억제대 사용에 대한 간호사 교육프로그램의 효과

여정민 계명대학교 대학원 2005 국내석사

본 연구는 억제대 사용에 대한 교육프로그램을 개발하고, 중환자실 간호사를 대상으로 적용한 후 억제대 사용에 대한 지식과 태도 및 간호수행에 미치는 효과를 검증하기 위해 시도되었다. 비동등성 대조군 전후설계를 적용한 유사실험연구로, 경북 지역 K시 소재 2개 대학부속병원의 중환자실에 근무하는 간호사 중 대상자 선정기준에 적합한 간호사를 대상으로 실험군 20명, 대조군 20명이 연구에 참여하였다. 연구의 진행과정은 억제대 사용에 대한 간호사 교육프로그램을 개발 및 적용하고, 그 효과에 대한 가설을 검증하는 단계로 이루어졌다. 자료수집과 프로그램 실시기간은 2005년 9월 1일부터 9월 27일까지로 측정변수에 대한 사전조사, 총 3회의 실험처치, 사후조사를 실시하여 자료를 수집하였다. 프로그램 효과를 검증하기 위해 사용된 측정도구로 억제대에 사용에 대한 간호사의 지식은 선행연구에서 개발된 도구를 본 연구자가 수정 보완한 지식 측정도구를 이용하였으며, 억제대 사용에 대한 태도는 박명화(1997)가 개발한 직접적 태도 측정도구와 Scherer 등(1991)이 개발한 간접적 태도 측정도구를 본 연구자가 수정 보완한 태도 측정도구를 이용하여 측정하였다. 억제대 간호수행 능력은 Park 등(2005)의 도구를 바탕으로 본 연구자가 수 정․보완하여 개발한 억제대 간호수행 능력 측정도구를 사용하였다. 자료분석방법은 SPSS/WIN 12.0을 이용하여 두 집단간의 동질성 검증은 χ²-test, t-test로, 종속변수의 정규분포 검증은 Kolmogorov-smirnov test, 가설검증은 ANCOVA를 사용하여 분석하였으며, 측정도구의 신뢰도는 Cronbach's α를 산출하였다. 연구결과는 다음과 같다. 1. 제 1 가설: “억제대 사용에 대한 교육프로그램에 참여한 실험군은 교육에 참여하지 않은 대조군보다 억제대 사용에 대한 지식점수가 높을 것이다”를 검증한 결과 실험군의 억제대 사용에 대한 지식점수가 대조군과 비교하여 유의하게 높은 것으로 나타났으므로(F=62.66, p=0.000), 제 1 가설은 지지되었다. 2. 제 2 가설: “억제대 사용에 대한 교육프로그램에 참여한 실험군은 교육에 참여하지 않은 대조군보다 억제대 사용에 대한 태도점수가 낮을 것이다”를 검증한 결과 실험군의 억제대 사용에 대한 태도점수가 대조군과 비교하여 유의하게 낮은 것으로 나타났으므로(F=23.77, p=0.000), 제 2 가설은 지지되었다. 3. 제 3 가설: “억제대 사용에 대한 교육프로그램에 참여한 실험군은 교육에 참여하지 않은 대조군보다 억제대 간호수행 능력점수가 더 높을 것이다”를 검증한 결과 실험군의 억제대 간호수행 능력점수가 대조군과 비교하여 유의하게 높은 것으로 나타났으므로(F=3.28, p=0.032), 제 3 가설은 지지되었다. 이상의 결과로 중환자실 간호사에게 제공된 억제대 사용에 대한 교육은 억제대 사용에 대한 지식을 증가시키고, 억제대 사용에 대한 태도를 변화시키며, 억제대 간호수행 능력을 높이는데 효과가 있는 것으로 나타났다. 따라서 억제대 사용에 대한 간호사 교육프로그램은 억제대 사용시 적절한 간호중재 능력을 향상시키고, 부적절한 억제대 사용을 줄이는데 효과가 있을 것으로 사료된다. This study was conducted to develop educational program for using restraints and verify the effect of the program on nurses' knowledge, attitude and nursing performance related to restraints use. It was a quasi experimental study with the pre and post design of non-equivalent. The subject of this study was the nurses who meet the selection criteria among nurses working in intensive care units of two university hospitals located at K-city, Gyeongbuk. Twenty nurses in A hospital were designated as experimental group and 20 nurses in B hospital were designated as control group. The process of study included the development and application of educational program for nurses about the use of restraints. This study was conducted from September 01, 2005 to September 27, 2005. The tool developed in the previous studies on the nurses's knowledge about the use of restraints, was modified by the researcher and used for evaluating nurses' knowledge of restraints use. For nurses' attitude toward using the restraints, the direct attitude evaluating tool by Park(1997) and the indirect attitude evaluating tool by Scherer et al.(1991) were modified and used. For the nursing performance of restraints, nursing performance evaluating tool by Park et al.(2005) was modified and used. SPSS/WIN 12.0 was used to analyze the data with χ²-test, t-test, Kolmogorov-smirnov test, Chronbach's α, and ANCOVA. The results from this research were as follows: 1. The first hypothesis which that assumed that the experimental group would have higher scores of knowledge than the control group was supported(F=62.66, p=0.000). 2. The second hypothesis which that assumed that the experimental group would have lower scores of attitude toward using restraints than the control group was supported(F=23.77, p=0.000). 3. The third hypothesis which that assumed that the experimental group would have higher scores of nursing performance than the control group was supported(F=3.28, p=0.032). From the results above, it was found that the education about the use of restraints for nurses in intensive care unit increases nurses' knowledge about restraints, changes attitude toward using restraints and enhancing appropriate nursing performance releated to restraints. Therefore, the educational program for nurses' use of the restraints need to be introduced to increase appropriate use and to decrease the inappropriate use of restraints.

