• 제목/요약/키워드: Integrated medical service

검색결과 217건 처리시간 0.026초

병원모바일앱 품질요인이 이용자의 지속이용의도에 미치는 영향: 정보시스템성공모형과 기대일치모형의 통합적 접근 (The Effect of Hospital Mobile App Quality Factors on Users ' Continuous Use Intention: An Integrated Approach of Information Systems Success and Expectation-Confirmation Models)

  • 김민수;윤상혁;이새봄;양성병
    • 서비스연구
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    • 제13권1호
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    • pp.76-95
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    • 2023
  • 정보통신기술 기반의 '스마트병원'과 '디지털 헬스케어'가 의료분야의 화두가 되면서 병원모바일앱이 주목받고 있지만, 홍보 부족, 불안정한 시스템, 늦은 업데이트 등의 이유로 이용률은 저조한 편이다. 이러한 상황에서 병원모바일앱의 이용률을 높이기 위한 체계적인 연구가 필요하지만, 관련 연구는 다소 부족한 실정이다. 이에, 본 연구에서는 기술적 관점의 정보시스템성공모형과 인지적 관점의 기대일치모형을 통합하여, 병원모바일앱 지속이용의도에 대한 영향 메커니즘을 실증하고자 한다. 이를 위해 병원모바일앱 이용 경험이 있는 국내 성인 181명을 대상으로 온라인 설문조사를 실시하였다. 구조방정식모형 분석 결과, 대부분의 품질요인이 기대일치와 인지된 유용성 및 만족도에 유의미한 영향을 미치는 것으로 나타났으며, 기대일치는 인지된 유용성과 만족도에 유의한 영향을 주는 것으로 나타났다. 또한, 인지된 유용성과 만족도는 병원모바일앱의 지속이용의도에 유의한 영향을 미친다는 사실을 밝혀냈다. 본 연구는 기대일치모형과 정보시스템성공모형을 통합하여 의료분야, 그 가운데에서도 이용률이 저조한 병원모바일앱 사용 맥락에 적용한 연구라는 점에서 의의가 있으며, 연구결과를 통해 병원모바일앱의 이용률 증대 및 효과적·효율적인 서비스 운영을 위한 실무적 시사점을 제시하였다.

근감소증에 대한 한의 치료 연구 동향: 스코핑 리뷰 (Research Trends in Korean Medicine Treatment for Sarcopenia: Scoping Review)

  • 김서은;한윤희;최승관;조정호;우현준;전병현;하원배;이정한
    • 한방재활의학과학회지
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    • 제33권3호
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    • pp.97-113
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    • 2023
  • Objectives This study examined the trends in domestic and international research on the treatment of sarcopenia and analyzed the effectiveness of the treatment. Based on the results, we suggest directions for future Korean medicine research on sarcopenia. Methods The study was conducted using Arksey and O'Malley's scoping review methodology. It included three international databases (PubMed, EMBASE, Cochrane Library) and five domestic databases (Korean studies Information Service System, Korean Medical database, Oriental Medicine Advanced Search Integrated System, Research Information Sharing Service, ScienceON) were used. Literatures published until April 30, 2023, including the contents of 'sarcopenia' and Korean Medicine treatment', were searched. Results A total of 45 studies were included in the analysis. The number of studies on Korean medicine treatments for sarcopenia is steadily increasing, with the majority of studies coming from Asian countries. Of the 45 studies, 30 were conducted in the field of medicine, and the study design was analyzed into 10 clinical studies and 35 non-clinical studies. Among the 10 clinical studies, the most common treatment interventions were herbs (n=4), followed by Daoist exercises (n=3). The most common diagnostic criteria used in clinical studies were those published by the Asian working group for sarcopenia, and various physical examinations and laboratory tests were used as outcome measures. Conclusions The future direction of Korean medicine research on sarcopenia should be to expand the number of clinical studies applying Korean medicine treatment interventions.

