• 보건의료산업학회지
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• 제2권1호
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• pp.105-124
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• 2008

The purpose of this research is to provide the data base for the activation of Quality Improvement operation through investigating the status of Quality Improvement operation, and finding out factors influencing on the goal-orientation of QI performers in the medical centers of more than one hundred beds where are practicing Quality Improvement operation. In order to reach the purpose, document study was carried out grounded on the proceeding researches and formulated statistical data in relation with the status of Quality Improvement performers, and proof study was carried out through questionnaire survey. The subjects of the survey were the Quality Improvement performers working in seventy three medical centers in Pusan-Gyeongnam, Daegu-Gyeongbuk, and Ulsan. Among eighty three Quality Improvement performers, fifty, five were questionnaire surveyed, on the result of which Reliability Analysis, Factor Analysis, and Multiple Regression Analysis were made, using statistical program. The the results of the proof analysis on this research are as follows. First, in the factors influencing the devoting to goal pursuit of QI performers, organization-goal contribution(0.44) had significant positive effects, while organization conflict(-0.25) had significant negative effects. In other words, the higher the organization-goal contribution was, the higher the devoting to goal pursuit was, while the less the organization conflict was, the higher the devoting to goal pursuit was, which was statistically significant.(p<0.05). Second, in the aspect of goal performance types of QI performers, the process-centered type showed high level of the devoting to goal pursuit, which was statistically significant.(p<0.05). Third, in the aspect of QI performance degree, the higher the devoting to goal pursuit was, the higher the QI performance degree was, which was statistically significant.(p<0.05). In addition, the performers who perceived their workplaces organic structure showed much higher QI performance degree, which statistically significant.(p<0.05). Generalizing the results of this research, it is possible to offer a few suggestions as follows. First, as the competition among the medical centers is more severe recently owing to medical center evaluation system, medical centers are practicing various Quality Improvement operation in all of medical services such as clinical performance and management performance, to reach the purpose of both cost-cutting and medical quality improvement. Thus in order to practice Quality Improvement operation more efficiently in medical centers, it is essential to nuke use of problem-solving methods and statistical members. This as the willingness of chief executives and positive attitude and recognition of organization members. This requires the installation of divisions in charge and disposition of persons in charge, not to speak of persistent training of Quality Improvement. Second, the divisions in charge of QI carry out Quality Improvement operation at the medical center level, and take the role of generalizing and adjusting QI performances of various departments. Owing to this role, the division in charge of QI is considered indispensable organization in the QI operation of medical centers along with medical QI committee, while it contributes to the government's goal of reducing quality level gaps among medical centers. Therefore it is necessary for government and QI organizations to give institutional support and resources for the sake of QI operation of medical centers, besides to supply systematic trainning and informations to the divisions and persons in charge of QI. Third, it is certain that disposition of persons in charge should be determined in view of the scale and the scope of QI operation in medical centers.

• 한국산학기술학회논문지
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• 제21권10호
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• pp.299-307
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• 2020

연구목적: 본 연구는 암 환자의 삶의 질에 영향을 미치는 재정 관련 어려움 요인을 찾고자 수행하였다. 방법: 연구대상은 항암, 방사선 치료 경험이 있는 암 환자이며, 종속변수는 삶의 질, 독립변인은 인구사회학적 요소, 의료적 상황, 재정관련 어려움(암 치료비로 인한 물질적 상황, 심리적 반응, 대처행동)을 변인으로 하여 모형을 구성하였다. 자료수집은 자기기입식 설문지를 활용, 5개 요양병원에서 수집하였으며, 422부의 설문지를 분석에 사용하였다. 분석방법은 인구사회학적, 의료적 변인과 함께, 세 유형으로 분류한 재정관련 어려움 변인을 각각 단계적으로 투입하여 5단계로 위계적 다중 회귀분석 하였다. 결과: 삶의 질에 가장 영향력이 큰 요인은 평소처럼 일할 수 없거나, 가계에 도움이 될 수 없다는 좌절감이었으며, 신체활동수행정도가 나쁠수록, 동반질환이 있는 경우, 여자인 경우, 암 치료비에 대한 심리적 부담감이 클 경우, 치료비용에 대한 의료진과 의사소통 만족도가 낮을 경우, 경제적 상황에 대해 잘 관리되고 있다고 느끼지 못하는 경우, 삶의 질이 나쁜 것으로 나타났다. 결론: 본 연구결과가 암 환자 삶의 질 향상을 위한 실천 현장의 중재 프로그램 개발, 임상적 개입방안 및 관련 정책 방안 마련을 위한 근거로 활용되길 기대한다.

