간호실무에서 신봉이론(Espoused theories)에 대한 탐색적 연구

서문자,김혜숙,이은희,박영숙,조경숙,강현숙,임난영,김주현,이소우,조복희,이명하,지성애,하양숙,손영희,권성복,김희진,추진아 성인간호학회 2001 성인간호학회지 Vol.13 No.1

As a nursing practice involves nurses' actions in a specific context of health care, this study has focused on exploring the espoused theories in nursing practice within the action science perspectives, Espoused theories are the belief, principles, and rationale expressed by the practitioner as guiding her/his actions in a situation of practice. The data were analysed qualitatively and 25 elements of espoused theories of nursing action were identified and clustered into 6 categories. The 25 elements of espoused theories are as follows: The clinical nurse worked in wholistic and individual nursing, focussed on the patient's needed, comfort and supportive nursing (5 theories of nursing goal) ; excellent skills, knowledge based, assessment and data collection, explaining, educating or a scientific basis(6 theories of nursing intervention): advocacy, value oriented, treatment, account- ability and commitment(4 theories of nursing ethics) ; human respect. partnership, trust(3 theories of patient-nurse relationship) : knowledgable, accumulated clinical experiences and personally lived experiences. positive perspectives(4 theories of nurse), role of intervention. rewarding peer relationship(3 theories of situations) The above mentioned espoused theories are similar to that of nursing textbooks which students learned through basic nursing education and almost the same as the Acts ofa Nurse in Korean. However, we are doubtful whether nurses actually do as they think. Therefore. it is recommended to review the theories-in-use in order to and any discrepancies between the espoused theories and the reality of nursing actions