포착신경병증의 약침치료에 대한 국내 임상 연구 동향: 주제범위 문헌고찰 (Domestic Clinical Research Trends of Pharmacopuncture Treatment for Nerve Entrapment Syndroeme: A Scoping Review)

  • 이원형;우현준;한윤희;최승관;조정호;전병현;하원배;이정한
    • 한방재활의학과학회지
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    • 제33권4호
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    • pp.31-44
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    • 2023
  • Objectives The purpose of this study is to check the research trends of pharmacopuncture treatment in nerve entrapment syndrome, identify specific techniques, identify which pharmacopuncture are used, and provide directions for future research. Methods This study was conducted based on the five steps suggested by Arksey and O'Malley. We searched five domestic databases (Research Information Sharing Service, Oriental Medicine Advanced Searching Integrated System, Korean studies Information Service System, Science ON, and KMBASE) and identified studies with key search terms like "nerve entrapment" And "pharmacopuncture" until June 23, 2023. Results Twenty-nine studies were finally selected. among them, 25 papers were non-comparative studies (86.2%). The most common disease was carpal tube syndrome (n=10). All the investigated studies were treated by injecting pharmacopuncture into the pathway of the entraped nerve. The depth of pharmacopuncture injection was mentioned only in 13 studies. As for the pharmacopuncture used, sweet bee venom was 8 studies and bee venom was 6 studies, and about half of the pharmacopuncture manufactured with Bee venom as the main component accounted for. Conclusions This study is a scoping review of the pharmacopuncture treatment for nerve entrapment, which was first conducted in Korea. The treatment is mainly performed on the path way of the entraped nerve. After that, it is necessary to study the standardization of the specific technique method of pharmacopuncture and the uniformity of evaluation criteria.

사경증의 한방 치료에 대한 체계적 문헌고찰 (2018년부터 2023년 연구를 중심으로) (A Systematic Review of the Korean Medicine Treatments for Torticollis (Focused on Research from 2018 to 2023))

  • 서경준;최종찬;지민준;권도영;양재은;구지향;이은정;오민석
    • 한방재활의학과학회지
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    • 제34권2호
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    • pp.29-49
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    • 2024
  • Objectives The purpose of this study is to systemically review the recent studies in the Korean medicine treatments for torticollis. Methods We search the clinical studies from January 1, 2018 to December 31, 2023. The studies were searched through 10 databases (Oriental Medicine Advanced Searching Integrated System, Korean studies Information Service System, Research Information Sharing Service, Korean Medical Database, ScienceON, PubMed, Cochrane Library, Embase, Wanfang Data, China National Knowledge Infrastructure). Results A total of 19 studies were included in the study. 12 studies were case report studies, 5 studies were randomized controlled trials, 2 studies were non-randomized controlled trials. Of the 19 interventions, Chuna was the most used in this study and of the 28 evaluation tools, Sternocleidomastoid thickness was the most used in this study except efficiency rate. All 19 studies had improvements after treatment, and 8 studies had statistically significant improvements. As a result of the study, we found that Chuna, GB, GB20, BL10, Glycyrrhiza uralensis were commonly used Korean medicine treatments for torticollis. Conclusions We analyzed the Korean medicine treatments for torticollis. Through this study, we found that the Korean medicine was effective for torticollis. However, more research is needed to confirm the more detailed effect.

Prediction Model of User Physical Activity using Data Characteristics-based Long Short-term Memory Recurrent Neural Networks

  • Kim, Joo-Chang;Chung, Kyungyong
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • 제13권4호
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    • pp.2060-2077
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    • 2019
  • Recently, mobile healthcare services have attracted significant attention because of the emerging development and supply of diverse wearable devices. Smartwatches and health bands are the most common type of mobile-based wearable devices and their market size is increasing considerably. However, simple value comparisons based on accumulated data have revealed certain problems, such as the standardized nature of health management and the lack of personalized health management service models. The convergence of information technology (IT) and biotechnology (BT) has shifted the medical paradigm from continuous health management and disease prevention to the development of a system that can be used to provide ground-based medical services regardless of the user's location. Moreover, the IT-BT convergence has necessitated the development of lifestyle improvement models and services that utilize big data analysis and machine learning to provide mobile healthcare-based personal health management and disease prevention information. Users' health data, which are specific as they change over time, are collected by different means according to the users' lifestyle and surrounding circumstances. In this paper, we propose a prediction model of user physical activity that uses data characteristics-based long short-term memory (DC-LSTM) recurrent neural networks (RNNs). To provide personalized services, the characteristics and surrounding circumstances of data collectable from mobile host devices were considered in the selection of variables for the model. The data characteristics considered were ease of collection, which represents whether or not variables are collectable, and frequency of occurrence, which represents whether or not changes made to input values constitute significant variables in terms of activity. The variables selected for providing personalized services were activity, weather, temperature, mean daily temperature, humidity, UV, fine dust, asthma and lung disease probability index, skin disease probability index, cadence, travel distance, mean heart rate, and sleep hours. The selected variables were classified according to the data characteristics. To predict activity, an LSTM RNN was built that uses the classified variables as input data and learns the dynamic characteristics of time series data. LSTM RNNs resolve the vanishing gradient problem that occurs in existing RNNs. They are classified into three different types according to data characteristics and constructed through connections among the LSTMs. The constructed neural network learns training data and predicts user activity. To evaluate the proposed model, the root mean square error (RMSE) was used in the performance evaluation of the user physical activity prediction method for which an autoregressive integrated moving average (ARIMA) model, a convolutional neural network (CNN), and an RNN were used. The results show that the proposed DC-LSTM RNN method yields an excellent mean RMSE value of 0.616. The proposed method is used for predicting significant activity considering the surrounding circumstances and user status utilizing the existing standardized activity prediction services. It can also be used to predict user physical activity and provide personalized healthcare based on the data collectable from mobile host devices.

