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저널/프로시딩 상세정보

권호별목차 / 소장처보기

H : 소장처정보

T : 목차정보

대한간호학회지= Journal of Korean academy of nursing 14건

  1. [국내논문]   하지석고붕대 적용에 의한 활동저하가 석고붕대 적용하지와 비적용하지의 둘레, 피부두겹두께 및 근력에 미치는 효과  

    최명애 (서울대학교 간호대학 ) , 박미정 (인산전문대학 ) , 채영란 (아산재단 서울중앙병원)
    대한간호학회지= Journal of Korean academy of nursing v.24 no.4 ,pp. 517 - 528 , 1994 , 1598-2874 ,

    초록

    The purpose of this study was to compare the circumference, skinfold thickness and strength of the normal and casted lower limb prior to casting and following removal of the cast. The subjects for the study were nine orthopedic patients who had had long and short leg casts due to a tibial, fibula, or calcaneus fracture, or to a lateral collateral ligament rupture. Circumference, skinfold thickness, and strength of the normal and casted lower limb following removal of the cast were compared with those prior to the application of the cast. Measurements were made before cast application and after removal of the cast. Skinfold thickness was measured by fat caliper, circumference was measured by tape and strength was determined by measuring the length of time the leg was held elevated at 45 $^{\circ}$ . The results can be summarized as follows 1. There was no change in the normal limb in the circumference of the midthigh and midcalf after casting as compared to before cast application. 2. In the casted limb the circumference of the midthigh decreased by 3.23% and that of the midcalf decreased significantly by 7.49% during the period of casting. 3. In the normal limb skinfold thickness of the quadriceps decreased and that of gastrocnemius increased by 20.63% during the period of cast application. 4. In the casted limb skinfold thickness of the quadriceps decreased significantly by 12.37% and that of gastrocnemius decreased by 10% during the period of cast application. 5. Strength of the normal lower extremity decreased significantly by 48.37% and that of casted lower extremity decreased remarkably by 73.07% during the period of cast application. 6. Circumference of the midthigh and the midcalf decreased significantly by 7.6% and 9.4% respectively on the casted side as compared to the normal side. Skinfold thickness of the quadriceps and the gastrocnemius on the casted side decreased by 6.12% and 18.55% respectively as compared to the normal side and strength in the lower extremity on the casted side decreased significantly by 44.32% as compared to the nor-mal side. From these results, it may be concluded that muscle atrophy occurs in the casted lower limb and muscle strength of the normal lower limb are also reduced during the period of application of a leg cast.

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  2. [국내논문]   암 환아 가족의 질병에 대한 불확실성과 대처양상에 관한 연구  

    민영숙 (혜전전문대학)
    대한간호학회지= Journal of Korean academy of nursing v.24 no.4 ,pp. 529 - 544 , 1994 , 1598-2874 ,

    초록

    For most parents their child's illness and hospitalization is strssful. Internal stress and over anxiousness leads to uncertainty. Parents have a variety of ways of coping when faced with such stress factors, especialy when the child has cancer. The purpose of this study was to examine the relationship between uncertainty in illness and mastery and coping styles in parents of pediatric cancer patients, and further to identify differences between three groups of subjects. A cross-sectional descriptive correlational design was used in this study to investigate the relationship among the three groups. The sample was composed of 59 parents of children with cancer in pediatric wards in three hospitals in Seoul : 21 in Group 4 with a child newly diagnosed with cancer : 25 in Group B, with a child under treatment and rehospitalized with a relapse : and 13 in Group C, with a child with a terminal cancer, A formalized questionnaire which included demegrapic information and consisted of 75 items was used in this study ; The Parent Perception of Uncertainty Scale(PPUS) adapted form Mishel's Uncertainty in Illness Scale, Pearlin & Schooler's Mastery Scale(MS) and Folkman & Lazarus's Ways of Coping Checklist(WCC) were used to measure the variables : uncertainty in illness, mastery, and coping styles. A pretest was conducted on the questionnaire items for reliability. The results gathered were analyzed using SPSS /PC/sup +/. Data analysis included descriptive correltional statistics such as ANOVA, Pearson Correlation Coefficient, amd chi square test. The conclusions of this analysis are summarized as follows : 1. A higher level of uncertainty was seen among parents of children with terminal cancer. 2. The first hypothesis that uncertainty in illness would differ among the three groups was supported(F=4.182, P=.020). The second and third hypotheses that mastery and coping styles would differ among the three groups were not supported. There was a correlation between uncertainty, mastery, and coping styles which was positive, also there was a positive correlation between mastery and coping style(r=.3744, P

