• 한국임상약학회지
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• 제30권1호
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• pp.31-35
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• 2020

Objective: The 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) are frequently prescribed medications worldwide for the treatment of hypercholesterolemia. Statins are considered to be well tolerated; however, they have a potential for myotoxicity. Concomitant drugs that inhibit cytochrome P450 3A4 can increase the concentration of statins and thus the risk of developing myotoxicity. The purpose of this study was to evaluate risk factors associated with potential drug-drug interactions in patients receiving statins. Methods: The subjects of this study were patients aged more than 18 years who received at least one prescription of statins in a general hospital located in Chuncheon-si, Korea, between January 1, 2018, and March 31, 2018. Data regarding statin use and baseline characteristics was collected from the computerized hospital database. Logistic regression analysis was used to identify risk factors associated with potential drug-drug interactions. Results: A total of 1061 patients were finally included in the study. The incidence of potential drug-drug interactions was 45% in all subjects. According to the results of the multivariate logistic regression analysis, myocardial infarction as the indication of statin, arrhythmia or heart failure as a comorbidity, and aspartate aminotransferase levels higher than 40 IU/L were significant risk factors for potential drug-drug interactions in study subjects. Diltiazem was the most commonly co-prescribed drug that caused potential drug-drug interactions with statins. Conclusion: There was a considerable rate of potential drug-drug interactions in patients receiving statins. Health care professionals should attempt to reduce potential drug-drug interactions during statin administration.

• 한국화재소방학회논문지
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• 제29권3호
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• pp.70-80
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• 2015

본 연구는 여성119구급대원이 증가하고 있는 추세에 따라 소방 조직 내에서 여성119구급대원의 이미지를 향상시키고 그들을 효과적으로 활용할 수 있는 기초자료로 활용하고자 시행된 연구이다. 연구는 2013년 5월 1일부터 6월 30일까지 Q표본을 선정하여 구급차동승 현장실습을 경험한 응급구조(학)과 학생 총 31명을 대상으로 QUANL program을 이용한 Q방법론을 사용하여 분석하였다. 연구결과 '슈퍼우먼형', '체력한계 히어로형', '섬세한 수호천사형', '능숙한 데스크잡형'의 총 4가지 유형으로 분류되었으며 각각의 설명력은 제I유형 42.2%, 제II유형 4.8%, 제III유형 4%, 제IV유형은 3.6%로 전체변량의 54.7%를 설명하는 것으로 나타났다. 전체적으로 여성119구급대원을 전문가로 인식하고 있지만 체력적인면과 출산 및 육아에 대하여 부담을 가지고 있는 것으로 나타나 조직 구성원의 인식 변화와 제도적인 장치가 마련되어야 할 것이다.

• 대한예방한의학회지
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• 제3권2호
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• pp.129-150
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• 1999

This study was carried out to analyse a perception on acne for the Junior college students to provide basic data for the suitable treatment of acne to the students and the specialists. For this study, self-administering questionnaires were distributed to 480 students from 13 departments at a suburban women's junior college from May 1 to May 3, 1996. Of the students, 399 were responded and included in the analysis. The questionnaire includes the general question of objects, the question of knowledge and attitude of acne, and its treatment. The results were as follows: 1. Age distribution for the group less than 20 years was 63.7% and over 20 years was 36.3%, the group with acne was 66.2% and the group without acne was 33.8%. Proportions of acquiring the knowledge on acne was 49.6% from newspaper or magazine, 47.15 from friends, and 26.85 from TV or radio. 2. With regard to the knowledge on the presence of acne, a proportion of correctly answered for the question on the cause of acne was $3.41{\pm}1.02$ for the group with acne compared with $3.16{\pm}0.89$ for those without acne. This difference was statistically significant (p<0.05). 3. With regard to the knowledge levels on the treatment of acne, a proportion answered' skin-care center' for the question on where to select for the profer treatment was $13.21{\pm}1.88$ compared with $12.09{\pm}1.88$ for the other group. This difference was statistically significant (p〈0.05). A proportion of answered 'squeezing out acne by themselves' for the question of how to treat was $12.26{\pm}1.91$ compared with $10.83{\pm}1.25$ for the other group. 4. In the treatment according to the attitude of the group with acne, the positive group replied 'YES' in the intention of treatment by themselves was 55.9%. In conclusion, the differences in the knowledge and attitude on the presence of acne are not significant and it was found that the knowledge and attitude for the group with acne did not significantly influenced the treatment behavior. Accordingly, it is important to understand the cause of acne, provoking factors, remedy etc. For this, it is necessary to a provide an accurate information to professionals to enhance the knowledge of acne and to treat it properly.