경혈 조사를 중심으로 본 고출력 Yttrium Aluminum Garnet (YAG) 레이저의 활용 (Utilizing the Application of High-Intensity Yttrium Aluminum Garnet (YAG) Lasers Focused on Acupoint Irradiation)

  • 이마음;최유민;안수빈;이기향;이은희;임명진;서형식;황의형;장인수
    • Korean Journal of Acupuncture
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    • 제40권4호
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    • pp.141-148
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    • 2023
  • Objectives : The purpose of this study is to investigate on the application of the yttrium aluminum garnet (YAG) lasers for acupoints irradiation. Methods : We conducted a systematic search for peer-reviewed studies published from inception to November 2023, in the following electronic databases: PubMed, Scopus, and Web of Science in English, Science ON, Oriental Medicine Advanced Searching Integrated System (OASIS) and Research Information Sharing Service (RISS) in Korean, and China National Knowledge Infrastructure (CNKI) and Wanfang in Chinese, and Japan Science Technology Information Aggregator, Electronic (J-STAGE) and Citation Information by NII (CiNii) in Japanese. Inclusion criteria were original articles including clinical and experimental studies related with YAG lasers for acupoints including Ashi or meridian sinews. Results : Among the 8 selected studies, there were 7 studies on human subjects and 1 study on animals, 7 studies on Nd:YAG (1,064 nm) laser, and 1 study on Er:YAG (2,940 nm) laser. A total of 16 acupoints were used, 15 of which were in the face and 1 of which was located in the foot. In addition, there were two studies using Ashi. 4 studies looked at the effect of pain relief, 2 studies looked at safety, 1 study looked at changes in blood flow, and 1 study looked at the effect of skin care. There were no reported adverse events, and the YAG laser was confirmed to be safe and effective in pain relief, beautifying the skin, and increasing blood flow. Conclusions : We suggest that high intensity YAG lasers can be applied to laser acupuncture or laser moxibustion. YAG lasers are considered to be worth using for various clinical indications of Korean medicine because of photobiomodulation effects, analgesic action, and deep penetration depth. Further scientific research and clinical evidences should be warranted.

가족계획과 모자보건 통합을 위한 조산원의 투입효과 분석 -서산지역의 개입연구 평가보고- (An Intervention Study on Integration of Family Planning and Maternal/Infant Care Services in Rural Korea)

