• 제목/요약/키워드: CARE guidelines

검색결과 897건 처리시간 0.032초

國土管理의 方向定立을 위한 國土診斷 -專門家 集團의 問題意識을 中心으로- (Spatial problems of Korea -A delphi survey-)

  • 김인;류우익;허우긍;박영한;박삼옥;류근배;최병선
    • 대한지리학회지
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    • 제29권1호
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    • pp.16-38
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    • 1994
  • 본 연구는 국토관리의 기본방향을 정립하기 위한 기초 연구로서 국토 전반에 걸쳐 문제의 현 상황을 파악하고자 하였다. 이를 위해 국토문제에 관심을 가지는 전문가 집단을 대상으로 국토정책, 취락계층별 문제, 정책 및 전략평가, 당면 지역문제, 국토환경, 북한에 대한 평가 등에 대한 델파이 조사를 행하였으며, 문헌조사도 병행하였다. 국토의 전체적인 수준은 소비, 주거, 노동 환등을 영위하는데 대체로 만족하나, 교육, 휴양, 공동 생활 등의 부문에서는 상대적으로 미흡하다고 평가되었다. 국토구조의 핵심문제로 공간적 집중과 격차 를 생각하고 있었으며, 토지이용의 기본방향에 대해서는 개발과 보전을 적절히 절충하자는 의견이 제시되었다. 국토 환경 수준에 대해서는 대체로 낮게 평가하고, 정부의 환경관리 정 책에 대해서도 비판적이었다. 한편 취락계층별로 상이한 공간문제를 갖고 있는 것으로 조사 되었다. 북한지역은 국토기반시설이 취약하지만 환경의 질은 양호한 것으로 인식되었다. 국 토의 바람직한 미래상으로는 "건강한 국토"를 제안하며, 그 기본원리로는 미래지향적 국토 관리, 국토의 일체성 회복, 국토구조의 진취적 개편, 국토이용에 있어서의 공공성 확보, 국토 관리 패러다임의 친환경적 전환 등이 요구된다.

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의료기관의 외국인 대상 환자식 운영 현황 및 내실화 방안 분석 (Analysis of Operational Characteristics and Substantiality Plan of Inpatient Diets for Foreigners in Hospitals)

  • 김형미;김은미;김혜진;백희준;박미선;이금주;이해영
    • 대한영양사협회학술지
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    • 제22권2호
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    • pp.118-130
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    • 2016
  • The objectives of this study were to analyze the operational characteristics and to explore the substantiality plan of inpatient diets for foreigners in hospitals. Questionnaires were mail-delivered to 128 hospitals, and a total of 62 questionnaires were usable with a response rate of 48.4 percent. Statistical data analysis was completed using SPSS Win 11.0 for descriptive analysis, independent t-test, and ${\chi}^2$ test. Results can be summarized as follows. The average number of inpatient meals for foreigners in the last 6 months were 405 and 53 for general therapeutic diets and special therapeutic diets, respectively. The rates of hospitals with an exclusive department and exclusive staff for foreign inpatients were 48.4% and 53.2%, respectively. Major nationalities of foreign inpatients were China (37.5%) and Russia (31.3%), and their major medical departments were internal medicine (43.9%) and surgery (39.0%). The number of hospitals that provided inpatient diet only for foreigners was 42 (72.4%) and influencing factors were number of permitted beds (P<0.05), an exclusive department (P<0.001), and exclusive staff (P<0.01). The main type of menu was USA European style (61.1%), and the price of inpatient meals for foreigners was mostly \10,000~\25,000 (62.0%). As 75.9% of hospitals did not possess dietary slip manuals for foreigners, the case of preparing inpatient meals for foreigners in the form of a general therapeutic diet partially-modified according to disease was the majority (55.4%). Dietitians felt the need for nutrition management guidelines and dietary slip manuals (47.3%) as a substantiality plan of inpatient diets for foreigners. There is a need for exclusive foodservice standards for foreign inpatients in the changing medical environment.

