• 제목/요약/키워드: Medical statistics

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퇴행성 슬관절염에 대한 맞춤형 침 치료 효과 검증 무작위 대조군 임상연구(RCT) (ISRCTN 40706107) (Individualized Acupuncture versus Standardized Acupuncture in Symptomatic Treatment of Osteoarthritis of the Knee-a Randomized Controlled Trial (ISRCTN 40706107))

  • 변혁;김선웅;안지현;김용석;서정철;최선미;박지은;;;;이승덕
    • Journal of Acupuncture Research
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    • 제24권4호
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    • pp.183-195
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    • 2007
  • Objectives : To determine whether individualized acupuncture (IA) provides greater pain relief and improved function compared with standardized acupuncture (SA) in patients with osteoarthritis of the knee. Methods: Design is a randomized single blind controlled trial with two intervention arms (IA vs SA) of 6 weeks' duration and 3 months follow up. An orthopedist diagnosed 50 patients' symptoms as knee osteoarthritis. Interventions were applied by 2 residents studying the acupuncture and moxibustion specially in Dongguk University International Hospital. Primary outcome measure is pain as measured by visual analogue scale (VAS). Secondary measures of pain and disability include WOMAC, SF-36, LFI and KHAQ. Results : The 50 participants were well matched for age, sex, bad side, VAS, WOMAC, SF-36, LFI and KHAQ scores at the baseline. 3 participants dropped out. There have not been any adverse events in both groups. Participants in both groups experienced great improvement in all measures except SF-36at 3 and 6 weeks. At 18 weeks, the IA group experienced significantly greater improvement than the SA group in VAS but not in WOMAC, SF-36, LFI and KHAQ. Conclusions : Manipulation of IA seems to provide pain relief longer for osteoarthritis of the knee when compared with SA.

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강원도의 뇌혈관질환 사망과 지역사회 건강 지표와 관련성 (The Relationship between Cerebrovascular Mortality and Community Health Indicators in Gangwon-do)

  • 심정하;손미아
    • 농촌의학ㆍ지역보건
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    • 제34권1호
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    • pp.1-12
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    • 2009
  • 본 연구는 뇌혈관질환 사망에 영향을 미치는 지역의 건강상태 지표를 파악하기 위해 시도되었으며, 연구방법은 2000년 사망 원인 통계를 활용하여 뇌혈관질환으로 인한 사망자 수와 2000년 인구센서스 자료를 이용하여 인구수를 산출하여 뇌혈관질환 표준화 사망률을 산출하였다. 또한 지역사회 건강지표로 지역의 물질적 결핍 지수와 보건의료자원, 도로 포장율, 지방세를 지표로 하였다. 자료는 Excel 2003과 SAS 9.1을 활용하여 분석하였다. GIS 프로그램인 Arcview 9.1을 이용하여 뇌혈관질환 사망률과 지역의 물질적 결핍지수를 시각화하였다. 본 연구의 결과는 다음과 같다. 1. 강원지역에서 뇌혈관질환의 표준화 사망률은 지역, 성별에 따라 차이가 있었다. 남자의 사망률이 가장 높은 지역은 고성군이었고, 가장 낮은 지역은 평창군으로 나타났다. 여자의 사망률이 가장 높은 지역은 고성군이었고, 가장 낮은 지역은 양양군이었다. 2. 강원도의 지역의 물질적 결핍지수는 태백시가 가장 높게 박탈된 지역으로 나타났고, 가장 적게 박탈된 지역은 평창군이었다. 3. 병 의원의 수, 지역의 물질적 결핍지수, 도로포장율. 지방세와 남녀 표준화 사망률과는 관계가 없었다. 본 연구의 의의는 지역의 여러 건강상태를 나타내는 자원들을 지표로 산출하여 뇌혈관질환 사망과 관련지어 분석하고, 또한 소지역인 시 군별 사망률의 차이와 지역사회 건강 지표인 물질적 결핍지수와의 관계를 시각화하였다는 점이다.

