관상동맥중재시술을 시행 받은 급성심근경색증 환자의 성별에 따른 차이

한숙원 대한중환자의학회 2012 Acute and Critical Care Vol.27 No.4

Background: Limited data are available for gender-based differences among patients with acute myocardial infarction (AMI) undergoing coronary revascularization in Korea. The purpose of this study is to identify gender-based differences in clinical characteristics, risk factors and outcomes among Korean patients undergoing percutaneous coronary intervention (PCI). Methods: Patients with AMI undergoing PCI between Jan 2009 and Sep 2011 were included (n = 457) in the study. Clinical characteristics and cardiovascular risk factors as well as major adverse cardiac events (MACE), including death after PCI, were compared between women (n = 134) and men (n = 323). Results: Women were older (69.8 ± 10.7 vs. 60.0 ± 11.7 years, p < .001) and had more comorbidities, such as diabetes (44.0% vs. 32.8%, p = .025) and hypertension (64.9% vs. 48.9%, p = .002) compared to men. Women were less likely to have a smoking history (p < .001). There were no significant differences in all causes of death and in MACE between women and men. By the multivariate analysis, age, HDL-cholesterol and left ventricle ejection fraction are associated with mortality and MACE. Conclusions: In this study, women did not emerge as an independent predictor for MACE; however, they were older and had a higher incidence of hypertension and diabetes than men.

우리나라 치매노인 복지에 관한 고찰

한숙원 노인간호학회 1999 노인간호학회지 Vol.1 No.1

Senile dementia has become a social health issue as the elderly population has shown a tendancy to in crease. Demented elderly persons have usually been diagnosed as having an irreversible progression of their illness, becoming increasingly more dependent on their family members. The goal of this is to evaluate the types of social welfare services for the elderly -with dementia and to propose the appropriate measures needed to handle this social problem. The goal of this study was achieved by means of a literature review and data search of previously done studies in relation to the status of services for the elderly with dementia in Korea and other countries. Some problems were identified in the current welfare service system currently undertaken in Korea. They were: 1. The difficulty to estimate the prevalence rate of senile dementia due to a lack of public statistics. 2. Insufficient support and a poorly organized welfare service system to meet the health demands of the aged in the following aspects : A. The number of long term sanatoriums is limited. Therefore, most people with dementia are staying in their home without proper treatment. B. Although some home care service agencies are available to provide care, there are still some problems due to insufficient financial support from the government and the low rate of utilization of the services. Finally, the author would like to close the study with several suggestions, one being that a dementia service system should be established on the basis of the medical delivery system to let people sufficiently use the social resources. Also, it is recommended that community health centers should have a well structured and managed network system of information and a referral service coordinating home-based individual care and community-based follow up care through all health care levels. Therefore, dementia complex centers should be working hard to be perceived as advanced, helping institutions through clinical consultation, program design and operation and staff and volunteer training. Additionally the government should develops various dementia facilities and service programs. Finally, it is recommended that research activities related to dementia be encouraged by support from various financial sources-medical insurance and taxes.

