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

2003년 국내 중증급성호흡기증후군 진료 현황 및 문제점 분석

이진수,김은실,정문현,백제중,정선화,안주희,최영화,이선희,고철우,김성범,김민자,박승철,기현균,송재훈,최상호,김양수,이상오,조용균,박영훈,정숙인,김연숙,이흥범,손창희,장성희,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

목적 : 2002년 말 중국에서 SARS가 발생한 이후 국내에서도 2003년 10월까지 총 3명의 추정환자, 17명의 의심환자가 보고되었다. 향후 추가적인 SARS의 유행이 우려되는 상황에서, 그간의 SARS 환자 진료에 있어서의 실질적인 준비사항, 진료 현황 등에 대한 조사를 통해 문제점을 파악하여, 향후 더 나은 대비가 될 수 있도록 개선점을 제시하고자 하였다. 재료 및 방법 : SARS로 의심되는 환자를 진료 경험이 있는 병원의료진을 대상으로 2003년 10월에 설문조사를 실시하였다. 설문에는 SARS 환자 진료 시의 실질적인 조치, 진료 현황, 병실, 응급실 및 외래에서의 격리 시설과 준비사항, 보건당국의 관리와 지원에 관한 사항을 포함하였다. 결과 : 대상이 되는 22개 병원 중 17개(17/22, 77.2%) 병원이 설문에 응하였다. SARS 환자를 위한 격리실은 응급실, 외래, 일반병실 및 중환자실에서 각각 9개(9/17, 52.9%), 5개(5/17, 29.4%), 15개(15/16, 93.7%), 4개(4/16, 25%) 병원에서 음압처리가 되어있지 않은 일인실 혹은 다인실이 사용되었고, 1개(1/16, 6.3%) 병원에서만 일반병실에서 음압격리실이 운영되었다. 입원환자의 진찰 시 개인보호구의 착용은 거의 모든 의료기관에서 이루어졌다. 보건당국에서 SARS지정병원의 시설 등을 사전에 확인한 곳은 1곳(1/12, 8.3%)이였고, 14개 병원(14/15, 93.3%)에서는 보건당국에 의뢰한 검사결과를 통하 받지 못하였다. 결론 : 의료기관에서 SARS 환자용 격리실뿐만 아니라 기존의 격리실 설비 등이 미흡하였으며, 특히 중환자실 및 외래의 준비가 더욱 부족하였다. 보건당국의 의료기관에 대한 종합적인 지원이 부족하였고, 병원과의 원활한 연계가 잘 이루어지지 않았다. SARS 만이 아닌 격리를 필요로 하는 질환의 적절한 진료를 위해 향후 병원 시설의 정비와 정부차원에서의 보다 구체적이고 실질적인 대책마련이 필요하다. Background : There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. Materials & Methods : Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. Results : The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. Conclusions : The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

웹에서의 인터페이스 디자인에 관한 고찰.

