• 제목/요약/키워드: Hospital services evaluation

검색결과 210건 처리시간 0.026초

초등보건교사의 학교기반 아동비만 예방관리사업에 대한 인식과 경험 (School-based Obesity Prevention and Management Programs as Perceived and Experienced by Elementary School Health Teachers)

  • 추진아;양화미;김혜진;오상우;김수연;정미영;박미현
    • 한국학교보건학회지
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    • 제26권3호
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    • pp.158-168
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    • 2013
  • Purpose: Elementary schools are regarded as the best community setting for implementing obesity prevention programs and health teachers (HTs) are the main health professionals who can provide obesity prevention services. However, there is insufficient information on the actual conditions of school-based obesity prevention/ management programs in Korean elementary schools. The purpose of the study was to investigate the actual conditions of school-based obesity prevention/management programs, perceived and experienced by elementary school HTs, which may provide basic data for developing effective and sustainable programs for early childhood. We investigated (1) HTs' ratings on the program's importance, the confidence in the program's implementation, and the factors associated with the program's success (2), the correlates of the importance and confidence levels (3), the program's effectiveness and the factors associated with its sustainability, which were evaluated by HTs, and (4) the correlates of the effectiveness levels. Methods: The participants, 147 HTs working for elementary schools in Seoul were asked to fill out self-administrated questionnaires through mail. Results: The participants' rate on the program's importance was 7.1 on average (0~10 scale) and that on the confidence in the program's implementation was 6.2 (0~10 scale). Moreover, > 25% of the participants reported student and parent participation as a factor associated with the program's success. Of the total participants, 45.6% reported they had actually experienced the program, giving 4.8 points (0~10 scale), on average, in the evaluation of the program's effectiveness and > 22.0% of the participants regarded student and parent participation as a factor associated with the program's sustainability. The HTs' confidence in the program's implementation was a strong correlate of the effectiveness evaluated by HTs. Conclusion: School-based obesity prevention/management programs tend to be highly prioritized by HTs in elementary schools. To implement an effective obesity program in elementary schools, educational support for HTs is needed in order to enhance their confidence levels on the program's implementation.

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엔도크라운 디지털 인상을 위한 구강스캐너 3종의 정확도 평가: 실험실 연구 (Evaluation of the accuracy of three different intraoral scanners for endocrown digital impression: An in vitro study)

  • ;박지만
    • 대한치과보철학회지
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    • 제58권4호
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    • pp.282-289
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    • 2020
  • 목적:본 연구의 목표는 다른 유형의 엔도크라운(endocrown) 와동 형태를 세 가지 다른 구강스캐너로 디지털 인상을 채득하였을 때의 정확성을 평가하는 것이다. 재료 및 방법: 두 개의 인체 하악 대구치를 협측벽이 있는 것(Class 2)과 협측벽이 없는(Class 3), 두 가지 엔도크라운 지대주 디자인으로 치아형성 하였다. 와동 디자인 2종을 레퍼런스로 탁상용 스캐너(E3, 3shape)와 세 개의 다른 구강스캐너, Trios 3 (3shape, TRI group), Cerec Omnicam (Dentsply Sirona, CER group), i500 (Medit Corp., I5 group)로 스캔하였다. 표준 테셀레이션 언어(.stl) 데이터 세트를 얻어, 계측 소프트웨어에서 불러들였다. 각 구강스캐너로 획득한 반복된 스캔 데이터 사이의 편차에 기초하여 정밀도(precision)를 평가하였다. 기준 데이터와 반복하여 얻은 구강스캔 사이의 편차로서 진도(trueness)를 평가 하였다. 상호작용을 탐지하기 위해 데이터는 일변량 분산분석(ANOVA)을 사용하여 통계적으로 분석하였고, 실험군의 비교 분석을 위해 데이터는 .05의 유의 수준에서 일원 분산분석 및 사후 Tukey 테스트로 분석하였다. 결과: I5 군의 두 와동 형태에 대한 편차값은 진도의 측면에서 다른 구강스캐너 군에 비해 낮았다. 두 와동 디자인 모두에서 TRI 군은 다른 구강스캐너군 보다 우수한 정밀도를 보였다. 결론: 구강스캐너의 다양한 기술과 다양한 엔도크라운 치아형성 디자인이 디지털 스캔의 정확도에 영향을 미쳤다.

