• 정신신체의학
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• 제30권2호
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• pp.127-136
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• 2022

연구목적 자살관념이 있는 한국성인에서 자살시도와 연관된 요인을 규명하고자 하였다. 방 법 질병관리청에서 매년 실시하는 국민건강영양조사 중 자살행동을 조사한 2015, 2017, 2019년도 결과를 분석하였고, 만 19세 이상 성인을 대상으로 하였다. 자살관념자를 자살시도군(n=92)과 비자살시도군(n=831)으로 나누었고, 복합표본 교차분석으로 두 군의 사회인구학적, 정신의학적, 임상적 특성을 비교하였다. 복합표본 로지스틱 회귀분석으로 자살관념자에서 자살시도와 연관된 인자를 조사하였다. 결 과 자살관념자 중 자살시도군에서는 비자살시도군에 비해 우울증 진단 병력, 자살시도 전 정신의학적 상담 경험, 자살계획이 유의하게 많았다(p<0.001). 또한 두 군은 소득 수준, 폭음 빈도, 흡연 빈도에서 유의한 차이를 보였다(p<0.05). 다변량 분석 모형(Adjusted model)에서 자살계획이 있는 경우(Odds ratio [OR]=8.46, 95% Confidential Intervals [CI]=4.72-15.00), 매일 폭음을 하는 경우(OR=3.14, 95% CI=1.26-7.84), 최근 1년 동안 정신의학적 상담 경험이 있는 경우(OR=3.03, 95% CI=1.75-5.23), 소득 수준이 낮은 경우(OR=2.89, 95% CI=1.17-7.10), 평생 우울증을 진단받은 적이 있는 경우(OR=2.39, 95% CI=1.29-4.42)가 자살시도와 통계적으로 유의한 연관성이 있었다. 결 론 우리나라 일반인구의 자살관념자에서 사회인구학적, 정신의학적, 임상적 변수 모두에 걸쳐서 자살시도의 위험요인이 나타났다. 자살관념이 있는 환자들에서 자살계획, 문제음주, 소득수준, 우울증 병력 등을 평가하고 개입하는 것이 자살시도로의 이환을 방지해 줄 가능성이 있다.

• 기본간호학회지
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• 제6권2호
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• pp.228-239
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• 1999

In 1990 Home Care Education Programs started when legislation established certification for Home Care Nurses. The Ministry of Health and Welfare proposed a home care education curriculum which has 352 class hours and 248 hours of 'family nursing and practice'. Though Home Care Education Programs have been offered in 11 home care educational institutes, there has been no formal revision for the home care education programs. Also a first and second home care demonstration projects have been carried out, but there has been no research on outcomes for home care education as applied in home care practice. The purposes of this study were to identify the important content areas for home care nursing as perceived by home care nurses, and to identify their clinical competence in each of these areas, and from these to identify the education needs. The sample was 107 home care nurses who were working in home care demonstration hospitals and community-based institutions which have been offering home care services. Responses were received from 88 nurses, comprising a 82.2% return rate, and 86 were included in the final analysis. The instrument used was a modification of the instrument developed by Caie-Lawrence et(1995) and Moon's(1991) instrument on home care knowledge. The instrument's Cronbach's coefficient was 0.982. Among the respondents, 64% were working at home care demonstration hospitals and 36% were working at community-based institutions. Their home care experiences were from one month to six years, with a mean of 20.6 months. The importance rating for home care education content was 3.42 0.325, which means importance was rated relatively high. Technical aspects of home care were identified the most important. Five items 'education skill', 'counseling skill', 'interview skill', 'wound care skill', 'bed sore care skill' received 100% importance ratings. The competency rating was 2.87 0.367 and 'technical aspects of home care' was the highest, and 'application to home care skill' was the lowest. Home care nurses' education needs were identified and compared to the importance ratings and competency ratings. Eleven items were identified as the highest in the importance areas and eleven items were in the lowest competency areas. High importance ratings matched with low competency ratings determined training needs, but there was no matching items in this study. In the lowest competency areas four items were excluded, because of not being applicable in current home care practice. Therefore total eighteen items were identified as home care education needs. These items are 'bed sore care skill', 'malpractice', 'wound care skill', 'general infection control', 'change and management of tracheostomy tubes', 'CVA patient care', 'Hospice care', 'pain management', 'urinary catheterization and management', 'L-tube insertion and managements', 'Respirator use and management skill', 'infant care', 'prevention to burnout', 'child assessment', 'CAPD', 'infant assessment', 'computer literacy', and 'psychiatry patient care'.