• Journal of Radiation Protection and Research
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• 제35권4호
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• pp.151-156
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• 2010

국내 $^{18}F$-FDG 방사성의약품의 품질관리 시험성적서에 기록되는 시험항목의 종류는 성상, 반감기, 방사성 이핵종, 방사 화학적 확인(Rf값 측정), 방사화학적 순도, Ethanol, Acetonitrile, Kryptofix, Aluminium, pH, Endotoxin, 무균시험, 실용량으로 총 13종류로 나타났다. '성상', '방사성 이핵종', 'pH', 'Endotoxin', '무균시험'에 대해서만 모두 기록하는 것으로 나타났고, '반감기', '방사화학적 확인(Rf값 확인), '방사화학적 순도', 'Ethanol', 'Acetonitrile', 'Kryptofix', 'Aluminium', '실용량'은 방사성의약품 제조기관 마다 기록여부에 차이가 있는 것으로 나타났다. 시험판정 결과는 품질관리 시험항목이 기록된 자료를 근거로 총 13개 항목 모두 100% 적합한 것으로 나타났다. 연구소에서 제조하는 $^{18}F$-FDG 방사성의약품의 품질관리 시험항목이 병원과 기업보다 많았고 방사성의약품의 시험항목수가 많은 것이 적은 것보다 안정성 확보에 대한 신뢰성을 높일수 있는 방법이므로 이에 대한 보완이 필요하다고 본다. 국내의 경우 방사성의약품의 안전성을 나타내는 품질관리 시험성적서의 시험항목은 제조기관마다 차이가 나고 표준화되어 있지 않는 것으로 나타나 이에 대한 보완이 필요하다고 본다. $^{18}F$-FDG 방사성의약품의 품질보증을 위한 표준화된 품질관리 시험성적서의 제시를 위해 미국의 GMP와 유럽의 CE Mark를 참고하고 전문가 자문을 통해 국내 실정에 맞는 기준으로 표준화해야 한다고 본다.

• 기본간호학회지
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• 제7권1호
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• pp.71-85
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• 2000

Social support was found to have buffering effects on the stress response of stroke patients. Especially, the aspects of social support found to be most influential were support from a close, personal source, and overall satisfaction with support. The purpose of this study was to identify the current social network and its characteristics according to gender difference in post-hospitalized stroke patients in Korea. The sample consisted of a convenience sample of 254 patients was recruited 129 men and 125 women who were receiving follow-up care at outpatients clinics. Four aspects of social support-source, quantity, qualify & type- were measured using the modified Social Support Inventory for Stroke Survivors(SSISS) which was developed by McColl & Friedland(1989). Regarding sources of social support, 61.4% reported for 'spouse' as primary caregiver and 31.9%, 'children'. But the distribution of sources of personal support were related to gender; 82.2% of male patients had support from their spouses, while only 40% of female patients reported from 'spouse' but 51.4% from 'children'. Among the children, daughters and sons were more significant support persons than daughters-in-law. The percentages for sources of these significant other support persons were 55.5% for 'children', 8.7% for 'spouse', and 8.3% for 'brothers'. The physician at the outpatient department was the main source of professional support. For the quantify and qualify of social support, the primary caregiver's support was more significant than support by significant other persons. Male patients reported that primary the caregiver' support was greater than that of significant other persons, while female patients perceived significant other persons as giving greater support. Regarding the type of perceived social support, the stroke patients were highly satisfied with the primary caregiver's support in aspects of instrumental, emotional, and informational support. They also reported high satisfaction with support from significant others' support in the aspect of emotional support, while emotional and informational support from professionals was reported as satisfactory. In conclusion, gender difference in the social support network was found in that male patients perceived more support from their spouses, while female patients perceived more support from their children as compared to their spouses.