헬스케어 정보 수집을 위한 딥 러닝 기반의 서브넷 구축 기법 (Subnet Generation Scheme based on Deep Learing for Healthcare Information Gathering)

  • 정윤수
    • 디지털융복합연구
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    • 제15권3호
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    • pp.221-228
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    • 2017
  • 최근 IoT 기술이 발달함에 따라 헬스케어 서비스를 제공하는 많은 의료기관에서는 IoT 기술을 이용한 의료 서비스가 점점 증가하고 있는 추세이다. 그러나, 사용자 신체에 부착된 IoT 센서의 갯수가 증가하면서 서버에 전달되는 헬스케어 정보는 점점 복잡해져서 서버에서 사용자의 헬스케어 정보를 분석하는 시간이 증가하는 문제점이 발생하고 있다. 본 논문에서는 사용자에 부착된 IoT 장치를 통해 전달되는 다량의 헬스케어 정보를 서버에서 의료 목적에 맞게 헬스케어 정보를 수집 및 처리하기 위한 딥 러닝 기반의 헬스케어 정보 관리 기법을 제안한다. 제안 기법은 서버에 전달된 헬스케어 정보에 속성값을 부여하여 속성값에 따른 서브넷을 구축한 후 서브넷간 연계 정보를 시드로 추출하여 계층적 구조로 그룹화 한다. 제안 기법은 서버에서 그룹화된 헬스케어 정보를 딥 러닝에 적용하여 사용자의 치료 및 처방에 대한 관찰 속도 및 정확도를 향상시킬 수 있어 최적화된 정보를 추출할 수 있는 특징이 있다. 성능평가 결과, 제안기법은 헬스케어 서비스 모델에서 동작되는 의료 서비스의 처리속도가 기존기법에 비해 평균 14.1% 향상되었고, 서버의 오버헤드는 기존 기법보다 평균 6.7% 낮았다. 헬스케어 정보 추출에 대한 정확도는 기존 기법보다 평균 10.1% 높은 결과를 얻었다.

Development of tailored nutrition information messages based on the transtheoretical model for smartphone application of an obesity prevention and management program for elementary-school students

  • Lee, Ji Eun;Lee, Da Eun;Kim, Kirang;Shim, Jae Eun;Sung, Eunju;Kang, Jae-Heon;Hwang, Ji-Yun
    • Nutrition Research and Practice
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    • 제11권3호
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    • pp.247-256
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    • 2017
  • BACKGROUND/OBJECTIVES: Easy access to intervention and support for certain behaviors is important for obesity prevention and management. The available technology such as smartphone applications can be used for intervention regarding healthy food choices for obesity prevention and management in elementary-school students. The transtheoretical model (TTM) is comprised of stages and processes of change and can be adopted to tailored education for behavioral change. This study aims to develop TTM-based nutrition contents for mobile applications intended to change eating behaviors related to weight gain in young children. SUBJECTS/METHODS: A synthesized algorithm for tailored nutrition messages was developed according to the intake status of six food groups (vegetables, fruits, sugar-sweetened beverages, fast food and instant food, snacks, and late-night snacks), decision to make dietary behavioral changes, and self-confidence in dietary behavioral changes. The messages in this study were developed from December 2014 to April 2015. After the validity evaluation of the contents through expert consultation, tailored nutrition information messages and educational contents were developed based on the TTM. RESULTS: Based on the TTM, stages of subjects are determined by their current intake status, decision to make dietary behavioral changes, and self-confidence in dietary behavioral changes. Three versions of tailored nutrition messages at each TTM stage were developed so as to not send the same messages for three weeks at most, and visual materials such as figures and tables were developed to provide additional nutritional information. Finally, 3,276 tailored nutrition messages and 60 nutrition contents for applications were developed. CONCLUSIONS: Smartphone applications may be an innovative medium to deliver interventions for eating behavior changes directly to individuals with favorable cost-effectiveness. In addition, using the TTM for tailored nutrition education for healthy eating is an effective approach.

