뇌혈관 환자에 대한 간호진단 적용 분석

김명희 대구보건대학 1996 대구보건대학 論文集 Vol.16 No.-

간호진단의 실무적용을 증진시키고 간호의 질을 높이기 위해 대구시내에 소재한 Y의료원 신경계 변동에 입원한 환자 102명에게 적용된 간호진단수 총 109개를 NANDA회의에서 채택된 간호진단명 105개에 준하여 분석한 결과 환자 1인당 평균1개를 사용하였으며 총 사용 NANDA 간호진단명은 9개로 대상자 102명중 가장 많이 사용된 간호 진단은 안위의 변화 44.0%, 불안 19.3%, 부적절한 개인적 대응 12.8%로서 높게 나타났다. 본 연구의 결과 적용된 간호진단의 종류 및 빈도가 매우 낮았으며 간호진단에 대한 사정도구개발의 연구와 간호사들에게 지속적인 보수교육이 강화되어야 한다고 생각한다. This research was done for the improvement of practical appliance of Ng. diagnosis and for the elevation of nursing guality(level). I analized the Ng. diagnosis with 109 diagnosis used by NANDA conference from 102 patients who were admitted for Neuro Surgery Ward of Y medical Center which is in Taegu. Ther general characteristics of the patients are as follows ; by sex, men were 57 cases(55.9%) and women were 45 cases(45.1%). In age, 26~29 were I case(1.0%), 30~39 were 10 cases(9.8%), 40~49 were 30 cases(29.4%), 50~59 were 32 cases(31.4%), 60~69 were 26 cases(25.5%), and over 70 were 3 cases (2.9%). In diagnosis of the patients, Cerebral Infarction were 52 cases(50.9%), Intracerebral Hemorrhage were 20 cases(19.6%), Subarachnoid Hemorrhage were 12 cases(11.8%), Epidural Hemorrhage were 7 cases(6.9%), Subdural Hemorrhage were 5 cases(4.9%), Aneurysm were 4 cases(3.9%), Cerebrovascular Accident were 2 cases(2.0%). I used all 109 Ng. diagnoses which means one person used about 1.0 of NANDA'S diagnoses. All used NANDA'S was 9 diagnoses. The most popular diagnoses were alteration in Comfort(44.0%), Anxiety(19,3%), Ineffective individual Coping(12.8%) in 102 cases. Bae showed ineffective air way clearance(48.4%), impaired Physical mobility, ineffective Breathing pattern, Knowledge deficit, All of them were 41.9% in her diagnosis analysis research of Open Heart Surgery Patients. Kang showed self care deficit(27.7%), skin integrity(23.4%), tissue perfusion, alteration in cerebral area(16.4%), and high risk for infection(0.6%), in her diagnosis analysis research of brain disease patients. Park(1987) showed the representative diagnosis of high risk for injury, altered nutrition less than body reguirements, knowledge dificit, sleep pattern disturbance, and fluid volume excess, in her evaluations, of the original and revealational research rate of five diagnosis in patients with CAAH or CAVH. When we consider the specifics of each patient we can determine how the Ng assessment reveals that patients problems differ according to their disease. Signs and symptoms are one thing, and nursing requests are another. As the specific response-formal analysis of 9 Ng. Diagnoses in which the most popular diagnoses were Emotion(33.4%), Exchanging(22.2%), Moving(12.0%), choosing(11.1%) Knowing(11.1%) but Communicating and Relating, Valuing, Perceiving were not applied.

기서 (寄書) : 조선총림 (朝鮮叢林)에 용상대덕 (龍象大德)을 향 (向)하야 [ ㅎ.야 ] 청년도제 (靑年徒弟)의 교육장려 (敎育奬勵)를 충고함 [ ㅎ.ㅁ ] / 보수 (寶輸) 김명희 (金明熙)

김명희 조선불교월보사 1911 朝鮮佛敎月報 Vol.2 No.-

중증외상환자의 치료경과 시간과 활력징후에 따른 응급처치 및 간호활동

김명희,박정하,김명희,구지은 기초간호학회 2014 Journal of korean biological nursing science Vol.16 No.3

Purpose: The aim of this study was to identify necessary emergency treatment and nursing activities for severe trauma patients according to elapsed time and vital signs. Methods: A survey was conducted with 121 patients over 15 points ISS on EMR from June 1, 2011 to May 31, 2012. Collected data were analyzed with descriptive statistics, applying McNemar’s test using SPSS 12.0. Results: Almost all of the subjects were men and the mean age was 46.9. Run-time for primary diagnosis, treatment decision, and leaving for the hospital room was 0.19, 4.36, and 4.21 hours, respectively, and stayover time was 9 hours. Regardless of vital signs, emergency treatments involving ambu-bagging, intubation, ventilator, and central vein catheterization insertion were offered within an hour. Central venous pressure, Foley catheter/Levin tube preparation and maintenance were performed in cases of unstable vital sign patients within an hour. Unrelated to vital signs, nursing activities for consciousness assessment, skin assesment and wound care, bed sore/fall down assesment and care, intravenous injection insertion and maintenance were conducted for all severe trauma patients within an hour. Foley catheter/Levin tube drainage care was performed for patients who had unstable vital signs within an hour. Conclusion: Emergency treatment and nursing activities for severe trauma patients were specific according to elapsed time and vital signs.

