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

간호사의 임상 실무 경험

서문자,손행미,강현숙,권성복,김주현,박영숙,이은희,임난영,조경숙,지성애 성인간호학회 2002 성인간호학회지 Vol.14 No.4

purpose: This study was conducted to describe qualitatively the entities of nurse's experiences in general hospitals and to suggest basic data guiding research on developing Standards of clinical nursing practice in Korea. Method: Fourteen nurses working at general hospitals with over 300 beds in Seoul were interviewed in-depth until saturation using tape-recorders and transcription. Result: The central theme of clinical nursing practice experienced by subjects was "being with clients" that means accepting client's personal character, solving client's needs and providing client-centered nursing. A also "being with clients" was felt to be the responsibility of nurses which was learned from their nursing schools. The nursing strategies performed in order to be with patients were proving skillful nursing techniques, accepting, educating, emotional support, advocating, and self-reflecting, the subjects experienced somewhat problematic affects such as difficulties in interpersonal relationship, work overload, negative image of nursing, deficit of self-confidence for nursing actions, poor working conditions, and unfair treatment. Nurses at the hospital practiced with pride when they felt that they were accepted by clients. Conclusion: Further research is needed to analysis problems in clinical practice and the comparison of nurses' experiences of clinical practice, with nurses' experiences in various settings.

일부 소방공무원의 음주와 직무스트레스와의 관련성

강경화,이강숙,김석일,맹광호,홍현숙,정춘화 大韓産業醫學會 2001 대한직업환경의학회지 Vol.13 No.4

목적 : 소방공무원의 음주량과 직종별 직무 스트레스에 대해 알아보고 보다 나은 스트레스 관리방안과 문제성 음주예방을 위한 프로그램을 모색하기 위해 시도되었다. 대상 : 2000년 7월부터 8월까지 소방공무원 중 구조대원 97명, 구급대원 97명, 화재진압대원 179명,행정대원 116명, 기타대원 49명을 대상으로 설문지를 이용하여 수집된 자료를 분석하였다. 결과 : 소방공무원은 모든 직종에서 승진 및 임금제도의 스트레스 요인 점수가 가장 높았다. 직종별로 직무 내적 요인, 조직에서의 역할, 대인관계, 조직과 풍토, 직장환경과 스트레스 결과 점수에 있어 유의한 차이를 보였다 과음 주자인 경우 직무 내적요인, 직무 스트레스 수준, 개인적 특성, 대처방식의 점수가 높았으나 유의하지 알았다. 음주량은 직무내적 요인 중 업무 피드백과 음의 관련성을, 직무 스트레스 요인 중 역할 갈등은 음주량을 증가시키는 것으로 나타났다. 결론 소방공무원의 가장 높은 직무 스트레스 요인으로는 승진 및 임금제도인 것으로 나타났다. 음주량은 역할 갈등과 같은 직무 스트레스 요인과 관련이 있었으며, 향후 전향적인 음주행태조사를 통해 직무 스트레스 요인이 음주에 미치는 영향을 파악하기 위한 연구가 필요하다고 생각된다. 따라서 본 연구결과를 기초로 소방공무원의 직무 스트레스 요인에 대한 적절한 관리와 정책이 필요한 것으로 사료된다. Objectives : To establish the relationship between alcohol use and job stress among firemen, and to develop a comprehensive health promotion program including stress management and the prevention of problem drinking. Methods : Data was collected from July to August, 2000. Study subjects included 97 rescue workers, 97 emergency medical personnel, 179 fire extinguishers, 116 administrators and 49 others. Results : The firemen displayed higher scores of stress due to promotion-related pres-sures and salary. We found significant differences in job internal factors, job role, inter-personal relationship, organizational norm, work environment and stress outcome among the various jobs. Job internal factors, job stress factors, personal characteristics, coping skills, and stress outcome were higher in heavy drinkers compared with the light and moderate drinkers. Job internal factors and smoking habit showed a positive correlation with the amount of drinking, although coping skill, exercise frequency and monthly income showed a negative relation with the amount consumed. Conclusion : This study suggested that alcohol drinking is associated with job stress. This suggests that a comprehensive health promotion program including stress management and problem drinking prevention and control should be developed.