가정간호대상자와 입원간호대상자의 간호만족도 및 간호사이미지 비교 (A Study of Nursing Care Satisfaction and the Image of Nurses As Compared Between Home Health Care and Hospitalized Clients)

  • 용진선;한성숙;유인자;홍현자
    • 가정간호학회지
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    • 제9권1호
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    • pp.14-26
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    • 2002
  • The purpose of the study was to compare both the nursing care satisfaction and the image of nurses as experienced by home health care clients and hospitalized clients. For the descriptive survey study. data were collected from 69 home heath care clients and 342 in-patients in a university hospital. The tools used for the study were modified by Quality Patient Care Scale(Wandelt & Ager. 1974) and Image of Nurses (송인자, 1993). The data were analyzed using Pearson Correlation. Scheffe test. factor analysis. t-test. and ANOVA. The major findings were as follows: Regarding nursing care satisfaction, the mean score of total nursing care satisfaction in home health care clients was 3.28 out of 4.0. Among five domains, the domain with the highest score was the psychosocial domain, followed by the general. the professional. the physical. and the communication domain. The level of nursing care satisfaction was not significantly different according to demographic variables except for age: the age group of 41-60 showed the highest score (p<0.05). The mean score of total nursing care satisfaction in hospitalized clients was 2.95 out of 4.0. Among five domains, the domain with the highest score was the psychosocial domain, followed by the physical and the communication. the professional. and the general domain. The level of nursing care satisfaction was not significantly different according to demographic variables except age: the higher the age the higher the score (p<0.05). The levels of nursing care satisfaction in all five domains were significantly higher in home health care clients than in hospitalized clients(p=0.0005). Regarding image of nurses, the mean score of total image of nurses in home health care clients was 3.32 out of 4.0. Among four domains, the domain with the highest score was the sincerity domain, followed by the kindness. the spirit. and the knowledge and skill domain. The level of image of nurses was not significantly different according to demographic variables. The mean score of total image of nurses in hospitalized clients was 3.05 out of 4.0. Among four domains. the domain with the highest score was the sincerity domain, followed by the kindness, the knowledge and skill, and the spirit domain. The level of image of nurses was not significantly different according to demographic variables. The levels of image of nurses in all four domains were significantly higher in home health care clients than in hospitalized clients (p=0.001). Both the levels of nursing care satisfaction and image of nurses, part of an evaluation for quality of nursing care were significantly higher in home health care clients than in hospitalized clients. In light of the findings, we could consider that home health care nurses provided client-centered comprehensive nursing care. However, nurses need to have methods that more promote the social recognition of the image of nurses and nursing care services as well as professional knowledge and skills.

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소아 X선 촬영에서 청각과 시각의 환경변화에 따른 유용성 평가 (Evaluation of Usefulness according to Environmental Change of Auditory and Visual in Pediatric X-ray)

  • 백성욱;송종남;김정훈;한재복
    • 한국방사선학회논문지
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    • 제11권7호
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    • pp.605-610
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    • 2017
  • 성인과 달리 소아의 경우 인지능력과 의사전달이 정확하지 않아 X선 검사에 있어 심리적 불안감으로 인한 움직임은 재검사를 증가시키는 요인 중 하나이다. X선 검사라는 거부감을 최소화하고 의료 서비스의 만족도를 향상하기 위한 방법으로 검사실의 환경을 개선하여 심리적 안정에 도움을 주어 검사과정에서 발생하는 불필요한 재검사를 비롯한 피폭선량 절감에 긍정적인 방안을 알아보고자 하였다. 실험대상으로는 2017년 5월부터 2017년 8월까지 본원 일반촬영실에서 만 6개월 이상~만 36개월 미만의 총 186명의 소아를 대상으로 청각과 시각적 환경변화를 모두 적용시키지 않는 평소 검사실을 A 군, 시각적 환경변화는 제외시키고 청각적 환경변화만 적용한 검사실을 B 군, 청각적 환경변화는 제외시키고 시각적 환경변화만 적용한 검사실을 C 군, 청각과 시각적 환경변화를 모두 적용한 검사실을 D 군으로 설정하여 연구를 진행하였다. A 군에서는 재검사 건수가 10건, B 군 7건, C 군 5건, D 군 2건의 결과를 도출할 수 있었다. 특히 A 군과 D 군에서 통계학적 유의수준 p<0.053으로 유의 하다는 결과를 얻을 수 있었다. 결론적으로 청각과 시각적 환경변화가 소아 심리적 안정에 많은 영향을 미쳤으며, 재검사 건수도 감소하여 의료서비스의 질적 향상 보였다.

