• 제목/요약/키워드: Low Childbirth

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보존적 한방치료를 시행한 척추 수술 실패 증후군 환자 증례보고 : 출산 후 악화를 포함한 장기 경과 관찰 (A Case Report of Lumbar Spine Failed Back Surgery Syndrome (FBSS) Patient Treated with Korean Medicine: Long-Term Progress Including Postpartum Aggravation)

  • 노지애;이지원;변다영;홍정수;김동진
    • 대한한방내과학회지
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    • 제40권1호
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    • pp.126-135
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    • 2019
  • Background: Because of fear of reoperation and low efficiency, some patients with failed back surgery syndrome (FBSS) opt for Korean medicine treatment. Gold standard treatment is not present for FBSS, therefore both surgical and non-surgical treatment are possible. Studies of Korean conservative medicine for FBSS had a short duration of treatment and mainly pre- and post-treatment comparisons. And case of female patients who have worsened after childbirth is rare. The purpose of this study was to report long-term follow-up and rare cases of FBSS. Case summary: A 33-year-old female patient diagnosed with lumbar disc herniation complained with low back pain and radicular pain in the left leg after surgery in 2011. Acupuncture and decoction (Cheongpa-jeon, GCSB-5) were administered to her twice a day for about 6 years and 6 months. The patient's complaints improved with each hospitalization, and Magnetic Resonance Imaging (MRI) showed a slight decrease in the size of the recurrent disc (L4/5) and a newly developed disc (L5/S1) that had deteriorated after delivery. Conclusion: Korean medicine could be used to manage the pain of lumbar spine FBSS patients for 6-7 years and to alleviate lumbago after delivery.

외국인 유입에 따른 보건의료재정 변화 및 지속가능성 제고를 위한 대응방안 연구 (A Study on the Responses to the Change of Health and Medical Finance and Sustainability of the Influencing Foreigners)

  • 정용주
    • 한국병원경영학회지
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    • 제25권4호
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    • pp.38-47
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    • 2020
  • Purposes: The problem in the recent immigration policy and social policy changes for foreigners is that the preliminary analysis or research on the actual impact of the influx of foreigners has not been done enough in Korea yet.. This study is to examine the impact of the Korean health insurance finances on the influx of foreigners. Approach: This study analyzed the health insurance statistics for foreigners and overseas Koreans of the Health Insurance Corporation from 2013 to 2017. The data is the "Status of Health Insurance Premiums for Nationals, Foreigners, and Overseas Koreans from 2013 to 2017" submitted by the National Health Insurance Service to the Health and Welfare Committee during the 2018 National Audit Period. Findings: To summarize the analysis, first, the proportion of foreigners was only 1% of all subscribers (1.7% at work, 1.9% in regions) until 2017. Second, employees at work have a lower pay-to-pay ratio, and local subscribers have a higher pay-to-pay rate, regardless of nationality. Third, as immigrants are mostly concentrated in younger ages, they are healthy and use of hospitals is relatively low. Fourth, in terms of gender distribution, there are many women of childbearing age due to marriage immigration among foreign local subscribers, and more men use hospitals than workers who have a high proportion of males due to childbirth. In conclusion, the impact of immigration on health insurance finances is not large, and has a positive effect on finances. Practical Implications: If we simply consider the financial aspect, encouraging foreigners to subscribe to health insurance has a positive effect on finances. In particular, the more foreign workers are enrolled, the greater the financial gain. In particular, increasing the employment of foreign women through language education, vocational training, and employment support will help finance health insurance. One of the reasons foreign subscribers have a positive impact on health insurance finance is the low medical utilization rate. It can be said that young and healthy foreigners use fewer hospitals and clinics, but another aspect means that foreigners have difficulty using health insurance for various reasons. Therefore, various supports must be accompanied so that foreign subscribers can use medical services when necessary.

중소병원 간호활성화를 위한 현황조사 연구 (A Survey of Nursing Activities in Small and Medium-size Hospitals: Reasons for Turnover)

  • 김명애;박광옥;유선주;김문진;김을순
    • 임상간호연구
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    • 제15권1호
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    • pp.149-165
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    • 2009
  • Purpose: This study was done to identify the causes of turnover in nursing staff in small and medium‐size hospitals and prepare measures to decrease turnover. Nurses in these hospitals were surveyed focusing on their nursing activities, reasons for turnover, and content of their work. Method: A mail survey of hospitals with 300 beds or less was conducted using a questionnaire including items on the current state of nursing, performance of nursing tasks, turnover of nurses, working conditions, and supports and policies related to insufficient number of nurses. Results: The average number of nurses per 100 beds was 37.5, 3.3 less than the prescribed level of 40.8. The turnover rate was higher when the level of remuneration for nursing care was low, and the most frequent reason for nurses leaving was 'move to another hospital', showing that there is a continuous chain of moves for nurses. Other frequent reasons were situations related to working conditions such as childbirth, child care, irregular working hours, night work, and low wages. Conclusion: To guarantee adequate nursing coverage in these hospitals, working conditions for nurses should be improved, including higher wages, a more flexible work system, and installation and operation of 24-hour child care facilities.

