• Title/Summary/Keyword: 간호사 분포

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Types of Shared Medical Decision Making for Terminally Ill Patients (말기 환자의 공유 의료적 의사결정에 관한 의료인의 인식 유형)

  • Jo, Kae Hwa;Kim, Gyun Moo
    • Journal of Hospice and Palliative Care
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    • v.17 no.4
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    • pp.278-288
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    • 2014
  • Purpose: The purpose of this study is to analyze types of shared medical decision making by health professionals in a decision making position. Methods: The Q-methodology was used. Q sample was constructed with a total of 35 Q-statements that were offered with a 9-point rating scale. The statements were structured to generate answers that would form a shape of a normal distribution. Answers to Q sample were analyzed using a QUANL PC program. Results: Four types of shared medical decision making were identified. Type I is patient-centered decision making, Type II is physician-centered, Type III is health professional-centered and Type IV is patient-family-centered. Conclusion: Study results indicate that it is recommended to develop an education program based on the four types of shared medical decision making so that health professionals can be provided with different approaches according to their decision making style.

The Measurement of Spatial Dose Rate by Gravity Ventilation after Technegas Scanning (Technegas 스캐닝 후 중력환기에 의한 공간선량율 측정)

  • Kim, Sung-Bin;Won, Do-Yeon
    • Journal of the Korean Society of Radiology
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    • v.13 no.4
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    • pp.667-674
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    • 2019
  • Because examination with technegas produces images through simple diffusion accumulation, the examination room can become contaminated after scan. Therefore, radiation workers and patients awaiting examination will be affected by internal exposure from technegas inhalation. Before and after gravity ventilation, I am trying to find a way to reduce the exposure dose of waiting patients according to a comparative analysis of horizontal spatial dose rates over time. Spatial dose ratio were measured for 10 minutes from various distances and angles around ventilator's location before and after gravity ventilation. Then, mean values, standard deviation and reduction ratio were calculated. The highest reduction rate of gravity ventilation was 95.31% and the highest reduction ratio was 1 to 3 minutes. Therefore, the gravity ventilation could reduce the exposure dose of radiologic technologists, waiting patients, patient guardians and nurses. In conclusion, the reduction of the exposure dose during the technegas ventilation study through gravity ventilation will play a role in optimiging the protection and it is in accordance with the recommended reduction of the medical exposure by ICRP 103.

A Study on the Individual Radiation Exposure of Medical Facility Nuclear Workers by Job (의료기관 핵의학 종사자의 직무 별 개인피폭선량에 관한 연구)

  • Kang, Chun-Goo;Oh, Ki-Baek;Park, Hoon-Hee;Oh, Shin-Hyun;Park, Min-Soo;Kim, Jung-Yul;Lee, Jin-Kyu;Na, Soo-Kyung;Kim, Jae-Sam;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.2
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    • pp.9-16
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    • 2010
  • Purpose: With increasing medical use of radiation and radioactive isotopes, there is a need to better manage the risk of radiation exposure. This study aims to grasp and analyze the individual radiation exposure situations of radiation-related workers in a medical facility by specific job, in order to instill awareness of radiation danger and to assist in safety and radiation exposure management for such workers. Materials and Methods: 1 January 2007 to 31 December 2009 to work in medical institutions are classified as radiation workers Nuclear personal radiation dosimeter regularly, continuously administered survey of 40 workers in three years of occupation to target, Imaging Unit beautifully, age, dose sector, job function-related tasks to identify the average annual dose for a deep dose, respectively, were analyzed. The frequency analysis and ANOVA analysis was performed. Results: Imaging Unit beautifully three years the annual dose PET and PET/CT in the work room 11.06~12.62 mSv dose showed the highest, gamma camera injection room 11.72 mSv with a higher average annual dose of occupation by the clinical technicians 8.92 mSv the highest, radiological 7.50 mSv, a nurse 2.61 mSv, the researchers 0.69 mSv, received 0.48 mSv, 0.35 mSv doctors orderly, and detail work employed the average annual dose of the PET and PET/CT work is 12.09 mSv showed the highest radiation dose, gamma camera injection work the 11.72 mSv, gamma camera imaging work 4.92 mSv, treatment and safety management and 2.98 mSv, a nurse working 2.96 mSv, management of 1.72 mSv, work image analysis 0.92 mSv, reading task 0.54 mSv, with receiving 0.51 mSv, 0.29 mSv research work, respectively. Dose sector average annual dose of the study subjects, 15 people (37.5%) than the 1 mSv dose distribution and 5 people (12.5%) and 1.01~5.0 mSv with the dose distribution was less than, 5.01~10.0 mSv in the 14 people (35.0%), 10.01~20.0 mSv in the 6 people (15.0%) of the distribution were analyzed. The average annual dose according to age in occupations that radiological workers 25~34 years old have the highest average of 8.69 mSv dose showed the average annual dose of tenure of 5~9 years in jobs radiation workers in the 9.5 mSv The average was the highest dose. Conclusion: These results suggest that medical radiation workers working in Nuclear Medicine radiation safety management of the majority of the current were carried out in the effectiveness, depending on job characteristics has been found that many differences. However, this requires efforts to minimize radiation exposure, and systematic training for them and for reasonable radiation exposure management system is needed.