• 한국노년학
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• 제38권3호
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• pp.501-519
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• 2018

본 연구의 목적은 초기 치매환자 가족 돌봄제공자의 공유 의사결정에 대한 인식을 탐색하는 데 있다. 이를 위해 서울시 3개 치매지원센터에 등록된 초기 치매환자를 돌보는 가족 돌봄제공자 12명(여성 8명, 평균연령=$71.4{\pm}10.4$세)을 대상으로 반 구조화된 개별 심층면담을 이용하여 수집된 자료에 대해 질적 내용분석을 시행하였다. 본 연구를 내용 분석한 결과 6개 범주, 17개의 하위 범주가 도출되었는데 구체적인 연구결과는 다음과 같다. 초기 치매환자 가족 돌봄제공자의 공유 의사결정에 관한 인식은 치매환자와의 의사소통 촉진 수단과 치매환자의 자율성 보장 수단, 치료 촉진 기회, 가족 돌봄제공자의 부담감 증가 원인, 치매환자와의 관계 악화 원인, 우선순위 변화에 따른 선택 사항의 여섯 가지 범주로 나타났다. 또한, 공유 의사결정의 상황과 시기 및 공유 의사결정에 대한 인식이 가족 돌봄제공자의 경험을 통해 만들어졌다는 점을 알 수 있었다. 따라서 치매 관련 교육 시 간접경험을 통해 공유 의사결정을 선택 사항으로 생각하는 가족 돌봄제공자들에게 공유 의사결정을 경험할 수 있는 기회 등을 제공하는 것이 공유 의사결정에 대한 인식 제고에 도움이 될 수 있을 것으로 사료된다. 이상 결과에 근거하여 초기 치매환자의 자기결정권 존중과 가족 돌봄제공자들의 부담감을 감소시키기 위해 공유 의사결정을 성공적으로 할 수 있는 실제적이고 총체적인 교육 프로그램의 개발 및 평가 연구를 제언한다.

• Pediatric Infection and Vaccine
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• 제25권3호
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• pp.141-147
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• 2018

목적: 임신 중 tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) 접종의 효과 및 안전성에도 불구하고, 아직 국내 임신 중 Tdap 접종률은 낮다. 이에 저자들은 임신 중 Tdap 접종에 대한 임부들의 인식, 태도 및 행동에 대한 조사를 하였다. 방법: 본 연구는 서울 및 경기 소재 대학병원 산부인과를 방문한 임부를 대상으로 개별적인 설문지를 통해 임신 중 Tdap 접종에 대한 인식, 태도 및 행동을 수집한 단면 설문조사다. 결과: 총 184명의 임부들이 설문지 작성을 완료하였다. 이 중 158명(86%)의 임부들은 의사로부터 백일해 및 Tdap 백신에 대한 정보를 안내 받지 못했고, 166명(90%)의 임부들은 임신 중 Tdap 접종의 필요성을 알지 못했다. 현 임신기간 중 Tdap 접종을 하지 않을 것이라고 답한 임부 중 7%만이 백일해 및 백신에 대한 이해를 묻는 5문항 중 3문항 이상 올바르게 답하였다. 로지스틱 회귀분석에서 의사의 추천(adjusted odds ratio [OR], 236.2; 95% confidence interval [CI], 12.6-4,432), 백신이 효과적이라는 믿음(adjusted OR, 40.21; 95% CI, 2.35-687.7), 백신이 안전하다는 믿음(adjusted OR, 19.83; 95% CI, 1.54-255.9) 등이 Tdap 접종을 결정하는데 유의하게 중요한 요인이었다. 결론: 대부분의 임부들이 Tdap 접종에 대하여 적절하게 안내를 받지 못하거나, 추천받지 못하는 것으로 보인다. 임부들의 Tdap 접종률을 향상시키는 데에 의료기관 종사자에 의해 제공되는 정보가 매우 중요하다.

• 지역사회간호학회지
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• 제14권2호
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• pp.334-350
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• 2003