  • 방숙;한성현;이정자;안문영;이인숙;김은실;김종호
    • Journal of Preventive Medicine and Public Health
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    • 제20권1호
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    • pp.165-203
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    • 1987
  • This project was a service-cum-research effort with a quasi-experimental study design to examine the health benefits of an integrated Family Planning (FP)/Maternal & Child health (MCH) Service approach that provides crucial factors missing in the present on-going programs. The specific objectives were: 1) To test the effectiveness of trained nurse/midwives (MW) assigned as change agents in the Health Sub-Center (HSC) to bring about the changes in the eight FP/MCH indicators, namely; (i)FP/MCH contacts between field workers and their clients (ii) the use of effective FP methods, (iii) the inter-birth interval and/or open interval, (iv) prenatal care by medically qualified personnel, (v) medically supervised deliveries, (vi) the rate of induced abortion, (vii) maternal and infant morbidity, and (viii) preinatal & infant mortality. 2) To measure the integrative linkage (contacts) between MW & HSC workers and between HSC and clients. 3) To examine the organizational or administrative factors influencing integrative linkage between health workers. Study design; The above objectives called for quasi-experimental design setting up a study and control area with and without a midwife. An active intervention program (FP/MCH minimum 'package' program) was conducted for a 2 year period from June 1982-July 1984 in Seosan County and 'before and after' surveys were conducted to measure the change. Service input; This study was undertaken by the Soonchunhyang University in collaboration with WHO. After a baseline survery in 1981, trained nurses/midwives were introduced into two health sub-centers in a rural setting (Seosan county) for a 2 year period from 1982 to 1984. A major service input was the establishment of midwifery services in the existing health delivery system with emphasis on nurse/midwife's role as the link between health workers (nurse aids) and village health workers, and the referral of risk patients to the private physician (OBGY specialist). An evaluation survey was made in August 1984 to assess the effectiveness of this alternative integrated approach in the study areas in comparison with the control area which had normal government services. Method of evaluation; a. In this study, the primary objective was first to examine to what extent the FP/MCH package program brought about changes in the pre-determined eight indicators (outcome and impact measures) and the following relationship was first analyzed; b. Nevertheless, this project did not automatically accept the assumption that if two or more activities were integrated, the results would automatically be better than a non-integrated or categorical program. There is a need to assess the 'integration process' itself within the package program. The process of integration was measured in terms of interactive linkages, or the quantity & quality of contacts between workers & clients and among workers. Intergrative linkages were hypothesized to be influenced by organizational factors at the HSC clinic level including HSC goals, sltrurture, authority, leadership style, resources, and personal characteristics of HSC staff. The extent or degree of integration, as measured by the intensity of integrative linkages, was in turn presumed to influence programme performance. Thus as indicated diagrammatically below, organizational factors constituted the independent variables, integration as the intervening variable and programme performance with respect to family planning and health services as the dependent variable: Concerning organizational factors, however, due to the limited number of HSCs (2 in the study area and 3 in the control area), they were studied by participatory observation of an anthropologist who was independent of the project. In this observation, we examined whether the assumed integration process actually occurred or not. If not, what were the constraints in producing an effective integration process. Summary of Findings; A) Program effects and impact 1. Effects on FP use: During this 2 year action period, FP acceptance increased from 58% in 1981 to 78% in 1984 in both the study and control areas. This increase in both areas was mainly due to the new family planning campaign driven by the Government for the same study period. Therefore, there was no increment of FP acceptance rate due to additional input of MW to the on-going FP program. But in the study area, quality aspects of FP were somewhat improved, having a better continuation rate of IUDs & pills and more use of effective Contraceptive methods in comparison with the control area. 2. Effects of use of MCH services: Between the study and control areas, however, there was a significant difference in maternal and child health care. For example, the coverage of prenatal care was increased from 53% for 1981 birth cohort to 75% for 1984 birth cohort in the study area. In the control area, the same increased from 41% (1981) to 65% (1984). It is noteworthy that almost two thirds of the recent birth cohort received prenatal care even in the control area, indicating that there is a growing demand of MCH care as the size of family norm becomes smaller 3. There has been a substantive increase in delivery care by medical professions in the study area, with an annual increase rate of 10% due to midwives input in the study areas. The project had about two times greater effect on postnatal care (68% vs. 33%) at delivery care(45.2% vs. 26.1%). 