간호이론에서 '항상성' 개념의 발달

최스미 연세대학교 간호정책연구소 2003 간호학탐구 Vol.12 No.2

The concept of 'homeostatis' has guided medical research and physiological nursing research over many decades. Within homeostatis, healthy function has been defined as the return of system parameters to set points, mediated by negative or positive feedback system. Since nursing research, different from medical studies, considers both the individual and the context in which they live. Nursing approach has to be the one that is wholistic. Remarkable growth has been seen in the area of biobehavioral nursing research over the last 20 years. Many nurses are engaged in biobehavioral research that addresses questions that are either derived from clinical practice or have applicability to the clinical arena. Biobehavioral nursing often use the context of the human response model. This model considers person (vulnerability) as well as environmental (risk) factors as influencing individual responses or adaptation. Human responses are categorized as physiological, behavioral, experiential. In addition to human response model, many biobehavioral nurse scientists have embraced the study of psychoneuroimmunology (PNI) which considers the interactions among immune, nervous, and endocrine systems. This paper is intended to provide how 'homeostatis' concept has been evolved in nursing theory. I also intended to research how physiological concept such as 'homeostatis', has been integrated with psycho social concept in nursing research and practice and have the implication of further biobehavioral nursing research. Nursing concept such as 'Pain', 'Dyspnea' have been used as examples that illustrate the diverse models as well as the significant contributions of nurse scientists to the study of biobehavioral phenomenon. All these attempts will hopefully help us in formulating a nursing theory in biobehavioral research area.

신규간호사를 위한 맞춤형 멘토 프로그램(새싹프로그램)의 개발 및 적용 : 일개 대학병원 중환자실을 중심으로

권은옥,조정숙,송경자,최스미,장선주,김주희,박승현,신효연,유미,김정아 대한간호학회 간호행정학회 2009 간호행정학회지 Vol.15 No.4

Purpose: The purpose of this study was to develop specialized mentor program to improve adaptation for new nurses of intensive care unit and to identify the effect of the program on early resignation rate. Methods: The study adopted nonequivalent control group, non synchronized design. Based on the identification of problems and the needs of new nurses, a 6 month specialized mentor program was developed. The program was consisted of three parts; developing knowledge, improving interpersonal relationship and increasing coping competency for emergency situation. Data were collected between July 2006 and 2008 from 37 nurses and the early resignation rate was compared before and after the implementation of the mentoring program. Results: Early resignation rate of the nurses who received the mentor program was significantly lower than that of the nurses who didn't. The resignation rate within 1 year dropped from 44.5% to 8.3%(p=.034). Conclusions: The specialized six month mentoring program was effective in reducing early resignation rate.

'포스트 게놈'시대에서 간호학의 과제

최스미 대한기초간호자연과학회 2005 Journal of korean biological nursing science Vol.7 No.1

Since the Human Genome Project(HGP) has begun in the mid 1980s, the sequencing of the human genome has been finally completed in 2001. The knowledge developed from the HGP has revolutionized how health care professionals think about patient care, mandating a new paradigm of patient care in totally inconceivable ways from the past. For instance, the patients at risk for disease can be identified early enough for intervention;the medicine can be tailored for individual patients based on their own genetic information;the gene therapy could be a common procedure in the near future. The advancement in genetics, therefore, requires the shift of paradigm not only in nursing education, practice, but also in nursing research. It is attempted, in this article to introduce briefly the basic knowledge of genetics, the pharmacogenomics, and the overview of national genetic research initiated and organized by the Center for Functional Analysis of Human Genome in Korea. The current state of nursing genetic knowledge and its implications on nursing education, practice, and research has examined. Furthermore, the visions and the opportunities for nursing science and practice to participate in this genetic revolution were also explored.

성인 입원환자의 운동 욕구에 관한 조사연구

최명애,최스미,임영미 지역사회간호학회 1994 지역사회간호학회지 Vol.5 No.2

흡인성 폐렴 노인과 지역사회획득 폐렴 노인의 임상양상 비교

박명숙,최스미 노인간호학회 2008 노인간호학회지 Vol.10 No.2

Purpose: This study was done to identify differences between aspiration pneumonia and community acquired pneumonia (CAP) according to demographic characteristics and medical outcomes for elderly patients. Method: From January 2004 to December 2007 data were collected from 105 patients (> 65 years old) Y97 with aspiration pneumonia and 311 with CAP General characteristics pneumonia severity of illness score (PSI score) and medical outcomes were obtained by reviewing the medical records of those patients Data were analysed using SPSS window 12.0 version statistics package. Results: The aspiration pneumonia group was older (p<0.05) and more dependent in walking The incidence of stroke dementia Parkinson's disease (P<0.001) and diabetes mellitus (p= 0.027) was higher in the aspiration pneumonia group than in the CAP group PSI score (121.47 vs 90.65 points) length of hospital stay (17.77 vs 9.94 days) and mortality (17.1 vs 5.1%) were significantly higher in aspiration pneumonia group than in the CAP group In logistic regression the factors predicting aspiration pneumonia were Dementia (OR=44.37) Parkinson's disease (OR=18.63) stroke (OR=17.17) confusion (OR=8.62) hypoalbuminemia (OR=2.89) Conclusion: Aspiration pneumonia was more common in dependent malnourished elderly patients with neuro-degenerative diseases Special attention has to be paid to these patients to decrease the incidence of aspiration pneumonia in the older population.

