• 제목/요약/키워드: Illness Experience

검색결과 256건 처리시간 0.029초

북한 보건의료인력개발을 위한 제언 (A Proposal for the Development of Personnel in the DPRK for Public Health and Medicine)

  • 경쾌수
    • 의학교육논단
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    • 제18권1호
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    • pp.21-25
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    • 2016
  • The government of South Korea and its medical personnel must make a way by which health professionals who have escaped from the Democratic People's Republic of Korea (DPRK) can play a positive and practical role in unification and south-north medical unification while south-north authority talks on DPRK public health and medicine manpower development are not going smoothly. Medical personnel escaped from the DPRK have to be recruited for the interviewer of the national examination, to improve the accuracy of national examination interviews. For those medical professionals who have escaped from the DPRK with 6 years' medical college education, but failed the interview on the national examination, we propose here a course of 3.6 months for them to have a right to apply the Korean Medical Licensing Examinations (KMLE). We also propose that medical professionals who have escaped from the DPRK who have graduated from a 6-year medical college in the DPRK and who are medical doctors over the fifth grade or with more than 6 years of experience can be qualified as unification medical doctors and be exempted from the KMLE, getting the right to go directly into an internship and residency. They should be permitted to work in manpower development projects for the health professions. They should also be given opportunities such as to become psychiatrists who treat the mental illness of persons escaped from the DPRK and people from North Korea after unification. Medical students in South Korea should earn college credits on the topic of medical unification and not only students, but all South Korean medical personnel, should prepare for north-south medical unification with an open mind. A way for each medical college to participate in DPRK manpower development for the health professions through a memorandum of understanding between the medical colleges of the south and north.

초음파기기를 이용한 맥상(脈象) 연구 (A Study on Pulse Pattern Using Ultrasonic Device)

  • 김희영;박정빈;금유정;여인금;엄동명;송지청
    • 대한한의학원전학회지
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    • 제34권2호
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    • pp.85-94
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    • 2021
  • Objectives : Pulse diagnosis is one of the main diagnostic methods of Korean Medicine that understands the patient's condition and illness by reading changes in the patient's pulse, which is described in terms of pulse condition While they are described in detail in medical texts, it is difficult to grasp their true nature, as the written descriptions fail to do justice to the experience of pulse taking it tries to convey. As a way to approach pulse condition the effect of the body's tension on the radial vein was measured using an ultrasonic device, after which the measured changes and how they could be reflected in pulse condition were studied. In other words, changes in the radial vein following induced tension were analyzed. Methods : 1) The thickness of the subject's radial vein was measured using a linear probe of an ultrasonic device[LOGIQ 5 Basic, GE, USA]. 2) Fatigue level was increased through artificial stimulation using the Gripmeter[ks-301, Lavisen, Korea]. 3) Thickness of the radial vein post tension induction was measured. 4) The results were analyzed with the Tukey test or paired t-test as post hoc tests. Results : Thickness of the radial vein of the subject pre- and post- Gripmeter stimulation decreased with significance. Conclusions : Constriction of the radial vein that happened after tension induction could be linked to the Tight Pulse[緊脈] that is related to patterns of contraction and pulling.

Factors Associated with Worsening Oxygenation in Patients with Non-severe COVID-19 Pneumonia

  • Hahm, Cho Rom;Lee, Young Kyung;Oh, Dong Hyun;Ahn, Mi Young;Choi, Jae-Phil;Kang, Na Ree;Oh, Jungkyun;Choi, Hanzo;Kim, Suhyun
    • Tuberculosis and Respiratory Diseases
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    • 제84권2호
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    • pp.115-124
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    • 2021
  • Background: This study aimed to determine the parameters for worsening oxygenation in non-severe coronavirus disease 2019 (COVID-19) pneumonia. Methods: This retrospective cohort study included cases of confirmed COVID-19 pneumonia in a public hospital in South Korea. The worsening oxygenation group was defined as that with SpO2 ≤94% or received oxygen or mechanical ventilation (MV) throughout the clinical course versus the non-worsening oxygenation group that did not experience any respiratory event. Parameters were compared, and the extent of viral pneumonia from an initial chest computed tomography (CT) was calculated using artificial intelligence (AI) and measured visually by a radiologist. Results: We included 136 patients, with 32 (23.5%) patients in the worsening oxygenation group; of whom, two needed MV and one died. Initial vital signs and duration of symptoms showed no difference between the two groups; however, univariate logistic regression analysis revealed that a variety of parameters on admission were associated with an increased risk of a desaturation event. A subset of patients was studied to eliminate potential bias, that ferritin ≥280 ㎍/L (p=0.029), lactate dehydrogenase ≥240 U/L (p=0.029), pneumonia volume (p=0.021), and extent (p=0.030) by AI, and visual severity scores (p=0.042) were the predictive parameters for worsening oxygenation in a sex-, age-, and comorbid illness-matched case-control study using propensity score (n=52). Conclusion: Our study suggests that initial CT evaluated by AI or visual severity scoring as well as serum markers of inflammation on admission are significantly associated with worsening oxygenation in this COVID-19 pneumonia cohort.

