• 한국콘텐츠학회논문지
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• 제14권10호
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• pp.649-660
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• 2014

최근 급증하고 있는 요양병원 간호사와 간호조무사의 암성 통증관리에 대한 지식과 수행 정도를 평가하고자 본 연구는 실시되었다. 광주와 전라남도의 7곳의 요양병원에서 간호사 84명과 간호조무사 72명을 표출하여 자료를 수집하였다. SPSS/WIN 21.0 프로그램을 사용하여 기술통계, 독립 t-검정, one-way ANOVA, 피어슨 상관 계수, 단계적 다중회귀분석을 실시하였다. 분석 결과, 대상자의 지식은 30점 만점에 16.84점으로 나타났고, 수행의 평균평점은 4점 만점에 2.88점이었다. 대상자들의 지식은 교육 수준, 직업, 암성 통증관리지침 존재 여부 인식에 따라 차이가 있었다. 수행에서는 교육 수준, 직종, 병상 수, 암성 통증관리지침 존재 여부 인식, 암성통증 임상실무지침서 비치 여부에 따라 차이가 관찰되었다. 지식은 수행과 정적 상관관계를 보였으며, 수행에 영향을 미치는 요인은 지식, 병상 수, 암성통증 임상실무지침서 비치 여부였다. 향후 요양병원 간호사와 간호조무사의 암성 통증관리에 대한 교육 프로그램을 실시할 때 이러한 변수들을 고려해야 할 것이다.

• 한국의료질향상학회지
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• 제27권2호
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• pp.2-17
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• 2021

Purpose: The purpose of this study is to seek in-depth perspectives of stakeholders on the necessity and specific criteria for designating a specialized hospital for urologic diseases. Methods: Eight participants experts in urology medicine and specialized hospital system were divided into four groups. Following the semi-structured guidelines, an in-depth interview was conducted twice and a focus group discussion was conducted three times. All the interviews were transcribed verbatim and analyzed. Results: The majority of participants predicted that there would be demand for specialized hospitals for urologic diseases. The criteria of designating a specialized hospital, such as the number of hospital beds and quality of health care, have to be modified in consideration of the specificity of urology. The introduction of a specialized hospital would improve the healthcare delivery system, positively affecting hospitals and patients. Furthermore, government support is essential for the maintenance of specialized hospital systems as urology hospitals experience difficulties in generating profits. Conclusion: This study is expected to be used as base data for introducing and operating a specialized hospital for urologic diseases. In addition, it is expected that the methodology and results of this study would encourage follow-up studies on specialized hospitals and provide guidelines to evaluate the effectiveness of such hospitals in other medical fields.

• 의료법학
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• 제23권3호
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• pp.89-115
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• 2022

본 글에서는 보건의료관련 법령 중 의료법, 응급의료에 관한 법률, 의료사고 피해구제 및 의료분쟁 조정 등에 관한 법률을 민법에 기초하여 검토하고 해석하였다. 보건의료분야는 보건의료기술의 발달에 따른 의료현장의 변화를 반영하는 여러 법률이 존재하고 그 제정이나 개정도 매우 빈번하다. 그리고 제정이나 개정의 과정에서 현장의 수요를 반영하면서 보건의료관련 법령의 양상은 매우 복잡해지고 있다. 이러한 상황에서 법을 위반하지 않으려면 상당한 주의를 기울여야만 하고, 법적용을 위해서 구체적 지침이나 유권해석을 필요로 하는 경우도 많아지고 있다. 그리고 심지어는 그 지침이나 유권해석도 민법과 모순되는 경우가 종종 발생한다. 이 글에서는 보건의료관련 법령의 조문상 오류와 해석상 민법의 사고와 모순되는 경우를 찾아내어 보건의료관련 법령의 입안과 해석, 적용에도 민법적 사고가 필요함을 확인하였다.

