• 제목/요약/키워드: Care Providers

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부산시 응급의료서비스의 시공간적 분포특성 (Temporal and Spatial Distributions of Emergency Medical Services: Busan)

  • 남광우;김정건
    • 한국지리정보학회지
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    • 제10권1호
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    • pp.113-123
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    • 2007
  • 본 연구는 응급의료서비스를 제공하는 주요 시설인 소방파출소와 응급의료기관의 공간적 입지의 적절성 분석과 함께 응급처치를 위한 출동체계 및 후송체계와 관련된 119응급의료 활동권역의 진단을 연구 목적으로 한다. 이를 위해 부산시 119 구급관련 자료를 GIS상에서 분석 가능하도록 우선 환자 발생위치를 지번데이터와 주소를 기반으로 매칭시킴으로써 개별 개체로 입력하였으며 환자로의 출동 및 병원으로의 후송에 따른 시간을 초단위로 구축하였다. 또한 119 파출소의 위치 및 관할 구역, 응급의료기관 등을 입력하여 시간적 권역은 물론 공간적 권역의 분석을 실시하였다. 구축된 부산지역 16개 구군과 226개 읍면동별 GIS데이터를 활용한 분석결과 부산시 응급의료서비스의 5분이내 비율이 약 41%에 그쳤으며 각 구별로는 5분 초과 10분 이내의 비율이 가장 높음을 알 수 있었다. 또한 병원이용패턴에 있어서도 매우 비효율적인 활동이 이루어지고 있음을 알 수 있었다. 이와 같이 소방파출소와 응급의료기관의 출동시간대별, 후송시간대별 시공간적 분포에 대한 진단결과와 함께 이상적인 출동 및 후송 패턴을 제시하여 이를 비교함으로써 응급의료서비스 체계를 구성하는 공공시설들의 효율적 자원 활용방안을 제시하고자 하였다.

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대사증후군 위험 요인을 가진 독거노인의 질병관리교육 경험과 심혈관건강행태에 대한 융합적 연구 (Convergence study of the Disease Management Educational Experience and Cardiovascular Health Behaviors of Elderly Living Alone having Risk Factors of Metabolic Syndrome)

  • 김종임;김유미;박금옥;김태희
    • 한국융합학회논문지
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    • 제9권6호
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    • pp.329-337
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    • 2018
  • 본 연구는 대사증후군의 진단에 포함된 고혈압, 당뇨병을 가진 65세 이상 독거노인을 대상으로 의료인이 행한 질병관리교육이 대사증후군 발생을 예방할 수 있는 건강행태에 미치는 영향을 밝히기 위한 조사연구이다. 2014년 지역사회건강 조사 자료로부터 10분이상의 질병관리 교육 경험에 대한 문항이 있는 고혈압과 당뇨병을 가진 독거노인 9,042명을 자료로 이용하였다. 자료의 분석은 ${\chi}^2-test$, 다중 로지스틱 회귀분석을 실시하였다. 연구의 결과는 질병관리교육 경험이 있는 독거노인의 경우, 심혈관 건강관련 인자의 수치에 대한 인지율이 높았으며(p<.001), 주당 3일 이상 걷기를 시행할 확률은 1.145배(p=.002), 현재 음주를 하지 않을 확률은 1.212배(p<.001), 싱겁게 먹을 확률은 1.184배(p=.002)로 나타났다. 본 연구결과로부터 독거노인에게 건강정보 제공시 의료인에 의한 교육의 중요성과 이를 반영한 건강증진정책의 개발이 요구된다.

유전상담 교육프로그램 개발과 전문유전상담사 학회인증제도에 관한 연구 (A Study on Genetic Counseling Curriculum, Accreditation of the Training Program, and the Certification Process of Genetic Counselors in Korea)

