동료 교수학습 기반 자율실습이 핵심기본간호술 숙련도, 수행자신감 및 자아효능감에 미치는 효과에 관한 융합연구

구희선 한국융합학회 2019 한국융합학회논문지 Vol.10 No.12

The purpose of study was the non-equivalent control group pretest-posttest design to test the effect of self-directed nursing practice based peer-tutoring of same sophomore, on the level of confidence, performance and self-efficacy of core nursing skills in nursing students. The subjects were 68 nursing students in K City from May 1th to June 12th in 2019. The participants were shared into the peer tutoring practice group (experimental group, n=34) and the lecturer guided practice group (control group, n=34). The results of study, the experimental group scored significantly higher on the foley catheterization performance (t=11.60, p<.001), confidence (t=4.123, p<.001) and wearing protection equipment performance (t=5.91, p<.001), confidence (t=4.24, p<.001) and enema performance (t=2.82, p=.008), confidence (t=2.09, p=.044) and self-efficacy (t=4.52, p<.001) than control group. Therefore, the results justified that self-directed nursing practice based peer-tutoring could be effective in improving the performance, confidence and self-efficacy of core nursing skills in nursing students. Based on this, I suggest the study that examines the effects of peer-tutoring by applying it to various majors. 본 연구는 동 학년 동료 교수학습 기반 자율실습이 간호대학생의 핵심기본간호술 숙련도, 수행자신감 및 자아효능감에 미치는 효과를 규명하기 위한 비동등성 대조군 전·후 유사실험연구이다. 자료수집은 K시 소재 일개 전문대학 간호학과 2학년에 재학 중인 실험군 34명, 대조군 34명의 총 68명을 대상으로 2019년 5월 1일부터 6월 12일까지 시행되었다. 연구결과 동료 교수학습 기반 자율실습을 적용한 실험군과 적용하지 않은 대조군 간 유치 도뇨의 숙련도(t=11.60, p<.001), 수행자신감(t=4.12, p<.001), 보호장구 착용과 폐기물 관리의 숙련도(t=5.91, p<.001), 수행자신감(t=4.24, p<.001), 배출 관장의 숙련도(t=2.82, p=.008), 수행자신감(t=2.09, p=.044) 및 자아효능감(t=4.52, p<.001)은 통계적으로 유의한 차이가 있었다. 결과적으로 동료 교수학습 기반 자율실습은 핵심기본간호술 숙련도와 수행자신감 및 자아효능감 향상에 긍정적인 효과를 나타내었으며, 기존 자율실습을 보완할 수 있는 효율적인 방안으로의 활용 가능성이 확인되었다. 이를 토대로 향후 동료 교수학습을 다양한 전공과목에 확대 적용하여 효과를 검정하는 연구를 제언한다.

국내 간호대학생에게 적용한 플립러닝의 체계적 문헌고찰 및 메타분석

구희선 한국응용과학기술학회 2023 한국응용과학기술학회지 Vol.40 No.1

This study is a meta-analysis study to comprehensively investigate the effects of flipped learning teaching applied to nursing students in Korea through systematic review. Data collection was conducted by a team of two researchers from November 20 to December 20, 2022. A total of 129 papers were searched through the domestic database, and duplicate papers were removed and the final 9 studies were selected. Flipped learning improved critical thinking disposition of nursing students 0.91(Z=8.36, p<.001), learning self-efficacy 0.35 (Z=2.62, p=.009), self-directed learning ability 0.81(Z=6.53, p<.001), academic achievement 0.60(Z=5.18, p<.001), and self-efficacy 0.66(Z=4.79, p<.001). Based on the results of this study, it was confirmed that flipped learning is an effective teaching method applicable to the domestic nursing education field, and an objective basis was presented for the direction of flipped learning class design. In the future, we suggest repeated studies that comprehensively analyze the effects of various outcome variables that have a positive effect on flipped learning. 본 연구는 국내 간호대학생에게 적용한 플립러닝 교수법의 효과에 관한 연구를 체계적 고찰을통해 통합적으로 규명하기 위한 메타분석연구이다. 자료수집은 2022년 11월 20일에서 12월 20일까지 코크란 연합의 체계적 고찰 보고지침을 준수하여 진행하였다. 국내 데이터베이스를 통해 검색된 논문은 RISS 72건, KISS 11건, Dbpia 46건 총 129편이었으며, 중복논문 제거 및 선정기준에 따라 최종 9편의 연구를선정하였다. 국내 간호대학생을 대상으로 플립러닝 수업을 적용한 결과 플립러닝이 간호대학생의 비판적사고성향 0.91(Z=8.36, p<.001), 학업적 자기효능감 0.35(Z=2.62, p=.009), 자기주도적 학습능력0.81(Z=6.53, p<.001), 학업성취도 0.60(Z=5.18, p<.001), 자기효능감 0.66(Z=4.79, p<.001) 향상에 효과적인 것으로 나타났다. 본 연구결과를 토대로 플립러닝은 국내 간호교육 현장에 적용 가능한 효과적인 교수법임을 확인하였고, 플립러닝 수업설계 방향성에 객관적인 근거를 제시하였으며, 향후 플립러닝에 긍정적인 효과를 주는 다양한 결과 변인들의 효과를 통합적으로 분석하는 반복연구를 제언한다.

