• 대한간호
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• 제36권3호
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• pp.49-69
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• 1997

The urgent needs to establish hospice care systems in Korea arise from the following reasons: 0) a drastic increase in chronically ill patients with the increase of aged population: (2) rapid changes in living environment from the traditional habitation (e. g., Many Koreans living in apartment complexes, which is the most popular form of modern residence in recent years, prefer to die in the hospital.): the overall increase in patients with advanced cancer: (4) recent trends in early discharge of terminally ill patients from the limited hospital facilities to accomodate other medical insurance beneficiaries; (5) easy acceptance of euthanasia owing to the recent social atmosphere that belittles the dignity of human life; (6) medical and nursing care of AIDS patient in terminal stage; (7) and the problem associated with inhumane medical care system, overtreatment, and groundless fears against narcotics. Terminally ill patients were used to be treated in the hospital in the past. In these days, however, they are forced to have home cares with little assistance from the qualified medical personnel because of insufficient hospital facilities, which are even short for the need of emergency patients and provide priority cares to medical insurance beneficiaries with other acute problems. And yet, neither are there any administrative organizations nor systematic medical studies that deal with the level of terminally ill patient's need, their family's problems and resources of hospice care systems in Korea. Thus, most patients are not able to get appropriate medical care at the terminal stage of their lives. The objective of this study is to make comprehensive database for various hospice care organization currently in operation, link them through medical information system, and develop an easily accessible hospice care model that meets the need of most Korean people. Our survey results may be summarized as follows: Nationally there are 40 organizations that provide partial or full hospice care. However, these organizations are not linked to any formal medical service network. Furthermore, the objective of hospice care, care principles, personnel with appropriate training, educational programs, standard for care, costs, consulting service to patients' family members, the extent of medical care from professional staff members, status of hospice facility, and management of those institutions are neither clearly defined nor organized compared to the international hospice care standards. The surveys on patients of terminal stage. grouped in hospice and non-hospice care patients. reveal what they want visiting nursing care to help their pain control. psychological. social and spiritual demands. While the more than 90% of hospice care patients want to reduce their pains. the non-hospice care patients. in addition to their desire for pain control. demanded more psychological. social and spiritual helps as well. The results of this research could be utilized to 0) define the standard of hospice care. (2) provide the guidance for hospice medical care costs. (3) establish the database of hospice care systems. (4) develop softwares. (5) build communication network through Medinet. and (6) provide an organized visiting home nursing care system. These information should be a valuable resource to many medical staffs who are involved in cancer therapy. nursing care. and social welfare programs.

• 한국콘텐츠학회논문지
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• 제16권10호
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• pp.196-205
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• 2016

본 연구의 목적은 2006년부터 2012년까지의 질병관리본부의 퇴원손상심층조사 자료를 바탕으로 결핵환자의 환자 특성과 입원 및 질병관련 특성, 의료기관 특성에 따른 의료이용 현황과 치료결과에 영향을 미치는 요인을 파악하고자 한다. 본 연구는 질병관리본부에서 제공하는 퇴원손상심층조사자료를 활용하였고, 제6차 한국표준질병사인분류(KCD-6)의 중분류상 퇴원시 주진단 코드와 부진단 코드가 결핵(A15.0~A19.9)인 환자를 추출하여 총 8,305건을 최종 분석에 사용하였다. 본 연구에서 수집된 자료는 통계 프로그램 SPSS 20(Statistical Package for the Science)을 이용하여 빈도분석, 교차분석(chi-square test)과 로지스틱 회귀분석을 실시하였다. 연구결과는 먼저, 환자 특성과 치료결과가 호전되었는지의 관련성에 있어서는 연령그룹이 20-39세, 40-64세, 65세 이상과 의료급여의 결핵환자가 호전될 확률이 모두 통계적으로 유의하게 높았다(p<0.000). 그 다음, 입원 및 질병관련 특성과 치료결과와의 관련성 분석에서는 A16, A17, A19(p<0.000)와 A18(p<0.002) 모든 결핵코드와 재원일수가 31-90일(p<0.000)과 91-180일(p<0.041)인 경우에 호전될 확률이 통계적으로 유의하게 높았다. 마지막으로, 의료기관 특성과 치료결과의 관련성 분석에서는 300-499(p<0.008), 500-999(p<0.011), 1,000병상 이상(p<0.015)과 도지역(p<0.041)의 경우 호전될 확률이 통계적으로 유의하게 높았다(p<0.015). 결과적으로 결핵환자 발생시 철저한 접촉자 조사 및 예방치료, 정기적인 검진을 통한 조기 발견 방안 등 정부에서도 성공적인 결핵환자관리 프로그램을 지원하고 이를 적절하게 뒷받침 할 수 있는 단기적 뿐만 아니라 중장기적으로 종합적인 정책을 추진해야 한다.