更年1號丸의 抗酸化活性에 對한 硏究

이현숙,남경수,이태균 동국대학교 경주대학 1996 東國論集 Vol.15 No.-

To investigate the antioxidant effects of Gaengnyounilhohwan (GIH), we administrated acetaminophen (500mg/kg, i.P.) that induced hepatic lipid peroxidation to starved mice for 24hrs after pretreatment of GIH for 6 days. And the effects of GIH on the hepatic enzymes(glutathion-S-transferase, superoxide dismutase, glutathion peroxidase and catala se) which participate in lipid peroxidation and glutathion metabolism were investigated. The results were as follows 1. GST(glutathion-S-transferase) activity in the acetaminphen treated group was remarkably reduced compared with saline treated group (control group). However, in the pretreated group of GIH for 6 days GST activity was increased about 2.7 fold. 2. Compared with control group, SOD (superoxide dismutase) activity was decreased by 26.9% in the acetaminophen treated group. On the other hand, in the GIH pretreated group SOD activity was almost recovered to the level of control group. 3. In the acetaminophen treated group, GSH-Px(glutathion peroxidase) activity was decreased by 47.1 % compare with control group. And in the GIH pretreated group. GSH-Px activity was increased about 2 fold and recover to the control group. 4. Catalase activity was also decreased by 23.8% in actamlnophen treated group. However, in the GIH pretreated group, catalase activity was increased above 2 fold compared with control group. 5. In the acetaminophen treated group, malondialdehyde values of plasma and cytosolic fraction were significantly increased compared with control group. However, after the GIH treated group, lipid peroxide formation was decreased by 47% in plasma, and remarkably decreased 3.7 fold in cytosolic fraction. These results suggest that GIH plays a protective role in the formation of acetaminophen induced lipid peroxidation.

식이내 Mg 함량이 acute immobilization (IMMB) stress를 받은 흰쥐의 혈장 glucose, free fatty ascid, cortisol 및 creatine phosphokinase와 심장근육, 대퇴골 및 혈장의 전해질 배분에 미치는 영향

손숙미,신현경 가톨릭대학교 생활과학연구소 1995 생활과학연구논집 Vol.15 No.1

This study determined plasma glucose, free fatty acid (FFA), cortisol, creatine phosphokinase (CPK), calcium (Ca), magnesium (Mg), sodium (Na), potassium (K), and Ca and Mg in heart muscle and femur. 66 Sprague-Dawley male rats were devided into two diet groups : adequate Mg group (0.05% Mg), marginal Mg group (0.005% Mg). After the rats were on experimental diets for 5weeks, rats for each group were randomly assigned to no stress, stress stress+recovery group and 2hours of IMMB stress were administered to stress and stress+recovery group. Rats of stress group were decapitated shortly after the IMMB stress and rats of stress+recovery group were decapitated after 2hours of recovery. The following were found. 1) Plasma cortisol and CPK were significantly increased in group with stress and group with stress+recovery respectively regardless of Mg content in diet. 2) Plasma glucose and FFA and Ca in plasma, femur and cardiac muscle were not significantly different among groups. 3) Plasma Mg were siginificantly increased with stress only in rats fed marginal Mg.

소규모사업장 보건관리기술지원사업 지원여부에 따른 사업장내 의사소통 비교

정최경희,박혜숙,김정연,이경용,현성민,오지영,김수근,김현주,하은희 이화여자대학교 의과대학 2003 EMJ (Ewha medical journal) Vol.26 No.2