심근경색과 비만 패러독스

한숙원 대한임상건강증진학회 2012 Korean Journal of Health Promotion Vol.12 No.2

Background: Despite the adverse impact that being overweight or obese has on cardiovascular disorders, numerous studies have addressed the ‘obesity paradox’, which suggests that obese persons seem to have a better prognosis with these conditions than those with a normal body mass index (BMI). In addition, the effect of BMI on outcomes after percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) remains controversial. Methods: Our subjects included 457 patients who had undergone PCI for AMI between January 1, 2009 and September 30, 2011. They were classified into 3 groups according to baseline BMI - normal weight (BMI<23kg/m2), overweight (BMI 23-25 kg/m2), obesity (BMI>25 kg/m2). Clinical characteristic and cardiovascular risk factors and major adverse cardiac events (MACE), including death after PCI, were compared among the groups. Results: Overweight or obese subjects were younger (P<0.001) and associated with higher left ventricle ejection fraction (LVEF) (P=0.012) and less frequency of MACE (P=0.003). Multiple logistic regression analysis showed that independent predictors for death and MACE were not obesity but age (P=0.006, P=0.017),high-density lipoprotein cholesterol (P=0.002, P=0.005) and LVEF (P=0.001, P<0.001). Conclusions: In our study, BMI had no effect on MACE in patients undergoing primary PCI for AMI. The phenomenon,'obesity paradox', may be explained by the possibility that AMI was diagnosed at a younger age in obese patients and that these younger patients had higher LVEFs than the other groups in this study. 연구배경: 비만은 심근경색의 위험요인이며 그 부정적인 영향에도 불구하고 여러 연구에서 정상체중보다 좋은예후를 초래하는 것으로 보고되어 이를 비만 패러독스라고 부른다. 일차적 관상동맥중재술 후 심근경색 환자들의예후와 관련하여 체질량지수의 영향에 관하여는 많은 논란이 있다. 방법: 연구 대상자는 2009년 1월에서 2011년 9월 사이에일차적 관상동맥중재술을 실시한 457명이다. 이들은 체질량지수에 따라 정상체중군(<23 kg/m2), 과체중군(23-25kg/m2), 비만군(>25 kg/m2)으로 분류되었다. 세 군의 임상적 특성, 심혈관계 위험요인, 그리고 주요심장사건에 관하여 비교하였고 다변량분석을 통해 주요심장사건의 예측인자를 분석하였다. 결과: 본 연구 대상자들에서는 체질량지수가 정상인 환자는 과체중 또는 비만인 환자에 비해 심근경색의 발병연령이 낮았고(P<0.001) 좌심실 박출률이 높았으며(P=0.012)사망을 비롯한 주요심장사건의 발생이 적게(P=0.003) 나타났다. 다변량로지스틱회귀분석 결과 사망률 및 주요심장사건의 유의한 예측인자는 체질량지수가 아니라 연령(P=0.006, P=0.017)과 고밀도콜레스테롤(P=0.002, P=0.005),좌심실 박출률(P=0.001, P<0.001)로 나타났다. 결론: 체질량지수는 심근경색 환자에서 사망 및 주요심장사건 발생에 의미있는 예측인자가 아니며 비만한 환자가 보다 젊은 나이에 심근경색이 발생했기 때문에 나타난현상으로 볼 수 있다.

Concept Map를 활용한 학습이 간호학생의 역량에 미치는 융합적 효과

한숙원,전인숙 한국경영컨설팅학회 2022 경영컨설팅연구 Vol.22 No.2

In this study, an attempt was made to examine the effects of nursing students on their competencies, such as clinical reasoning ability, through learning using a concept map. This study was conducted to test the effects of clinical reasoning competence, problem solving ability, Critical thinking, clinical decision making ability, and self-directed learning before and after concept map supervised learning for 74 nursing students using G*Power 3.1.9.4. This is a single-group pre-post-experimental design study. As a data analysis method, the relationship between variables was identified by Pearson Correlation, and the difference before and after conceptual guidance experimental treatment was identified by paired t-test. As a result of the study, it was found that there was a correlation between the variables both before and after the concept supervised learning, the relationship between problem solving ability and critical thinking, problem solving ability and self-directed learning ability showed a high positive correlation. Clinical reasoning ability and clinical decision making ability showed a significant correlation after concept supervised learning. Clinical reasoning ability, problem solving ability, critical thinking, clinical decision making ability, and self-directed learning of nursing students were all high after concept map learning. All variables including clinical reasoning ability were statistically significant. The results of this study suggest that concept map learning will be effective in enhancing the competency of nursing students, and it will be possible to enhance nursing performance in clinical settings through convergence education of concept map learning in the future. 본 연구는 간호대학생을 대상으로 concept map(개념지도)을 활용한 학습을 통해 임상적 추론 역량 등 간호대학생의 역량에 미치는 효과를 확인하고자 시도되었다. 본 연구는 G*Power 3.1.9.4 프로그램을 이용하여 간호대학생 74명을 대상으로 개념지도 학습 전후 임상적 추론 능력, 비판적 사고성향, 문제해결능력, 자기주도 학습능력, 임상적 의사결정능력의 효과를 검정하는 단일집단 사전사후 실험설계 연구이다. 자료 분석 방법으로 변수들 간의 상관관계는 Pearson Correlation으로, 개념지도 중재 효과는 paired t-test로 파악하였다. 연구결과, 개념지도 학습 전과 후 모두에서 변수들 간 상관관계가 있는 것으로 나타났고, 문제해결능력과 비판적 사고 성향, 문제해결능력과 자기주도학습 능력간의 관계가 높은 양의 상관관계를 보였다. 임상적 추론능력과 임상적 의사결정능력은 개념지도 학습 후에 상관관계가 유의하게 나타났다. 개념지도 학습 후 간호대학생의 임상적 추론 능력, 비판적 사고성향, 문제해결능력, 자기주도 학습능력, 임상적 의사결정능력이 모두 높게 나타났으며 임상적 추론 능력을 비롯한 모든 변수가 통계적으로 유의하게 나타났다. 결론적으로 개념지도 학습이 간호대학생의 역량을 증진하는데 효과가 있다고 할 수 있으며 향후 개념지도 학습의 융합적 간호교육을 통해 임상현장에서 간호임상 수행능력을 증진시킬 수 있으리라 생각된다.

