• 대한불안의학회지
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• 제15권2호
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• pp.61-67
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• 2019

Objective : This study aimed to investigate the general process from the symptom onset to the psychiatric treatment in Korean panic patients and the effect of improved public awareness on it. Methods : This study has a retrospective design. The subjects were the new patients with panic disorder who visited the psychiatric outpatient clinic in twelve university-affiliated hospitals all across Korea. The medical chart was reviewed retrospectively and the data were collected including chief complaints of symptoms, recent stressors, the time to visit the psychiatric outpatient clinic, and visit of other departments and diagnostic approaches for their symptoms. Results : A total of 814 participants were included in the study. The most common department other than psychiatry the panic patients visited were cardiology (28.3%), general internal medicine (16.0%) and neurology (11.4%). The most frequently used diagnostic tests were a echocardiography (17.9%), 24-hour Holter monitoring (11.2%), and brain MRI (8.2%). Only 37.3% of participants visited psychiatric clinic directly. About 80% of participants visited psychiatric department within 1 year after their first panic symptoms and it took $13.8{\pm}13.7weeks$ on average. Comparing before and after 2012, the number of participants increased who visit directly the psychiatric clinic without visiting other departments (p=0.002) and without visiting emergency room (p<0.001). Conclusions : Our results suggest that a substantial number of patients visit departments other than psychiatry when they experience first panic symptoms. However, most patients begin psychiatric treatment within 1 year after their first symptoms and the number of patient are increasing who visit psychiatric department directly without visiting other departments.

• 의학교육논단
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• 제11권2호
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• pp.15-24
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• 2009

Medical Students' competencies depend on the medical school curriculum. Basic medical education, in particular, is an important starting point for further medical competency development. We aimed to identify the most important areas of reform in the basic medical education curriculum of Yonsei Medical School. To accomplish this, we sought case studies of different medical schools and discussion points for quality improvement methods. A qualitative comparison method saturated through the systematic discussions on the emerging thematic approaches to determine the current directions in medical school curriculum reform. The discussions, which involved 7 experts, spanned 8 months and were based on a literature review, with focus on the 7 selected case studies. From the discussions, we concluded that in order to improve basic medical education curriculum, the following measures need to be carried out. First, an outcome-based curriculum is to be designed. The expected outcome is to be deliberately and succinctly defined and should be expressed as teaching and learning objectives. Second, the core subjects and elective subjects are to be classified on the basis of the aim, content, and passage level of the subjects. Hence, the core curriculum must be treated as a standard part of medical knowledge, and the elective curriculum must be richer and more in-depth. Third, universities should institutionalize regular evaluation of their departments. Appropriate and just evaluations should be made, and feedback given to the school's administrative department. Fourth, the departmental and administrative management of the basic medical education curriculum should be harmonized with each other. Finally, teaching and learning resources are to be increased and diversified and made available to professors and students for basic medical education.

• Pediatric Infection and Vaccine
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• 제22권3호
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• pp.186-193
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• 2015

목적: 소아병원 의료기관 종사자들의 손 위생 수행률을 계량화하고 분석함으로써 소아병원 종사자의 손 위생 수행실태에 대한 기본 자료를 구축하고자 수행되었다. 방법: 3차 의료기관이며 대학병원인 313병상 소아병원의 533명 직원을 대상으로 WHO 손 위생 모니터링 도구로 2010년도 11월 1일부터 12월 31일까지 직접관찰법으로 자료를 수집하였다. 결과: 총 관찰건수 2,999으로, 손 위생 수행률은 95.3%였고, 직종별로 간호사(97.7%), 의사(89.2%), 이송직(72.1%) (P<0.001), 부서별로 중환자실(92.5%), 외래(95.4%), 응급실(97.2%), 수술실(97.2%) 이었으며(P<0.001), 의사직급별로 전임의(97.5%), 교수(93.9%), 전공의(89.7%), 인턴(80.9%)이었다(P<0.001). 손 마찰(81.1%)을 많이 사용하였고, 손 씻기는 '환자 체액 노출 후'(37.7%), '환자 환경 접촉 후' (28.5%)에 많이 사용하였다. 손 위생 방법은 부서별로 차이가 없었으나(P=0.083), WHO 5 Moments 별로 차이가 있었다(P<0.001). 직종별 WHO 5 Moments 분포는 차이가 있었다(P<0.001). 손 위생 이행 odds ratio는 의사직 0.353 (95% CI, 0.241-0.519), 중환자실 0.291 (95% CI, 0.174-0.487), 외래 0.484 (95% CI, 0.281-0.834)이었다. 결론: 손 위생 수행은 직종별, 부서별로 차이가 있었다. 직종별, 부서별로 효과적인 손 위생 교육 및 훈련 프로그램 개발이 필요하다.