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Attitude of Hospital Staff toward Hospice Care - The Program at Wonju Christian Hospital - (일 병원직원들의 호스피스 프로그램에 대한 인식)

  • Choi, Sang-Soon;Hu, Hea-Kung;Park, So-Mi;Kim, Dae-Ran;Kim, Ki-Kyong;Rhoe, Byoung-Seon
    • Journal of Hospice and Palliative Care
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    • v.4 no.2
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    • pp.145-153
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    • 2001
  • Purpose : This study was conducted to describe the attitude of hospital staff toward the hospice program. The purpose of this study was to promote the extension and organization of hospice activities to include hospital staff. Method : This is a descriptive study using a survey method. The subjects for this study were the nurses, physicians, technicians, and support staff at Wonju Christian Hospital. Using a stratified sampling method based on position of staff, the researchers recruited 430 staff members as the sample for this study. Data collection was done through a questionnaire developed by the researchers. The data were analyzed using descriptive statistics and content analysis. Findings : 1)Ninety seven percent (n=417) of the subjects understood the concept of hospice care, and 97.4% (n=419) answered that dying patients should be respected. When considering the hospice team, the subjects of this study indicated that the team should include family members (n=245), physicians (n=77), pastors (n=41), and nurses (n=34), in that order of priority. 2) When asked to indicate priorities for systematic operation of a hospice program, the subjects indicated that the highest priority was "setting up a team for hospice service(31.4%)", followed by "setting up a hospice ward(28.6%)". Sixty seven percent(n=289) recognized the importance of the hospice activities provided by the volunteers, and 85.3%(n=367) intended to use the hospice service of the hospital. The highest merit of hospital-based hospice program is 'acomplishment of mission'. 3) The average score on attitude toward death was 2.84(maximum=4), and the best needful service except hospitalization is 'constructing of support system'. Conclusion : Most of the staff at Wonju Christian Hospital perceive the necessity for systematic hospice activities, and that to achieve this goal, administrative and structural support at the hospital governance level is the first necessity. The results of this study could be useful for any hospital which is in the first stages of setting up and promoting a hospice program.

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Subjectivity of Parents in Refusal of Childhood Vaccination: A Q-methodology Approach (자녀 예방접종 거부 부모의 주관성: Q 방법론적 접근)

  • Cha, Hye-Gyeong;Ha, Eun-Ho
    • Child Health Nursing Research
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    • v.19 no.3
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    • pp.216-227
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    • 2013
  • Purpose: Despite the well-known public health benefits of vaccination, increasing public concern about the safety of childhood vaccinations has led some parents to refuse or hesitate having their children immunized. The purpose of this study was to identify the subjectivity of parents toward refusal of childhood vaccination. Methods: Q-methodology, in which subjective viewpoints are explored and analyzed using a combination of quantitative and qualitative techniques, was used. Thirty-five participants were asked to rank 42 statements on diverse issues of childhood vaccination according to a continuous 9-point scale ranging from -4 for strongly disagree to +4 for strongly agree. Collected data was analyzed using the PC-QUANAL program. Results: The results revealed three discrete groups of parents in the refusal of children's immunization: type I, distrust; type II, concern about side effects, and type III, belief that vaccinations are unnecessary. Conclusion: Special nurse counselors who can provide correct information about vaccination based on the three types should be part of the government policy. Customized education programs to shift viewpoints should be also redeveloped according to the results in this study.

