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지역사회 만성정신질환자를 돌보는 가족의 부담감과 정신건강
오경옥,홍춘실 대한간호학회정신간호학회 2000 정신간호학회지 Vol.9 No.4
This study was designed to ivestigate the burden and mental health of family Caregiver with Chronic mentally ill patients in Community. The subject were ill family caregiver with Chronic mentally ill patients, living in Daejon, Cheungzu, Chungnam, Chungbook, from October 1999 to February, 2000. The lsnstrument for this study were the burden scale developed by Yang li-kyung(1995) and SCL-90R by Kim and Won(1978). The data was analysed by descriptive statistics, t-test. Person correlation coefficient and ANOVA. The results of analysis were as follows : 1. The mean score of family caregiver burden was 156.13. The mean score of the dimension for family burden raged down in following order : Social politics (3.96), family problem (3.80), social activity of mentally ill patients(3.77). Violence behavior and risk for disorder(3.70). Social prejudice(3.68). 2. The relative factors influencing family burden were perspective patient's future (F=4.32, p=0.001), marriage status (F=2.61, p=0.01), relationship with patients (F=2.51, P=0.02), relationship with residence (F=2.51, p=0.01). 3. The mean score of mental health for family caressive was 166.20. The mean score of the dimension for mental health ranged down in the following order : Depression(2.90), Obsessive compulsive(2.08), interpersonal sensitivity(1.96), socialization(1.89), anxiety (1.88). 4. The relative factors influencing mental health for family caressive were : sex (t=4.91, p=0.02), age(F=4.73, p-0.001), Education (F=3.72, p=0.01) relationship with patents (F=3.15, p=0.01). 5. The relationship between the degree of family caregiver burden and mental health was statistically correlated(r=0.26, p=0.01). As a result, this study suggests that nursing intervention program is needed to develop the effectiveness of various program intended not only to reduce family caregiver burden among chronic mentally Ⅲ patients in community, but also to improve mental health. Further study is needed to examine the affecting factor of family caregiver burden and mental health among chronic mentally Ⅲ patients in community.
교육용 비디오를 이용한 정신건강 교육이 정신분열병 환자 가족의 대처방식에 미치는 효과
이길자,김철권 대한간호학회정신간호학회 2000 정신간호학회지 Vol.9 No.4
In order to compare the effect of psychoeducation on the coping styles of family members of schizophrenia toward the difficult situations, 64 family members of schizophrenia were assigned into three groups, such as traditional lecture group(N=20), educational videotape group(N=21), and non-educational group(N=23), and were participated psychoeducation program separately for 4 hours by tow weeks. The four difficult situations include patients' noncompliance with medication, violent behaviors, unusual talking and behaviors, and lack of motivation. The results were as follows. family members of schizophrenia use most frequently two strategies of 'soothe and plead with patients' or 'compromise between what they want and what patient wants'. 2) Regarding the change of perception of the coping styles of family members of schizophrenia toward the four common difficult situation after psychoeducation, lecture group and videotape group showed marked changes compared with those of the non-educational group after psychoeducation. And lecture group was superior to videotape group in those changes. These results suggest that the psychoeducation using the educational videotape might be the useful way to educate family members of schizophrenia.
