• 제목/요약/키워드: Health Care Providers

검색결과 584건 처리시간 0.025초

학령기 아동의 학업스트레스, 회복탄력성이 라이프케어를 위한 삶의 질에 미치는 영향 (Effects of Academic Stress and Resilience on Quality of Life for Life Care in School-age Children)

  • 양미란;유미
    • 한국엔터테인먼트산업학회논문지
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    • 제13권8호
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    • pp.563-572
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    • 2019
  • 본 연구는 학령기 아동의 학업 스트레스와 회복탄력성이 아동의 삶의 질에 미치는 영향을 확인하기 위해 시행되었다. G 광역시 2개 초등학교에서 4, 5, 6학년 266명을 대상으로 하는 단면적이고 서술적인 연구 설계였다. 자료 수집은 2019년 9월부터 10월까지 수집하였다. 연구 대상자에게 학업 스트레스, 회복탄력성, 삶의 질을 측정하였고 SPSS / WIN 25.0 프로그램을 사용하여 기술 통계, t- 검정, 분산 분석, Pearson 상관 계수 및 다중 회귀 분석을 사용하여 데이터를 분석했다. 그 결과 학령기 아동의 삶의 질에 영향을 미치는 요인은 학업 스트레스(β=-.29, p<.001), 과외 학업 스트레스(β=-.19, p=.004), 회복탄력성(β=.19, p<.001)으로 이 변수는 학령기 아동의 삶의 질의 31.0 %를 설명했다. 결론은 학업 스트레스가 낮고 회복탄력성이 높을수록 삶의 질이 높은 것으로 나타났다. 따라서 학령기 아동의 삶의 질을 향상시키기 위해 의료 제공자는 이러한 요소를 고려한 중재 프로그램을 개발할 필요가 있다.

근거기반 유치도뇨간호 실무지침 개정 (Updates of Nursing Evidence-Based Practice Guideline for Indwelling Urinary Catheterization)

  • 박경희;추희정;서현주;홍혜경;이주현;임경춘
    • 임상간호연구
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    • 제29권3호
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    • pp.211-222
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    • 2023
  • Purpose: This study was conducted to update the existing evidence-based nursing clinical practice guideline for indwelling urinary catheterization (IUC). Methods: The guideline have been revised in 22 steps based on international standards. The quality of the practice guidelines to be used for revision was evaluated using the Appraisal of Guidelines for Research and Evaluation II. The evaluation of the content appropriateness and applicability of the draft recommendations of the revised practice guidelines was performed using the RAND/UCLA Appropriateness Method, a decision-making method developed by the RAND Corporation. Four guidelines were used for the revision. Results: The updated nursing practice guideline for IUC consisted of 9 domains and 134 recommendations. The numbers of recommendations in each domain were: 4 Assessment, 20 Equipment, 11 Catheter insertion, 52 Catheter maintenance, 4 Catheter and drainage bag change, 9 Catheter removal, 22 Complications management, 5 Education and consult, and 7 Hospital support. The recommended grade was 8.2% for A, 38.1% for B, and 53.7% for C. Among these, the major revision was done in 11 recommendations (8.2%). A total of 29 recommendations (21.6%) were newly added. 30 (22.4%) recommendations had minor revisions such as changes or addition for some words or sentences, and 13 (9.7%) recommendations were deleted. Conclusion: Revised nursing practice guideline is expected to serve as an evidence-based practice guideline for IUC in Korea. This guideline will provide health care providers, patients, and caregivers with information to help manage IUC, leading to improved patient outcomes.

도진우(都鎭羽)의 『동서의학요의(東西醫學要義)』에 대한 연구 (A Study of Do Jinwoo's Dongseo uihak youi (東西醫學要義))

  • 김현구;안상우;김남일
    • 한국의사학회지
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    • 제36권1호
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    • pp.99-112
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    • 2023
  • This paper analyzes the historical context, the author, and the organization of contents of Dongseo uihak youi (Essentials of Eastern and Western Medicines), which was written by Do Jinwoo. In the colonial situation of the early twentieth century, the tradition of Korean medicine faced crises and challenges in many ways. Members of the Korean medicine community were simultaneously faced with continuing the tradition of Korean medicine and becoming healthcare providers with a specific role within the healthcare system of the time. Dongseo uihak youi is the result of the collective and official efforts of the Association of Korean Medicine of the time to maintain its tradition where only Western medicine was officially allowed to be taught and tested after the promulgation of the Rules of the Medical Student (ŭisaeng). Dongseo uihak youi was the first Korean medicine book to precisely describe and compare the names of diseases in Eastern and Western medicines. Dongseo uihak youi contained not only medical theories and prescriptions but also laws and forms, in that the purpose of the book was not simply to cultivate clinical skills but also to demarcate the boundary of medical knowledge and activities required of a practitioner of Korean medicine in the modern colonial health care system of the time.