  • 최지영;김현주
    • Journal of Genetic Medicine
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    • 제6권1호
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    • pp.38-55
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    • 2009
  • 목 적: 국내실정에 맞는 전문 유전상담사 교육프로그램과 교육기관의 인정 및 유전상담사의 전문 자격 인증 제도를 설립에 근거자료로 활용하고자 하였다. 대상 및 방법: 국외의 유전상담사 교육 프로그램 인정과 유전상담사 인증 제도를 파악하고, 관련 업무 종사자에게 설문조사를 실시하였으며, 전문가 회의를 통해 도출된 의견을 분석하였다. 결 과: 인정받은 교육기관 수료자만을 인증시험요건으로 규정한 미국과는 달리, 일본은 관련 분야의 임상경력을 갖춘자에게도 한시적으로 인증시험 자격을 부여하였다. 일본은 필기와 면접시험으로, 미국은 필기시험으로 인증 시험이 진행되고 있으며, 주기는 미국 2년, 일본 1년, 인증기간은 미국 10년, 일본 5년이었다. 설문조사에서는 '대한의학유전학회에서 위원회를 구성하여 교육기관 인정과 전문 유전상담사 인증을 담당하며, 관련학회의 의견수렴과 자문을 얻는다'에 대다수가 찬성하였다. 지원자의 전공은 제한할 필요가 없으며, 인증시험은 필기와 실기로 이루어져야하고 주기는 2년, 인증기간은 5년이 적당하다는 응답이 가장 많았다. 결 론: 유전상담 교육기관 및 유전상담사 인증 제도는 대한 의학유전학회에서 주관하며, 미국과 일본의 프로그램을 참고하여 국내실정에 맞게 도입한다. 대한의학유전학회에서는 위원회를 구성하여 관련 학회 등의 의견수렴과 자문을 얻어 교육프로그램 개발과 인증 제도를 구체화 할 것을 촉구하는 동시에 정부에서도 유전상담의 급여화와 필요한 제도적인 지원이 있어야만 국내의 유전의료의 발전에 필요한 인프라 구축의 내실을 다질 수 있게 될 것이다.

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Quality of Life for Patients with Esophageal/Gastric Cardia Precursor Lesions or Cancer: A One-year Prospective Study

  • Wen, Ying;Pan, Xiong-Fei;Huang, Wen-Zhi;Zhao, Zhi-Mei;Wei, Wen-Qiang;Chen, Feng;Lan, Hui;Huang, He;Yang, Chun-Xia;Qiao, You-Lin
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권1호
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    • pp.45-51
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    • 2015
  • Background: The current study examined health-related quality of life (QoL) for patients with esophageal/gastric cardia precursor lesions or cancer before and after treatment to facilitate improved prevention and treatment. Materials and Methods: Patients with different stages of esophageal/gastric cardia lesions completed two QoL questionnaires, EORTC QLQ-C30 and supplemental QLQ-OES 18, before primary treatment, and at 1, 6 and 12 months after treatment. Results: Fifty-nine patients with precursor lesions, 57 with early stage cancer, and 43 with advanced cancer responded to our survey. Patients with precursor lesions or early stage cancer reported better QoL overall than those with advanced cancer before treatment (p<0.01). Global QoL scores before treatment and at 1 month after treatment were $71{\pm}9$ versus $69{\pm}9$ (p>0.01), $71{\pm}8$ versus $61{\pm}11$ (p<0.01), $67{\pm}11$ versus $62{\pm}9$ (p<0.01) for three stages of lesions. At 6 months after treatment, some QoL measures recovered gradually in precursor lesion and early cancer patients, while some continuously deteriorated in advanced cancer patients. At 12 months, all QoL scores were comparable to baseline for patients with precursor lesions (p>0.01), while global QoL, social, pain, and insomnia scores for early stage and advanced cancer were inferior to corresponding baseline levels (difference between means>5, p<0.01). At this time point, compared with patients with early stage cancer, those with advanced cancer showed worse QoL with all function and most symptom measures (p<0.01). Conclusions: Patients with precursor lesions or early stage esophageal/gastric cardia cancer show better QoL than those with advanced cancer. This indicates that screening, early diagnosis and treatment may improve the QoL for esophageal/gastric cardia cancer patients. Target intervention and counseling should be given by health care providers during treatment and follow-up to facilitate QoL improvement.

