• 제목/요약/키워드: Health-related Quality of life

검색결과 1,624건 처리시간 0.027초

지역사회가 가족관계만족에 미치는 영향 : 한국 가족행복종합지수를 중심으로 (The Impact of Community on Family Relations Satisfaction : Focusing on the Family Happiness Composite Index in Korea)

  • 오영은;추주희;고광이
    • 지역과문화
    • /
    • 제7권2호
    • /
    • pp.173-202
    • /
    • 2020
  • 이 연구는 가족관계와 지역사회 환경의 관계를 살피고, 가족을 둘러싼 지역 환경을 객관적으로 비교함으로써 지역의 가족친화성 제고방안을 제시하고자 한다. 이를 위해 가족관계 만족도에 영향을 주는 사회문화적, 경제적 차원의 영역을 검토하였으며, 특히 지역사회지표로 개발된 한국가족행복종합지수(이하, 종합지수)를 활용하여, 지역별 종합지수 변화 추이를 분석하였다. 이 연구에서 활용한 종합지수는 국가통계포털의 「e-지방지표」에서 공시한 지역사회지표를 활용하였으며, 이 변수들은 가족관계만족도와 연관된다. 이에 본 연구에서는 가족행복종합지수의 7개 영역(인구가족, 건강문화, 교육, 소득소비, 고용노동, 주거 교통, 환경 및 사회통합)을 비교하여 10년간 추이를 검토하였다. 연구결과, 2008년도부터 2018년도까지 종합지수의 전국 평균점수는 점점 상승하고 있었다. 전반적으로 가족관계만족도에 영향을 주는 지역사회환경 역시 개선되고 있다고 볼 수 있다. 상위레벨에 속한 지역은 전남, 강원, 충남, 전북, 경북으로 비수도권 및 농촌권역이었다. 하위레벨에 속한 지역은 서울, 부산, 대구, 인천, 광주로 모두 특광역시로 대도시권역이다. 전반적으로 하위레벨에 속한 지역들은 인구 밀집 및 과밀도에 비해 관련 물리적 인프라가 충분하지 않았으며 조금씩 개선하고 있었으나, 지역민의 욕구를 반영하고 삶의 질을 개선할 수 있을 만큼은 아니었다. 향후 가족관계의 질을 향상할 수 있는 각 지역별 맞춤형 정책 마련을 위해서 보다 정기적이고 보완된 지표 개발이 필요하다. 또한 사회적 재난으로 인한 사회경제적 위기가 각 영역별, 지역별 미친 영향과 향후 변화추이를 지속적으로 검토할 필요가 있음을 제언하였다.

병원 간호사의 선호근무시간대에 관한 연구 (A Study on Hoslital Nurses' Preferred Duty Shift and Duty Hours)

