인지면담을 이용한 한국형 사전의료의향서 모델 개발

김신미,홍영선,홍선우,김진실,김기숙,Kim, Shin Mi,Hong, Young Sun,Hong, Sun Woo,Kim, Jin Shil,Kim, Ki Sook 한국호스피스완화의료학회 2013 한국호스피스.완화의료학회지 Vol.16 No.1

Purpose: The purpose of the study was to develop a feasible form of a Korean version of advance directives (K-AD). Methods: Sixteen adults participated in this study: 10 aged 20~50 years and nine aged 65 years or older. Using a draft version of the K-AD, cognitive interview was conducted on the participants to establish a culturally acceptable form of advance directives whose directions can be understood and responded accordingly by the general population. Results: Cognitive interviews revealed areas of concerns for the draft version of K-AD: lack of instructions or clarity for technical and medical terms, context complexity and inadequate response categories. The draft version was revised by rewording, offering examples and rearranging the context. Editorial style was added with appropriate uses of bold fonts, bullet-points and underlines to facilitate interviewees' cognitive responses. Conclusion: Study results feasibility of the revised version of the K-AD. Further study should be performed with a larger number of participants to develop a K-AD with an acceptable level of reliability and validity. 목적: 본 연구의 목적은 사전의료의향서 사용 집단을 대상으로 초안에서 도출된 한국형 사전의료의향서 콘텐츠의 구성 요소를 바탕으로 실제 사용자 집단에서 인지적, 심리적 및 사회적으로 수용 가능한 문장과 문항으로 구성된 문서를 구축하여 한국형 사전의료의향서 모델을 제시하는 것이다. 방법: 실제 사용자인 일반 성인의 보건의료정보 문해력과 정서적 수용성 및 작성 과정을 고려하여 초안을 작성하였으며 초안을 바탕으로 인지면담(Cognitive Interviewing) 방법을 통한 문항 개발 과정을 수행하였다. 대상자는 9명의 65세 이상 노인을 포함한 16명의 인지면담에 장애가 없는 성인이었다. 결과: 총 2회기에 걸친 인지면담 결과를 분석한 후 최종적으로 3개 속성(가치관, 의료지시[9문항] 대리인 지정)을 중심으로 총 430개 단어로 구성되는 모델을 확정 제안하였다. 결론: 본 연구에서는 한국형 사전의료의향서 문서를 효과적으로 향상시킬 수 있는 방법으로 인지면담을 사용하였으며 그 가능성을 검증하였다. 한국형 사전의료의향서 최종 모델을 위해서는 대규모 양적 연구를 통해 가용성을 검증하며, 신뢰도와 타당도를 확보하여 모델을 확정하는 과정이 포함된 추후연구가 필요할 것이다.

노인시설 간호제공자의 신체적 억제대에 대한 인식, 태도 및 지식에 대한 연구

김신미(Kim, Shinmi),이윤정(Lee, Yunjung),김덕희(Kim, Duckhee),김숙영(Kim, Sook Young),안혜영(Ahn, Hye Young),유수정(Yu, Su Jeong) 한국간호교육학회 2009 한국간호교육학회지 Vol.15 No.1

한국판 사전의료의향서(K-AD)의 가용성 평가

김신미(Kim, Shin Mi),홍선우(Hong, Sun Woo),김진실(Kim, Jin Shil),김기숙(Kim, Ki Sook) 한국간호교육학회 2014 한국간호교육학회지 Vol.20 No.4

Purpose: This study evaluates the feasibility of Korean Advance Directives (K-AD) developed earlier. Method: From January 1 to February 28, 2013, data were collected from 330 adults through a self-reported questionnaire established by the authors based on literature review and expert consultation. The feasibility of K-AD was multi-dimensionally evaluated through four criteria: cognitive, psychological, document making and socially expecting aspects. Data were analyzed using t tests, one-way ANOVA, and Scheffe post hoc tests via the SAS 9.1.3 program. Results: The feasibility of K-AD differed significantly by gender (p=.003), educational level (p<.001), religion (p=.002), and self-reported health status (p=.039). Differences in the level of easiness with K-AD by gender (p=.008) and education (p=.047) were significant. Perceived simplicity of AD differed significantly by religion (p=.005), and the necessity of AD differed significantly by gender (p=.025) and religion (p=.005). Conclusion: K-AD are sufficiently feasible to be tentatively utilized in practice. This is the first study to explore the feasibility of K-AD on the basis of multiple aspects. However, further studies involving diverse populations and methodologies to validate the usefulness of K-AD are warranted.

