• 한국산학기술학회논문지
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• 제14권3호
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• pp.1350-1358
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• 2013

본 연구는 발 반사마사지를 받는 이용자들의 발 반사요법에 대한 인식수준을 알아보고 그에 관련된 요인을 규명하고자 2011년 09월 01일부터 10월 30일까지의 기간 동안에 대전지역에 소재하고 있는 전문 발 관리실 3곳의 이용자 181명을 대상으로 구조화된 자기기입식 설문지를 이용한 설문조사를 실시하였다. 연구결과, 전체 조사대상자의 발 반사마사지요법 인식수준에 대한 평균점수는 $32.19{\pm}5.32$점(11개 항목의 점수범위; 0-44점)으로 나타났으며, 일반적 특성별 발 반사마사지요법 인식수준은 학력이 높을수록 유의하게 높았다(p=0.020). 조사대상자의 발 반사마사지 요법에 대한 태도 및 실천도에 따른 발 반사마사지요법 인식수준은 "질병치유를 위해서 한다"는 군에서(p=0.034), 발 반사마사지 시작 시 "질병이 있었다"는 군에서(p=0.030). 발 마사지 이용기간이 길수록(p=0.000), 발 반사마사지를 타인에게 "권유 하겠다"는 군에서 유의하게 높았다(p=0.004). 다중회귀분석 결과 발 반사마사지요법 인식수준에 영향을 미치는 관련요인으로는 발 반사마사지 이용 이유, 발 반사마사지 시작 시 건강상태, 발 반사마사지 이용기간 및 발 반사마사지의 타인에의 권유여부가 유의한 변수로 선정되었으며 이들 변수에 대한 설명력은 26.1%이었다. 위와 같은 결과를 볼 때, 전문 발 관리실 이용자들의 발 반사마사지요법 인식수준은 일반적 특성 변수들보다는 발 반사마사지에 대한 태도 및 실천도를 설명하는 변수들과 관련성이 높은 것을 알 수 있었다.

• 대한족부족관절학회지
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• 제15권3호
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• pp.165-169
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• 2011

Purpose: The objective of this study was to analyze diabetic foot patients' direct service costs until the cure of the disease. Materials Methods: The subjects of this study were randomly sampled 60 patients who had been treated for diabetic foot at one of two tertiary hospitals and cured of the disease during from January 2008 to December 2009, and whose diagnostic code was E11.5 or E14.5. Data were collected from medical records and direct service costs were analyzed using data on the payments of individual service charges. Direct service costs spent at other medical institutions for the same disease were excluded. Collected data were analyzed using descriptive statistics. Results: The subjects' mean hospital stay was 29 days, and mean period until cure was 132 days. The inpatient cost per patient was 10,844,648 won, outpatient cost was 715,751 won, and home care services cost was 641,854 won, so total direct service cost per patient was 11,913,419 won. The total direct service cost in patients who had their foot amputated was 12,769,822 won, 1.3 times higher than without amputation, who had vascular intervention was 16,219,477 won, 1.9 times higher than non-vascular intervention, who had both infection and artery occlusion was 17,522,435 won, 2.0 times higher than either infection or artery occlusion. Conclusion: In diabetic foot patients, the direct service cost was highest as 17,522,435 won in patients accompanied with both infection and occlusion of lower extremity artery.

• 가정∙방문간호학회지
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• 제16권1호
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• pp.49-58
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• 2009

Purpose: This study aimed to clarify the needs for hospital-based home care nursing medical services in elder care institutions by analyzing the details and frequency of medical services provided by, and the needs for, hospital based home care nursing in select institutions in Korea. Methods: Seventy-seven staffs at elderly care institutions located throughout the country completed self-report questionnaires between February 1 and May 31, 2009. SPSS ver. 14.0 was used for data analysis regarding frequency and percentage, mean and standard deviation. Results: Forty-eight hospital-based home care nursing medical services in eight domains were identified as being needed in elderly care institutions. The most commonly used medical services were providing instruction in oral drug administration, checking drug beneficial/adverse effects, and administering blood glucose test, while the most needed medical services requiring hospital based home care nursing were complex pressure ulcer care, followed by diabetic foot ulcer management and nutrient injection. Conclusion: The present results should provide fundamental data for better healthcare services with hospital based home care nursing at elderly care institutions as part of a 'win-win' strategy through which medical expenses are reduced, insurance costs are kept stable, and safe and high-quality medical services are provided for residents of elder care institutions. Political decisions intended to promote visits by hospital based home care nurses to elder care institutions would be a prudent course.

