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허혜경,박소미,김기연,신윤희,임은실 성인간호학회 2003 성인간호학회지 Vol.15 No.1
Purpose: The purpose of this study was to analyze related factors for major nursing diagnoses used in caring for institutionalized elders. Method: This study was a descriptive study. The participants were 92 residents in a long-term care facility in Wonju, selected by convenience sampling. The instrument was a checklist designed on the basis of the related factors suggested by NANDA (1997) and a literature review. Data was collected by chart review, observation, and interviews with the participants. Data was analyzed using descriptive statistics with the SPSS WIN program. Result: The most frequent nursing diagnosis was 'risk for injury', 'self-esteem disturbance', 'activity intolerance', 'impaired physical mobility', and 'powerlessness'. The most frequent component for related factors for the five component for each nursing diagnosis was the physical component, followed by the social component. Common related factors for the nursing diagnoses were 'pain', 'change of emotional state/disorder', 'cognitive disorder', 'change of physical structure and function', and 'physical impairment', and 'immobility'. Conclusion: The results of this study can contribute to the development of appropriate nursing intervention programs for elders (eg. 'Injury Prevention Programs', 'Self-esteem Improvement Programs' etc.). Clinical guidelines that gerontological nurses can use to accurately assess health problems and select appropriate nursing interventions may be developed.
허혜경,박소미,김기연 성인간호학회 2004 성인간호학회지 Vol.16 No.1
Purpose: The purpose of this study was to examine factors related to different stages of mammography screening based on the transtheoretical model (TTM) and health belief model (HBM). Method: 143 women were recruited from community centers in W city. The mean age was 44.08 (SD=7.78) and 74 (51.7%) had experienced education on preventative behavior related to breast cancer. The Decisional Balance Scale (Pros and Cons of mammography) and Stages of Adoption of Mammography Scale by Rakowski et al. (1992) and the revised Health Belief Model Scale (Perceived Seriousness. Perceived Susceptibility and Health Motivation) by Champion (1993) were used. Result: According to the stage of adoption of mammography, 17.4% of the women were in pre-contemplation, 45.5% in contemplation. 24.5% in action, and 12.6% in maintenance. The mean differences for pros, and the decisional balances between the stages of mammography adoption were significant (F=8.84. p=.000; F=7.20, p=.000). Education related to prevention of breast cancer was the most important variable. Prevention education, history of breast disease and pros of mammography explained the stages of mammography adoption (R²=26%). Conclusion : Findings support TTM as a useful tool for improving mammography adherence. Behavioral interventions that target decisional balance and health belief can effectively promote adherence to mammography.
Predictors of Mammography Paricipation Among Rural Korean Women Age 40 and Over
허혜경,김기연,박소미 한국간호과학회 2005 Journal of Korean Academy of Nursing Vol.35 No.8
Purpose. The study was conducted to identify predictors of mammography screening for rural Korean women according to ‘Stage of Change’ from the Transtheoretical Model which, along with the Health Belief Model, formed the theoretical basis for this study. Methods. A cross-sectional descriptive design was utilized. Through convenience sampling 432 women were selected from 2 rural areas. Data were collected by survey. Health beliefs constructs were measured with Champion’s HBM Scale-Korea version. Mammography participation was measured using the Stage of Mammography Adoption Scale developed by Rakowski, et al. (1992). Results. The most frequent stage of mammography adoption was ‘contemplation’ (40.5%). Predictors of stage of mammography adoption included ‘mammogram recommended by health professional’ (beta=0.59, t=16.12, p=.000), ‘perceived benefits’ (beta=0.09, t=2.21, p=.050), ‘perceived susceptibility’ (beta=0.09, t=1.98, p=.050), and ‘perceived barriers’ (beta= 0.07, t= 2.05, p=.041). ‘Mammogram recommended by health professional’ demonstrated the greatest association with having a mammogram. Conclusion. Health professionals play key roles in improving mammography participation and should recognize the importance of their role in cancer prevention and be more actively involved in education and counseling on prevention of breast cancer.
