• 제목/요약/키워드: Clinical education

검색결과 3,723건 처리시간 0.039초

말기 암환자의 체험에 관한 현상학적 연구 (Lived Experience of patients with Terminal Cancer : Parses Human Becoming Methodology)

  • 이옥자
    • 대한간호학회지
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    • 제25권3호
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    • pp.510-537
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    • 1995
  • Human health is an integral part of experience in the process of Human Becoming. Through continual interaction with the environment human beings freely choose experience and develop as responsible beings. The process of the health experience of patient with terminal cancer is a unique. he objective of this study is to understand the lived experience of patients with terminal cancer in order to provide basic information for nursing care in the clinical setting and to develop a theoretical background for clinical practice. This study is to de-scribe and define the lived experience of patients with terminal cancer in order to provide a foundation for nursing research and education. Data collection has been done between December 1993 and November 1994. The subjects included five persons -four females and one male : one who was in her sixties, one in his fifties, two in their forties, and one who was in her thirties. The researcher has met with these patients 35 times, but at eight times the patient was in a stuporous condition and not able to participate, so these were not included in the data analysis. Parse's "Human Becoming Methodology", an existential phenomenological research methodology is used for this study. Data has been collected using he dialogical engagement process of "I and You", the participant researcher and the participant subject. Dialogical engagement was discontinued when the data was theoretically saturated. Data was analyzed using the extraction - synthesis and heuristic interpretation. The criteria of Guba and Lincoln(1985). and Sandelo wski(1986) : credibility, auditability, fitness and objectivity were used to test the validity and reliability of the data. The following is a description of the structure of the lived experience of patients with terminal cancer as defined by this study : 1. Structure : 1) Suffering through the reminiscence of past experience 2) The appearance of complex emotions related to life and connectedness 3) The increasing importance of significant people and of the Absolute Being 4) The increasing realization of the importance of health and belief 5) Desire for a return to health and a peaceful life or for acceptance of dying and a comfortable death In summary the structure of the lived experience of these patients can be said to be : suffering comes through reminiscence of past experience, and there are complex emotions related to life and connectedness. Significant people and the Absolute Being become increasingly important along with a realization of the importance of health and faith. And finally there is a desire for either a return to health and a peaceful life or for the acceptance of dying and a comfortable death. 2. Heuristic Interpretation : Using Parse's Human Becoming Methodology, the structure of the lived experience of patients with terminal cancer identified in this research is interpreted as. The lived experience of patients with terminal cancer involves the solving of past conflicts, and the experience of the healing and valuing of sorrow and pain. Through the relation of life and health, and the complex emotions that arise, the lived experience of revealing - concealing is of paradoxical emotions. The increasing importance of significant others and of the Absolute Being shows Connecting and Separating an on- going process of nearness and farness. Revision of thoughts about health and faith is interpreted as transforming and desire for restoration to health and a peaceful life or acceptance of dying and a cowfortable death, as powering. In summary, it is possible to see, in the lived experience of patients with terminal cancer, the relationship of the five concepts of Parse's theory : valuing, revealing -concealing, connecting-separating, transforming, and powering. From Parse's theory, the results of this study show that meaning is related to valuing, rhythmicity to revealing-concealing and connect-ing-separating, and cotranscendence to transforming and powering.

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말레이시아 1개 병원과 병상규모가 유사한 한국의 병원 간 보건정보관리자 직무 비교연구 (Comparative Research on the Health Information Manager(HIM) Duties of One Malaysian Hospital and Similar Scale Korean hospitals)