수술수가의 적정성에 관한 연구 - 상대가격체계와 항목분류를 중심으로 - (A Study on the Propriety of the Medical Insurance Fee Schedule of Surgical Operations - In Regard to the Relative Price System and the Classification of the Price Unit of Insurance Fee Schedule -)

  • 오진주
    • 한국보건간호학회지
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    • 제2권2호
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    • pp.21-44
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    • 1988
  • In Korea, fee-for service reimbursement has been adopted from the begining of medical insurance system in 1977, and the importance of the relative value unit is currently being investigated. The purpose of this study was to find out the level of propriety of the difference in the fees for different surgical services, and the appropriateness of the classification of the insurance fee schedule. For the purpose of this study, specific subjects and the procedural methodology is shown as follows: 1. The propriety of the Relative Price System(RPS). 1) Choice of sample operations. In this study, sample operations were selected and classified by specialists in general surgery, and the number of items they classified were 32. For the same group of operations the Insurance Fee Schedule(IFS) classified the operations into 24 separate items. In order to investigate the propriety of the RPS, one of the purpose of this study, was to examine the 24 items classified by the IFS. 2) Evaluation of the complexity of surgery. The data used in this study was collected The data used in this study was collected from 94 specialists in general surgery by mail survey from November I to 15, 1986. Several independent variables (age, location, number of bed, university hospital, whether the medical institution adopt residents or not) were also investigated for analysis of the characteristics of surgical complexity. 3) Complexity and time calculations. Time data was collected from the records of the Seoul National University' Hospital, and the cost per operation was calculated through cost finding methods. 4) Analysis of the propriety of the Relative Price System of the Insurance Fee Schedule. The Relative Price System of the sample operation was regressed on the cost, time, comlexity relative ,value system (RVS) separately. The coefficient of determination indicates the degree of variation in the RPS of the Insurance Fee Schedule explained by the cost, time, complexity RVS separately. 2. The appropriateness of the classification of the Insurance Fee Schedule. 1) Choice of sample operations. The items which differed between the classification of the specialist and the classification of medical, Insurance Fee Schedule were chosen. 2) Comparisons of cost, time and complexity between the items were done to evaluate which classification was more appropriate. The findings of the study can be summarized as follows: 1. The coefficient of determination of the regression of the RPS on-cost RVS was 0.58, on time RVS was 0.65, and on complexity RVS was 0.72. This means that the RPS of Insurance Fee Schedule is improper with respect to the cost, time, complexity separately. Thus this indicates that RPS must be re-shaped according to the standard element. In this study, the correlation coefficients of cost, time, complexity Relative Value System were very high, and this suggests that RPS could be reshaped I according to anyone standard element. Considering of measurement, time was thought to be the most I appropriate. 2. The classifications of specialist and of the Insurance Fee Schedule were compared with respect to cost, time, and complexity separately. For complexity, ANOVA was done and the others were compared to the different values of different classifications. The result was that the classification of specialist was more reasonable and that the classification of Insurance Fee Schedule grouped inappropriately several into one price unit.

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New Directions in Communicating Better Nutrition to Older Adults

  • Guldan, Georgia-Sue;Wendy Wai-Hing Hui
    • Journal of Community Nutrition
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    • 제2권1호
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    • pp.62-70
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    • 2000
  • Nutrition education should be an important component of ongoing health promotion for older adults and their caregivers. This is because prevention through sound nutrition and food hygiene practices and regular excercise is the most cost-effective way to reduce risks for and deal with their major health problems. nutritions education services should effectively promote optimum intake and successful self-care. Unfortunately, however relative to other vulnerable groups, nutrition education for older adults has not been systematically developed or evaluated. Usually oder adults care a lot about their health, so this should be a relatively easy group to teach - but their increasing numbers, longevity and great diversity with respect to health, physical, and economic status and educational level present challenges. Some older adults may not perceive they would benefit from nutrition education, so interesting and motivating them is a challenge. The food and nutrition knowledge of older people has been acquired through a lifetime of experience. For most older adults in the Asian region, their sources are restricted by their restricted education, so that their major sources of information have been informal sources, such as television, radio, friends, family, and perhaps newspapers and magazines if they are literature. Nonetheless, dietary advice for older people should build on their existing knowledge and ingrained values. It should provide information useful in daily food selection, and focus on food, not nutrients - the same foods and groups considered appropriate for younger people, with consistent messages as given throughout the population. Attention must also be paid to discovering learning styles in older people. When we teach in schools, the young students are a captive audience resigned to their learning role. Learning by an older adult, however, reflects an effort to meet his or her perceived needs. Therefore, nutrition education should be a positive experience in a non-threatening environment, relaxed and non-competitive, and perhaps even social environment. The messages also need to be practical and achievable. A needs assessment is essential, because our ability to provide the most effective nutrition education will depend on our success in matching the needs, both perceived and unperceived. of this vulnerable group. Therefore, go to the potential older learners to assess their interest and preferences. Nutrition education activities for older adults are widespread, but few have been evaluated. Evaluation is therefore also recommended, particularly when new methods are used. Tips from other countries for giving successful nutrition education will be given, including some examples of applications as attempted in Hong Kong. Research needs will also be described. In conclusion, successful nutrition education for older adults depends on positive needs-based messages. This is may be hard to do, as few good examples are available to illustrate these principles.

