말기 환자의 존엄요법 개념분석

정복례,오은희,Chung, Bokyae,Oh, Eunhee 한국호스피스완화의료학회 2016 한국호스피스.완화의료학회지 Vol.19 No.3

목적: 본 연구의 목적은 말기 환자에게 이루어지는 존엄요법의 의미와 속성을 파악함으로써 말기 환자 간호의 질적인 향상에 기여할 수 있도록 하기 위함이다. 방법: 개념의 모든 사용을 확인하기 위하여 2014년 8월에서 2014년 12월까지 한국교육학술정보원(http://www.riss.net), 학술연구정보서비스(http://kiss.kstudy.com), 디비피아(http://www.dbpia.co.kr)에서 '존엄', '존엄요법'을 검색어로 국내문헌을 검색하였고, 국외 문헌의 경우 PubMed와 National Digital Science Links (NDSL)에서 'dignity', 'dignity therapy'를 검색어로 문헌을 검색하였다. 총 51개의 문헌을 Walker와 Avant(2005)의 개념분석 방법을 적용하여 분석하였다. 결과: 존엄요법의 선행요인은 말기 환자, 다양한 고통과 괴로움, 존엄한 죽음에 대한 바램이었다. 속성으로는 삶과 죽음의 질 향상, 치료적 대화, 인간의 존엄과 가치존중, 삶과 죽음에 대한 생각 표현, 체계적 과정으로 나타났고, 결과는 자신의 삶에 대한 반추 기회, 고통과 괴로움 감소, 가치와 존엄감 상승, 자신의 삶에 대한 가족과의 공유, 삶과 죽음의 질 향상, 환자와 가족에게 편안함 제공으로 나타났다. 결론: 존엄요법은 삶의 마지막을 경험하는 환자들이 좀 더 편안함을 느낄 수 있게 해 준다. 따라서 호스피스환자 간호 시 그들의 삶과 죽음의 질을 향상시키기 위해 존엄요법의 속성을 활용할 수 있을 것이다. Purpose: Dignity therapy is a very effective intervention to improve the dignity of end-stage patients. A concept analysis by Walker and Avant (2005) was adopted to define, describe, and delimitate the concept of dignity therapy. Methods: Nursing literature in the National Digital Science Links (NDSL) and Medline database were searched for the definitions of "dignity" and "dignity therapy". Definitions, uses, and defining attributes of dignity therapy were identified; model and contrary cases were developed; and antecedents, consequences, and empirical references were determined. Results: Through dignity therapy patients and their families share their stories, and that in turn improves the quality of life and death. Five attributes were identified: higher quality of life and death, therapeutic conversation, respect of human dignity and worth, expressing thoughts about life and death and systematic process. Conclusion: Patients at the end of their lives feel more comfortable about death. Hospice care providers should try to protect dignity of patients in their care. The attributes of the dignity therapy clarified in this study should be applied for terminally ill patients to improve their quality of life and death.

호스피스 환자 가족돌봄제공자의 건강상태 영향 요인

정복례,박현숙,Chung, Bok Yae,Park, Hyeon Sook 한국호스피스완화의료학회 2014 한국호스피스.완화의료학회지 Vol.17 No.2