  • 김혜경;이현주
    • 한국산학기술학회논문지
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    • 제15권10호
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    • pp.6158-6167
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    • 2014
  • 본 연구는 말레이시아 병원과 유사규모의 한국 병원을 대상으로 보건정보관리자(HIM)의 새로운 역할 7가지에 대한 직무를 비교연구하기 위한 것이다. 말레이시아 병원은 272병상 규모의 종합병원을 선정하였다. 말레이시아는 해당병원을 연구자가 직접 방문하여 담당자 면담 등을 실시하였고 기간은 2013년 7월 22일부터 8월 2일까지 약 2주간이었다. 국내병원은 말레이시아와 병상규모가 유사한 병상대의 종합병원 총 13곳을 대상으로 유선 상 질의응답을 통해 확인하였다. HIM의 새로운 7가지 역할에서는 Health information manager로서 말레이시아 병원은 ICT가, 한국 병원은 조사대상 병원의 30.8%가 역할을 수행하고 있었다. Clinical data specialist역할 관련 classification of disease & procedure는 양국 모두 실시하고 있었고 tumor registry은 말레이시아 병원은 담당하고 있었던 반면 한국 병원에서는 15.4%만이 담당하고 있었다. 퇴원환자 통계는 말레이시아에서는 담당하지 않았고 한국은 76.9%에서 담당하고 있었다. 특수질환 등록업무는 한국은 22.1%에서 담당한 반면 말레이시아는 전체 법정전염병 등록 뿐 아니라 병원출생아와 사망자에 대한 정보등록까지 실시하고 있었다. 그 외 Patient Information Coordinator, Data Quality Manager, Document and Repository Manager, Research and Decision Support Analyst 역할은 양국 모두에서 실시하고 있지 않았다. HIM의 새로운 역할은 한국 중소병원에서 실천률이 낮은 편이다. 따라서 한국전체에서 HIM 역할이 확고히 정립되려면 중소규모 병원까지도 그 역할을 잘 수행할 수 있도록 해당 협회차원의 지속적인 교육, 지원을 통해 일부 대형병원뿐 아니라 중소병원을 포함한 전체 병원에서 역할이 명확화 될 수 있는 노력이 필요하다. 특히 특수질환 등 등록업무는 말레이시아 병원이 한국 병원에 비해 역할이 잘 정립되어 있어 이를 벤치마킹하여 업무를 확대하는 방안도 모색할 필요가 있다고 사료된다.

혈액투석을 실행중인 말기 신부전 환자의 식사관련 삶의 질(Diet-Related Quality of Life)과 식사요법 실천도, 건강관련 삶의 질 및 위장관 증상과의 관련성 연구 (Association of diet-related quality of life with dietary regimen practice, health-related quality of life, and gastrointestinal symptoms in end-stage renal disease patients with hemodialysis)

  • 이진주;김지명;김유리
    • Journal of Nutrition and Health
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    • 제46권2호
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    • pp.137-146
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    • 2013
  • 혈액투석 식사요법을 실천하고 있는 말기 신부전 환자들을 대상으로 식사관련 삶의 질을 측정하고 식사관련 삶의 질과 식사요법 실천정도, 건강관련 삶의 질, 위장관 증상과의 관계를 살펴본 결과는 다음과 같다. 1) 대상자들의 평균 연령은 53.0세, 남성의 비율이 58.4%, 운동을 하는 대상자는 55.4%, 흡연비율은 11.9%, 음주비율은 10.9%로 대체적으로 자기관리를 하고 있는 것으로 나타났으며, 대상자들의 66.3%가 영양교육 경험이 있었다. 합병증으로 당뇨가 38.6%, 고혈압이 32.7%이었고, 위장관 증상으로 대상자의 72.3%가 변비, 14.9%가 과민성 장 증후군인 것으로 나타났다. 2) 식사요법 실천정도는 55점 만점에 35.4점으로 나타났고, 식사요법 실천정도가 상승할수록 식사요법과 관련된 비용, 자기관리에 대한 만족감 영역의 삶의 질이 증가 (p < 0.05)하는 것으로 나타났다. 3) 식사관련 삶의 질은 건강관련 삶의 질과 여러 항목들과 양의 상관관계가 있는 것으로 나타났고 (p < 0.05, p < 0.01), 특히 만족감 영역, 정신적 영역에서의 관련성이 높은 것으로 나타났다 (p < 0.01). 4) 변비가 있는 대상자의 식사관련 삶의 질은 변비가 없는 대상자에 비해 맛, 편의성, 식사에 대한 부담감 영역의 식사관련 삶의 질이 유의적으로 낮았고 (p < 0.05), 과민성 장 증후군이 있는 대상자의 맛, 식사에 대한 부담감 영역 (p < 0.05)의 식사관련 삶의 질이 유의적으로 낮았다. 5) 대상자들의 식사관련 삶의 질에 영향을 미치는 변수들에 대한 다중회귀 분석 결과, 건강관련 삶의 질 (p < 0.05)과 변비 (p < 0.01)가 식사관련 삶의 질에 유의한 영향을 미치는 것으로 나타났다. 결론적으로, 식사요법을 실천중인 혈액투석 환자들은 식사요법 실천정도가 높았으나, 식사요법으로 인한 부담감이 크고 전반적인 건강영역의 삶의 질이 저하되어 있고, 더불어 위장관 증상에 따라 식사관련 삶의 질의 차이를 보였다. 따라서 영양교육 시에는 개개인의 식사관련 삶의 질, 식사요법 실천정도, 건강관련 삶의 질, 위장관 증상 등을 고려한 균형 있는 영양관리, 삶의 질 관리가 요구된다. 또한 식사 관련 삶의 질은 혈액투석 환자가 식사요법으로 인해 받는 사회적, 심리적 영향을 잘 반영할 수 있어 앞으로 영양교육이나 식사요법의 효과를 다각도로 평가하는데 있어서 좋은 도구로 사용 될 수 있을 것으로 기대된다.

