• 대한간호학회지
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• 제47권4호
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• pp.514-525
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• 2017

Purpose: The purpose of this study was to construct and test a structural equation model for Diabetes self-management (DSM) behavior and Quality of life (QoL) in older adults with diabetes who use Citizen Health Promotion Centers. The theory used this study was a combination of the Information-Motivation-Behavioral Model (IMB) and Self-Determination Theory (SDT) to reflect autonomous characteristics of participants. Methods: Data were collected from April 20 to August 31, 2015 using a self-report questionnaire. The sample was 205 patients with type 2 Diabetes who regularly visited a Citizen Health Promotion Center. SPSS 22.0 and AMOS 22.0 programs were used to analyze the efficiency of the hypothesized model and calculate the direct and indirect effects of factor affecting the participants' DSM behavior and QoL. Results: The supported hypotheses were as follows; 1) The variable that had a direct effect on QoL was health behavior adherence (${\gamma}=.55$, p=.007). 2) The variables that had a direct effect on DSM behavior were DSM information (${\gamma}=.15$, p=.023), DSM confidence (${\gamma}=.25$, p<.001), and autonomous motivation (${\gamma}=.13$, p=.048). 3) The variable that had a direct effect on DSM confidence was autonomy support (${\gamma}=.33$, p<.001). Conclusion: The major findings of this study are that supporting patient's autonomous motivation is an influential predictor for adherence to DSM behavior, and integrative intervention strategies which include knowledge, experience and psychosocial support are essential for older adults with diabetes to continue DSM behavior and improve QoL.

• Journal of Hospice and Palliative Care
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• 제26권1호
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• pp.22-25
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• 2023

Although most patients prefer dying at home, patients whose condition rapidly becomes critical need care in the intensive care unit (ICU), and it is rare for them to die at home with their families. Therefore, interest in hospice and palliative care for patients in the ICU is increasing. Hospice and palliative care (PC) is necessary for all patients with life-threatening diseases. The following patients need palliative care in the ICU: patients with chronic critical illnesses who need tracheostomy, percutaneous gastrostomy tube, and extracorporeal life support; patients aged 80 years or older; stage 4 cancer patients; patients with specific acute diseases with a poor prognosis (e.g., anoxic brain injury and intracerebral hemorrhage requiring mechanical ventilation); and patients for whom the attending physician expects a poor prognosis. There are two PC models-a consultative model and an integrative model-in the ICU setting. Since these two models have advantages and disadvantages, it is necessary to apply the model that best fits each hospital's circumstances. Furthermore, interdisciplinary decision-making between the ICU care team and PC specialists should be strengthened to increase the provision of hospice and palliative care services for patients expected to have poor outcomes and their families.

• 가정∙방문간호학회지
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• 제26권1호
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• pp.5-18
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• 2019

Purpose: Frailty is associated with an increased risk of adverse health outcomes. We aimed to review the relationships between frailty and health outcomes in community-dwelling Korean elderly individuals. Methods: Whittemore and Knafls' framework for conducting integrative reviews was used. PubMed, Cumulative Index to Nursing and Allied Health Literature, and six Korean databases were searched. For analysis, the study included articles written in English and Korean published between January 1960 and June 2018. Of the total 1,488 studies found in the databases, we analyzed 15 studies that met the quality of the evaluation criteria. Results: The prevalence of frailty in Korean elderly individuals ranged from 6.5% to 11.7% when divided into three levels of frailty. The health outcomes assessed in relation to frailty were divided into five domains: quality of life, physical health, psychosocial health, health behavior, and health care quality. Frailty was negatively associated with all five domains. Conclusions: Our study suggested that nurses should be aware of the limitations in the physical and cognitive functions of frail elderly individuals and provide tailored interventions for Korean elderly individuals. Furthermore, a large-scale study is needed to develop the Korean model of the frailty assessment tool and to verify the conceptual model of this study.

• 한방재활의학과학회지
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• 제27권4호
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• pp.111-119
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• 2017

Objectives Clinical pathway (CP), is management plans that display goals for patients and have led to improve outcomes for many diseases. In Korea, Interest in Korean medicine's stabilization (Clinical pathway, Clinical Practice Guideline) is increasing, But the number of studies is scare. Method and Analysis This trials composes nonequivalent control group pretest-posttest design to conduct clincal pathway trial for the acute pain after back surgery. The subjects were 10 control patients with back surgery, and 10 experimental patients with application of integrative CP. Each group patient will observed 6 weeks. We check validation of CP. Also we compared the patient's status using the pain, function, Quality of life index between the two groups. Discussion This trial is the first CP for the acute pain after back surgery using integrative medicine concepts. Aim of this trial is to find the effectiveness and validity of clincal pathway for acute pain after back surgery.

