• 제목/요약/키워드: Intervention System

검색결과 1,378건 처리시간 0.034초

우리나라 기업집단(企業集團)의 소유(所有)·경영구조(經營構造)와 정책대응(政策對應) (The Ownership Structure of Korea's Big Business Conglomerates and Its Policy Implications)

  • 유승민
    • KDI Journal of Economic Policy
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    • 제14권1호
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    • pp.3-36
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    • 1992
  • "오너" 지배체제(支配體制)를 특징으로 하는 우리나라 대규모기업집단의 소유(所有) 경영구조(經營構造)는 개인자본주의(個人資本主義)를 마감하고 대중자본주의(大衆資本主義)를 발전시키는 데 제약요인(制約要因)이 되고 있다. 본고(本稿)에서는 소유(所有) 경영구조(經營構造)의 문제(問題)를 경제력집중문제(經濟力集中問題)의 일부로 파악하면서 선진자본주의경제(先進資本主義經濟)의 소유(所有) 경영구조(經營構造)를 참고기준으로 우리나라의 경제력집중문제(經濟力集中問題)를 생산집중(生産集中), 업종다변화(業種多邊化), 소유집중(所有集中), "그룹"식(式) 경영방식(經營方式), 금융기관(金融機關)의 역할(役割) 등을 중심으로 분석했으며, 이를 토대로 그동안 정부(政府)가 추진해 온 제반시책(諸般施策)을 평가하였다. 현황(現況)과 정책(政策)에 관한 병렬식(竝列式) 논의(論議)를 통하여 과거 출자규제(出資規制)와 여신관리(與信管理)를 중심으로 한 정부(政府)의 경제력집중대책(經濟力集中對策)이 경제력집중(經濟力集中)의 세가지 측면인 생산집중, 업종다변화, 소유집중 가운데에서도 주로 생산집중(生産集中)과 업종다변화(業種多邊化)를 규제했음을 보였다. 향후에는 소유분산(所有分散)을 중심으로 경제력집중대책(經濟力集中對策)을 재편(再編)할 필요성과, 생산집중(生産集中)과 업종다변화(業種多邊化)에 관한 규제는 가급적 축소하되 오히려 금융(金融) 산업(産業) 언론(言論) 등 주요부문간 다변화(多邊化)에 관한 규제도입(規制導入)의 필요성을 제기하였다. 또한 경영구조(經營構造)에 관한 정부개입(政府介入)의 타당성이 의문시되기 때문에 소유(所有)와 경영(經營)의 분리(分離) 및 독립전문경영체제(獨立專門經營體制) 등에 있어서 정부(政府)가 기업집단(企業集團)을 일정한 방향으로 유도하는 것은 자제되어야 함을 지적하였다.

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폐암 억제유전자 RRM1의 단일염기다형성 검사를 위한 PCR-RFLP법과 Real-Time PCR법의 유용성 비교 (Comparison of PCR-RFLP and Real-Time PCR for Allelotyping of Single Nucleotide Polymorphisms of RRM1, a Lung Cancer Suppressor Gene)

