• Journal of Hospice and Palliative Care
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• 제25권2호
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• pp.85-97
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• 2022

Purpose: This study aimed to describe nurses' perceived needs and barriers to pediatric palliative care (PPC). Methods: Mixed methods with an embedded design were applied. An online survey was conducted for nurses who participated in the End-of-Life Nursing Education Consortium- Pediatric Palliative Care (ELNEC-PPC) train-the-trainer program, of whom 63 responded. Quantitative data were collected with a survey questionnaire developed through the Delphi method. The 47 items for needs and 15 items for barriers to PPC were analyzed with descriptive statistics. Qualitative data were collected through open-ended questions and analyzed with topic modeling techniques. Results: The mean scores of most subdomains of the PPC needs were 3.5 or higher out of 4, and those of PPC barriers ranged from 3.22 to 3.56, indicating the items in the questionnaire developed in this study properly reflect each factor. The needs for PPC were divided into 4 categories: "children and adolescents," "families," "PPC management system," and "community-based PPC." Meanwhile, PPC barriers were divided into 3 categories: "healthcare delivery system," "healthcare provider," and "client." The keywords derived from the topic modeling were perception, palliative, children, and education for necessities and lack, perception, medical care, professional care providers, service, and system for barriers to PPC. Conclusion: In this study, by using mixed-methods, items of nurses' perceived needs and barriers to PPC were identified, categorized, and weighted, and their meanings were explored. For the stable establishment of PPC, the priority should be given to improving perceptions of PPC, establishing an appropriate system, and training professional care providers.

• 한국건강관리협회지
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• 제2권1호
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• pp.1-8
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• 2004

Background : Since 2001 the Korean Association of Health Promotion has attempted to establish her own reference valves that can be used in her all fifteen branch laboratories instead of using those adapted from the published data or there commended data by the reagent companies supplied as inserts. However, the previous two reference values derived from the statistics(year 2001 and 2002) were need to adjust to apply to actual practice. Besides there was an unavoidable situation that the reagent has to be changed to other companies in 2002 that creates another statistical problem. Subsequently, the third attempt to derive the reference ranges of tests in KAHP to solve those problems and define common)v acceptable reference ranges was done and and reported here. Methods : Al1 the results performed during January 2, 2003 through September 30, 2003 were collected in Excel tile format. All the data include dthe necessary information such as age and sex. The age was grouped in six; baby(0-3y), children(4-l2y), adolescent(13-l8y), adult(19-S4y), younger elderly (65-79y),old elderly(oyer 80y), with references of statistics in medical informatics and WHO classification. The data were statistically analyzed with SAS 6.04 for-Gaussian distribution as the previous two occasions. None of the tests showed Gaussian distribution. These procedures had been repeated twice or three times after trimming out the results lying outside three standard deviations. Though, all the tests showed non-Gaussian distribution. Subsequently, the reference ranges were defined in the range from the point of lower 2.5% to the point of higher 97.5 %. And in case the lower range could be "0", the reference ranges were defined in the range of 0 to 95%.Results : The reference ranges of most of 56 test items were newly assigned. Also with adaptation of the recommendation of WHO etc. on fasting blood sugar, hemoglobin, cholesterol. Among these there were eight tests that needed reference ranges by the age groups and nine tests by the sex. Conclusions : The third attempt will credit more the reference range of all15 laboratories of Korean Association of Health Promotion, which will be essential part of the better service to the patient and clients to visit KAHP.

• 한국사회복지학회:학술대회논문집
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• 한국사회복지학회 2000년도 춘계학술대회 자료집
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• pp.615-628
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• 2000