• Journal of Hospice and Palliative Care
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• 제22권3호
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• pp.105-116
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• 2019

목적: 소아청소년 호스피스 완화의료(이하 소아완화의료)는 생명을 위협하는 질환을 가진 소아청소년의 삶의 질을 향상시기 위한 총체적 돌봄 철학이자 실무의 표준이다. 국내에서는 2018년 7월 국가 지원의 소아완화의료 시범사업을 도입하였는데, 소아완화의료의 발전 방향을 제시하기 위해 국외 선진국의 소아완화의료 제공체계를 고찰하였다. 방법: 소아완화의료 제공 수준을 검토하여 영국, 미국, 일본, 싱가포르를 대상으로 선정하였다. 소아완화의료 제공체계를 다룬 국내외 학술지 등 문헌을 통합적으로 고찰하고 현지 전문가의 자문과 현지 방문조사를 수행하였다. 1990년 이후 영어, 일본어로 발간된 문헌을 중심으로 PubMed, Google, Google Scholar에서 검색하여 학술지, 정책보고서 등을 참고하였다. 각국의 소아완화의료 발전과정, 정책, 재정 모델, 대상 기준, 전달 체계, 질 관리 체계에 대해 분석하였다. 결과: 영국은 지역사회의 독립형 소아전문 완화의료기관이 일차 의료체계와 협력하며 어린이병원의 전문 소아완화의료 자문팀과 의뢰와 자문을 주고받는다. 미국은 병원기반의 전문 소아완화의료 자문팀을 중심으로 지역사회의 호스피스기관, 가정의료기관이 네트워크를 구축하고 돌봄 코디네이터를 지정하여 소아완화의료를 제공한다. 일본은 완화의료, 재택의료, 장애아동 및 만성질환아동 지원체계에서 완화의료 성격의 서비스를 제공한다. 싱가포르는 소아전문 가정 완화의료 단체가 어린이병원의 전문 자문팀과 협력하여 높은 지리적 접근성을 토대로 중추적으로 완화의료를 제공한다. 결론: 국외의 제공체계를 참고하고 국내의 현장의 요구를 반영하여 소아완화의료의 제공체계를 정비하여 미충족 요구가 발생하지 않도록 한국 소아청소년 호스피스완화의료를 최적화해 나가야 한다.

• 대한통합의학회지
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• 제6권3호
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• pp.93-102
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• 2018

Purpose : The purpose of this study was to conduct an in-depth interview with dentists in order to provide fundamental data regarding their thoughts in relation to the dental hygiene process of care and its necessity in clinical practice, with the aim of ensuring that dental hygienists can perform their duties as experts. Method : Following explanation of the study, we administered the questionnaire to those who agreed to participate between September 26 and October 28, 2017. A Naver-form (mobile) questionnaire was distributed to the research subjects for data collection. Data were analyzed using SPSS (Statistical Package for the Social Sciences) 24.0. Analysis was performed by calculating the frequency and percentage of the general characteristics of the subjects, occupational expertise, and the dental hygiene process of care. Result : Among the 56 research subjects, 48 (85.7 %) were men and 8 (14.3 %) were women. Awareness on the part of respondents of the job responsibilities associated with the dental hygiene process of care ratio was as follows: 11 (19.6 %) categorized their level of knowledge regarding the dental hygienist's job duties as "very much know"; 13 (23.2 %) as "somewhat know"; 18 (32.1 %) as "neither"; and 9 (16.1 %) as "somewhat don't know", while 5 (9.0 %) said "I have no idea". The dental hygiene process of care was categorized as "very much necessary" by 50.0 % of respondents; as "somewhat necessary" by 35.7 %; and as "neither" by 14.3 %. Conclusion : The dental hygiene process of care is one of the methods used to continuously manage patients with dental-related concerns. Recently, the management of patients in the dental clinic has changed from a disease treatment model to a concept of active prevention for improving the quality of life related to oral health. The dental hygiene process of care is considered a very necessary dental health care service because it functions to continuously introduce oral health care or preventive care programs in clinical practice.

• 한국유통학회지:유통연구
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• 제15권1호
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• pp.1-24
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• 2010