  • 정주연;김미란;손준광;정종필;오인재;김규식;김영철
    • Tuberculosis and Respiratory Diseases
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    • 제62권5호
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    • pp.406-416
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    • 2007
  • 연구배경: 단일염기다형성(Single nucleotide polymorphism, SNP)은 인간의 유전자 서열 1000염기에 1개 빈도로 발견되어 인간은 대략 300만개의 유전자 다형성을 가지고 있다. 이 유전자 다형성의 조합결과로 인간의 개체 간 특성들이 결정되는 것으로 이해되고 있다. 이러한 다형성들의 조합양상에 따라 특이 질환에 대한 유전자 감수성 또한 달라지게 되므로 최근에는 많은 질환들과 유전자 다형성들과의 상관관계를 보는 연구들도 활발하게 진행되고 있다. 이러한 SNP분석은 큰 집단을 대상으로 진행되어 지므로 적은 비용으로 정확하게 그리고 대용량으로 분석할 수 있는 방법이 필요하다. 방 법: 대상 환자 89명의 genomic DNA를 가지고서 promotor상에 위치한 -37과 -524 염기부위에서 유전자 다형성을 보이는 것으로 보고되어져 있는 RRM1(ribonucleotide reductase M1) 유전자를 대상으로 PCR-RFLP(polymerase chain reaction-restriction fragment length polymorphism)와 real-time PCR(RTPCR, TaqMan probe assay)을 동시에 시행한 후 각각의 결과를 비교 분석하였다. 결 과: 대상 DNA 89예 중 -37에서는 2예(2.17%), -524에서는 15예(16.26%)가 서로 다른 양상을 보였다. 결과 차이를 보인 샘플 17예를 대상으로 직접 염기서열 분석을 시행하여 본 결과, 17예 모두 RT-PCR에서 확인되었던 결과와 일치함을 확인할 수 있었다. 추가 샘플 138예를 대상으로 RT-PCR을 2회 연속 실행하여 genotyping을 해 본 결과 98%이상의 높은 일치율을 보였으며, 그중 10예를 무작위로 골라 직접 염기서열 분석을 시행하여 본 결과, 역시 100%일치, 높은 정확도를 보였고 이는 in-tube assay 방식으로 샘플의 오염을 최소화 할 수 있었으며 72 well based system(Corbett Research)을 이용함으로 1회 유전자 증폭반응을 통해 많은 검체를 한 번에 확인할 수 있어 매우 빠른 검사방법 이었다. 결 론: 큰 집단을 대상으로 다량의 SNP를 분석하기 위한 실험 방법으로는 RT-PCR이 신속하면서도 정확한 결과를 얻을 수 있는 방법으로 사료된다.

만성 성인성 치주염 치료시 비외과적, 외과적 방법에 대한 의사결정 (Decision Making on the Non surgical, Surgical Treatment on Chronic Adult Periodontitis)

  • 송시은;이승원;조규성;채중규;김종관
    • Journal of Periodontal and Implant Science
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    • 제28권4호
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    • pp.645-660
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    • 1998
  • The purpose of this study was to make and ascertain a decision making process on the base of patient-oriented utilitarianism in the treatment of patients of chronic adult periodontitis. Fifty subjects were chosen in Yonsei Dental hospital and the other fifty were chosen in Severance dental hospital according to the selection criteria. Fifty four patients agreed in this study. NS group(N=32) was treated with scaling and root planing without any surgical intervention, the other S group(N=22) done with flap operation. During the active treatment and healing time, all patients of both groups were educated about the importance of oral hygiene and controlled every visit to the hospital. When periodontal treatment needed according to the diagnostic results, some patients were subjected to professional tooth cleaning and scaling once every 3 months according to an individually designed oral hygienic protocol. Probing depth was recorded on baseline and 18 months after treatments. A questionnaire composed of 6 kinds(hygienic easiness, hypersensitivity, post treatment comfort, complication, functional comfort, compliance) of questions was delivered to each patient to obtain the subjective evaluation regarding the results of therapy. The decision tree for the treatment of adult periodontal disease was made on the result of 2 kinds of periodontal treatment and patient's ubjective evaluation. The optimal path was calculated by using the success rate of the results as the probability and utility according to relative value and the economic value in the insurance system. The success rate to achieve the diagnostic goal of periodontal treatment as the remaining pocket depth less than 3mm and without BOP was $0.83{\pm}0.12$ by non surgical treatment and $0.82{\pm}0.14$ by surgical treatment without any statistically significant difference. The moderate success rate of more than 4mm probing pocket depth were 0.17 together. The utilities of non-surgical treatment results were 100 for a result with less than 3mm probing pocket depth, 80 for the other results with more than 4mm probing pocket depth, 0 for the extraction. Those of surgical treatment results were the same except 75 for the results with more than 4mm. The pooling results of subjective evaluation by using a questionnaire were 60% for satisfaction level and 40% for no satisfaction level in the patient group receiving nonsurgical treatment and 33% and 67% in the other group receiving surgical treatment. The utilities for 4 satisfaction levels were 100, 75, 60, 50 on the base of that the patient would express the satisfaction level with normal distribution. The optimal path of periodontal treatment was rolled back by timing the utility on terminal node and the success rate, the distributed ratio of patient's satisfaction level. Both results of the calculation was non surgical treatment. Therefore, it can be said that non-surgical treatment may be the optimal path for this decision tree of treatment protocol if the goal of the periodontal treatment is to achieve the remaining probing pocket depth of less than 3mm for adult chronic periodontitis and if the utilitarian philosophy to maximise the expected utility for the patients is advocated.