Effects of Smoking on the Pulse Wave Velocity andAnkle Brachial Index in Adolescents

구희선,길태영,이히우,이근,홍영미 대한심장학회 2007 Korean Circulation Journal Vol.37 No.9

Background and Objectives:Smoking is known to increase arterial stiffness in adults. The pulse wave velocity (PWV) is known as an established index of arterial stiffness. The effects of smoking on the PWV in adolescents have not yet been established. We measured the PWV and ankle-brachial index (ABI) in adolescents to determine the effects of smoking on adolescents. Subjects and Methods:Four hundred twenty-seven adolescents between 14 to 16 years of age were enrolled from three high schools in Seoul, Korea. The study group was comprised of 48 smokers (38 males and 10 females) and 379 nonsmokers (254 males and 125 females). Measurements of the height, weight and body mass index (BMI) were performed. The blood pressures of the extremities, and the PWV, the ABI, the ejection time and the pre-ejection period were measured using an automatic device (VP-1000). Among the smoking group, we investigated the association between the duration of smoking, the age at which smoking started and the total number of cigarettes smoked with the PWV and ABI. Results:The brachial-ankle PWV (baPWV) in the smoking group was higher than that of the non-smoking group, but the difference was not statistically significant. There was no significant difference between the ABI of the two groups. Among the smokers, the heart-brachial PWV (hbPWV) was significantly associated with the duration of smoking and the total number of cigarettes smoked. Conclusion:Our study showed no significant difference in the PWV between the two groups. A longitudinal, long-term investigation is needed to more accurately determine the effects of smoking on adolescents. (Korean Circulation J 2007;37:414-418)

Gene Expressions of Nitric Oxide Synthase and Matrix Metalloproteinase-2 in Monocrotaline-Induced Pulmonary Hypertension in Rats After Bosentan Treatment

구희선,김관창,홍영미 대한심장학회 2011 Korean Circulation Journal Vol.41 No.2

Background and Objectives: Nitric oxide (NO) is a major endothelium dependent vasomediator and growth inhibitor. NO synthesis is catalyzed by endothelial nitric oxide synthase (eNOS), and NO can also produce peroxynitrite, which activates matrix metalloproteinases (MMPs). The purpose of this study was to determine the gene expression of eNOS and MMP-2 in the lungs of a rat model of pulmonary hypertension after bosentan treatment. Materials and Methods: Six-week-old male Sprague-Dawley rats were treated as follows: control group, subcutaneous (sc) injection of saline; monocrotaline (MCT) group, sc injection of MCT (60 mg/kg); and bosentan group, sc injection of MCT (60 mg/kg) plus 20 mg/day bosentan orally. The rats were sacrificed after 1, 5, 7, 14 and 28 days. Results: The right ventricle/(left ventricle+septum) ratio significantly increased in the MCT group compared to the control group on day 14 and 28. The expression of eNOS messenger ribonucleic acid was significantly increased in the MCT group compared to the control group on day 28. MMP-2 gene expression was significantly increased in the MCT-treated rats compared to the control group on day 5 and 28. Following bosentan treatment to reduce pulmonary hypertension, the expression levels of MMP-2 gene were significantly decreased on day 7 and 28. eNOS and tissue inhibitor of MMPs genes were also significantly decreased on day 28 after bosentan treatment. Conclusion: These results suggest that elevated eNOS expression may be responsible for MMP-2 activation. The causal relationship between eNOS and MMP-2 and their role in pulmonary hypertension require further investigations.