• 대한통합의학회지
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• 제10권3호
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• pp.73-84
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• 2022

Background : Lymphedema is a progressive disorder characterized by the impairment of lymph flow from tissues to the blood circulation system. This occurs as a result of damage to the lymphatic system. Complex decongestive therapy (CDT) is a multimodal, conservative therapeutic approach that is used for the management of lymphedema. CDT consists of a combination of compression therapy, manual lymphatic drainage, exercise, and skin care. Purpose : This study aimed to provide a review of available physical therapy interventions as well as general care guidelines for patients with lymphedema. Methods : The recommendations and guidelines for physical therapy management, medical management, and general information were reviewed from the following sources: 1) The American Physical Therapy Association, 2) The Norton School of Lymphatic Therapy, and 3) The International Society of Lymphology. This review contains general information, including the medical management and the importance of physical therapy in lymphedema. Physical therapy management should be based on an assessment of the patients' presenting impairments, including based on inclusion or exclusion of physical therapy interventions. This review also outlines a step-by-step approach that starts with disease diagnosis and progression all the way through to rehabilitation as an outpatient. Conclusion : Depending on the patients' journey to recovery and the requirement for rehabilitation, physical therapy interventions should focus on the patients' needs including pain, appearance, physical function and general rehabilitation. We hope that this review will provide information on evidence-based physical therapy and general care to patients with lymphedema.

• 대한한방내과학회지
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• 제33권4호
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• pp.347-366
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• 2012

The aim of this new statement is to provide comprehensive and timely evidence-based recommendations on stroke management for clinical practitioners. Many countries are already well engaged in developing and releasing their own clinical practice guidelines, whereas Korean Medicine (KM) is still beginning. It will take time and effort to develop evidence-based guidelines and recommendations of KM or other traditional medicine because they are weak in the area of scientific evidence. The clinical practice guideline of Korean medicine for stroke was formulated through extensive review of published literature and consensus meeting of Korean medicine specialists. This project was supported by a grant of the Oriental Medicine R&D Project, the Ministry of Health and Welfare. Referring to guidelines developed in other countries, the experts in the subject tried to organize and develop guidelines and recommendations adequate for domestic medical circumstances. In December, 2008, a multi-disciplinary team called the Evidence Based Clinical Practice Guidelines Development Group (EBCPGsDG) for Stroke was organized. The writing committee was comprised of experts in internal medicine, acupuncture, rehabilitation, and Sasang constitution. Outside specialists and associated panels were invited for consultation. The scope of the guideline encompasses acupuncture, moxibustion and herbal medicine (including Korean medicine, traditional Chinese medicine, Kampo medicine) as interventions for stroke patients. It includes statements about ischemic stroke (I63), stroke not specified as hemorrhage or infarction (I64), and sequelae of cerebrovascular disease (I69) according to the International Classification of Disease (ICD). The committee subdivided the description of herbal medications into acute stroke management, subacute stroke management, post-stroke management, and secondary prevention of stroke. Guidelines on the practice of acupuncture and moxibustion were described in order for acute stroke management, subacute stroke management, chronic stroke management, and post-stroke rehabilitation. Clinicians who are working in the field of stroke care can adopt this guideline for their practice.

• 한국융합학회논문지
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• 제12권5호
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• pp.85-91
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• 2021

본 연구는 치매환자에게 적합한 인지 프로그램 실무지침을 개발하는 과정에서의 효과성을 검증하는 절차를 기술한 방법론적 연구이다. 근거중심의 임상진료지침 신규개발 방법에 기초하여 국내 치매환자용 인지프로그램 실무지침 예비 권고안을 개발하였다. 이후, 효과검증을 위해 전문가 내용타당도 및 실무자 현장 적용성 검증을 수행하였다. 실무지침은 최종 4개 유형으로 구성하였으며 구성항목의 내용타당도는 0.87-1점을 나타냈다. 현장 적용성의 하위항목에서는 적절성이 3.95-4.34점, 적용가능성이 3.57-4.27점, 효과성예측이 3.84-4.22점이었다. 전문가 내용타당도 및 현장 적용성 예측 조사를 통해 본 연구에서 개발한 실무지침이 임상에 종사하는 치매 인지프로그램 관리자의 중재 계획수립과 임상 근거로 활용할 수 있음을 확인하였다. 추후 연구에서는 치매환자에게 최적의 치료적 활동을 제시하기 위한 근거중심의 실무지침 개발연구가 더욱 활성화되어야 할 것이다.