The effects of dietary self-monitoring intervention on anthropometric and metabolic changes via a mobile application or paper-based diary: a randomized trial

  • Taiyue Jin;Gyumin Kang;Sihan Song;Heejin Lee;Yang Chen;Sung-Eun Kim;Mal-Soon Shin;Youngja H Park;Jung Eun Lee
    • Nutrition Research and Practice
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    • 제17권6호
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    • pp.1238-1254
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    • 2023
  • BACKGROUND/OBJECTIVES: Weight loss via a mobile application (App) or a paper-based diary (Paper) may confer favorable metabolic and anthropometric changes. SUBJECTS/METHODS: A randomized parallel trial was conducted among 57 adults whose body mass indices (BMIs) were 25 kg/m2 or greater. Participants randomly assigned to either the App group (n = 30) or the Paper group (n = 27) were advised to record their foods and supplements through App or Paper during the 12-week intervention period. Relative changes of anthropometries and biomarker levels were compared between the 2 intervention groups. Untargeted metabolic profiling was identified to discriminate metabolic profiles. RESULTS: Out of the 57 participants, 54 participants completed the trial. Changes in body weight and BMI were not significantly different between the 2 groups (P = 0.11). However, body fat and low-density lipoprotein (LDL)-cholesterol levels increased in the App group but decreased in the Paper group, and the difference was statistically significant (P = 0.03 for body fat and 0.02 for LDL-cholesterol). In the metabolomics analysis, decreases in methylglyoxal and (S)-malate in pyruvate metabolism and phosphatidylcholine (lecithin) in linoleic acid metabolism from pre- to post-intervention were observed in the Paper group. CONCLUSIONS: In the 12-week randomized parallel trial of weight loss through a App or a Paper, we found no significant difference in change in BMI or weight between the App and Paper groups, but improvement in body fatness and LDL-cholesterol levels only in the Paper group under the circumstances with minimal contact by dietitians or health care providers.

병원시장지역 내 경쟁 정도가 의원급 의료기관의 항생제 처방률에 미치는 영향 (The Effect of the Degree of Competition of the Hospital Market Regions on Clinic's Rate of Antibiotics Prescription)

  • 조창익;임재영;이수연
    • KDI Journal of Economic Policy
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    • 제30권2호
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    • pp.129-155
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    • 2008
  • 급성상기도감염증에 대한 항생제 처방률은 의료기관의 유형, 표시과목, 의료기관이 위치한 지역 등 여러 요인에 따라 차이를 보인다. 본 연구는 1차 의료기관인 의원들 중 내과, 소아과, 이비인후과 의원의 급성상기도감염증에 대한 항생제 처방률에 환자의 특성과 같은 의학적 요인이 아닌 의원의 수입과 밀접한 관계가 있는 의원 수의 변화(경쟁 정도의 변화)와 같은 경제적 요인이 미치는 영향을 실증 분석하였다. 2006년 건강보험심사평가원에서 발표한 전국 각 의료기관의 급성상기도감염증에 대한 항생제 처방률을 주 자료원으로 하여, 경쟁지수를 두 가지 형태로 정의하고 수요 측면을 나타내는 변수와 공급 측면을 나타내는 변수를 통제변수로 선정하여 회귀분석을 실시한 결과 경쟁지수를 어떤 형태로 정의하든, 의원이 위치한 지역의 경쟁정도는 의사들의 항생제 처방률에 통계적으로 유의한 영향을 미친 것으로 분석되었다. 이러한 결과는 시장지역 내 경쟁 정도의 변화와 같은 경제적 요인이 의사들의 처방행태에 영향을 미치는 요인 중 하나라고 해석할 수 있다. 아울러 인과관계의 방향과 관련하여, 의사가 진료하는 지역의 경쟁 정도가 높아질수록 항생제 처방률이 통계적으로 유의하게 높아지는 것으로 나타났다. 이러한 결과는 의사의 진료수입 감소를 초래할 것으로 예상되는 시장환경의 변화에 대해 자신의 진료수입을 예전상태로 보전하기 위해 불필요한 의료서비스 소비를 유도해서 얻는 편익(소득효과)이 이를 위해 자신이 지불해야 할 비용(대체효과)보다 크기 때문에 항생제 처방률을 증가시킨 것으로 해석할 수 있으며, 또한 경제적 유인체계의 변화에 대하여 의사의 진료행태가 영향을 받을 수 있음을 실증적으로 뒷받침하는 것으로 이해할 수 있을 것이다.