출소 후 정신질환 치료결정에 영향을 주는 요인에 관한 연구 (Examining the Factors Affecting Prisoner's Decision-Making for Medical Treatment of Mental Illness after Release from Prison)

  • 홍문기;박종선
    • 디지털융복합연구
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    • 제20권1호
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    • pp.15-23
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    • 2022
  • 정신질환 재소자의 출소 후 치료에 대한 연구가 부족한 편이다. 본 연구의 목적은 정신질환 재소자들의 출소 후 치료결정에 영향을 주는 요인에 대해 분석하는 것이다. 따라서 2019년 남성 재소자들을 대상으로 설문조사를 실시하여 출소 후 치료에 대한 재소자들의 선호도와 여러 변수들의 인과관계를 이항 로지스틱회귀분석을 적용해서 분석하였다. 출소 후 치료계획이 없다고 응답할 가능성을 낮추는 요인은 재소자의 양극성 조울증, 우울증, 불안장애, 공황장애 증세이며, 반대로 출소 후 치료계획이 없다고 응답할 가능성을 높이는 요인은 수감 중 정신치료 경험이 없는 경우였다. 재소자의 양극성 조울증, 불안장애, 교도관 상담, 의사 치료와 학력은 정신건강병원에서 치료받을 계획이 있다고 응답할 가능성을 높이는 요인이었으며, 정신건강복지센터에서 치료받을 계획이 있다고 응답할 가능성을 높이는 요인은 재소자의 우울증이었다. 이를 바탕으로 관련 규정의 명문화, 정신질환 재소자 병력 공유 등을 정책대안으로 제안하며, 후속연구에서는 여성재소자들이 포함된 보다 다양한 변수들의 영향을 분석할 예정이다.

조현병 환자의 아동기 외상 경험에 따른 정신병리 및 임상적 특성 (Associations of Childhood Trauma with Psychopathology and Clinical Characteristics in Patients with Schizophrenia)

  • 이현수;정유란;유태영;이주연;이수인;김재민;윤진상;김성완
    • 대한조현병학회지
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    • 제20권2호
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    • pp.37-43
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    • 2017
  • Objectives : This study was aimed to investigate the associations of childhood trauma with psychopathology and clinical characteristics in patients with schizophrenia. Methods : This study enrolled 66 inpatients with schizophrenia. Korean Childhood Trauma Questionnaire (K-CTQ) and Life Event Questionnaire (LEQ) were administered to assess childhood trauma. Psychopatholgy and clinical characteristics were assessed with the Positive and Negative Syndrome Scale (PANSS), Beck Depression Inventory (BDI), Korean Version of Internalized Stigma of Mental Illness (K-ISMI), Perceived Stress Scale (PSS), and visual analogue scale of EuroQoL-5 Dimension Index (EQ-5D). Results : Total scores on K-CTQ were positively associated with scores on the BDI, K-ISMI, PSS, and PANSS and negatively associated with the score on the EQ-5D. Among subscales of K-CTQ, emotional abuse was significantly associated with all measures for psychopathology and clinical characteristics. Patients with physical abuse (36.5%), emotional abuse (30.2%), or bullying (30.6%) according to the LEQ showed sighificanlty higher the ISMI score and lower EQ-5D score. Emotional abuse and bullying were also significantly associated with higher scores on BDI and/or PSS. Conclusion : Our results suggest that childhood trauma negatively influences on internalized stigma, depression, perceived stress and quality of life in patients with schizophrenia. Clinicians should carefully evalute and manage childhood traumatic experience of patients with schizophrenia.