정맥주입요법 간호실무지침 수용개작 (Adaptation of Intravenous Infusion Nursing Practice Guideline)

  • 구미옥;조용애;조명숙;은영;정재심;정인숙;이영근;김미경;김은현;김지혜;이선희;김현림;윤희숙
    • 임상간호연구
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    • 제19권1호
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    • pp.128-142
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    • 2013
  • Purpose: This study was conducted to adapt the previously developed intravenous infusion guidelines with good quality for development of the evidence-based intravenous infusion nursing practice guideline in Korea. Methods: Guideline adaptation process was conducted according to guideline adaptation manual version 2.0 developed by NECA (Kim, Kim et al., 2011) which consisted of three main phases, 9 modules including a total of 24 steps. Results: Adapted intravenous infusion nursing practice guideline was consisted of 19 domains and 180 recommendations. The domains and number of recommendations in each domain were: general guide, 4; assessment, 1; vascular access device selection, 4;site selection, 14;site preparation, 5;site care, 29; maintaining patency, 11; blood sampling via vascular access, 4; vascular access device exchange and removal, 9; add-on device selection, 27; infusion related complications, 63; education, 7; and documentation and report, 2. There were 11.9% of A, 28.4% of B, 58.7% of C in grade of recommendations. Conclusion: Adapted intravenous infusion nursing practice guideline is expected to contribute providing an evidence based practice guides for intravenous infusion. The guideline is recommended to be disseminated to nurses nationwide to improve the efficiency of intravenous infusion practice.

일지역 갱년기 여성의 요실금 실태와 삶의 질 (The Relationship between Urinary Incontinence and Quality of Life in Climacteric Women)

  • 송애리
    • 한국간호교육학회지
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    • 제9권1호
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    • pp.51-63
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    • 2003
  • The purpose of this study was to identify the prevalence of urinary incontinence of community residing climacteric women, and to identify the relationship between urinary incontinence and quality of life. The subjects of this study were 156 women(45 to 59 years old). Data was collected from Sep. 1 to Dec. 1 2002 by an interview or self-reporting by a structured questionnaire. The questionnaire was composed of items of general characteristics, urinary characteristics, and conditions of urinary incontinence, using the modified Henderickson's stress incontinence scale(1981), and the quality of life scale developed by RO, You Ja(1988). The data was analyzed by the SPSS/WIN program using descriptive statistics, Pearson correlation coefficients, t-test and AVOVA. The results of the study were as follows : 1. The prevalence of urinary incontinence was 76.3%. Of the incontinent women, 42.0% had experienced urinary incontinence for a period of one to three years. Frequency of urinary incontinence was once or twice per day for 42.9% of the urinary incontinent women. Most of the participation with urinary incontinence(91.6%) had mild leakage of urine. In the whole urinary incontinent women, 70.6% had never treated or managed their urinary incontinence. Most of the subjects(79.8%) were mildly incontinent, and the prevalence of moderate and severe urinary incontinence was 20.2%. The mean scores among the items of urinary incontinence, in descending order, were increase of abdominal pressure($1.45{\pm}1.05$), coughing($1.16{\pm}0.93$), and sneezing($1.03{\pm}0.92$). 2. The average score in the level in the quality of life variables was 3.12. The urinary incontinence and quality of life were correlated negatively(r=-0.103, p<0.001). 3. There were statistically significant differences in the score of climacteric woman's self reported quality of life according to : amount of urinary incontinence(F=12.68, P=0.001), duration of urinary incontinence(F=6.97, P=0.009), number of urinary incontinence(F=4.77, P=0.03), existence of urinary incontinence(t=148, P=0.05). In conclusion, this study was a preliminary study to provide nursing practice guidelines for climacteric woman with urinary incontinence. Nurses working with climacteric woman should develop and provide adequate care for the incontinent climacteric subjects. In future research, it is recommended to identify comprehensive factors related to urinary incontinence, including the effective management of urinary incontinence.