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  3. [국내논문]   조기퇴원 수술환자의 병원중심 가정간호 효과 및 비용분석에 관한 연구  

    박경숙 (중앙대학교 의과대학 부속병원 ) , 정연강 (중앙대학교 의과대학 간호학과)
    대한간호학회지= Journal of Korean academy of nursing v.24 no.4 ,pp. 545 - 556 , 1994 , 1598-2874 ,

    초록

    Medical insurance and health care delivery system enabled Korean people to get the necessary medical service, but it caused increased needs for medical service, and resulted in the occurence of some problems such as a lack of manpower and medical facilities. In order to solve these problems, many countries, which already had medical insurance system had developed home care system and it has been regarded effective both in reducing costs and in increasing the rates of turnover of bed. Recently, Korea has included home nursing care in its health care delivery system, and some models of the hospital based home nursing care had been tried and its effects had been evaluated. So, author tried to run a home nursing care for the Cesarean section mothers and evaluate Its effects both in the mother's health and costs. This study was designed as a Quasi-experimental study. Subjects were thirty mothers who got Cesarean section operation in hospital in Seoul. Experimental group consisted of 15 volunteers, and control group were selected by means of matching technique. Data were gathered from February 1st to March 26th by two assistants who were trained by author. Experimental group were discharged on the 4th day after their operation, and got nursing care and assessment about their home three times on the 5th, 6th, and 7th day. Control group stayed in the hospital until 7th day as usual and were checked on the same day as above mentioned To evaluate the state of physiological recovery, vital signs, H.O.F, presence of edema in the legs, bathing, appetite, sleep, presence of pain or discomfort in the breasts, amount of lochia, color of lochia, defecation urination. To compare incidence of complication in experimental group with that in control group, specific assessment was done such variables as smell of lochia, presence of inflammation of operation wound, dizziness, and presence of immobilization in the extremities. The activities of daily living were checked Satisfaction of nursing were checked To calculate costs, author asked subjects to specify expenditure including hospital charge, traffic enpenses, and food expenses. The results were as fellows. 1. On effectiveness of home nursing careThere were n significant differences between experimental and control group in incidence of abnormal symptoms and any complication. The number of taking a bath [POD #5 P=0.001, #6 P=0.0003, #7 P=0.001] and the degree of appetite [POD #5 P=0.03, #6 P=0.02, #7 P=0.013] were significantly higher in experimental group than in control group. Contrary to author's expectation, the degree of the activities of daily living in experimental group was not higher than that of control group. All of the experimental group said they were satisfied with the home nursing care. 2. Cost analysis 1) Hospital charge of experimental group was lower than that of control group. [P=0.009] By taking home nursing care, average period of hospitalization was shortened to 3.1 days, and family members could save 22.8 hours. Total amount of money saved by early discharge was 3,443,093 Won. It is estimated that total amount of money saved by early discharge in a year will be 40,398,956 Won. 2) Home nursing care charge of 15 mothers was 1,781,633 Won. It is estimated that total amount of money Saved by it in a year Will be 20,904,493 Won. It was lower altogether than hospital charge of the three days which is 5th, 6th, 7th day of operation. The average cost of single home visit was calculated 10,940 Won. It took 87 minutes per round and it costed 1,017.3 Won. The average hour of home care was 39.0 minutes. 3) It is expected that early discharge can bring forth the increase of hospital income. On the condition that the rate of running bed is 100%, the expected increase of hospital income will be 202,374, 026 Won in a year. Suggestions for further study and nursing practice are as follows : 1. For the welfare of patients and the increased rates of running bed, home nursing care system s

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  4. [국내논문]   고위험 신생아 어머니의 지각과 정서  

    이자형 (이화여자대학교 간호대학)
    대한간호학회지= Journal of Korean academy of nursing v.24 no.4 ,pp. 557 - 567 , 1994 , 1598-2874 ,