병원중심 가정간호사업에 대한 의사, 간호사의 인식과 태도에 대한 조사연구 (A Study on the Recognition and Attitude on Home Health Care Program between Physicians and Nurses in a Hospital, Pusan)

  • 김정순;고영희;김대숙;김정화;신재신;이길자;정인숙;황선경
    • 가정∙방문간호학회지
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    • 제8권2호
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    • pp.148-158
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    • 2001
  • Purpose: This study is to investigate the attitudes on the Home Health Care among the physicians and nurses in P University. Method: Data were gathered from 71 physicians and 264 nurses. working at P University Hospital. from May 1 to May 15, 2001 and analyzed using descriptive statistics and Fisher exact test. Results: 1) As to the previous information about home health care program, those who have been familiar to it were 100% of physicians, and 99.6% of nurses, and 39% of the physicians and 66.1% of the nurses. were found to have responded with right answers, 2) As to the acceptance of the home health care program, 87% of physicians and 98.5% of nurses were found to be positive and there showed a significant difference(p= .019), 3) The main reasons for accepting the system were: the alleviation of the family burden of time, the maintenance of continuity of care, and the reasons for opposing the system were incomplete legal assurance. the possibility of providing illegal medical services. 4) The physician's intention rate of patient referrals to home care program reveled 49.2%. 5) According to the services related to Home Health Care. the orders of acceptance rates were medical tests related services (77.8%, 92%); therapeutic nursing interventions(69.0%, 88.2%): and services for medication(68.3%, 82.5%) among physicians and nurses. respectively. Conclusion: For the stabilization and successful implementation of home health care system. it should be accompanied with education for physicians about home care. setting specific laws and regulations for home care. legal assurance of home care business. outcome research for home care recipients. and support systems of hospital administration.

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한방병원(韓方病院) 소아과(小兒科) 입원(入院) 환자(患者)의 주소증(主訴證)에 대한 연구(硏究) (An Observation of the Chief Complaints of Padiatric Inpatients in the Oriental Hospital)

  • 천진홍;유현영;김기봉;민상연;김장현
    • 대한한방소아과학회지
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    • 제23권3호
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    • pp.109-119
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    • 2009
  • Objectives The purpose of this study is to collect the statistics of pediatric problems and to develop more effective oriental medical treatments for pediatric diseases, their clinical applicability, and chief complaints on pediatric inpatients in oriental hospitals. Methods The study was composed of seventy inpatients that were age from 0 to 20, had received hospital treatment at the pediatrics in Dongguk Bun-Dang Oriental Medicine Hospital for seven years from 1 January 2002 to 31 December 2008. The chief complaints were mainly categorized by oral examination on their patients. Results 1. In this study, male children were thirty one and female children were 39. Thus, sex ration of male to female was 0.79:1. 2. In age distribution, one month to one year were three (4.3%), 1 to six years were forty two (60%), six to ten years were fifteen (21.4%), and ten to twenty years were ten (14.3%). 3. In November, the number of inpatients was the highest (15.7%) in a year. However, there were no significant seasonal differences. 4. In the systemic division, the respiratory diseases : 44(62.9%), the digestive diseases : 11(15.7%), the infectious diseases : 5(7.1%), the musculoskeletal diseases : 3(4.3%), the diseases of nervous system : 3(4.3%), the gynecologic diseases : 1(1.4%), the liver and biliary disorders : 1(1.4%), and etc. : 3(4.3%). 5. The chief complaint of the inpatients is pneumonia, a common cold, respiratory complex symptoms, rhinitis, sinusitis, bronchitis, tonsillitis, diarrhea and etc. Conclusions The two main causes of inpatients were respiratory diseases and digestive disease. More data of inpatients are required for further study. Thus, the new diseases and treatment methods should be studied as a field of oriental medical treatment.

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소방대원의 출동충격스트레스와 소진에 관한 구조모형 (A Model for Post-Traumatic Stress and Burnout in Firefighters)