병원 헬스케어 서비스 혁신: ICT 조직기능 연관성 (ICT Relatedness)에 기반한 상호작용과 지식공유 (Hospital Healthcare Service Innovation: Interaction and Knowledge Sharing based on ICT Relatedness)

  • 김찬영;이강덕;김용진
    • 경영정보학연구
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    • 제17권1호
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    • pp.19-47
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    • 2015
  • 본 연구의 목적은 병원 헬스케어 서비스 분야에서 ICT 조직기능 연관성(Information and Communication Technology Relatedness)과 조직환경이 의료진간 또는 의료진과 환자간 상호작용과 지식공유에 어떻게 영향을 미치며, 지식공유는 의료 서비스 혁신, 그리고 서비스 혁신은 서비스성과에 어떻게 영향을 미치는지를 구조화된 모델을 통해 연구하는 것이다. 자원준거관점(Resource based view), 적합구조화이론(Adaptive Structuration Theory), 그리고 서비스 혁신이론을 기반으로 헬스케어 서비스 시스템에서 성과에 영향을 미치는 주요요인으로 ICT 조직기능 연관성, 구성원간의 상호작용과 지식공유를 설정했고, 성과요인으로는 서비스 혁신과 서비스 성과를 설정였다. 모델의 검증을 위해 병원에서 종사하는 의료직, 기능직, 사무직 종사자들을 대상으로 설문을 실시하여 분석하였다. 모델 검증 결과, 모든 가설들은 유의미하게 성과창출에 긍정적인 영향을 주는 것으로 밝혀졌다. 구조화된 조직환경과 ICT 조직기능 연관성은 서비스 조직구성원 및 환자들의 행위에 영향을 주어 상호작용 및 지식공유를 촉진하고, 병원 헬스케어 서비스의 혁신과 성과에 영향을 미치는 중요한 요소임을 시사하고 있다.

일부 농촌지역 주민들의 대사증후군 유병실태 및 관련요인 (Prevalence and associated Factors of Metabolic Syndrome in a Rural Community)

  • 조연순;곽정옥;김영신;박서영;성연희;우두임;이경옥;이미숙;이정경;조현주;최정희;한정애;김봉정
    • 한국농촌간호학회지
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    • 제7권1호
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    • pp.5-17
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    • 2012
  • Purpose: The objectives of this study were to investigate the prevalence of the metabolic syndrome (MetS) and to identify associated factors with MetS among rural residents. Methods: Data were collected from 1,196 subjects over aged 30 years by a self-administered questionnaire, physical measurement, and blood test in a rural area. The prevalence of MetS was determined by the criteria of the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) and 2005 the Korean society for the study of obesity. Results: The prevalence of MetS was 40.5% for men, 49.2% for women. The prevalence of risk factors of MetS was 57.4% for elevated blood pressure, 49.0% for low HDL-cholesterol, and 48.6% for abdominal obesity. Unemployment and higher Body mass index (BMI) were associated factors for MetS regardless of gender. And higher age and physical inactivity in women only increased the odds of the MetS. Especially, BMI was a strong risk factor of MetS in both men and women. Conclusion: The prevalence of metabolic syndrome was higher in a rural area. Therefore, health care providers should develop lifestyle modification program to increase physical activity level and to prevent the obesity among rural residents in order to decrease the prevalence of MetS.

자녀를 둔 어머니의 출산과정 경험 (An Ethnographic Research Study on Childbearing Process of Mother with Children in Korea)