4. The study area had better reproductive efficiency (wanted pregancies with FP practice & healthy live births survived by one year old) than the control area, especially among women under 30 (14.1% vs. 9.6%). The proportion of women who preferred the 1st trimester for their first prenatal care rose significantly in the study area as compared to the control area (24% vs 13%). B) Effects on Interactive Linkage 1. This project made a contribution in making several useful steps in the direction of service integration, namely; i) The health workers have become familiar with procedures on how to work together with each other (especially with a midwife) in carrying out their work in FP/MCH and, ii) The health workers have gotten a feeling of the usefulness of family health records (statistical integration) in identifying targets in their own work and their usefulness in caring for family health. 2. On the other hand, because of a lack of required organizational factors, complete linkage was not obtained as the project intended. i) In regards to the government health worker's activities in terms of home visiting there was not much difference between the study & control areas though the MW did more home visiting than Government health workers. ii) In assessing the service performance of MW & health workers, the midwives balanced their workload between 40% FP, 40% MCH & 20% other activities (mainly immunization). However, $85{\sim}90%$ of the services provided by the health workers were other than FP/MCH, mainly for immunizations such as the encephalitis campaign. In the control area, a similar pattern was observed. Over 75% of their service was other than FP/MCH. Therefore, the pattern shows the health workers are a long way from becoming multipurpose workers even though the government is pushing in this direction. 3. Villagers were much more likely to visit the health sub-center clinic in the study area than in the control area (58% vs.31%) and for more combined care (45% vs.23%). C) Organization factors (admistrative integrative issues) 1. When MW (new workers with higher qualification) were introduced to HSC, it was noted that there were conflicts between the existing HSC workers (Nurse aids with less qualification than MW) and the MW for the beginning period of the project. The cause of the conflict was studied by an anthropologist and it was pointed out that these functional integration problems stemmed from the structural inadequacies of the health subcenter organization as indicated below; i) There is still no general consensus about the objectives and goals of the project between the project staff and the existing health workers. ii) There is no formal linkage between the responsibility of each member's job in the health sub-center. iii) There is still little chance for midwives to play a catalytic role or to establish communicative networks between workers in order to link various knowledge and skills to provide better FP/MCH services in the health sub-center. 2. Based on the above findings the project recommended to the County Chief (who has power to control the administrative staff and the technical staff in his county) the following ; i) In order to solve the conflicts between the individual roles and functions in performing health care activities, there must be goals agreed upon by both. ii) The health sub·center must function as an autonomous organization to undertake the integration health project. In order to do that, it is necessary to support administrative considerations, and to establish a communication system for supervision and to control of the health sub-centers. iii) The administrative organization, tentatively, must be organized to bind the health worker's midwive's and director's jobs by an organic relationship in order to achieve the integrative system under the leadership of health sub-center director. After submitting this observation report, there has been better understanding from frequent meetings & communication between HW/MW in FP/MCH work as the program developed. Lessons learned from the Seosan Project (on issues of FP/MCH integration in Korea); 1) A majority or about 80% of the couples are now practicing FP. As indicated by the study, there is a growing demand from clients for the health system to provide more MCH services than FP in order to maintain the achieved small size of family through FP practice. It is fortunate to see that the government is now formulating a MCH policy for the year 2,000 and revising MCH laws and regulations to emphasize more MCH care for achieving a small size family through family planning practice. 2) Goal consensus in FP/MCH shouBd be made among the health workers It administrators, especially to emphasize the need of care of 'wanted' child. But there is a long way to go to realize the 'real' integration of FP into MCH in Korea, unless there is a structural integration FP/MCH because a categorical FP is still first priority to reduce the rate of population growth for economic reasons but not yet for health/welfare reasons in practice. 3) There should be more financial allocation: (i) a midwife should be made available to help to promote the MCH program and coordinate services, (in) there should be a health sub·center director who can provide leadership training for managing the integrated program. There is a need for 'organizational support', if the decision of integration is made to obtain benefit from both FP & MCH. In other words, costs should be paid equally to both FP/MCH. The integration slogan itself, without the commitment of paying such costs, is powerless to advocate it. 4) Need of management training for middle level health personnel is more acute as the Government has already constructed 90 MCH centers attached to the County Health Center but without adequate manpower, facilities, and guidelines for integrating the work of both FP and MCH. 5) The local government still considers these MCH centers only as delivery centers to take care only of those visiting maternity cases. The MCH center should be a center for the managment of all pregnancies occurring in the community and the promotion of FP with a systematic and effective linkage of resources available in the county such as i.e. Village Health Worker, Community Health Practitioner, Health Sub-center Physicians & Health workers, Doctors and Midwives in MCH center, OBGY Specialists in clinics & hospitals as practiced by the Seosan project at primary health care level.