통증 대응 측정도구(Coping Strategy Questionnire)의 타당도 조사 연구
허혜경 성인간호학회 1995 성인간호학회지 Vol.7 No.2
The coping strategy questionnaire(CSQ)(Rosenstiel & Keefe 1983) is a self report instrutment designed to assess six cognitive and two behavioral coping strategies of patients with chronic pain. Studies examining the factor structure of the CSQ have yielded factor that have generally not replicated across samples and are difficult to interpret. Accordingly the CSQ responses for 101 Korean patients with chronic pain was examined for construct validity and concurrent validity. An item factor anslysis of CSQ revealed an eight factor structure of the eight original subscales : Factor 1, Reinterpreting Pain Sensation, Ignoring Pain Sensation ; Factor 2, Diverting attention; Factor 3, Ignoring Pain Behavior; Factor 4, Catestrophizing ; Factor 5, Praying or Hoping related to God; Factor 6, Increasing Pain Behavior; Factor 7, Increasing Activity Level ; Factor 8, Praying or Hoping related to Health Professional. Because Factor 3 appeared to mix up three subscales, it was renamed 'Ignoring Pain Behavior'. The four of eight factor solution obtained in this study is similiar to the five factor subscales obtained by Swartzman et al (1994) and Tuttle, Shutty & DeGood (1987). The eight factors obtained in this study are similar to the theoretical constructs used in developing the CSQ. The concurrent validity was analyized using the correlation between the seven subscales of the CSQ and depression assessed using Zung's Depression Scale. The subscales interpreting pain sensation and ignoring pain sensation (Factor 1), ignoring pain behavior (Factor 3) and increasing pain behavior (Factor 6) were associated negatively with depression(r=-.2993, p<.05;r=-.3783, p<.01; r=-.2859, p<.05), and catestrophizing (Factor 4) was associated positively with depression (r=.5200, p<.01) but only for patients reporting scores of pain intensity higher than five. Some individuals cope with chronic pain effectively and are emotionally well adjusted, leading an active and full life style. Therefore it is an important to understand how individuals cope with chronic pain. The results of this study can be used to assess coping strategies that Korean patients use to deal with chronic pain.
Vygotsky의 인지발달이론에 기초한 부모의 역할에 관한 연구
허혜경 한국교육과정학회 1997 교육과정연구 Vol.15 No.2
자녀의 인지발달에 관한 부모의 관심과 역할에 대한 방향제시는 부모교육 학문의 내용이 되어야 할 것이나 종래 Piaget의 인지발달이론을 기초로 삼는 부모교육 분야에서는 부모의 역할에 대한 근거와 지침을 제시하기 어려웠다. 이에 반하여 학습이 발달을 주도한다는 입장을 취하는 Vygotsky의 이론에 의하면 자녀의 인지발달을 위한 부모의 역할은 매우 중요하다. 본 연구에서는 자녀의 인지발달에 관한 Vygotsky의 이론을 이론적 경험적으로 검증하고, 그 이론에 입각하여 자녀의 인지발달에 유익한 부모의 구체적 역할을 진단적 관찰자와 scaffolder라는 두 가지 개념적 도구로써 제시한다. 아울러 이러한 방향 제시가 부모교육 학문의 내용에 내포되어야 한다고 주장한다. The orientation of the parent's concern and role about their children's cognitive development must be contained in the field of parent education. But, up to now, it is mainly based on Piagetian theory of cognitive development, so that it is hard to furnish the ground and guide of the parent's role for their children's development. On the contrary, the Vygotskian theory, that the learning leads development, emphasizes the parent's role. In this study, the Vygotskian theory is to be examined theorically and empirically. And the parent's role that is profitable to their children's cognitive development is to be offered in the conception of observative diagnoser and scaffolder. Then this orientation is insisted to be the contents of the parent education.
호스피스 자원봉사자의 발마사지와 지지적 의사소통이 외래 항암화학요법 환자의 우울, 불안 및 기분에 미치는 효과
허혜경,송희영,Hur, Hea-Kung,Song, Hee-Young 한국호스피스완화의료학회 2010 한국호스피스.완화의료학회지 Vol.13 No.4
목적: 종합병원 외래 주사실에서 항암화학요법을 받는 암환자를 대상으로 발마사지와 지지적 의사소통 제공 후 우울, 불안, 긍정적 및 부정적 기분의 변화를 확인하기 위함이다. 방법: 비동등대조군 전후 시차 유사 실험설계로 연구의 대상은 원주시의 일 3차 종합병원 외래 주사실에 항암화학요법을 받는 암환자를 편의표집하여 대조군 34명 실험군 30명 총 64명이었다. 연구도구는 일반적 특성과 질병특성, 최근에 경험하는 신체적 증상 측정 문항, 그리고 각각 10 cm 시각상사척도를 이용하여 우울, 불안, 활기, 의욕, 희망, 긴장 및 무기력을 측정하였다. 결과: 제 1 가설인 '발마사지와 지지적 의사소통을 받은 실험군은 대조군보다 처치 후에 우울과 불안이 더 많이 감소될 것이다'는 처치 후 실험군에서 우울(t=5.26, P<0.001)과 불안(t=5.07, P<0.001)이 유의하게 감소되어 지지되었다. 제 2 가설인 '실험군은 대조군 보다 처치 후에 활기, 의욕 및 희망이 더 증가될 것이다'는 두 군에서 활기, 의욕 및 희망의 처치 전후의 변화를 비교한 결과 실험군에서 유의한 변화가 없어 기각되었다. 제 3 가설인 '실험군은 대조군보다 처치 후에 긴장과 무기력이 더 감소될 것이다'는 처치 후 두 군 모두에서 긴장과 무기력이 유의한 감소를 나타냈으므로, 중재 전후 변화의 정도에 차이가 있는지를 확인하기 위해 두 변수의 중재 전과 후의 차이값의 평균을 비교하였다. 검정결과 대조군에 비해 실험군에서 긴장(t=5.64, P<0.001)과 무기력(t=5.38, P<0.001)이 더 큰 감소를 보여 제 3 가설은 지지되었다. 결론: 본 연구의 결과는 외래 주사실에서 항암화학요법을 받는 동안 호스피스 자원봉사자가 제공한 발마사지와 지지적 의사소통이 암환자의 우울, 불안, 긴장, 무기력을 감소에 유용함을 제시하였다. 