    초록

    The purpose of this study was to defined mothers perception of their infants when the babies were high - risk babies, and to describe the feelings and responses of the mothers following on the birth of high - risk babies and on their hospitalization. The subjects of the study were 30 mothers of high-risk infants at D and M Hospital of E University. Data were collected between August 1993 and June 1994. Using the Neonatal Perception Inventory(NPI ) devised by Broussard to determine the perception of mothers and an open-ended, semi-structured interview which was conducted in the nursery room within 24 to 72 hours after delivery And NPI tested 1 month after the babies were discharged from the NICU also. Data were analyzed using SAS and content analy-sis. The results of this study are as follows ; 1. The mothers tended to perceive their infants positively, regardless of the condition of the infant. Mothers who perceived their infant negatively were slightly increased at 1 month after the babies were discharged from the NICU, but the difference was not statistically significant. 2. Mothers reported that they thought that the newborn can see and hear well, and also they can ex-press themselves. 3. There were many types of response noted such as anxiety, fear, helplessness, pity, resentment, guilt, resignation, hope, relief, appreciation, and feelings of being able to overcome the situation. These were differentiated into positive and negative responses. The finding of positive responses being expressed by mother of high -risk infants while their infants were in NICU was a unique finding especially, appreciation and feelings of being able overcome the situation. The results suggest the need for replication studies and for research on nursing interventions directed at improving the quality of life of high-risk infants and their mother.

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  5. [국내논문]   보건 진료원 제도 운영 평가에 관한 연구 -우리나라 1차 보건의료 제도 방향 재설정을 위하여 -  

    홍여신 (서울대학교 간호대학 ) , 이인숙 (서울대학교 간호대학)
    대한간호학회지= Journal of Korean academy of nursing v.24 no.4 ,pp. 568 - 583 , 1994 , 1598-2874 ,

    초록

    In the changing social and economic conditions, reorientation of the health care system is a process of rearranging health care resources keeping in mind the appropriativeness, relevancy, and efficacy of health care programs. Also it has been recognized recently that the CHP program is in need of review for the same reasons, that is to say, the ease in which health care facilities are available, the high rate of coverage with insurance and the development of an effective transportation system. Therefore there is a social inclination to think that there are no remote areas and to question the roles of public health facilities, health centers, health sub centers and CHP posts. This paper was done to review problems and to propose new directions for the CHP system. The findings of this study are as follows ; 1) It is necessary that primary health care should be simplified into three parts, medical treatment, preventive care services and the organization of administration and logistics. Also each department should be supplemented with the appropriate professional personnel in order to develop a task oriented system. The reorientation of the CHP system should be managed in keeping with that of other public health care systems. Therefore it is necessary to look at the CHP system problems as one aspect of the reorientation process of public health care systems, and to work to find new ways to address these problems. 2) The location of the CHP post should be decided by the needs of the community in both the medical and preventive areas. If the people have a minimum need, the location of the CHP post should be altered and the existing roles of the CHP should be modified to allow for flexibility according to the community needs. 3) Use of the problem solving method in regular team meetings will prove to be as efficient as continuing education programs in improving job competancy. 4) The supervision of CHP's activities should be made by the same type professional personnel, that is, senior CHPs or charge nurses in the public health center at the county level. 5) The operational expensies of CHP post should be supported by the administrative department of the public health center and should create working conditions that will allow the CHP to concentrate on community health service programs. 6) The organizations for community participation, working committees, community health workers and a number of the local assembly, should be activated to provide for participation in finding solutions to health related problems in the com-munity.

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  6. [국내논문]   간호생산성에 관한 연구: 관련변수의 검증을 중심으로  

    박광옥 (아산재단 서울중앙병원)
    대한간호학회지= Journal of Korean academy of nursing v.24 no.4 ,pp. 584 - 596 , 1994 , 1598-2874 ,

