• 한국식생활문화학회지
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• 제11권4호
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• pp.487-495
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• 1996

건강식품 및 원료의 유효성분 및 위해요소 조사분석에 관한 연구의 기초조사로 건강식품에 대한 소비자의 의식조사를 실시하였다. 건강식품에 관한 이용실태 조사와 건강식품에 대한 객관적 지식정도 조사로 구성된 설문지를 이용하여 서울, 경기 지역에 거주하는 방문 및 협조가 가능한 20세 이상의 일반 소비자 1000명을 대상으로 1995년 10월부터 96년 2월에 걸쳐 직접 방문하고 설문지를 배부하여 설명한 후 조사대상자가 직접 기입하게 하는 방법으로 조사하였다. 882부를 회수(회수율 88%)하였으나 이중 불완전한 응답 23부를 제외한 859부(유효회수율 86%)를 SAS프로그램을 이용하여 통계처리하였다. 조사대상자의 사회경제적 여건에 대하여는 단순빈도와 백분율을 구하였고 교차표를 이용하여 결혼 여부, 월수입, 교육정도 등의 사회 경제적 여건과의 통계적 연관성을 파악하였다. 건강식품에 관한 이용실태 조사결과로는 응답자의 58.8%가 건강식품을 사용한 경험이 있었으며 68.2%는 건강식품의 효능을 믿는다고 응답하고 있어 건강식품에 대한 관심도가 매우 큰 것으로 나타났다. 건강식품에 대한 가장 큰 기대효과는 전체적 건강유지에 도움을 주는 것(59.8%)이라고 응답하였으며 가장 큰 부정적 견해로는 과대선전(52.1%)이라고 응답하였다. 건강식품에 대한 정보 선택 경로로는 주로 친지의 권유나 소개(30.6%)로 이용하고 있었으며 우리나라 식품법에서 건강보조식품의 등록관리사실은 63.7%가 모르고 있다고 응답하여 응답자의 과반수 이상이 건강식품의 행정적 관리사실에 무지한 것으로 나타났다. 건강식품의 등록관리 사실을 알고 있는 건강식품의 종류로는 로얄제리(22.7%), 스쿠알렌(16.0%), 정제어유(15.1%), 유산균(10.6%), 알로에(8.8%)순으로 나타났다. 건강식품과 약품(또는 한약)과의 차별인식 조사결과에서는 응답자의 84.2%가 건강식품과 한약이 다르다고 생각하면서도 가장 잘 알고있는 건강식품의 종류와 약품(또는 한약)의 종류를 묻는 두 문항에 모두 인삼(22.7%, 41.7%)을 가장 많이 응답하여 전체적으로 건강식품과 약품의 구별을 제대로 하지 못하는 것으로 나타나 이를 위한 계몽과 교육이 시급함을 알 수 있었다.

• 대한간호학회지
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• 제13권1호
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• pp.7-21
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• 1983