• 의료법학
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• 제22권4호
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• pp.159-184
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• 2021

첨단재생바이오법의 제정 의의는 본질적으로 '이식'이라는 의료행위인 재생의료를 약사법 규제에서 벗어나 의료기술적 접근으로 환자치료기회를 확대하는 데 있다. 그러나, 법이 시행된 지 1년여가 지난 상황에서 식약처가 승인하는 고위험연구는 1건도 승인되지 않고 있는 등 임상연구가 활성화되지 않고 있다. 그 이유는 환자치료기회 확대를 위한 법률 취지에도 불구하고 법률적 근거가 미흡함에도 임상연구 승인을 위한 자료요건을 의약품 개발과 연결하여 정하고 있어 많은 연구자들이 자료요건을 맞추기가 어려운 실정이다. 법 제정 이전 약사법 체계 내의 세포치료제 임상연구를 위한 제출자료는 품질 및 비임상시험 자료가 상당히 면제되었지만, 첨단재생바이오법이 시행되면서 임상연구 계획 승인신청 시 품질 및 비임상시험자료를 의약품에 준해 요구하고 있다. 이를 바로잡으려면 치료기회 확대를 위한 첨단재생의료 임상연구의 정체성을 고려할 때 의약품 개발과 연결하는 데는 제한점이 있음을 인식하고 첨단재생의료 임상연구의 정체성을 지키고, 한편으로 품목허가 시 임상연구 결과를 활용할 수 있도록 하면서 활용요건을 구체화하여 시장의 힘으로, 임상연구자의 자발적인 동기로 임상연구 승인을 위한 기본요건보다 필요한 자료를 스스로 준비할 수 있도록 해야 한다.

• 가정∙방문간호학회지
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• 제9권2호
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• pp.78-89
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• 2002

The purpose of this study was to identity degree on self-care agency & self efficacy of hemodialisis patients. The subjects for the study consisted of 260 hemodialisis patients and the data were collected from April 1st. 2002 to April 30. 2002. The instruments used for this study were the Self-carer As Inventory Scale(Genden & Taylor. 1998) and Concrete Self Efficacy Scale(Joo-Hyen Kim. 1995). The Self-carer As Inventory translated by So Hyang-Sook and was modified by auther of this study. The data were analysed by using SPSS/WIN program and included number. percentange. t-test, ANOV A and Pearson Correlation Coefficient. The results of the study are summarized as follows. 1. As the average score Self-care agency indicated $132.21\pm19.11$ points and Self efficacy showed $597.33\pm130.95$points. it can be said that Self-care agency and Self efficacy were high. 2. In the relationship between general and hemodialisis cure characteristics and Self care agency were significant difference in age(F=3.065. p=0.018). married(F=3.160. p= 0.029). religion(F=4.128. p=0.003). hemodialisis cure duration(F=2.615. p=0.049). 3. In the relationship between general and hemodialisis cure characteristics and Self efficacy were significant difference in age (F=2.992. p=0.019). married(F=4.427. p=0.013), job(before attack-F=1.926. p=0.044. after attack-F=1.784. p=0.048). incomes (F=2.235. p=0.041), hemodialisis cure frequency (F=1.718. p=0.042). diet practice (F=2.248. p=0.025). 4. Self efficacy was significantly related to Self-care agency(r=0.474. p<(0.001). That is the higher the self efficacy. the higher the level of Self-care agency. The result in the above showed that more concern and endeavors need to improve hope. medical support. self efficacy, self-care agency of hemodialisis patients.

