recommend the adequate management method by tailored intervention system. The「Stress-down」program was released using URL:http://www.stressdown.net. It is expected that this web-based stress management system will contribute to the mental health promotion on Korean adults as well as provide a community for the stress related researchers and professionals to share information on the web-based stress management. (Korean J Str Res 2010;18:379∼387)

지역사회정신보건 재활간호사업이 만성정신질환자 가족의 부담감에 미치는 영향

하양숙,김수지,김기숙,박혜숙 대한간호학회정신간호학회 1997 정신간호학회지 Vol.6 No.2

This study was designed to testify the effects of Community-based mental health program on burden of family carers of mentally ill patient. The sample of this study consisted of 26 family carers whose mentally ill relatives were registered with a certain health center in Seoul and attending this program. The study was conducted for 1 year from the beginning of August 1996 to the end of August 1997. Subjective and Objective Burden Measurement was used to measure burden of family carer. This tool was originally developed by Montgomery(1985) and revised by researchers to 4-point Likert type scale. Data were collected three times : in month one, six and twelve, and analyzed by SPSS PC^+. During the program, burden of family carer was significantly reduced so that main hypothesis and three sub-hypothesis were all supported(main hypothesis p=0.00, 1st sub-hypothesis p=0.00, 2nd p=0.00, 3rd p=0.001). In conclusions, Community-based mental health program can reduce burden of family carers by helping them to continue their life and to function as a good support system for the chronic mentally ill relatives. The researchers, therefore, propose that this program should be extended to the other place and be supported by local and central government.

Mood의 주기성에 관한 연구

하양숙 최신의학사 1986 最新醫學 Vol.29 No.12