• Child Health Nursing Research
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• 제12권1호
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• pp.25-33
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• 2006

Purpose: To investigate the health problems and health services in child day care centers. Methods: Data were collected from 115 teachers at 16 child day care centers in Seoul city. A questionnaire was used to collect data, which were analyzed with the SPSS 12.0 program. Results: Most teachers had experienced various child health problems such as colds, hand․foot․mouth diseases, chicken pox, skin injuries, nasal bleeding, vomiting and diarrhea. Furthermore, they even experienced some serious ones including dysentery, measles, asthma and seizures, which demand professional skill. However, there were no registered nurses and most teachers requested that parents take a child home when these health problems happened. Only 31.3% of the child care centers had a teacher with CPR training. Approximately half of the centers kept child health records which included reports on allergic substances, and medical history but only 18.7% of the child care centers offered regular immunizations for the children. Conclusion: Various health problems were found in child day care centers. To maintain the children's health, there is a need to develop and make provisions for health services and programs in child day care centers.

• 간호행정학회지
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• 제14권4호
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• pp.421-431
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• 2008

Purpose: Using comprehensive and valid instrument, MDS-HC 2.0, this study aimed to analyze the functional status and to evaluate the care needs of the community-dwelling disabled with cerebral impairment. Method: With a convenient sample of 88 disabled with cerebral impairment, the data were collected at a community health center located in rural area in Choongchung providence in August 2005. Subject's functional status and care needs were evaluated using Minimum Data Set-Home Care version 2.0. Result: Significant proportion of subjects were totally dependent for locomotion-outdoor (26.1%), personal hygiene (24.1%), bathing (24.1%). For IADLs, over 40% of subjects were totally dependent for ordinary house work, managing finances, or shopping. Top five ranked care needs were preventive health care measures (100%), communication disorders (71.6%), visual function (55.7%), health promotion (52.3%), and pressure ulcers (48.9%). The proportion of triggered clinical assessment protocols were significantly higher in disability level I group for the risk of institutionalization (p=<.001), communication disorders (p=.004), cognitive problems (p=.001), pressure ulcers (p=<.001), skin and foot conditions (p=.010), and urinary incontinence and indwelling catheters (p=<.001). Conclusions: It is necessary to provide community based rehabilitation services that are individualized for their service needs thus enhance optimal level of functioning.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제25권4호
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• pp.7-15
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• 2019

Purpose: The purpose of this study is to identify the current status and use of Gyungrodang located in Heungeop-myeon, Wonju-si and to present improvement and implication for community care in rural area. Methods: The survey of the current status was conducted with interview and observations. The use status of Gyungrodang was surveyed for the elderly over 65 years old who live in Heungeop-myeon using questionnaire. A face-to-face interview was conducted to complete a questionnaire and 181 samples were collected for the study. Results: In the current status, some of the Gyungrodang did not operate during farming season. The external environment, in terms of accessibility, 74.2% of Gyungrodang were located more than 60 minutes on foot from community center, health post, and pharmacy. In addition, the interval between buses run minimum 15 minutes to 120 minutes on average. The internal structure, 35.7% was divided room and toilets. In the use status, the reason for non-use of the Gyungrodang was discomfort(29.0%), and the reason for using was because friends go to the Gyungrodang(44.6%). The most satisfying program was te health care program(65.6%). Implications: First, it is necessary to develop and operate customized health promotion program for target population and seasons. Second, it is necessary to make a plan focused on consumers' needs through satisfaction and demand survey. Third, it is necessary to divide the space of each Gyungrodang by gender when planning the expansion or new construction of Gyungrodang.

• 농촌의학ㆍ지역보건
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• 제18권1호
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• pp.77-91
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• 1993