  • 최은숙
    • 한국응급구조학회지
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    • 제5권1호
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    • pp.147-164
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    • 2001
  • The purpose of this study was to examine the hypothetical model designed to explain the post-traumatic stress and burnout in firefighters. Six exogenous variables such as career, control, impact mobilization frequency, life event, work burden, social support, and four endogenous variables, eg., mobilization impact, coping, post-traumatic stress, burnout were considered for the study. The target population for the distribution of the questionnaire was 428 firefighters in Daejeon, Chungnam Province, Seoul and Kyonggi Province. The data was collected about five weeks, July 12-August 25, 1999. The survey instrument was 8 control items by Seo(1995), 10 life event items by Brugha and Cragg(1990), 20 work burden items by Choi(2000), 12 social support items by Park(1985), post-traumatic stress of 17 items by Foa et al.(1998) and 45 items by Kang(1997). The reliability of the survey instrument and the cronbach's alpha was .62 - .93 level. SAS PC Program and LISREL 8.12a program were used for descriptive statistics and linear structural relationship(LISREL) modeling. Based on the data collected, the following results were obtained. 1. The overall fit of the hypothetical model to the data was good (${\chi}^2=54.65$ [df=17, p=0.000007], RMSEA=0.07, standardized RMR=0.03, GFI=0.98, AGFI=0.91, NFI=0.90, NNFI=0.75). 2. After considering statistical significance and theoretical meaningfulness of paths of the model, a modified model was sought. Compared to the hypothetical model, the modified model has become parsimonious and had a better fit to the data(${\chi}^2=55.90$ [df=20, p=0.0003], RMSEA=0.06, standardized RMR=0.03, GFI=0.98, AGFI=0.93, NFI=0.90, NNFI=0.80). 3. The results of statistical testing of hypotheses were as follows: (1) Work burden, career had a significantly direct effect on mobilization impact. These variables explained 9% of the total variance of mobilization impact. (2) Control, social support, work burden, mobilization impact had a significantly direct effect on coping. These variables explained 15% of the total variance of coping. (3) Control, work burden, social support, coping had a significantly direct effect on post-traumatic stress. These variables explained 49% of the total variance of post-traumatic stress. (4) Coping, post-traumatic stress had a significantly direct effect on burnout. These variables explained 60% of the total variance of burnout.

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당뇨병 환자의 당뇨지식, 자가간호활동과 자기효능감의 관계 - 일 종합병원 환자를 대상으로 - (Relationship between Knowledge on Diabetes, Self-care Activities, and Self Effectiveness of Diabetics Patients)

  • 이미화;김은영
    • 가정∙방문간호학회지
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    • 제10권1호
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    • pp.15-24
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    • 2003
  • This study provides some basic information on the improvement of diabetics' self-care activities through examining the patients' knowledge on diabetes, self-care activities, and how much they feel those activities are effective and through studying the correlation among the three factors. One hundred and fifty four patients were subjected to this study, who were treated or hospitalized in a hospital in Pusan. Researches were conducted from October 21 to November 9, 2002, and information were gathered by questionnaire and direct conversation with the patients. The data was processed through SPSS WIN 10.0 program. The Date were analyzed by descriptive statistics, ANOVA, t-test, Pearson correlation coefficient and Spearman rank correlation coefficient. The results of this study was the followings; 1) The subjects' knowledge on diabetes ranged from 6 to 23 points with a mean of 17.01 points. 2) The subjects' self-care activities ranged from 21 to 103 points with a mean of 67.72 points. That of the patients with regular treatments appeared to have the highest points (3.51) and the lowest points appeared in the measurement of sugar level in blood (2.60) 3) The subjects' feelings of effectiveness ranged from 21 to 103 points with a mean of 70.01 points. Drug therapy had the highest point (3.94) and diet showed the lowest (3.37) 4) In the general characteristics of the subjects, the more education a subject had, the more knowledge on diabetes he or she appeared to have (F=3.36, p=0.012). The self-care activities were significantly high among non-alcoholic subjects (F=4.301. p=.016). The subjects' feelings of effectiveness were higher in female patients than in male patients(t=2.132 , p=.035), and those in the ages between 51 and 60 felt more effectiveness (F=4.198. p=.003). In addition, married subjects felt more effectiveness than the unmarried (t=2.856, p=0.005), and the more education a patient had. the more effectivess he or she felt (F=2.879, p=.025). 5) In the subjects' pathological characteristic, the subjects who experienced diabetes education showed more knowledge on diabetes, more self-care activity, and more effectiveness than those without the education (t=3.193, p=.002; t=2.299, p=.023; t=2.128, p=.035). 6) As the results of the analyses of correlations among knowledge on diabetes, self-care activity, and effectiveness, the more knowledge on diabetes a patient had, the more self-care activity and the more effectiveness he or she showed (p=0.283. p=0.002; p=0.182, p=0.036). Self-care activity became higher as the feeling of effectiveness appeared higher (r=.550, p=.000). Based on the results above, several suggestions were made; 1) This study was conducted in one hospital, so it is difficult to generalize the results. It is necessary to gather more information from more patients through repeated researches. 2) The study on the other factors which can affect a patient's self-care activity is required. 3) The development of a program which improves a patient's self-care activity, knowledge on diabetes. and effectiveness is needed.