한국 산모의 산후 우울과 산후 외상 후 스트레스장애 관련성: 종단적 연구 (Association of postpartum depression with postpartum posttraumatic stress disorder in Korean mothers: a longitudinal survey)

  • 조현진;고민선;유혜지;안숙희
    • 여성건강간호학회지
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    • 제28권1호
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    • pp.46-55
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    • 2022
  • Purpose: This study aimed to determine the level of postpartum posttraumatic stress disorder (PTSD) and postpartum depression (PPD) in Korean mothers with healthy babies and to explore the factors related to postpartum PTSD. Methods: This study used a longitudinal survey design to explore the levels and association of PPD and PTSD. Two hundred women were recruited during pregnancy and the data were collected via online survey from 166 mothers (84% retained) who gave birth to healthy babies, at two postpartum periods: Fear of childbirth was assessed at the 1st week; and spousal support, PPD, and postpartum PTSD were surveyed at the 4th week postpartum. Descriptive statistics, t-test, one-way analysis of variance, Chi square test, and multiple regression were done. Results: The mean age of mothers was 33.12 (±3.97) years old. Postpartum PTSD was low (8.95±6.49) with 1.8% (n=3) at risk (≥19). PPD was also low (6.68±5.28) and 30.1% (n=50) were identified at risk (≥10). The comorbid rate of PPD with PTSD was 6%. Mothers who did not have a planned pregnancy had higher scores of PPD (t=-2.78, p=.008), whereas spousal support and PPD had negative relationship (r=-.21, p=.006). The overall explanatory power for postpartum PTSD was 55.2%, of which PPD was the only significant variable (β=. 76, t=13.76, p<.001). Conclusion: While only 1.8% was at risk of postpartum PTSD at 4 weeks postpartum, PPD prevalence was 30.1% and PPD was the only influential factor of postpartum PTSD. Assessment and counseling of PPD are required as well as screening for postpartum PTSD. More research is also needed on postpartum PTSD in Korean women.

미혼 남녀의 향후 일.가정 양립 방안, 부부 성역할 태도, 저출산 문제에 대한 견해 간 관계 탐색 연구 (An Exploratory Study on the Relationships among the Future Work-Family Compatibility, Gender Attitude of Couples, and Reasons for Low Birth Rate)

  • 엄명용;김효순
    • 한국인구학
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    • 제34권3호
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    • pp.179-209
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    • 2011
  • 본 연구는 한국보건사회연구원의 "2009년도 전국 결혼 및 출산 동향 조사" 패널자료를 활용하여 20~44세에 이르는 2,678명의 미혼 남녀(남 1,425명, 여 1,253명)가 생각하는 이상적인 일 가정 양립 방안, 성역할 태도 및 저출산 원인에 대한 견해 등을 성별 및 교육정도에 따라 알아보고 이들 사이의 관계를 탐색적으로 분석해 보았다. 이를 통해 향후 저출산 문제 해결을 위해 미혼 남녀들의 일 가정 양립을 어떻게 지원할 것이며, 이 과정에서 미혼 남녀의 성역할 태도가 어떻게 변화되어야 할 것인가를 유추해 보고자 했다. 연구결과를 정리하면, 첫째, 이상적인 일 가정 양립 방안은 미혼자의 성별에 따라 차이가 없었으나 교육정도에 따라서는 통계적으로 유의한 차이가 드러났다. 둘째, 이상적인 일 가정 양립방안과 부부 성역할 태도 및 성별 간 관계에 있어서는 여성에 비해 남성이 '남성은 직장, 여성은 가사'를 더 찬성했으며, 전일제일 보다 시간제 일을 선호하는 미혼자들이 '남성은 직장, 여성은 가사' 방안에 대한 찬성이 높았다. '남편의 자녀 돌봄 능력'에 대해서는 여성이 남성보다 그리고 2자녀를 두고 전일제로 일하겠다는 미혼자가 1자녀를 두고 전일제로 일하겠다는 미혼자에 비해 높은 평가를 보였다. 셋째, 두 자녀 이상을 두고 전일제로 일하고자 하는 미혼 남녀가 저출산 문제를 가장 심각하게 받아들이고 있었다. 넷째, 저출산 이유로 가장 높은 동의를 보인 것은 '양육비와 교육비용'이었으며 다음으로 '주택마련의 어려움'과 '취업여성의 증가'였다. "취업여성의 증가"를 저출산의 원인으로 여기는 정도는 남성보다 여성이 높게 나타났으며, 무자녀로 전일제 일하는 것을 원하는 미혼자들에게서 이러한 성향이 두드러지게 나타났다. 이러한 연구결과를 통해 일 가정 양립방안과 성역할 태도에 대한 기본적인 이해를 높일 뿐만 아니라 저출산 문제에 대한 정책적 개입방향을 제시하고자 하였다.