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국내 호스피스 논문 분석($1991{\sim}2004$) (The Analysis of Research Trend about Hospice in Korea ($1991{\sim}2004$))

  • 김상희;최성은;강성년;박정숙;손수경;강은실;이영은
    • Journal of Hospice and Palliative Care
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    • 제10권3호
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    • pp.145-153
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    • 2007
  • 목적: 본 연구는 약 15년간의 우리나라 호스피스 연구의 총체적인 주제와 경향을 확인함으로써 추후 호스피스 연구의 방향을 제시하고자 실시되었다. 방법: 1991년 1월부터 2004년 7월까지의 우리나라 박사학위논문 7편, 석사학위논문 44편과 호스피스와 관련된 논문이 주로 수록되는 분야별 간호학회지, 의학회지, 호스피스 학회지, 호스피스 협회 학술지, 호스피스 연구소 논문집의 논문에서 호스피스와 관련된 개념이 제시된 논문 59편으로 총 110편을 목록화하여 분석하였다. 분석은 연구 발표년도, 연구설계, 연구대상, 상관관계 연구, 조사연구, 실험연구, 질적 연구, 측정도구 별로 분류하여 분석하였다. 결과: 2000년 이후의 논문이 52편으로 2000년 이후부터 본격적으로 호스피스 논문이 증가하였음을 알 수 있다. 학회지에 발표한 논문으로는 한국 호스피스 완화 의료학회지가 16편으로 가장 많았고, 질적 연구는 13편으로 다소 적은 편수였다. 연구대상별로 살펴보면, 사람을 대상으로 한 연구가 98편으로 가장 많았고, 이 중 말기환자를 대상으로 한 연구가 44편으로 나타났다. 결론: 분석 결과 향후에는 호스피스 간호이론의 기초 정립을 위한 양적방법론에 근거한 서술적 연구와 질적 연구가 더욱 많이 행해져야 할 것이며, 호스피스 간호 중재의 효과를 확인하는 실험연구를 통하여 간호중재의 효율성을 입증하는 연구도 필요한 것으로 생각된다.

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경기도 일지역의 문제음주실태와 알코올 미충족욕구 조사연구 (Alcohol Problems and Related Service Needs in Urban Korean Community)