  • 이경식;정금희
    • 대한간호
    • /
    • 제36권1호
    • /
    • pp.77-96
    • /
    • 1997
  • The duty shifts of hospital nurses not only affect nurses' physical and mental health but also present various personnel management problems which often result in high turnover rates. In this context a study was carried out from October to November 1995 for a period of two months to find out the status of hospital nurses' duty shift patterns, and preferred duty hours and fixed duty shifts. The study population was 867 RNs working in five general hospitals located in Seoul and its vicinity. The questionnaire developed by the writer was used for data collection. The response rate was 85.9 percent or 745 returns. The SAS program was used for data analysis with the computation of frequencies, percentages and Chi square test. The findings of the study are as follows: 1. General characteristics of the study population: 56 percent of respondents was (25 years group and 76.5 percent were "single": the predominant proportion of respondents was junior nursing college graduates(92.2%) and have less than 5 years nursing experience in hospitals(65.5%). For their future working plan in nursing profession, nearly 50% responded as uncertain The reasons given for their career plan was predominantly 'personal growth and development' rather than financial reasons. 2. The interval for rotations of duty stations was found to be mostly irregular(56.4%) while others reported as weekly(16.1%), monthly(12.9%), and fixed terms(4.6%). 3. The main problems related to duty shifts particularly the evening and night duty nurses reported were "not enough time for the family, " "afraid of security problems after the work when returning home late at night." and "lack of leisure time". "problems in physical and physiological adjustment." "problems in family life." "lack of time for interactions with fellow nurses" etc. 4. The forty percent of respondents reported to have '1-2 times' of duty shift rotations while all others reported that '0 time'. '2-3 times'. 'more than 3 times' etc. which suggest the irregularity in duty shift rotations. 5. The majority(62.8%) of study population found to favor the rotating system of duty stations. The reasons for favoring the rotation system were: the opportunity for "learning new things and personal development." "better human relations are possible. "better understanding in various duty stations." "changes in monotonous routine job" etc. The proportion of those disfavor the rotating 'system was 34.7 percent. giving the reasons of"it impedes development of specialization." "poor job performances." "stress factors" etc. Furthermore. respondents made the following comments in relation to the rotation of duty stations: the nurses should be given the opportunity to participate in the. decision making process: personal interest and aptitudes should be considered: regular intervals for the rotations or it should be planned in advance. etc. 6. For the future career plan. the older. married group with longer nursing experiences appeared to think the nursing as their lifetime career more likely than the younger. single group with shorter nursing experiences ($x^2=61.19.{\;}p=.000;{\;}x^2=41.55.{\;}p=.000$). The reason given for their future career plan regardless of length of future service, was predominantly "personal growth and development" rather than financial reasons. For further analysis, the group those with the shorter career plan appeared to claim "financial reasons" for their future career more readily than the group who consider the nursing job as their lifetime career$(x^2$= 11.73, p=.003) did. This finding suggests the need for careful .considerations in personnel management of nursing administration particularly when dealing with the nurses' career development. The majority of respondents preferred the fixed day shift. However, further analysis of those preferred evening shift by age and civil status, "< 25 years group"(15.1%) and "single group"(13.2) were more likely to favor the fixed evening shift than > 25 years(6.4%) and married(4.8%)groups. This differences were statistically significant ($x^2=14.54, {\;}p=.000;{\;}x^2=8.75, {\;}p=.003$). 7. A great majority of respondents(86.9% or n=647) found to prefer the day shifts. When the four different types of duty shifts(Types A. B. C, D) were presented, 55.0 percent of total respondents preferred the A type or the existing one followed by D type(22.7%). B type(12.4%) and C type(8.2%). 8. When the condition of monetary incentives for the evening(20% of salary) and night shifts(40% of. salary) of the existing duty type was presented. again the day shift appeared to be the most preferred one although the rate was slightly lower(66.4% against 86.9%). In the case of evening shift, with the same incentive, the preference rates for evening and night shifts increased from 11.0 to 22.4 percent and from 0.5 to 3.0 percent respectively. When the age variable was controlled. < 25 yrs group showed higher rates(31.6%. 4.8%) than those of > 25 yrs group(15.5%. 1.3%) respectively preferring the evening and night shifts(p=.000). The civil status also seemed to operate on the preferences of the duty shifts as the single group showed lower rate(69.0%) for day duty against 83. 6% of the married group. and higher rates for evening and night duties(27.2%. 15.1%) respectively against those of the married group(3.8%. 1.8%) while a higher proportion of the married group(83. 6%) preferred the day duties than the single group(69.0%). These differences were found to be statistically all significant(p=.001). 9. The findings on preferences of three different types of fixed duty hours namely, B, C. and D(with additional monetary incentives) are as follows in order of preference: B type(12hrs a day, 3days a wk): day shift(64.1%), evening shift(26.1%). night shift(6.5%) C type(12hrs a day. 4days a wk) : evening shift(49.2%). day shift(32.8%), night shift(11.5%) D type(10hrs a day. 4days a wk): showed the similar trend as B type. The findings of higher preferences on the evening and night duties when the incentives are given. as shown above, suggest the need for the introductions of different patterns of duty hours and incentive measures in order to overcome the difficulties in rostering the nursing duties. However, the interpretation of the above data, particularly the C type, needs cautions as the total number of respondents is very small(n=61). It requires further in-depth study. In conclusion. it seemed to suggest that the patterns of nurses duty hours and shifts in the most hospitals in the country have neither been tried for different duty types nor been flexible. The stereotype rostering system of three shifts and insensitiveness for personal life aspect of nurses seemed to be prevailing. This study seems to support that irregular and frequent rotations of duty shifts may be contributing factors for most nurses' maladjustment problems in physical and mental health. personal and family life which eventually may result in high turnover rates. In order to overcome the increasing problems in personnel management of hospital nurses particularly in rostering of evening and night duty shifts, which may related to eventual high turnover rates, the findings of this study strongly suggest the need for an introduction of new rostering systems including fixed duties and appropriate incentive measures for evenings and nights which the most nurses want to avoid, In considering the nursing care of inpatients is the round-the clock business. the practice of the nursing duty shift system is inevitable. In this context, based on the findings of this study. the following are recommended: 1. The further in-depth studies on duty shifts and hours need to be undertaken for the development of appropriate and effective rostering systems for hospital nurses. 2. An introduction of appropriate incentive measures for evening and night duty shifts along with organizational considerations such as the trials for preferred duty time bands, duty hours, and fixed duty shifts should be considered if good quality of care for the patients be maintained for the round the clock. This may require an initiation of systematic research and development activities in the field of hospital nursing administration as a part of permanent system in the hospital. 3. Planned and regular intervals, orientation and training, and professional and personal growth should be considered for the rotation of different duty stations or units. 4. In considering the higher degree of preferences in the duty type of "10hours a day, 4days a week" shown in this study, it would be worthwhile to undertake the R&D type studies in large hospital settings.