• 한국간호교육학회지
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• 제3권2호
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• pp.163-192
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• 1997

As the population over the age of 65 increases, the demand for nurses who care for this group also continues to grow. Well-prepared nurses who are knowledgeable and skilled for the elderly can be prepared through systematic gerontological nursing curricula. This study was carried out to identify the needs for gerontological nursing curricular contents. The subjects for this study were two participant groups the educators who teach gerontological nursing in three-year and four-year baccalaureate nursing programs, and the nurses who are working with the elderly in hospitals, community health centers, social welfare agencies, and community health practioner's posts. The major findings of the study are as follows : 1. The differences between actual contents and essential contents of the educators : Concerning the actual contents that is actually taught, the educators showed the highest scores on the demographics of older adults and the lowest scores on the cultural variations affecting health care. Regarding the essential contents, the educators showed the highest scores on the demographics and the lowest scores on the economics of aging. Aside from the demographics, all of the items were found to have significant differences between essential and actual contents. This implies that all the content areas except demographics should be emphasized. 2. The differences between actual knowledge and essential knowledge of the nurses : Concerning the nurses' actual knowledge, the nurses showed the highest scores on the common health problems and their treatment and the lowest scores on the politics of aging. Regarding the essential knowledge, nurses showed the highest scores on the chronic illness and common health problems and the lowest scores on their roles and functions. However, they thought all the items to be essential. All of the items were found to have significant differences between actual and essential knowledge. The nurses who studied gerontological nursing in their school years and after graduating had more knowledge. However, they felt more knowledge was needed. This implies that the nurses need more education in all content areas of gerontological nursing. 3. The differences between educators and nurses : Concerning the essential contents, the educators showed higher scores on the demographics and growth and development than the nurses. Whereas, the nurses showed higher scores on the cultural variations, long-term care, economics of aging, politics of aging, legal and ethical issues, and common health problems than the educators. 4. Activities of nursing care for the elderly : Most common activities were related to direct nursing care such as giving physical care, counseling/teaching clients, and assessing and planning care for the clients. Nurses thought that all the items were critical, but they showed relatively low scores on the following :'serve on multidisciplinary committee', 'preparing reports', 'evaluation of outcomes of care', 'determine policy for nursing service', 'set patient care standards', and 'participate in nursing research' The constraints in providing better nursing service were time constraints, administrative restraints, social restraints, and inadequate knowledge.

• Archives of Plastic Surgery
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• 제35권5호
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• pp.589-596
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• 2008

Purpose: The nasal bone fracture is most common fracture in facial bone injuries. Regardless of the severity or type of fracture, closed reduction has traditionally been the common method of treatment. However, through detailed pre-operative evaluation, we found out that many patients consider rhinoplasty prior to trauma due to aesthetic desire or nasal deformity with or without septal deviation. In treatment of nasal bone fracture, we focused not only on the fracture management but also on the patients' desire prior to trauma, and we made additional operation according to patients' desire with fracture reduction and gained rewarding outcomes. Methods: From March 2005 to June 2007, total 263 patients were treated for nasal bone fracture. Among these patients, 57 patients (21%) had the additional operation with nasal fracture reduction. The additional operations were categorized in three types: augmentation rhinoplasty with tip plasty (40%), septoplasty only (16%), corrective rhinoplasty (44%). The mean follow-up period was 5.6 months and results were evaluated by scoring. Results: Forty four of 57 patients (77%) were highly satisfied regardless of any additional operation kinds. The complications were one septal perforation, two displacement of implant and four remnant nasal deformities. For the septal perforation, no further management was performed because we lost the contact with the patient. Then 4 of the other complicated patients were revised. Conclusion: In general, many physicians tend to consider nasal fracture as a simple trauma. However through the strict history taking, physical examination and professional counseling, we could catch the patient's cosmetic desire and get the eyes on new concept: the nasal fracture is not only a trauma but a cosmetic and functional field. In the treatment of nasal bone fracture, if additional rhinoplasty is performed, patients will be more satisfied and we also can expect higher profits.

• 한국산학기술학회논문지
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• 제18권6호
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• pp.547-557
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• 2017