기복가스 가온요법이 복강경하 대장절제술 노인 암환자의 체온, 저온 불편감 및 마취회복에 미치는 효과

구희선 한국자료분석학회 2013 Journal of the Korean Data Analysis Society Vol.15 No.5

The purpose of this study was to identify the effects of warmed carbon dioxide gases for pneumoperitoneum on body temperature, thermal discomfort and post-anesthetic recovery in the elderly colorectal cancer laparoscopic surgery. Research design was randomized, double-blinded controlled trial. The subjects were assigned equally to either an experimental group (35 patients) to which carbon dioxide gas 37℃ heating intervention was applied or a control group (35 patients) to which ordinary carbon dioxide gas intervention was applied. Statistical analysis of the collected data was performed using SPSS version 21.0. The statistical method included the chi-square test, t-test, repeated measures ANOVA. There were significant differences in body temperatures (F=31.157, p<0.001 (intra-operative), F=37.814, p<0.001 (post-operative)), objective thermal discomfort (F=6.339, p=0.042), subjective thermal discomfort (F=12.881, p<0.001), post-anesthetic recovery (F=9.216, p=0.015) between the experimental group and the control group. According to the results of the present study, body temperature was more effectively maintained in the experimental group (37℃ heated carbon dioxide gas for pneumoperitoneum) than in the control group (21℃ carbon dioxide gas for pneumoperitoneum), showing that the intervention is effective for laparoscopic surgery patients with elderly colorectal cancer. 본 연구는 전신마취 하에 복강경 대장절제술을 시행한 65세 이상 노인 암환자를 대상으로 기복가스 가온요법을 적용한 후 체온, 저온 불편감 및 마취회복에 미치는 효과를 규명하기 위한 무작위 통제군 전후 설계의 유사 실험연구이다. 수집된 자료는 SPSS/WIN 21.0 Program을 이용하여 기술통계와 카이제곱검정 , t-검정, 시점에 따른 그룹 간 교호작용효과 측정을 위해 반복측정분산분석으로 통계 분석하였다. 연구결과 37℃ 이산화탄소 가온 기복가스 주입이 수술 중 체온(F=31.157, p<0.001), 수술 후 회복실에서의 체온(F=37.814, p<0.001), 객관적 저온 불편감(F=6.339, p=0.042), 주관적 저온 불편감(F=12.881, p<0.001), 마취회복(F=9.216, p=0.015)에서 통계적으로 유의한 차이가 있었으며, 저체온 예방과 회복실 입실 후 정상체온으로의 회복에 효과적인 가온중재임을 확인하였다. 이에 본 연구는 노인 복강경 수술 대상자의 효율적인 체온관리 방법을 이해하는데 도움이 될 것이며, 본 연구에서 적용한 이산화탄소 기복가스 가온방법은 복강경하 대장절제술 노인 환자의 저체온 예방 중재로서의 기초자료로 활용될 수 있을 것으로 사료된다.