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고등학생의 기숙사생활 여부에 따른 건강증진행위와 관련요인 (Health Promotion Behavior and Related Factors on the High School Students Who Live in a Dormitory)

  • 한창현;박종옥;박재용
    • 보건교육건강증진학회지
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    • 제23권2호
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    • pp.63-76
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    • 2006
  • Objectives: The purpose of this study is to find out practicing the health promotion behaviors and the factors relating their health promotion behavior between high school students who live in dormitory and the one who live in their house. Method: This study was carried out by using with questionnaire answered by 1,572 students. Some students are from two academic high schools, and the others are from two girl's high schools in Northern Kyungpook Province from the 27th through 30th of June 2005. Among them, 1,562were included in final analysis. The collected data was analyzed through frequency and percentage, mean and standard deviation, chi-square test, t-test and multiple regression. The data was analyzed using a SPSS/win ver. 12.0. Results: Analysis showed that the total score of practicing health promotion behaviors was 115.1. In case of male students, the score for students in dormitory was 119.6 and the one attending school from house was 114.9(p<0.05). In case of female students, score for students in dormitory was 113.7, and the score for students who live in house was 114.7. According to the data from multiple regression of analysis which has the health promotion behavior practice as a subordinate variable, in male students' case the degree of health promotion behavior practice becomes type of live in a dormitory, high in proportion to their parents' interest in health, disease of student and family, perceived health status, and the perceived self efficacy and the perceived benefit of the health promotion behavior. As to the female students, their health behavior practice becomes level of family economics, high in proportion to their parents' interest in health, perceived health status, and the perceived self efficacy and the perceived benefit of the health promotion behavior. Conclusions: On consideration of above findings, through the systematic development of health education program, we induced to desirable direction for the changeable factors of actions to health promotion for the health. and through the connective guidelines between the school and the home, we have to adapt to effective health promotion program for the health management of the young boys and girls.

초등학생의 건강증진행위 실천에 영향을 미치는 요인 - 초등학교 6학년을 중심으로 - (The Related Factors on the Health Promotion Behavior of Primary School Students)

  • 한창현;김귀영;김동식
    • 보건교육건강증진학회지
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    • 제22권2호
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    • pp.155-171
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    • 2005
  • Objectives: The purpose of this study is to find out how well the primary school students are practicing the health promotion behaviors and the factors relating their health promotion behavior. Methods: This study was carried out by using questionnaires with 1,215 students attending at a 6th grade, 16 primary schools which arranged the school health teachers in Kyoungpook, Chilkok Gun from the 21th through 22th of December 2004. Among them, 1,189 were included in final analysis. The collected data was analyzed through frequency, percentage mean and standard deviation, multiple regression. Results: According to the data from multiple regression of analysis which has the health promotion behavior practice as a subordinate variable, in male students' case the degree of health promotion behavior practice becomes high in proportion to their parents' interest in health, to their perceived self efficacy, and in case of the barriers of the health promotion behavior practice. As to the female students, their health behavior practice becomes high in proportion to their parents' interest in health. It also becomes high in proportion to the perceived health status, the understanding of the importance of the health, internal health locus of control in personality, the perceived self efficacy and the perceived benefit of the health promotion behavior. But in case of the barriers of the health promotion behavior, it was the same as the male students' case. Conclusions: As the results of study, it showed that the knowledge to importance of health, the self efficacy, the knowledge of benefit of health promotion behaviors and the health concern to the children of the parents were related to health promotion behaviors of the primary school students. So, through the systematic development of health education program, we induced to desirable direction for the changeable factors of actions to health promotion for the health, and through the connective guidelines between the School and the Home, we have to adapt to effective health promotion program for the health management of the young boys and girls.

