• Journal of Hospice and Palliative Care
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• 제20권2호
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• pp.111-121
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• 2017

목적: 본 연구는 2개 대학병원의 인턴을 대상으로 임종돌봄에 대한 교육 현황을 파악하고자 하였다. 방법: 2개 대학병원의 64명의 인턴들에게 구조화된 설문지를 배포하여 임종돌봄 교과과정의 강의습득 경험과 임상견학 경험 여부를 확인하였다. 또한 임종돌봄 관련 교육이나 진료에 대한 태도를 평가할 수 있는 7개의 자가평가질문을 파악하였다. 결과: 임종돌봄 교과과정 강의 습득과 임상실습 견학 개수의 평균은 각각 5개(총 영역 개수: 9)와 2개(총 영역 개수: 7)였다. 가장 많이 교육받은 항목은 나쁜 소식 전하기(96.9%)였고 임상실습 동안 가장 많이 견학한 항목은 신체증상 조절(56.5%)였다. 그러나 사전연명의료의향서를 포함한 의사소통 영역에 대한 경험은 20% 미만이었다. 임종돌봄 단독 교과목 교육군은 그렇지 않은 군과 비교하여 임종돌봄 교과과정에 대한 만족도, 관심도, 준비됨의 7가지 항목에서 모두 유의하게 긍정적인 답변을 하였다. 결론: 본 연구는 임종돌봄이 필요한 환자를 진료해야 하는 인턴들이 임종돌봄에 대한 교과과정 습득과 임상경험이 매우 부족함을 관찰하였다. 추후 국내 임종돌봄 교육에 대한 의과대학교육의 전체적인 상황을 파악하여 관련된 적절한 지식과 기술을 연마하는 교육체계를 세울 필요가 있다.

• 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.

• Childhood Kidney Diseases
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• 제21권2호
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• pp.81-88
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• 2017

Purpose: The American Society for Apheresis provides clinical guidelines for therapeutic apheresis in adults, but there are no guidelines for children. This study aimed to analyze the effect of therapeutic plasma exchange (TPE) in pediatric patients with various kidney diseases in Korea. Methods: We retrospectively reviewed the data of 16 children (up to 18 years of age) who were admitted to Severance Children's Hospital with refractory kidney disease. All patients received TPE between 1994 and 2016. Clinical and laboratory characteristics such as age, weight, sex, change in blood urea nitrogen (BUN), and creatinine level before and after TPE, and complications after TPE were analyzed. Results: The mean age and weight of the 16 patients at the time of TPE was $11.3{\pm}4.0$ years and $34.6{\pm}17.5$ kg, respectively. The BUN level was 35.4 mg/dL before TPE and significantly decreased to 21.5 mg/dL (P=0.025) at 1 week and 20.5 mg/dL (P= 0.01) at 1 month after TPE. The creatinine level significantly decreased from 1.20 mg/dL before TPE to 0.90 mg/dL (P=0.02) at 1 week after TPE. Four complications (hypovolemia, anemia, hypocalcemia, and thrombocytopenia) were reported, but were not fatal. Conclusion: Our findings suggest that TPE is an effective therapeutic modality in children with refractory kidney disease and can be indicated for the treatment of various kidney diseases.

• Tuberculosis and Respiratory Diseases
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• 제40권3호
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• pp.283-291
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• 1993

연구배경 : 장기간의 저농도 산소요법은 저산소혈증을 가진 만성폐쇄성폐질환 환자들의 생존율을 향상시킬 뿐만 아니라 삶의 질을 향상시킨다. 저자들은 재택산소요법을 시행하는 환자의 실태를 알아보고 효과적인 개선책을 알아보기 위하여 추적관찰중인 환자 26예에 대한 임상적 관찰을 하였다. 방법 : 대상환자는 경북대학병원 호흡기내과에서 진료를 받고 있는 환자 가운데 가정에서 장기간의 저농도 산소요법을 시행하고 있는 남자 18명 여자 8명 이었으며 재택산소요법을 시행하기전에 신체적 특성과 병력, 폐기능검사, 심전도, 동맥혈가스 및 말초 혈액검사 소견들과 사용중인 산소용기의 종류, 하루에 흡입하는 시간, 투여산소의 농도, 그리고 사용기간 및 문제점 등에 대해서 조사하였다. 결과 : 원인질환은 만성폐쇄성폐질환 14예, 중증폐결핵의 후유증 9예, 기관지확장증 2예 그리고 특발성 폐섬유증 1예였다. 산소치료의 시행동기는 폐성심이 21예, 운동시 호흡곤란 및 심한 환기장애 4예, 그리고 수면중 산소포화도가 90%미만인 경우가 1예였다. 치료시작전의 동맥혈가스소견의 평균치는 $PaO_2$ 57.7 mmHg, $PaCO_2$ 48.2 mmHg 및 $SaO_2$ 87.7% 였으며 폐활량의 평균치는 VC 2.05 L, $FEV_1$ 0.92 L, $FEV_1$/FVC% 51.9%였다. 사용중인 산소용기는 산소탱크를 사용하는 경우가 19예, 산소농축기를 사용하는 경우가 1예, 산소탱크와 액화산소를 함께 사용하는 경우가 2예, 그리고 산소탱크와 휴대용산소를 함께 사용하는 경우 4예였다. 산소사용 기간은 1년 미만이 3예, 1년에서 2년이 15예, 3년에서 5년이 6예 그리고 9년, 10년 동안 산소요법을 시행한 경우도 각각 1예씩 있었다. 산소농도는 전예에서 2.5L/min 이하를 사용하고 있었고 하루 사용시간은 10예 만이 15시간 이상을 사용하였고 대부분이 짧은 시간 동안만 산소를 사용하고 있었다. 결론 : 효과적인 산소투여를 위해서는 환자 및 주위의 사람들에게 장기간의 저농도 산소요법에 대한 교육이 필요하며 편리하게 사용할 수 있는 산소용기의 구입을 위한 제도적 뒷받침이 필요하다.