  • PDF

설비공학 분야의 최근 연구 동향: 2008년 학회지 논문에 대한 종합적 고찰 (Recent Progress in Air-Conditioning and Refrigeration Research: A Review of Papers Published in the Korean Journal of Air-Conditioning and Refrigeration Engineering in 2008)

  • 한화택;최창호;이대영;김서영;권용일;최종민
    • 설비공학논문집
    • /
    • 제21권12호
    • /
    • pp.715-732
    • /
    • 2009
  • This article reviews the papers published in the Korean Journal of Air-Conditioning and Refrigeration Engineering during 2008. It is intended to understand the status of current research in the areas of heating, cooling, ventilation, sanitation, and indoor environments of buildings and plant facilities. Conclusions are as follows. (1) Research trends in thermal and fluid engineering have been surveyed in the categories of general fluid flow, fluid machinery and piping, new and renewable energy, and fire. Well-developed CFD technologies were widely applied in developing facilities and their systems. New research topics include fire, fuel cell, and solar energy. Research was mainly focused on flow distribution and optimization in the fields of fluid machinery and piping. Topics related to the development of fans and compressors had been popular, but were no longer investigated widely. Research papers on micro heat exchangers using nanofluids and micro pumps were also not presented during this period. There were some studies on thermal reliability and performance in the fields of new and renewable energy. Numerical simulations of smoke ventilation and the spread of fire were the main topics in the field of fire. (2) Research works on heat transfer presented in 2008 have been reviewed in the categories of heat transfer characteristics, industrial heat exchangers, and ground heat exchangers. Research on heat transfer characteristics included thermal transport in cryogenic vessels, dish solar collectors, radiative thermal reflectors, variable conductance heat pipes, and flow condensation and evaporation of refrigerants. In the area of industrial heat exchangers, examined are research on micro-channel plate heat exchangers, liquid cooled cold plates, fin-tube heat exchangers, and frost behavior of heat exchanger fins. Measurements on ground thermal conductivity and on the thermal diffusion characteristics of ground heat exchangers were reported. (3) In the field of refrigeration, many studies were presented on simultaneous heating and cooling heat pump systems. Switching between various operation modes and optimizing the refrigerant charge were considered in this research. Studies of heat pump systems using unutilized energy sources such as sewage water and river water were reported. Evaporative cooling was studied both theoretically and experimentally as a potential alternative to the conventional methods. (4) Research papers on building facilities have been reviewed and divided into studies on heat and cold sources, air conditioning and air cleaning, ventilation, automatic control of heat sources with piping systems, and sound reduction in hydraulic turbine dynamo rooms. In particular, considered were efficient and effective uses of energy resulting in reduced environmental pollution and operating costs. (5) In the field of building environments, many studies focused on health and comfort. Ventilation. system performance was considered to be important in improving indoor air conditions. Due to high oil prices, various tests were planned to examine building energy consumption and to cut life cycle costs.