손상희 한국비쥬얼디자인학회 2000 한국디자인포럼 Vol.5 No.-

WWW의 출현은 인터넷 사용자의 폭을 확애시켰을 뿐만 아니라, 나아가 사회의 생활 환경을 변화시키고 있다. Web 시장은 전세계적으로 50∼60억 달러 이상의 수익성 있는 시장으로 보고 있다. Web은 거대한 수익을 안겨줄 잠재력을 갖고 있다고 할 수 있다. 인터넷 환경에서 정보 제공자들은 그 정보를 어떻게 방문자들에게 효과적으로 보여 줄것인지를 고민하게 된다. Web에서 user의 정보 접근성을 극대화하기 위해 정보를 일관성 있는 개념으로 조직하기 위한 정보의 구조가 필요하다. 정보 구조의 효율성을 통해 사용자 접근성을 높이고 목적하는 정보를 효율적으로 전달하기 위한 구조를 설계하게 되는 것이다. 또한 Web에서의 user interface의 가장 기본적인 요소는 컨텐트의 체계화이다. 아무리 디자인이 훌륭한 사이트라도 information, 컨텐츠의 구조가 체계적이지 않다면, 사용자들은 혼란스러울 것이다. 즉, 사용자가 필요한 정보가 사이트에 있다고 할지라도 쉽게 찾지 못할것이다. 다른 하나는 훌륭한 Graphical User Interface이다. Homepage를 방문하는 User들은 버튼을 click하거나, 화면상에서 선택할때, information의feedback을 기대하게 된다. Mouse의 롤오버시 image변화나 상호작용적인(interactive) communication들이 그것이다. 이런 상호작용들이 GUI이다. GUI(Graphical User Interface)는 User에게 data를 보여주거나, User가 입력이나 선택을하게 하고, 또한 사용자의 액션을 유도한다. 그리고 GUI는 그 사이트이 디자인 및 정보 체계의 요소를 제공한다. 본 논문에서는 웹에서의 정보의 접근성을 극대화하기 위한 방법을 모색하고자 했다. 인터페이스 이해를 통해 웹의 정보 구조를 고찰하는데 그 주안점을 두었다. Appearance of WWW(World wide Web) is not only to scale up range of internet users but also in changes people is life style. Web market has over 5∼6billion marketability. Therefore web has great potential power of huge benefit. Information provider morrys about how to show the information effectiely. For the maximum accessibility to the information consistently, that is, dfficiency of information struction promotes user's accesibility, and it builds the structure to transmit information they want. Besides the most fundamental factor of user interface on the web is the systematigation of contents. Unless the structure of information and contents is systematic, user world fall info disorder though it has great design. Therefore even it there's information in the site they need, they can't find if easily. Another important factor is graphical user interface. When user clicks button, they expect feed back of information. For instance when user roll-over mouse wheel, it happens to change of image in the monitor and interactive commumnication such things are GUI. GUI(Graphical User Interface) shows data to user, makes user to choose or leads user's action. And GUI also offers information scheme and design. In the report tried tofind a solution to maximize accessibilty to information on the web and put the main point to consider structure of information on the web under understanting of interface.

통합된 학습장애아동의 귀인양식이 학습의욕에 미치는 영향

손상희 국립특수교육원 2002 특수교육연구 Vol.9 No.1

통합된 장면에서 학습장애아동의 학업성취 및 학습 참여도 등에 관한 전문적인 연구가 부족하며, 학습의욕과 귀인양식과의 관계에 입각한 학습전략이 부족한 실정이다. 이에 본 연구는 통합된 학습 장애아동의 귀인양식과 학습의욕 특성을 비 장애아동과 비교하여 살펴보고, 통합된 학습장애아동의 귀인양식에 따른 학습의욕의 영향요인을 밝혀내었다. 그 결과 통합된 학습장애아동의 귀인양식은 교사나 과제에 따른 외적 통제 요인에 학습성공과 실패를 귀인하는 경향이 있으며, 비장애아동에 비해 낮은 학습의욕을 가지고 있음을 밝혔다. 따라서, 통합된 학습장애아동의 학습의욕을 높이기 위해서는 지도 교사의 지도방법의 다양화 및 교육과정 수정의 필요성을 주장하였다. The purpose of this research was to examined the effect of attribution for learning motivation toward children with disability in integrated situation. For the purpose of this study, 57 children with disability were selected in regular classroom. And comparison group was selected 60 children in regular classroom. The comparison on Attribution for sucess/failure learning situation and on learning motivation between disabilities children and non disabilities children. The results of this study were followed (a) The disabilities children has attribution on learning situation which extra-control factor and non disabilities children has internal-control factor. (b) The disabilities children has low level in learning motivation then non disabilities children. (c) The disabilities children's attribution on learning situation influenced learning motivation. Specially teaching method and difficult level of task were very important factor which learning motivation in integration situation. The implications of this study could be summarized as follows First, it is necessary to study a follow-up research to get attribution and learning motivation of disabilities children. Second, important factor for disabilities children's increasing ratio of learning participation and academic achievement in integrated situation was there attribution on extra-control attribution. Third, it is necessary to study a follow-up research to get more data in learning motivation for disabilities children.