[기획특집] 2007년 신춘문예 당선자 특집 - 김명희

김명희 고요아침 2007 시조시학 Vol.- No.-

중증외상환자의 주 손상 부위별 특성과 간호활동

김명희,김명희,박정하 기초간호학회 2013 Journal of korean biological nursing science Vol.15 No.4

오늘날 산업화와 경제성장에 따라 교통사고, 재해, 산업 재해 등의 각종사고가 증가하면서(Kim, J. J. et al., 2011) 매년 12만 5천 명의 중증외상환자가 발생하고, 이 중 1만 1천 명이 사망하고 있지만, 적절하고 신속한 치료가 이루어진다면 살릴 수 있는 중증외상환자도 3천 5백 명에 달한다(Joo, 2010). 외상환자의 예방가능 사망률은 그 나라의 전체적인 외상체계를 평가할 수 있는 지표로(Mackenzie, 1999) 미국과 일본의 중증외상환자 예방가능 사망률은 10-15% (Esposito, Sanddal, Reynolds, & Sanddal, 2003; Kunihiro, 2005)인 데 비해 국내는 33%로(Kim, 2011) 2배가 넘는 실정이다. 외상진료체계를 구축하여 외상환자의 예방가능 사망률을 줄이고 있는 외국사례를 토대로(Stewart, Lane, & Stefanits, 1995) 국내에서는 2009년 중증외상 특성화 후보센터를 지정하였고, 향후 전문외상센터를 운영할 계획이다(Central Emergency Medical Center, 2009). 현재 중증외상환자들은 권역응급의료센터에서 치료를 전담하고 있으나 입원대기 환자들이 정체되고(Chun, 2008) 치료전담 의료 인력이 부족(Lee, 2011)하여 중증외상환자의 진단, 치료 및 처치가 지연되고 있다. 외상환자는 외상초기의 적절한 치료여부에 따라 예후에 많은 영향을 받으므로(Nguyen, Rivers, & Havastad, 2000), 진단 및 치료에 소요되는 시간을 단축시켜 빠른 시간 내에 처치가 이루어지는 것이 매우 중요하다(Kim et al., 2007). 외상환자의 대부분은 다발성 외상환자들로(Kim, T. Y. et al., 2011) 복합적인 문제들을 동반하는 경우가 많기 때문에 생명유지를 위한 기본적인 처치와 동시에 손상부위에 따른 사정, 처치 및 간호활동이 이루어져야 한다. 국군간호사관학교의 외상간호교육과정(Trauma Nursing Core Course, TNCC)에 신체의 해부학적 부위에 따른 간호가 있지만, 이는 사고현장에서부터 병원에 도착하기까지의 상황에 대한 것(Korean Nurses Association, 2013)이고, 응급환자 매뉴얼의 외상환자 간호처치는 이론적이므로 임상실무현장을 반영한 병원 도착 후의 중증외상환자의 간호활동에 대한 연구가 필요하다.

조손가족 조모의 자아분화 상태

김명희,김신희 보건의료산업학회 2015 보건의료산업학회지 Vol.9 No.3

Objectives : This study investigated the general characteristics, child rearing characteristics, and the level of self-differentiation of 120 custodial grandmothers. Methods : Data were collected with a self-administered questionnaire from 120 custodial grandmothers who registered Kinship Network in Busan City. Results : For the self-differentiation measure, the mean score of the sample was 2.52±0.51. However, the level of the fusion with emotion 1.89±0.80 was extremely low partly due to the influence of collectivist culture of Korean society. The levels of emotional reactivity and fusion with emotion were significantly low which were dependent on depression (F=4.387, p=0.015). Conclusions : The findings of this study show the need to improve the level of self-differentiation by increasing the score of emotional reactivity and fusion with the emotion among the kinship network grandmothers. Therefore, supportive programs for kinship network grandmothers need to develop self-differentiation.

간호 대학생의 약물계산역량에 영향을 미치는 요인

김명희,박정하,김명수 기초간호학회 2012 Journal of korean biological nursing science Vol.14 No.3

투약은 임상현장에서 전문적이고 책임감이 따르는 중요한 업무로 모든 간호사는 안전하고 효과적인 투약을 제공할 수 있어야 한다. 하지만 Institute of Medicine (IOM, 2006)의 보고에 따르면 미국에서 해마다 15,000여 개의 예방 가능한 투약위해사건(preventable adverse drug events)이 발생하여 환자들은 입원하는 동안 매일 한 개의 투약오류에 노출되고, 이로 인해 입원기간이 길어지며, 사망률 또한 증가하고 있다(Pirmohamed et al., 2004). 투약오류의 65-87%가 처방과 투여단계 동안에 발생하며 잘못된 약 혹은 잘못된 용량의 투여가 가장 흔한 유형이라 보고되었다(Tang, Sheu, Yu, Wei, & Chen, 2007). 이 중 과다 혹은 과소용량으로 투여되는 용량관련오류(Hicks, Becker, Krenzischeck, & Beyea, 2004)는 흔히 계산착오로 인해 발생하는 경우가 많으므로(Haw, Stubbs, & Dickens, 2007) 환자안전을 위해 간호사들은 적합한 약물계산역량을 갖추어야 한다.

