• 한국산학기술학회논문지
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• 제11권12호
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• pp.4863-4872
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• 2010

본 연구는 농 어촌지역 환자들을 대상으로 질병양상을 살펴보고 의료이용 실태를 분석하여 농 어촌지역 의료 관련 기관의 보건의료서비스 계획수립에 필요한 자료를 제공 하고자 시행되었다. 노령화가 진행된 농 어촌지역 G도 G군에 소재한 종합병원을 대상으로 2009년 7월부터 12월까지 6개월 동안 퇴원환자 2,365건 전수의 의무기록 자료를 토대로 분석하였다. 분석결과, 조사대상 환자의 성별은 남자 55.3%, 여자 44.7%, 연령별은 70세 이상 후기 고령자가 42%로 나타냈다. 입원유형별로는 외래경유 입원환자가 65.5%이며, 진료과목으로는 내과 49.7%, 정형외과 16.7%, 신경외과 13.8% 순이었다. 주 진단명(3단 분류)별 10대 다 빈도에서 S00-T98 18.4%, J00-J99 15.5%, I00-I99 11.5% 순이었다. 평균재원일수는 14.8일이었으며, 주 진단명을 포함한 상병개수는 평균 5.6개이었다. 주 진단명(3단 분류) 다빈도 10대에서 성별, 보험유형별, 입원경로, 연령별 분포 등이 통계적으로 유의한 차이가 있었다. 월별 주 진단명(3단 분류) 다 빈도 10대 분류 분포는 통계적 유의한 차이가 있었다. 주 진단명(3단 분류) 다 빈도 10대분류에 따른 평균재원일수와 상병개수는 통계적으로 유의한 차이가 있었다. 결론적으로, 농 어촌지역의 질병분포는 작업환경과 연중 신체적 무리가 가는 노동행위에 따른 외상성 질환 및 호흡기 질환과 노령화에 따른 각종 만성질환 등 이었다.

• 농촌의학ㆍ지역보건
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• 제33권2호
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• pp.232-242
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• 2008

- Abstract - Objectives: We examined the effects of diabetes mellitus (DM) case management program developed by National Health Insurance Corporation in Korea. Methods: One trained nurse performed the case management for 30 DM patients recruited through the reimbursement information of National Health Insurance in a rural community. The case manager had four home visits and two telephone calls for 12 weeks. We evaluated the effectiveness of the program in terms of self-efficacy, self-care behaviors and glyco-metabolic control. Results: The self-efficacy score was significantly increased from 70.0 of pre-intervention to 80.5 of post-intervention (p<0.001). The self-care score was also significantly increased from 2.86 to 3.60 (p<0.001). The scores of its components such as nutritional care, self-test of sugar level, foot care, oral care, and aerobic exercise were significantly improved (p<0.001). However, the improvement of score in medication management was statistically marginal (p=0.071). The fasting blood sugar level and HbA1c level was significantly decreased from 128.6 mg/dl to 114.5 mg/dl (p<0.001) and from 6.78 % to 6.54 % (p<0.001) respectively. Conclusions: The case management program was effective to improve the self-efficacy and self-care behaviors, and to control blood sugar level in DM patients.

• 기본간호학회지
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• 제19권1호
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• pp.6-15
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• 2012

Purpose: The purposes of this study were to identify the level of health literacy and to determine its impact on disease-related knowledge and adherence to self-care in adults with hypertension. Methods: This was a cross-sectional, descriptive study in which patients with hypertension were recruited from outpatient hypertension clinics in Seoul, Korea from December, 2009 to February, 2010. A total 186 patients completed series of questionnaires to assess health literacy, disease-related knowledge, and adherence to self-care. Hierarchical linear regression was used to determine whether health literacy was associated with disease-related knowledge and adherence to self-care. Results: Seventy-one (38.2%) and seventy-two (38.7%) patients had inadequate and marginal health literacy, respectively. In hierarchical linear regression, health literacy independently predicted disease-related knowledge (${\beta}$= .43, p < .001) and adherence to self-care (${\beta}$= .37, p < .001) after controlling for age, education level, having a job or not, and body mass index. Conclusion: These findings show that health care providers need to pay attention to patients with hypertension who have inadequate health literacy. Further, it is recommended to develop and implement new strategies for assessing health literacy in clinical practices. Interventions to improve health literacy could promote disease-related knowledge and adherence to self-care in patients with hypertension.