한국의료패널을 이용한 구급 이송 서비스 이용 특성 분석: 임신, 출산, 산후기 여성을 중심으로 (Analysis of the Use of Ambulance Services Among Pregnant, Childbearing, and Postpartum Women Using Data from the Korea Health Panel)

  • 강경희
    • 한국화재소방학회논문지
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    • 제33권6호
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    • pp.152-158
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    • 2019
  • 본 연구에서는 한국보건사회연구원과 국민건강보험공단의 한국의료패널 2008-2016년 연간 데이터(Version 1.5)를 이용해 임신, 출산, 산후기 여성의 구급 이송 서비스 이용 특성을 분석하였다. 분석 결과를 요약하면, 첫째, 임신, 출산 및 산후기 여성의 119 구급차, 민간 구급차 등 구급 이송 서비스 이용률은 12.0%로 전체 구급 이송 서비스 이용률 18.9%보다 상대적으로 낮았다. 둘째, 임신, 출산 및 산후기 여성의 응급에서 분만이 38.7%로 가장 큰 비중을 차지하였으며, 진통 및 분만의 합병증이 20.0%, 유산된 임신이 17.3% 등의 순으로 나타났다. 셋째, 임신, 출산 및 산후기 여성의 구급 이송 서비스 이용 특성 중 연 평균 가구소득, 응급실 도착 소요시간, 응급실 도착 지연 인식 등에서 구급 이송 서비스의 이용자 집단과 비이용자 집단 사이에 통계적으로 유의한 차이가 나타났다. 따라서 저출산과 고령 산모로 인하여 분만 취약지가 늘어날수록 임신, 출산, 산후기 여성을 위한 사회안전망으로서 구급 이송 서비스의 양적 확대와 질적 제고는 더욱 시급한 과제가 될 것이다.

Healthcare access challenges facing six African refugee mothers in South Korea: a qualitative multiple-case study

  • Kim, Min Sun;Song, In Gyu;An, Ah Reum;Kim, Kyae Hyung;Sohn, Ji Hoon;Yang, Sei Won
    • Clinical and Experimental Pediatrics
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    • 제60권5호
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    • pp.138-144
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    • 2017
  • Purpose: Following legal reform in 2013, the annual number of asylum seekers entering South Korea has increased from 1,143 in 2012 to 5,711 in 2015. We interviewed six African refugee mothers of young children regarding their health needs and barriers to access maternal child health services. Methods: We recruited mothers who had visited a clinic for immigrants between July 2013 and August 2015. Participants were African refugee women, aged over 18 years, who had given birth in Korea within the previous 5 years and had come to Korea over a year before recruitment. Interview questions examined participants' experiences in pregnancy and childbirth and concerns regarding their child's health status. Initial data analysis involved all researchers' immersion in the entire collection of transcripts. We then noted recurrent topics and themes and identified similar issues. Results: At the time of giving birth, 5 participants were asylum seekers and one had undocumented status. The following barriers impeded their access to maternal child healthcare: socioeconomic factors (unstable social identity, low economic status, difficulty obtaining health insurance), language barriers (lack of linguistically appropriate health information, limited access to translation services), and cultural barriers (religious and cultural differences). Weak social support also hindered access to healthcare soon after migration; however, social links with the community emerged as a key coping strategy following settlement. Conclusion: We identified barriers to maternal and child healthcare and coping strategies among African refugee mothers in Korea. Future research should assess refugees' health status and improve health access and literacy among refugee mothers.