본 연구는 전문대학생들의 학습참여에 관한 학습과정 수준이 성별, 수업연한, 계열, 학점에 따라 어떠한 차이가 있는지를 비교 분석하였다. 연구대상은 G시 소재 K전문대학 정규교육과정 재학생들 중 2015학년도 2학기 학습과정 설문조사 참여에 응답한 재학생 총 684명이었다. 측정도구는 전문대학 학습과정 분석 척도를 수정 및 보완하여 사용하였다. 연구방법은 빈도분석과 성별, 수업연한, 계열, 학점에 따라 전문대학생들의 학습과정 수준 차이를 살펴보기 위하여 일원배치 분산분석과 사후검증을 실시하였다. 연구결과는 첫째, 성별에 따른 전문대학생의 학습과정은 하위요인 중 수업 외 학습활동, 수업 중 학습활동, 학습성과, 대학시설서비스에서 유의한 차이가 있었다. 둘째, 수업연한에 따른 전문대학생의 학습과정은 하위요인 중 수업 외 학습활동, 수업 중 학습활동, 수업만족도, 대학시설서비스에서 유의한 차이가 있었다. 셋째, 계열에 따른 전문대학생의 학습과정은 하위요인 중 수업 외 학습활동, 수업 중 학습활동, 학습 상호작용, 학습성과에서 유의한 차이가 있었다. 넷째, 학점에 따른 전문대학생의 학습과정은 학습과정과 전체 하위요인(수업 외 학습활동, 수업 중 학습활동, 수업만족도, 학습 상호작용, 학습성과, 대학 시설 서비스)에서 유의한 차이가 있었다. 마지막으로 본 연구결과에 대한 논의 및 함의를 기술하였다.

• 한국산학기술학회논문지
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• 제18권3호
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• pp.586-599
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• 2017

본 논문은 빅데이터 분석방법인 텍스트 마이닝 기법을 활용하여 직업학 분야 전반의 연구동향을 파악하기 위한 것이다. 분석 결과 우리나라에서 직업학은 1997년 IMF외환위기를 기점으로 급격한 성장세를 보이는 등 글로벌 경제위기에 직접적인 영향을 받고 있는 것으로 나타났다. 또 연구 주제가 정부 정책이나 제도 등 '거시'에서 개인의 진로 설정 등 '미시'로 전환되고 있고, 연구 관점도 장애인 여성 등 사회적 약자에서, 은퇴자 실업자 등 경제적 약자로 변화되는 모습을 보였다. 조사 대상은 초 중 고등학생보다 대학생이 압도적으로 많았다. 그러나 진로상담의 임상적 결과분석이나 직업정보가공, 직업발달사적 논점의 시도는 적었음을 확인할 수 있었다. 본 연구는 분석대상을 학술지 초록에 한정하여 수행했다는 한계점이 존재하나, 텍스트 마이닝 기법 중 하나인 토픽분석을 통해 검색이 가능한 논문을 전수 조사하는 등 직업학 연구에 있어 정량적 분석 방법론의 틀을 마련했다는 점에서 의의가 있다. 또한 직업학 연구의 발전단계별 논점들을 분석한 최초의 시도라는 점에서도 의미가 있다고 할 수 있다.

• 한국임상약학회지
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• 제25권1호
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• pp.18-26
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• 2015

Background: The recent change in pharmaceutical education system following the paradigm shift to patient-oriented pharmacy service requires an in-depth discussion to reorganize a future direction and establish a basis for maximizing social values of community pharmacy service. Objective: This study was conducted to review the current status of community pharmacy service provision in Korea based on published literatures. Methods: The electronic databases of National Digital Science Library and Electronic National Assembly Library were used to search the journal articles and dissertation papers. A search term "community pharmacy" was used and the published period was limited to papers published after year 2001, when the legal separation of prescribing and dispensing was implemented. Relevant study reports were also searched manually. Information about pharmacy service provision and study outcomes were retrieved from the selected papers, and classified by predefined individual service scope. Results: A total 33 papers reporting services provided by community pharmacies were selected (journal article 11, dissertation paper 17, and study report 5). Pharmacy services identified in these papers could be classified into prescription dispensing service, pharmaceutical care service, self medication service, other products service, and health promotion service. Twenty papers reported prescription dispensing services, three papers reported pharmaceutical care service, and only two papers reported health promotion service. Current community pharmacy services are highly dependent on prescription drugs while expanded services such as pharmaceutical care and health promotion are peripheral. Most prevalent research topic was medication counseling service (18 papers), reflecting that community pharmacists generally consider it to be the most important and fundamental service. Overall, current pharmacy services are very limited and focus on prescription dispensing service. Conclusion: At this point of time requiring expansion and quality improvement of community pharmacy services, we suggest further lively discussion to strengthen pharmacist's functional identity and set conditions for providing socially expected services.