성인 척추마취 후 절대 침상안정시간에 따른 두통발생 비교연구

구희선,김정순 한국자료분석학회 2013 Journal of the Korean Data Analysis Society Vol.15 No.4

본 연구는 척추마취 후 8시간, 4시간 절대 침상안정 군 간에 두통발생률과 두통의 임상적 특성의 차이를 비교한 전향적 비교 조사 연구(prospective case-control study)이다. 수집된 자료는 SPSS/WIN 18.0 Program을 이용하여 기술통계, chi-square test, t-test, 반복측정 이원배치분산분석, Fisher 정확검정(exact test)으로 통계 분석하였다. 분석결과 8시간 침상안정 군과 4시간 침상안정군에서의 두통발생률은 각각 17.6%, 18.7%로 통계적으로 유의한 차이가 없었으며(chi-square=.083, p=.621), 두통의 강도(F=.952, p=.347). 두통의 발현시간(F=.395, p=.543,) 두통의 지속기간(F=.163, p=.702), 두통의 발생부위(chi-square=.273, p=.892), 두통의 동반증상(chi-square=.312, p=.547), 두통의 중증도(chi-square=.641, p=.426)에서도 두 군 간 통계적으로 유의한 차이가 없었다. 이에 현재 임상에서 척추마취 후 두통예방 차원에서 의례적으로 실시하고 있는 8시간 이상의 절대 침상안정은 환자가 겪는 불편감과 합병증 및 회복지연을 다각적으로 고려해 볼 때, 반드시 필요한 것은 아니라는 객관적인 근거를 제시하였다는데 본 연구는 의의가 있다. 덧붙여 본 연구결과를 바탕으로 척추마취 후 8시간 절대 침상안정에 대한 임상적인 프로토콜 변경에 근거를 제시하였다고 사료된다. The purpose of this study was to compare the clinical characteristics and occurrence of post dural puncture headache (PDPH) according to 8hr absolute bed rest and 4hr absolute bed rest after spinal anesthesia. This study was a prospective case-control research. Patients was divided into two groups such as absolute bed rest for 8 hours group (131 patients) and 4 hours group (104 patients). The data were analyzed by SPSS/WIN 18.0 program. The incidence of PDPH was 18.7% and 17.6% in 8 hour group and 4 hour group, and no significant (chi-square=.083, p=.621). The study was proved that the incidence of PDPH was no significant by CSF leakage (t=-.488, p=.627), trial of puncture (t=-1.475, p=.148), PDPH history (chi-square=.422, p=.517), puncture approach methods (chi-square=.147, p=.714), anesthesiologist clinical career (chi-square=.373, p=.542), intensity of PDPH (F=.952, p=.347), occurrence time (F=.395, p=.543), occurrence region (chi-square=.273, p=.892), duration time (F=.163, p=.702), symptom of comorbidity (chi-square=.312, p=.547), severity of PDPH (chi- square=.641, p=.426). The suggestion that in spinal anesthesia patients, more than 8 hours absolute bed rest is no more obligate management for prevention of PDPH, was speculated.

가온가습호흡회로 적용이 복강경 담낭절제술 노인 환자의 체온과 전율 및 통증에 미치는 효과

구희선 한국자료분석학회 2019 Journal of the Korean Data Analysis Society Vol.21 No.5

The purpose of this study was to identify the effects of HHBC (heated-humidified breathing circuit) applied for general anesthesia on body temperature, shivering and pain in the elderly patient undergoing laparoscopic cholecystectomy. Research design was randomized, double-blinded controlled trial. The subjects were assigned equally to either an experimental group (35 patients) to which HHBC intervention was applied or a control group (35 patients) to which ordinary circuit was applied. Statistical analysis of the collected data was performed using SPSS version 23.0. The statistical method included the chi-square test, t-test, repeated measures ANOVA. There were significant differences in body temperatures (F=5.284, p<.001, F=9.432, p<.001), shivering (F=5.253, p=.042), pain (F=4.851, p=.032) between the experimental group and the control group. According to the results of the present study, core body temperature was more effectively maintained, reducing the shivering and pain in the experimental group than in the control group, showing that the intervention is effective for laparoscopic cholecystectomy patients with elderly. 본 연구는 전신마취 하에 복강경 담낭절제술을 시행하는 만 65세 이상 노인 환자를 대상으로 수술 중 가온가습호흡회로를 적용한 후 수술 중 체온과 수술 후 회복실에서의 체온과 전율, 통증에 미치는 효과를 파악하기 위한 무작위 대조군 전후 설계의 유사 실험연구이다. 수집된 자료는 SPSS/WIN 23.0 Program을 이용하여 기술통계와 카이제곱검정, t-검정, 피셔의 정확도 검정, 시점에 따른 집단 간 교호작용효과를 측정하기 위해 반복측정분산분석으로 통계 처리하였다. 연구결과 수술 중 가온가습호흡회로를 적용한 가온요법은 수술 중 체온(F=5.284, p<.001), 수술 후 체온(F=9.432, p<.001), 전율(F=5.253, p=.042), 통증(F=4.851, p=.032)에 유의한 차이가 있었다. 본 연구결과를 토대로 가온가습호흡회로를 적용한 가온요법은 수술 중 저체온 예방과 수술 후 정상체온 유지 및 전율 감소에 효과적인 것으로 확인되었으며, 수술 후 통증을 완화할 수 있는 비약물적 중재라는 객관적인 근거를 제시하였다. 아울러 최근 지속적으로 증가하고 있는 복강경 담낭절제술 노인 대상자의 체온관리를 위한 근거기반 실무 가이드라인에 기초자료로 활용될 수 있을 것으로 생각한다.

