• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제2권1호
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• pp.116-124
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• 1991

1985년 9월 30일부터 1990년 12월 31일 사이에 서울대병원 소아정신과에 입원하여 행동장애로 진단받은 어린이 및 청소년 총 48명을 대상으로 병록고찰을 통해 간호문제를 분석해보았다. 그 결과 미성숙한 자아발달, 낮은 자아정체감, 역기능적 부모-자녀관계, 가족내 상황적 위기, 정신지체, 간질 등 원인적 요인에 따르는 개인의 비효율적 대처기전, 사회적 상호작용장애, 자기개념장애, 폭행잠재성, 부모역할장애, 성장 ${\cdot}$ 발달장애 같은 문제가 입원초기부터 중기이후까지 지속되었고 자기간호결핍, 수면장애, 영양장애, 불안, 고체온증 등 입원중기 이후에는 해결된 일시적 문제들을 보였다. 따라서 행동장애 입원환아들을 위한 간호접근은 보다 근본적이고 지속적인 문제에 따른 장기적 계획을 통해 환아들의 자아기능 증진, 자아정체감 확립, 대인관계개선을 도와야 하고 환아 뿐 아니라 가족을 위한 지지적, 교육적 접근에 중점을 두어야 함을 보았다.

• Journal of Chest Surgery
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• 제48권4호
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• pp.289-293
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• 2015

A 38-year-old male was admitted with symptoms of upper respiratory infection. Despite medical treatment, his symptoms of dyspnea and anxiety became aggravated, and bilateral lung infiltration was noted on radiological imaging studies. His hypoxemia failed to improve even after the application of endotracheal intubation with mechanical ventilator care, and we therefore decided to initiate venovenous extracorporeal membrane oxygenation (VV ECMO) for additional pulmonary support. On his twentieth day of hospitalization, hypotension and desaturation (arterial saturated oxygen <85%) developed, and right ventricular failure was confirmed by two-dimensional echocardiography. Therefore, we changed from VV ECMO to venoarteriovenous (VAV) ECMO, and the patient ultimately recovered. In this case, right ventricular dysfunction and volume overloading were induced by long-term VV ECMO therapy, and we successfully treated these conditions by changing to VAV ECMO.

• 한국실내디자인학회논문집
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• 제24권2호
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• pp.189-196
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• 2015

In case of Senior Hospitals, meticulous care is required in both amount and quality of natural lighting because of the semi-long term residence of patients. Natural lighting has a huge impact on the physical and psychological part for the seniors. Likewise, natural lighting is an important factor considered for hospital design because it can also effect hospitalization period of patients. Research subject was K Senior Hospital which was determined as the courtyard-type building made to provide healing environment through natural lighting. Analysis was performed by dividing the space of K Senior Hospital into Central Treatment Department directly used by patients, Outpatient Department(OPD), Ward Department, Common Use Department. Research was carried out in two ways of integration value analysis using SPACE SYNTAX and illumination intensity analysis using ECOTECT. K Senior Hospital intended to actively let in natural light through courtyard and to make patients exposed to natural light when they walk along the circuit corridor built around the courtyard. This environmental consideration affected the utilization rate of Common Use Department and residence time of patients raising the average of Common Use Department on every floor. As a resuit of this study presenting type C and type D, part of four types of illumination intensity, takes higher percentage of almost every spaces compare to the others therefore K Senior Hospital was designed on the assumption of healing environment composition through natural light. The result of this research would be used meaningfully in the space programming phase of Senior Hospitals in the future. Utilization rate can be adjusted using illumination intensity value in the space that integration rate should be planed to be high. The use(purpose) of space and integration rate can be used as a guideline to set illumination intensity of natural.

• 간호행정학회지
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• 제7권2호
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• pp.205-221
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• 2001

It will become more and more popular to use the long-term care facilities and home health care services with the chronic disease increasing. It depends on how much the consumers would pay and purchase the services. They might get more benefits from that kind of services than from ordinary hospitalization. So far, the study of determining the medical service price has focused most often on the efforts from the providers' view. But it must be reasonable to include the consumers' value for the service. This study was performed to assess WTP(Willingness to Pay) for home health care service in order to apply to the determination of nursing price in a reasonable manner. In this study, respondents were asked if they would pay for the service's intangible benefits under the four different types(open-ended minimum WTP, open-ended maximum WTP, bidding WTP, referendum WTP). The contingent valuation method is a potentially useful tool in understanding how people value the benefits of the service. As a result, average open-ended minimum WTP was W16,015 per day among 65 respondents. Average open-ended maximum WTP was W29,154 per day among 65 respondents. Average bidding WTP was W26,300 per day among 65 respondents. Average referendum WTP was W22,200 per day among 70 respondents. The results of regression analyses were also consistent with theoretical prediction, e.g., increasing WTP with consumers' value for the service, state of patients, and household income. This study demonstrated that it was more reasonable to consider the consumers' value in determining the services' price. In addition, a further study is needed to test the validity of this CV method and to determine a proper nursing price based on the consumers' view.