• 한국응급구조학회지
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• 제7권1호
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• pp.81-94
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• 2003

This study tries to examine the level of safety consciousness and first aid knowledge of 124 college students who attend non-public health departments in Gwangju from April 1 to 30, 2003 and apply the results of the study to curriculum. The results of this study are as follows; 1. On experiences of need of first-aid, 87.5% of respondents said 'yes' and there was a significant difference in the number of their siblings($x^2$ = 7.482, p = .048). 2. Sources of education of first aid were mostly at school(46.8%), no education(23.4%), through mass communication(22.6%) and by themselves(7.3%). There were significant differences by characteristics in sex($x^2$ = 30.230, p = .000), year($x^2$ = 10.821, p = .013) and mother's education($x^2$ = 18.932, p = .025). 3. Sources of information of first aid were mostly through TV(46.8%), followed by others (42.7%), newspapers(7.3%) and magazines(3.2%). 4. On the opinions of the most suitable period for educating first aid, elementary school was highest(41.9%), followed by kindergarten(29.0%), middle school(21.0%) and high school (8.1%) and there were significant difference by characteristics of subjects in sex($x^2$=9.689, p= .021) and year($x^2$=19.661, p= .000). 5. Score of knowledge level of safety consciousness was mean $71.58{\pm}12.05$ based on Likert 5-point scale with a full mark of 100 points and there was a significance only in current residence of subjects' general characteristics(F or t=3.894, p=.023). 6. Score of knowledge level of first aid was mean $62.73{\pm}13.29$ based on Likert 3-point scale with a full mark of 90 points and there was a significance only in residential type of subjects' general characteristics(F or t=3.058, p= .031). Although college students felt needs of first aid more than middle and high school students, it was found that their actual safety consciousness and knowledge level of first aid were low. Therefore, knowledge and ability should be developed to save human life from all kinds of emergencies and safety accident and first aid subjects should be separated in college curriculum and opportunity for actual education should be given.

• 한국산학기술학회논문지
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• 제14권5호
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• pp.2281-2292
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• 2013

본 연구는 보건계열 대학생의 스마트폰 이용 동기와 과다사용 간의 관계를 살펴보고, 과다사용을 예측할 수 있는 요인을 확인하고자 시행하였다. 연구대상자는 G광역시에 소재한 G대학교 보건계열 3년제 학과인 응급구조과, 물리치료과, 보건행정과를 임의선정하고 편의표집 한 250명으로 하였다. 2012년 10월 22일부터 25일까지 연구의 목적을 설명하고 동의를 얻은 후, 구조화된 자기기입식 설문지를 이용한 조사를 하였다. 수집된 자료는 SPSS 12.0 for Window를 이용하여 최종 223부를 분석에 사용하였다. 연구결과를 요약해보면, 과다사용 하위요인의 금단에서는 오락 및 여가의 이용 동기가, 내성에서는 과시 및 유행성의 이용 동기가, 강박 및 집착에서는 오락 및 여가의 이용 동기가, 생활불편 및 부작용에서는 과시 및 유행성의 이용 동기가, 과다사용 평균에서는 오락 및 여가의 이용 동기가 가장 높은 영향을 미치는 것으로 확인되었다. 따라서 보건계열 대학생을 대상으로 한 스마트폰 과다사용 예방 교육 프로그램 개발과 적용이 필요하며, 또한 스마트폰 과다사용자를 대상으로 한 실천적 개인 상담 및 관리가 필요하다고 사료된다.