    초록

    The objective of the study is to explore the relationships between the variables of nursing productivity on the framework of system del in the tertiary university based care hospital in Korea. Productivity is basically defined as the relation-ship between inputs and outputs. Under the proposition that the nursing unit is a system that produces nursing care output using personal and material resources through the nursing intervention and nursing care management. And this major conception of nursing productivity system comproises input, process and output and feed-back. These categorized variables are essential parts to produce desirable and meaningful out-put. While nursing personnel from head nurse to staff nurses cooperate with each other, the head nurse directs her subordinates to achieve the goal of nursing care unit. In this procedure, the head nurse uses the leadership of authority and benevolence. Meantime nursing productivity will be greatly influenced by environment and surrounding organizational structures, and by also the operational objectives, the policy and standards of procedures. For the study of nursing productivity one sample hospital with 15 general nursing care units was selected. Research data were collected for 3 weeks from May 31 to June 20 in 1993. Input variables were measured in terms of both the served and the server. And patient classification scores were measured drily by degree of nursing care needs that indicated patent case-mix. And also nurses' educational period for profession and clinical experience and the score of nurses' personality were measured as producer input variables by the questionnaires. The process varialbes act necessarily on leading input resources and result in desirable nursing outputs. Thus the head nurse's leadership perceived by her followers is defined as process variable. The output variables were defined as length of stay, average nursing care hours per patient a day the score of quality of nursing care, the score of patient satisfaction, the score of nurse's job satis-faction. The nursing unit was the basis of analysis, and various statistical analyses were used : Reliability analysis(Cronbach's alpha) for 5 measurement tools and Pearson-correlation analysis, multiple regression analysis, and canonical correlation analysis for the test of the relationship among the variables. The results were as follows : 1. Significant positive relationship between the score of patient classification and length of stay was found(r=.6095, p.008). 2. Regression coefficient between the score of patient classification and length of stay was significant (β=.6245, p=.0128), and variance explained was 39%. 3. Significant positive relationship between nurses' educational period and length of stay was found(r=-.4546, p=.044). 5. Regression coefficient between nurses' educational period and the score of quality of nursing care was significant (β=.5600, p=.029), and variance explained was 31.4%. 6. Significant positive relationship between the score of head nurse's leadership of authoritic characteristics and the length of stay was found (r=.5869, p=.011). 7. Significant negative relationship between the score of head nurse's leadership of benevolent characteristics and average nursing care hours was found(r=-.4578, p=.043). 8. Regression coefficient between the score of head nurse's leadership of benevolent characteristics and average nursing care hours was significant(β=-.6912, p=.0043), variance explained was 47.8%. 9. Significant positive relationship between the score of the head nurse's leadership of benevolent characteristics and the score of nurses' job satis-faction was found(r=.4499, p=050). 10. A significant canonical correlation was found between the group of the independent variables consisted of the score of the nurses' personality, the score of the head nurse's leadership of authoritic characteristics and the group of the dependent variables consisted of the length of stay,

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  7. [국내논문]   만성 재가 기동장애자의 가정병실 모델 개발을 위한 현장 연구  

    김태연 (중앙대학교 의과대학 간호학과 ) , 정연강 (중앙대학교 의과대학 간호학과)
    대한간호학회지= Journal of Korean academy of nursing v.24 no.4 ,pp. 597 - 615 , 1994 , 1598-2874 ,

    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

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  8. [국내논문]   강인성 (Hardiness)의 개념 분석  

    이영애 (원광보건전문대학)
    대한간호학회지= Journal of Korean academy of nursing v.24 no.4 ,pp. 616 - 622 , 1994 , 1598-2874 ,

    초록

    Precise concept analysis has been neglected be-cause of a lack of understanding of its necessity and a lack of conceptual analytic knowledge. Concept analysis is the mental work of examining parts, phenomenon and the interrelated whole of a thing. Focus in this article is to extract the critical attributes of hardiness and make an operational delinition. The process of concept analysis is illustrated and documented using the analytic approach described by Walker and Avant (1983). To explore the explicit or implicit meanings of hardiness, existing literature was reviewed. The evolution of hardiness and the dictionary definitions were also added. Hardiness can be defined as follows : A condition of being inured to fatigue or hardship which has three subcomponents-challenge, control and commitment. Critical attributes of hardiness were extracted that may be used in naming the occurrence of the phenomenon. Model case, contrary case, borderline case and related case were described. Antecedents and consequences were explored. The defining critical attributes of hardiness are : 1. Resistance-hardiness involves resistance of stress or hardship. 2. Hardiness involves appraisal of change as a chance. 3. Hardiness implies interpretation of events and self as influential,. 4. Hardiness requires active involving reaction Implications for nursing and for further study are added.