목적: 소규모사업장 보건관리기술지원사업 지원여부에 따라 사업장내 위험의사소통채널이 마련되었는지와 이 채널이 기능을 하는지, 그리고 의사소통채널마련과 사업장내 위험의사소통 활성화의 기본적이고 중요한 배경이 되는 사업주의 산업보건에 대한 관심이 차이가 있는지에 대해 살펴보고자 하였다. 방법: 서울, 안산, 대전, 광주, 포항 지역에서 보건관리기술지원사업을 받은 사업장과 받지 않은 사업장을 대상으로 비례층화무작위표본추출법을 사용하여 추출한 후 1991년 12월 6일부터 10일간 우편설문조사를 실시하였다. 설문대상은 각 사업장의 남녀 각 1명, 보건업무담당자, 사업주였으며, 설문내용은 사업장 및 응답자의 일반적 특성 및 사업장내 위험의사소통이었다. 설문에 응답이 온 463개 사업장의 자료를 자료처리하여 총 228개 사업장(단해년도지원 사업장 189개, 연속2년지원 사업장 13개, 비지원사업장 26개)을 대상으로 분석하였다. 결과: 사업장내 의사소통에 대한 단변량분석에서는 보건업무 담당자의 선정여부만이 통계적으로 유의한 차이가 있었다. 소규모사업장 보건관리기술지원사업을 지원받지 않은 사업장과 지원받은 사업장의 사업장내 위험의사소통을 비교하기 위한 로지스틱회귀분석 결과, 모든 항목에서 통계적으로는 유의한 차이를 보여주지 않았다. 그러나 사업주의 관심(OR ; 1.63, 95% CI ; 0.38~7.01)과 보건업무담당자의 선정(OR ; 3.67, 95% CI ; 1.00~13.44) 및 결정권한(OR ; 1.48, 95% CI ; 0.25~8.91), 사업주의 산업보건문제 소통(OR ; 3.07, 95% CI ; 0.81~11.71), 보건업무담당자의 정보요청경험(OR; 4.48, 95% CI ; 0.97~20.57)에서는 지원받지 않은 사업장에 비해 지원받은 사업장에서 교차비가 증가하는 양상을 보여주었다. 반면 노동자의 산업보건문제 소통가능성여부는 오히려 교차비가 0.53(95% CI ; 0.11~2.44)로 감소하는 경향을 보여주었다. 결론: 소규모사업장 보건관리기술지원사업을 의사소통의 측면에서 평가해보면, 사업주나 보건업무담당자에게는 다소 효과가 있었지만 노동자가 지속적으로 참여할 수 있도록 의사소통문화를 바꾸어내는 데에는 한계가 있었다. 개선을 위해서는 노동자 중심의 접근 프로그램의 개발 및 시행이 시급하다 할 수 있다. Objectives :This study was to evaluate the effectiveness of the government-funded subsidized occupational health program for small-scale enterprises(GSOHP_SSE) by occupational health com-munication in workplace. Methods : We sampled the 1,835 enterprises of study by proportional stratified random sampling among industries of supported and not supported by GSOHP_SSE in Seoul, Ansan, Daejeon, Kwang-joo and Pohang. Information on the general characteristics of enterprises and respondants and occupational health communication in the workplace was collected on self-reported questionnaires by post-survey between December 6 and 15 in 2001. We received answers from 463 enterprises and analyzed 228 enterprises through data-cleaning by logistic regression to evaluate effectiveness of GSOHP-SSE about occupational health communication in the workplace. Results : By multiple logistic regression analysis, GSOHP_SSE turned out not to be statistically significant factor in all dependent variables about occupational health communication in the work-place. The concern of owner(odds ratio (below OR) ; 1.63, 95% confidence interval(below 95% CI) ; 0.38-7.01), formation(OR ; 3.67, 95% CI ; 1.00-13.44) and empowerment(OR ; 1.48, 95% CI ; 0.25-8.91) of health manager, request about occupational health problem of health manager(OR ;4.48, 95% CI ; 0.97-20.57) and occupational health communication of owner (OR ; 3.07, 95% CI ; 0.81-11.71) had the trend increasing OR in the industries supported GS-OHP_SSE relative to the industries not supported. But in recognition of possibility on occupational health communication of laborers, OR of GSOHP_SSE was decreased in 0.53(95% CI ; 0.11-2.44). Conclusions: This study found that the GSOHP_SSE was some effective to the side of employer and health manager, but had a limitation about change of communication culture useful to the laborers. We suggested the laborer-centered health training programs or the empowerment-based health training programs for effective occupational health management in the workplace.

상징놀이와 인지발달의 관계에 대한 Piaget와 Vygotsky의 관점 비교 : A Piagetian Framework Vs A Vygotskyian Framework

김현경,이정숙 기전여자대학 2000 論文集 Vol.20 No.-

This article suggests new directions for application of symbolic play and cognitive development based on Piaget's paradigm and Vygotsky's paradigm. Children's symbolic play has focused on the way early childhood curriculum formation process differently as historical and philosophical background. This study emphasize the meaning of relationships between symbolic play and cognitive development. Piaget's framework and Vygotsky's framework are multual negotiation and collaboration. Central to the role of teachers is conceiving of Piagetian framework and Vygotskyian framework about cognitive development. And then they have to do various intervention as a scaffolder.