3. Rhizopus nigricans 에 의한 Progesterone 의 Hydroxylation 에 관한 연구

김명희,김말남 한국균학회 1986 韓國菌學會誌 Vol.14 No.4

『순조기축진찬의궤』에 나타난 의례식 분석- 의주(儀註)를 중심으로 -

김명희,김아현,송은주 한국외식경영학회 2015 외식경영연구 Vol.18 No.2

『순조기축진찬의궤』는 1829년(순조 29) 효명세자가 순조의 40세와 즉위 30년을 경축하기 위해 올린 연향 기록이다. 본 연구는 「의주」를 중심으로 의례 절차와 참여자들의 자리배치, 상차림과의 관계를 살펴봄으로써 조선시대 궁중연향의식(儀式)과 궁중음식특징에 대해 이해하고자 하였다. 연구 결과, 의례 절차에는 일정한 격식이 존재하였다. 외진찬과 내진찬에서 왕에게 술을 올리는 진작례가 거행되었다. 외진찬(外進饌)에서는 제1작(爵) 왕세자를 시작으로 진작재신까지 9작례가 시행되었으며 내진찬(內進饌)에서는 제1작 왕세자를 필두로 왕세자빈․내외명부, 종친․의빈․척신반수까지 7작례가 시행되었다. 진작(進爵)을 할 때마다 왕에게 외진찬은 9미수가 올려졌으며 내진찬은 7미수가 왕에게 올려졌다. 또한 진찬의 성격에 따라 참석자들이 다름을 알 수 있었다. 명정전 외진찬에서는 왕이 주빈이 되었고 참가자는 왕세자, 종친, 의빈, 문무백관 등 남성이 주축이 되었다. 자경전 내진찬의 경우에는 왕이 주빈이 되었고 참가자는 왕세자, 왕세자빈, 좌우명부, 종친, 의빈, 척신 등 여성들도 다 같이 참여하는 연향인 것을 알 수 있다. 이상으로 본 연구는 궁중연향의 의례식(儀禮食)을 분석함으로써 조선시대 궁중음식이 갖는 역사적 의미와 궁중연향음식의 문화에 대해 살펴보았다. 『Soonjo Gichuk Jinchan Euigwe』 is a record of the banquet that Prince Hyomyeong had held to celebrate the 40th birthday of King Soonjo and the 30th anniversary of his accession to the throne in year 1829. As focusing on Euiju, this study looked into the ritual ceremony processes, the seat arrangement and table setting and then, aimed to understand characteristics of court ritual ceremonies and royal cuisines as well as in the Joseon Dynasty. The study confirmed that when it comes to how to proceed with the ritual ceremonies, there had been always these fixed formal processes. In addition, the study learned that different attendees had been invited to different banquets depending on purposes of the functions.

자기정체성과 역할스트레스가 회복 탄력성과 행복에 미치는 영향

김명희,남승규 대전대학교 인문사회과학연구소 2022 인문사회과학논문집 Vol.1 No.1

In order to find ways to raise activation of consumption and the quality of consumers’ life, this study was conducted to investigate effects of consumers’ self identity and role stress on resilience and happiness. Data were collected and analyzed by 250 of experimenters from 10’s to 60’s usingquestionnaires including self identity, role stress, resilience and happiness scale. In the statistical analysis, the reliability and validity of the used scales were confirmed through internal consistency coefficient and factor analysis. Moreover, effects of self identity and role stress on resilience and happiness were examined using multiple regression analysis and differences of resilience and happiness according to level of self identity and role stress were examined using two-way ANOVA. According to the results of the study, Hypothesis I, “Self identity will make a positive impact on raisingresilience but role stress will make a negative impact on raising raisingresilience”, and Hypothesis II, “Self identity will make a positive impact onraising happiness but Role stress will make a negative impact on raising happiness”were supported. Also, Hypothesis Ⅲ and Ⅳ, “There will be differences of resilience according to level of self identity and role stress”, Hypothesis Ⅴ and Ⅵ, “There will be differences of happiness according to level of self identity and role stress”, and Hypothes Ⅷ, “There will be differences of happiness according to interaction of self identity and role stress” were supported. This findings show that building of self identity andmitigation of role stress can raise consumers’ resilience and happiness. Therefore, in order to achieve the goal of raising activation of consumptionand the quality of consumers’ life, it is necessary to pay attention to consumers’self identity and role stress and prepare the solution to improve consumer' s resilience and happiness by education and programs that estabilish consumers’self identity and reduce role stress. Finally, the limitations of the study and future research directions were discussed.