전공의 의료커뮤니케이션 능력과 진료수행 자기효능감, 공감능력과의 상관관계 (Associations of Communication Skills, Self-Efficacy on Clinical Performance and Empathy in Trainee Doctors)

  • 김도형;김민정;이해영;김현석;김영미;이상신
    • 정신신체의학
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    • 제29권1호
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    • pp.49-57
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    • 2021
  • 연구목적 전공의 공통역량으로서 의료커뮤니케이션의 중요성을 환기시키기 위하여 전공의를 대상으로 의료커뮤니케이션 능력을 조사하고 의료커뮤니케이션 능력, 진료수행 자기효능감 그리고 공감능력의 관련성을 분석하고자 하였다. 방 법 일 대학병원 소속 총 106명 전공의를 대상으로 자기평가 의료커뮤니케이션 능력, 수정된 진료수행 자기효능감 척도, 한국판 의사 공감 척도를 조사하였다. 성별, 나이, 전공과목(인턴, 내과계, 외과계), 연차(인턴, 1~2년차, 3~4년차)에 따른 의료커뮤니케이션 능력의 차이를 조사하였다. 상관분석으로 의료커뮤니케이션 능력, 수정된 진료수행 자기효능감, 공감능력의 상관계수를 구하였고 구조방정식 모형을 이용하여 의료커뮤니케이션 능력에 영향을 미치는 각 변수의 효과를 검증하였다. 결 과 인턴 31명(31.6%), 내과계 레지던트 45명(45.9%), 외과계 레지던트 22명(22.4%)으로 총 98명이 참가하였다. 성별, 나이, 전공과목, 연차에 따른 자기평가 의료커뮤니케이션 능력 점수는 통계적으로 유의한 차이가 없었다. 의료커뮤니케이션 능력은 수정된 진료수행 자기효능감(r=0.782, p<0.001) 및 공감능력(r=0.210, p=0.038)과 유의한 정적 상관관계가 있었다. 공감능력은 진료수행 자기효능감에 직접적으로 유의한 영향을 미쳤으며(β=0.30, p<0.01), 진료수행 자기효능감은 의료커뮤니케이션 능력에 직접적으로 유의한 영향을 보였다(β=0.80, p<0.001). 공감능력은 진료수행 자기효능감을 매개하여(β=0.26, p<0.05) 간접적으로 의료커뮤니케이션 능력에 영향을 미치고 있었다. 결 론 전공의 의료커뮤니케이션 능력은 성공적 진료를 위해 필요한 진료수행 자기효능감과 직접적 연관성이 있었으므로 전공의 공통교육과정의 하나로서 중요한 위치를 차치한다고 할 수 있다. 그리고 현재의 의료커뮤니케이션 모델은 공감 능력과는 구별해서 이해될 필요가 있음이 시사된다.

간호사(看護師)들의 간호사고(看護事故) 경험(經驗)과 사고원인(事故原因)에 관한 지각(知覺) (Perception on the Nursing Accident Experience of the Nurses and Its Cause)