Incidence of Low Seroimmunity to Hepatitis B Virus in Children with Inflammatory Bowel Disease: A Single Center Experience

  • Hala H. Mansour ;Ayman E. Eskander;Sara M. Osman;Normeen H. Rady
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제27권2호
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    • pp.104-112
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    • 2024
  • Purpose: Immunosuppressive therapy is frequently administered to patients with inflammatory bowel disease (IBD), which may make them more susceptible to infections like hepatitis B. Methods: A cross-sectional study was conducted on patients aged 5-18 years diagnosed with IBD who visited a gastroenterology clinic along with controls who were the same age as the patients with IBD and were healthy overall. A logistic regression analysis using the independent variables of age, sex, race, disease phenotype, surgery, and medications and the dependent variable of adequate hepatitis B surface antibody (HBsAb) titers (>10 mIU/mL) was performed on quantitative serum HBsAb titers. Results: The study enrolled 62 patients, including 37 males and 25 females. Crohn's disease, ulcerative colitis, and indeterminate colitis were diagnosed in 16, 22, and 24 patients, respectively. Thirty-nine patients were taking corticosteroids at the time of the study, 42 were taking immunomodulators, and four were taking biologics. Compared to 44.7% of the control group, 9.3% of the patients had protective titers. Only 12 out of 62 patients had HBsAb titers greater than 10 million IU/mL. None of the patients who received biologics or corticosteroids and 3.2% of those who received immunomodulators were found to be seroimmuned. Conclusion: The younger patients had the highest titers. Patient-specific factors that may impact these low titers include the length of the patient's illness and the use of immunosuppressants.

Nutritional Intervention for a Critically Ill Trauma Patient: A Case Report

  • Seong Hyeon Kim;Sun Jung Kim;Woojeong Kim
    • Clinical Nutrition Research
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    • 제11권3호
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    • pp.153-158
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    • 2022
  • Critically ill trauma patients generally show good nutritional status upon initial hospitalization. However, they have a high risk of malnutrition due to hyper-metabolism during the acute phase. Hence, suitable nutritional support is essential for the optimal recovery of these patients; therefore, outcomes such as preservation of fat-free mass, maintenance of immune functions, reduction in infectious complications, and prevention of malnutrition can be expected. In this report, we present the experience of a patient subjected to 40 days of nutritional interventions during postoperative intensive care unit (ICU) care. Although the patient was no malnutrition at ICU admission, enteral nutrition (EN) was delayed for > 2 weeks because of several postoperative complications. Subsequently, while receiving parenteral nutrition (PN), the patient displayed persistent hypertriglyceridemia. As a result, his prescription of PN were converted to lipid-free PN. On postoperative day (POD) #19, the patient underwent jejunostomy and started standard EN. A week later, the patient was switched to a high-protein, immune-modulating formula for postoperative wound recovery. Thereafter, PN was stopped, while EN was increased. In addition, because of defecation issues, a fiber-containing formula was administered with previous formula alternately. Despite continuous nutritional intervention, the patient experienced a significant weight loss and muscle mass depletion and was diagnosed with severe malnutrition upon discharge from the ICU. To conclude, this case report highlights the importance of nutrition interventions in critically ill trauma patients with an increased risk of malnutrition, indicating the need to promptly secure an appropriate route of feeding access for active nutritional support of patients in the ICU.

대도시 일부 여대학생들의 식이섭취행태, 체성분 및 골밀도와 치아우식증과의 관련성에 관한 연구 (Correlation between Food Intake PatternBody ComponentBMD and Dental Caries Experience of College Women)