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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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실시간 헬스케어 시스템을 위한 데이터 스트림 서버의 설계 및 구현 (The Design and Implementation of the Real-time Data Stream Server for Continuity of Care Record)

  • 오택군;이연;배해영
    • 한국컴퓨터정보학회논문지
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    • 제16권12호
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    • pp.71-81
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    • 2011
  • 스마트폰 기반 개인 전자의료기록 관리 서비스는 병원과 의사와 환자가 병력을 공유하고 조회하여 환자의 병력을 효과적으로 관리하여 진단 효율을 높이는 서비스이다. 그러나 이런 전자의료기록 관리 서비스에서 발생되는 데이터는 도시와 같은 큰 범위의 모든 환자들의 병력 데이터를 전통 데이터베이스 관리시스템(DBMS)을 사용해 처리할 경우 빈번하게 발생하는 질의 처리 요청 등의 원인으로 병목현상이 발생 할 수 있어 실시간 데이터 스트림의 처리를 지원하는 데이터 스트림 관리시스템(Data Stream Management System)에 대한 연구가 진행되고 있다. 본 논문에서는 시스템 구조 및 연속 질의 처리기와 CCR 데이터 구조를 포함한 CCR 데이터 스트림 서버 시스템을 제안한다. 제안 시스템은 실시간적으로 발생하는 CCR 데이터 스트림을 처리 및 모니터링 하기 위한 시스템으로 사용자의 CCR 데이터 이력데이터에 대한 조회 및 실시간으로 발생하는 CCR 데이터에 대한 연속질의를 지원한다. 또한 개인 건강 정보는 지리적으로 떨어져 있는 헬스케어 프로바이더 사이에서 공유되어 환자의 병원이력정보를 관리한다. 또한 본 논문에서는 제안시스템에 기반한 아이폰 헬스케어 응용어플리케이션을 설계 및 개발하여 제안 시스템의 설계와 구축과정 및 성능을 보여준다.

상급종합병원의 간호·간병통합서비스 병동에 근무하는 간호사의 직무스트레스, 직무만족 및 이직의도 (Exploring Job Stress, Job Satisfaction, and Turnover Intention of Nurses in the Comprehensive Nursing Service)

  • 곽숙희;현수경
    • 문화기술의 융합
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    • 제5권2호
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    • pp.23-30
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    • 2019
  • 본 연구는 상급종합병원의 간호 간병통합서비스 병동에서 근무하는 간호사의 직무스트레스, 직무만족도, 이직의도를 파악하기 위한 서술적조사연구로서 상급종합병원 두 곳을 편의추출하여 이 두 의료기관의 간호 간병통합서비스 병동에 근무하고 있는 간호사를 대상으로 설문조사를 실시하였다. 자료 분석은 대상자의 일반적 특성, 직무스트레스, 직무만족, 이직의도는 서술통계로, 대상자의 일반적 특성에 따른 직무스트레스, 직무만족, 이직의도의 비교는 Mann-Whitney U test를 이용하였다. 본 조사연구가 실시된 상급종합병원 두 곳의 간호 간병통합서비스 병동에서 근무하는 간호사는 모두 여성으로 30세 미만이며 미혼이 대부분이었다. 학력은 학사가 대부분이었다. 간호사 월수입은 93.8%가 150이상 300만원 미만으로 응답하였다. 직무스트레스가 높게 나타난 하위영역은 '의사와갈등', '보호자와 환자', '대인관계갈등'이었고, 직무만족이 가장 낮은 영역은 '보수및승진' '필수적직무'였다. 높은 이직의도를 보인 경우는 '본인이 원하지 않는 부서이동이 되었을때 이직하고 싶다', '부서이동을 인해 업무수행에 어려움이 심할 때 이직하고 싶다', '업무에 비해 월급이 적다고 느낄 때 이직하고 싶다' 등이었다. 간호 간병통합서비스 본래의 취지에 부합하도록 이 서비스를 정착하고 확대하기 위해서는 이 서비스를 제공하는 주요 의료인력인 간호사의 근무환경에 대한 체계적인 평가가 필요하다. 간호 간병통합서비스를 제공하는 간호사의 직무스트레스를 낮추고, 직무만족을 높이기 위해서는 적절한 보상, 명확한 업무에 대한 규정, 일반병동과 간호 간병통합서비스 병동 중에 선호하는 곳에서 근무할 수 있는 여건 등이 고려되어야 하며 이를 위해 정책적인 지원이 필요하다.