  • 이순복;문희자
    • 간호행정학회지
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    • 제1권2호
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    • pp.246-267
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    • 1995
  • Recently the request of the patients to participate in the medical courses has been expanding due to the elevated sense of right on the people's health, merchandised medical treatment by mass supply, human right declaration of the patients, generalized medical informations by the mass media and the change of human relation between the medical personnels and the patients. Under these phenomena the patients have been in the thought of solving such accidents only by regulation of the laws which they think to be all powerful, Such trends are same in the area of nursing service. Also today the accident by the nurses have been increasing by the area of the nurses having been expanded and their independent roles having been increased. Such nursing accidents are the important subject which the professional occupation of the nurse has been facing but legal protective capability of the nurses has been very weak. Therefore this study has examined the degree of the experience of the nursing accident that happens in the clinical nursing scenes in the general hospital to provide the basic materials for the protection and the counter measures of the nursing accident. The following is the conclusion based by the above examination. 1) The experience degree of the whole nursing accidents has been appeared as 1.90 in average. And the degree according to service area has been 1.77 in the area of supervising management of patients, 1.54 in the area of the same management of patients by head-nurses, 1.84 in the area of doctors' treatment performances, 14 in the enforcement and education areas of the nursing technology, 2.04 in the area of observing patients and judgement and 2.07 in the area of nursing records and maintaining confidentials. Accordingly there has been higher degree of accidental experiences in the independent service areas of the patients than in the dependent ones directed by the doctors. 2) The perception of the nurses showed that the cause of the nursing accident has been due to the heavy work of the nurses with the 60.4% of the response rate, the highest rate. They report the accident to the head nurse first by 2/3 nurses after accident. And the hour of the accident has been frequently happened regardless of service hours with 48.1% in response rate, the highest rate, and the nursing accident happens in the night more than the daytime with the rate of 37.5% at night while 14. 4% daytime. 3) The nurses are in the perception that the patients are responsible for the accident with 48.2% response rate while 43.9% rate in response showed that it has been caused by many people. They are in the perception that 41.7% when the nursing power was lacking, 46.7% lower recognition of actual state about indivitual patient in the section of technical speciality and 35.8% when the patients were not cooperative and 37.8% when the wards were dirty and in disorder. 4) the attitude of the patients after the various nursing accidents has been violent words in 72.7%, violence in 17.4% and 3.9% in attending the court by the sue of the patient's side(18 nurses). 5) The action of the hospital has been : requesting the submission of the story of the accident in 22.8%, the report of the accidents in 14.4%, thus the written statement disposal was most, 4.5% was the transfer to the other departments when the accident was larger or the patients' guardians protested strongly and 0.6% of the dismissals of the nurses. 6) In regard to the responsiblity of the nurse accidents, 78.9% was the highest rate of supplying the nursing manpowers, 48.4% of mutual cooperation of the medical personnels, 37.2% of strengthening the education for the nurses and hospital facilities reformation in 32.7%. 7) The review of relation between the general characters of the object of the study and the degree of experience of nursing accidents showed the significant differences in ages (F=4.04, p=0.000).

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한국인 알코올중독 환자의 예후인자에 관한 연구 : 심리적, 사회적, 생물학적 요인을 중심으로 (A Study for The Prognostic Indicators of Korean Alcoholics in Psychological, Social and Biological Aspects)

  • 성상경;장환일
    • 생물정신의학
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    • 제2권2호
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    • pp.218-236
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    • 1995
  • The author studied prognostic indicators of sixty Korean male alcoholics in psychological, social and biological aspects who were divided into abstinent and drinking groups. Thirty patients were assigned to each group. They were controlled in age and sex. Both groups were compared in terms of the demographic characteristics, past drinking history, treatment history, famaily history, ego strength and personality factors differences and distribution of dopamine $D_2$ receptor gene Al allele. Also the author studied relation of clinical course, alcoholic family history and dopamine $D_2$ receptor gene Al allele in both groups. The results were as follows; 1) The abstinent group had higher rate of married state, higher economic status, longer education years and maintained more stable job than the drinking group. But made no differences in occupation and religion. 2) The abstinent group showed higher rate of living with family members than the drinking group, and wives and fellows of the alcoholics anonymous were important factors for maintenance of abstinence. Family loading and parent's characters were not different. 3) The abstinent group had longer maximal length of abstinence but mean amount of alcohol consumption per day were larger than the drinking group. But there were no differences in duration of past drinking, drinking pattern, main drinking time, first drinking age and preference of the kind of alcoholic beverage in the past drinking history. 4) The abstinent group showed stronger treatment motivation, absolute abstinence in treatment goal, more voluntary adimission and maintained longer therapeutic relationship otter discharge than the drinking group. But both groups showed negative attitude toward antabuse therapy. 5) The abstinent group had higher mean score in ego strength scale than the drinking group. 6) In the personality factor questionnaire, the abstinent group showed strong laugh poise and the trait of praxernia, conservatism personality but the drinking group showed tough poise, the trait of weak ego strength(unstableness) and tough mindedness personality. 7) In comparision of dopamine $D_2$ receptor gene A1 allele, the prevalence of A1 allele was seventy percent and the frequency was 0.38 in the abstinent group. The prevalence of A1 allele was sixty percent and the frequency was 0.42 in the drinking group. Both groups were not significantly different in A1 allele prevalence and frequency. 8) In comparision of dopamine $D_2$ receptor gene A1 allele according to alcoholic family history, the prevalence of A1 allele was seventy percent and the frequency was 0.43 in the family history positive group. The prevalence of A1 allele was sixty-one percent and the frequency was 0.38 in the family history negative group. Both groups were not significantly different in A1 allele prevalence and frequency. In comparision of past drinking history according to alcoholic family history, the family history positive group showed earlier first drinking and problem drinking, but the family history negative group hod longer duration of past drinking. The mean amount of alcohol consumption per day, the longest duration of abstinence and Alcoholism Screening Test of Seoul Natoinal Mental Hospital(NAST) results were not significant. In conclusion, the results suggest that successful prognostic indicators of Korean alcoholics are married state, higher economic status, longer education years, stable job, living with family members, longer abstinence during past drinking history, strong treatment motivation, absolute abstinence in treatment goal, voluntary adimission, maintained therapeufic relationship, strong ego strength and the trait of praxernia, conservatism personality. But occupation, religion, alcoholic family history, parent's characters, duration of past drinking, drinking pattern, main drinking time, first drinking age, preference of the kind of alcoholic beverage, attitude to antabuse therapy and distribution of dopamine $D_2$ receptor A1 allele were not significantly related to the prognostic indicators of Korean alcoholics.