목적: 본 연구는 호스피스 환자 가족돌봄제공자의 수면의 질, 불안, 희망 및 건강상태의 관계를 확인하여 이들의 건강상태를 높이기 위한 중재를 위한 기초 자료를 제시하기 위함이다. 방법: 연구대상자는 D시에 소재한 3개 호스피스 병동에 입원한 환자를 주로 돌보는 가족 118명이다. 수집된 자료는 SPSS program version 18.0을 이용하여 서술통계, One-way ANOVA, Pearson correlation coefficients, 단계적 다중회귀분석 등을 실시하였다. 결과: 호스피스 환자의 가족돌봄제공자는 각각 4점 만점인 척도로 측정한 결과 수면의 질은 평균평점 2.55, 불안은 1.91, 희망은 2.78, 건강상태는 2.68로 나타났다. 회귀분석 결과 건강상태에 유의한 영향을 미치는 주요 요인은 수면의 질(${\beta}=0.526$), 성별(${\beta}=-0.195$), 불안(${\beta}=-0.232$) 및 희망(${\beta}=0.169$)으로 나타났다. 모형의 설명력은 59.8% (F=44.510, P<0.001)이었고, 그 중에서 수면의 질이 47.3%를 차지하였다. 결론: 결론적으로 호스피스 환자를 돌보고 있는 가족의 건강상태를 높이기 위해서 간호사는 수면의 질을 높이고, 불안을 감소시키고, 희망을 높이는 방안을 모색해야 할 것이다. Purpose: This study was conducted to explore predictors of health status of family caregivers of hospice patients. Methods: This study included 118 family caregivers of patients who were admitted to the hospice ward of three general hospitals in D city. The collected data were analyzed by frequency, percentage, t-test, one-way ANOVA, Pearson's correlation coefficients, and stepwise multiple regression using the SPSS WIN 18.0 program. Results: The mean score for overall health of family caregivers was 2.68 (${\pm}0.42$). Mean scores for variables related to health were 2.55 (${\pm}0.37$) for sleep quality, 1.91 (${\pm}0.41$) for anxiety and 2.78 (${\pm}0.33$) for hope. Variables such as sleep quality, gender, anxiety and hope explained 59.8% of variance among family caregivers' health conditions. Conclusion: These results suggest the need for nurses to search for ways to promote health of hospice patients' family caregivers, such as improving the quality of sleep, easing their anxiety and encouraging hope.

두통을 호소하는 초등학생의 스트레스요인과 대처방식

정복례,홍연란,Chung Bok Yae,Hong Youn Lan 한국아동간호학회 2000 Child Health Nursing Research Vol.6 No.3

The purpose of this study was to examine the stressors and coping styles between headache- suffering children and headache-free children. The subjects of this study consisted of 112 headache-suffering children and 203 headache- free children. They were 5th and 6th grade of elementary school around Taegu city. The periods of study was from June 1, to July 20, 2000. Data were analyzed by SAS computer programme The results of this study were as follows: 1. The score of stressor of headache-suffering children was higher than that of headache- free children significantly. The scores of school stressor and mess media stressor of headache-suffering children were higher than those of headache-free children significantly. 2. There was no significant difference even though the mean score of the coping style in headache-suffering children was higher than that of headache-free children. There were also no significant differences in both problem-oriented coping style and emotion- oriented coping style. 3. Logistic regression analysis(stepwise) revealed that the most powerful predictor was the variable stressor in school(standardized estimate=0.316, P<.001), followed by stressor in mass media(standardized estimate=0.224, P<.05).

존엄한 죽음의 의미

정복례,조영화,Chung, Bok-Yae,Cho, Young-Hwa 한국호스피스완화의료학회 2017 한국호스피스.완화의료학회지 Vol.20 No.2