정신질환자의 타해(他害)사고와 의료과오책임 (Psychotherapist's Liability for Failure to Protect Third Person)

  • 손흥수
    • 의료법학
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    • 제11권1호
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    • pp.331-393
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    • 2010
  • Psychiatrists who treat violent or potentially violent patients may be sue for failure to control aggressive outpatients and for the discharge of violent inpatients. Psychiatrists may be sued for failing to protect society from the violent acts of their patients if it was reasonable for the psychiatrists to have known or should have known about the patient's violent tendencies and if the psychiatrists could have done something that could have safeguarded in public. The courts of a number of jurisdictions have imposed a duty to protect the potential victims of a third party on persons or institutions with a special relationship to that party. In the landmark case of Tarasoff v Regents of University of California, the California Supreme Court held that the special relationship between a psychotherapist and a patient imposes on the therapist a duty to act reasonably to protect the foreseeable victims of the patient. Under Tarasoff, when a therapist has determined, or under applicable professional standards should determine, that a patient poses a serious threat of violence to another, he incurs an obligation to use reasonable care to protect the intended victim against such danger. In addition to a Tarasoff type of action based on a duty to warn or protect foreseeable victims of psychiatric outpatients, courts have also imposed liability on mental health care providers based on their custody of patients known to have violent propensities. The legal duty in such a case has been stated to be that where the course of treatment of a mental patient involves an exercise of "control" over him by a physician who knows or should know that the patient is likely to cause bodily harm to others, an independent duty arises from that relationship and falls on the physician to exercise that control with such reasonable care as to prevent harm to others at the hands of the patient. After going through a period of transition, from McIntosh, Thompson and Brady case, finally, the narrow rule of requiring a specific or foreseeable threat of violence against a specific or identifiable victim is the standard threshold or trigger element in the majority of states. Judgements on these kinds of cases are not enough yet in Korea, so that it may be too early to try find principles in these cases, however it is hardly wrong to read the same reasons of Tarasoff in the judgements of Korea district courts. To specific, whether a psychiatric institute was liable for violent behavior toward others depends upon the patients conditions, circumstances and the extent of the danger the patients poses to others; in short, the foreseeability of a specific or identifiable victim. In this context if a patient exhibit strong violent behavior toward others, constant observation should be required. Negligence has been found not exist, however, when a patient abruptly and unexpectedly attack others or unidentifiable victim. And the standard of conduct that is required to meet the obligation of "due care" is based on what the "reasonable practitioner" would do in like circumstances. The standard is not one of excellence or superior practice; it only requires that the physician exercise that degree of skill and care that would be expected of the average qualified practitioner practicing under like circumstances. All these principles have been established in cases of the U.S.A and Japan. In this article you can find the reasons which you can use for psychotherapist's liability for failure to protect third person in Korea as practitioner.

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간호사와 치위생사의 환자안전문화 인식수준 비교연구 (Comparative studies in Perception of Patient safety culture of Nurses and Dental hygienist)

  • 김미영;김영미
    • 한국산학기술학회논문지
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    • 제13권11호
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    • pp.5196-5205
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    • 2012
  • 목적 : 본 연구는 간호사와 치위생사의 환자안전문화에 대한 인식수준을 파악하기 위해 시행되었다. 방법 : 2010년 9월부터 12월까지 부산, 경남지역의 병원에 종사하는 간호사와 치위생사 399명을 대상으로 환자안전문화 인식 도구를 사용하여 설문조사가 시행되었으며, 수집된 자료는 SPSS 프로그램을 사용하여 평균과 표준편차, t-test와 ANOVA, Scheffe test, spearman 상관관계분석을 시행하였다. 결과 : 환자안전문화에 대한 인식을 조사한 결과, 간호사는 3.48점, 치위생사는 3.51점으로 나타났다. 세부 영역에서 차이를 보인 항목은, '부서내 안전문화에 대한 인식' 영역 중 '직원배치'(t=2.841, p<.01), '직속상관 관리 태도'(t=-2.471, p<.05), '사고에 대한 피드백과 의사소통'(t=-3.356, p<.01)으로 나타났다. 간호사와 치위생사에게서 환자안전문화에 영향을 미치는 요인으로는 연령과 경력 주당 근무시간이었다. 결론 : 간호사와 치위생사의 환자안전문화 인식수준은 중간정도 수준으로, 환자안전문화 인식수준에 영향을 미치는 연령, 경력, 주당 근무시간 등이 고려된 접근과 적절한 근무시간 정착이 필요할 것으로 사료된다.