  • 양재원;왕수연;황인숙;김선미;배기혜;이홍재;고영훈
    • 정신신체의학
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    • 제21권1호
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    • pp.62-71
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    • 2013
  • 연구목적 본 연구는 경기도 일지역의 음주실태, 위험음주와 알코올사용장애의 정도 및 지역사회 음주정책 요구도 조사를 위해 수행되었다. 방 법 연구대상자는 경기도 안산시 거주 19세 이상 65세 미만 성인 1,000명으로 2011년 6월부터 7월까지 두 달 간 조사하였다. 조사설문지는 연구목적에 의해 구성한 사회인구학적 특성 문항, Alcohol Use Disorder Identification Test(AUDIT)와 Cut down, Annoyed, Guilty, Eye-opener(CAGE) 척도, 지역사회 음주문제 해결에 대한 서비스 및 정책 요구도에 대한 문항으로 구성하였다. 자료분석은 SPSS version 18.0 통계프로그램을 이용하였다. 결 과 대상군의 평생음주율은 97.4%이고, 이들 중 21.9%가 주 2~4회 음주 빈도를 보였으며, 유해음주 빈도는 남성의 24.4%로 남성 4명 중 1명은 한 번의 좌석에서 소주 한 병 또는 맥주 4병 이상을 마시는 빈도가 주 1회 이상이었다. 음주시작 연령은 평균 20.3세이나 19세 이전에 음주를 시작하는 경우가 51.6%이었다. AUDIT 척도를 적용한 유해음주 및 알코올사용장애의 비율은 각각 14.9%, 3.3%, CAGE 척도 기준을 적용하였을 때 알코올사용장애자는 9.6%였다. 조사응답자들의 지역사회 음주문제에 대한 서비스 및 정책요구도는 예방교육(57.2%), 치료시설 연계(50.1%), 알코올상담과 개입(41.7%), 그리고 재활프로그램(39.8%) 순이었다. 결 론 본 연구결과, 경기도 도시 지역의 유해음주와 알코올사용장애 등 문제음주의 정도는 높은 비율로 나타나며, 지역주민들의 음주문제 관련 요구도와 음주시작연령에 대한 고려를 통해 효과적인 음주예방프로그램과 정책개발이 요구된다.

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국가의 해양주권 수호를 위한 한국해군의 전력건설 방향 (The Construction Direction of the ROK NAVY for the Protection of Marine Sovereignty)

  • 신인균
    • Strategy21
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    • 통권30호
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    • pp.99-142
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    • 2012
  • Withe increased North Korea's security threats, the South Korean navy has been faced with deteriorating security environment. While North Korea has increased asymmetric forces in the maritime and underwater with the development of nuclear weapons, and China and Japan have made a large investment in the buildup of naval forces, the power of the Pacific fleet of the US, a key ally is expected to be weakened. The biggest threat comes from China's intervention in case of full-scale war with North Korea, but low-density conflict issues are also serious problems. North Korea has violated the Armistice Agreement 2,660 times since the end of Korean War, among which the number of marine provocations reaches 1,430 times, and the tension over the NLL issue has been intensifying. With tension mounting between Korea and Japan over the Dokdo issue and conflict escalating with China over Ieo do Islet, the US Navy has confronted situation where it cannot fully concentrate on the security of the Korean peninsula, which leads to need for strengthening of South Korea's naval forces. Let's look at naval forces of neighboring countries. North Korea is threatening South Korean navy with its increased asymmetric forces, including submarines. China has achieved the remarkable development of naval forces since the promotion of 3-step plan to strengthen naval power from 1989, and it now retains highly modernized naval forces. Japan makes an investment in the construction of stat of the art warship every year. Since Japan's warship boasts of its advanced performance, Japan's Maritime Self Defense Force is evaluated the second most powerful behind the US Navy on the assumption that submarine power is not included in the naval forces. In this situation, naval power construction of South Korean navy should be done in phases, focusing on the followings; First, military strength to repel the energy warship quickly without any damage in case of battle with North Korea needs to be secured. Second, it is necessary to develop abilities to discourage the use of nuclear weapons of North Korea and attack its nuclear facilities in case of emergency. Third, construction of military power to suppress armed provocations from China and Japan is required. Based on the above naval power construction methods, the direction of power construction is suggested as follows. The sea fleet needs to build up its war potential to defeat the naval forces of North Korea quickly and participate in anti-submarine operations in response to North Korea's provocations. The task fleet should be composed of 3 task flotilla and retain the power to support the sea fleet and suppress the occurrence of maritime disputes with neighboring countries. In addition, it is necessary to expand submarine power, a high value power asset in preparation for establishment of submarine headquarters in 2015, develop anti-submarine helicopter and load SLAM-ER missile onto P-3C patrol aircraft. In case of maine corps, division class military force should be able to conduct landing operations. It takes more than 10 years to construct a new warship. Accordingly, it is necessary to establish plans for naval power construction carefully in consideration of reality and future. For the naval forces to safeguard maritime sovereignty and contribute to national security, the acquisition of a huge budget and buildup of military power is required. In this regard, enhancement of naval power can be achieved only through national, political and military understanding and agreement. It is necessary to let the nation know that modern naval forces with improved weapon system can serve as comprehensive armed forces to secure the command of the sea, perform defense of territory and territorial sky and attack the enemy's strategic facilities and budget inputted in the naval forces is the essential source for early end of the war and minimization of damage to the people. If the naval power construction is not realized, we can be faced with a national disgrace of usurpation of national sovereignty of 100 years ago. Accordingly, the strengthening of naval forces must be realized.