The Relationship between Alcohol Drinking Patterns and Blood Pressure in Some Rural Elderly Aged 60~64 (일부 60~64세 농촌노인에서 음주양상과 혈압과의 관련성)

  • Lee, Moo-Sik;Bae, Jang-Ho;Park, Ki-Rack;Lee, Choong-Won
    • Journal of agricultural medicine and community health
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    • v.26 no.1
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    • pp.1-17
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    • 2001
  • This study was conducted to investigate the role of drinking pattern in the relationship of alcohol consumption by face-to-face interview in rural elderly(n=994) aged 60~64 in Dalsung County, April to September in 1996. Pattern of alcohol drinking included drinking status, alcohol drinking at the morning without breakfast, average drinks per day, frequency of drinks per month, quantity of alcohol drinking, kind of preferred alcoholic beverage and duration of alcohol drinking. Blood pressure was measured once in each subject using a portable automatic sphygmomanometer. Difference in means of systolic blood pressure, alcohol drinking status, alcohol drinking at the morning without breakfast, and kind of alcoholic beverage were statistically significant before adjusting covariates, but alcohol drinking status and alcohol drinking at the morning without breakfast were statistically significant after adjusting covariates. And difference in means of diastolic blood pressure, kinds of alcoholic beverage was statistically significant before adjusting covariates, but no variables was significant after adjusting covariates. Model I multiple regression for systolic blood pressure that included average drinks per day as the variable of drink pattern, age, educational attainment and, previous history of cardiovascular disease were statistically significant, and multiple regression for diastolic blood pressure, educational attainment, BMI, and previous history of cardiovascular disease were statistically significant. Model II multiple regression for systolic blood pressure that included drinking patterns variables except average drinks per day, previous history of cardiovascular disease were statistically significant. However, multiple regression for diastolic blood pressure, no variables were significant. So, inconsistent with prior research, a positive relationship was not found between average drinks per day and diastolic and systolic blood pressure. The effect of alcohol drinking patterns on blood pressure has public health as well as clinical relevance. The study should be replicated to determine the reliability of our findings.

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A Study on Estimation of Caring Demand for Extended Care Facilities by Activities of Daily Living (ADL(Activities of Daily Living)을 이용한 무료노인요양시설 수용노인의 돌봄필요도에 관한 연구)

  • Kim, Chul-Woung;Moon, Ok-Ryun;Lee, Sang-Yi;Yoo, Jae-Won;Yi, Sang-Gu
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.3 s.62
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    • pp.564-578
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    • 1998
  • Most extended care facilities have admitted both the healthy and unhealthy elderly, among which members' average caring demand vary. The Aged Welfare Law, however, currently provides no reasonable basis on the staffing policy for extended care facilities. It just reflects the admitted number of the elderly rather than differences in members' average caring demand among facilities. This study is designed to estimate the need for caring staff on the basis of the correlation between the individual health status measured by various tools including Activities of Daily Living and caring demand by actual service time for each one. The sample included all of the admitted elderly(187 persons) in 4 extended care facilities, two in Seoul and the other two in Kangwon-Do over the survey period October 5 through October 20, 1996. The survey process consisted of 3 stages. (1) The current staffing information was collected through self-completed written questionnaires left for head of official in each facility. (2) Six graduate students at School of Public Health interviewed all residents to collect information on their health status and sociodemographics. The response rate for the interview was relatively high(85%). (3) Information on direct and indirect caring time consumed for each residents came from self-completed written questionnaires given to nurses and helpers in each target facilities. Analysis of the data was made using Pearson's correlation and multiple regression technique through SAS program. Based on this procedure, the following was found. 1. No facility meet the staffing standard in the Aged Welfare Law completely. 2. It is actual service time that is most correlated with ADL(Activities of daily living). 3. When all of the elderly are divided by four groups based on the level of ADL, the mean values of needed caring time in each group are 15, 21, 36 and 88 minutes respectively. 4. There is no significant difference among facilities in distribution of elderly person by group. 5. No facility meets the estimated number of nurses and helpers which reflects health status of the admitted elderly. Therefore, it is required that severity of the admitted elderly be considered in establishing staffing standard for extended care facility.

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Cost Analysis of Home Nursing Care Patients in Rural Hospital (농촌 지역 중소병원의 가정간호사업소 등록환자의 방문비용분석)

