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최스미 대한뇌졸중학회 2003 Journal of stroke Vol.5 No.1
College of Nursing, Seoul National University*, and University of Ulsan, Asan Medical center, Department of Neurology**Background : Although stroke patients often use herbal treatment after being discharged from a hospital, studies regarding the prevalence, types, and effect of herbal medicine use, and possible predictors of herbal treatment use have not been carried out in our country. Subjects and Methods : We randomly selected 340 stroke patients who were admitted to the Asan Medical Center between 1994-1998. A follow up telephone interview was performed 3~7 years after the onset of stroke in 100 patients. With the use of a questionnaire, we assessed the rates, types, duration, reasons for use, and the subjective effects, of herbal treatment. We also assessed the current use of herbal treatment, and the patients’socio-economic status. The presence of risk factors & neurological deficits were obtained from the medical records. Results : Forty (40%) of the patients reported that they tried herbal treatment after a discharge. Subjective positive effects of treatment were noted in 50% of users. An average duration of treatment was 4 years, and a combined therapy of acupuncture and herbal medicine was common (63%). The most common reason of receiving herbal treatment was recommendations from friends/family(83%). Univariate analysis showed that factors related to the use of herbal treatment were: the presence of diabetes mellitus p〈0.01), motor impairment (p〈0.05), sensory dysfunction (p〈0.01), dysarthria (p〈0.05) and dysphagia (p〈0.01). Logistic regression analysis showed that economic status was the most mportant factor explaining the use of herbal treatment. The presence of sensory dysfunction (p=0.063), age (p=0.052), the level of education(p=0.058), and gender( p=0.089) reached a marginal significance. C o n c l u s i o n s : Herbal medicine use is popular even in stroke patients who are admitted to a western style hospital. Approximately half of the herbal medicine users consider it as effective. Herbal medicine use is closely related to the patients’economic status.
연소 · 고령 노인의 성별에 따른 건강 및 영양상태 비교 조사 연구
최스미,최명애,김금순,이명선,서은영,서민희 기초간호학회 2012 Journal of korean biological nursing science Vol.14 No.3
최근 우리나라 노인의 수명이 증가함에 따라 특히 75세 이상의 노인 수가 급격히 증가하였다. 국외 선행 연구 결과 75세 이상 노인의 경우 성별에 따라 영양소 섭취량의 차이가 있으며 영양상태가 나쁘고 이는 만성질환으로 이환율을 증가시킬 수 있음을 보고하였다(Volkert, Kreuel, Heseker, & Stehle, 2004). 노인들의 영양결핍 위험은 활동량이 감소하고, 소화기능이 저하되며, 맛감각이 저하 된 것에 기인할 수 있으며 이는 또한 노인의 건강상태와 밀접한 관련이 있는 것으로 보고되었다(Brownie, 2006; Park et al., 2002). 영양결핍 노인은 질병으로부터 회복 속도가 느리고 합병증 발생률이 2-3배 높아 입원기간이 연장될 수 있다(Kim, Cho, Kim, & Cho, 2002). 특히 75세 이상 노인의 경우 호흡기, 심장 질환, 감염, 또는 욕창 등의 발생률이 증가되며 만성질환 유병률 또는 사망률도 증가하는 것으로 보고되었다(Brownie, 2006).
급, 만성 뇌졸중 환자와 의료인이 지각하는 뇌졸중 교육요구도/필요도의 차이
최스미 대한뇌졸중학회 2002 Journal of stroke Vol.4 No.2
Background: This study was undertaken to determine what patients with stroke need to know about their condition, and to discern what differences exist between patients and medicalpersonnel regarding the patients’need for stroke education. Methods : Fifty consecutive newly diagnosed stroke patients, 55 consecutive out- patients with stroke and 88 medical personnel (doctors and nurses) who were working in either Neurology or Neurosurgery Departments at the Asan Medical Center were studied using a structured questionnaire consisting of 5 subsets with a total of 49 questions. Results : Newly diagnosed stroke patients gave a higher priority on items such as‘post stroke diet management’,‘stress management’ and ‘the possibility of cure with drug treatment’than medical personnel whereas doctors gave a low priority on them. Patients in chronic stages tended to score high for ‘exercise’, ‘reason for regular administration of medicine’, duration of drug administration’and ‘post stroke depression’. Gender was a factor related to differences in patients’ perceived needs whereas current employment status and educational level were not. While medical personnel gave a higher priority to the subset of ‘risk factor management’ than patients, the latter gave a higher priority to the subset of ‘medical knowledge regarding stroke’, than the former. Conclusions : An educational program for stroke patients should be developed on the base of the understanding that there are differences in perspectives of stroke education between acute and chronic patients, and between patients and medical personnel. Korean Journal of Stroke 2002;4(2):78~87
최스미 연세대학교 간호정책연구소 2003 간호학탐구 Vol.12 No.2
The concept of 'homeostatis' has guided medical research and physiological nursing research over many decades. Within homeostatis, healthy function has been defined as the return of system parameters to set points, mediated by negative or positive feedback system. Since nursing research, different from medical studies, considers both the individual and the context in which they live. Nursing approach has to be the one that is wholistic. Remarkable growth has been seen in the area of biobehavioral nursing research over the last 20 years. Many nurses are engaged in biobehavioral research that addresses questions that are either derived from clinical practice or have applicability to the clinical arena. Biobehavioral nursing often use the context of the human response model. This model considers person (vulnerability) as well as environmental (risk) factors as influencing individual responses or adaptation. Human responses are categorized as physiological, behavioral, experiential. In addition to human response model, many biobehavioral nurse scientists have embraced the study of psychoneuroimmunology (PNI) which considers the interactions among immune, nervous, and endocrine systems. This paper is intended to provide how 'homeostatis' concept has been evolved in nursing theory. I also intended to research how physiological concept such as 'homeostatis', has been integrated with psycho social concept in nursing research and practice and have the implication of further biobehavioral nursing research. Nursing concept such as 'Pain', 'Dyspnea' have been used as examples that illustrate the diverse models as well as the significant contributions of nurse scientists to the study of biobehavioral phenomenon. All these attempts will hopefully help us in formulating a nursing theory in biobehavioral research area.