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모유수유 저해요인에 대한 산모와 신생아실 간호사간의 인식정도 비교 연구 (A Comparative Study on the Perception of the Impediment Factors between Mothers and Nurses in Nursery)

  • 이미자
    • 여성건강간호학회지
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    • 제1권1호
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    • pp.138-152
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    • 1995
  • The condition of nutrition during infancy will greatly affect infants' physical, emotional growth, especially breast feeding is important in their growth and development, and emotional stability, too. Despite such advantages of breast-feeding, its rate has continued to fall year after year in Korea : the 95% rate in 1960's has fallen to 25.4% in 1990. It is known that such a downfall of breast-feeding rate is associated with various factors. The purpose of the study is to examine mother's and nurses' in nursery perception of the impediment factors of breast-feeding : to compare those between of breast-feeding : to compare those between two groups : to provide fundamental data for developing strategies for increasing breast-feeding. The subjects were 45 new mothers from one hospital and the same number of nurses sampled from 3 university hospitals, in Seoul. The data were collected for 11 days from April 12 to April 23, 1994 and a questionnaire was developed based on the interview with 14 nurses and 10 mothers and the literature reviews. Liker's Five-Point Scale was used as measurement. The Data were analyzed using SPSS / PC and descriptive statistics, t-test, ANOVA. The results of study are as follows : 1) Most new mothers get the information about breast-feeding from their mothers, books or newspaper, and relatives in rank than professionals(nurses or doctors). 2) The impediment factors the breast-feeding are categorized as mothers, hospital system, medical personnels and social factors. The most frequently mentioned impediment factors from mothers are 'Difficulty by operational wounds'(3.13), 'Lack of will for breast-feeding'(3.47), 'Insufficient rest and sleep'(3.52) and 'Opposition from husband or his family members'(4.77)in rank. On the other hand those factors from nurses are 'Inadequate nipple condition'(2.37), 'Decreasing milk secretion given medicine after operation'(2.63), 'Mothers knowledge deficit by poorly prepared education'(2.79) and 'Mothers abhorance of breast-feeing'(3.87) in rank. 3) As for the hospital system, the highly perceived impediment factors by mothers are 'Seperation of baby from mother after birth'(2.78), 'Lack of space for breast-feeding in the hospital'(2.93), 'Lack of facility for informing the time for breast-feeding'(3.18) and 'Because of babys' preference artificial nipple by being accustomed to it in hospital(3.97), in rank. Meanwhile, those from nurses are "Seperation of baby from mother after birth",(1.92), "Inconsistency between hospital's nursing time and mother's breast secretion time" scretion time(2.97), "Lack of space for breast-feeding in the hospital"(3.39), and "Lack of facility for informing the time for breast-feeding"(3.74) 4) As for the medical personnels, the highestly perceived Impediment factor from mothers in "Lack of professional nurses for breast-feeding"(2.96), and the lowestly perceived one is "Doctors' reluctance"(4.75). Nurses perceived same as mothers, too. 5) As for the social factors, the highestly perceived impediment factor by mothers and nurses is "Inconvience of social activities"(2.83) and the lowestly ones are "The sense of self-sacrifice"(4.22) by mothers, and "The sense of old fashioned"(4.13) by nurses. 6) The difference of the perception of impediment factors between mothers and nurses is statistically significant only in mother factor.

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족삼리 애구가 고혈압 환자의 혈압 강하에 미치는 영향 ; 무작위배정 임상연구 (Effect of Choksamni(족삼리, $ST_{36}$) Moxibustion on Blood Pressure Elevation in Hypertensive Patients: A Randomized Controlled Trial.)

  • 김보성;장인수;여진주;이태호;손동혁;서의석;강신화;곽민정;임영진
    • 대한한의학회지
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    • 제26권3호
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    • pp.66-73
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    • 2005
  • Objectives : The purpose uf this study was to evaluate the effect of Choksmni$(ST_{36})$ moxibustion in hypertensive patients who showed sudden elevation of blood pressure. Methods : Among patients admitted to Woosuk University Hospital from June to September 2004, sixty-one patients who had shown sudden elevation in systolic blood pressure over 100mmHg were chosen by random sampling and divided into a treatment group (Choksamni moxibustion group) and a control group. In the Choksamni $(ST_{36})$ moxibustion group, moxibustion was done at the point between tibial tuberosity and head of fibula where the $ST_{36}$ is known to be located. Direct moxibustion was practiced on the patients 5 times with an increase of size from a grain of rice to a bigger cluster. Male patients were chosen to practice on the left meridian and female patients were chosen to practice on the right meridian point. Changes in blood pressure after He moxibustion were checked 4 times at tine intervals of 30 minutes. In the control group, the patients took bed rest without my medical treatment. The two groups were compared in order to demonstrate whether then were any remarkable changes in depression of blood pressure. Results : There were significant decreases in the systolic and diastolic blood pressure before and after moxibustion. We found significant decreases in systolic blood pressure at 60 minutes, 90 minutes, and 120 minutes ana diastolic blood pressure at 120 minutes in the patient group compared with the control group. Conclusions : There was a statistically significant depressing effect on blood pressure elevation observed in the group with moxibustion at $ST_{36}$ versus the control group without any medical treatment.