보건의료환경에서 환자와 가족 참여 가이드라인의 체계적 문헌고찰

고영혜 忠南大學校 大學院 2020 국내박사

간호사의 시스템 사고력 향상을 위한 환자안전교육 프로그램 개발 및 효과

백수미 忠南大學校 大學院 2022 국내박사

It is considered even more crucial by the fact that investments on and endeavors in cultivating systems thinking skills in nurses could contribute to nurturing patient safety competency. Given above, the purpose of this study is to develop patient safety education program that can improve systems thinking skills in nurses and to evaluate the effects of such program on patient safety competency and systems thinking skills. This study employed various stages of ADDIE model based on the Input-Process-Output(IPO) model to develop the education program.This study was performed from August 1st to August 30th in 2021 and used Nonequivalent Control Group Design. Regarding study subjects, a total of 74 participants -experimental group(N= 37), control group nurses (N= 37)- applied for the patient safety education program, to advance systems thinking skills for nurses working in a hospital in J-do, Korea.The education program in this study was conducted four times during two weeks for a total of 400 minutes to the experimental group, and the topics of the program were 'patient safety', 'systems thinking', 'causal loop diagram', and 'preventive diagram'. The research variables were measured by two criteria: patient safety competency and systems thinking skills. The data derived was analyzed with descriptive statistics, independent t-test, paired t-test, χ2-test using pc-SPSS program. The study was able to collect quality data through focus group interviews whose findings were analyzed using qualitative content analysis method suggested by GiorgiThe analysis revealed that patient safety competency(t=7.46, p<.001) and systems thinking skills(t=4.42, p<.001), increased significantly after the patient safety education program aimed at improving systems thinking skills of nurses. Further research is needed to evaluate efficacy of educational strategies in improving systems thinking.In summary, this study showed that patient safety education program aimed at developing systems thinking skills of nurses is effective in cultivating both patient safety competency and systems thinking skills.Therefore, the findings of this study are expected to contribute to the development and improvement of patient safety in hospitals and to enhance patient safety competency and systems thinking skills of nurses.