• 한국지역지리학회지
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• 제23권2호
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• pp.388-402
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• 2017

본 연구는 중력모델 기반의 접근도 분석 모델을 수정 보완하여 연령별 응급의료 서비스의 접근도를 분석한 내용이다. 보건의료 접근도 분석에 적용되고 있는 Two-Step Floating Catchment Area(2SFCA) 모델을 보완하여 임계거리 차별화, 거리조락 반영, 연령별 응급의료 이용가중치, 관내 응급의료기관 선택가중치 등을 반영하였다. 개선된 접근도 모델(Modified Three-Step Floating Catchment Area model, M3SFCA)을 통해 충청남도 응급의료기관의 공간적 접근성 분석을 하였다. 분석 결과는 다음과 같다. 첫째, 유소년층, 청장년층, 노년층 모두 응급의료기관을 중심으로 접근성이 높고, 임계거리가 중첩되는 지역에서 접근성이 높았다. 둘째, 시군 연령별 공간적 접근성은 연령대별로 지역차가 뚜렷하며, 전반적으로 북부지역이 남부지역보다 접근성이 높게 나타났다. 셋째, 연령별로 접근성 차이가 발생한 이유는 연령별 임계거리, 응급의료기관 이용비중, 관내 기관 이용비중이 각각 다르며, 연령별 총 인구수의 차이로 나타났다. 마지막으로 본 연구는 응급의료 접근도 모델 개선을 통해 이론적 연구를 통한 실제 현장의 활용성의 가능성과 잠재성을 확인하였다. 연구 결과를 바탕으로 보건의료 및 응급의료 관련 정책 개발 및 활용에 기여할 것으로 기대한다.

• 시큐리티연구
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• 제61호
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• pp.87-107
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• 2019

"공공부문 정규직 전환"이라는 정부의 정책 변화에 따라 국회, 정부청사, 인천공항 등 국가중요시설에 대한 보안산업에 상당한 변화가 일어나고 있다. 또한, 현역병 지원감소 등의 이유로 2023년 의무경찰 제도가 폐지하게 되어 국회, 정부청사, 경찰청 등 국가중요시설뿐만 아니라 경찰관서, 국회의장 등의 공관 및 전직 대통령 사저 등에서 기존 의무경찰이 담당하던 시설경비업무를 대체할 수 있는 인력 마련이 시급한 현실이다. 이에 따라 본 연구에서는 대체 인력으로 거론되고 있는 청원경찰, 특수경비원, 방호원의 법적근거 및 관리감독, 고용형태 및 임금, 직무범위 및 직무권한에 대한 비교분석을 실시하였으며, 수도권 5개 대학(2년제 전문대학 3개, 4년제 대학교 2개)의 경호 및 보안 관련 학과에 재학 중인 학생 234명을 대상으로 설문조사를 실시한 결과 청원경찰로 대체하는 것이 가장 효과적인 방안이라 할 수 있다. 이러한 보안산업의 변화에 따라 경호 및 보안 관련 학과에서는 청원경찰로의 취업 등 우수한 인력을 양성하기 위해 '위급상황 대처능력', '무도능력'을 중심으로 학생들의 다양한 능력을 향상시키기 위해 노력해야 한다. 또한, '무도 단증'과 '응급구조 및 심폐소생술', '경비지도사 및 신변보호사' 등의 자격증을 취득하기 위한 '무도실기', '청원경찰법', '응급구조 및 심폐소생술' 등의 과목을 경호 및 보안 관련 학과 교육과정에 적극적으로 반영할 필요성이 있다.

• 임상간호연구
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• 제26권3호
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• pp.395-406
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• 2020