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뇌졸중 환자의 Charlson Comorbidity Index에 따른 사망률 분석 (Mortality of Stroke Patients Based on Charlson Comorbidity Index)

  • 김가희;임지혜
    • 한국콘텐츠학회논문지
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    • 제16권3호
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    • pp.22-32
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    • 2016
  • 인구구조의 급속한 고령화로 뇌졸중 질환의 발생빈도와 진료비가 지속적으로 증가하고 있다. 이에 본 연구는 대표성이 있는 퇴원손상심층조사 자료를 이용하여 뇌졸중 환자의 Charlson comorbidity index에 따른 사망률 현황을 살펴보고, 뇌졸중 환자의 사망에 영향을 미치는 요인을 분석해 보고자 시행하였다. 2005년에서 2010년까지의 6년간 퇴원손상심층조사 자료를 이용하였으며, 연령이 20세 이상이며 주진단명이 뇌졸중으로 분류된 21,494건을 대상으로 분석하였다. 분석대상자의 동반상병 분포와 CCI에 따른 사망률 현황을 파악하기 위해 기술통계를 실시하였으며, 뇌졸중 환자의 사망에 영향을 미치는 요인을 파악하기 위해서는 로지스틱 회귀분석 기법을 이용하였다. 분석 결과, 뇌졸중 환자의 사망에 유의한 영향을 미치는 독립변수는 연령, 보험유형, 거주지 도시규모, 병상규모, 의료기관 소재지, 입원경로, Physical therapy 유무, 뇌수술 시행 유무, 뇌졸중 유형, CCI로 나타났다. 이는 뇌졸중 환자의 연령, 뇌졸중 유형, 동반상병의 위험요인에 따른 좀 더 효율적인 접근법과 모니터링이 필요하며, 의료급여 환자의 지원 확대가 개선되어야 함을 시사해준다. 이러한 결과들은 향후 뇌졸중 환자들의 의료의 질 평가와 보건의료 정책 수립에 기초자료로 의미 있게 활용되어질 수 있으리라 여겨진다.

F-18 FDG PET/MRI와 PET/CT 전신 영상에서 VOI를 이용한 정상부위의 $SUV_{LBM}$-최대치에 의한 영상평가 (Image Evaluation Via $SUV_{LBM}$ for Normal Regions of VOI by Using Whole Body Images Obtained from PET/MRI and PET/CT)

  • 박정규;김성규;조인호;공은정;박명환
    • 한국의학물리학회지:의학물리
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    • 제24권1호
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    • pp.68-75
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    • 2013
  • 본 연구의 목적은 26명의 건강한 검진자들을 대상으로 PET/CT와 PET/MRI의 전신 영상에서 조기 정밀/ 진단 수준을 향상하고자 관심부피를 이용하여 정상부위의 $SUV_{LBM}$-최대치를 이용하여 PET/CT와 PET/MRI를 조영제 사용 유무와 관계없이 동시 평가할 수 있는 데이터를 구축하고자 하였다. 전신 F-18 FDG PET/CT와 전신 F-18 FDG PET/MRI의 정상부위의 VOI를 이용한 $SUV_{LBM}$-최대치평가는 PET/CT를 기준으로 PET/MRI의 영상은 매우 유의한 차이를 보였다(p<0.0001). 그러나 통계학적으로 높은 상관관계를 가진다(R>0.8). PET/MRI의 $SUV_{LBM}$ 평가 시 26.3% 감소하여 판단할 것과 조영제를 사용할 경우는 29.3% 감소하여 판단할 것으로 생각한다. PET/CT와 PET/MRI의 모든 영상의 판독에서는 $SUV_{LBM}$-최대치를 사용하는 것이 편리성과 효율성을 고려하여 임상의나 연구자들에게 많은 도움이 되리라 판단된다.