상호동료 교수학습을 적용한 기본간호학실습 교육이 간호대학생의 핵심기본간호술 수행도, 수행자신감 및 학습만족도에 미치는 효과

구희선(Gu Hee Seon) 학습자중심교과교육학회 2021 학습자중심교과교육연구 Vol.21 No.16

목적 본 연구는 간호현장에서 요구되는 가장 필수적인 핵심역량으로써 그 중요성이 날로 강조되고 있는 핵심기본간호술 수행능력 향상을 위하여, 상호동료 교수학습법을 기본간호학실습 교육에 적용하여 핵심기본간호술 수행도, 수행자신감 및 학습만족도에 미치는 효과를 확인하였다. 방법 본 연구는 비동등성 대조군 전.후 유사실험설계로, 2020년 8월 24일부터 11월 13일까지 경북 K시에 소재한 U대학교 간호학과 2학년 재학생 중 연구목적을 이해하고 연구참여에 자발적으로 동의한 75명을 무작위로 실험군과 대조군에 배정하였다. 수집된 자료는 IBM SPSS Statistics 23.0 프로그램을 이용하여 분석하였다. 결과 수행도는 핵심기본간호술 항목 중 난이도 ‘중’ ‘상’ 수준에 해당하는 유치도뇨(t=8.727, p<.001), 기관내흡인(t=6.405, p=.008), 피내주사(t=6.595, p<.001), 피하주사(t=4.288, p=.008), 간헐적위관영양(t=4.005, p=.008) 항목에서, 수행자신감은 난이도 ‘상’ 수준에 해당하는 유치도뇨(t=5.099, p<.001), 기관내흡인(t=2.576, p=.014), 피내주사(t=3.797, p<.001) 항목에서 실험군이 대조군보다 통계적으로 유의하게 증가하였으며, 학습만족도도 실험군이 유의하게 높게 나타났다(t=6.418, p<.001). 결론 이상의 연구 결과에서 상호동료 교수학습법을 적용한 기본간호학실습 교육이 간호대학생의 핵심기본간호술 수행도, 수행자신감 및 학습만족도에 효과적임을 확인하였다. 아울러, 상호동료 교수학습법은 기본간호학실습 교육뿐만 아니라, 난이도가 높아서 어렵게 인지되는 핵심기본간호술 항목의 수행능력 향상을 위한 학습방안으로 활용될 수 있을 것으로 기대된다. Objectives In order to improve the performance of core basic nursing skills, the importance of which is being emphasized as the most essential core competency required in the nursing field, this study applied the mutual peer teaching and learning method to basic nursing practice education to improve performance and confidence in core basic nursing skills, and the effect on learning satisfaction was confirmed. Methods This study is a similar experimental design before and after the non-equivalent control group. From August 24 to November 13, 2020, among the 2nd year students of the Department of Nursing at U University in K city, Gyeongbuk, taking basic nursing practice courses, the purpose of the study was met. 75 people who understood and voluntarily agreed to participate in the study were randomly assigned to the experimental group and the control group. The collected data were analyzed using IBM SPSS Statistics 23.0 program. Results Performance was measured by indwelling catheterization (t=8.727, p<.001), endotracheal suction (t=6.405, p=.008), intradermal injection (t=6.595, p<.001), subcutaneous injection (t=4.288, p=.008), and intermittent gavage (t=4.005, p=.008), performance confidence was also at the ‘high’ level of difficulty. In indwelling catheterization (t=5.099, p<.001), endotracheal aspiration (t=2.576, p=.014), and intradermal injection (t=3.797, p<.001), the experimental group significantly increased than the control group, Learning satisfaction was also significantly higher in the experimental group (t=6.418, p<.001). Conclusions From the above study results, it was confirmed that the basic nursing practice education applying the mutual peer teaching and learning method was effective for the core basic nursing skills performance, performance confidence and learning satisfaction of nursing students. Therefore, it is expected that the mutual peer teaching and learning method can be used as a learning method to improve the performance of core basic nursing skills, which are recognized as difficult due to their high difficulty, in basic nursing practice education.