퇴원한 정신질환자가 지각한 사회적 지지와 정신건강상태에 관한 연구
김희정 대한간호학회정신간호학회 1992 정신간호학회지 Vol.1 No.-
This study was designed to identify the relationship between perceived social support and the mental health status of persons receiving psychiatric care as out-patients. The purpose was to contribute to the theoretical understanding of the relationship between these two concepts and eventually to the enhancement of theoretically directed nursing care. The subjects for this study were 54 patients receiving treatment for mental illness in an out-patient clinic or out-patient rehabilitation program at one of three general hospitals, a private clinic, or a social welfare institute. The data were collected from sept. 2 to 20, 1991. Perceived social support was measured by the Social Support Scale developed by Bak, Ji-Won. A questionnare developed by Derogatis, et al(1976) and modified by lee(1986) was used to measure mental health status. The data were analyzed by desciptive statistics and t-test, ANOVA, and pearson coorelation coefficients, using an S.P.S.S. program. The results of this study can be summerized as follows : 1. The mean perceived social support was 2.52 in a possible range of 0 to 4, and the major source of social support was the mother(83.3%). The major type of support was emotional(44.7%), and the frequency of contact with the supportive person ranged from once a week to once a week to once a month. 2. The mean mental health status was 0.9456 in possible range of 0 to 4. The severity of the subscales ranged down in the following order : obscession, depression, somatization, phobic anxiety, anxiety, hostility, paranoid ideation, interpersonal sensitivity, and psychosis. 3. The relationship between preceived social support and mental health status was not significant(r=-0.2124, p<.05), but there were relationship between certain subscales of the independent and dependent variables. Variables related to appraisal support were the total mental health status(r=-0.2756, p<.05), hostility(r=-0.2305, p<.05), interpersonal sensitivity(r=0.2546, p<.05), and psychosis(r=-0.3034, p<.05). Psychosis was related to emotional support(r=-0.2332, p<.05) and to total social support(r=-0.2300, p<.05). For this sample, some subscales dimensions of social support may have and affect on some aspects of mental health status. Future research of these conceptual relationships is essential to the development of theoretical nursing to give direction to the planning of scientifically sound nursing care.
정신질환자 가족과 정상 가족의 가족환경 지각정도 비교연구 : A COMPARATIVE GROUP STUDY.
박혜숙 대한간호학회정신간호학회 1992 정신간호학회지 Vol.1 No.-
The family is of critical importance in human-environmental interaction and a primary resource for health. Individuals are in continuous interaction with their families. The family environment is of crucial importance not only in health but also illness, including the mental illness of one member of the family. In this study, the family environment of families where one member of the family was receiving psychiatric care was compared with that of families where threre was no history of psychiatric care. The purpose of this study was to contribute to theoretical understanding and eventually to the planning of theoretical nursing care toward the enhancement of the family as a health promoting environment. Data were collected from September 1 to 30, 1991, from 113 families of patient admitted to two hospitals or attending two clinics in Seoul and KyongKi Province for psychiatric care. The comparative group consisted of 131 families where there was no reported history of psychiatric care. The instrument used was the Moos Family Environment Scale(FES) Form R modified by the investigator. The data were analyzed by using an SPSS computerized program and include percent age, X2-test, frequencies and ANOVA. 1. Only occupation was significantly different between the two groups' general characteristics(P=0.0030). 2. There werer differences in the FES scores between the two groups : Personal Growth(P=0.000) and System Maintenance (P=0.000) scores of the comparison group werer higher than those of the families where one member was reveiving psychiatric care. Scores were also higher for the comparison group on six subscales, cohesion (P=0.000), independence(P=0.000), intellectual-cultural orientation(P=0.000), organization(P=0.005) and control(P=0.000), Only conflict(P=0.001) scores were higher for families where one member was receiving psychiatric care. 3. There were relationships between certain general characteristic variables' and the three dimensions of the FES for the total group. 1) In the Relationship dimension, age, sex, education, religion, occupation, family economic level and the number of people in the family were related to Cohesion and Conflict. 2) In the Personal Growth dimension, age. sex, education, religion, occupation, family economic level and the number of people in the family were related to Independence, Intellectual-cultural orientation and Active-recreational orientation. Sex was related to Achievement Orientation and Religion to Moral-Religious Emphasis. 3) In the system Maintenance dimension, age, sex, education, religion, occupation, family economic level and the number of people in the family were related to Organization. Age, sex, education, religion, occupation, family economic level and the number of people in the family were related Control. The FES scores were generally higher for families where no one was receving psychiatric care than for families where one was. The family environment-individual interaction patterns may be critical to the recovery of the individual's mental heath and the health promotion of the whole family. Recommendations were made for further research and questions raised about the instrument's cultural appropriateness.