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우리나라 가정방문간호의 현황과 향후 과제 (Current State and the Future Tasks of Home Visit Nursing Care in South Korea)

  • 박은옥
    • 농촌의학ㆍ지역보건
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    • 제44권1호
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    • pp.28-38
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    • 2019
  • 본 연구에서는 우리나라 보건소 방문건강관리사업과 노인장기요양보험의 방문간호, 의료기관의 가정간호사업 등 가정방문간호사업 현황을 살펴보고, 향후 발전과정을 모색하고자 수행되었다. 본 연구를 위하여 각 가정방문간호사업의 관련 법령, 통계자료, 지침과 안내서, 연구논문과 학술대회 자료집 등을 검색하여 관련 문헌을 고찰하였다. 연구결과 보건소 방문건강관리사업은 지역보건법에 근거하여 주로 취약계층을 대상으로 간호사에게 의해 비용부담 없이 제공되고 있으며, 2017년 12월을 기준으로 1,261,208명 등록 관리되는 것으로 나타났다. 보건소 방문건강관리사업 등록 대상자는 흡연율, 걷기 실천율, 혈압조절율, 혈당조절률 등이 향상되는 것으로 나타나, 건강행위와 질병관리 측면에서 긍정적인 효과가 있고, 비용-편익이 있다고 보고되었다. 노인장기요양보험에서의 방문간호는 노인장기요양보험법에 근거하여 간호사 또는 간호조무사에 의해 재가장기요양기관에서 방문간호를 제공하고 있으며, 시간당 정해진 수가에 따라 비용을 받고 있는데, 2017년에 전체 요양급여비의 0.2%만이 방문간호로 이용하는 것으로 나타났다. 재가장기요양보험 방문간호 이용자는 비이용자에 비해 의료비도 더 적게 쓰고, 입원일도 적다고 보고되었다. 의료기관 가정간호는 의료법에 근거하여 2명 이상의 가정간호사(가정전문간호사)를 고용한 의료기관에서 의사의 처방 하에 가정간호서비스를 제공하는데, 2017년 460명의 가정간호사가 가정간호서비스를 제공하고, 전체 의료비의 0.038%가 가정간호비용으로 지불된 것으로 나타났다. 우리나라 가정방문간호 유형은 관련법이나 인력, 사업 대상이 다르지만, 서비스 이용자의 건강관리에 효과가 있고, 비용-편익이 상당히 높은 것으로 나타났다. 우리나라 가정방문간호를 발전과 활성화를 위해 세 개 유형의 가정방문간호 서비스가 통합적으로 제공될 수 있는 방안을 모색하고, 근로 조건의 개선, 가정방문간호서비스 제공인력기준이나 방문간호수가 체계의 개선과 같은 법령의 개정 등을 고려할 필요가 있다고 본다.

질적 간호에 대한 환자와 가족의 지각 (Perceptions of Quality Nursing care of Patients and Families)

  • 지성애;권성복;박은희
    • 간호행정학회지
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    • 제4권1호
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    • pp.247-275
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    • 1998
  • The purpose of this study was to offer the results of content analysis and qualitative study that explored the perceptions about quality nursing care of patients and families as consumers and to identify the implications of this study for quality nursing care management and research. The data was collected from 12 adult patients and 9 families who were admmitted at medical and surgical nursing unit of one university hospital in Seoul from October, 1996 to January, 1997. Research participants were asked to response "what do you think quality nursing care?" and similar questions during the interviews was performed. Data were analyzed using open coding and content analysis with frequencies and percents of attributes of quality nursing care. Attributes of quality nursing care and meaning of quality nursing care that patients and families perceived were explored. 1. The attributes of quality nursing care that patient and families perceived were categorized into 56 attributes. The highest response rate among the attributes was 'one's heart at ease' (76.2%), and the next high response rates were ranked in order 'consideration' , 'care about' (each 61.9% 'expert skill' (57.1%), 'deal with problem promptly' , 'information offer' (42.9%), 'intimate feeling' (38.1%), 'smile' 'service spirit' , 'do one's best' (each 33.3%), 'frequent visit' (23.8%), 'observe the time' (23.8%), 'direct nursing care' , 'speaking warmly' , give a hope' , 'address kindly' , 'a sense of duty' , 'good facilities' (each 19.0%), 'inquire after a patient health' , 'patient-centered nursing care' , 'showing an example' , 'professional knowledge' , 'careless moraly patient' , 'give encourage to patients' , 'good answer a question' (each 14.3%), 'do not imprudently' , 'do not disregard' , 'broad knowledge' , 'emergency treatment skill' , 'dependability' ,'consolation' giving a sense of security' , 'a self sacrificing spirit' , 'a sense of responsibility' 'hard - working', 'enough disposition of nursing staff (each 9.5%), 'improve patient's pride' and the rest attributes exhibited 4.7%, respectively. 2. The attributes that were identified in patients' data only were 8 categories, 'service sprit' (58.3 %) 'expert knowledge' , 'good answer a question' (each 25.0%), 'hard working' (16.7%), 'a warm character', 'professional attainments', 'do without reserve', 'satisfaction' (each 8.3%), 3. The attributes were identified to families' data only were 31 categories, 'speaking warmly' , 'direct nursing care', 'adress kindly', 'patientcentered nursing care', 'showing an example' (each 33.3%). 'do not imprudently' , 'do not disregard' , 'consolation', 'giving a sense of security', 'broad knowledge' , 'emergency treatment skill', 'dependability' ,'a self - sacrificing spirit', 'a sense of responsibility' (each 22.2%), 'improve patient's pride' , 'without discrimination' , 'show kindness' , 'individual nursing care', 'being with patient' , 'helping' , 'accuracy' , 'without any mistake' , 'love' , 'self - confidence', 'self possession', 'a self - denying spirit' , 'a sense of duty' , 'tighten discipline' , 'disposed room with similar patient to diagnosis', 'compensatory relationship between me dical team' , 'role of connection' (each 11.1 %). 4. The attributes of quality nursing care were integrated into 11 categories that they were 'patientcentered nursing care' (25.1%), 'expertise' (22.1%), 'caring'(18.1%), 'kindness'(11.1%L 'nurse attainments(10.1%), 'sincerity' (7.5%), 'good environment' (2.0%), 'effective organizational management', 'coordination', 'enough nursing staff' ( each 1.0%), 'satisfaction' (0.5%) were showed in the order of the highest rate. 5. The concept of quality nursing care were defined as 'give a satisfaction to patients by patientcentered care based on professional skill and caring with kindness and sincerity'. The description of the meaning of quality nursing care provided by this research participants, patients and families can provide important information for quality nursing care management, medical marketing, education and researches of this field. On the basis of the above findings the following recommendations are made: to suggest to utilize this results for patient care in practice setting, development of quality assessment tool in nursing care, repeat study by the same subjects and method, and to a comparative study by the same method to nurse.