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Quantitative Light-Induced Fluorescence-Digital을 이용한 치면세균막 검사법의 임상적 활용 가능성 평가 (Assessment of Clinical Applicability of a New Plaque Scoring System Using Quantitative Light-Induced Fluorescence-Digital)

  • 황혜림;조영식;김백일
    • 치위생과학회지
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    • 제14권2호
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    • pp.150-157
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    • 2014
  • 본 연구에서는 기존에 임상에서 염색제를 사용한 치면세균막검사와 periodental probe를 사용한 치은지수 평가방법대신 새로운 디지털 형광 장비인 QLF-D를 이용한 검사법의 활용 가능성을 확인하고자 하였다. 염색제를 이용하여 치면세균막지수를 산출하여 연구 대상자를 위험군별로 구분하여 일반적 특성을 확인하였고, 분석 소프트웨어를 이용하여 산출되는 QLF-D score와 전체 및 전치부 치면세균막지수, 치은지수의 상관성을 확인하였다. 정상치은과 치은염에 따른 QLF-D score를 비교하였고, 각 QLF-D score에 따른 치면세균막지수와 치은지수의 평균값을 비교하여 다음과 같은 결론을 내렸다. 연구대상자의 염색제를 이용한 평균 치면세균막지수는 $42.28{\pm}17.90$이었고, 6개의 선택치아의 치은지수는 $1.05{\pm}20.38$로 나타났으며, QLF-D score는 $1.26{\pm}1.50$이었다. 상하악전치부 QLF-D score와 치면세균막염색을 이용하여 평가한 전치부 치면세균막지수의 상관 분석 결과, 유의한 양의 상관관계를 확인하였다(r=0.638, p<0.001). 또한 상하악 전치부 QLF-D score와 periodontal probe를 이용한 치은지수와의 관계를 분석한 결과에서도 두 가지 평가 지표 간에 유의한 양의 상관관계를 보였다(r=0.562, p<0.001). 치면세균막지수와 치은지수에 따른 QLF-D score의 차이를 저위험군과 고위험군으로 분류하여 비교한 결과, 치면세균막지수(p<0.0001)와 치은지수(p=0.007) 모두 저위험군에 비해 고위험군 집단에서 QLF-D score가 통계적으로 유의하게 높았다. QLF-D score에 따른 치면세균막지수 및 치은지수 평균값을 비교한 결과, QLF-D score가 증가할수록 두 가지 지수 모두 통계적으로 유의하게 증가하는 양상을 보였다(p<0.0001). 이와 같은 결과를 통해, QLF-D로 치면세균막을 평가함으로써 치은상태를 모니터링 하는 것이 가능함을 확인하였다. 이를 통해 임상 현장에서 QLF-D를 활용한다면, 비교적 간편하게 구강 이미지를 획득하고 구강 상태를 점수화하여 제시함으로써 술자의 진단 절차가 간편해지고 환자와의 의사소통이 원활해질 수 있을 것으로 사료된다.