한반도 통일에 관한 하나님의 뜻과 교회와 성도의 역할

한숙원 기독교통일학회 2023 기독교와 통일 Vol.14 No.1

As the only divided country in the world, Korea is in a complex international situation and nuclear threat. As the division is prolonged, public opinion that unification is necessary is decreasing year by year. In this situation, as a Christian, I would like to highlight unification in the Bible and examine what role churches and saints should play. The Bible presents a message that God wants Israel's repentance and recovery through various precepts, including the Book of Ezekiel, about the division of Judas and Israel and its captive history. It also deals with topics such as "peace," "justice," "unification," "reconciliation," "Junior," "God's Kingdom," and "Israel's Recovery" in various places of the Old and New Testament. Similar to Korea, Germany was divided according to the decisions of neighboring countries, but it was ultimately able to achieve unification through political, religious, and multilateral efforts and support. On the other hand, it is difficult to reach an agreement on unification due to ideological confrontations such as anti-communist consciousness due to the experiences of war between the same ethnic groups. The state is a community established by God along with the church, and the church is a relationship of mutual support with the state, so the Korean church needs to make united and consistent efforts to pursue unification by understanding God's will. First of all, the church needs to promote a sense of mission for unification across society, pursue integration and solidarity between the two Koreas, and develop projects such as caring for North Korean defectors. It is God who achieves unification, so you should not give up and pray. 우리나라는 세계 유일의 분단 국가로서 복잡한 국제 정세와 핵위협 속에 있다. 분단이 장기화되면서 통일이 필요하다는 여론은 해마다 감소하고 있다. 이러한 상황 속에서 그리스도인으로서 성경적으로 통일에 대해 조명해보고 교회와 성도는 어떠한 역할을 해야 할지에 대해 살펴보고자 한다. 성경에서 유다와 이스라엘의 분단과 포로된 역사에 대해 에스겔서를 비롯한 여러 선지서를 통해 하나님은 이스라엘의 회개와 회복을 원한다는 메시지를 제시하고 있다. 또한 구약과 신약 여러 곳에서 ‘평화’, ‘정의’, ‘통일’, ‘화해’, ‘희년’, ‘하나님 나라’, ‘이스라엘의 회복’ 등의 주제를 다루고 있다. 독일은 한반도와 유사하게 주변국의 결정에 따라 분단이 이루어졌지만 정치적 종교적 다각적인 노력과 지원들을 통해 궁극적으로 통일을 이루어낼 수 있었다. 한반도는 독일과 비교하여 동족의 전쟁을 경험했고 이로 인한 반공의식 등 이데올로기적인 대립으로 통일의 합의점을 찾기가 어려운 실정이다. 국가는 교회와 더불어 하나님이 세운 공동체이며 교회는 국가와 상호지지의 관계이므로 한국교회는 하나님의 뜻을 헤아려 통일을 추구하기 위해 연합하고 일치하는 노력이 필요하다. 우선 교회는 범사회적으로 통일에 대한 사명의식을 고취시키고, 남북한의 통합과 연대를 추구하고, 북한 이탈주민 돌봄과 같은 사업들을 전개할 필요가 있다. 통일을 이루시는 이는 하나님이므로 포기하지 말고 기도해야 할 것이다.