  • 김영희
    • 여성건강간호학회지
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    • 제7권3호
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    • pp.271-283
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    • 2001
  • The childbearing process is a sociocultural phenomenon of a woman who gives birth to a child as well as a biological phenomenon. The purpose of this ethnographic research study was to explore the experience of childbearing process of mothers with children from pregnancy to the 3 months postpartum in Korea and to understand deeply the perspectives of childbearing women reflected on Korean sociocultural values. A convenient sample of 10 childbearing women were observed from January to October 2000 through field work in Seoul, Korea. Data analysis was accomplished under ongoing process. The results of this study were as follows : The mothers with children experienced self-reflection, family relation, and physical adaptation during pregnancy. In self-reflection, all mothers experienced universality and diversity in their self-discovering process. The universal experiences were maturation, life with family and priority on maternal value between being a mother and a woman. The diverse experiences were taking a dual role of working mother, emotional drift of a resigned mother, and disheartened life of a mother who has two daughters. In family relation, the foundation of the new marital relationship were attained during childbearing process and sexual life were changed for the benefit of a healthy mother and a healthy baby. All mothers established friendly relations with their mothers, but established friendly or conflicting or constraining relations with their mother-in-laws due to husband based family culture. In physical adaptation, the informants endured well the physical discomfort and recognized general appearance change. Also maternal-fetal interaction occurred and mothers realistically felt motherhood and accepted themselves as mother-to-be. The mothers prepared for the best delivery, look for a safe childbirth center, newborn goods, endorsed family coping during hospitalization and responded labor pain to make it more endurable, less painful, fast passed owing to labor recognition of the natural process to be a mother. After childbirth, they felt emancipation, satisfaction, accomplishment, more easiness, actually feeling as mother-to-be, emptiness, and showed response to the sex of newborn. Their Sanhujori practice was different according to the Sanhujori environment including provider, place, time in postpartum and reflected on Sanhubyung. The mothers felt actually mother-to-be and happiness during lactation regardless of feeding pattern. These mothers had a different maternal image about rearing subjecthood through their child-rearing experience. But all mothers felt need for family support and social support. The universal rearing response were actual feeling of mother-to-be, a strenuous experience, a pride on child-rearing, confusion, reflecting marital relationship, and wondering rivalry among children. In conclusion, mother of all with children went through self-discovery, self-reflection and made connections with the family as a mother and as a woman simultaneously during the childbearing process. Therefore it is suggested when harmony and balance between a mother and a woman is accomplished, the woman will lead a healthy and high quality of life. Also, this study sought to confirm the sociocultural factors affecting the childbearing process from the perspectives of the women with children. Therefore health care providers must understand deeply the childbearing women with children based on this finding of and try a integrative approach with new ideology of maternity with biocultural perspectives in a clinical setting.

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일상화된 회음절개술에 대한 여성의 지식, 교육요구, 불편감 및 통증정도에 관한 일 연구 (A Study on Women's Level of Educational Need & Knowledge about Routine Episiotomy and the Degree of Discomforts and Pain after Episiotomy)

  • 유은광;김진희
    • 여성건강간호학회지
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    • 제7권3호
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    • pp.393-406
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    • 2001
  • The purpose of this study was to find out women's need and level of knowledge about episiotomy, pain and discomfort related to episiotomy on a cross-sectional survey design. The subjects were 102 postpartal women agreed on oral consent. 34 postpartal women admitted at obstetric ward of H university hospital, 34 postpartal women admitted at 2 Sanhujoriwons, and 34 women within one year afterbirth. They were selected in Seoul, Korea. Data were collected from July, 1 to September 30, 2000, by a structured questionnaire. The instrument used for this study was a questionaire consisted of 5 items of general characteristics, 12 items of obstetric characteristics, 10 items of level of knowledge (Chronbach $\alpha$ .8176), 8 items of need of education(Chronbach $\alpha$ .8836), 3 items of pain (Chronbach $\alpha$ .9252), and 3 items of discomfort (Chronbach $\alpha$ .8092). The data were analyzed by the SPSS/PC+ program using t-test, ANOVA and Scheffe test as a post hoc and Pearson Correlation Coefficient. The results of the study were as follows; 1. 63.2% of respondents had right answer on 6-8 items among 10 items. Only 4.4% of women got right answer on 10 items all. 2. The need of education was high(4.45%) on all items and the range of score was $4.25{\sim}4.64$. 3. The strength of pain was the highest within one week afterbirth(5.93/10) and became lower in 8-14 days afterbirth(2.55). And after 15days of postpartum, the pain level became to the lowest level(1.08). However, pain was delayed until more than one month afterbirth. 4. The level of discomfort was the highest one week afterbirth(6.88/10) and became lower in 8-14 days afterbirth(4.20). And after 15days of postpartum, the discomfort level became to the lowest level(2.47). Universally, the degree of discomfort was higher than pain. 5. There was a strong positive correlation between discomforts and pain ($r=.752^{**}$) and weak positive correlation between discomforts and the level of educational need($r=.308^*$). In conclusion, women have a right to choose whether she will have episiotomy or not according to her decision making based on the comprehensive knowledge of episiotomy before they get episiotomy with consent process and explanation in detail. Women health care providers like nurses have a responsibility to do conscious raising and empowerment for women so that they could lead themselves to choose given medical treatments for women's health and wellbeing and the quality of life in her life cycle.