온라인 건강 커뮤니티 사용자의 지속적 참여의도 영향요인

김자현 忠南大學校 大學院 2022 국내석사

The purpose of this study is to establish the theoretical basis for identifying the effects of Expectation confirmation, Perceived usefulness, and satisfaction on continuous participation intention among online health community users, and to seek continuous participation methods. This study was conducted on members of the online health community, which has the largest number of members among online social networks related to chronic diseases in Korea. Data were collected from April 1 to May 31, and the final 134 questionnaire was used for analysis. The questionnaires were composed of the following : Expectation confirmation( 4 items; Cronbach’s α =.938), Perceived usefulness(4 items; Cronbach’s α =.941), Satisfaction(4 items Cronbach’s α =.926), Continuous participation intention(4 items; Cronbach’s α =.932) This study conducted the following statistical analysis using the SPSS 26.0 program for effective samples. First, the general characteristics of the subjects were analyzed by descriptive statistics, t-test and ANOVA were analyzed to test the difference in continuous participation intention, and the Scheffe'method was performed as a follow-up analysis. Second, in order to find out the relationship between Expectation confirmation, Perceived usefulness, Satisfaction, and Continuous participation intention, Pearson's correlation coefficient was performed to examine the linear relationship between each variable. Third, the influence relationship between Expectation confirmation, Perceived usefulness, satisfaction, and Continuous participation intention, was finally confirmed using multiple regression analysis. The study findings were as follows: 1. As a result of correlation analysis, it was found that perceived usefulness, match Expectation confirmation, and satisfaction all had a significant positive(+) correlation with continuous participation intention, and the satisfaction (r=.897) variable showed the highest correlation with continuous participation intention. 2. As a result of multiple regression analysis, it can be seen that continuous participation intention in the online health community increases as satisfaction(= .640, p<.001)and perceived usefulness(=.177, p<.05) improve, and satisfaction with continuous participation intention has a relatively greater effect than perceived usefulness. In conclusion, it was found that perceived usefulness and satisfaction had a significant effect on the intention to continue participation. However, the interpretation of the effect of Expectation confirmation matching on the intention to continue participation has not been identified in this study and will be possible through further research. Therefore, in order to ensure that users continue to participate in the online health community, it is necessary to identify users' needs and provide useful services to satisfy them.