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치과위생사의 근무환경 연구 -근무기관·경력·지역을 중심으로- (A study on work environments for dental hygienists: - focusing on kind of workplace. career and service area)

  • 류정숙;김영남;한경순
    • 한국치위생학회지
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    • 제7권2호
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    • pp.135-151
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    • 2007
  • The purpose of this study was to examine the work environments of dental hygienists, to find out about what problems there were with their work environments and ultimately to help improve their work environments. It's basically intended to pave the way for furthering the welfare and interests of dental hygienists. The subjects in this study were dental hygienists who were selected by random sampling from among the members of Korean Dental Hygienists Association. Approximately 20 percent of the members each were selected from every region across the nation, and their work environments were investigated in consideration of the kind of their workplaces, service area, career and field of duties. As for the demographic characteristics of the dental hygienists investigated, there were differences between those who worked in the field of health care and the clinical workers. More of the former were older and married, and the former was ahead of the latter in career and education as well. Regarding working hours and leave of absence by kind of workplace, the number of regular average holidays was different according to their place of employment. Dental hospitals(6.66 days) and dental clinics(6.81 days) gave their employees less days off on the whole, whereas public dental clinics(19.29 days) granted the dental hygienists the longest leave of absence. Also, there was a broad gap in the number of regular average holidays among different regions in the nation. The dental hygienists who worked in Gangweon province enjoyed the longest holidays(10.88 days), while those on Jeju Island took the shortest vacation(4.46 days). Concerning monthly mean pay by place of employment, those who worked in public dental clinics were paid the best, and the dental hospital employees received the smallest pay. Their monthly mean pay significantly varied with the kind of their workplaces. As to connections between service area and pay level in the event of the dental hygienists with a four-year career, those who served in Seoul were paid the best(1,820,800 won), followed by Gyeonggi province(1,795,800 won), Gyeongsang province(1,604,200 won), metropolitan cities(1,424,800), Gangweon province(1,300,000 won) and Jeolla province(1,016,700 won). In regard to the starting pay in the different areas, the starting pay was largest in Seoul(1,501,800 won) and smallest in Jeolla province(904,000 won). Concerning work environments by place of employment, the dental hygienists in public dental clinics, general hospitals and university hospitals were far older than the others, and the career of the former was much larger than that of the latter. As to the number of regular leave of absence, public dental clinics, general hospitals and university hospitals were different from dental hospitals and clinics in that regard as well. Concerning monthly pay, public dental clinics paid their employees the best, and dental hospitals and clinics were ahead in terms of pay raise. But the reason seemed that public dental clinics and general hospitals increased the pay of their employees based on a fixed wage system and according to a fixed rate at the same time. As for relations between career and work environments, the pay of the dental hygienists differed with their career. The amount and rate of pay raise were largest for those whose career was between four years and less than six years, and smallest for those whose career was between seven years and less than nine years. The above-mentioned findings of the study suggested that in order to give dental hygienists better treatment, pay and welfare benefits should urgently be improved, and that it's required to take actions to boost their job satisfaction. Besides, they should be given more chances to receive education or to take training courses in pursuit of self-development, and how to narrow gaps in work environments among different regions or fields should carefully be considered.