치과임상영역에서 발생된 의료분쟁의 판례분석 (The Jurisdictional Precedent Analysis of Medical Dispute in Dental Field)

  • 권병기;안형준;강진규;김종열;최종훈
    • Journal of Oral Medicine and Pain
    • /
    • 제31권4호
    • /
    • pp.283-296
    • /
    • 2006
  • 과학기술의 발전과 더불어 보건의료분야는 괄목할 성장을 가져왔고 국민생활 수준의 향상과 건강에 대한 관심이 고조됨에 따라 의료서비스의 수요가 급증하고 있다. 이 과정에서 국민의 권리의식의 신장, 의료행위의 본질에 대한 이해부족, 의료기술에 대한 지나친 기대, 상업화된 의료공급체계, 의사의 윤리의식 저하 및 의료법리에 대한 무지 그리고 사회적 불신풍조의 만연, 분쟁해결을 위한 제도적 장치의 결여 등이 요인으로 작용하여 의료사고 및 분쟁이 급증하는 추세이다. 본 연구는 치과관련 단체에서 보유하고 있는 소송과 관련된 자료 및 연세대학교 치과대학병원 구강내과에서 신체감정을 시행한 재판기록을 중심으로 하여 판결전문을 확보할 수 있는 치과 의료사고 판례 중 1994년부터 2004년까지의 민사소송 30례의 판례를 분석하여 다음과 같은 결과를 얻었다. 1. 소송의 연도별 분포에서 2000년 이후 급증하는 추세를 보였다. 2. 소송의 유형별 분포에서 발치와 관련된 소송이 전체의 36.7% 이었다. 3. 소송의 원인을 분석한 결과 불편감, 치료불만족과 관련된 것이 전체의 36.7%, 사망 및 영구손상이 각각 16.7% 이었다. 4. 원고의 소송결과 승소 및 강제조정, 화해권고결정이 60.0% 이었다. 5. 소송에 관련된 병원유형은 치과의원이 60.0%로 가장 높게 나타났다. 6. 소송의 심급별 구성비율에서 2,3심 이상 진행된 경우가 전체의 30.0% 이었다. 7. 손해배상 청구금액은 5천만원 이상 1억원 미만이 36.7%, 1억원 이상이 13.3% 이었고 손해배상 판결금액은 1천만원 이상 3천만원 미만이 40.0%, 1억원 이상이 6.7% 이었다. 8. 소송과 관련된 치과의사수는 2명 이상이 26.7%이었다. 9. 판결까지의 소요기간은 11개월에서 20개월이 46.7%, 21개월에서 30개월이 36.7% 이었다. 10. 의료과실 유무에서는 과실을 판정한 경우가 46.7% 이었고 소송과정에서 신체감정이나 사실조회가 이루어진 경우는 70.0% 이었다. 11. 의사패소 판례(18건)에서 판결의 주안점은 주의의무위반이 72.2% 이었고, 설명의무위반이 16.7% 이었다. 치과 의료분쟁의 경우 치료의 긴급성이 상대적으로 적어 의사의 설명의무 중요성이 폭넓게 요구되며, 주관적인 치료 만족도가 중요시되는 분야이기 때문에 결국 분쟁을 줄이는 방법으로 기술적인 과실도 줄여야 하지만 치과의사와 환자와의 신뢰 관계를 개선하는 것과 의사집단의 자율성(autonomy)의 회복이 중요하다. 그리고 불합리하게 시행되고 있는 의료배상책임보험의 보완과 함께 치과의사단체와 학계가 주도하는 교육 및 의료분쟁시 자문을 구할 수 있는 체계의 확립으로 의료분쟁에 대한 대처가 이루어져야 할 것이다.