혈액투석실 간호사의 근거중심 혈액투석간호에 대한 지식과 수행도

주혜숙 충남대학교 대학원 2014 국내석사

This study was to investigate the level of knowledge and performance of evidence based practice for hemodialysis among nurses in dialysis units. Nurses play an important role in hemodialysis care as they are the ones near the patients and more responsive to patient’s concerns or needs than other hemodialysis professionals. Descriptive research was conducted to obtain information concerning the current knowledge level of hemodialysis nurses and their adherence to hemodialysis nursing procedure. Self administered questionnaire was used that data were collected for 24 days from September 1st 2013. The sample consisted of 173 nurses who work in hemodialysis units located in three different district areas in Korea with at least a year of experience as hemodialysis nurses. The survey items were carefully chosen from the evidence based hemodialysis to measure the knowledge and performance of nurses in hemodialysis units. Other pre-existing guidelines were also reviewed to find recommendations that best fit to hemodialysis practice in Korea. All the reviewed guidelines were published by international organizations thus the selected items were then translated to Korean by professional translator. The types of hospitals that the participants work vary from clinics to tertiary hospitals. Using SPSS/WIN 20.0, t-test, ANOVA and Scheffe’s analysis were performed. The study results were as follows; 1. About 98.8% of nurses in dialysis units had received education mostly from dialysis conferences or symposium. In each areas of the survey questionnaire, ‘somewhat’ in knowledge about hemodialysis, ‘very much’ in necessity of hemodialysis nursing, ‘somewhat’ in awareness of evidence based nursing hemodialysis guidelines, ‘a little’ in performance of evidence based nursing, ‘a lack of time due to work overload’ in reason for poor adherence to evidence based protocols and ‘sufficient nursing staff is required’ in strategies to implement evidence based hemodialysis guidelines were chosen most frequently by participants of this study. 2. The mean score regarding Evidence Based Practice (EBP) was 15.77 (68.5%) out of 23 that the highest score was obtained in knowledge area with 4.36 (72.6%) out of 6. The participants had highest score in anemia management followed by blood vessel management and nutrition management. In regards with adherence to evidence based hemodialysis protocols, there were statistically significant differences were found among participants with more than 8 years of work experience, master’s degree and those working in tertiary hospital. Conducting Scheffe’s test, significantly higher scores were recorded when participants were ‘very well’ in knowledge about hemodialysis and ‘very well’ in performance of evidence based nursing hemodialysis guideline. 3. The performance of EBP in hemodialysis nursing was scored 4.01 out of 5 that the highest score was obtained in hemodialysis management followed by nutrition management and anemia management. In analysis of knowledge of EBP according to general characteristics of participants, statistically significant differences were found among participants with work experience of 8 years and above and those practicing in tertiary hospitals. Conducting Scheffe’s test, significantly higher scores were recorded when participants were ‘very well’ in knowledge about hemodialysis, 'heard about' in awareness of evidence based hemodialysis guidelins and ‘very well’ in performance of evidence based nursing hemodialysis guideline. Despite that there are internationally developed evidence based guidelines for hemodialysis nursing practice the actual adherence to guidelines varies by experience and education level of participants and types of hospital. The findings of this study can be baseline data for further research into development of strategies to enhance knowledge of hemodialysis nurses and utilization of EBP guidelines.

요양병원 중심 낙상예방 및 관리 교육프로그램의 개발 및 효과

유수경 충남대학교 대학원 2014 국내석사

본 연구는 낙상 위험이 높은 노인환자를 돌보는 요양병원 간호사, 간호조무사, 간병사를 대상으로 근거기반의 노인낙상 예방 및 관리 교육프로그램을 개발하고 적용한 후 낙상예방 및 관리에 대한 지식과 수행도의 변화를 파악함으로써 교육프로그램의 효과를 검증 하기 위하여 실시하였다. This study is to develop a education program of nurse, nurse’s aids and nursing helper about fall prevention for the elders, and examine the nurse, nurse’s aids and nursing helper change of knowledge and performance about the fall prevention and management after applying the program.

500병상 이상 종합병원 간호사의 간호업무 누락 실태 및 관련요인

김정진 충남대학교 대학원 2014 국내석사

This paper contributes to securing patient safety and improving quality. Basic data to come up with a method that can reduce missed nursing care by understanding types, frequency, and related factors of missed nursing care of the nurses is provided. Data was collected with structured questionnaire and a survey was conducted from the 6th to the 24th of September, 2013. Research was done with 193 questionnaires by conducting a survey of 5 general hospitals. The hospitals are located in Daejeon and Chungcheongbuk-do. Structured questionnaire was used as a research tool for missed nursing care. The questionnaire was evaluated and revised by adapting the development and testing of a tool to measure missed nursing care (Kalisch and Williams published in 2009) to match Korean clinical situation. An adaptation of a tool to measure missed nursing care by E.J. Lee (2013) was used for related factors of missed nursing care. Data was analyzed with frequency, percentage, average, standard deviation, t-test, ANOVA, and Scehffe’s test by using statistical program SPSS/WIN 20.0. Results of the study are as follows: 1. Missed nursing care of nurses working at a general ward of general hospital (over 500 beds) is measured as 4-point scale and total missed nursing care is 1.93-point (20.8%). Hygiene/skin nursing has the most missed nursing care with 2.59-point (48.6%) and blood transfusion has the least missed nursing care with 1.06-point (4.9%). 2. According to general and professional characteristics of nurses, there is a difference on missed nursing care depending on the total number of years in service and extra duty hours. There is no difference on missed nursing care depending on the highest level of education, work unit, and the number of patients that a nurse takes care of per day. 3. Related factors of missed nursing care of nurses working at a general ward of general hospital with over 500 beds are classified into three categories. Human resources is recognized as the most related factor followed by material resources and communication (team work). 4. When it comes to perception difference on related factors of missed nursing care according to general and professional characteristics of nurses, extra duty hours and the number of patients that a nurse takes care of per day have statistically significant difference. And there is no perception difference according to age, the highest level of education, work unit, and the total number of years in service. This study provides data for continuous education to improve the quality of patient safety and nursing by conducting a survey on reality of missed nursing care of nurses and related factors. Based on the results, further studies are suggested on objective measurement method for missed nursing care, relationship between human resources management and missed nursing care, and effects of missed nursing care on results of patients.