목적: 본 연구는 우리나라 사람들이 인지하고 있는 존엄한 죽음의 의미를 참여자의 관점에서 있는 그대로 탐구하여 확인하고 기술함으로써 그 구조와 본질을 규명하기 위한 것이다. 방법: 현상학적 분석방법을 적용한 질적 연구로 본 연구의 참여자들은 연령대와 성별을 고려한 일반인으로 총 13명이었다. 자료수집은 참여자와 개별적 심층면담을 통해 이루어졌으며, 자료분석은 Colaizzi(1978)의 현상학적 분석방법을 이용하였다. 결과: 우리나라 사람들이 인지하는 존엄한 죽음은 4개의 범주와 9개의 주제모음 및 18개의 주제로 구조화할 수 있었다. 4개의 범주는 '편안한 죽음', '보기 좋은 죽음', '해결하고 죽는 죽음', '남긴 죽음'이었고, 9개의 주제모음은 '고통 없는 죽음', '자연에 순응하는 죽음', '흉하지 않은 죽음', '좋은 회상을 남기는 죽음', '원하는 방식으로 죽는 죽음', '주변을 정리한 죽음', '응어리를 풀고 가는 죽음', '잘 살고 죽는 죽음', '인정받는 죽음'이었다. 결론: 우리나라 사람들이 의미하는 존엄한 죽음은 고통 없이 편안하게 죽으면서 다른 사람에게 피해를 주지 않고 남아 있는 삶 동안 모든 일을 해결하고 가족을 포함한 다른 사람과의 관계 속에서 좋은 이미지로 남아야 하는 것으로 나타나 우리나라 사람들의 존엄한 죽음을 위하여 임종을 앞둔 대상자의 호스피스 간호에 적용할 수 있을 것이다. Purpose: We explored Koreans' perception of the meaning of death with dignity that Korean people. Methods: A phenomenological research methodology was applied. A total of 13 participants were sampled based on their age and gender. Participants were interviewed in depth from September 2015 through February 2016. Colaizzi's phenomenological analysis method was used for data analysis. To establish the validity of the study, we evaluated its realistic value, applicability, consistency and neutrality of the qualitative evaluation criteria of Lincoln and Guba. Results: Koreans' perception of death with dignity was structured as 19 themes, nine theme clusters and four categories. The four categories were "comfortable death", "good death", "resolving problems before death", and "death with good reputation". The theme clusters were "death without pain", "death submitting to one's fate", "death that is not ugly", "leaving good memories to others", "dying in a way we want", "death after proper settling of things", "dealing with chronic resentment before death", "death after living a good life", and "death with recognition". Conclusion: For Koreans, death with dignity meant not burdening others, settling things right and leaving good memories to their families and friends. Such perceptions can be applied to hospice care for terminally ill patients.

유방암 환자의 인지기능 측정도구 개발

정복례(Chung, Bok Yae),최은희(Choi, Eun Hee),김경덕(Kim, Gyung Duck),김경혜(Kim, Kyung Hae),변혜선(Byun, Hye Sun) 대한종양간호학회 2017 Asian Oncology Nursing Vol.17 No.1

Purpose: This is the methodological study to develop the cognitive function scale for breast cancer patients. Methods: Study was consisted with 1st and 2nd items developing and testify for reliability and validity of them. 94 breast cancer patients in 2 university hospitals and 1 general hospitals responded to a questionnaire that assessed cognitive function scale. Collected data were analysed using the program SPSS/PC Win 21.0. Structural validity was determined factor analysis and convergent validity. This method yielded Cronbach’s α value as an internal consistency for the reliability. Results: Factor analysis resulted in six factors and 24 items accounted for 76.31% of the variance. Cronbach’s α of scale developed was high as a .95. Conclusion: The developed cognitive function scale in breast cancer patients scale has reliability and validity as linear analogue scale witch quantitatively measure the subjectivity. Over these results, providing the way on an assessment in cognitive function in effect for breast cancer patients, it is supposed to contribute the development of nursing knowledge about the cognitive function in breast cancer patients.

알코올중독 입원 환자의 알코올에 대한 인식

정복례(Bok Yae Chung),안효자(Hyo Ja An),변혜선(Hye Sun Byun),이영내(Young Nae Lee),정경순(Kyung Soon Jeong),김지연(Ji Youn Kim),박현주(Hyun Joo Kim),김옥희(Ok Hee Kim),김윤경(Yun Kyung Kim) 한국간호과학회 정신간호학회 2009 정신간호학회지 Vol.18 No.1

베트남 결혼이주여성의 임신과 출산 경험

정복례(Bok Yae Chung),유광자(Kwangza Yu),김지숙(Ji Suk kim) 한국가족학회 2014 가족과 문화 Vol.26 No.2