• 한국한의학연구원논문집
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• 제16권2호
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• pp.57-64
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• 2010

Background : Meditation is one of the healing therapies used to prevent and cure ailments and to improve health through regular practice. Although Meditation is within the paradigm of modern Western medical science, effects on the human body could be possible. Objectives : This study performed a systematic review of the literature published in Korea focused on mindfulness meditation (MM), which is being applied as mind-body therapy around the USA lately. Method : Three hundred sixty six articles were found after searching with keyword, 'mindfulness meditation (MM)' in 6 journals and web databases. Ninety papers related MM were analyzed trend, Seventeen randomized controlled trials (RCTs) and 38 controlled clinical trials (CCTs) were researched by systematic review. Result : Most of them were studies about relationship between MM and syndrome such as stress, depression, anxiety and MM was also applied to some disease like hypertension, temporomandibular joint disorder in some cases. In 55 studies, It was shown that MM has positive effects on various symptoms and sometimes the effect of MM showed at post and follow-up study although there was no significant difference between control group and experimental group in some cases according to outcome measurement. Interestingly, there was no study reported about side effects of MM after the application. Conclusions : MM is being clinically applied at both western and oriental hospital in Korea, but more clinical trials with the high quality are needed to support its scientific basis.

• 한국콘텐츠학회논문지
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• 제16권2호
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• pp.503-512
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• 2016

본 연구의 목적은 유방암 생존자의 사회경제적 지위가 삶의 질에 미치는 영향을 검토하는 것으로, 자료수집은 우리나라에서 유방암 발생률이 가장 높은 40대 유방암 생존자들을 대상으로 이루어졌다. 총 607사례가 분석에 포함되었으며, FACT-B로 측정된 대상자의 삶의 질 총점평균은 93.75(SD=21.50)이었다. 다른 인구사회학적 변수와 의료적 변수를 통제하였을 때, 삶의 질은 소득 및 직업유형과 유의미한 관계가 있는 것으로 나타나 높은 수준의 사회경제적 지위와 높은 삶의 질 간의 관계를 확인해주었다. 구체적으로 자영업이나(${\beta}=0.10$, p= .01) 전문/사무직에 종사할수록(${\beta}=0.17$, p< .001), 또한 소득수준이 400만 원 이상일수록(${\beta}=0.11$, p= .03) 유의미하게 삶의 질이 높은 것으로 나타났다. 공적 사적 자원을 포함하여 사회경제적 지위가 낮은 유방암 생존자에 대한 관심과 지원의 필요성과 실천상의 함의가 논의되었다.

• 대한물리의학회지
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• 제13권1호
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• pp.89-98
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• 2018

PURPOSE: While underwater, patients with hemiplegia experience unwanted limb flotation on their paretic side due to low muscle mass and high body fat. However, only a limited number of studies support the effectiveness of this practice. Therefore, the purpose of this study was to determine how the balance and walking abilities of patients with hemiplegia due to stroke were affected by wearing an aquatic cuff on their ankles during underwater treadmill walking. METHODS: Twenty stroke patients were divided into an experimental group comprised of 20 patients who would wear an aquatic cuff and a control group comprised of 10 patients without an aquatic cuff. Both groups underwent a six-week intervention for 30 minutes a day three times a week. To evaluate the groups' balance and walking abilities before and after the intervention, the 10 m walking test, timed up go test, Berg Balance Scale, functional reaching test, and the GAITRite system were used. RESULTS: The results of the 10 m walking test, timed up go test, differences between the left and right gait cycles, and functional reaching test showed statistically significant differences in the rates of change between the two groups (p<.05). CONCLUSION: The study results suggest that underwater treadmill training in stroke patients can be more effective when they wear an aquatic cuff on their ankles compared to wearing no aquatic cuff.