국내 대형마트 점포 수는 2008년 기준 403개로 포화시점에 근접하고 있다. 이러한 경쟁상황에서 '점포충성도(store loyalty)'가 지속적 경쟁우위를 위한 전략적 도구로써 그 활용성이 점점 더 중요시 되고 있다. 다양한 관점에서 점포충성도를 대형마트 연구의 핵심적 과제 다루어왔으나, 통합적인 연구 접근 방법이 미흡한 실정이다. 따라서 본 연구에서는 통합적 관점에서 점포충성도가 형성되는 두 가지 경로를 제안하였다. 이중경로모형은 첫째, 내재적 경로 '서비스품질$\rightarrow$고객만족$\rightarrow$점포충성도', 둘째, 외재적 경로 '점포개성$\rightarrow$점포동일시$\rightarrow$점포 충성도'로 구성된다. 조사대상은 대형마트를 이용하는 소비자들을 대상으로 진행하였으며, 구조방정식모형 분석을 통하여 제안된 이중경로모형의 적합성 및 가설검증을 실시하였다. 연구결과, 모형의 적합지수들은 상당히 좋은 값들을 보여주고 있다. 또한 본 연구에서 새롭게 제시된 내재적 경로인 서비스품질은 고객만족에 정의 영향을 미치고, 고객만족은 결과변수인 대형마트의 점포충성도에 매우 유의하게 영향을 준 것으로 나타났다. 그리고 외재적 경로에서 대형마트의 점포개성은 점포동일시에 긍정적인 영향을 주고 매개변수인 점포개성은 점포충성도에 영향을 미치는 것으로 나타났다. 이를 통해 본 연구는 대형마트의 점포충성도 형성에 관한 두 가지 경로를 제시함으로써, 이론적, 관리적 시사점을 도출하였고 연구의 한계점과 미래연구방향을 제시하였다.

• 대한한방부인과학회지
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• 제22권1호
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• pp.263-278
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• 2009

Purpose: The purpose of this study is to research trends in the study of breast cancer in Traditional Chinese Medicine (TCM) and to establish the further direction for its study. Methods: We reviewed TCM papers published in the last 29 years (1979-2008). Results: 1. We researched 49 papers and the patterns of study were as follows: in vitro studies were 27 papers (55.1%), in vivo studies were 9 papers (18.4%) and clinical studies were 19 papers (38.8%). 2. In vitro studies on breast cancer research in TCM were focused on cytotoxicity (17 papers) and apoptosis (8 papers). Most of in vivo studies (6 papers) were done for the purpose of inducing growth suppression of tumor cell after administration of the test drug. Each drug acted on this effect through various types of mechanism. 3. Unlike in vitro and in vivo studies, clinical studies on growth suppression of tumor cell were rare (4 papers). Most of the studies were focused on reduction of side effect of chemotherapy or synergistic effect with chemotherapy (7 papers), immune regulation (7 papers), and improvement of quality of life (6 papers). 4. Among the treatment method we reviewed, 'Runing Ⅱ(Ⅱ號方)' was the only medication that further studied as clinical trial after experimental study. 5. Since almost all studies have defects like poorly designed model or insufficient data description, it was difficult to make any definite conclusion about these studies. Conclusion: More subsequent clinical studies based on experimental study will be needed afterwards. Strict and high-level study design with detailed description will be needed in further study.

• 생태와환경
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• 제40권1호
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• pp.130-142
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• 2007

본 연구에서는 용담댐의 탁수 방류로 인한 하류 하천의 영향을 알아보기 위하여 생태계 건강성 평가 모델, 물리적 서식지 평가 모델, 해부학적 건강성 평가 모델을 적용하였다. 건강성 평가 결과 $S1{\sim}S4$의 생태계 건강도는 평균 43으로 최적${\sim}$ 양호 상태였고, 물리적 서식지 건강도는 평균 154로 양호상태로 나타나 건강도가 양호하게 유지되고 있는 것으로 나타났다. 한편 개체의 건강도를 평가하는 해부학적 건강도 평가 결과 10개 메트릭에서 이상증상이 나타나지 않아 어류 건강성에 대한 영향은 없는 것으로 판단되었다. 한편, 부유물의 증가에 따른 어류 아가미의 전자현미경적 영향 분석을 위해 탁도 처리군 및 대조군의 비교분석 결과에 따르면, 어류 아가미에서 많은 부유물 미세 입자가 관찰되어 고탁도에 장기간 노출될 경우 건강성에 영향을 미칠 가능성이 있을 것으로 사료되었다. 또한, 탁도 증가에 따른 부유사 이동에 의한 어류의 물리적 서식지 영향 분석(특히, 하상 매몰도 및 하상특성 분석)을 위해 서식지 건강성 평가모델을 적용 평가한 결과에 따르면, 대상 조사지역$(S1{\sim}S4)$이 대조군 지역(C1, C2)보다 더 좋은 것으로 나타났다. 즉, 부유사의 증가는 현재의 결과로는 서식지 건강도에 영향을 주지 않는 것으로 나타나 어류의 먹이사슬, 산란장 및 서식처에 대한 부정적 영향은 없는 것으로 사료되었다. 한편, 이런 결과는 단기간 연구 결과에 의한 현재 상태의 건강도 평가의 결과이지만 향후 탁수가 지속될 경우 수 환경이 어떻게 변할 것인가에 대해서는 사후 지속적인 모니터링이 이루어져야 하며, 향후 $3{\sim}5$년 후의 지속적인 모니터링을 실시할 경우 용담댐 건설에 의한 생태 건강도가 어떻게 변할 것인지에 대한 정보를 제공하기 때문에 지속적인 모니터링이 요구된다.