가정간호 기록지 분석 - 원주기독병원 가정간호 보건활동을 중심으로 - (An Analysis of Referrals, Nursing Diagnosis, and Nursing Interventions in Home Care - Wonju Christian Hospital Community Health Nursing Service -)

  • 서미혜;허혜경
    • 가정간호학회지
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    • 제3권
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    • pp.53-66
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    • 1996
  • Home Health Care is one part of the total health care system. It includes health care services that link the hospital to the community. While it is important for early discharge patients, home care is also important for people with chronic illnesses or handicapping conditions. In 1989 the Korean government passed a law that opened the way for formal development of home health care services beginning with education programs to certify nurses for home care, and then demonstration home care services. Part of the mandate of the demonstration projects was evaluation of home care services. This study was done in order to provide basic data that would contribute to the development of records that could be used for evaluation through a retrospective audit and to examine the care that had been given in Home Care at Wonju Christian Hospital over a twenty year period from 1974 to 1994. The purposes of the study were : to identify to characteristics of the clients who had received home care, to identify the reasons for client referrals, to identify the nursing problems of these clients, to identify the nursing care provided to these clients, and to identify differences in these areas over the twenty year period. The study was a descriptive study involving a retrospective audit of the client records. Demographic data on all clients were included : 4,171 clients from 2,564 families. Data on referrals, nursing diagnosis and nursing interventions were from even numbered records which had a patient problem list included in the record, 2,801 clients, Frequencies and ANOVA were used in the analysis. The results of the study showed that the majority of the clients were from Wonju city /county. There were more women than men related to the high number of postpartum clients(1,300). The high number of postparttum clients and newborns was also evident in the age distribution. An the number of maternal-child clients decreased over the 20 years, the mean age of the clients increased significantly. Other factors also contributed to this change ; as increasing number of clients with brain injuries or with cancer, and fewer children with burns, osteomyelitis and tuberculosis. There was a decrease in the mean number of visits and mean length of coverage, reflecting a movement towards a short term acute care model. The number of new clents dropped sharply after 1985. The reasons for this are : the development of other treatment alternatives for clients, the establishment of an active wellbaby clinic, many more options plus a decreasing number of new cases of Hansen's Disase, and insurance that allows people with burns to be kept in hospital until skin grafts are healed. Socioeconomic changes have resulted in an increase in the number of cases of cancer, stroke, head injuries following car accidents, and of diabetes. Of the 2,801 client records, 2,541(60.9%) contained a written referral but for 1,802 it contained only the medical diagnosis. The number of records with a referral requesting specific nursing care was 739(29.1%). Many family members who were identified as in need of nursing care had no written referral. Analysis of the patient problem list showed that 41.9% of the enteries were nursing diagnoses. Others incuded medical diagnosis, symptoms, and plans. The most frequently used diagnoses were alteration in nutrition, less than body requirements(115 entries), alteration in skin integrity(114), knowledge deficit(111), pain(78), self-care deficit(66), and alteration in pattern of urinary elimination(50). These are reflected in the NANDA categories for which the highest number of diagnosis was in the Exchanging pattern(446), followed by Moving(178), Feeling(136) and Knowing (115). Analysis of the frequency of interventions showed that exercise and teaching about exercise was the most frequent intervention, followed by teaching concering the need for follow-up care, checking vital signs, managing nutritional problems, managing catheters, giving emotional support, changing dressings, teaching about medication, teaching (subject not specified), teaching about diet, IM and IV medications or fluid, and skin care, in that order. Recommendations included: development of a record that would allow for efficient recording of frequently used nursing diagnoses and nursing interventions: expansion of the catchment area for Home Care at Wonju Christian Hospital ; expansion of the service to provide complication prevention, rehabilitation services, and support to increase the health maintenance /health promotion of the people being served as well as providing client dentered care ; and development of a clinical record that will allow efficient data collection from records, even though the recording is done by a variety of health care providers.