청소년의 자아분화와 정신건강과의 관계 : 서울 지역 남ㆍ녀 고등학생을 중심으로
이혜숙 대한간호학회정신간호학회 1992 정신간호학회지 Vol.1 No.-
The purpose of this study was to test Bowen's family theory. Adolescents are in a vulnerable stage of mental health and have many mental health problems and psychosis. In Bowen's theory differentiation of self is related to mental health suatus. So this study was designed to identify the relation between differentiation of self and mental health in adoleescents. Therefore the point of this study was to contribute to the theoretical understanding of the relationship between these two concepts and eventually to the enhancement of theoretically directed nursing care. The subjects for this study were 299 high school students attending a high school in Seoul : the number of first year, second year and third year students included was 101, 100 and 98 students respectively. The data were collected during the period form from March 31, 1992 to April 4, 1992. For measuring the differentiation of self as described by Bowen a questionnaire by Je (1989) was used. A simplified Mental Diagnostic Test adapted for Koreans from Derogatis, et al(1976) by Lee(1986) was used to measure the level of mental health. The data were analyzed with the SPSS Program using descriptive statistics, Pearson Correlation Cofficients, ANOVA and Stepwise Multiple Regression. The results of this study can be summarized as follows : 1. The mean score for the differentiation of self scale was 101.88. 2. The mean score for the level of mental health was 99.06, which was higher than the results from other age-groups for which this tool has been used. 3. Hypothesis 1) "the higher the level of cognitive function vs emotional function, the higher the level of mental health" was supported(r=.53 p<.001). Hypothesis 2) "the higher the level of integration of self, the higher the level of mental health" was not supported (r=.08 P>.05). Hypothesis 3) "the lower the level of family projection process, the higher the level of mental health" was supported(r=-.30 p<.001). Hypothesis 4) "the lower the level of emotional cutoff, the higher the level of mental health" was supported(r=-.36 p<.001). Hypothesis 5) "the lower family regression, the higher the level of mental health" was supported(r=-.41 p<.001). 4. By using Stepwise Multiple Regression Analysis, the main influencing factors for the five different categories of differentiation of self were identified, as follows : 1) For the first subcale of differentiation of self the "Cognitive function vs Emotional function" ; three main variables : hostility, depression, and paranoid ideation explained 41.5%( p<.001) of the varance. 2) For the second subcale "Integration of self" ; two main variables; depression and hostility explained 9%(p<0.001) of the variance. 3) For the third subcale "Family projection process" ; three main variables hostility, paranoid ideation, and psychosis explained 15%(p p<.001) of the variance. 4) For the fourth subcale "Emotional cutoff"; four main variables hostility, depression, obscession, and paranoid ideation explained 21%( p<.001) of the variance. 5) For the fifth subcale "Family regression ; two main variables hostility and paranoid ideation explained 18%( p<.001) of the variance. 5. 1) The results from the test for the differentiation of self in the area of demographic variables showed that there were significant differences related to sex(F=6.88 p<.001), school year(F=6.08 p<.001). and educational level of parents(F=8.87, F=5.01 p<.001). 2) The results from the tests for the level of mental health in the area of demographic variables showed that there was significant difference related to school year(F=6.70 p<.001). 6. The relationship of differentiation of self to the nine different categories of mental health status were as follows : The higher the degree of differentiation of self was, the higher the results of the nine different categories of mental health status were (p<.001). 7. By using Stepwise Multiple Regression Analysis ; the main infuencing factors on mental health status were found to be congnitive function vs emotional function, family projection process and emotional cutoff. These factors accounted for 41%( p<.001) of the variance. In conclusion, this study revealed that differentiation of self is an important factor influencing mental health status. Further multidimensional study is needed to identify ways to improve the mental health of adolescents through the differentiation of self. Future research of these conceptual relationships is essential for the development of theoretical nursing that will give direction to the planning of scientifically sound nursing care. Key words : Adolescent, Differentiation of self, Mental health status.