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간호센타 개발을 위한 건강증진 프로그램 요구사정 연구-유방자가검진 프로그램을 중심으로- (A Study on Need Assessment in Health Promotion Programs for Developing Nursing Centers - Breast Self Examination-)

  • 박인혜;강혜영;이정희;류현숙
    • 지역사회간호학회지
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    • 제11권1호
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    • pp.21-36
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    • 2000
  • The purpose of this study was to assess the needs of breast self examination education (BSEE) programs for developing nursing centers. A first, we reviewed the literature of activity and management-related factors of nursing centers: and, second. we used a questionnaire to discover the degree of knowledge, attitude, and practice on breast cancer, as well as an individual's intention to participate BSEE program. 1. Reviewing the literatures of nursing center activities. Nursing centers which were administered by a professional nurse are an ideal site for faculty and student practices. With the use of nursing models of health. professional nurses in nursing centers diagnose and treat human responses to potential and actual health problems and offer holistic, client-centered health service. In nursing centers professional nursing services include health education, health promotion, and health-related research. A nursing center is comprised of the advisory and exacutive commitee; the advisory commitee serves consultants and links community needs to the nursing center, while the director of the exacutive commitee identifies the potential resources to generate funds, support, and facilitate the activities of staffs in a nursing center. Nursing centers mobilize various financal resources for reimbursement of services from college and insurance companies, collect minimum service fees from the client, and further collect fees for providing programs to community groups, this also includes membership fees, and donations. The services provided by nursing centers focus on services related to primary prevention, health maintenance & health promotion, direct nursing care for acute & chronic diseases, and holistic care for actual and potential health problems. The client satisfaction for the services was high. Students also showed positive reponses for their clinical experiences and independent working conditions. 2. The degree of knowledge, attitudes, and practices for breast cancer. and an individual's intention to participate in the BSEE program. The subjects of this study were 308 females in K-city in the Republic of Korea. Data were collected using a self-administered questionnaire. The mean age of the respondents was 35.0 years old. Those who already participated in the BSEE were 64.9%, and those who had support and encouragement to practice BSE from significant others were 25.1 %. Clients intent to participate in the BSEE were 37.0%. The mean score of knowledge(2.4 out of 5 points) and practices(1.8 out of 5 points) for breast cancer were quite low, but the mean score of attitudes was relatively positive04.5 out of 20 point) for breast cancer. Those who already had BSEE showed significantly high scores in knowledge(t=6.48, p<0.01), attitudes (t=10.54, p<0.01). and practices(t=57.07, p<0.001) for breast cancer than those who had not participated in the BSEE. In all age groups no intention to participate in the BSEE was higher than who the intention to participate. These findings suggest some strategies should be developed to increase the awareness of breast cancer's early detection.

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임상에서 사용하고 있는 임플란트 토크조절기의 정확도와 적용에 관한 사용실태 (A study on accuracy and application of the implant torque controller used in dental clinic)