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  9. [국내논문]   폐경에 대한 적응 과정  

    이미라 (중앙대학교 의과대학 간호학과)
    대한간호학회지= Journal of Korean academy of nursing v.24 no.4 ,pp. 623 - 634 , 1994 , 1598-2874 ,

    초록

    Although the average menopausal age has not changed, women's life span has increased. Today's women live longer after their menopause than those in the past, and this calls for attention in both nursing and medical fields. Many studies have revealed how women reacted to menopause and suffered from it. But they did not discriminate the menopausal meaning and effects from the climacteric phenomena. So, this author tried to clarify what menopause itself meant to the climacteric women, by means of grounded theory methodology. The interviewees were 21 women, whose ages were between 46 and 60 years. They were selected by theoretical sampling technique, and the author tried to include all levels of important variables such as age, educational background, religion and job. Data were collected by the author through in -depth interviews and observations in July, 1994. The interviews were mostly done in the homes of the subjects, or in some cases at the author's office or in a hospital. Interviews took from 30 minutes to 2 hours. Interviews were tape recorded and transcribed later by a research assistant. Data were analyzed as gathered, by the constant comparative method proposed by Strauss and Corbin. Eleven concepts were discovered from the data, and they were grouped under six higher order categories. These six categories were "to give menopause a meaning", "to experience value change", "to have self-help strategies", "to have no strategies", "to live a life worth living", "to have a sense of powerlessness" Among these "to experionce value change" was . selected as the core category. Five major categories were systematically integrated around the core category. Women's adaptation to menopause was defined as proceeding as follows : Most women felt relief and sorrow at the same time when they faced menopause, and some only sorrow or agony. Then, they consulted with others about menopausal symptoms, or tried to think of them by themselves. Finally, they gave menopause a meaning, which was that menopause and its symptoms were natural phenomena. But menopause made women reflect on them-selves and their past lives. As they reflected on themselves, their value on life began to change. As their value changed, some women seeked self help strategies. Those self help strategies were what they had learned from collegues, professionals or mass media. The quality of their lives depended on whether they practiced self help strategies or not. Three types of lives were found. Twelve women enjoyed a life worth living, and practiced the self help strategies, because they accepted menopause a chance to change. They were characterized by a high educational level, having a professional job and a sincere faith in God. Seven women were living as usual, because they did not have the necessity to change. They were high school graduates and house wives. Two women recognized menopause a chance to change, but they did not try self help strategies. Their characteristic was low educational level. Those who did not try self help strategies complained of powerlessness to varying degrees. The educational background, full-time jobs and faith helped women adapt to menopause positively. But social support was not helpful to women's adaptation to menepause. Three hypotheses were derived from the analysis. (1) The higher the educational level, the more theneed to change. (2) Women with higher educational background will practice self help strategies more than those with lower edcational background. (3) The more women practice self help strategies, the worthier lives they will live. Suggestions for further studies are as follows. (1) Studies to test hypotheses are needed. (2) A study to find the relationship between the degree of practicing self help strategies and locus of control. (3) Spiritual approaches would better be applied to help menopausal women. (4) Education through mass media should be given mere frequently.

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  10. [국내논문]   당뇨병 환자의 자기효능, 자기조절, 상황적 장애, 자기간호행위간의 관계  

    구미옥 (경상의대 간호학과)
    대한간호학회지= Journal of Korean academy of nursing v.24 no.4 ,pp. 635 - 651 , 1994 , 1598-2874 ,

    초록

    The purpose of this study was to identify the degree of self efficacy, self regulation, situational barriers and self care behavior in patients with diabetes and to identify the relationships among those variables. Ninety five non insulin dependent diabetic patients participated. Data were collected by a self report questionnaire. The results are as follows 1) Mean scores for self care behavior were 4.64 (diet) and 6.60(medication) on a 7 point scale. 2) Mean scores for self efficacy were 65.12(diet) and 88.46 (medication) on a 100 point scale. 3) Mean score for self regulation was 0.42 on a 0-1 point scale. 4) Mean score for situational barriers was 1.48 on a 4 point scale. 5) Self efficacy was significantly highly correlated with self care behavior (r=0.72, P

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