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119구급대원의 심폐소생술 성적 분석 - 병원전 심정지를 중심으로 - (Factors Affecting the Survivals of Out-of-hospital Cardiac Arrests by 119 Fire Service)

  • 강병우
    • 한국응급구조학회지
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    • 제9권2호
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    • pp.111-128
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    • 2005
  • Background: Cardiac arrest is one of the most critical diseases which can likely lead to severe cerebral disability or brain death when the cases can not recover their circulation within 10 minutes. Saving out-of-hospital cardiac arrest cases is a recent concern in Korea. Resuscitation has become an important multidisciplinary branch of medicine, demanding a spectrum of skills and attracting a plethora of specialities and organizations. The best survival can be achieved if all the following links have been optimized : rapid access, and early CPR, defibrillation and ACLS, Since the "Utstein Style" was advocated in 1991, many reports about out-of-hospital cardiac arrest have been published based on this guideline. These differences prevent valid inter-hospital and international comparisons. However, it is not known how effective resuscitation has become to the patients. In other words, there are no guidelines for reviewing, reporting, and conducting research on resuscitation in Korea. This dissertation aims to provide the basic data for a unified reporting guideline of resuscitation in Korea and evaluating the out-of-hospital factors associated with survival discharge of out-of-hospital cardiac arrest. Methods: As for this study, uses the collected data about Out-of-hospital cardiac arrests at 4 area, from January, 2005 to April. 2005. With a retrospective study, 174 cases were analyzed. The data was recorded based on the Out-of-Hospital Utstein Style. Results: Resuscitation was performed on 174 out-of-hospital cardiac arrest cases at the 4 area 14 patients(8.1%) recovered their spontaneous circulation. Overall, the ROSC of the out-of-hospital cardiac arrest patients was 8.1%, which was poorer than that of western countries. Gender distribution was 50 females(28.7%) and 124 males(71.3%), approximately twice as many males as females. ROSC of witnessed arrests was found out to be 97.7%. The ratio of the witnessed arrest groups showed higher results than that of unwitnessed arrest groups in the above-examined cases. Cardiac etiology consisted of cardiac(33.5%), non-cardiac(45.7%), trauma(20.1%), and unknown(6.0%). Cardiac was the best performance. Initial rhythm showed Ventricular Tachycardia/pulseless Ventricular Fibrillation in 8 patients(6.0%), asystole in 100(75.2%) and unknown in 25(18.8%). The results of the Ventricular Tachycardia/pulseless Ventricular Fibrillation showed higher results than the others cases, The proportion of the cardiogenic cause was 33.5%, which was only half of western countries. Ventricular Tachycardia/pulseless Ventricular Fibrillation is relatively rare. These differences were due to the prevalent pattern of Out-of-hospital cardiac arrest as well as prematurity of the EMSS. Bystander CPR was practiced on 13 patients(7.52%). ROSC was shown in 46.2% cases. CPR by EMT was carried out on 167 cases(96.5%). ACLS by EMf was rare. From collapse, 4 cases(2.6%) arrived to ED within 6 minutes. 13 (8.6%) within 10 minutes, and 49(32.5%) over 31 minutes. The sooner the patients arrived, the greater the ratio of ROSC and discharged alive became, and the same with collapse time to ROSC. As the results of the logistic regression analysis, ROSC was found out to be highly influenced by the time of ED arrival from collapse and Ventricular Tachycardia/pulseless Ventricular Fibrillation. Therefore, the ratio of ROSC depends on not any single factor but various intervention factors. Conclusion: This dissertation presents the following suggestions and directions of the study hereafter. First, the first step for a chain of survival should be taken to activate EMSS early with a phone as soon as cardiac arrests are witnessed. Second, it is keenly needed that emergency medical technicians should be increased through emergency education for living. Third, it is necessary to establish the emergency transportation system. Fourth, most of the Koreans have little understanding of EMT and the present operation systems have many problems, which should be fundamentally changed. Fifth, it is required to have an active medical control over Out-of-hospital CPR, And proper psychological supports should be given not only to patients themselves and their family but also individuals who are engaged in emergency situation. Finally, through studies hereafter on nationwide, comprehensive, and standard forms, it is needed to examine into the biological figures of human body, causes and trends of cardiac arrests, and then, to enhance the survival rate of Out-of-hospital cardiac arrests. Korean guidelines for Cardiopulmonary resuscitation need to be made.