개인 및 조직 차원의 특성이 간호사의 혁신행동에 미치는 영향

김성진 충남대학교 대학원 2014 국내박사

The purpose of this study was to identify factors affecting the innovative behavior of nurses and to develop interventions for nurses through understanding of the paths and effects between related variables. A hypothetical model was constructed on the basis of Scott & Bruce’s innovative behavior model(1994), Blakeney’s innovation- creativity-environment model(2009), and a review of the literature on innovative behavior. The exogenous variables of the hypothetical model were self-leadership, knowledge sharing of individuals, and knowledge sharing of organizations. The endogenous variables of the hypothetical model were creative self-efficacy, innovative organization culture, and individual innovative behavior. Data were collected between March 25 and April 6, 2014. Data were collected using a self-report survey. The subjects were nurses working at the general hospital with 300 or more hospital beds. Of the 425 distributed questionnaires, 347 without any missing data were used for the analysis. To examine individual innovative behavior, a translated version of the 14-item questionnaire developed by Kleysen & Street(2001) was used. To examine creative self-efficacy, a translated version of the 8-item questionnaire developed by Carmeli & Schaubroeck(2007) was used. To assess self-leadership, the 18-item questionnaire developed by Manz (1983) and modified by Kim(2003) and Cho(2003) was used. To examine knowledge sharing of individual, a modified version of the developed by Bae(2005) was used. To examine knowledge sharing of organization and knowledge sharing of organization, this study used respectively the 5-item and 9-item questionnaire developed by Bae (2005). To investigate innovative organization culture, the 5-item questionnaire selected by Kwon(2011) based on studies by Cameron and Quinn(1999), and Kim and Lee(1997) was used. The Cronbach’s α scores for these scales ranged from .68 to .95. Data were subjected to descriptive analysis and path analysis, using SPSS 21.0 and AMOS 21.0. The study findings were as follows: 1. The model showed a much better fit(GFI = 1.000, AGFI = .999, RMR = .046, RMSEA ≤ .001) with the empirical data than the hypothetical model. 2. The variables directly affecting creative self-efficacy were self-leadership(β = .522, p < .05) and knowledge sharing of individual(β = .126, p < .05). These variables explained 37.5% creative self-efficacy. 3. The variables directly affecting innovative organization culture were knowledge sharing of organization(β = .419, p < .05) and self-leadership (β = .113, p < .05). These variables explained 24.4% of innovative organization culture. 4. The variables directly affecting individual innovative behavior were knowledge of individual(β = .406, p < .05), self-leadership(β = .325, p < .05), creative self-efficacy(β = .251, p < .05), and innovative organization culture(β = .141, p < .05). These variables explained 51.6% of individual innovative behavior. In conclusion, self-leadership, creative self-efficacy, and knowledge sharing of individual were shown to have a direct effect on individual innovative behavior, necessitating the development of various nursing interventions. Thus, in order to promote the innovative behavior of nurses, an knowledge sharing of organization must be established through the distribution of innovative organization culture. The innovative behavior of nurses and related factors were investigated, and the causal relationships among as well as effects of these variables were analyzed. The results of this study may contribute to the effective management of the individual and organization through the innovative behavior of nurses, and ultimately, provide directions for nursing interventions as well as qualified nursing for the patient.