뇌졸중 환자를 돌보는 가족간호자의 부담감에 대한 종적연구

강수진,최스미 성인간호학회 2000 성인간호학회지 Vol.12 No.2

This longitudinal study examines the burdens and related factors for stroke patient's primary family caregivers. Sixty-one patients treated for stroke at a general hospital in Chung-nam province and family member caregivers participated in this study from July 28. 1998 to August 1, 1999. Family caregivers' burdens were assessed by the burden scale originally developed by Zarit(1980) and Novak & Geust(1989) and modified by Oh's(1993) for use in Korea. The burden scale instrument consists of five subscales. : financial burden, social burden, physical burden, dependency burden, and emotional burden. Repeated ANOVA and Stepwise multiple regression were used in the data analyses. The results were as follows : The burden mean score was 3.23 in the hospital, 3.26 after hospital release, and 3.27 in the home environment. In the hospital, a patient's decree of cognition, and social support for family caregivers war·e significant factors affecting the sense of burden felt by family caregivers. After hospital release, the significant factors affecting the sense of burden were the degree to which stroke patients could participate in daily living activities social support for family caregivers, and changing to a second caregiver. In the home environment, the most significant factor affecting the sense of burden was social support for family caregivers.

한국 노인의 특성에 따른 맛 감지 능력의 차이에 관한 연구

박경애,이희주,박명숙,이정희,전상은,김종성,최스미 대한노인병학회 2002 대한노인병학회지 Vol.6 No.4

Post-Stroke Fatigue May Be Associated with the Promoter Region of a <b><i>Monoamine Oxidase A </i></b>Gene Polymorphism

Choi-Kwon, Smi,Ko, Mihye,Jun, Sang-Eun,Kim, Juhan,Cho, Kyung-Hee,Nah, Hyun-Wook,Song, Hasup,Kim, Jong S. S KARGER AG 2017 Cerebrovascular Diseases Vol.43 No.1

<P><B><I>Background:</I></B> Post-stroke fatigue (PSF) is a common sequela of stroke. Despite reports of serotonergic involvement in the etiology of PSF, the potential contribution of serotonergic genes in the development of PSF needs to be investigated. <B><I>Methods:</I></B> A total of 373 patients, who experienced ischemic stroke for PSF, were evaluated 3 months after the stroke. PSF was assessed using the Fatigue Severity Scale. The genomic DNA collected and stored in a -70°C freezer was genotyped for 6 polymorphisms in genes associated with serotonin synthesis (tryptophan hydroxylase 1 (TPH1) A218C, TPH2 rs10879355, and TPH2 rs4641528), transport (the promoter region of the serotonin transporter protein), and catabolism (the 30-bp functional variable number tandem repeat) polymorphism in the promoter region of <I>monoamine oxidase A (MAO-A)</I>. <B><I>Results:</I></B> Among the 373 patients, 164 (44%) had PSF. All patients were ethnic Koreans. Of the 6 polymorphisms examined, only one marker, that is, low-activity <I>MAO-A</I> was associated with PSF (p < 0.05) in female patients. Multiple logistic regression analyses showed that post-stroke depression (PSD; 95% CI 1.561-14.323, p = 0.006) and low <I>MAO-A</I> activity (95% CI 0.166-0.722, p = 0.005) were factors associated with PSF in female patients, whereas only PSD (95% CI 5.511-65.269, p = 0.000) was associated with PSF in male patients. <B><I>Conclusions:</I></B> Our findings suggest that PSF may be associated with a genetic polymorphism involving <I>MAO-A</I>, at least in female stroke patients.</P>

Nursing Interventions for Poststroke Fatigue

Choi-Kwon, Smi,Mitchell, Pamela H.,Kim, Jong S. American Heart Association, Inc. 2015 Stroke Vol.46 No.10

Anger, a Result and Cause of Stroke: A Narrative Review

Smi Choi-Kwon,Jong S. Kim 대한뇌졸중학회 2022 Journal of stroke Vol.24 No.3

Post-stroke mood and emotional disturbances are frequent and diverse in their manifestations. Among them, post-stroke depression is the best known. Although post-stroke anger (PSA) has been studied relatively less, it can be as frequent as depression. Manifestations of PSA range from overt aggressive behaviors (including hitting or hurting others) to becoming irritable, impulsive, hostile, and less tolerable to family members. The possible pathophysiological mechanisms of PSA include neurochemical dysfunction due to brain injury, frustration associated with neurological deficits or unfavorable environments, and genetic predisposition. PSA causes distress in both patients and their caregivers, negatively influences the patient’s quality of life, and increases the burden on caregivers. It can be treated or prevented using various methods, including pharmacological therapies. In addition, anger or hostility may also be a risk or triggering factor for stroke. The hazardous effects of anger may be mediated by other risk factors, including hypertension or diabetes mellitus. The identification of anger as a result or cause of stroke is important because strategic management of anger may help improve the patient’s quality of life or prevent stroke occurrence. In this narrative review, we describe the phenomenology, prevalence, factors or predictors, relevant lesion locations, and pharmacological treatment of PSA. We further describe the current evidence on anger as a risk or triggering factor for stroke.