본 연구는 심층적인 면담을 근거로 다문화가정 결혼이주여성의 임신과 출산 경험을 이해하고자 한다. Giorgi(2004)의 자료수집과 순환적 분석 방법을 적용한 기술적 현상학적 연구이다. 참여자는 총 5명이었으며, 31개의 의미단위와 14개의 주제를 묶어 6개로 범주화하였다. ‘임신을 기다림’,‘도장 찍음’ 주제를 묶어 ‘가족의 신뢰감 얻기’로 범주화하였다. ‘가족의 지지’, ‘고향친구와 도움주고 받기’의 주제를 ‘도움 주고받기’로 범주화시켰으며, ‘태교하기’ 그리고 ‘공부하기’ 주제는 ‘좋은 엄마가 되기 위해 노력하기’로 범주화하였다. 다문화 가정 이주여성들의 ‘말 못하는 답답함’ ‘서운함’, ‘힘겨움’ 그리고 ‘도와주는 사람 없음’에 대한 주제들을 ‘참고 견디기’로 범주화하였고, ‘역할획득’ ‘위안 받음’은 ‘자식을 위해 살아가기’로, ‘아기양육에 대한 걱정’, ‘남편의 불 건강에 대한 걱정’은 ‘삶에 대한 걱정’으로 범주화하였다. 본 연구결과 베트남 결혼이주여성은 결혼에 대한 의미를 임신으로 여기고 임신을 기다리고 확인하면서 좋은 엄마가 되고자 노력하고 한국 사회와 문화에 적응하기 위해 스스로 노력하고 견디면서 살아가고 있었다. 본 연구는 베트남 여성만을 대상으로 그들의 삶의 경험을 분석한 바, 차후에는 베트남 외에 중국, 일본, 필리핀 등 각 나라에 따른 그들의 임신출산 경험을 깊이 있게 분석･연구하고, 이를 토대로 각 나라별 임신출산 문화를 인정하고 존중할 수 있도록 교육 책자와 홍보에 필요한 정보를 제공할 것을 제언한다. The purpose of this paper is for us to understand the experience of pregnancy and postpartum experiences of migrant women in a vietnam in korea. This study is based on in-depth interviews in accordance with the procedures of the Giorgi(2004).The participants of this study were consists of five members and then 31 meaning units and 14 theme were categorized into six. First, ‘Get the confidence of the family’ was categorized into ‘Waiting to see the pregnancy’, and ‘Taken painting’. Second, ‘Giving and receiving help’ was categorized into ‘Family support’, ‘Sending and receiving home help friend’ Third, ‘Good mother’ was categorized into ‘Guidance to’ and ‘Study’. Forth, ‘Hold on and withstand’ was categorized into ‘Tightness dumb’, ‘disappointment’ ‘Feels stuffy’ and ‘Can anyone help’ Fifth, ‘For the child to live’ was categorized into ‘Role Attainment’, ‘Comfort’. Finally, ‘worry about life’ was categorized into Worried about baby parenting and her husband’s ill. Therefore, marrid migrant women think that the meaning of marriage is pregnant and waiting for the Get the confidence of the family. She trying to become a good mother in the Korea Society and endure themselves while trying to adapt in the Korea Society and Culture. It is necessary to understand and analyze of the tough learning experience of migrant women while pregnant and giving birth in Korea, which will make a new family with the multi-cultural families and solve social problems and conflicts in the future.

유방암 환자를 대상으로 한 모바일 헬스

정복례(Chung, Bok Yae),오은희(Oh, Eun Hee),송수정(Song, Su Jeong) 대한종양간호학회 2017 Asian Oncology Nursing Vol.17 No.3

Purpose: The purpose of this study was to evaluate the effect of smart health care service in the breast cancer patients through a systematic review. Methods: For the study, 10 studies were selected by using PubMed, ScienceDirect, ProQuest, CINAHL, RISS4U, KISS, DBpia and the National Assembly Library. The Risk of Bias Assessment Tool was used by two reviewers to evaluate independently the quality of the selected articles. Results: 10 studies for the analysis of the effect of smart health care service using mobile applications on breast cancer patients since 2000 were found. The purpose of mobile based intervention was to check whether post-operative outpatient follow up could be substituted with mobile apps to measure and monitor weight loss or weight management, sleep, mood, depression and mental state, exercise, uncertainty management and feedback. Conclusion: Although mobile research is still limited, it may be sufficient to monitor the symptoms of breast cancer patients and to provide dietary and exercise interventions. This study suggests that various mobile apps can be used for breast cancer patients in various situations. Future study is recommended for repeated intervention studies on the effect of apps.