• Asian Pacific Journal of Cancer Prevention
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• 제13권7호
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• pp.3443-3449
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• 2012

Introduction: Despite health education efforts to educate women on breast cancer and breast cancer screening modalities, the incidence of breast cancer and presentation at an advanced stage are still a problem in Malaysia. Objectives: To determine factors associated with the uptake of breast cancer screening among women in the general population. Methods: This pre-intervention survey was conducted in a suburban district. All households were approached and women aged 20 to 60 years old were interviewed with pre-tested guided questionnaires. Variables collected included socio-demographic characteristics, knowledge on breast cancer and screening practice of breast cancer. Univariate and multivariate analysis were performed. Results: 41.5% of a total of 381 respondents scored above average; the mean knowledge score on causes and risks factors of breast cancer was 3.41 out of 5 (SD1.609). 58.5% had ever practiced BSE with half of them performing it at regular monthly intervals. Uptake of CBE by nurses and by doctors was 40.7% and 37.3%, respectively. Mammogram uptake was 14.6%. Significant predictors of BSE were good knowledge of breast cancer (OR=2.654, 95% CI: 1.033-6.816), being married (OR=2.213, 95% CI: 1.201-4.076) and attending CBE (OR=1.729, 95% CI: 1.122-2.665). Significant predictors for CBE included being married (OR=2.161, 95% CI: 1.174-3.979), good knowledge of breast cancer (OR=2.286, 95% CI: 1.012-5.161), and social support for breast cancer screening (OR=2.312, 95% CI: 1.245-4.293). Women who had CBE were more likely to undergo mammographic screening of the breast (OR=5.744, 95% CI: 2.112-15.623), p<0.005. Conclusion: CBE attendance is a strong factor in promoting BSE and mammography, educating women on the importance of breast cancer screening and on how to conduct BSE. The currently opportunistic conduct of CBE should be extended to active calling of women for CBE.

• Nutrition Research and Practice
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• 제12권1호
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• pp.78-84
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• 2018

BACKGROUND/OBJECTIVES: Folic acid supplementation before pregnancy is known to reduce the risk of neural tube defects. The purposes of this study were to investigate the awareness, knowledge, and use of folic acid supplements along with their associated factors among non-pregnant Korean women of childbearing age. SUBJECTS/METHODS: From August 2012 to March 2013, 704 women aged 19-45 years completed a self-administered questionnaire regarding their awareness, knowledge, and use of folic acid as well as questions to identify risk of inadequate folate intake. RESULTS: Approximately 67% of women reported that they had heard of folic acid, and 23.7% had knowledge of both the role of folic acid in preventing birth defects and appropriate time for taking folic acid supplements to prevent birth defects. However, only 9.4% of women took folic acid supplements at the time of the survey. Women aged 19-24 years, unmarried women, and women who had never been pregnant were less likely to be aware and knowledgeable of folic acid or take folic acid supplements. In addition, women at high risk of inadequate folate intake were less likely to take folic acid supplements. In a multivariate analysis, women aged 19-24 years, women with a high school diploma or lower education level, and unmarried women were less likely to be aware and have knowledge of folic acid. The percentage of women taking folic acid supplements was significantly higher among knowledgeable women than among unknowledgeable women. CONCLUSIONS: These results support our hypothesis that women with knowledge of folic acid are more likely to take folic acid supplements. Therefore, educational programs or campaigns to improve knowledge regarding the importance of folic acid and to promote consumption of folic acid supplements as well as folate-rich foods are needed to target young, less educated, and unmarried women.

• 대한의용생체공학회:의공학회지
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• 제36권4호
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• pp.103-108
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• 2015

Discrimination of Parkinson's disease (PD) from Essential tremor (ET) is often misdiagnosed in clinical practice. Since tremor is time-varying signal, and dominant and harmonic frequencies are shown in tremor only with moderate or severe symptom, there are some limitations to use frequency related features. Moreover, patients with PD or ET can suffer from both resting tremor and postural tremor. In this study, 28 patients with PD and 17 patients with ET were enrolled. Tremor was measured with accelerations on the more affected hand during resting and postural conditions. The ratio of root mean square (RMS) of resting tremor to RMS of postural tremor, the mean coefficients of autocorrelation function (ACF), and the mean of differences of two adjacent coefficients of ACF at resting and postural were calculated and compared between PD and ET. The performance showed 98% accuracy with support vector machine and leave-one-out cross validation. In addition, the method accurately differentiated the patients with tremor-dominant PD from patients with ET, with 100% accuracy. Therefore, the developed algorithm can assist clinicians in diagnosing and categorizing patients with tremor, especially, patients with mild symptom or the early stage of a disease, for proper treatment.