• 한국콘텐츠학회논문지
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• 제11권9호
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• pp.372-383
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• 2011

본 연구의 목적은 관상동맥중재술 입원 환자의 재원일수의 변이를 규명하기 위해 중증도 보정 모형을 개발하였다. 2004~2006년 퇴원손상환자 조사자료 중 관상동맥중재술 입원 환자 1,011건을 연구대상으로 하였으며, 재원일수의 변이분석은 t검정, 분산분석을 실시하였고, 중증도 보정 재원일수 모형은 데이터마이닝 기법을 이용하였다. 개발된 다중회귀분석 모형을 이용하여 예측 재원일수를 산출하고 이를 실제 재원일수와 비교한 결과 병상규모별, 보험유형과 지역별로 재원일수의 변이가 존재하는 것으로 나타났다. 환자 특성과 중증도를 통제하고 나타난 재원일수의 변이는 공급자 요인으로 설명될 수 있는데, 진료행태나 의료자원에 대한 후속 연구가 필요한 것으로 보인다. 본 연구는 행정 데이터를 이용하여 중증도 모형을 개발하고 변이를 확인하였다는 점에서 활용의 효용성을 높이는 데 기여할 것으로 사료된다.

• 재활간호학회지
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• 제15권2호
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• pp.91-99
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• 2012

Purpose: The purpose of this study was to identify the frequency and status of mentally ill patients who registered in a community health center (CHC) but they could not be accessed. Methods: A total of 233 mentally ill individuals who were registered to a CHC in B Metropolitan City participated in this survey. Data were collected from December 1 to 31, 2010 and analyzed. Results: There were 140 (60.1%) community dwelling mentally ill patients who had been registered to that CHC but were not accessible. The major reasons of this inaccessibility were patients' rejection to be accessed (27.1%) and the wrong or missing address in hospital's discharge note (22.9%). The nursing problems of the subjects were rejection of medication (93.4%); poor personal hygiene (85.8%); violence including harassment of family member(s), assault, property destruction, threat with weapon (38.7%); and so on. Among 159 cases of referrals and requests for help immediate action with patient's compliance were only 8.8%. Conclusion: The findings show that mentally ill patients who had registered to the CHC but were not able to be accessed failed to be managed properly. This would become risk factors of social problems which threat to the community as well as individuals. Thus, we need to prepare programs for this population to make them take medicine at a minimum.

• Child Health Nursing Research
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• 제3권1호
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• pp.99-107
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• 1997

The subjects of the study were the 120 mothers who had children hospitalized in 6 hospitals in P city during the period from Feb. 1. to May 30. 1996. The purpose of the study are(1) the problems encountered when they carried out Home Care after discharge and (2) the degrees of demand that they had against Home Care Services. In order to investigate the purposes above-mentioned the researchers used the 55 items of Home Care services belonging to 10 areas selected by Korea Home-Care Association in 1994. The items were modified and supplemented to 4-point scale. The selected data were analyzed by SPSS : PC+ and the following results were derived. 1. The subjects payed great attention to 5 items such as 'pain control, OPD visits, diet-control problems' among the 15 sources of anxiety that they had against Home Care services after discharge. Especially, 'OPD visits and knowledge deficit' would to be overcome by the nursing activities of the Home Care Nurses. 2. The acknowledge level of the subjects to the Home Care Project that governmental plans to carry out was surveyed and found as under 50. 0% responded they heard about Home Care Nursing System. 60.8% said that they thought the system was 'very necessary' and 'somewhat necessary'. 65.0% said they would like to use the system. However, the acknowledge level of 50.0% is still low and is thought to need further national promotion and propagation. 3. The demand of the subjects against 55 Home Care Services was investigated and found as