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현대사회의 환경변화에 따른 Bio-Terror의 위협요인 연구 (A Study on the Threat of Biological Terrorism in modern society)

  • 강영숙;김태환
    • 한국재난정보학회 논문집
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    • 제1권1호
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    • pp.3-26
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    • 2005
  • In recent years, there is growing concern about the potential use of biological agents in war or acts of terrorism accompanied an increased realization that rapid preparedness and response are needed to prevent or treat the human damage that can be caused by these agents. The threat is indeed serious, and the potential for devastating numbers of casualties is high. The use of agents as weapons, even on a small scale, has the potential for huge social and economic disruption and massive diversion of regional and national resources to combat the threat, to treat primary disease, and to clean up environmental contamination. Biological weapons are one of weapons of mass destruction (or mass casualty weapons, to be precise. since they do not damage non-living entities) that are based on bacteria, viruses, rickettsia, fungi or toxins produced by these organisms. Biological weapons are known to be easy and cheap to produce and can be used to selectively target humans, animals, or plants. Theses agents can cause large numbers of casualties with minimal logistical requirements (in wide area). The spread of disease cannot be controlled until there is awareness of the signs of infection followed by identification of agents; and if the organism is easily spread from person to person, as in the case of smallpox, the number of casualties could run into the tens of thousands. Biological weapons could be used covertly, there can be a lot of different deployment scenarios. A lot of different agents could be used in biological weapons. And, there are a lot of different techniques to manufacture biological weapons. Terrorist acts that make use of Biological Agents differ in a number of ways from those involving chemicals. The distinction between terrorist and military use of Biological Weapon is increasingly problematic. The stealthy qualities of biological weapons further complicate the distinction between terrorism and war. In reality, all biological attacks are likely to require an integrated response involving both military and civilian communities. The basic considerations when public health agencies establish national defence plan against bioterrorism must be 1) arraying various laws and regulations to meet the realistic needs, 2)education for public health personnels and support of concerned academic society, 3)information collection and cooperative project with other countries, 4)Detection and surveillance(Early detection is essential for ensuring a prompt response to biological or chemical attack, including the provision of prophylactic medicines, chemical antidotes, or vaccines) and 5) Response(A comprehensive public health response to a biological or chemical terrorist event involves epidemiologic investigation, medical treatment and prophylaxis for affacted persons, and the initiation of disease prevention or environmental decontamination measures). The purpose of this paper is providing basic material of preparedness and response for biological terrorism in modern society.

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