스트레스란, 개인과 환경간의 특별한 관계가 개인의 안녕을 위협하고 개인이 가진 자원을 초과하는 것을 말한다. 븐 연구는 청소년 임신과 스트레스에 관한 문헌연구를 통하여 청소년 임신과스트레스와의 관계에 대해서 살펴봄으로써 임신력 있는 청소년들을 위한 스트레스 관련 임상사회 사업 서비스 개입 방안을 제시하고자 하는데 목적이 있다. 임신으로 인한 부모됨의 변화가 청소년기 자체의 인생 주기 상에서의 스트레스와 중복될 때, 누적된 스트레스는 보다 커진다. 변화의 중첩은 개인 역할의 애매함을 초래하여 스트레스를 가중시키고 발달 과업의 우선순위에 혼란을 가져온다. 청소년기의 임신은 성인기로 이동하는 청소년 당사자, 그 자녀, 사회이 부정적인 영향을 미친다. 이러한 부정적인 영향은 단기간에 끝나지 않으므로 임신한 청소년들의 대처 기술과 적응력을 향상시키기 위한 개입의 노력이 필요하다. 임신한 청소년들의 경우에는 개인 상담 접근만으로는 불충분하며 효과적인 예방 프로그램은 보다 나은 대안이자 동시에 목적이 될 수 있다. 이러한 개입은 임신한 청소년들을 출산 이후에 노출되기 쉬운 디스트레스로부터 보호해주고 성인으로 성장하게 될 청소년들의 건강한 정신건강 도모이 기여하는 것으로 나파났다. 이는 결국, 임신한 청소년들을 대상으로 한 스트레스 대처 능력을 향상시키고 긍정적인 인지를 발달시킬 수 있는 스트레스 관리 프로그램의 필요성을 암시하고 있다. 이러한 연구 결과가 갖는 결론과 함께 앞으로 실천적 개입방안에 대한 더욱 정교한 연구가 요구된다.

• 정신신체의학
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• 제24권2호
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• pp.157-164
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• 2016

Objectives : The objective of this study was to investigate the characteristics of language profiles according to whether or not Korean children with autism spectrum disorder(ASD) also have ADHD, and to examine the relationship with executive function. Methods : Participants in the study were boys with ADHD aged 6 to 11 years who visited the clinic from January 2012 to December 2013. In this study, 25 boys with ASD were included, and completed scales included the Korean version of Autism Diagnostic Interview-Revised(K-ADI-R), Korean version of Autism Diagnostic Observation Schedule(K-ADOS), Korean ADHD Rating Scale(K-ARS), and Korean-Conners' Parent Rating Scale(K-CPRS). They also completed neuropsychological tests and assessed language profiles. Patients were categorized into two groups(with ADHD and without ADHD). T-test and Multivariate analysis of covariance (MANCOVA) was used for analysis. Results : Statistically, no difference was found in receptive and expressive language ability between the ASD groups with and without ADHD. However, a lower score in Test of Problem solving(TOPS) was observed for ASD with ADHD than for ASD without ADHD, with problem solving and finding cues showing significant differences. Conclusions : These findings suggest that language profiles in the ASD group without ADHD could be similar to those in the ASD group with ADHD, but comorbid ADHD could lead to more difficulty in linguistic ability for problem solving and could be related with executive function of the frontal lobe.

• 한국경제지리학회지
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• 제26권3호
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• pp.289-309
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• 2023

우리나라의 국민건강보험은 빠른 시간에 보편적 의료시스템을 정착시키는데 큰 기여를 했다. 하지만 연령대에 따른 의료서비스의 차이는 지속되고 있으며, 내과, 가정의학과, 소아청소년과와 같은 핵심의료 서비스에서 이러한 불평등이 존재하는 것은 큰 우려를 불러일으킬 수 밖에 없다. 진료기관 접근에 대한 불평등은 연령대만이 아니라 지역, 특히 도시와 농촌 사이에도 크게 나타나고 있다. 본 연구는 1995년부터 2021년까지 초기진료기관의 분포를 이용하여 변화하는 경제환경 속에서 의료서비스의 공간적 불평등이 어떻게 변화되어 왔는지를 살핀다. 다양한 불평등 지수와 공간통계분석의 결과를 토대로 볼 때, 1997년 IMF 경제위기, 2008년 금융위기, 그리고 2020년의 COVID-19 공중보건 위기를 겪으며 불평등이 심화 확대된 것을 확인할 수 있었다. 또한 초기의료기관의 불균등 분포에 큰 변화가 온 시기도 밝혀낼 수 있었는데, 이러한 변화에는 유소년이나 전체 인구 분포보다는 고령인구의 분포가 큰 역할을 하고 있었다. 본 연구결과는 인구와 의료서비스의 공간적 분포를 통합적으로 고려하여 핵심적인 의료자원의 불평등을 해소하기 위한 노력이 절실히 필요하다는 것을 강조한다. 특히 이러한 노력은 미래의 경제적 충격에도 적절한 수준의 의료 서비스를 지속할 수 있는 기반이 될 수 있을 것이다.