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장애인에 대한 태도 측정도구(SADP and ATDP-O)의 타당도 검증 (Validation of the Scale of Attitudes towards Disabled Person(SADP and ATDP-O) in Korea)

  • 신은경;이한나
    • 한국사회복지학
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    • 제63권1호
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    • pp.267-289
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    • 2011
  • 본 연구의 목적은 Antonak(1982)이 개발한 SADP and ATDP-O(Scale of Attitudes for Disabled Persons and Attitudes towards Disabled Persons Scale-Original)척도의 타당도를 검증하고 국내에서의 활용방안을 모색하는 것이다. 이를 위해 공무원, 의료인, 교사, 언론인, 장애인복지시설 종사자로 구성된 표적집단과 일반집단으로 구분한 비장애인 500명을 표집하여 척도의 타당도 및 신뢰도를 검증하고, 표적집단과 일반집단 간의 장애인에 대한 태도 차이를 비교하였다. 탐색적 요인분석 결과, 원 척도는 '염세주의-고정관념', '낙관주의-인권', '손상된 성격' 세 가지 차원의 15개 문항으로 정리되었고, 확인적 요인분석 결과, 재구성한 척도의 적합성은 수용할만한 수준(good/reasonable fit)인 것으로 나타났다. 전체척도의 Cronbach's ${\alpha}$ 값은 .8이 넘어 안정적인 신뢰도를 보였으며, DFS(Disability Factor Scale)와는 전반적으로 높은 수준에서 통계적으로 유의미한 상관관계를 나타내 수렴타당도가 확보되었다. 또한 표적집단이 일반집단보다 장애인에 대해 긍정적인 태도를 지닌 것으로 나타났다. 본 연구에서 타당도가 검증된 도구는 다양한 장애유형에 활용할 수 있도록 장애유형별 검증이 필요하며, 척도의 활용으로 장애인에 대한 태도를 개선하기 위한 임상적, 실천적 방안이 모색되어야 할 것이다.

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서울시 보건소 모성실 운영실태에 관한 현장 연구 (A Field Study on Managing System of Maternity Clinic at Public Health Centers in Seoul)

  • 정연강;권영미;김희영
    • 지역사회간호학회지
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    • 제6권2호
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    • pp.259-274
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    • 1995
  • The study is to grasp the problems related to operation of Maternity clinic of public health centers in seoul and needs for public health of community in relation to consumers and providers in order to improve efficiency of community public health for mothers and children. Four pregnancy woman, who receive medical care at the maternity clinic of M public health centers in seoul and understand the purpose of this study, and one nurse who works at the were the objects of this field study. Participating observation and intensive interviews were conducted to collect data. All of them were performed as necessary from time to time since December, 1994, and not during a specific period. Through an data analysis in the order of sector analysis and classification analysis, the data were classified into specific patterns and the results are the following; 1. All of the subjects were using both private hospitals and public clinics, but managing activities prior to delivery were not carried out in accordence with theories for those activities. 2. The subjects showed two types of response to utilizing maternity clinic. they answered that the advantages of the clinic were 'short waiting time for medical treatment', 'medical treatment by female doctors' and 'economical benefit.' Meanwhile, they gave negative response to the problems of 'non-implementation of delivery' 'uncleanness and insufficient facilities', 'limited time of treatment', 'lack of expertise' and 'want of public health education for materity.' 3. Problems related to operation of maternity clinic were 'lack of experts', 'irrational facility structure' and 'absolutely lack budget'. In terms of the status of managing the subjects, 'programs only aimed at attaining the central-government-assigned objects' and 'limited management before and after delivery by non-implementing delivery' were pointed out to be problems. Regarding public health education before delivery and PR relations, 'superficial public health education for maternity' and 'absence of PR programs' were named. In planning and evaluation, 'absence of autonomous planning and evaluation by the clinic itself' was a major problem in operating the clinic. 4. 'Substantial health education and PR', 'supplementation of facilities and eqipment', 'development' and supply of demanded service by the subjects', 'implementation of autonomous programs', and 'reinforcement of supplementary education' were presented as alternatives for efficient opration of maternity clinics.

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