The purpose of this descriptive study was to evaluate the clinical validity of QSCCII (Questionnaire for the Sasang Constitution Classification), whose high accuracy as a constitutional diagnostic tool has been recognized by medical professionals. The subjects of this study were 568 clients from an A university hospital in Suwon. Of the subjects, 259 were health center visitors and 292 were ambulatory clinic visitors. Data were collected using self-reported questionnaire and were analyzed by $X^2$-test and one-way ANOVA. The results of this study as follows: 1. In 4 types of constitution, Soeumin type was found in 41.5% of the subjects. Taeumin type in 39.2%.,and Soyangin type in 19.2%, respectively. There was no Tayangin type found in this study. There were no significant differences on types of constitution by demographic characteristics such as age, sex, marital status, education, religion, and economic status. 2. As for 15 item-selective questionnaire, there were statistically significant differences on the response rate of the 12 items, except items such as A4, A11 and A14, by the types of constitution. When the subjects' own criteria on their constitution were compared to the given constitutional criteria on each item, 4 items such as A6, A11, A13 and A14 were advisable to be excluded from the questionnaire or to be reunited to the other criteria. In the meanwhile, 3 items such as A7, A18 and A15 were desirable to be re-categorized to the other constitutional types and reconstructed to the QSCC II questionnaire. 3. In terms of 106 true-false questionnaire, there were statistically significant differences on the response rate of 46 items by the types of constitution. The 46 items include 15 items (32.6%) of the domain of 'handling something/strength and weakness', 4 items (8.7%) of the domain of 'interpersonal relationship', 9 items (19.6%) of the domain of 'state of mind at ordinary times', 2 items (4.3%) of the domain of 'distinctive emotional characteristics' area, 11 items (23.9%) of the domain of 'specific behavioral trait' and 5 items (10.9%) of the domain of 'physical characteristics'. Therefore, the areas of 'handling something/strength and weakness' and' specific behavioral trait' mainly contributed to the classification of constitutional type. 4. When the 106 true-false items were simplified to the 46 items, statistically significant differences were found on the rate of items allocated to the 3 types of constitution. The rate of selection assigned to the 3 constitutional types of the simplified 46-item questionnaire was higher than that of the original 106-item questionnaire. Conclusions; It was concluded that the rate of selection of each lay person about his own constitutional type would be still higher even though the simplified items of QSCC II questionnaire were applied. If more replicated studies are conducted on the diverse population using the simplifying QSCC II questionnaire in the future, a more simplified standardized Sasang Constitution Questionnaire that is available to the public rather than to medical staffs in the clinical settings could be developed. Moreover, the simplified scale will help nurses deliver more efficient nursing care by providing a more rapid way of health assessment.

• 근관절건강학회지
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• 제5권1호
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• pp.39-56
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• 1998

This study was an quasi-experimental study, done to identify factors Influencing the reduction of symptoms in patients with fibromyalgia. The primary purpose of the study was to develop a Self-Help Program suitable for patients with fibromyalgia in Korea. The secondary purpose was to identify the effects of a Self-Help Program which included stretching exercise. This study was carried out between Feb. 24 and July 8, 1997 and patients in the study Included out patient diagnosed with fibromyalgia based on the criteria developed by the American College of Rheumatology(1990) and H, University which is a tertiary patient care clinic for Rheumatism. The experimental group included 38 patients who were residents of Seoul or Kyungi province, and a control group of 38 patients who were residents of other areas. The control patients were matched to the experimental group patients and they were selected considering the number of tender points on the Fibromyalgia Impact Questionnaire score and a score of self-efficacy. The experimental group participated in a Self-Help Program based on the American Arthritis Foundation(1995) guidelines. The program participants participated in a small group which consisted of 12-15 members attending the program once a week, for 6 weeks with each program lasted two to two and a half hours. The stretching exercise was carried out in each patient's home every day following the video tape exercise provided by the researcher, and the researcher provided encouragement and concern to the patients by calling them once a week. The number times the exercise was performed was divided by the number of participants to calculate the percentage of performance and determine the amount of exercise. Self-efficacy was measured by the Self-Efficacy Scale developed by Lorig et al. (1989) for arthritis patients. The degree of pain was converted to scores based on the Visual Analog Scale, the number of tender points was converted to scores based on the criteria of the ACR(1990) and of Yunus. Depression was measured by CES-D and physical disability, sleep disturbance, fatigue, and anxiety of patients with fibromyalgia were measured by the Fibromyalgia Impact Questionnaire. The level of the exercise performance was converted to scores using the number of times the exercise was performed following the video tape prepared by Association of Rheumatology Health Professionals. Data were analyzed by SPSS windows and the results ire described below. 1. The experimental group which participated in the Self-Help Program showed higher efficacy scores than the control group when both groups were analyzed for depression and the number of tender points as common variables(F=9.146, p=.003). 2. The experimental group which participated in the Self-Help Program showed lower scores than the control group, for pain, the number of tender points, depression, physical disability, fatigue, sleep disturbance and anxiety. These symptoms of fibromyalgia can all be seen to have subsided(F=9.483, p=.003 : F=32.680, p=.001 ; F=11.104, p=.001, F=5.344 : p=.024, F=7.630 : P=.007, F=15.6512, p=.003 : F= 7.5412, p=.008). 3. In the experimental group, the self-efficacy score for the first three weeks showed a positive correlation with the exercise-performance score for four to six weeks (r=.387, p=.043). 4. In the experimental group, the relationship between the level of exercise-performance and the reduction of symptoms showed a significant correlation only to physical disability(r= -.500, p=.001). 5. In the experimental group, the relationship between the self-efficacy score and pain, the number of tender points, depression, physical disability, fatigue, sleep disturbance and anxiety score showed inverse correlations and thus, a reduction of symptoms occured when the self-efficacy score increased(r=-.325, p=.004 ; r= -.253, p=.027, r=-.452, p=.001 : r=-.434, p=.001 ; r=-.316, p=.005 ; r=-.460, p=.001 ; r=-.397, p=.014). Therefore, self-efficacy improved following the Self-Help Program including the stretching exercise. It was also found that physical symptoms (pain, number of tender points, level physical disability) and psychological symptoms (depression, fatigue, sleep disturbance, anxiety) were reduced. Moreover, It was found that the higher the self-efficacy, the the higher the degree of achievement of goals set for the stretching exercises. In addition, the level of exercise-performance influenced the level of physical disability, one of the symptoms of fibromyalgia. Accordingly, the conclusions from this study are that exercise-performance and the reduction of symptoms is achieved through promotion of self-efficacy. Therefore, it is proposed that are the Self-Help Program including stretching exercises is an appropriate nursing intervention for the reduction of symptoms of fibromyalgia.