  • Kim, Jin-Soon;Kum, Ran;HwangBo, Soo-Ja
    • Journal of agricultural medicine and community health
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    • v.24 no.1
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    • pp.91-101
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    • 1999
  • The home nursing care system is an integral part of the health care delivery system in order to meet the various needs of consummer, in particular, early discharge patient from the hospital, patient with long term care needed and the elderly. To find out the cost of home nursing care services, the home nursing care records of patients registered by home nursing care units established in public hospital with 150beds during the period of 1996 - 1997 were analyzed. The subjects were 102patients, 45 of male patients and 57 of female patients, those who live in a rural area in Kymiggi - Do The results obtained are as follows : 1. The male patients accounted for 44.1% of the total, with 45cases : group aged 60 years and more was the largest group, accounting for 79.5%. 2. The most frequent disease revealed was the osteoporosis which constitute 35.3% of the total registered patients, followed, in order, by malignant tumor, cerebrovascular disease. 3. It revealed that the cost per visit for the male was 47,764won ; the female, 46,078 won per visit. Noteworthy the cost per visit was high in the older patient. It was clearly that the gender, years of age and the cost per visit were statistically significant at 0.01 level and 0.05 level. 4. The cost per visit for the non complicated disease was slightly higher than the complicated disease, but it is not statistically significant, the cost per visit by type of disease varied, the cost per visit for COPD was the highest, followed, in order, by in malignant tumor, cancer, diabetes, osteoporosis etc. 5. It revealed that home nursing care cost for a eligible disease for home nursing care was less than the cost for hospitalization of the same disease, therefore, we expect that the home nursing care is cost efficiency. In conclusion, the home nursing care costs are needed to analyze further in comparison with the hospitalization costs for a certain disease.

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The Social Psychological Meaning of Occupation-related Identities among Generations (세대에 따른 직업 관련 사회정체성의 사회심리학적 의미)

  • Choi, Yu-Jung;Choi, Set-Byol;Lee, Myoung-Jin
    • Korea journal of population studies
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    • v.34 no.3
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    • pp.55-84
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    • 2011
  • This study initiated with the intention to reveal the social consultations and fissures through a comparative analysis on generational characteristics by indicating occupation-related identities with the concept of social identity supported by theoretical resources. According to the three dimensions of social identity which are evaluation, potency and activity, there was more generational agreement rather than difference toward occupation-related identities. Among the 44 identities, only evaluation dimensions on minister, congressman, plane captain, farmer and potency dimensions on CEO of a major companies, professor, medical doctor, nurse, celebrity, shaman, unemployed person were statistically significant. For 'Leader and Professional', the respondents in their 50's gave high scores in both evaluation and potency dimensions. On the other side, the 30's had negative viewpoints while the 20's and 40's had neutral perspectives. For the potency dimension, the age groups were divided into the 20's, 30's and 40's, 50's; having the younger generations underestimate the potency dimension of such categories. Also for the 'General Occupation', 20's and the 30's relatively devaluated with more distinctive degree toward evaluation dimensions. For religion, 20's and 30's were positive toward buddhist monks while the 40's and 50's were more favorable with priests. For the non-economically active population, the lifetime cycle influenced each generations. When performing a two dimensional analysis toward the 'Leader and Professional' with evaluation and potency on each axis, the 50's highly evaluated both evaluation and potency dimension of such identities. However, for the 40's, 30's and 20's, the average value fell while the focus of the distribution deepened. The 30's had negative perspective toward the evaluation dimension while the 20's reflected critical attitude toward the potency dimension.

Hand Hygiene Compliance of Healthcare Workers in a Children's Hospital (소아병원 종사자의 손 위생 수행)

  • Oh, Hyang Soon
    • Pediatric Infection and Vaccine
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    • v.22 no.3
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    • pp.186-193
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    • 2015
  • Purpose: The aim of study was to estimate the hand hygiene (HH) compliance of healthcare workers (HCWs) in a children's hospital. Methods: This study was conducted in a hospital which is a tertiary and educational children's hospital with 313 beds and 533 HCWs. Data were collected by direct observation methods from November 1, 2010 to December 31, 2010. Results: A total of 2,999 opportunities for HH were observed, and the overall HH rate was 95.3%. HH rate of the registered nurse, physicians and transferer was 97.7%, 89.2%, and 72.1%, respectively (P<0.001). Among physicians, HH rate of the fellows, professors, residents and interns was 97.5%, 93.9%, 89.7%, and 80.9%, respectively (P<0.001). HH rate in the emergency room, operation room, outpatient department (OPD), and the intensive care unit (ICU) was 97.2%, 97.2%, 95.4%, and 92.5%, respectively (P<0.001). Hand rubbing was the most frequently used (81.1%), and hand washing was frequently used in the case of 'after body fluids exposure risk' (37.7%) and 'after touching patient surroundings' (28.5%). HH methods were not statistically different from each departments (P =0.083), however, they were significantly different according to the World Health Organization (WHO) 5 Moments (P<0.001). Distributions in WHO 5 Moments by the job titles were significantly different (P<0.001). The odds ratio of physicians, ICU and OPD was 0.353 (95% CI, 0.241-0.519), 0.291 (95% CI, 0.174-0.487), and 0.484 (95% CI, 0.281-0.834), respectively. Conclusions: Compliance of HH was different by the job titles and departments. Effective custom-tailored HH programs for each job title and department need to be developed.