실시간 컴퓨터 통신망에서의 주기적 패킷 전달 방법

구희선(Koo Hee Sun),박문화(Park Moon Hwa) 한국정보과학회 1992 한국정보과학회 학술발표논문집 Vol.19 No.2

다양한 정보를 주고 받는 다중매체 통신에서 실시간 통신은 매우 중요한 역할을 한다. 특히 음성 신호와 같은 경우 실시간 뿐만 아니라 일정한 간격으로 전송되어야 합성시 유리하다. 본 논문에서는 기존 컴퓨터 통신망에서 일정 비트율 근원지로부터의 패킷이 실시간 그리고 일정 시간 간격으로 최종 목적지에 전달되도록 도착 시간과 네 개의 큐를 이용한 방법을 제시한다.

PETTLEP 모델 기반 심상훈련 적용이 간호대학생의 핵심기본간호술 수행자신감 및 수행능력, 자율실습 참여도에 미치는 효과

구희선(Hee-Seon Gu) 한국응용과학기술학회 (구.한국유화학회) 2021 한국응용과학기술학회지 Vol.38 No.4

본 연구는 PETTLEP 모델 기반 심상훈련을 기본간호학실습 교육에 적용하여 핵심기본간호술 수행자신감 및 수행능력, 자율실습 참여도에 미치는 효과를 규명하기 위한 비동등성 대조군 전후 유사실험연구 이다. 연구대상은 K도 소재 U대학교 간호학과 2학년 재학생 중 연구목적을 이해하고 연구참여에 자발적으로 동의한 74명을 무작위로 실험군과 대조군에 배정하여 자료 수집하였다. 수집된 자료는 SPSS Statistics 23.0 프로그램을 이용하여 대상자의 일반적 특성은 빈도와 백분율, 정규성검정은 왜도와 첨도를 이용하였으며, 실험처치의 효과측정을 위한 종속변수 검정은 paired t-test로 분석하였다. 연구결과 PETTLEP 모델 기반 심상훈련은 핵심기본간호술 수행자신감(t=4.18, p<.001), 핵심기본간호술 수행능력(지식(t=2.241, p=.032), 간호술기(t=8.402, p<.001)), 자율실습 참여도(t=6.822, p<.001)에 통계적으로 유의한 차이가 있었다. 본연구 결과를 토대로 PETTLEP 모델 기반 심상훈련은 기본간호학실습 교육에 적용 가능한 교수학습방법이될 수 있음을 확인하였다. 따라서, 핵심기본간호술 중 난이도가 높은 항목의 수행능력 향상을 위해 PETTLEP 모델 기반 심상훈련을 활용할 수 있을 것으로 기대된다. This study is a similar experimental study before and after the inequality control group to investigate the effect of PETTLEP model-based image training on fundamental nursing practice education on the confidence and competence ability of core basic nursing skills, and participation in autonomous practice. Data were collected by randomly assigning 74 students who understood the purpose of the study and voluntarily agreed to participate in the study among second-year students of the Department of Nursing at U University located in K Province, randomly assigned to an experimental group and a control group. For the collected data, frequency and percentage were used for general characteristics of subjects using SPSS Statistics 23.0 program, skewness and kurtosis were used for normality test, and the dependent variable test for measuring the effect of experimental treatment was analyzed by paired t-test. As a result of the study, PETTLEP model-based image training showed confidence in core basic nursing skills(t=4.18, p<.001) and competence (knowledge(t=2.241, p=.032), nursing skills(t=8.402, p<.001)), there were statistically significant differences in self-practice participation(t=6.822, p<.001). Based on the results of this study, the PETTLEP model-based image training provided Based on the results of this study, it was confirmed that PETTLEP model-based image training can be a teaching and learning method applicable to basic nursing education. In addition, PETTLEP model-based image training is expected to be utilized as a learning method to improve the competence of core basic nursing skills, which are recognized as difficult due to their high level of difficulty.