• 지역사회간호학회지
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• 제19권4호
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• pp.660-672
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• 2008

Purpose: To analyze the home care services provided to the elderly aged 65 and older by a hospital-based home care agencies and to investigate the effects of long-term care insurance for the elderly. Method: The subjects were the home care service recipients aged 65 and older in 172 hospital-based, home care agencies registered in Health Insurance Review & Assessment Service in January, 2007. The data were collected using a questionnaire from March 16 to April 15, 2007. The questionnaire return rate was 43.8%. Result: The hospital-based home care agencies were able to visit 66.5% of the national administrative districts. Of the home care service recipients, over 50% were 65 years old and older. About 43% of the agencies reported that over 50% of their patients would be subject to the long-term care insurance. They expressed concern that home care services would be withdrawn once the insurance system is initiated. Conclusion: This study suggests that hospital-based home care agencies need to manage home care services with long-term care insurance. It also recommends developing guidelines for the use of services and referrals.

• Journal of Chest Surgery
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• 제49권6호
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• pp.413-420
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• 2016

Doctors are often faced with difficult decisions and uncertainty when patients need a certain treatment. They routinely rely on the scientific literature, in addition to their knowledge, experience, and patient preferences. Clinical practice guidelines are created with the intention of facilitating decision-making. They may offer concise instructions for the diagnosis, management (medical or surgical treatments), and prevention of specific diseases or conditions. All information included in the final version are the result of a systematic review of scientific articles and an assessment of the benefits and costs of alternative care options. The final document attempts to meet the needs of most patients in most circumstances and clinicians, aware of these recommendations, should always make individualized treatment decisions. In this review, we attempted to define the intent and applicability of clinical practice guidelines, expert consensus documents, and registry studies, focusing on the management of patients with thoracic aortic disease.

• Journal of Nutrition and Health
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• 제46권3호
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• pp.276-284
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• 2013

This study compared levels of health and dietary behavior practices and health beliefs according to the stage of weight loss behavior change of Korean male workers. A self-administered survey questionnaire was collected from 411 male adult workers residing in Seoul, Kyeonggi, Chungcheong region. Practices of health related behavior, including smoking, drinking, exercise, work related physical activity, and dietary behavior according to dietary guidelines were evaluated. In addition, the levels of perceived benefit, perceived barrier, perceived susceptibility, perceived seriousness, and perceived cue to action from the health belief model were measured according to the stages of weight loss behavior change. Significant differences in BMI, level of daily exercise, and practices of dietary behavior according to dietary guidelines were observed among stages of weight loss behavior change. Subjects who were in action/maintenance stage showed a more desirable level of health behavior and health belief model variables, except perceived barrier. Based on the findings of this study, it is suggested that subjects with different stages of behavior change need an appropriate specific nutrition education method and material for improvement of nutrition education efficacy.

• 아동학회지
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• 제2권
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• pp.83-103
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• 1981

1. Outline of the Study A boom of baby hotels is taking place in Japan. Baby hotel means day care centers that renders services day and night for babies of working mothers. These baby hotels are thriving because many mothers welcome the system because of their needs. However, accidents occurred in a row recently and therefore baby hotel has suddenly become a social issue. According to the ministry of health welfare, there are 587 baby hotels in Japan accommodating about 10,000 children and they are mostly located around amusement centers. The reasons that these baby hotels thrive in spite of the fact that there are 22,000 day care centers in Japan are : (1) shortage of day care centers compared to the needs (2) most centers do not take in babies below 1 year. This study aims to describe the present status of the baby hotels and the background of the phenomena that made it possible for them to thrive with no permission from the government. This study mostly deals with the phenomena in Tokyo. 2. Day Care Policy in Japan and the Problems of Baby Hotels The present review deals with the problems from the following 6 dementions. (1) the shortage of day care centers (2) inadequate system for the care of babies (3) inadequate daily hours of day care centers (4) Unflexable enrollment system of day care centers (5) imperfect enfollment process & guidelines (6) lack of alternative institutions 3. Result The Ministry of Health & Welfare affered the following ways to cape with the problems of baby hotels : (1) restraint of the baby hotels (2) utilization of existing day care centers for the care of babies. In my opinion, these suggestions seem too superficial in solving the problems. I would rather suggest that the Japanese government review the whole system of child welfare administration. The Child welfare Law of Japan made a clear statement in its article 24 that, "if day care centers are not available, alternative institution for proper care of children must be sought for." My suggestions for the alternative care are : (1) public nursing rooms (2) family day care (3) extention of kindergarten hours (4) foster family care.