누적외상성질환 위험 요인의 정량적 평가 및 관리를 위한 점검표 개발 -자동차 조립 작업을 중심으로- (The Development of a Checklist for Quantitative Assessment of Risk Factors and Management of Cumulative Trauma Disorders : Application to Automobile Assembly Lines)

  • 이윤근;김현욱;임상혁;박희석
    • 한국산업보건학회지
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    • 제11권1호
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    • pp.56-69
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    • 2001
  • Objectives : This study was designed to develop and standardize a checklist for ergonomic risk factors, and to provide ergonomic guidelines for managing cumulative trauma disorders (CTDs) in automobile assembly lines. Methods : The Checklist for Ergonomic Risk Factors (CERF-1) was developed based on the results of previous studies, and then modified after performing pilot study. Information on the symptoms possibly related with CTDs was obtained using a self-reported Questionnaire from 465 automobile assembly workers. Their job conditions were examined to assess risk factors through both direct observation and video analysis. Results : Rate of detecting risky job through CERF-1 was 85.6%, and was similar to that (88.8%) by Occupational Safety and Health Adminstration(OSHA) checklist but higher than that (63.7%) by American National Standards Institute(ANSI) Z-365. Relationship of the exposure scores derived from CERF-1 with levels of symptom was greater (r=0.49) than OSHA (r=0.28) and ANSI Z-365 (r=0.22). Considering the relationship, jobs scoring higher than 16 could be classified as the Risk Job. and lower than 16 as the Low Risk Job. Sensitivity and specificity of the Risk Job were 92.5 % and 31.5 %, respectively. Odds ratio (OR) after age adjustment was 5.69 (95 % confidence interval 3.15-10.29) for the Risk Job, and these ORs were significantly different from those of the Low Risk Job. The exposure scores were Quite valid, in that the scores at the main survey were significantly correlated with those at the follow-up survey, as suggested by test-retest(r=0.88) and inter-rater reliability(r=0.80). Conclusions : The CERF-1, developed in this study, will be an efficient tool for evaluation of risk jobs for CTDs in automobile assembly lines, and can be used easily by health care providers.

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중증 다발성 늑골골절에 대한 조기 수술적 늑골고정술 (Early Surgical Stabilization of Ribs for Severe Multiple Rib Fractures)

  • 황정주;김영진;류한영;조현민
    • Journal of Trauma and Injury
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    • 제24권1호
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    • pp.12-17
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    • 2011
  • Purpose: A rib fracture secondary to blunt thoracic trauma continues to be an important injury with significant complications. Unfortunately, there are no definite treatment guidelines for severe multiple rib fractures. The purpose of this study was to evaluate the result of early operative stabilization and to find the risk factors of surgical fixation in patients with bilateral multiple rib fractures or flail segments. Methods: From December 2005 to December 2008, the medical records of all patients who underwent operative stabilization of ribs for severe multiple rib fractures were reviewed. We investigated patients' demographics, preoperative comorbidities, underlying lung disease, chest trauma, other associated injuries, number of surgical rib fixation, combined operations, perioperative ventilator support, and postoperative complications to find the factors affecting the mortality after surgical treatment. Results: The mean age of the 96 patients who underwent surgical stabilization for bilateral multiple rib fractures or flail segments was 56.7 years (range: 22 to 82 years), and the male-to-female ratio was 3.6:1. Among the 96 patients, 16 patients (16.7%) underwent reoperation under general or epidural anesthesia due to remaining fracture with severe displacement. The surgical mortality of severe multiple rib fractures was 8.3% (8/96), 7 of those 8 patients (87.5%) dying from acute respiratory distress syndrome or sepsis. And the other one patient expired from acute myocardial infarction. The risk factors affecting mortality were liver cirrhosis, chronic obstructive pulmonary disease, concomitant severe head or abdominal injuries, perioperative ventilator care, postoperative bleeding or pneumonia, and tracheostomy. However, age, number of fractured ribs, lung parenchymal injury, pulmonary contusion and combined operations were not significantly related to mortality. Conclusion: In the present study, surgical fixation of ribs could be carried out as a first-line therapeutic option for bilateral rib fractures or flail segments without significant complications if the risk factors associated with mortality were carefully considered. Furthermore, with a view of restoring pulmonary function, as well as chest wall configuration, early operative stabilization of the ribs is more helpful than conventional treatment for patients with severe multiple rib fractures.