• 대한간호학회지
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• 제25권2호
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• pp.279-294
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• 1995

The purpose of this study was to determine values and value changes in clinical nurses in clinical situations. A survey was conducted of 200 nurses of one of university hospital in Seoul Korea. This study was conducted between July 1 and July 5, 1994, using the Survey of Interpersonal Values (SIV) developed by L. V. Gordon, and standardized for Korea by Kyung Hye Lee & Eung Yun Hwang. The results of the study were as follows, 1. The clinical nurses surveyed showed Independence(18.32 : 63rd percentile) as their highest value, with Support(14.8 : 62nd percentile) next and then Benevolence(16.28 53rd percentile), Leadership(9.06 : 46th percentile), Conformity(18.15 : 42nd percentile) and Recognition(18.32 : 41s1 percentile) in that order in the area of general values. Using a standardised women's value Indicator, the clinical nurses value orientation was within the 32nd∼69th percentile indicating means found among Korean women in general. 2. Looking at how the values were related to demographics, Leadership was most highly valued among the 30∼34 year olds and least valued among the 25∼29 year olds. Unmarried nurses valued Independence more than married nurses did, and junior college graduate nurses valued Conformity more than baccalaureate graduate nurses did. 3. The study showed that the values of with less than one year (16.00) clinical experience were higher than those who had over 10 years (13.60) clinical experience (p<.05). Therefore clinical experience did not positively influence value orientation for clinical nurses. 4. There was no significant differences in the value of nurses in relation to their workplace, their level of motivation, or their aptitude. The study shows that clinical nurses have similar values compared with ordinary Korean women. This means that professional nurses may not be able to satisfy client needs and also that they do not have satisfaction and a positive attitude regarding the nursing profession. Therefore it is suggested that new strategies and continuing education programs be established to help clinical nurses fomulate higher values.

• 한국치위생학회지
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• 제2권1호
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• pp.115-129
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• 2002

The purpose of this study was to examine the actual dental hygiene status of workers in cement industry in an effort to serve as a basis for enhancing their dental hygiene. The subjects in this study were 420 laborers from the cities of Curi, Donghae and Samcheok who handled cement. As a result of conducting a survey, the following findings were given : l. The workers investigated found their working environment satisfactory, getting a mean score of 323. They also expressed a high job satisfaction with a mean score of 333. 2. They didn't have a big interest in oral health. By age group, those who were aged between 36 and 40, or who cared less about health management, showed a higher interest in oral health. Besides, the laborers who kept smoking for a longer period, or who drunk more, expressed greater interest. 3. The toothbrushing method was considered most important for periodontal health, by 45.0% of the workers, and the next most crucial one was regular dental examination, followed by refraining from smoking and staying away from sweet food in the order named. 4. Concerning daily mean toothbrushing frequency, 455% brushed their teeth three times a day on the average. More than half them didn't pay enough attention to toothbrushing. 5. Regarding scaling, the large number of the workers, 42.4%, had no experience to get their teeth scaled, 37.6%, the greatest percentage, didn't have their teeth scaled because it seemed to make their teeth painful or cold. 6. As fororal health education experience, 67.6%, the great number of them, had no experience to receive dental health education. The above-mentioned findings suggest that the cement-related workers generally neglected dental health management. They should be encouraged to correct their wrong oral health knowledge or habit to make their oral cavity more healthy. To make it happen, it's required to provide oral health education and promote organized dental health projects.

