집중치료 후 증후군 경험에 관한 질적 통합 연구

강지연,정연진,윤선영,이민주,백민정,신소영,홍희진,김수경,조영신,Kang, Jiyeon,Jeong, Yeon Jin,Yun, Sun Young,Lee, Min Ju,Baek, Min Jung,Shin, So Yeung,Hong, Hee Jin,Kim, Soo Kyung,Cho, Young Shin 한국중환자간호학회 2017 중환자간호학회지 Vol.10 No.1

Purpose: The purpose of this study was to integrate the results of qualitative studies to understand critical care survivors' experience of the post-intensive care syndrome (PICS). Methods: This was a meta-synthesis of primary studies that used qualitative methods. We reviewed 26 qualitative studies on PICS selected from 8 international and Korean databases and from a manual search. Thomas and Harden's 3 stages (free coding, development of descriptive themes, generation of analytical themes) for thematic synthesis were utilized to analyze the collected qualitative data. Results: Four descriptive themes emerged from the thematic synthesis: weak physical conditions, psycho-emotional changes, the painful-memory of intensive care units, and social vulnerability. The analytical theme for the current study was "unfamiliarity with the vulnerable self." Critical care survivors had to confront entirely different "selves" after discharge from intensive care units. They had become physically weak, psychologically unstable, and the critical memories continued to create distress. These changes increased their social vulnerability by making them dependent on others, causing family conflicts, and changing interpersonal relationships. Conclusions: Finding from this qualitative synthesis and other related literature highlight the severity of PICS and the importance of rehabilitative intervention for critical care survivors.

Rasch 모형을 이용한 한국어판 중환자실경험 측정도구의 문항 분석

강지연,김민희,Kang, Jiyeon,Kim, Minhui 한국중환자간호학회 2022 중환자간호학회지 Vol.15 No.3

Purpose : This study aimed to examine the item characteristics of the Korean version of the intensive care experience questionnaire (K-ICEQ) using the Rasch analysis model of the item response theory. Methods : In this methodological study, the validity of the scale was examined, and a secondary analysis was conducted using cohort data of patients who were discharged from the intensive care units (ICU). Data from 891 patients who responded to the K-ICEQ upon ICU discharge were analyzed. The WINSTEP program was used to analyze item characteristics, including item difficulty, fit indices, appropriateness scale, and separation reliability. Results : The difficulty level of all 26 items of the K-ICEQ was appropriate, and the fit indices of the 25 items, except for item 18, were good. The 5-point scale of the K-ICEQ was not appropriate in the three subscales. The item separation reliability was good in all subscales, but did not meet the criteria in terms of respondents. Conclusion : The results of examining the item characteristics of the K-ICEQ revealed a good degree of difficulty, fitness, and item separation reliability. To increase the validity of the K-ICEQ, we suggest the rearrangement of the overall item order, modification of the item description of the "recall of experience" subscale, and reduction of the scale response level.

호흡지지요법을 적용 중인 중환자실 입원환자의 액티그래피 측정 수면특성

강지연,권용빈,Kang, Jiyeon,Kwon, Yongbin 한국중환자간호학회 2022 중환자간호학회지 Vol.15 No.3

Purpose : This study aimed to investigate sleep parameters and to identify differences according to respiratory support therapy, sedation, and pain medication in intensive care unit (ICU) patients. Methods : In this observational study, sleep parameters were measured using actigraphy. We observed 45 sleep events in 30 ICU patients receiving respiratory support therapy. We measured the sleep parameters, time, efficiency, and wakefulness after sleep onset (WASO). The differences in sleep parameters according to the respiratory support therapy were analyzed using the Mann-Whitney U test. Results : The average daily sleep time of the participants was 776.66±276.71 minutes, of which more than 60% accounted for daytime sleep. During night sleep, the duration of WASO was 156.93±107.91 minutes, and the frequency of WASO was 26.02±25.82 times. The high flow nasal cannula (HFNC) group had a significantly shorter night sleep time (𝑥²=7.86, p =.049), a greater number of WASO (𝑥²=5.69, p =.128), and a longer WASO duration (𝑥²=8.75, p =.033) than groups of other respiratory therapies. Conclusion : ICU patients on respiratory support therapy experienced sleep disturbances such as disrupted circadian rhythm and sleep fragmentation. Among respiratory support regimens, HFNC was associated with poor sleep parameters, which appears to be associated with the insufficient use of analgesics. The results of this study warrant the development of interventions that can improve sleep in ICU patients receiving respiratory support, including HFNC.