중년기 성인의 사전의료의향서, 호스피스완화의료, 연명치료에 대한 인식

김신미(Shin Mi Kim),김기숙(Ki Sook Kim),이인숙(In Sook Lee),김순이(Soon Yi Kim) 연세대학교 사회복지연구소 2013 한국사회복지조사연구 Vol.37 No.-

본 연구는 중년기 성인을 대상으로 사전의료의향서, 호스피스완화의료, 연명치료에 대한 인식을 파악하여 장차 사전의료의향서와 호스피스완화의료 제도를 우리사회에 정착화할 때 기초자료를 제공하고자 수행되었다. 연구대상은 일 광역시 및 중소도시에 거주하는 40세 이상 65세미만의 중년기 성인으로 200명을 편의추출 하였으며, 자료수집은 2011년 3월부터 6월까지 연구자들에 의해 개발된 구조화된 질문지를 이용하여 수행하였다. 자료 분석은 SPSS 19.0 프로그램을 이용하여 분석하였으며, 수집된 총 200부의 설문지 중 자료가 미비한 내용을 제외한 164부를 최종분석에 사용하였다. 연구결과, 대상자의 대부분이 사전의료의향서에 대한 지식은 없다고 응답한 반면 생전 유언에 대한 지식과 대리인 지정에 대한 지식, 호스피스완화의료에 대한 지식 및 연명치료에 대한 지식이 있다고 응답하였다. 대부분의 대상자들이 사전의료의향서 작성과 생전유언 및 대리인 지정에 대해 동의하는 것으로 나타났다. 반면, 본인의 연명치료에 대해 대부분이 시행하지 않겠다고 응답하였으며, 인공호흡 시 행에 가장 반대하는 것으로 나타났다. 본 연구의 결과 대상자 대부분이 사전의료의향서 작성에는 동의하나 지식은 없는 경우가 많은 것으로 나타났으므로 향후 국내에서 사전의료의향서에 대한 논의가 진행되기 위해서는 일반 국민을 대상으로 한 다양하고 활발한 교육과 홍보를 통해 사전의료의향서에 대한 인식을 확산시키고 국민적 동의를 거치기 위한 노력이 필요하다. 또한 이러한 노력이 보다 효과적으로 수행되기 위하여 추후 연구에서는 다양한 생애주기에 있는 대상자를 포함하여 사전의료의 향서에 대한 인식에 대해 조사하는 연구를 시행할 것을 제언한다. The purpose of this study was to identify the perception towards advance directives (AD), hospice-palliative care, life-sustaining treatment (LST) among middle aged adults. A descriptive survey was performed from March to June, 2011 in a megalopolis and a medium-sized city of Korea. The participants were 164 community dwelling adults aged between 40 and 65 years old. Data were analysed using SPSS 19.0 Program. The results revealed that most respondents had knowledge about hospice-palliative care and LST while reporting lack of knowledge about AD. In addition, most of the respondents agreed to fill out AD, receive hospice-palliative care, and not to have LST during end-of-life (EOL) period in general. When the respondents were questioned specifically regarding LST, considerable numbers of the respondents reported that they could not decide whether they would receive cardiopulmonary resuscitation, artificial ventilation, and artificial feeding respectively while preference for artificial ventilation was found as being the lowest among three types of LST stated above. From the results of the present study, preference towards AD and hospice-palliative care and reluctance to have LST at the EOL were revealed. Yet, any concrete conclusion regarding knowledge level related to AD, hospice-palliative care, LST seems to be premature due to conflict results of the present study and further studies are called for. In addition, efforts should be made for general population including middle aged population to help them to understand any necessary concepts and processes related EOL care and decision making.