조현병 환자의 동반 만성신체질환 현황 및 총 의료비용에 관한 연구 (Chronic Physical Comorbidities and Total Medical Costs in Patients with Schizophrenia)

  • 이상욱;이예린;오인환;유빈;구애진;김유석
    • 정신신체의학
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    • 제26권1호
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    • pp.26-34
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    • 2018
  • 연구목적 본 연구에서는 조현병 환자의 만성신체질환 유병현황을 확인하고, 총 의료비용에 미치는 영향을 제시하고자 하였다. 방 법 2014~2015년 건강보험심사평가원 자료를 활용하였으며, 자료의 정확성을 높이기 위하여 조현병 및 만성신체질환은 주/부상병으로 동일 상병을 3회이상 진단받은 경우만 해당 질환으로 분류하였다. 총 의료비용은 보건의료체계적 관점으로 보험자의 비용과 함께 본인부담비용을 포함하였다. 결 과 조현병 환자의 24.5%는 1개, 17.3%는 2개, 23.4%는 3개이상의 만성신체질환을 가지고 있는 것으로 나타났으며, 만성신체질환의 1~5순위는 만성위염/위식도역류질환이 27.3%, 알레르기가 19.5%, 고혈압이 13.2%, 만성요통이 11.0%, 당뇨병이 10.6%로 위장간질환 및 알레르기 질환, 대사성 질환뿐만 아니라 근골격계 질환의 유병률도 높게 나타났다. 2014년에 진단받은 조현병 환자의 2015년 총 의료비용은 약 1조 8백억원이었으며, 총 의료비용에 영향을 미치는 요인으로는 성별, 연령, 만성신체질환의 수, 건강보험여부로 나타났다. 결 론 조현병 환자의 만성신체질환의 문제를 해결하기 위한 접근방법은 단순히 개별 질환을 중심으로 치료하기 보다는 조현병 환자의 다양한 신체 질환을 동시에 치료 및 관리할 수 있는 새로운 형태의 진료체계에 대한 모델 개발이 필요할 것이다.

의사들의 정보추구행태를 반영한 의학정보시스템 개발 및 평가 (Construction and Feedback of an Information System by Analyzing Physicians' Information-Seeking Behavior)

  • 김나원;이지연
    • 정보관리학회지
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    • 제33권1호
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    • pp.161-180
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    • 2016
  • 의사들은 학술연구와 환자진료에 관한 정보요구를 가지고 있고, 전자정보원을 이용하여 해결하고 있으나 정보원의 선택이나 검색에서 어려움을 겪는다. 본 연구는 의사들의 연구와 진료정보요구를 지원할 수 있는 검색시스템을 설계하고 개발하는 것이 목적이다. 이를 위해 의사들의 정보요구에 적합한 정보원 개발을 위해서 정보이용행태에 관하여 심층인터뷰를 하였고, 그 결과를 바탕으로 검색 시스템인 MediSearching을 개발하였다. 개발된 시스템은 효용성 검증과 제안을 얻기 위해 추가 인터뷰와 테스트검색을 통하여 피드백을 받았다. 의사들의 정보이용행태에 관한 인터뷰 결과 소속병원의 종류나 진료 과목에 따라서 차이를 보였다. 대학병원 의사들은 연구와 관련된 정보요구가 컸으며 학술지 논문을 주로 이용하고 있었으나, 전문병원이나 개인병원 의사들은 진료와 관련된 정보요구가 대부분으로 동료와의 대화로 해결하는 형태를 보였다. MediSearching은 연구와 진료정보요구를 동시에 지원할 수 있는 검색시스템으로 개발되었고, 인터페이스와 검색효용성이 검증되었다. 기존의 한국 의학 정보 사이트에서는 제공 정보의 종류나 검색방법에 따라 서비스 범위가 모두 달라 의사들은 동일한 검색 과정을 반복하는 불편함이 있었으나 이를 해결한 것으로 파악되었다. 또한 파일 형태나 언어와 상관없이 정보원의 추가가 가능하도록 한 점에서 유용한 것으로 평가되었다.