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이명선(Yi, Myungsun) 한국간호과학회 2009 Journal of Korean Academy of Nursing Vol.39 No.2
Purpose: The purpose of the study was to identify functional structure and patterns of dialogue sequence in conversations between elderly patients with dementia and nurses in a long-term care facility. Methods: Conversation analysis was used to analyze the data which were collected using video-camera to capture non-verbal as well as verbal behaviors. Data collection was done during February 2005. Results: Introduction, assessment, intervention, and closing phases were identified as functional structure. Essential parts of the conversation were the assessment and intervention phases. In the assessment phase three sequential patterns of nurse-initiated dialogue and four sequential patterns of patient-initiated dialogue were identified. Also four sequential patterns were identified in nurse-initiated and three in patient-initiated dialogues in the intervention phase. In general, “ask question”, “advise”, and “directive” were the most frequently used utterance by nurses in nurse-initiated dialogue, indicating nurses’ domination of the conversation. At the same time, “ask back”, “refute”, “escape”, or “false promise” were used often by nurses to discourage patients from talking when patients were raising questions or demanding. Conclusion: It is important for nurses to encourage patient-initiated dialogue to counterbalance nurse-dominated conversation which results from imbalance between nurses and patients in terms of knowledge and task in healthcare institutions for elders.
유방암예방 자원봉사활동에 참여한 유방암 생존자들의 자기효능감, 우울 및 외상 후 성장의 변화
이명선(Myungsun Yi),차지은(Jieun Cha),유영미(Youngmi Ryu) 한국콘텐츠학회 2014 한국콘텐츠학회논문지 Vol.14 No.4
본 연구는 유방암예방 자원봉사활동을 통한 유방암 생존자들의 자기효능감,우울,및 외상 후 성장의 장기적 효과를 탐색하기 위해 실시되었다.본 예비연구는 종단적 방법을 이용하였으며 참여자는 유방암예방교육프로그램에 참여한 유방함 생존자 14명이었다. 자료는 2013년 2월부터 8월까지 수집되었으며 자가보고식 설문지를 이용하여 유방암 자가관리에 대한 자기효능감, 우울, 및 외상 후 성장을 교육 전(T0),교육 후 1개월(T1), 교육 후 3개월(T2), 교육 후 6개월(T3)에 각각 측정하였다. 효과분석을 위해 일반화 추정 방정식을 사용하였다. 자기효능감 점수는 T0과 비교했을 때 T1(χ²=5.56,p=.018), T3(χ²=4.56,p=.033)시점에 유의하게 증가하였다. 6개월 동안 우울은 일반인에 비해 낮은 수준으로 큰 변화가 없었고 외상 후 성장은 비교적 높은 점수가 유지되었다. 이러한 결과는 유방암 생존자들의 유방암예방 자원봉사활동이 자기효능감을 향상시키고 심리적 안녕을 유지하는데 효과적일 수 있음을 시사한다. 유방암 생존자의 유방암예방 자원봉사활동은 일반인 뿐 아니라 참여한 유방암 경험자들에게도 유용한 교육프로그램임을 보여주었다. Purpose: This study was to explore the long-term effects of breast cancer prevention volunteering on self-efficacy, depression, and posttraumatic growth among survivors with breast cancer. Methods: This pilot study utilized a longitudinal design. Participants were 14 women with breast cancer who participated in the breast cancer prevention educational program. The data were collected between February and August in 2013. Self-report questionnaires were used to measure the self-efficacy for self-management of breast cancer, depression, and posttraumatic growth at pre-education(T0), 1 month(T1), 3 months(T2), and 6 months(T3) post-education. A generalized estimating equation regression model was used to identify the effects. Results: The scores of self-efficacy increased significantly at T1(χ²=5.56,p=.018) and T3(χ²=4.56, p=.033) compared with T0. Depression and posttraumatic growth remained stable with fairly good levels through out the 6-month period. Conclusion: The results of this study suggest that breast cancer prevention volunteering in survivors with breast cancer can be effective for enhancing their self-efficacy and maintaining psychological well-being. Also the study showed that such volunteering activity could be a useful program not only for the general public but also for breast cancer survivors.
이명선(Yi, Myungsun),정우정(Joung, Woo Joung),박은영(Park, Eun Young),권은진(Kwon, Eun Jin),김해진(Kim, Haejin),서지영(Seo, Ji Young) 한국간호과학회 2016 Journal of Korean Academy of Nursing Vol.46 No.6
Purpose: The purpose of this study was to explore decision making experiences of Korean women with breast cancer who underwent breast reconstruction with/after a mastectomy. Methods: Data were collected during 2015-2016 through individual in-depth interviews with 10 women who had both mastectomy and breast reconstruction, and analyzed using phenomenological method to identify essential themes on experiences of making a decision to have breast reconstruction. Results: Five theme clusters emerged. First, “expected loss of sexuality and discovery of autonomy” illustrates various aims of breast reconstruction. Second, “holding tight to the reputation of doctors amid uncertainty” specifies the importance of a trust relationship with their physician despite a lack of information. Third, “family members to step back in position” describes support or opposition from family members in the decision making process. Fourth, “bewilderment due to the paradox of appearance-oriented views” illustrates paradoxical environment, resulting in confusion and anger. Lastly, “decision to be made quickly with limited time to oneself” describes the crazy whirling process of decision making. Conclusion: Findings highlight aims, worries, barriers, and facilitators that women with breast cancer experience when making a decision about breast reconstruction. Deciding on breast reconstruction was not only a burden for women in a state of shock with a diagnosis of breast cancer, but also an opportunity to decide to integrate their body, femininity, and self which might be wounded from a mastectomy. These findings will help oncology professionals provide effective educational counselling before the operation to promote higher satisfaction after the operation.