• Journal of Preventive Medicine and Public Health
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• 제49권6호
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• pp.394-405
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• 2016

Objectives: The survival outcomes of antiretroviral treatment (ART) programs have not been systematically evaluated at the state level in India. This retrospective study assessed the survival rates and factors associated with survival among adult human immunodeficiency virus (HIV)-infected patients in Andhra Pradesh, India. Methods: The present study used data from 139 679 HIV patients aged ${\geq}15$ years on ART who were registered from 2007 to 2011 and were followed up through December 2013. The primary end point was death of the patient. Mortality densities (per 1000 person-years) were calculated. Kaplan-Meier and Cox-regression models were used to estimate survival and explore the factors associated with survival. Results: The overall median follow-up time was 16.0 months (2.0 months for the deceased and 14.0 months for those lost to follow-up). Approximately 13.2% of those newly initiated on ART died during follow-up. Of those deaths, 56% occurred in the first three months. The crude mortality rate was 80.9 per 1000 person-years at risk. The CD4 count (adjusted hazard ratio [aHR],4.88; 95% confidence interval [CI], 4.36 to 5.46 for < $100cells/mm^3$ vs. > $350cells/mm^3$), functional status (aHR, 3.05; 95% CI, 2.82 to 3.30 for bedridden vs. normal), and body weight (aHR, 3.69; 95% CI, 3.42 to 3.97 for <45 kg vs. >60 kg) were strongly associated with the survival of HIV patients. Conclusions: The study findings revealed that high mortality was observed within the first three months of ART initiation. Patients with poor baseline clinical characteristics had a higher risk of mortality. Expanded testing and counseling should be encouraged, with the goal of ensuring early enrollment into the program followed by the initiation of ART in HIV-infected patients.

• 재활복지공학회논문지
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• 제9권2호
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• pp.89-103
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• 2015

본 연구는 척수손상 환자를 대상으로 병원기반 사회복귀 지원프로그램을 개발하고, 프로그램 시행 전 후를 비교 분석함으로써 프로그램의 효과성을 평가하고자 하였다. 재활병원에 입원해 있는 25명의 척수손상 환자를 대상으로 2~3개월 동안 일주일에 2번 평균 6.1개의 프로그램을 실시하였다. 프로그램 시행 전, 후 COPM, HADS, AD-R, WHOQOL-BREF를 통해 작업 수행도 및 만족도, 불안과 우울, 장애수용, 삶의 질을 비교하였으며, 퇴원 시 CIQ로 지역사회통합 수준과 퇴원 후의 사회복귀여부를 측정하였다. 자료분석은 기술통계와 대응표본 t검정(paired t-test)을 실시하였다. 연구결과 병원기반 사회복귀 지원프로그램 실시 후 작업 수행도 및 만족도, 장애수용, 삶의 질에 향상을 보였다(p<0.05). 또한 퇴원 후 25명의 척수손상 환자 중에서 10명이 가정, 학업, 직업으로 복귀하였다. 이를 통해 병원기반 사회복귀 지원프로그램이 척수손상 환자들이 퇴원 후 그들이 속한 지역사회로 돌아가는데 효과적임을 알 수 있었다. 척수손상 환자들이 가정과 사회로의 빠른 복귀를 위해서는 사회복귀를 위한 다양한 프로그램 개발과 더불어 체계적인 사회복귀 연계시스템이 이루어져야 할 것으로 사료된다.

• 대한예방한의학회지
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• 제23권3호
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• pp.41-57
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• 2019

Objective : The purpose of our study is to compare and analyze the standards for the 2nd cycle of Evaluation and Accreditation system on institute of Korean Medicine Education & Evaluation (2nd IKMEE standards) and WHO guidelines for quality assurance of Traditional Medicine Education in the Western Pacific Region (WHO/WPRO guidelines) around the global standards of World Federation for Medical Education for basic medical education (WFME standard) to identify the shortcomings and improvements of 2nd IKMEE standards. Method : Each article of 2015 revised WFME standard was translated and summarized with focus on its core content. The next step was to review and analyze the corresponding contents of 2nd IKMEE standards in 2016 and the WHO/WPRO guidelines in 2005 for each item, focusing on the WFME standards. Results : All items in the fields of 3. assessment of students and 7. program evaluation in the WFME domain were absent from the 2nd IKMEE standards, and almost none of the WHO/WPRO guidelines. Most items in 1. the mission and outcomes domain, except for some items in the 1.1 mission field, the items of 2.6~2.8 fields in 2. education program domain, the items of 4. student domain except for the items of 4.3 student counseling and support field, and almost all items about quality development in WFME standards did not have a corresponding item in both the 2nd IKMEE standards and the WHO/WPRO standards. Conclusion : 1. The WFME standards are applicable to the criteria development of IKMEE standards. Several items of the WFME standards may need to be modified to apply the educational characteristics of Korean medicine, but consensus or further study is required. 2. Both the 2nd IKMEE standards and the WHO/WPRO standards are very insufficient to meet the WFME standards. In particular, 3. assessment of students and 7. program evaluation in the WFME domain were not in the 2nd IKMEE standards. This standard needs to be supplemented.