• 농촌계획
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• 제22권2호
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• pp.141-152
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• 2016

The role of rural towns as a leisure space has recently been increasing with changes in the consumption trends in domestic tourism. Based on the tourists visiting the town of Sunheul-ri, Jocheon-eup, a rural Village in Jeju Island, this study categorized the market according to the images formed by the tourists of rural towns, and analyzed the preferred mode of participation in rural field activities for each category. We analyzed the characteristic factors of the images of rural tourism formed by the tourists, extracted three factors for cluster analysis, and then formed three groups: "Group of Rural Experience Activity" "Group of Rural Environment and Service" and "Group of Rest in the Rural" After analyzing the preferred activity in each image-category group, we found no significant differences among the groups in ordinary activities such as viewing the scenery, experiencing and learning about the natural environment, and culinary experiences. However, there were significant differences among the groups regarding participation in experiential tour programs with the purpose of active tourism. The "Group of Rural Experience Activity" sought to actively participate in various activity programs, whereas the "Group of Rest in the Rural" comparatively had a weaker preference for such active programs. We thus learnt that tourists' preferred activities are different according to the types of images formed by the tourists visiting rural towns. Therefore, to strengthen the competitive advantage of the rural tourist destinations of Jeju Island, it is necessary to provide various activity programs that are appropriate for the rural regions of Jeju and to accord with the expectations associated with each market segment category by positioning the programs according to the characteristics of the images held by the tourists.

• 지역사회간호학회지
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• 제20권1호
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• pp.12-22
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• 2009

Purpose: This study was done to investigate factors associated with depression and quality of life (QoL) among the community-dwelling elderly. Methods: This study used a descriptive correlational research design. The subjects were 730 elders aged over 65 living in D district of Daegu. Data were collected using questionnaires for 30 days in April, 2007. The research instruments utilized in this study were a physical function scale of long-term care insurance system, Geriatric Depression Scale Short Form Korea Version (GDSSF-K), and Korean Quality of Life Scale (KoQoLs). The collected data were analyzed by descriptive statistics, t-test, ANOVA, Duncan, stepwise multiple regression, and Spearman correlation. Results: The mean age of the subjects was 72.6, and 68.8% and 57.9% of subjects were, respectively, female and living alone. 12.3% of variance in depression was explained by age, education, economic status, subjective health, alcohol consumption, condition of teeth, and fall experience. 18.2% of variance in QoL was explained by economic status, number of diseases, condition of teeth, incontinence, paralysis, and IADL. Economic status and condition of teeth were contributing factors to depression and QoL of the elderly. Conclusion: Findings of this study may be useful in understanding the health status of the community-dwelling elderly and developing more regionally specific health promotion strategies.

• 대한기계학회논문집A
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• 제37권2호
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• pp.161-168
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• 2013

오늘날 자동차 산업에서 가장 대두되고 있는 충돌 안전성과 배기가스의 감축을 위해서 dual phase 강, ferrite bainite 강 등의 고강도 강판이 개발 되었다. 이러한 강재는 주로 차체 구조부에 적용되며, 적용시에 차체 구조부가 가져야 하는 강도와 디자인 적인 측면에서 사용자의 요구에 맞추기 위하여 홀 플랜징 가공이 자주 사용된다. 이때 재료의 성형성을 알아보기 위한 홀 확장성 평가가 수행된다. 홀 확장실험에서는 크랙 생성 전후의 하중의 차이가 매우 작기 때문에, 단축 인장 시험에서와 같이 하중의 변화로 크랙 발생 유무를 판단하기가 쉽지 않다. 따라서 본 연구에서는 기존의 홀 확장성 평가에서 사람의 눈으로 크랙의 발생 유무를 판단하는 방법의 부정확성을 보완하기 위해 CCD 카메라를 이용하여 크랙의 발생 유무를 판단하는 시스템을 개발하였다.

• 한국자기학회지
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• 제7권2호
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• pp.103-108
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• 1997

본 논문에서는 퍼지결정법을 적용한 유도전동기의 최적설계 방법을 제시하였다. 이 방법은 설계자의 경험, 관점, 판단을 반영할 수 있을 뿐만 아니라 다목적 최적설계에 쉽게 적용가능하다. 특성 해석방법은 등가 자기회로법이며, 설계방법은 기존 설계법 중의 하나인 D$^{2}$L 법에 퍼지 결정법과 최적화 루틴을 결합하였다. 사용한 최적화 알고리즘은 확률론적 최적화기법인 (1+1) Evolution Strategy(ES)를 이용하였다. 제안된 알고리즘은 유도전동기의 무게최소화와 동시에 주요 동작점에서의 효율, 역률을 최대화 설계하는 다중목적 최적설계에 적용되었다.