국내 수면장애 성인을 위한 비약물적 중재 효과에 대한 메타분석

정복례(Bok-Yae Chung),박현숙(Hyeon-Sook Park) 한국산학기술학회 2017 한국산학기술학회논문지 Vol.18 No.1

본 연구는 국내 수면장애를 가진 성인을 대상으로 비약물적 중재를 실시한 논문을 메타분석하여 중재 효과의 크기를 확인하고자 실시되었다. 본 연구의 자료검색은 국가과학기술정보 통합서비스 (NDSL), 한국교육학술정보원 (RISS), 한국학술정보원 (KISS), 학술데이터베이스서비스 (DBpia)에서 이루어졌으며, 검색된 2000년부터 2016년까지의 연구 1,334편 중 16편의 연구를 선정하였다. 분석은 메타분석 R(version 3.3.1)을 활용하였으며, 랜덤효과모형을 이용하여 비약물적 중재의 효과크기를 산출하였다. 메타분석 결과 수면장애가 있는 성인에게 수행된 비약물적 중재의 효과크기 Hedges" g는 2.36 (95% CI:1.44~3.28)로 큰 효과크기이었으며, 통계적으로 유의한 것으로 나타났다. 조절효과 분석에서 연령 집단, 중재방법, 입원유무 및 결과측정 도구에 따른 효과크기는 통계적으로 유의한 차이가 있었으나 연구설계 및 참여자 유형에 따른 효과크기는 유의한 차이가 없었다. 중재 중 이압요법이 가장 큰 효과크기를 보였고, 발반사 마사지, 아로마요법, 기타 및 웃음치료 순이었다. 연구결과는 수면증진을 위한 비약물적 중재가 수면에 효과적임을 확인하게 되었고, 실무에서 수면장애를 가진 성인을 위한 중재를 선택하고 실행하는데 객관적인 근거를 제공할 수 있을 것이다. The purpose of this study was to identify the effects of non-pharmacological interventions for Korean adults with insomnia. Literature review was performed for articles published between 2000 and 2016 in electronic databases. Sixteen articles met the inclusion criteria. Data were analyzed by R version 3.3.1 for windows. Meta-analysis was performed using the random effects model; the overall effect size of non-pharmacological interventions on sleep was significantly large (Hedges" g=2.36, 95% CI: 1.44~3.28). For heterogeneity, a moderator analysis was performed using the study design, participants, age group, intervention, presence of hospitalization, and sleep measurement. There was a statistically significant difference between the effects of moderator variables, except for the study design and participants. Of the interventions, auricular acupressure reported to have the largest effect size on sleep. The findings in this study indicate that non-pharmacological interventions have a positive effect on sleep, providing objective evidence to improve sleep in adults with insomnia using effective interventions.

항암화학요법을 받은 유방암 여성의 인지기능변화 경험

정복례 ( Bok Yae Chung ),변혜선 ( Hye Sun Byun ),김경덕 ( Gyung Duck Kim ),김경혜 ( Kyung Hae Kim ),최은희 ( Eun Hee Choi ) 여성건강간호학회 2012 여성건강간호학회지 Vol.18 No.1

Purpose: The purpose of this study was to describe the experiences of the process of the change in cognitive function for women treated with chemotherapy for breast cancer. Methods: There were ten participants in total in this study. Data were gathered utilizing in-depth interviews over 3 times from September 2010 to January 2011. Data were analyzed by employing Strauss and Corbin`s (1998) grounded theory methodology. Results: Findings indicate that causal conditions of these results were ``side effects of chemotherapy`` and ``menopausal state``, including contextual conditions as, ``mental fatigue`` and ``anxiety about recurrence``. The core category was identified as ``confronting with unexpected chaos``. Intervening conditions were ``support from other people``, ``lack of information on cognitive impairment``. Interaction strategies were ``changing the habit of life``, ``making efforts for living life`` and ``seeking for medical information``. Consequences of the process were ``physical restriction``, ``difficulty in social life``, ``disturbed working ability`` and ``psychological distress``. Conclusion: The results of this study show that nurses should recognize there is a notable difference between individual patient`s contextual conditions and interactive strategies. Furthermore educational information and individualized intervention should be provided to improve cognitive function for women with breast cancer.