분만경험에 대한 주관성연구 (Subjectivity of the Delivery Experience - A Q methodology Approach -)

  • 신혜숙
    • 대한간호학회지
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    • 제30권2호
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    • pp.307-318
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    • 2000
  • The researcher would like to suggest that the delivery experience varies depending on the personal situation and the childbirth experiences of the mother. The goals of this study are : 1. To find out the subjectivity structure on delivery experience. 2. To describe the differences in delivery experience depending on the delivery methods. 3. To suggest effective nursing intervention for each type. Q-methodology was used for the research design. One of the main reasons to use this Q methodology. Because each individual's delivery experience can be different. The result of this study shows that the subjectivity related to the delivery experience of mother has at least four distinctive types. Type I mothers can be named as "Motherhood Identity Recognition Type". Type I subjects accept delivery experience very positively, show interest in the health of the baby, and identify their motherliness with responsibility. Type II mothers can be named "Leaping to Maturity Type". It can be explained as a state that mothers experience pain, but by understanding and enduring the pain, the pain is changed to maturity. Type III mothers can be named as "Pride Experience Type". Type III feels vaginal delivery as a process to become a real mothers, and have great pride in making this type of significant emotiange delivery. Therefore, they think the labor pain is worth the value and believes that there are other differences between vaginal delivery and cesarean section. Mothers of Type III take the delivery experience to be meaningful. Type IV mothers can be named as "Lack of Motherhood Transition Type". This type does not seem to feel sorry for their babies for going through a cesarean section delivery. The also do not have the satisfaction of delivery and motherliness identity is low. In addition, they especially do not feel affection towards their babies. Also, because they delivered babies in a state of anesthetics, they do not seem to feel much different, but show negative reactions toward themselves.ow negative reactions toward themselves.

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간호사의 이직결정과 관련요인에 관한 연구 (Factors influencing the decisions of nurses to resign)

  • 김조자;박지원
    • 대한간호학회지
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    • 제21권3호
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    • pp.383-395
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    • 1991
  • This study was to investigated the factors influencing the decisions of nurses to resign. The purpose was to contribute information useful for the effective management of nurse staffing resources. The specific objectives were as follows : 1. To investigate the level of job satisfaction of nurses who resign. 2. To analyze the relationship of job expectations and the decisions to resign. 3. To investigate the major reason for nurses' resignations. 4. To identify the relationship of the general characteristics of the nurses and the factors influencing their decisions to resign. 5. To analyze the relationship of the intention to resign and the factors influencing the decisions to resign. The sample consisted of 90 nurses who worked at Y hospital in Seoul from march. 1987 to Feb. 1988 and who had resigned. The instruments used for this study were slavitt et al's Index of Work Satisfaction Scale and a job expectations scale developed by the researcher Analysis of data was done using frequency, t-test and ANOVA. The results of study were as follows : 1. There was no difference in the job satisfaction level of nurses who resigned compared with nurses in active service but the subcategory interaction score was lower and the subcategory salary score was higher than for nurses in active service. 2. Low job expectation scores influenced the decision to resign. 3. The major reason for resigning were personal problems such as marriage, childbirth, and relocation of family. 4. The length of employment and the number of different service areas of the nurses who resigned were associated with the job satisfaction level. 5. The nurses who had have an intention to resign while in active service had lower scores for job satisfaction and the job expectation score was a greater influence on the decision to resign. In conclusion, the factors influencing the decisions of nurse to resign were job satisfaction, job expectations and intention to resign while still in active service.

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다문화가정 맞춤형 영양교육 프로그램과 운영시스템 개선을 위한 질적 연구 : 프로그램 제공자 측면 (Qualitative Study on Improvement of Operating System and Tailored Nutrition Education Program for Marriage Immigrants to Korea: Program Providers' Perspective)

  • 조미영;황지윤
    • 대한지역사회영양학회지
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    • 제22권4호
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    • pp.323-335
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    • 2017
  • Objectives: The purpose of this study is to analyze the current status of nutrition education programs for multicultural families and to provide policy suggestions for improvement. Methods: In-depth interviews of a total of 21 multicultural experts were conducted; 15 people were interviewed individually, while 6 people were interviewed in groups of three. Results: In-depth interviews revealed various problems related to the operation of nutrition education programs. The causes of problems were analyzed and categorized as four factors: systemic, practical, environmental and cultural. As for the systematic factors, insufficient linkage between related organizations and duplicate performance of several projects were identified as concerns Establishment of a control tower and strengthening the linkage among the related organizations may be needed to address this concern. With regard to practical factors, the study identified that language barriers, and lack of nutritional education media and tools translated into multicultural languages were limiting factors. These limitations the development of nutrition education materials that aretranslated into multiple languages, implementation of education programs that are different from the Korean education, and by providing interpreters. As for the environmental factors, low educational level and poor nutritional knowledge of multicultural women made it difficult for them to understand the contents of the education. Demonstration, practical training and urgent education on pregnancy and childbirth nutrition were identified as needs to address these concerns. Withregard to cultural factors, food culture conflict with Korean families, and difficulties in home practices were detected as concerns. Participants in the study suggested that getting education with family and facilitation of weekend and nighttime programs health of this community. Conclusions: Further studies are needed to adopt more effective and efficient nutrition intervention to promote the healthy eating of the married immigrant women based on the study results.