국내 중환자실 섬망 예방 중재에 관한 체계적 고찰 및 메타분석

강지연,최민정,Kang, Jiyeon,Choi, Min Jeong 한국중환자간호학회 2021 중환자간호학회지 Vol.14 No.3

Purpose : This study aimed to systematically review the preventive interventions for delirium in Korean intensive care unit (ICU) patients and evaluate their efficacy. Methods : For this systematic review and meta-analysis, we searched the literature and selected studies from data sources that included the RISS, KISS, National Central Library, National Assembly Library, DBpia, Science on, MEDLINE, and Cochrane Library. We used Cochrane's revised tool for risk of bias in randomized trials and non-randomized studies of intervention tools to assess the quality of the selected studies. The effect size of the intervention was calculated as odds ratio (OR) and standardized mean difference (SMD). Results : Preventive interventions reported in 23 studies with a total of 4,799 ICU patients were effective in reducing the occurrence of delirium (OR=0.64, 95% CI : 0.49~0.91, p=.011), but not the duration (SMD=-0.22, 95% CI : -0.51~0.08, p=.148). As a result of a subgroup analysis, non-pharmacological interventions were effective in reducing the occurrence of delirium (OR=0.66, 95% CI : 0.47~0.94, p=.020), while pharmacological interventions had no effect (OR=0.68, 95% CI : 0.33~1.40, p=.295). Among the non-pharmacological interventions, multi-component intervention had the largest effect size (OR=0.38, 95% CI : 0.26~0.55, p<.001). Conclusion : Non-pharmacological interventions were effective in reducing the occurrence of delirium. We recommend the development and application of multi-component interventions to prevent delirium in the Korean ICU patients.

중환자실 간호사가 인식한 간호조직문화와 직장 내 괴롭힘 경험과의 관계

강지연,윤선영,원윤희,안유선,Kang, Jiyeon,Yun, Seonyoung,Won, Youn-Hui,An, Yu-Seon 한국중환자간호학회 2014 중환자간호학회지 Vol.7 No.2

Purpose: The purpose of this study was to identify the relationship between organizational culture and workplace bullying of intensive care unit (ICU) nurses. Methods: A secondary analysis was conducted using three different data sets on workplace bullying of hospital nurses. This analysis focused on the relationship between organizational culture and workplace bullying of 240 ICU nurses. The original data were collected using self-reporting questionnaires and were analyzed using hierarchical multiple regression. Results: ICU nurses were aware of their organizational culture as being rank-oriented, relationship-oriented, innovation-oriented, and task-oriented in that order. The results showed that 15.0% of the ICU nurses reported being victims of workplace bullying, mostly work-related bullying. The perception of a relationshiporiented culture explained a variance of 29% in the workplace bullying of ICU nurses. Conclusion: The findings suggest that ICU nurses who are strongly aware of a relationship-oriented culture would experience less workplace bullying. Further research is needed to develop interventions that can foster a relationship-oriented culture in ICUs.

간호사간 직장내 괴롭힘 발생률에 관한 체계적 문헌고찰과 메타분석

강지연,이민주,Kang, Jiyeon,Lee, Minju 한국중환자간호학회 2016 중환자간호학회지 Vol.9 No.1

Purpose: This study aimed to estimate the pooled prevalence of workplace bullying among nurses and examine the effect of moderate factors. Methods: Studies that assessed nursing workplace bullying using the negative act questionnaire developed by Einarsen et al. were searched for in 8 databases. The pooled prevalence was calculated with overall event rate and meta-ANOVA was performed for subgroup analysis. A funnel plot and Egger's linear regression asymmetry test were performed to confirm the publication bias of meta-analyzed studies. Results: A total of 23 studies (N=11,748) were included in the systematic review, and 14 studies (N=4,585) that reported prevalence using operational criteria of victim were selected for meta-analysis. The pooled prevalence of workplace bullying was 22.2% (95% CI: 19.0~25.7). Domestic studies reported lower prevalence than international studies (18.6% vs. 27.0%, Q=8.75, p=.003). The prevalences were different according to publication year (30.6% in 2008~2010, 19.5% in 2011~2014, 21.8% in 2015, Q=11.89, p=.003). Studies that recruited only new nurses reported higher prevalence than others (28.4% vs. 20.6%, Q=3.92, p=.048). Publication bias was not found. Conclusions: Workplace bullying is prevalent in the nursing profession, and is more serious for new graduate nurses. Individual and organizational measures for preventing workplace bullying among nurses need to be sought.