한 도시지역 저소득층 주민의 정신건강수준

이영문,김흥모,이문숙,이호영 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.6

연구목적: 본 연구에서는 A시 지역사회 정신보건사업을 시행하면서, 지역사회 정신보건사업의 일차적 관리대상인 저소득층 주민들의 정신건강수준을 파악하고, 정신건강수준에 영향을 미치는 요인을 알아봄으로써 지역사회에 정신질환자들이 통합되어지기 위해서 시행해야 하는 사업계획을 수립하는데 기초자료로 활용함에 그 목적이 있다. 대상 및 방법: 본 연구의 대상은 A시에 거주하는 20-59세의 저소득층 주민들 536명이며, 조사도구로는 정신건강수준을 집단적으로 선별 검사할 수 있는 조사도구인 GHQ와 자아존중감 정도를 측정하는 SES도구를 이용하여 설문지를 통한 면접조사를 실시하였다. 대상인구의 인구. 사회학적 특성과 자아존중감 정도에 따른 정신건강수준을 알아보았고, 또한 정신건강수준을 세 가지 유형(전반적 정신건강수준, 사회생활 적응 정도, 불안·우울감 정도)으로 나누어 분석하였다. 결 과: 1) 대상인구의 인구학적 특성에 따른 정신건강수준을 살펴보면 여성보다 남성이, 연령이 높을수록, 배우자 없이 혼자 사는 계층이, 그리고 신체적 건강상태가 나쁠수록 전반적 정신건강수준과 사회생활 적응 정도가 낮았으며, 불안·우울감 정도도 높았다. 2) 대상인구의 사회. 경제적 특성에 따른 정신건강수준을 살펴보면 무직이나 단순근로직이, 교육수준이 낮을수록 월세나 임대로 사는 저소득계층에서 전반적 정신건강수준과 사회생활 적응 정도가 낮았으며, 불안·우울감 정도도 높은 것으로 조사되었다. 3) 자아존중감 정도가 높을수록 전반적 정신건강수준과 사회생활 적응 정도가 높았으며, 불안·우울감 정도는 낮았다(p<0.01). 4) 정신건강수준에 영향을 미치는 요인으로는 자아존중감과 신체적 건강상태, 연령을 들 수 있는데 이 가운데 자아존중감이 가장 많은 영향을 주었으며, 그리고 자아존중감이 높은 상태에서 신체적 건강상태가 좋을수록, 또한 연령이 증가할수록 전반적인 정신건강수준이 유의하게 증가되는 것으로 조사되었다. 5) 정신건강 위험집단의 특성에 대해 비위험집단을 비교 분석한 결과 위험집단이 비위험집단에 비해 20대와 40대가 이환율이 높은 것으로 조사되었으며, 배우자가 없는 계층이, 학력수준이 낮은 계층, 단순 근로직인 계층, 신체적 건강상태가 나쁜 계층에서 이환율이 높았다.(p<0.05). 결 론: 위의 결과로 보아 향후 지역사회 정신보건사업은 전반적으로 정신건강수준이 낮은 저소득층을 주요사업대상으로 추진해야 하고, 이환율이 높은 계층 즉, 20대와 40대이고 배우자가 없이 혼자 살며 학력수준이 낮아 단순근로직에 종사하고 신체적 건강상태가 나쁜 계층에 우선적으로 역점을 두어 정신건강 프로그램을 개발하고 교육과 홍보를 지속적으로 해 나가야 될 것으로 판단한다. Objective: This study was performed to support and enhance the community mental health for the urban poor. The purpose of the study were as follows: 1) to investigate the mental health states of the urban poor, who are the first target population, 2) to identify the factors influencing their mental health states. Methods: The subjects were community residents in low socioeconomic level, who are 20-59 years old. And the scale used was GHQ(General Health Questionnaire) which is used for screening the mental health states of groups and self-esteem. The survey subjects were directly interviewed by staffs in Public Mental Health Center. SPSS PC 6.0 was used for the statistical analysis. It investigated the mental health states, according to social and demographic attributes, and self-esteem of target population. And the mental health states were analyzed to three subdomains: overall mental health states, social dysfunction, and anxiety-depression domains. Results: First, in demographic attributes, the old men, who are of low socioeconomic level, single, bad physical health, low community life satisfaction, low educational background, and having no religions, were low in overall mental health states, social function, and high in anxiety-depression domain. Second, the residents, who had high self-esteem, were high in overall mental health states, social function, and low in anxiety-depression domain. Third, the residents, who had high self-esteem scores, were significantly high in overall mental health states, social function, and low in anxiety-domain. Fourth, Among the various factors influencing the mental health states, the self-esteem was the most important factor, and the physical health was the next important factor. And the higher self-esteem they had, the better physical health states, the order they were, the higher the mental health states became. Fifth, comparing the high risk group with non-risk group, those who were in their 20`s and 40`s, had no wives or husbands, low educational background, physical workers, and were not well healthy, were apt to have mental diseases. Conclusion: In the future, the first target population in the community mental health services will be the urban poor in low mental health states. For those who are apt to have mental diseases, the first step of community mental health works is to find, select and give basic mental health services. The staffs in community mental health center have to develop various mental health programs and inform the public of them.

2003년 국내 중증급성호흡기증후군 진료 현황 및 문제점 분석

이진수,김은실,정문현,백제중,정선화,안주희,최영화,이선희,고철우,김성범,김민자,박승철,기현균,송재훈,최상호,김양수,이상오,조용균,박영훈,정숙인,김연숙,이흥범,손창희,장성희,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