연구 결과의 타당성을 높이기 위해 대상자 수를 확대하고 좀 더 정련화된 중재의 개발과 효과검증을 위한 추후 연구가 필요하다. Purpose: This study was done to investigate effects of foot massage and supportive communication provided by hospice volunteers on depression, anxiety, and mood of cancer patients who are going under intravenous chemotherapy at out patient department (OPD). Methods: A non-equivalent control group non-synchronized design was used. Sixty-four participants were recruited from out-patients setting in a university hospital by a convenient sampling. Two trained- hospice volunteers first provided regular hospice volunteer service to 34 patients in the control group. Subsequently, foot massage and supportive communication were provided to 30 participants in the experimental group. After the intervention, all participants answered the structured questionnaire with visual analog scales on depression, anxiety, and mood including general characteristics. Data were analyzed using descriptive statistics, two sample t-test, and paired t-test by PASW 17. Results: After the intervention, changes in negative moods, i.e. strain and powerlessness in the experimental group were significantly different from those in control group; strain and powerlessness in the experimental group were significantly decreased by foot massage and supportive communication provided by hospice volunteers. Conclusion: The current findings provide an empirical evidence of a brief and efficacious intervention for cancer patients. Further studies are warranted with larger sample size to validate the effectiveness of foot massage and supportive communication as a solid intervention for cancer patients who are undergoing intravenous chemotherapy at OPD.
허혜경,이은현,이원희,소향숙,정복례,강은실 성인간호학회 2002 성인간호학회지 Vol.14 No.3
Purpose: This study was to investigate symptom occurrence related to the disease characteristics of patients with cancer. Method: A total of 301 patients with cancer participated in this study. The participants were recruited from University Hospitals located in Seoul, Wonju, Kwangju, Daegu, and Pusan. Data collection was performed by using a questionnaire on symptom occurrence. The obtained data was analyzed using SPSS computer program that included descriptive statistics, Pearson correlation, one-way ANOVA, and t-test. Result: The mean score of fatigue was the highest (3.24), followed by loss of appetite, lack of concentration, change in appearance, pain, insomnia, change in bowel pattern, nausea/vomiting, coughing, and dyspnea. Most symptoms were significantly correlated with each other. The level of symptom occurrence in patients with lung cancer or cervix cancer was significantly higher than the level in patients with stomach cancer. Patients receiving radiation therapy or a combined therapy of radiation therapy and chemotherapy experienced significantly higher level of symptom occurrence significantly higher level of symptom occurrence than those receiving chemotherapy only. Also, female patients experienced higher level of symptom occurrence than male patients did. Conclusion: The sites of cancer, types of treatment, and gender influence the level of symptom occurrence of patients with cancer. Thus, these variables should be considered when assessing and planing for symptom occurrence of patients with cancer.
허혜경 성인간호학회 2000 성인간호학회지 Vol.12 No.2
Nurses play an important role in patient education, including providing patients with useful and appropriate information. The purpose of this study was to explore what particular types of information were important to women diagnosed with breast cancer. Sixty seven women with breast cancer an outpatient clinic in W Christian Hospital responded to the structured questionnaires developed by the investigator. Interviews and mail surveys were used in this study. The findings in this study showed that six kinds of information needs arose, ranked as the signs and symptoms of recurrence, the possibility of recurrence the possibility of metastasis, treatment, diet and physical activities in daily living. Marital status, level of education, and level of monthly income were not related to level of informational need. Younger women rather than older women had a greater need to seek information(r=-.471, p<.01). There was a significantly negative relationship between duration of disease and the score on information needs(r=-.32. p<.05) . The findings have implications that the opportunity to ask questions and have accurate information on the recurrence should be provided to women with breast cancer.