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다기관 설문조사를 통한 국내 소아 음성질환 환자의 검사 및 치료 유형 연구 (Study on Assessment and Treatment Patterns of Speech-Language Pathologists in Pediatric Vocal Problem Through Multicenter Survey)

  • 이종근;방승환;전재민;이정규;김연;우정수;조재구
    • 대한후두음성언어의학회지
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    • 제30권1호
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    • pp.39-47
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    • 2019
  • Background and Objectives : Pediatric vocal health problems are relatively common. However, it is not yet well studied whether uniform diagnosis and treatment is done properly in South Korea. The purpose of this study was to investigate the methods that the Korean speech therapists use to diagnose and treat pediatric voice problem. Materials and Method : An anonymous online questionnaire was administered to 32 speech language therapists registered at the Korean laryngeal speech linguistics society detailing demographics, employment institution, general management of pediatric patients with vocal problem including assessment and treatment procedures. Results : Current practice patterns were analyzed on 32 speech language therapists providing services in South Korea mostly working at tertiary university hospital. One third of pediatric patients were assessed without proceeding to treatment. One fifth of patients were treated without assessment. Perceptual assessment was the main pretreatment assessment methods used. Treatment was done in the following order : Voice rest, SOVT, yawn-sigh and resonant voice. Post-treatment evaluation was used in the following order : Instrumental assessment, clinical judgment, and recording comparison. Conclusion : Speech language therapists practice in South Korea mostly follows the ASHA practice guidelines. However, there are still great amount of cases in which only the evaluation was done without appropriate treatment. Further research is needed to make SPLs more systematic and efficient for evaluating and treating pediatric vocal patients.

한 대학병원 내과계 중환자실에서 장기간 기계환기를 받은 노인 환자들의 특징 및 예후 (Clinical Characteristics and Prognosis of Elderly Patients Receiving Prolonged Mechanical Ventilation in the Medical Intensive Care Unit at a University Hospital)

  • 한민수;문경민;이양덕;조용선;나동집
    • Tuberculosis and Respiratory Diseases
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    • 제64권6호
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    • pp.445-450
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    • 2008
  • 연구배경: 최근 노인 인구가 급격히 증가하면서 중환자실로 입원하는 노인 환자도 증가하는 추세이다. 내과계 중환자실에서 30일 이상 장기간 기계환기를 받은 노인 환자들의 임상적 특징 및 예후에 대하여 알아보고자 하였다. 방 법: 2004년 4월부터 2007년 3월까지 을지대학병원 내과계 중환자실에 입원했던 환자들 중에서 연속해서 30일 이상 기계환기를 받았던 65세 이상 환자 41명을 대상으로 임상적 특징과 예후에 대하여 후향적으로 조사하였다. 결 과: 대상 환자 41명의 평균 연령은 $74.6{\pm}6.0$세이었고, 남자가 27명(65.9%)이었다. 중환자실로 입원한 주된 이유는 급성호흡부전 30명(73.2%)으로 가장 많았고 패혈증 5명(12.2%), 신경계장애 4명(9.8%), 위장관출혈 2명 (4.9%) 순이었다. 평균 APACHE II 점수는 $26.9{\pm}4.5$이었다. 중환자실 평균 입원 기간은 $49.3{\pm}23.0$일 이었으며 기계환기의 평균 기간은 $57.5{\pm}32.8$일이었다. 사망한 환자는 25명(60.9%)이었으며 사망과 관련있는 인자는 APACHE II 점수(p=0.038)와 수혈(p=0.007) 등이었다. 결 론: 장기간 기계환기 치료를 받은 노인 환자들에서 호흡부전이 가장 흔한 중환자실 입원 이유이었으며 사망률은 60.9%이었고 사망에 영향을 주는 인자는 APACHE II 점수와 수혈 등이었다.