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우리나라 어머니의 자녀 양육의 의미 - 거제지역을 대상으로 - (An Ethnography of Child-Rearing Experiences of Korean Mothers Living on Koje Island)

  • 이수연
    • 여성건강간호학회지
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    • 제7권4호
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    • pp.518-535
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    • 2001
  • Nursing practices should be based on the understanding of human beings. In order to understand human beings, it is important to study the lifestyles and thoughts of people in their natural environment. In this sense, the cultural aspects of a society need to be studied for a culture-bound nursing service. Child care, which is an important element of nursing, is also strongly influenced by the culture of a society. Therefore, a cultural study is necessary to understand the child-rearing practices of any society. The major purpose of this dissertation is to provide basic foundations for developing a culture-based theory for nursing intervention through studying traditional cultural elements of child care in Korean society. The study examined child-rearing practices in a small village on Koje Island in the southern part of Korea. It utilized ethnographic methodologies including participatory observations and in-depth interviews. The study participants were 9 Korean mothers living on Koje Island. The average age was 52. The data were collected between July in 1998 and December in 1999. The average number of interviews per person was 7-8, and the duration of each interview was approximately 2 hours. The data were analyzed using the Spradley Analytical Method. The following 9 major child-rearing aspects of mothers on Koje Island were discovered as a result of the study: 1. Firstly, mothers on Koje Island were mostly concerned about the "Old Birth Goddess' Curse", especially during their child's early years. This concern was evidenced by their careful behavior when their child was very young and by their praying to the Old Birth Goddess not to be jealous of their babies. 2. Secondly, they wished their children to live a different and better life than themselves. It was represented by their strong motivation toward their children's education as well as their expectation for their children's success. In traditional Korean culture, Korean people think that the rise and fall of the household depend on their offsprings. Therefore, Korean mothers wish their children attain to a higher level of social status through education. 3. Third, mothers are concerned about their children's righteousness. Mothers on Koje island expect their children to live with discretion, justice, strength, respect, harmony, and to do their best in life. 4. Next was an 'anticipation of their children's happy marriage'. The attributes of this category were an 'anxiety about their children's married life', and 'an expectation of a good spouse for their children'. Because Korean people believe that only a son can continue the bloodline of a family, especially Korean mothers have a great concern of the possibility of their daughters not having a son after marriage. Also they have different expectations toward their daughter-in-laws than son-in-laws. 5. Korean mothers also derived their satisfaction from their son. It was characterized by 'excessive affection toward their son', 'dependency on their son', and 'being afraid of their married daughter having a girl like themselves'. Korean society has been a patriarchy. Therefore, a son is beloved as someone who will take care of his old parents, be in charge of ancestral rites, and provide a daughter-in-law who can conceive a son. 6. The sixth category concerned 'the differences in their expectations for their children'. The attributes in this category were 'different expectations depending on their children's gender', 'different expectations depending on their children's ability', and a 'great sympathy toward children with low abilities'. Korean mothers expect their son to become better than their daughter. 7. The seventh category was related to their 'roles in child-caring practices'. Traditionally a child was raised in an extended family system in Korea So it was not the sole duty of a mother to bring up the child. Korean mothers used to receive much help rasing children from their in-laws, and family members. On the other hand, many children grew up by themselves, because their mothers were very busy taking care of housework. Furthermore, many children also grew up in poverty. 8. Mothers also had issues related to 'conflicts in child rearing'. They were characterized by 'lack of understanding', 'rudeness of children', and 'giving vent to one's anger'. 9. Finally, mothers regretted not doing their best in child-rearing practices. It was characterized by a 'bitter feeling of repentance', 'feeling irritated', and 'feeling of unsatisfaction'.

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