이영자 대한간호학회정신간호학회 2000 정신간호학회지 Vol.9 No.4
To be nursing as a profession, the most essential requirement in nursing education is theoretical orientation of nursing to students and the application of their theoretical orientation to clinical. Unfortunately, nursing theory in classroom and clinical practices are separated. While the classroom grand theories remain in abstract discussion, the clinical practices have been adhered to institutional rules and procedures without serious self-reflection as an autonomous nursing professional. The article attempts to develop a model of nursing theory education articulating theory and practice. The model developed from the idea of Choo's sense-making and creation of knowledge in organizational activities, which emphasizes individual capacity and construction process of social reality among actors. As a strategy for an effective teaching of nursing theory, the study introduces several progressive steps articulating theoretical ideas and situational factors in clinical practices. The educational program is composed with five progressive steps: 1) group assignment, 2) selection of nursing problem, 3) information collection for sense-making, 1) arrangement of tacit knowledge content for externalization, 5) combination of explicit knowledge for knowledge or concept creation.
김선경,서문자 대한간호학회정신간호학회 2000 정신간호학회지 Vol.9 No.4
The patient's behavioral characteristics were measured at the time of admission and discharge. Patient Satisfaction were measured at the time of discharge. The state of self-care activities prior to admission were measured at the time of discharge and the state of self-care activities at discharge was measured one week after discharge. The data were analyzed with SAS program. The homogeneity of general characteristics between experimental and control group was tested using Cochran-Mantel-Haenszel statistics. The t-test for behavioral characteristics and patient satisfaction, and ANCOVA for self-care activities were done. The results of this study were as follows : Primary Nursing was relatively effective on diminishing the patient's s negative behavioral factors such as irritability and depression, and effective on enhancing the patient's positive factors such as neatness and competence. The patients of experimental group were more satisfied with the nurse's professional skill, trust relationship and education although statistically insignificant. Primary Nursing also was effective on the patient self-care activities after discharge such as eating, personal hygiene, elimination, clothing, safety and leisure time activities. Considering the obtained results, it was suggested that Primary Nursing should be widely implemented to the psychiatric inpatients in order to provide more conductive environments for better self-care activities, patient's satisfaction and patient's behavioral change. Therefore, the Primary Nursing could be expanded to the psychiatric ward of university hospitals and the acute setting of large psychiatric hospitals.
청소년의 성적 발달과 문제행동 및 우울과의 관계 연구 : 서울의 일 개교 남자 중학생을 중심으로 Focused on male middle school students
현명선 대한간호학회정신간호학회 2000 정신간호학회지 Vol.9 No.4
This study was designed to examine the relationship between adolescents' sexual development and problem behavior and depression. The subjects for this study were 199 students at middle school in Seoul. The data were collected during the period form April 14, 2000 to April 17, 2000, and were obtained by use of questionnaires. The instruments used for this study were for sexual development genital development and pubic hair growth divided by Tanner(1996), and for the depression, the Beck Depression Inventory developed by Beck(1978). The data was analyzed by use of descriptive statistics, Pearson Correlation Coefficient, t-test, and ANOVA using the SPSS-Win program. The results of this study are as follows : 1. The mean stages of the sexual development were 2.84±1.27(genital development) and 2.77±.90(pubic development). The mean score of the problem behavior was 56.71±10.43, depression 26.81±5.95. 2, The result of this study of the relationship between sexual development and problem behaviors indicated a no significant correlation between genital development and problem behavior(r=-.122. P=.122). However, there was a significant negative correlation between sexual development and social withdrawal behavior(r=-.186, P=.016). 3. There a significant correlation between problem behavior and depression(r=.626, P=.000). 4. The stage of the genital and pevic hair development (t=17.06, P=.000, t=29.40, P=.000) was significantly different according to grade. Also, The levels of the problem behavior and depression (t=-2.48, P=.014, t=-3.17, P=.002) was significantly different according to grade. 5. The levels of the problem behavior (F=6.29, P=.002) and depression (F=6.61, P=.002) was significantly different according to school scores. And the level of depression was significantly different according to socioeconimic status perceived by subjects (F=4.51, P=.002). In conclusion, this study showed a deep relationship between sexual development and social withdrawal problem behavior; the lower the sexual development, the higher the social withdrawal problem behavior. Therefore, the level of the sexual development for the adolescents should be considered in school and the other field. And the depressive mood of delinquent adolescents should be managed.