목적 : 2002년 말 중국에서 SARS가 발생한 이후 국내에서도 2003년 10월까지 총 3명의 추정환자, 17명의 의심환자가 보고되었다. 향후 추가적인 SARS의 유행이 우려되는 상황에서, 그간의 SARS 환자 진료에 있어서의 실질적인 준비사항, 진료 현황 등에 대한 조사를 통해 문제점을 파악하여, 향후 더 나은 대비가 될 수 있도록 개선점을 제시하고자 하였다. 재료 및 방법 : SARS로 의심되는 환자를 진료 경험이 있는 병원의료진을 대상으로 2003년 10월에 설문조사를 실시하였다. 설문에는 SARS 환자 진료 시의 실질적인 조치, 진료 현황, 병실, 응급실 및 외래에서의 격리 시설과 준비사항, 보건당국의 관리와 지원에 관한 사항을 포함하였다. 결과 : 대상이 되는 22개 병원 중 17개(17/22, 77.2%) 병원이 설문에 응하였다. SARS 환자를 위한 격리실은 응급실, 외래, 일반병실 및 중환자실에서 각각 9개(9/17, 52.9%), 5개(5/17, 29.4%), 15개(15/16, 93.7%), 4개(4/16, 25%) 병원에서 음압처리가 되어있지 않은 일인실 혹은 다인실이 사용되었고, 1개(1/16, 6.3%) 병원에서만 일반병실에서 음압격리실이 운영되었다. 입원환자의 진찰 시 개인보호구의 착용은 거의 모든 의료기관에서 이루어졌다. 보건당국에서 SARS지정병원의 시설 등을 사전에 확인한 곳은 1곳(1/12, 8.3%)이였고, 14개 병원(14/15, 93.3%)에서는 보건당국에 의뢰한 검사결과를 통하 받지 못하였다. 결론 : 의료기관에서 SARS 환자용 격리실뿐만 아니라 기존의 격리실 설비 등이 미흡하였으며, 특히 중환자실 및 외래의 준비가 더욱 부족하였다. 보건당국의 의료기관에 대한 종합적인 지원이 부족하였고, 병원과의 원활한 연계가 잘 이루어지지 않았다. SARS 만이 아닌 격리를 필요로 하는 질환의 적절한 진료를 위해 향후 병원 시설의 정비와 정부차원에서의 보다 구체적이고 실질적인 대책마련이 필요하다. Background : There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. Materials & Methods : Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. Results : The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. Conclusions : The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.

오방색과 청동은입사보상당초봉황문합의 전통문양을 응용한 창작 업스타일 제작

전소리ㆍ문소희ㆍ이재숙(So Ri JeonㆍSo Hee MoonㆍJae Sook Lee) 한국인체미용예술학회 2016 한국인체미용예술학회지 Vol.17 No.1

In hairstyling, a creative updo is a sector in which creativity, artistry, and originality are particularly important. Traditional Korean patterns have their own artistic and creative values. This study attempted to express effective artistic images through creative updos using obangsaek based on the traditional patterns in Korea’s national treasure ‘Bronze Lidded Bowl with Silver-inlaid Phoenix Design.’ The study results found that the most effective artistic cultural images were expressed through the recreation of creative updos using the five traditional colors of Korea based on the traditional patterns from the National Treasure No. 171 ‘Bronze Lidded Bowl with Silver-inlaid Phoenix Design.’ It is expected that this study would offer an opportunity to re-illuminate and utilize cultural heritage from diverse perspectives in all art and industrial sectors, including cosmetology and hairstyling sectors, after re-illuminating the beauty and value of traditional Korean patterns and reinterpreting and recreating them in a modern style.