간호대학생의 임상적 추론 역량에 미치는 융합적 영향요인

한숙원,전열어 한국융합학회 2020 한국융합학회논문지 Vol.11 No.10

본 연구에서는 간호대학생을 대상으로 임상적 추론 역량에 대하여 조사하고 이에 영향을 미치는 요인을 파악하 고자 시도되었다. 본 연구는 G*Power 3.1.9.4를 이용하여 간호대학생 3, 4학년 297명을 대상으로 간호핵심역량과 관 련된 학습능력을 파악하고자 임상적 추론, 문제해결능력, 비판적 사고성향, 임상적 의사결정, 자기주도학습, 임상수행능 력을 측정하고 임상적 추론 역량에 영향을 미치는 변수를 검정하는 서술연구이다. 연구결과를 살펴보면, 학년별로 임상 적 추론역량을 비교한 결과 유의한 차이를 보였으며(p=0.001), 또한 임상적 추론역량에 대한 영향변수를 확인한 결과 문제해결능력, 임상적 의사결정 능력, 임상수행능력, 임상실습경험(학년)이 유의한 변수로 나타났다.(p,.001). 본 연구결 과는 간호대학생의 임상적 추론 역량을 높이기 위한 다양한 교육과정개발의 근거로 활용될 수 있을 것으로 보이며, 향후 임상적 추론 역량을 높일 수 있는 교육 개발을 위한 연구가 필요할 것으로 사료된다. In this study, an attempt was made to investigate the clinical reasoning of nursing students and to identify the factors that influence it. This study was held to grasp the learning ability related to core nursing competency for 297 3rd and 4rd grade nursing students. Results indicated that there was a significant difference when comparing clinical competence by grade(p=0.001). Also variables effecting clinical reasoning competence were Problem solving ability, Clinical Decision making ability, Clinical practice performance, and grade of nursing students were found to be significant (p,.001). Outcome of this study can be used as the basis for the development of various curriculums to enhance the clinical reasoning competence, in the future, research for this education development is expected to be needed.

敎育의 發達課業 및 靑年期를 바로잡는 性敎育 問題

한숙원 이화여자대학교 건강교육학과 1969 건강교육 Vol.- No.3

관동맥 조영술 후 요통완화를 위한 운동요법과 경피적 전기 신경자극의 효과

한숙원(Hahn Sook-Won) 한국성인간호학회 2002 성인간호학회지 Vol.14 No.2

PTCA 시술 환자의 인지적 평가와 위험요인수정행위

한숙원(Hahn Sook-Won),이명선(Lee Myung-Sun) 한국성인간호학회 2004 성인간호학회지 Vol.16 No.4

Trends in research on clinical reasoning in nursing over the past 20 years: a bibliometric analysis

유영미,한숙원 한국과학학술지편집인협의회 2022 Science Editing Vol.9 No.2

Purpose: Clinical reasoning is an essential component of nursing education. This study aimed to identify the trends in research on clinical reasoning in nursing over a 22-year period.Methods: The Web of Science Core Collection was used as the target database, with the search terms “clinical reasoning,” “clinical judgement,” and “clinical decision.” The scope of the search included the subject, abstract, author’s keywords, and Keywords Plus for each article. Our literature search included journal articles from 2000 to 2021, with the subject area restricted to nursing. A total of 4,675 articles met the inclusion criteria after the removal of duplicates using digital object identifier. We used bibliometric analyses to conduct quantitative and statistical analyses of publication trends, the journals and countries with the most publications, the most productive authors, the most globally cited documents, and the most frequent keywords.Results: In nursing, studies related to clinical reasoning have increased significantly since 2000. The most prolific country has been the United States. The journal with the most publications was the Journal of Clinical Nursing. The most productive author was Considine J, with 23 publications. The most widely cited author was Tanner CA, with 614 citations. The most frequent keywords in the literature related to clinical reasoning were “care,” “nurses,” and “decision-making,” in that order.Conclusion: This study examined the quantitative analysis and statistics of publications related to clinical reasoning in nursing in the past 20 years using bibliographic information. This study can help guide future research on clinical reasoning for nurse educators.