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만성 재가 기동장애자의 가정병실 모델 개발을 위한 현장 연구
A Ethnographic Field Study for a Model Development of the Chronic Bed-ridden Patient s Home-ward

김태연    (중앙대학교 의과대학 간호학과   ); 정연강    (중앙대학교 의과대학 간호학과  );
  • 초록

    This study is designed to facilitate the creation of home environment conducive to the family taking care of chronic bed-ridden patients with more effective method. The need for this study has emerged against the background of marked changes in the structure of ailments and causes of death, resulting in the number and plights of chronic bed-ridden patients as well as of a rapid increase in demand for medical care and resulting premature discharge. Keeping these in mind, this study focused on home-wards where the majority of chronic bed-ridden patients are being cared for. Despite. their overriding importance, home-words are less than efficient in caring (or chronic bed-ridden patients. These circumstances require the designing of home-wards that can offer greater comfort to patients and at the same time make things easier for caregivers, on the basis of an overall analysis of patients' life and home - ward situation. According1y this study adopted a Participant Observation Method derived cultural anthropology, Toward this end, 3 patients were chosen as subjects of this study for intensive interviewing and participant observation. In the process of this field re-search efforts were made to collect emprical data, that is, to faithfully record the words of the subjects and their caregivers for analysis and interpretation. The findings of these analyses are as follows. Firstly, the chronic bed-ridden patients are mostly being taken care by close family members. Secondly, a room for the exclusive use of the patient, floor, kitchen, bathroom and multipurpose space were found to be necessary for proper caring of the patient. These spaces were respectively used with a view to 1) accomodating the patient as well as caregivers' activities, 2) keeping general and medical supplies and other appliances for patient's care and drying the patient's washing, 3) preparing and keeping the patient's foods and beverages, 4) keeping the supplies necessary for cleaning the patient's body and treating the patient's eliminations, 5) washing the patient's clothes, underwears and bedclothes. The patient's room in turn is subdivided into six portions in terms of uses : specifically the places for accomodating 1) the patient, 2) medical supplies, 3) medicines, 4) linens St clothes, 5) bedclothes and, 6) diapers. Thirdly, the activities of the caregiver are subdivided into seven key areas : hygiene, exercise, diet, elimination, therapeutic nursing, prevention of sore, and other activities. Each area is further classified into several different activities of caring. These activities we mainly carried out in the patient's room. Fourthly, the supplies for caring the chronic bed-ridden patient is divided into two large domains : medical and general supplies. Finally, three main problems areas were found in this study on the part of caregivers, that is, sore prevention, hygiene problem related frequent urination / defecation, the caregiver's physical, psych ological and emotional burden. In consideration of the aforesaid problem areas, a model home-ward was developed in this study. The newly-developed model has been found to have the following six advantages. Firstly, the time and effort required for maintaining the patient's hygiene are reduced, thus relievins the caregiver's physical and psychological bur-den. Secondly, the patient's hygiene can be maintained in satisfactory conditions, because the patient's eliminations are more easily removed. Thirdly, skin irritations caused by the patient's eliminations were remarkably reduced and so were the patient's sores due to moisture and bacteria. Fourthly, the home-ward have a tilt-table ef-fect thanks to the inclining room floor. This improves the patient's cardiovascular function as well as constantly changes pressed skin areas and thus prevents sores. Fifthly, improved shelf arrangements help make the best use of patient's supplies. Sixthly, the trouble of continuously changing clothes, underwears, diapers & be


  • 주제어

    기동장애자 .   가정병실 현장연구.  

 저자의 다른 논문

  • 정연강 (46)

    1. 1983 "I. 지역사회 간호관리의 정의와 원칙" 대한간호 = The Korean nurse 22 (4): 35~38    
    2. 1986 "직장의료보험 수진분석을 통한 만성 순환기계질환의 실태연구" 대한간호학회지= Journal of Korean academy of nursing 16 (3): 38~66    
    3. 1988 "간호교육 철학정립 및 교육과정 개발을 위한 기초조사" 대한간호학회지= Journal of Korean academy of nursing 18 (2): 162~188    
    4. 1988 "서울시 산업간호사의 업무에 관한 조사 연구" 대한간호 = The Korean nurse 26 (5): 81~101    
    5. 1989 "양호겸직교사의 학교보건간호 업무활동에 관한 조사연구" 韓國學校保健學會誌 = The Journal of the Korean society of school health 2 (1): 108~130    
    6. 1989 "서울시 산업간호사의 배치현황 및 간호업무 제공 실태에 관한 연구" 지역사회간호학회지 = Journal of korean academy of community health nursing 1 (1): 238~275    
    7. 1993 "초등학교(國民學校) 교과서별(敎科書別) 구강보건(口腔保健)에 관(關)한 실태분석(實態分析)" 韓國學校保健學會誌 = The Journal of the Korean society of school health 6 (2): 56~68    
    8. 1993 "학생(學生)의 건강행위(健康行爲), 신념(信念), 가치(價値) 및 보건의료(保建醫療) 이용(利用)에 미치는 영향(影響)에 관(關)한 연구 -가족(家族)의 형태(形態) 및 제특성(諸特性)을 중심(中心)으로-" 韓國學校保健學會誌 = The Journal of the Korean society of school health 6 (1): 9~44    
    9. 1994 "조기퇴원 수술환자의 병원중심 가정간호 효과 및 비용분석에 관한 연구" 대한간호학회지= Journal of Korean academy of nursing 24 (4): 545~556    
    10. 1994 "학교보건간호를 통한 금연 교육의 실태에 관한 연구" 韓國學校保健學會誌 = The Journal of the Korean society of school health 7 (2): 135~143    

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