  • 정영희
    • 치위생과학회지
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    • 제10권3호
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    • pp.147-153
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    • 2010
  • 본 연구에서는 대학생들을 대상으로 영양상태평가를 위해 먼저 식품섭취빈도조사지를 이용하여 이들의 식이섭취행태를 영양소 단위에서 분석하고, 두 번째로 체성분 및 골밀도를 측정하였으며, 마지막으로 구강검진을 시행하여 여대생들의 전반적인 식이섭취행태, 체성분 및 골밀도와 치아우식증과의 관련성에 대해 분석하였다. 본 연구대상자는 지역적 편차와 지리적 접근이 용이한 부산광역시 소재 D대학 치위생과 재학생 150명을 연구모 집단으로 선정하여 2009년 10월 10일 1차 조사를 시행하여 자발적으로 연구참여에 동의한 150명중 자료처리에 부적합한 18명을 제외한 132명을 최종 연구대상자로 선정하였다. 본 연구결과는 다음과 같다. 1. 본 연구대상자의 일반적 특성에서 총 섭취에너지는 평균 $1921.230{\pm}236.865kcal$였고, 나트륨 섭취는 $4433.026{\pm}1970.72mg$으로 상당히 높게 나타났고, 체형은 $2.98{\pm}0.99$점으로 표준체형(3점)이었으며, T-score는 평균 $-1.110{\pm}1.647$로 대부분의 학생이 약간의 골감소증(T-Score -1 ~ -2.5이내)이 있는 것으로 나타났고 우식경험영구치지수는 평균 $6.03{\pm}1.95$개로 나타났다. 2. 분석결과 대상자의 1일 평균 영양소 섭취량과 우식경험영구치지수와의 상관관계 검정에서 1일 평균 섭취에너지, 영양소 모두에서 우식경험영구치지수와는 유의하지 않은 것으로 나타났다. 3. 분석결과 대상자의 체성분과 우식경험영구치지수와의 상관관계 검정에서도 유의하지 않은 것으로 나타났다. 4. 분석결과 대상자의 골밀도와 우식경험영구치지수와의 상관관계 검정에서 SOS, BQI에서 우식경험영구치와 유의한 상관관계가 ${\pm}0.2$미만으로 아주 미약하게 나타났다(p<0.05). 5. 독립변수들의 유의성 검증결과 T-score(p<0.05)가 ${\alpha}=0.05$수준에서 통계적으로 유의한 것으로 나타나 우식경험영구치지수에 영향을 주는 요인으로 나타났다. 이상의 결과를 종합해 볼 때 여대생들의 영양상태 및 체성분은 치아우식증과 유의한 관련성은 없는 것으로 나타났으나 골밀도척도인 SOS, BQI에서는 미약한 상관관계를 나타내고, T-score는 우식경험영구치지수에 영향을 주는 요인으로 나타났다. 추후 연구조사에서 연구대상자의 수를 확대시키고 구강관리행태와 사회경제적 요인을 보정하여 연령별 영양상태, 체성분 및 골밀도과 치아우식증간의 관련성을 구명할 수 있는 자료를 더 많이 확보하여야 할 것으로 생각된다.

응급의료 전달체계의 충실 방안 (A Study in an Effective Programs for Emergency Care Delivery System)

  • 권숙희
    • 한국보건간호학회지
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    • 제9권1호
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    • pp.83-102
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    • 1995
  • As the society is being industrialized, the fast-paced economic development that has caused substantial increase in cerebrovascular and coronary artery diseases and the industrial development and increased use of means of transportation have resulted in the rapid rise of incidents in external injuries as well. So the pubic has become acutely aware of the need for fast and effective emergency care delivery system. The goal of emergency care delivery system is to meet the emergency care needs of patients. The emergency care delivery system is seeking to efficiently satisfy the care needs of people. Therefore the purpose of this study is designed to develop an effective programs for emergency care delivery system in Korea. The following specific objectives were investigated. This emergency care delivery system must have the necessary man power, for transfering the patients, communication net work, and emergency care facilities. 1) Man power Emergency care requires n0t only specialized traning in the emergency treatment but also knowledge and experience i11 other related area, so emergency care personnel traning program should be designed in order to adapt to the specific need of emergency patients. It will be necessary to ensure professional personnel who aquires the sufficient traning and experience for emergency care and to look for legal basis. We have to develop re-educational programs for emergency nurse specialist. They should be received speciality of emergency nursing care so that they will work actively and positively in emergency part. Emergency medical doctor and nurse specialist should be given an education which is related in emergency and critical care. Emergency care personnel will continue to provide both acute and continuing care as partner with other medical team. 2) Transfering the patients. Successful management of pre-hospital care requires adequate traning for the emergency medical technician. Traning program should be required to participate in a actual first aids activites in order to have apportunities to acquire practical skills as well as theoretical knowledge. The system of emergency medical technician should be remarkablly successful with first responder firefighters. Establishing this system must add necessary ambulances operating at any given time. It will be necessary to standardize the ambulance size and equipment. Ambulance should be arranged with each and every fire station. 3) Communication net work. The head office of emergency commumication network should be arranged with the head office of fire station in community. It is proposed that Hot-line system for emergency care should be introduce. High controlled ambulance and thirtial emergency center should simultaneously equip critical-line in order to communication with each other. Ordinary ambulance and secondary emergency facility should also simultaneously equip emergency-line in order to communication with each other. 4) Emergency care facilities. Primary emergency care facilities should be covered with the ambulatory emergency patients-minor illness and injuires. Secondary emergency care facilities should be covered with the emergency admission patients. Third emergency care center should be covered with the critical patients who need special treatments and operation. Secondary and third emergency care facilities should employ emergency medical doctor and emergency nurse specialist to treat in-patients with severe and acute illness and multiple injuires. It should be fashioned for a system of emergency facilities that meets emergency patients needs. Provide incentives for increased number of emergency care facilities with traning in personal/clinical emergency care. 5) Finance It is recommended to put the finance of a emergency care on a firm basis. The emergency care delivery system should be managed by the government or accreditted organizations. In order to facilitate this relevant program the fund is needed for more efficient and effective emergency researchs, service, programs, and policy. 6) Gaining understanding and co-operation of pubic It is also important to undertake pubic education to improve understanding of first aids and C. P. R of individuals, communities and business. It is proposed that teachers and health officers be certified in C. P. R. The C. P. R education can be powerful influence save lives. Lastly appropriate emergency care information must be provided to the pubic for assisting them in choosing emergency care.