전통음식에 대한 경북지역 주부들의 의식 및 실태조사

한재숙,한경필,성선향,조연숙,박경숙,김현옥,정종기 동아시아식생활학회 2000 동아시아식생활학회지 Vol.10 No.6

The purpose of this study was to survey the awareness and use for traditional foods of housewives in Kyong-buk area. The results were as follows : Residental areas were city(43.9%) and the county(56.1%). Region were divided as the north resources circle(28.3%), the east coast circle (21.0%), the middle west circle (21.7%), and the south city circle (29.0%). The performance degree of times and seasons of the year customs was Seolnal, Chuseuk, Daeboreum and Dongji in order. Preparation foods of Seolnal were deukguk, vegetablejeon, fishjeon, namul and gangjeung in order. Preparation foods of Chaseuk were songpeon, vegetablejeon, namul, fishjeon and fruits in order. The country foods were sikhae, muk, pumpkin, golbangiguk, yakga and potato in order.

우리나라 농촌지역의 가족보건서비스 이용상태 및 가족보건 서비스 이용 요인분석

방숙,정경희,한성현 순천향대학교 1988 논문집 Vol.11 No.3

This study is aimed at (1) describing the current status of FP / MCH care services in Eumseong County, (2) identifying the determinants of the utilization of FP and MCH care services, and (3) providing the basic data needed for the effective management of FP and MCH services. This survey was conducted in Eumseoung County, Chungcheong Puk Do, a typical rural community. The data was obtained from a interview survey of 1,440 married rural women between the ages of 15 and 44 who lived in Soyi, Wonnam, and Maingdong townships. The findings were as follows. 1. Demographic characteristics of women studied On average the women's age at first marriage was of 23.7 years. The Women had 2.6 children(1.3 sons and 1.3 daughters). 10% of the women experienced deaths of children 14% of them were spontaneous abortions, 4% still-birth, and 5.5% are currently pregnant. The average ideal mnuber of children was 2.2. 44% of them considered a son as a necessity. 2. The contact rate with health service institutions was relatively high, 43.7% of them visited the health sub-center more than once over the last year, 59.6% of them the private clinic, and 41.5% the Soochunhyang-Eumseong Hospital. 3. The FP acceptance rate of respondents was 76.5% 52.3% of them used tubaligation. 54.2% of the practice was done at the pursuasion of health worker., 8.4% of the respondents had discontinued the practice of which only 26% of them had done so because they wanted to have children or reached menopause. While 74% of them did so due to side effects, discomforts, and the method failure. Thus, proper choices in contraceptive methods are not being made. The FP acceptance rate of women who have one child or less was 35.3%. Of which 38.3% resort to permanent sterilization methods. Accordingly, the case of early stopping of child-birth(after the first child) is ever increasing. According to the results of multiple regression analysis, among the variables used in this analysis, the most important factor in determining the FP practice was the number of sons. 4. Asked about attitudes toward the need for prenatal care, 66.0% of the women who gave birth during the period from Jan. 85 to June 87 stated that it was necessary. But only 50% of the women knew the proper time for the first prenatal care and its frequency. The actual percentage of women receiving prenatal care was 82%, while only 34.6% received it five times or more. Among those receiving pre-natal care, 67.8% of them used clinics or hospitals, 25.8% the MCH center. And while 70% to 80% pregnent women underwent urine tests (78%), weight measurements(77%), and blood pressure measurements(83%), only about 40% received blood tests. 5. 32.0% of the women delivered their babies at the MCH center, 23.2% at hospitals, and 18% at private clinics. Thus, institutional delivery amounted to 76.2%, while home deliveries accounted for 23.8%. Among the home delivery cases, only 26.3% used the safe delivery kit'. The reasons for choosing home delivery were low economic conditions and poor geographical accessibility. 6. 32.0% of the respondents made medical visits after birth and 27.8% of them experienced post-natal problems. The above shows that women who do not experience postnatal problems have a tendency not to make medical visits. 50% or more of the women who received postnatal care used clinics or hospitals. 7. 90% or more of the children got basic immunizations such as BCG, Polio, DPT, but 39% or them did not get the vaccinations in time. Vaccination rates for measles, JBE, and hepatitis were between 50% at birth, 30.3% of them weighed 3.0 kilograms or less and 8.9% of them were 2.5 kilograms or less. 8. Concerning the various medical institutions, respondents regarded the doctors of clinics and the workers at MCH center more highly than any other institution, and they were satisfied with the adequate medical equipment of the Soonhunhyang-Eumseong Hospital, In regard to costs, most of them said that medical costs of private institutions were rather high. 9. In examining which factors were important in utilizing institutions for prenatal care, multiple regression analysis were conducted. Results showed that the number of prenatal care received was affected by birth order and attitudes towards the necessity of prenatal care. That is getting more prenatal care demands a lower birth order and more recognition of the necessity thereof. But risk factors, except for the experience of abnormal delivery, did not have a relation with the number of prenatal care examinations. According to the multiple logit regression analysis, hospital and clinic deliveries are affected by the past experience of abnormal delivery, health insurance, birth order, and the women's pattern of labor, in the stated order. MCH center delivery is affected by the level of costs, the women's pattern of labor, and the birth order, in that order. That is, in the selection of hospital and clinic delivery, risk factors and enabling factors were more important than other factors. And in the case of MCH center delivery, enabling factors(cost) and individual characteristics (pattern of labor) were more important. Based on the findings above, it is recommended that more emphasis be placed on the following strategies in the management of family health services 1. Quantitative increase of FP activities can not be expected any further. Female sterilization has been conducted by target oriented policies. For the adequate choice of FP method which will fit the woman's characteristic, information and knowledge about her preferences must be promoted properly. And it is desirable to diversify service points for easier selection. Public education activities (for discarding son preference, spacing between children, early child-birth stopping) should also be actively done. 2. Recongnition of the necessity of prenatal care and institutional delivery is ever increasing, but the lowerclass and risk groups are being continuously alienated. Contact rates with service institutions are relatively high, but adequate and effective choices have not been made due to the lack of information and knowledge concerning prenatal care. Public institutions are not credible, and private institutions are too high in cost, and referal systems between the public and private sectors do not exist. These are the reasons for woman's dissatifaction in delivery. Postnatal care is absolutely necessary for maternal health care but being neglected. Child care is limited to only vaccination, disregarding other important and more imminent lowing strategies are recommended. First, econimic accessibility is expected to be higher by the national health insurance policy while the number of deliveries is declining. But it is uncertain whether all women will be able to receive adequate care. In order to reach the risk groups people living in remote areas requires: 1) More MCH information and education services to every women in community should be carried out through public health sub-centers and CHP's post. 2) Organization of voluntary community participation such as VHWs and more opportunities for obtanining information are needed. Second, health insurance must be applied to the preventive care, actively supporting pre-and postnatal care and child health care activities. That means the minimal MCH services should be reinforced and child health care required to include nutrition care, health examinations, etc. All the above things should be done on a public service basis. Third, a feedback system between public and private health institutions ought to be formalized. Technical and institutional support is needed for the effective management of a referal system in FP and MCH services.