통합적 고찰과 키워드 분석을 이용한 최근 10년(2008-2017) 동안의 국내 중환자간호 연구 동향 분석

강지연,김수경,조영신,고현영,백지현,이수진,Kang, Jiyeon,Kim, Soo Gyeong,Cho, Young Shin,Ko, Hyunyoung,Back, Ji Hyun,Lee, Su Jin 한국중환자간호학회 2018 중환자간호학회지 Vol.11 No.2

Purpose : The purpose of this study was to examine the possible direction of critical care nursing research in the future by analyzing the trends of recent Korean studies. Method : Using a database search, we selected 263 articles on critical care nursing that were published in Korean journals between 2008 and 2017. Then, we conducted an integrative review of the contents of the selected articles and analyzed the English abstracts using the relevant packages and functions of the R program. Results : The number of studies concerning critical care nursing has increased over the 10-year period, and the specific topic of each study has diversified according to the time at which it was conducted. In terms of quality, the majority of the research was published in high-level academic journals. The key words regularly studied over the past decade were: knowledge, delirium, education, restraint, stress, and infection. Studies related to vancomycin-resistant enterococci infection, compliance, and standards have decreased, while studies related to death, communication, and safety have increased. Conclusion : Randomized controlled trials and protocol research for evidence-based critical care need to be conducted, as does research on family involvement. The key word analysis of unstructured text used in this study is a relatively new method; it is suggested that this method be applied to various critical care nursing research and develop it methodologically.

중환자실 간호사의 근무환경과 인간중심 간호의 관계

강지연,임윤미,Kang, Jiyeon,Lim, Yun Mi 한국중환자간호학회 2019 중환자간호학회지 Vol.12 No.2

Purpose : The purpose of this study was to investigate the effect of the perceived nursing work environment (NWE) on person-centered critical care nursing (PCCN) practices among nurses in intensive care units (ICUs). Methods : A cross-sectional research design was adopted for this study; participants were 126 ICU nurses working in five hospitals in B city. From December 2018 to February 2019, a survey questionnaire on NWE and PCCN were conducted. The collected data were analyzed with a multiple hierarchical regression analysis. Results : The mean score for NWE was $2.98{\pm}0.39$. Among the factors, basic work system was the highest ($3.39{\pm}0.41$), followed by leadership of the head nurse ($3.31{\pm}0.55$), interpersonal relationships ($2.77{\pm}0.62$), and institutional support ($2.58{\pm}0.52$). The mean score for PCCN was $3.52{\pm}0.46$. Among the factors, comfort was the highest ($3.77{\pm}0.62$), followed by respect ($3.55{\pm}0.56$), compassion ($3.43{\pm}0.60$), and individuality ($3.38{\pm}0.56$). The interpersonal relationship (${\beta}=.31$, p=.001) and the number of patients per shift (${\beta}=-.23$, p=.005) had a significant effect on PCCN, accounting for 25.9% of the total variance. Conclusion : These results suggest that it is necessary to enhance the relationship-oriented culture and reduce the workload of nurses in order to improve the quality of nursing care in ICUs.

응급실 간호사의 교육중재 수행능력과 수행빈도

강지연(Kang, Jiyeon),이은남(Lee, Eun-Nam),김복자(Kim, Bok-Ja) 한국간호교육학회 2009 한국간호교육학회지 Vol.15 No.1

단축형 ICF 핵심지표로 측정한 뇌졸중 환자의 기능상태

강지연(Kang, Jiyeon),공주(Gong, Ju),박미진(Park, Mi-jin),이여원(Lee, Yeo-won),김유리(Kim, Yuri) 대한근관절건강학회 2013 근관절건강학회지 Vol.20 No.1