• Journal of Hospice and Palliative Care
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• 제15권1호
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• pp.18-29
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• 2012

목적: 본 연구는 말기환자의 의료적 의사결정에 대한 임상간호사의 인식 구조와 유형을 분류하고 파악하여 향후 실무현장에서 말기 의료적 의사결정 수행능력 향상과 공유된 의료적 의사결정 체계를 구축하기 위해 기초자료를 제공하기 위한 Q 방법론을 적용한 조사연구이다. 방법: 관련 문헌고찰과 개방형 질문지 그리고 개별 면담을 통해 Q 모집단을 추출하여 167개의 Q 진술문을 표집하여 내용의 중복과 표현의 명확성 등을 고려하여 수정한 후 Q 모집단을 의미와 주제별로 6개의 범주로 분류한 다음 각 범주에서 대표적이거나 상이한 의미의 Q 진술문 34항목을 선정하였다. P 표본은 대학병원에서 근무하고 있는 2년 이상의 임상간호사 37명을 편의표집방법으로 선정하였으며 34개의 진술문은 Q 카드에 인쇄하여 연구대상자들로 하여금 강제 정상분포가 되도록 각자 의견의 중요도에 따라 9점 척도 상에 Q 분류하도록 하였고, 양극단에 분류한 진술문과 관련하여 대상자와 면담을 시행하였다. 수집된 자료는 PC-QUANL Program으로 요인분석 하였다. 결과: 분류된 말기환자의 의료적 의사결정에 대한 대상자의 유형은 모두 4가지로 나타났으며 이들 유형에 의해 설명된 전체 변량은 52.7%였다. 제1유형은 '환자 참여형'으로 의료적 의사결정에 대한 환자의 자율성 보장과 이와 관련된 규율이나 법적 장치의 정비와 가이드 라인 마련에 중점을 두었다. 제2유형은 '의료인 역할중시형'으로 환자의 자율성 존중이 실현되기 위한 의료인간의 공유된 의사결정에 중점을 두었다. 제3유형은 '개방적 죽음문화형'으로 평소 죽음에 대해 환자, 가족, 의료인과의 개방적이고 솔직한 대화의 분위기 조성을 효율적인 말기 의료적 의사결정의 실천적 행위로 인식하였다. 제4유형은 '가족의사결정 참여형'으로 말기 의료적 의사결정에 가족의 현존과 역할이 갖는 의미에 강조점을 두었다. 결론: 이상의 결과를 통하여 임상에서 말기환자의 의료적 의사결정에 대한 교육프로그램을 계획하고 수행할 때에는 각 유형에서 나타난 임상간호사의 인식을 반영한 통합적이고 다 학제적인 교육내용이 반영되어야 할 것으로 본다. 본 연구는 임상간호사를 대상으로 오늘날 우리 사회에서 중요시 되고 있는 말기환자의 의료적 의사결정과 연관된 다양한 관점들을 문화적 측면에서 조명했다는 점에서 의의가 있다. 따라서 성숙하고 통합적인 말기 의료적 의사결정 교육프로그램을 위한 기초자료로 유용하게 활용될 것으로 기대된다. 본 연구 결과를 바탕으로 제언을 하면, 첫째, 말기환자의 의료적 의사결정과 관련된 의학과 간호학 분야의 통합적이고 다 학문적인 공통교육과정 개발을 제언한다. 둘째, 본연구를 토대로 한국인의 말기 의료적 의사결정에 대한 태도 측정도구 개발을 제언한다.