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Rogers 이론에 근거한 가족양상 사정지침개발 (Development of a Family Pattern Appraisal to Guide a Rogerian Nursing Practice)

  • 이광옥;한영란;김희정
    • 대한간호학회지
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    • 제25권4호
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    • pp.751-773
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    • 1995
  • We, clinical nurse specialists practising and guiding student practice in a Community health nursing clinic, wanted to develop a family pattern appraisal consistent with Rogers' conceptual system, the nursing model guiding our practice. We use Rogers' model because it is harmonious with the traditional Korean view of the one human, natural and cosmic world. The purpose of our research was to contribute to science - based nursing practice, not only, one helpful model, but also a model of how to use, in guiding practice, a conceptual system which reflects nurse practitioners' philosophy of nursing, is intellectually satisfying, and enriches meaning in daily nursing life. The research objectives were to review the literature on Rogers' model and analyse it according to Kim's five - level analytical framework, to explore Rogers' definition of family, to review appraisals based on Rogers' model, and to develop a family appraisal which is culturally appropriate for use in our community. This work including the use of the appraisal and its refinement with families in our practice which was done during 1994 and 1995, in Seoul, in the Capital of the Republic of Korea. At the highest level of analysis, Rogers conceptual system emphasizes acausality and multidimentional meaning ; the world view is characterized by process, movement and wholeness. The epistemology Is one of holism and the knowledge base includes all forms of experience, from sensory to mystical, objective, and subjective. At the metaparadigm level, nursing focuses on the unitary human being and the environment. At the level of nursing philosophy, the model identifies human being, nursing, nurse, and illness and health. At the paradigm level the model assumes the irriducibility of the human to parts, noncausality and continual change. Rogers' practice methodology consists of pattern manifestation appraisal and deliberative mutual patterning. Under-standing patterns and patterning of people is the key to helping them achieve their potential. At the theory level, the basic assumptions, key concepts, and homeodynamic principles were identified. Rogers states the family energy field is an undividable, four-dimensional negentropic energy field which is in a larger envircinmental field show-ing such characteristics as cannot be predicted by knowledge of individual family members. Based on the word of Rogers scholars, we chose Rogers' correlates of patterning to understand the family unit as a whole-frequency, rhythms, motion, time perception, sleeping-waking beyond waking, pragmatic -imaginative-visionary to develop the appraisal. We, also used some of Barrel's (1988) criteria including interpersonal network and professional health care access and use, and Cordon's (1982) criteria including self perception - self concept modified to fit the family. Our family Pattern appraisal included 1. Influencirg data, 2. Professional health care access and use, 3. Family self perception-self concept, 4. Family interpersonal network, 5. Sleep-wake-be-yond waking, 6. Pragmatic-imaginary-visionary, 7. Family frequency and rhythm, 8. Family motion, 9. Family time perception. The appraisal was used with four families and modified to eliminate overlap and to make it possible for the family member to express themselves more easily. We plan to gain more experience with the appraisal toward further development of the tool.

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