• 대한영양사협회학술지
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• 제17권3호
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• pp.313-326
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• 2011

This study was performed to investigate the relationship between milk and milk product consumption and dietary nutrient intake among Korean adolescents. Questionnaire survey and 3-day diet survey using the food record method were completed by a total of 664 subjects. Subjects were divided into three groups, Q1 (low group), Q2 (middle group), and Q3 (high group), according to dairy equivalent of calcium. Dairy equivalent of calcium was determined by the amount of calcium eaten from milk and milk products by individual subjects. As a result, the ratio of school milk service was higher in Q3 (P<0.001). The most frequent answer about the reason for consuming milk and milk products was 'to be taller' followed by 'good taste' and 'health promotion'. Preference for all types of milk such as white-, enriched-, and flavored-milk was higher in Q3 followed by Q2>Q1 (P<0.05). Ratio of mean daily dietary nutrient intakes of dietary fiber, vitamin C, folate, and calcium to RNI was lower than 2/3 for all of the groups. These mean daily dietary nutrient intakes were significantly higher in Q3 (P<0.05), and in particular, mean daily dietary calcium intake, which was the lowest nutrient consumed by Korean adolescents, was also the highest in Q3 followed by Q2>Q1 (P<0.05). The above results suggest that the school milk program is very helpful in encouraging adolescents to consume milk and milk products and consequently ensure their optimal nutrition. Therefore, we should try to encourage adolescents to participate in the school milk program more actively through nutritional education and government policy.

• 한국식품위생안전성학회지
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• 제33권2호
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• pp.89-93
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• 2018

고염식식습관은 다양한 질병을 일으키고 공중보건을 위협할 수 있다. 그 동안 고염식식습관을 통제하기 위한 다양한 시도가 이루어져 왔으나 건강커뮤니케이션을 통해 고염식식습관을 변화시킬 수 있는지에 대한 연구는 아직 이루어지지 못하였다. 본 연구는 고염식의위험성과 식습관의 통제가능성에 대한 인식이 고염식식습관을 얼마나 예측하는지를 검토함으로써 식습관 개선 교육을 위한 시사점을 찾고자 하였다. 이러한 연구목적을 달성하기 위해 보호동기 이론의 하위요인인심각성, 취약성, 효율성, 효능 및 행동 경향을 측정하기 위한 설문지를 개발하였으며 설문지를 충남소재 대학의 대학생들과 그들의 가족을 대상으로 배포하였다. 설문결과를 SPSS프로그램으로 분석한 결과를 보면 다음과 같다. 첫째, 청년층은 장년층보다 나트륨섭취가 더 많았다. 둘째, 상관관계분석에서 장년층은 고염식으로 인한 위험에 취약하다는 것을 알고 있지만 고염식을 억제할 수 있다고 확신할 때 까지는 식습관을 바꾸지 않는다. 셋째, 구조모델분석에 따르면 대처지각이 높을수록 고염식식습관의 경향성이 낮아지는 경향을 보인다. 이 결과는 고염식식습관을 줄이기 위해서는 실행 가능한 정보를 제공하고 저염식을 하였을 때 어떤 변화가 발생하는지를 인식 시킴으로써 대처지각을 높이는 방안이 더 효과적임을 시사한다.

• 치위생과학회지
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• 제11권4호
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• pp.367-373
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• 2011

본 연구는 중 고등학생들의 치과치료공포감 및 치과의사불신감에 따른 치아우식경험도를 파악하고 이에 영향을 미치는 요인들을 조사하기 위하여 2009년 7월 1일 부터 9월 30일까지 임의 선정된 대구광역시 소재 6개 중학교 1, 2, 3학년과 2개 고등학교 1학년 총 750부를 자기기입식 설문조사를 시행 한 후 성실하게 답변 하지 못한 30부의 설문지를 제외한 최종 720부와 치아우식경험실태조사 자료를 분석하여 다음과 같은 결과를 얻었다. 1. 치과치료공포감의 요인 중 자극반응이 3.42점으로 가장 높은 점수를 보였고, 치과의사불신감은 치과의사에 대한 환자 불신 요인이 3.07점의 평균점수를 보였다. 2. 인구사회학적 특성 중 여학생이 남학생보다 치과치료공포감과 치과의사불신감이 높게 나타났고, 중학생의 경우 연령이 증가할수록 치과치료에 대한 공포감이 높게 나타났다. 3. 치과치료공포수준이 높을수록(p<0.01), 치과의사불신감(p<0.05)이 높을수록 우식경험영구치지수가 높게 나타났으며, 통계적으로 유의미한 차이가 있었다. 4. 치과의사불신감($\beta$=0.393)이 높을수록 치과치료공포감이 높게 나타났으며, 통계적으로 유의한 정적관계가 있는 것으로 밝혀졌다. 이상의 결과를 미루어 볼 때 치과진료회피 현상을 감소시키기 위하여 환자 맞춤형 의료서비스를 제공한다면 치과치료에 대한 공포감 및 치과의사불신감을 줄이고 치아우식증 발생률이 감소함으로써 청소년들의 구강건강향상에 큰 도움이 될 것이다.