화살나무 추출물에 의한 Doxorubicin-유도 조직손상의 억제

이정호,신숙정,문용,이동근 大韓免疫學會 1996 大韓免疫學會誌 Vol.18 No.2

Doxorubicin(DR), a potent antineoplastic drug, is effective in adult and childhood solid tumors and hematologic cancer. However, it has minor(mucositis, nausea, vomiting and alopecia) and major(myelosuppression, cumulative dose-related cardiomyopathy, and skin and subcutaneous ulcers) clinical toxic effects. Accidental subcutaneous DR-extravasation may provoke a prolonged and severe cutaneous inflammatory reaction for which there is currently no simple and effective treatment method. Because of this, apart from measures to prevent paravenous extravasation, many methods of preventing these ulcers have been tried clinically or experimentally, but the efficacy is uncertain. The present study was undertaken to exploit Euonymus alatus extract(EA) as an antidote for DR-induced skin ulceration, using animal model, and to evaluate the effects of EA on the pharmacological activity of DR. Sprague-Dawley rats and ICR mice were intradermally injected DR(0.5 mg/rat and 0.2 mg/ mouse) with or without EA(10 mg/rat and 5 mg/mouse). In rat model, intradermal injection of DR alone produced predictable uniform skin necrosis and ulceration involving the deep dermis. These ulcers developed within 3-7 days, remained stable for 2-4 weeks, and all rats died in 55 days of observation. However, intradermal injection of DR plus EA into rat developed only minor transient edema, erythema and mild inflammation involving the superficial dermis, which healed quickly, and all rats survived throughout the experimental periods. In mouse model, intradermal injection of DR alone produced an ulcer approximately 15.2 mm2 at 5 days. This ulcer was progressively aggravated in size until 15 days, and regressed and healed after that. But, when mice were intradermally injected DR plus EA, the ulcers were reduced in size and healed quickly. These results suggest significant efficacy for EA as a DR-extravasation antidote. B16 cells, 3LL cells and human tonsillar lymphocytes were cultured in the presence of DR with or without EA, and the proliferation responses of these cells were evaluated. DR alone de-creased remarkably the proliferation of malignant cells as well as normal cells, in a dose-dependent fashion. On the other hand, the EA itself reduced weakly the responses of tumor cells but increased those of normal cells. And EA also slightly enhanced the DR- induced inhibition of the tumor cell-proliferation, but it restored the DR-derived decrease of the lymphocyte-prol-iferation. These results suggest that EA itself has no side effects, and also suggest that EA may possibly diminish the systemic toxic effects of DR-administration. Taken together, the present study reveals that EA has an antidotic activity against DR-ex-travasations and systemic DR. And these results suggest the possibility that EA could be developed and used in a form of DR-annex as an antidotic and reinforcing agent of DR.

비예기항체의 검출과 혈액은행 전담자의 안전수혈 태도

이종숙,정문희 한양대학교 의과대학 1997 한양의대 학술지 Vol.17 No.1

The purpose of this study is to provide some basic date useful to standardize the blood tests and enhance the safety of blood transfusion. For this purpose, 36,410 patients were sampled (who visited a university hospital in Seoul for transfusion or operation from July 1, 1990 to June 30, 1995) and thereupon, the results of their antibody screening tests were analyzed to identify the types of the antibodies. Meanwhile, in order to survey the method of pre-transfusion serologic tests as well as the social medical environment, 32 third medical institutions were selected to be categorized into two groups : those who perform the tests and those who do not. Lastly, the blood bank chief technologists of this final sample were surveyed again by means of questionnaires from March 1, 1996 to April 20, 1996, The collected data were statistically analyzed using the SPSS program for frequency, percentage, means, t-test, Pearson's correlation coefficient and discriminant analysis. The results of this study can be summarized as follows; First 168 cases or 0.46% out of36,410 antibody screening tests were found to have unexpected antibodies. Second, the antibodies which belong to Lewis family accounted for 27.9% of the unexpected cases, followed by usual cold antibodies (20.8%), Rh-family ones (10.1%). Third, the variables affecting most of the antibody screening tests were blood bank chief technologists' burden of detecting warm antibodies, the number of the special medical technologists working for blood bank and routine cross matching phases.