  • 주용훈;이진한
    • 대한치과보철학회지
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    • 제49권3호
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    • pp.197-205
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    • 2011
  • 연구 목적: 임상에서 사용하고 있는 임플란트 토크조절기의 정확도를 평가하고, 사용방법에 있어서 적절하게 적용하고 있는지의 사용실태를 조사하였다. 연구 대상 및 방법: 대전, 충청지역의 개인 치과 의원을 방문하여 50명의 임상의와 진료실에서 사용하고 있는 50개의 임플란트 토크조절기를 연구 대상으로 하였다. 실험에 참가한 임상의의 임플란트 시술에 대한 정보를 얻기 위해 설문조사를 시행하였다. 설문조사 내용에는 임상경력과 임플란트 시술 경력, 임플란트 시술 도중 경험한 임플란트 나사의 파절과 풀림, 임플란트 토크조절기 사용법에 대한 교육 이수 여부, 토크조절기의 감염 관리 방법을 포함하였다. 또한 실험을 통하여 진료실에서 사용하고 있는 토크조절기의 정확도를 평가하였다. 임상의가 토크조절기를 사용하여 측정된 토크 값을 측정 한 후, 임플란트 토크조절기에 대한 교육 이수에 따른 측정된 토크 값의 평균을 독립 변수 T 검정법을 시행하여 95% 신뢰수준에서 유의성을 검증하였다. 결과: 임상의가 사용하는 토크조절기 자체의 정확도를 측정한 결과, 50개 토크조절기의 평균 오차율은 4.78%였다. 평가된 50개 토크 조절기 중 최대 오차율은 18.96%, 최소 오차율은 0.88% 였다. 임상의가 의도한 25 Ncm의 토크 값에 대해 실제 측정된 토크 값 평균은 $29.0{\pm}8.4$ Ncm 이었고, 30 Ncm의 토크 값에 대해 실제 측정된 토크 값 평균은 $34.3{\pm}9.1$ Ncm였다. 각각의 실험에서 임플란트 토크조절기에 대한 교육을 받은 실험 군과 받지 않은 실험 군 간에 평균 값에서 통계적으로 유의한 차이를 나타냈다. 결론: 임상가는 자신이 의도한 토크 값과 실제 임플란트 나사에 가해지는 토크 값에 차이가 발생할 수 있으므로, 자신이 사용하는 토크조절기의 정확한 사용방법을 숙지하여 일정하고 정확한 토크 값을 부여해야 한다. 또한 토크조절기가 일정하고 정확한 토크 값을 유지하도록 토크조절기를 유지, 관리하여야 나사의 파절이나 나사의 풀림의 문제를 최소화하는 임상적인 결과를 얻을 수 있을 것으로 사료된다.

In-Check Inspiratory Flow Meter(TM)를 사용하여 추정한 다양한 흡입기구의 사용 가능한 연령 (Estimation of the Possible Age for Using Various Types of Inhaler by In-Check Inspiratory Flow Meter(TM))

  • 정경현;김선예;이준호;김계성;장욱;한만용
    • Clinical and Experimental Pediatrics
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    • 제45권2호
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    • pp.192-198
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    • 2002
  • 목 적 : 천식치료에 사용되는 DPI와 BAM는 소아의 연령과 증상 정도에 따라 기구의 올바른 사용과 선택이 중요하다. 몇가지 종류의 흡입기가 개발되었으며 각기 다른 흡입기의 저항을 고려하여 사용을 권고하게 된다. 이에 본 저자들은 In-Check Inspiratory Flow $Meter^{(TM)}$ 기구를 사용하여 네가지 흡입기 종류(TFI, MUD, BAM, Auto)의 흡입량을 측정하여 사용 가능한 연령을 알아보고자 본 연구를 시행하였다. 방 법 : 2000년 7월부터 2001년 5월까지 포천중문의대 분당 차병원에 입원한 호흡기 감염이 없는 3세에서 6세 사이(mean $57{\pm}12.9$개월)의 연령 93명(남/여 59/34)을 대상으로 하였다. 검사 대상자에게 완전히 숨을 내쉬라고 한 후, 마우스피스를 물고 강하고 빠르게 흡입하도록 하여 커서가 가리킨 곳의 PIF를 체크하였다. 세번 측정하여 가장 높은 수치를 PIF로 정하였다. 3세부터 4세를 A군, 4세부터 5세를 B군, 5세부터 6세까지를 C군, 6세부터 7세까지를 D군으로 하였다. 각각의 대상환자는 31명, 32명, 18명, 12명이었다. 결 과 : A군 9명(29%), B군 5명(16%), C군 1명(6%)이 교육에도 불구하고 흡입하지 못하였다. D군 12명은 모두 흡입하였다. 키, 몸무게, 개월수와 PIF의 상관관계는 0.5에서 0.7의 높은 상관계수를 보였다(P<0.05). 단순회귀분석으로 TFI의 사용 가능한 연령, 키, 몸무게는 각각 8년 7개월, 142 cm, 32 kg이었으며, MUD는 2년 10개월, 92 cm, 12 kg이었다. BAM는 1년 8개월, 83 cm, 8.5 kg이었으며 Auto는 2년 8개월, 91 cm, 11 kg에서 흡입이 가능하면 치료 가능한 흡입력을 보여주었다. 결 론 : PIF는 개월수, 키, 몸무게 변수로 예측가능하며, 3세 이후 소아 71% 에서 교육을 통하여 MUD, BAM, Auto로 약물을 흡입할 수 있었다.