큰 용량성 부하를 구동하기 위한 새로운 TFT/LCD 구동 드라이버용 OP-AMP에 관한 연구

손상희,박수양 청주대학교 산업과학연구소 2006 産業科學硏究 Vol.24 No.1

In this paper, the op-amp with new structure is proposed and designed to drive large capacitive loads of TFT LCD panel. The proposed op-amp is composed of rail-to-rail structure for full swing from VDD to GND. To reduce static current of op-amp, gate voltage difference of _(p)MOs and _(n)MOs in output buffer is more enlarged using self-biasing circuit. The proposed op-amp can be used as a buffer of TFT LCD Source driver to drive large TFT LCD panels. It is simulated bar HSPICE with 0.35 ㎛ CMOS standard process.

변류기 포화가 거리계전 알고리즘에 미치는 영향 분석

孫天明,姜相熙 明知大學校 産業技術硏究所 2003 産業技術硏究所論文集 Vol.22 No.-

Abstract - Distance relays need accurate current and voltage for determining the trip ignition. Therefore we must analyze nonlinear phenomena which cause distortion in signals first of all. This paper presents the effect of current transformer saturation in power system. The saturation of a current transformer distorts the input current of a distance relay. This paper describes modeling methods of a current transformer, simulation results of two distance relay algorithms (discrete fourier transform and modified differential equation methods) and some interesting results of the algorithm by using an CT secondary current compensating technique.

원예치료가 정신 및 지체 장애인의 재활에 미치는 영향

손기철,고언희,엄수진,이상훈,송종은 建國大學校附設農業資源開發硏究所 2002 農資源開發論集 Vol.24 No.-

This study was to investigate the effect of horticulture therapy on the healing and rehabilitation of the mentally retarded (MR) and physical disorder (PD) persons. Horticultural therapy program was carried at S rehabilitation center located in Kyounggi-DO from Jun 29, 1999 to Oct 12, 1999. The participants in this program were 36 clients of MR and PD. They attended 14 times once a week for 1 hour at a time for horticultural therapy. Evaluation of horticultural activities and ADL (Activities of daily living) has been assessed two times, that is, before and after horticultural therapy program (HTP) whereas horticultural therapy group activity treatment procedure and horticulture task skill inventory have been assessed 3 times, that is, before HTP and after each 7 weeks. MR in the evaluation of horticultural activities showed statistically significant in participation, interest and assistance, verbal interaction during activity, self-concept and identity, need-drive adaptation, interpersonal and social relations, cognition and problem solving, exercise perceptivity, life-tasks skill and vocational adjustment. In activities group of MR also showed significant improvement in terms of physical perceptual abilities, cognitive ability, writing ability, social interaction (P<0.001). Additionally, their horticulture task skill were improved significantly in skill and efficiency factor (P<0.008) and their ADL were changed positively but not significant. On the other hand, PD in evaluation of horticultural activities showed significantly positive changes in self-concept and identity, interpersonal and social relations, life-tasks skill and vocational adjustment. However, physical perceptual abilities factor was proven to be effective in horticultural therapy group activities treatment procedure (P<0.002). Only grooming was significantly improved in ADL evaluation of PD (P<0.03). Putting these results together, it was found that horticultural therapy programs would be very useful for rehabilitation and healing method in both MR and PD.

Planar Type GaAs MESFET의 Numerical Simulation에 관한 硏究

손상희 순천향대학교 1988 논문집 Vol.11 No.4

In this paper, two-dimensional numerical simulation of planar type GaAsMESFET with 0.7㎛ gate length is performed. While drift-diffusion model is used as current model, new mobility model is adapted to this simulation to agree with experimental current value. Also, CVF(Control Volume Formulation) method is used as numerical method. The I-V characteristics, potential distribution, electron concentration distribution and current vector flows are derived from this paper and they have a good agreement with experimental result.

Bipolar-mode Static Induced Transistor(SIT) 소자 설계에 관한 연구

손상희,김홍배,박찬석,곽계달 청주대학교 산업과학연구소 1993 産業科學硏究 Vol.11 No.-

BSIT is simulated in two-dimensional and simulation results are compared with those of experimental device. To get the accurate design data of BSIT, device operation, carrier dynamics depending on channel impurity concentration and current flows depending on gate depth are examined through two-dimensional numerical simulation. Also, conductivity modulation effect in saturation-mode is analyzed from the distribution of minority carrier and electric field. Through the above procedure, the design procedure of SIT will be more effective.