Purpose: The purpose of this study was to analyze nurse staffing according to patients' acuity and dependency by measuring nursing hours. Methods: The study sample included patients who visited the adult emergency departments (EDs) of three tertiary referral hospitals and nurses who worked on shifts for 48 hours from October 24 to 26, 2019. Hourly patient census and nurse staffing were analyzed. Patient acuity was measured using the Korean Triage and Acuity Scale (KTAS), ranging from Level 1 (highest) to Level 5 (lowest). Patient dependency was measured using six items (e.g., clinical attention and communication) and classified into four groups. Nursing activities were observed every 10 minutes and nursing hours per patient and nurse staffing were analyzed according to acuity and dependency. Results: Nurse-to-patient ratio ranged from 1:1.8 to 1:4.2 during the 48 hours of observation. The average work hours of nurses, excluding breaks and meals, was 8.57 hours; 42.5% of which was spent providing direct care. Higher acuity and dependency were associated with higher nursing hours and staffing level. Patients with KTAS Level 1 were provided 74.3 minutes per hour, 5.02 times higher than Level 5 (14.8 minutes). Patients in the highest dependency group were provided 87.4 minutes per hour, 5.75 times higher than the lowest group (15.2 minutes). Newly arrived patients received more nursing hours than continuously stayed patients within the same KTAS Levels. Conclusion: Large variations were found in hourly patient census, acuity, and dependency. Nurse staffing in EDs should be determined based on patient acuity and dependency.

• 한국시뮬레이션학회논문지
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• 제31권3호
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• pp.55-61
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• 2022

현재 경찰과 소방이 범죄신고, 긴급출동과 같은 구조 상황발생 시 통화권영역 내에서는 이동통신 사업자가 구축한 네트워크,와이파이,GPS기반의 긴급 구조용 측위시스템을 활용하여 요구조자의 단말과 직접 연동하여 예상위치를 정밀 측위를 하고 있다. 그러나 산악구조의 경우 조난자가 산악지형의 음영지역에 위치하거나 단말의 방전(power off) 시에는 단말과 직접 연동하여 정밀 측위가 불가능하며 마지막 접속 기지국 정보만을 받고 있어 수색의 위치를 한정할 수 없으므로 구조 골든타임 확보가 어려운 상황이다. 본 논문에서는 개선방안으로 시계열 기지국 정보, 위치정보 및 조난자의 성별, 나이, 행동적 특성을 반영한 이동성 모델과 지능형 추론을 기반으로 하는 전파분석 및 위치추정 시뮬레이션과 같은 이동통신 포렌식 기술을 통해 조난자의 예상 위치정보의 확률에 따른 히트맵 방식의 시각화를 통해 위치정보의 정확성을 높여 소방, 수색대의 수색지역을 축소하여 신속하고 정확한 인명구조에 기여할 수 있기를 기대한다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제34권1호
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• pp.4-14
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• 2023

This study aimed to discuss mental health services for children and adolescents that are being implemented as initiatives of the Korean government and to review the functions and roles of these projects during the COVID-19 pandemic. Three government departments are in charge of providing mental health services for children and adolescents: Ministry of Education, Ministry of Gender Equality and Family, and Ministry of Health and Welfare. The Ministry of Education has implemented several policies to facilitate the early detection of mental health issues among school students (from preventive interventions to selective interventions for high-risk students). The Ministry of Gender Equality and Family additionally serves out-of-school children and adolescents by facilitating early identification of adolescents in crises and providing temporary protection or emergency assistance (as required) through the Community Youth Safety-Net Project. Furthermore, the Ministry of Health and Welfare operates relevant mental health agencies for individuals of all ages including children and adolescents. Any high-risk students who have been screened through the projects of the Ministry of Education are supported through referrals to the following institutions for appropriate treatment of their symptoms: specialized hospitals, the Youth Counseling and Welfare Center operated by the Ministry of Gender Equality and Family, the National Youth Healing Center, the Mental Health Welfare Center operated by the Ministry of Health and Welfare, the Suicide Prevention Center, and the Child Welfare Center. To assist students who are facing any psychological difficulties because of the COVID-19 pandemic, the Ministry of Education has established a psychiatric support group for providing emergency mental health care; furthermore, schools are promoting psychological surveillance (e.g., provision of non-face-to-face counseling services that are centered around the Wee Center). The Ministry of Education, Ministry of Gender Equality and Family, and Ministry of Health and Welfare have provided varied mental health support services in order to address the challenges faced by children and adolescents during the pandemic. Nevertheless, the mental health services operated by each ministry do show some limitations because their service provision system is insufficiently collaborative. The present study discussed the positive effects of each initiative as well as its limitations; furthermore, it suggested improvements for facilitating the healthy development of children and adolescents' mental health.