미용업의 동종업종 간 거리제한 도입의 필요성에 관한 연구

김신미 ( Sin-mi Kim ),나명석 ( Myung-suk Na ) 한국미용학회 2022 한국미용학회지 Vol.28 No.1

Recently, there has been a shift in beauty market from beauty salon-led market where demand was higher than supply to customer-driven market when demand is lower than supply. At present, beauty salons are already saturated. Under excessive competitions, furthermore, profitability has significantly decreased. Despite high competitiveness and great ripple effects, however, domestic beauty industry is undergoing some difficulties due to industry polarization and absence of a decent system. Considering a necessity of protecting right to life and goodwill for beauty businesses and establishing the ground for co-prosperity, therefore, this study targeted to minimize damages resulting from business overlapping and find a way for co-prosperity through a questionnaire survey on the awareness of model transactions against franchise chain and mom-and-pop beauty salon managers, and the results found the followings: According to detailed analysis on the current situations of beauty industry, 91.7% said that supply is now greater than demand. In addition, 80.6% understood a necessity of adopting minimum distance among businesses in beauty industry because of decrease in sales and difficulties in recruitment difficulties. Therefore, this study aimed to suggest such necessity and improve value orientation in beauty industry.

황색 산성염모제로 염색한 모발의 염색견뢰도 및 물리적 특성 변화

김신미 ( Sin-mi Kim ),나명석 ( Myung Suk-na ) 한국미용학회 2016 한국미용학회지 Vol.22 No.5

This study attempted to investigate the physical features of hair and hair color, which change after washing shampoo, friction with comb, sunlight, and physiochemical treatment of alkaline and acidic sweat against sample hairs colored with yellow acidic hair dye. The color difference(△E) of alkali perspiration solution was showed a higher from 26.95 to 45.19 value but daylight was a lower from 2.13 to 6.99. The results found that the dyed hair repeatedly exposed to natural daylight revealed the most approximate color value while the biggest color change was found in colored hair soaked in alkaline sweat continuously. The lower values of tensile strength and elongation according to repeated hair treatment is affected by the frequency of it. Therefore, this study confirmed that when hair colored with acidic hair dye is physiochemically treated over and over, its color gradually changes and hair damages.

노인의 노화불안과 삶의 질

김신미 ( Shin Mi Kim ),김순이 ( Soon Yi Kim ) 한국간호과학회 정신간호학회(구 대한간호학회정신간호학회) 2009 정신간호학회지 Vol.18 No.2

중년기 성인의 노화불안과 자기효능감에 관한 연구

김신미 ( Shin Mi Kim ),김순이 ( Soon Yi Kim ) 대한간호학회정신간호학회 2008 정신간호학회지 Vol.17 No.3

재가 치매환자 주부양자가 인지하는 애로 요인

김신미 ( Shin Mi Kim ),이윤정 ( Yun Jung Lee ),유수정 ( Soo Jung Yoo ),박명자 ( Myung Ja Park ) 한국정신간호학회 2007 정신간호학회지 Vol.16 No.4

파란색 산성염모제를 이용한 모발염색 및 염색견뢰도

김신미 ( Sin-mi Kim ),나명석 ( Myung Suk-na ) 한국미용학회 2016 한국미용학회지 Vol.22 No.5

This study attempted to investigate dyeing fastness and hair damage, which change after washing, friction, sunlight, and physiochemical treatment of alkaline and acidic sweat against sample hairs colored with blue acidic hair dye. The results found that the dyed hair repeatedly exposed to sunlight and colored hair soaked in acidic sweat again and again revealed the most approximate color value. In addition, the biggest color change was found in colored hair that was repetitively washed with shampoo. Therefore, this study confirmed that when hair colored with acidic hair dye is physiochemically treated over and over, the dye discolors as well.