• 한국가정과교육학회지
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• 제10권2호
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• pp.131-144
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• 1998

The lack of characteristical understanding of the Home Economics Education will have difficulty in achieving the goal of the Home Economics Education. To allow the Home Economics Education class in school contribute toward the enhancement of the quality of life, it is inevitable to reinforce the recognition of the importance and necessity of the Home Economics Education and to newly propose a directional guidance forward the coming 21st century. The purpose of this study was to provide basic data for planners of the future Home Economics Education by surveying research administrators in charge of programming the overall school curriculum. This study was conducted under the following procedure to have the outcome as follows ; 1. Answers from respondents of age over 50 or careers over 16 years tended to grasp the goal of Home Economics Education in relation to the enhancement of quality of life rather than to the accumulation of knowledge, skill or capacity. 2. Of all the surveyed, 9.64% regarded Home Economics Education as an essential part of school education and the positive ratio was higher with younger respondents. 3. To the question asking if the high school Home Economics Education could have influence on one's capacity, 97.2% of the answerers said yes. The respondents with career under 15 year showed 100% of positive agreement in this matter and of age under 40 marked much higher ratio of 98.84% than the elders. 4. The overall recognition of the necessity for separate sections in Home Economics Education programmed in accordance with the 6th Revision of High School Curriculum displayed a considerably high ratio, with a little differences among age and job groups. The purpose of this study is to analyze and understand adolescents'culture, thereby to provide fundamental information for Preventive Education for Adolescents'Problems in Home Economic Education. 745 articles collected in computer communication service were used for the analysis. The data were analyzed by frequency and percentage using the SPSS/PC+computer program. The most important results of this study were as follows ; 1) Concerning 'Adolescent's Problems's, problems such as violence, homicide and robbery were treated with the greatest frequency. It was also analyzed that the older generations are highly inclined to understand adolescents'culture as a negative one, for example, 'delinquency'or 'immaturity'. 2) Although the area of 'Adolescents'Education'was treated most frequently reflecting the high educational concern in our society, the significant part of those articles were on wrongful educational administration. As much as 70.6% of the articles analyzed were on 'Education'and 'Problems'. Thereby it may be concluded that the other areas such as health, activities, worries, values and harmful environments ere treated respectively as only a 'subculture'or'fragmentary culture'. The articles containing correlations and interactions among them and certain alternative proposals were very rare. 3) The areas such as 'Worries and Counselling'and 'Health'were occupying only a small portion of the articles. The articles which were treating the practical worries and their resolutions were even rarer. 4) 'Values'of the adolescents tended to be viewed by the older generations very negatively. It was also found that the older generations gave the tendency to see the 'consumption culture'of the adolescents as a kind of 'counter culture'or'subculture'.

• Tuberculosis and Respiratory Diseases
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• 제78권4호
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• pp.349-355
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• 2015

Background: The tuberculin skin test (TST) is the standard tool to diagnose latent tuberculosis infection (LTBI) in mass screening. The aim of this study is to find an optimal cut-off point of the TST+ rate within tuberculosis (TB) contacts to predict the active TB development among adolescents in school TB outbreaks. Methods: The Korean National Health Insurance Review and Assessment database was used to identify active TB development in relation to the initial TST (cut-off, 10 mm). The 7,475 contacts in 89 schools were divided into two groups: Incident TB group (43 schools) and no incident TB group (46 schools). LTBI treatment was initiated in 607 of the 1,761 TST+ contacts. The association with active TB progression was examined at different cut-off points of the TST+ rate. Results: The mean duration of follow-up was $3.9{\pm}0.9years$. Thirty-three contacts developed active TB during the 4,504 person-years among the TST+ contacts without LTBI treatment (n=1,154). The average TST+ rate for the incident TB group (n=43) and no incident TB group (n=46) were 31.0% and 15.5%, respectively. The TST+ rate per group was related with TB progression (odds ratio [OR], 1.025; 95% confidence interval [CI], 1.001-1.050; p=0.037). Based on the TST+ rate per group, active TB was best predicted at TST+ ${\geq}$ 16% (OR, 3.11; 95% CI, 1.29-7.51; area under curve, 0.64). Conclusion: Sixteen percent of the TST+ rate per group within the same grade students can be suggested as an optimal cut-off to predict active TB development in middle and high schools TB outbreaks.