• 대한물리치료과학회지
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• 제21권1호
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• pp.45-52
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• 2014

Purpose : This study is to research about the need of a home visiting physical therapy for children with disabilities. Methods : We surveyed the guardians related to it and one hundred and three questionnaires of one hundred and twenty were returned and analyzed. The results are listed below. Results : First, there are many opinions that a need of physical therapy is necessary, but many people suffer from financial problem to use this service. Second, most of opinions using a home visiting physical therapy of children with disabilities are positive. People who need this service prefer it to manage by national public organization. They also want physical therapists who have worked more than five years to treat them and one hour for treatment time required with about twenty thousand won and At last, in the survey, people ranked solving the inconvenience of coming and going hospitals as a highest expectation and avoiding discharge by force due to long-term hospitalization as a lowest one. Conclusion : To sum it up, high demand and expectation of effectiveness of a home visiting physical therapy for children with disabilities mean that study and analysis are essential to establish this system through implementation on a trial basis within a certain period of time for verifying the effectiveness of this service.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제40권
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• pp.29.1-29.11
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• 2018

Background: For proper recovery from craniofacial fracture, it is necessary to establish guidelines based on trends. This study aimed to analyze the patterns and causes of craniofacial fractures. Methods: This retrospective study analyzed patients who underwent surgery for craniofacial fractures between 2010 and 2017 at a single center. Several parameters, including time of injury, region and cause of fracture, alcohol intoxication, time from injury to surgery, hospitalization period, and postoperative complications, were evaluated. Results: This study analyzed 2708 fracture lesions of 2076 patients, among whom males aged 10 to 39 years were the most numerous. The number of patients was significantly higher in the middle of a month. The most common fractures were a nasal bone fracture. The most common causes of fracture were ground accidents and personal assault, which tended to frequently cause more nasal bone fracture than other fractures. Traffic accidents and high falls tended to cause zygomatic arch and maxillary wall fractures more frequently. Postoperative complications-observed in 126 patients-had a significant relationship with the end of a month, mandible or panfacial fracture, and traffic accidents. Conclusions: The present findings on long-term craniofacial fracture trends should be considered by clinicians dealing with fractures and could be useful for policy decisions.

• 간호행정학회지
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• 제10권3호
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• pp.375-386
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• 2004

The purpose of this study was to identify the present use of caregiver services, to evaluate the degree of satisfaction with the services according to type of caregiver service, private or public, and to provide data for the development of a plan which will provide good quality service with less economic and psychological burden to the patients and their families. Survey data were collected from 130 patients in 4 general hospitals in Seoul, and their families. Data were collected during April, 2004, using a questionnaire which included the patient satisfaction scale developed by Jun (2001). Data were analyzed using frequencies, percentages, means and standard deviations, $X^2$ analysis, t-test. The SPSS computer program was used to facilitate analysis. The results of this study are summarized as follows; The total score for satisfaction was high for both groups. For the private caregiver group it was $52.38{\pm}11.08$, and for the public caregiver group, $58.14{\pm}9.64$. This difference was significant(t=-3.391, p=.001). In all of areas, the scores for satisfaction of the public caregiver service group were higher than private caregiver service group, ie. caregivers' attitude, role, confidence, performance, and service charge, and all the differences were significant. In conclusion, it was found that long-term hospitalization of older patients with high dependence resulted in more caregiver service. There were more severe patients in the public caregiver group, but the service charges, additional costs and paid holidays were less. Based on these results, patients and their families were significantly more satisfied with public caregiver service because it was not only less expensive but also had a high quality of service. Thus, caregiver services should be systemized so that patients and their families will get the best quality caregiver service

• 대한치과마취과학회지
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• 제11권2호
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• pp.146-152
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• 2011