• 성인간호학회지
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• 제22권5호
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• pp.537-551
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• 2010

Purpose: This study was designed to identify meaningful themes related to the recognition of lifestyle risk factors and barriers in seeking treatment following an acute event of first-time acute myocardial infarction. Methods: A methodological mixed method of thematic content analysis and a quantitative analysis was used. The sample consisted of 120 male patients < 65 years of age who agreed to be in the study were interviewed using a semistructured during 2008-2009. Data were analyzed according to the procedure of thematic content analysis and the meaningful themes were coded into SPSS data for quantitative analysis. Results: Pre-hospital delay greater than three hours reported by 58.3% (n=70) of the sample and similarly 63.3% had no recognition about their symptoms as cardiac in origin. The mean number of risk factors was $3.9{\pm}1.8$ out of 11 when lifestyle and psychosocial factors were included. From the interview data among the 70 patients delayed greater than three hours, thirty-five themes categorized into 12 main themes influenced the delayed decision which was identified according to personal-cognitive, socio-cultural, and contextual factors. Conclusion: Health care providers should consider these themes in designing individual interventions to make lifestyle changes and to facilitate more prompt decisions to seek care.

• 기본간호학회지
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• 제22권1호
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• pp.79-86
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• 2015

Purpose: The purpose of this study was to examine levels of self-care behavior according to levels of depression among patients with heart failure (HF). Methods: Participants in this descriptive research were 169 outpatients with HF who being seen in three university hospitals and one general hospital located in B, Y, and D cities. Data were collected using the Korean version of the Center for Epidemiologic Depression Scale and European Heart Failure Self-care Behavior Scale. Data collection period was from April 25, 2012 to September 26, 2013. Data were analyzed using Chi-square tests and ANOVAs with SPSS WIN 21.0. Results: A higher proportion of patients who were female, without a spouse, with lower household income, not employed, and having lower functional status with serious symptoms of HF tended to be clinically depressed. HF patients with depression tended not to report symptom changes to their health care providers. Conclusion: The findings of this study indicate the need to screen for depression in patients with HF and to develop strategies to improve self-care behaviors in these patients in order to promote reporting of symptom changes to health care providers.

• 기본간호학회지
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• 제13권3호
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• pp.447-456
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• 2006

Purpose: This study was done to examine symptom experiences and related factors in angina patients. Method: The participants were 92 patients admitted to C university hospital between October and December 2004. The tools used were a questionnaire on symptom experience related to angina developed by Gensini(Coronary Angiographic Gensini Score). Global Assessment of Recent Stress Scale and a tool measuring performance of health behavior. Results: The mean score for symptom experience was relatively low (M=27.65, SD=18.44) as was the score for coronary severity (Gensini score) was 16.30 point (SD=18.04). The mean score for perceived stress was moderate (M=30.16, SD=12.26). Compliance was relatively good in these patients with angina (M=61.55, SD=7.60). Analysis of the correlation of symptom experience showed a statistically significant positive relationship with perceived stress (r=.410, p=.000). There was significant negative relationship (r=-.251, p=.016) between symptom experience and compliance. In the regression analysis, symptom experience was found to be significantly influenced by stress ($R^2$=.168, p=.000), age ($R^2$=.057, p=.002), and economic status ($R^2$=.061, p=.007). These variables explained 26.2% of the variance in symptom experience. Conclusion: The results of this study provide evidence that symptoms of angina can present not only as chest pain itself but also with fatigue, shortness of breath, and sleep disturbance as the most common symptoms.

• 한국HCI학회논문지
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• 제12권4호
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• pp.37-44
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• 2017

Eye-typing은 인간-컴퓨터 상호작용의 일종으로 시선의 위치 정보를 기반으로 하는 입력 체계이다. 눈동자의 움직임 이외의 물리적 행위를 필요로 하지 않아 거동이 어려운 전신마비 환자들을 위한 입력 수단으로 널리 사용된다. 하지만 eye-typing을 위한 한글 기반의 인터페이스는 거의 제시되지 않은 것이 현실이다. 이에 본 연구에서는 한글 입력에 최적화된 eye-typing 입력 체계를 구현하였다. 우선 큰 잡음과 Midas touch problem으로 대표되는 eye-typing의 특성을 고려하여 설계 목표를 정립하였다. 잡음 문제를 해결하기 위해 개별 버튼의 크기를 극대화하기 위해 단계식 입력 체계를 도입하였고 Midas touch problem을 해결하기 위해 입력 영역 중간에 시선 보류 영역을 두었다. 다음으로 각 음절이 자음과 모음의 조합으로 생성되는 한글의 언어학적 특성에 대한 고찰을 바탕으로 두 종류의 eye-typing 인터페이스를 설계하였다. 각각 자모 일체형, 자모 분리형 인터페이스로 정의한 두 인터페이스는 한글의 자모음을 유형화하여 단계적으로 입력하도록 구현되었다. 그리고 이들의 성능을 검증하기위해 한글 두벌식자판과 비교하고 입력 과정에서 시선의 동선을 분석하는 실험을 수행하였다. 그 결과, 제시한 인터페이스가 실용적인 eye-typing 수단으로 활용될 가능성이 충분함을 확인하였다.