전북지방 대학생의 식행동에 관한 조사 연구

김현신,서은숙,신미경 동아시아식생활학회 1996 동아시아식생활학회지 Vol.6 No.2

This study was carried out to investigate food behaviors of 349 college students(male 233, female 116) in Jeon Buk area by questionnaires. 89.1 percent of the students were living in city and 48.8% of those were residing in their own home or relatives. The average height and weight was 172.9㎝, 64.2㎏ for male and 161.0㎝, 50.1㎏ for female. Drinking and smoking rate of males were 88.0% and 61.8%, respectively. Both of male and female were most preferring the kind of rice and the skipping rate of breakfast was highest. Mean score of interest in eating attitudes was 11.7 in male and 13.2 in female(p<0.001), and score for regular eating time was highest and that for reducing pungent food intake was lowest. The score of interest in eating attitudes was higher in subjects who exercise regularly(p<0.001), no drinking (p<0.05), had a good health status (p<0.01) and attended a lecture related to food and nutrition (p<0.001) than others. In the sense of value on eating, male had a meal for the physiological needs and female had a meal for enjoy(p<0.05). The score of interest in eating attitudes had a negative correlation with drinking(p<0.001) and smoking (p<0.05), and had a positive correlation with health status(p<0.01), effort for a balance of life(p<0.001), the sense of value on eating and attending a lecture related to food and nutrition(p<0.001).