파키슨병 환자에서의 우울증상

이문숙,양창국,한홍무,김재우 한국정신신체의학회 2003 정신신체의학 Vol.11 No.1

노년층 남·녀에 있어서의 체력관리에 따른 심폐기능 적응

이문숙 이화여자대학교 체육대학 1985 建美 Vol.- No.18

한국 야생고양이에서 바르토넬라 감염

이지영,강재승,김미경,황태숙,곽이경,채민병,장철순,김일권,서동범,정문현 대한감염학회 2001 감염 Vol.33 No.5

Background : Cat scratch disease (CSD) is an emerging disease worldwide and is mainly caused by Bartonella henselae, a gram-negative bacterium. The most common clinical manifestation is regional lymphadenopathy, though clinical recognition may be difficult, as atypical manifestations occur. The condition can be complicated by neuroretinitis, endocarditis, and sometimes fatal encephalopathy. The reservoir of B. henselae is the cat, and the prevalence rates of B. henselae infection in cat populations range from 4 to 70% . The prevalence of Bartonella infection in Korea has not been studied, thus, in this study Bartonella infection was investigated in cats captured in the Inchon and Ansan areas. Methods : Twenty wild cats were captured and their livers and spleens were examined by polymerase chain reaction (PCR), bacterial culture, and histopathologically, PCR used two primers : Cat (sense : 5'-GAT TCA ATT GGT TTG AA(G/A) GAG GCT-3', antisense : 5'-TCA CAT CAC CAG G(A/G)C GTA TTC-3') and Barto (sense:5'-(C/T) CT TCG TTT CTC TTT CTT CA-3', antisense : 5'-AAC CAA CTG AGC TAC AAG CC-3'). Culture was performed by inoculating sliced spleen and liver into the ECV304 cell line and bacterial growth was observed over a period of 3 weeks. If no visible bacterial growth was identified, the presence of bartonella was examined by DNA staining, indirect immunofluorescent staining, and PCR. Liver and spleen were stained with H&E and scrutinized under the light microscope. Results : Nine pairs of culture cells inoculated with liver and spleen were examined by indirect immunofluorescent staining and PCR; no positive case was found. In addition, no positive case was identified by PCR in the liver and spleen specimens of eleven cats. Spleen and liver specimens of eleven cats were examined by light microscopy and none showed granuloma. Conclusion : This preliminary study suggests that the Bartonella infection is probably uncommon in the cat population of the Inchon and Ansan areas. Further studies should be undertaken to detail the prevalence of Bartonella infection in other areas and in human. (Korean J Infect Dis 33:319∼324, 2001)

적혈구침강속도와 급성기물질의 혈중변화에 따른 상관성과 임상적평가

이호준,김미송,장숙진,문대수,박영진 朝鮮大學校 附設 醫學硏究所 1991 The Medical Journal of Chosun University Vol.16 No.2

The authors determined erythrocyte sedimentation rate(ESR) and the level of acute phase reactants such as ceruloplasmin, α1-antitrypsin, haptoglobin and C-reactive protein and evaluated their correlation in 101 patients with active inflammation, chronic infection, collagen disease and neoplastic disease from Jan. 1990 to Aug. 1990 in Chosun university hospital, Shortly after the patients had been diagnosed, the tests was performed using their blood. ESR was measured by standardized Win trobe method. Ceruloplasmin, α1-antitrypsin, and haptoglobin were measured by radial immunodiffusion method. C-reactive protein was measured by turbidimethc immunoassay. The correlation of ESR and the levels of ceruloplasmin, α1-antitrypsin, haptoglobin and C-reactive protein was analysed in the control group and the disease group. The results were summarized as follows. 1. The ESR rose with each decade increase of age in most cases of the disease group. 2. The author judged that the ESR was increased when the ESR was upper than 20mm / hr. The 45 of 101 cases of the disease group showed increase of ESR. So the sensitivity of ESR to detect disease is 44.55%. 3. The difference of the level of ceruloplasmin and α1-antitrypsin of control group and that of the disease group showing normal ESR value was not statistically significant(P>0.05). 4. The difference of the level of C-reactive protein and haptoglobin of the control group and that of the disease group showing normal ESR value was statistically significant(P<0.05). 5. The difference of the level of ceruloplasmin, α1-antitrypsin and haptoglobin of the disease group showing normal ESR value and that of disease group showing high ESR value was not statistically significant (P>0.05). 6. The difference of the level of C-reactive protein of the disease group showing normal ESR value and that of the disease group showing high ESR values was statistically significant (P<0.05). 7. C-reactive protein played a major role in increasing ESR and haptoglobin played some influence also. But α1-antitrypsin and ceruloplasmin played little influence.