농촌지역 주민들의 보건의료원에 대한 인식도 및 이용양상을 파악하여 보건의료원 제도와 관련된 연구에 기초자료를 제공하고자 1990년 9월 24일부터 90년 9월 28일 까지 5일간 정상북도 울진군 소재 국민학교 3개교와 중학교 3개교의 학부모들에게 설문지를 배부, 회수된 832가구의 가구원 754명을 대상으로 분석한 결과를 요약하면 다음과 같다. 응답자는 남자 60.3%, 여자 39.7%였고 연령은 30, 40대가 81.3%로 대부분을 차지하였으며, 교육수준은 고졸이 40.3%, 의료보장형태로는 지역의료보험이 44.1%를 차지하였다. 응답자의 58.4%가 보건의료원이라는 명칭을 알고 있었는데, 응답자의 학력과 수입이 높을 수록 그리고 거주지역이 보건의료원에 근접한 지역일수록 보건의료원에 대한 인식도가 높았다(p<0.01). 보건의료원의 진료사업 내용중에서 의료보호대 상자 진료와 치과진료를, 각각 35.1%와 31.0%가 알고 있었으며, 보건예방서비스 사업에서는 예방접종사업을 36.1%로 가장 많이 인지하고 있었는데, 학력과 지리적 근접도가 높을수록 보건의료원의 사업내용 인지도는 높게 나타났다. 보건의료원의 연간 외래이용율과 예방서비스 이용율은 대상자 100명당 11.1회 및 4.5회였으며, 입원이용율은 10,000명당 34.6회였다. 보건의료원 이용동기는 잘나아서(45.7%), 약이 좋아서 (45.2%), 거리가 가까워서(42.9%) 순이었다. 일반병의원과 비교해서 보건의료원의 진료수준이 더 좋다고 응답한 이용자는 16.3% 였고, 더 못하다는 19.0%였다. 또한 보건의료원의 진료비가 저렴하다고 한 응답자는 61.5%인데 비해 비싸다고한 경우는 3.9%였다. 보건의료원 이용시의 교통수단으로는 도보가 55.0%, 버스가 35.5%로 대부분이었다. 보건의료원 이용시 느낀 불편사항으로는 장시간 대기가 46.7%로 가장 많았고, 그 다음으로 이용시간이 제한되어 있어서가 17.8%였다. 보건의료원을 한번도 이용하지 않은 이유로는 아픈적이 없어서가 33.5%, 교통이 불편하고 거리가 멀어서가 28.0%, 장시간 대기한다고 해서가 12.8%순으로 나타났다. 이상과 같이 아직도 보건의료원에 대한 인식이 낮고, 잘못 인식하고 있는 주민이 많기 때문에 보건의료원에 대한 전반적인 홍보가 필요할 것으로 보이며, 보건의료원의 이용율을 높이기 위해서는 의료시설, 장비확충과 더불어 의료진의 보강이 필요하고 관리의 효율성도 고려해야 할 것으로 생각된다.

• 대한족부족관절학회지
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• 제23권3호
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• pp.121-130
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• 2019

Purpose: To investigate the spatial distribution of diabetes-related lower limb amputations and analyze the relationship between the spatial distribution of diabetes-related lower limb amputations and regional factors. Materials and Methods: This study was performed based on the data from the Korean Health Insurance Review and Assessment Service, in 2016. The unit of analysis was the administrative districts of city·gun·gu. The dependent variable was the age- and sex-adjusted incidence of diabetes-related lower limb amputations and the regional variables were selected to represent two aspects: socioeconomic factors, and health and medical factors. Along with traditional ordinary least square (OLS) regression analysis, geographically weighted regression (GWR) was applied for spatial analysis. Results: The age- and sex-adjusted incidence of diabetes-related lower limb amputation varied according to region. OLS regression showed that the incidence of diabetes-related lower limb amputation had significant relationships with the health and medical factors (number of healthcare institution and doctors per 100,000 population). In GWR, the effects of regional factors were not consistent. Conclusion: The spatial distribution of the incidence of diabetes-related lower limb amputations and the effects of regional factors varied according to the regions. The regional characteristics should be considered when establishing health policy related to diabetic foot care.

• Journal of Trauma and Injury
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• 제26권3호
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• pp.111-124
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• 2013

Purpose: We should prepare proper medical service for disaster control as South Korea is not free from terrorism and war, as we experienced through the two naval battles of the Yeonpyeong, one in 1999 and the other in 2002, the sinking of Cheonan in 2010, and the attack against the border island of Yeonpyeong in 2010. Moreover, North Korea's increasingly bellicose rhetoric and mounting military threats against the world demand instant action to address the issue. The aim of this article is to describe our experience with three patients with combat-related gunshot and explosive injuries to their extremities and to establish useful methods for the management of patients with combat-related injuries. Methods: Three personnel who had been injured by gunshot or explosion during either the second naval battle of the Yeonpyeong in 2002 or the attack against the border island of Yeonpyeong in 2010 were included in our retrospective analysis. There were one case of gunshot injury and two cases of explosive injuries to the extremities, and the injured regions were the left hand, the right foot, and the right humerus. In one case, the patient had accompanying abdominal injuries, and his vital signs were unstable. He recovered after early initial management and appropriate emergency surgery. Results: All patients underwent emergent surgical debridement and temporary fixation surgery in the same military hospital immediately after their evacuations from the combat area. After that, continuous administration of antibiotics and wound care were performed, and definite reconstructions were carried out in a delayed manner. In the two cases in which flap operations for soft tissue coverage were required, one operation was performed 5 weeks after the injury, and the other operation was performed 7 weeks after the injury. Definite procedures for osteosynthesis were performed at 3 months in all cases. Complete union and adequate functional recovery were achieved in all cases. Conclusion: The patient should be stabilized and any life-threatening injuries must first be evaluated and treated with damage control surgery. Staged treatment and strict adherence to traditional principles for open fractures are recommended for combat-related gunshot and explosive injuries to the extremities.