간호사의 외상 후 스트레스 증상, 자아탄력성과 전문직 삶의 질

박수영 忠南大學校 大學院 2017 국내석사

This study was conducted to assess post-traumatic stress symptom, resilience and professional quality of life, identify correlations between variables, and identify factors affecting the professional quality of life among hospital nurses. Data were collected from 245 nurses working in three hospitals over 300 beds in D and S city in August 2016 using self administered questionnaires. Data were analyzed by pearson's correlation coefficient and multiple regression analysis. Post-traumatic stress symptom showed a significant positive correlation with compassion fatigue and burnout , negative correlation with resilience. Resilience showed a significant positive correlation with compassion satisfaction and negative correlation with burnout. Compassion satisfaction showed a significant positive correlation with compassion fatigue and negative correlation with burnout. Compassion fatigue showed a significant positive correlation with burnout. Post-traumatic stress symptom and resilience explained 36.2% of the nurses' compassion satisfaction. Post-traumatic stress symptom and resilience explained 20.8% of the nurses' compassion fatigue. Post-traumatic stress symptom and resilience explained 28.8% of the nurses' burnout. Resilience is a important factor which is affecting the professional quality of life, and facilitating positive coping with post-traumatic stress symptom.

환자중심간호 개념분석

이미현 忠南大學校 大學院 2019 국내박사

The purpose of this study is to clarify the concept of patient-centered nursing by confirming the properties of the attributes of patient-centered nursing of patients and nurses in hospital environment by using hybrid model. The electronic databases used for foreign literature searches are PubMed, CINAHL and the Cochrane Library and Google scholar. Domestic literature searches were conducted through RISS, NDSL, KISS, and Google scholar. The search period was from January 1, 2001, when the recommendations of the American Medical Association (IOM) were published to provide patient - centered care for quality improvement, to the most recent. The final attributes of patient-centered nursing were derived by comparing and analyzing the properties confirmed through the field work phase and the theoretical work phase based on literature review. Literature review in the theoretical work phase was final analysis of 24 out of the 4,942 documents retrieved. A total of 25 field work participants participated in the in-depth interviews, including 13 patients and 12 nurses. The results of this study are as follows. There were five attributes of patient centered nursing identified through the theoretical phase: individualized, participation, integration, holism and cooperation. The four attributes of the field work phase are as follows: individualized, participation, inclusiveness and centralization. The results of the comparative analysis of the theoretical phase and the field work phase of the patient centered nursing showed that the nurse should try actively in the individualization and participation of the field work phase. The integration and holism of the theoretical phase were identified as the inclusiveness of the fieldwork phase. In the theoretical phase, place the patient at the center of authority that has not been identified, patient-centered systems, and patient-centered collaboration with the community were derived. Collaboration at the theoretical level was identified as the center of the field work phase. In the final stage, four attributes of individualization, participation, inclusiveness, and centrality were extracted as attributes of patient- centered nursing and 21 significant topic bundles were identified. Based on the results of the final analysis, patient centered nursing is defined as follows. ‘Patient-centered nursing’ is the individualization of nursing for each patient and participation of the patient in the nursing process. It also provides the comprehensive care include standardized nursing knowledge, the treatment process according to the disease, multidisciplinary care physically, psychologically and emotionally, physical environment, maintaining continuity of care. It is defined as patient-centered nursing, where family, authority, teamwork, system, and community are all patient-centered.’ The results of this study will help to clarify the concept of patient-centered nursing in the domestic hospital environment, to provide information on both patients and nurses in patient-centered nursing, and to understand patient-centered nursing from the perspective of patients and nurses.