• Journal of the Korean Data and Information Science Society
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• 제27권2호
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• pp.463-475
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• 2016

본 연구는 졸업학년 간호대학생의 지식, 간호술기, 지각된 수행 정도를 알아보기 위해 시행되었다. 핵심간호술기 checklist와 질문지를 이용하여 D광역시 졸업학년 간호대학생 90명을 대상으로 2014년 9월 4일부터 2014년 9월 22일까지 시행하였고, SPSS/WIN 23.0을 이용하여 기술분석, 상관관계분석을 하였다. 연구결과 손 씻기 지식은 간호술기, 지각된 수행 정도와 정적 상관관계가 있는 것으로 나타났으며 간호술기에서 손 씻기가 가장 취약한 것으로 나타났다. 그리고 가장 수행이 잘 되는 항목은 [내관을 과산화수소수 용액 (과산화수소수: 생리식염수=1:2)에 담가놓는다]로 멸균제품과 환자로부터 오염된 제품을 제거하는 부분인 것으로 조사되었다. 따라서 멸균과 손 씻기 등의 감염에 대한 지식이 행위로 이어지도록 구체적 동기와 인지를 유발하는 경험적 학습이 요구된다.

• 한국보건간호학회지
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• 제30권1호
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• pp.105-121
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• 2016

Purpose: This study examined the influencing factors from the Transtheoretical Model on the stage of change in the self-management behaviors, i.e. regular physical activity and diet, among community-residing adults with hypertension in a rural area. Methods: With a cross-sectional descriptive design, 134 adults who had registered and received a prescription for hypertension medication from a public health center in W city were recruited using convenient sampling. The instrument was an interviewer-administered questionnaire on the stage of change, process of change, self-efficacy, and decisional balance of physical activity and diet. The data were analyzed using descriptive statistics, 2-sample t-test, ${\chi}^2$ test, and logistic regression. Results: The results revealed significant differences in the process of change, self-efficacy, and decisional balance of physical activity and diet between those who were in the pre-execution stage (precontemplation, contemplation, preparation) and those who were in the execution stage (action and maintenance). Logistic regression showed that consciousness raising and self-efficacy were significant predictors of the execution stage in physical activity, and self-reevaluation, social liberation and self-efficacy were significant predictors in the diet. Conclusion: The relevant processes of change, differentiated according to the stage of change, along with self-efficacy, should be addressed to enhance the execution of self-management behaviors among hypertensive adults residing in the community.

• Journal of Hospice and Palliative Care
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• 제2권1호
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• pp.1-6
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• 1999

배경 : 안락사는 조절되지 않는 고통을 경감시킬 목적으로 한 사람의 생명을 끝낼 의도를 가지고 가해지는 중재를 말한다. 안락사를 합법화하고 규정을 만드는데 대한 논쟁이 의학 논문들을 통하여 계속되어 왔다. 방법 : 지난 수년간 발표된 안락사에 대한 논문들을 정리하였고 안락사를 시행하는 이유들을 알아보았다. 또한 네덜란드에서 안락사를 정책적으로 허용한 이후에 빚어진 결과를 문헌 고찰을 통하여 소개하였다. 결과 : 안락사가 아닌 행위가 종종 안락사로 불리어 왔으나 그 안에 내포된 윤리적 원칙들을 조사함으로써 구분이 가능하다. 네덜란드에서 안락사를 시행하는데 사용하였던 지침들은 부적절하였고 남용된 바가 컸는데도 렘멜링크 위원회의 보고서는 네덜란드에서는 안락사가 적절히 잘 이루어 졌다고 소개하였다. 결론 : 안락사를 합법화 해야할 임상상황은 어디에도 존재하지 않는다. 총괄적이고 여러 분야의 전문가가 협동하는 완화의학은 안락사를 시행해야 할 이유라고 불리는 말기환자들의 고통의 대부분을 효과적으로 조절해 줄 수 있다.