Background: Elderly patients with progressive dementia including Alzheimer's disease (AD) are more and more often scheduled to undergo general anesthesia for various pathologies including dental problem. But, there is high risk of deterioration of underlying mental diseases and other co-morbidities. So it is important to implement preventive strategies and take adequate measures to minimize negative perioperative events in these patients. Methods: We reviewed the 17 cases of 11 patients with AD who underwent ambulatory general anesthesia for dental treatment at the clinic for the disabled in Seoul National University Dental Hospital. Results: The mean age was 68 (57-81) years. All of them were diagnosed with AD and some had hypertsnsion, bronchiectasis, urinary incontinence. For anesthesia induction, 3 cases (1 patient) was needed physical restraint, but others showed good or moderate cooperation. Drugs used for anesthesia induction was thiopental (11 cases), propofol (3 cases) and sevoflurane (3 cases). All patients received nasotracheal intubation without difficulties. Mean total anesthetic time was 3 hour 44 min ${\pm}$ 60 min and staying time at PACU was 83 ${\pm}$ 34 min. All the patients except one who showed hypertension discharged without any complication. There was no death or long term hospitalization because of severe complications. Conclusions: If general anesthesia is needed, pertinent diagnostic tests and workup about other medical problems, and appropriate anesthetic planning are essential for safety.

• 사회복지연구
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• 제39호
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• pp.57-81
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• 2008

알코올 중독자의 동기가 치료의 효과에 미치는 영향은 매우 중요한 것으로 알려져 왔다. 본 연구는 알코올 중독문제를 가진 개인들의 치료에 대한 동기를 나타내는 지표로서 입원치료에 대해 환자자신이 동의하였는지의 여부에 주목하였다. 자의입원환자와 타의입원환자는 치료에 대한 동기수준이 다르다고 볼 수 있으므로 치료의 효과성에 대한 지표로서 퇴원후 단주기간에도 차이가 있을 것으로 생각되었다. 이러한 연구목적을 가지고 알코올문제로 진단을 받고 입원치료중인 환자 66명을 대상으로 조사를 실시하였다. 이들의 퇴원후 단주기간은 1차 조사후 8개월 시점에서 전화로 추적조사 하였다. 연구결과, 자의입원환자가 타의입원환자에 비하여 유의미하게 오랜 기간 동안 단주를 유지하는 것으로 나타났으며, 단주기간을 예측하는 요인으로 자의입원 외에 환자가 인지하는 가족지지 역시 유의미한 요인임을 알 수 있었다. 이러한 연구결과는 알코올 중독자들의 입원치료에 있어서 환자들의 자발적 의지가 매우 중요함을 다시 한번 보여주는 것이라 하겠다.

• Clinical and Experimental Pediatrics
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• 제61권12호
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• pp.387-391
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• 2018

Purpose: Subgaleal hemorrhage (SGH) is a rare but potentially fatal condition in newborns; however, few studies have reported on this condition. We aimed to identify the clinical characteristics and prognostic factors of SGH. Methods: We retrospectively reviewed the medical records of 20 neonates diagnosed with SGH between January 2000 and June 2017. Enrolled neonates were clinically diagnosed when they had tender fluctuant scalp swelling that crossed the suture lines. Results: Among 20 neonates with SGH, 12 were boys and 7 were girls; median hospitalization duration was $9.7{\pm}6.9days$. Fourteen neonates (70%) were born via vacuum-assisted vaginal delivery, and 4 via vacuum-assisted cesarean section. Of the neonates enrolled, half of them initially showed unstable vital signs, including apnea, desaturation, and cyanosis. Ten neonates had acidosis and 3 had asphyxia (pH<7.0). Intracranial lesions associated with SGH were observed in 15 neonates (75%), including subdural hemorrhage (50%), subarachnoid hemorrhage (15%), intraventricular hemorrhage (5%), cerebral infarct (15%), skull fracture (30%), and cephalohematoma (20%). Twelve neonates (60%) required transfusion, 5 (25%) had seizures, and 3 (15%) died. Eight neonates (40%) had hyperbilirubinemia (mean total bilirubin, $13.1{\pm}7.4$). The mean follow-up period was $8.4{\pm}7.5months$. At follow-up, 10 neonates (58.8%) were healthy with normal development, whereas 7 (41.2%) had neurological deficits. Conclusion: The morbidity rate was 41.2% due to severe metabolic acidosis. Anemia, hyperbilirubinemia, low Apgar scores, and subdural hemorrhage did not affect the prognosis. The long-term outcomes of neonates with SGH are generally good. Only arterial blood pH was significantly associated with death.