For the flexible and rational distribution of limited existing health resources based on measurements of individual risk, the socalled Risk Approach is being proposed by the World Health Organization as a managerial tool in maternal and child health care program. This approach, in principle, puts us under the necessity of developing a technique by which we will be able to measure the degree of risk or to discriminate the future outcomes of pregnancy on the basis of prior information obtainable at prenatal care delivery settings. Numerous recent studies have focussed on the identification of relevant risk factors as the Prior infer mation and on defining the adverse outcomes of pregnancy to be dicriminated, and also have tried on how to develope scoring system of risk factors for the quantitative assessment of the factors as the determinant of pregnancy outcomes. Once the scoring system is established the technique of classifying the patients into with normal and with adverse outcomes will be easily de veloped. The scoring system should be developed to meet the following four basic requirements. 1) Easy to construct 2) Easy to use 3) To be theoretically sound 4) To be valid In searching for a feasible methodology which will meet these requirements, the author has attempted to apply the“Likelihood Method”, one of the well known principles in statistical analysis, to develop such scoring system according to the process as follows. Step 1. Classify the patients into four groups: Group $A_1$: With adverse outcomes on fetal (neonatal) side only. Group $A_2$: With adverse outcomes on maternal side only. Group $A_3$: With adverse outcome on both maternal and fetal (neonatal) sides. Group B: With normal outcomes. Step 2. Construct the marginal tabulation on the distribution of risk factors for each group. Step 3. For the calculation of risk score, take logarithmic transformation of relative proport-ions of the distribution and round them off to integers. Step 4. Test the validity of the score chart. h total of 2, 282 maternity records registered during the period of January 1, 1982-December 31, 1982 at Ewha Womans University Hospital were used for this study and the“Questionnaire for Maternity Record for Prenatal and Intrapartum High Risk Screening”developed by the Korean Institute for Population and Health was used to rearrange the information on the records into an easy analytic form. The findings of the study are summarized as follows. 1) The risk score chart constructed on the basis of“Likelihood Method”ispresented in Table 4 in the main text. 2) From the analysis of the risk score chart it was observed that a total of 24 risk factors could be identified as having significant predicting power for the discrimination of pregnancy outcomes into four groups as defined above. They are: (1) age (2) marital status (3) age at first pregnancy (4) medical insurance (5) number of pregnancies (6) history of Cesarean sections (7). number of living child (8) history of premature infants (9) history of over weighted new born (10) history of congenital anomalies (11) history of multiple pregnancies (12) history of abnormal presentation (13) history of obstetric abnormalities (14) past illness (15) hemoglobin level (16) blood pressure (17) heart status (18) general appearance (19) edema status (20) result of abdominal examination (21) cervix status (22) pelvis status (23) chief complaints (24) Reasons for examination 3) The validity of the score chart turned out to be as follows: a) Sensitivity: Group $A_1$: 0.75 Group $A_2$: 0.78 Group $A_3$: 0.92 All combined : 0.85 b) Specificity : 0.68 4) The diagnosabilities of the“score chart”for a set of hypothetical prevalence of adverse outcomes were calculated as follows (the sensitivity“for all combined”was used). Hypothetidal Prevalence : 5％ 10％ 20％ 30％ 40％ 50％ 60％ Diagnosability : 12% 23% 40% 53% 64% 75% 80%.

• 한국산학기술학회논문지
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• 제19권1호
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• pp.517-526
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• 2018

본 연구는 최근 10년간 해외 학술지에 게재된 복지관 이용 노인의 생활만족도에 영향을 미치는 요인들의 체계적 문헌 고찰 및 메타분석을 통해 노인의 생활만족도를 증진하기 위한 한국형 노인 생활만족도 도구 개발 및 복지관 운영 및 정책 개발 시 기초 자료로 제시하고자 한다. 분석에 사용된 문헌은 2017년 11월 1일까지 게제 된 국외 논문을 Medline complete, Pubmed central, Scopus를 통해 검색하였다. 검색 용어는 "Elderly. OR aged/) AND Personal Satisfaction/ or life satisfaction. mp"를 사용하였고, 검색된 595편의 초록을 통해 최종 6편의 연구를 분석 대상으로 선정하였다. 각 연구의 내용을 정성적으로 분석한 후 3편 이상의 정량값이 있는 요인들은 메타분석을 시행하였다. 연구 결과 노인 생활 만족도에 영향을 주는 요인으로는 신체적 건강(통합효과크기 0.582, p=.000), 정신적 건강(통합효과크기 0.423, p=.000), 경제적인 문제(r=.51, p=.001), 사회활동, 일상생활정도가 영향요인을 분석되었다. 본 연구를 통해 노인의 생활 만족도의 폭넓은 이해뿐만 아니라 초고령화 사회를 대비한 고령자 취업의 사회적인 함의 및 체계적인 건강관리를 통해 생활만족도를 높이는데 기여할 수 있을 것이다.

• 근관절건강학회지
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• 제7권1호
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• pp.89-101
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• 2000

This study was carried out to compare the bone mineral density and risk factors of osteoporosis between normal and rheumatoid arthritis in postmenopausal women. Sixty-eight postmenopausal patients with rheumatoid arthritis(RA) were compared with 124 postmenopausal normal women. Data were collected from october, 1998 to April, 1999 at Dong-a university hospital in Pusan. From all subjects, individual characteristics such as age, body weight, height, age of menarche, duration of menopause, gravity, parity, and breast feeding period and factors of life style such as milk consumption, exercise, alcohol intake, cigarette smoking, coffee consumption were identified as influencing factors of osteoporosis by questionnaire. From RA patients, health assessment score, Ritchie articular index, erythrocyte sedimentation rate, C-reactive protein and steroid dosage were measured by rheumatologist on measuring bone mineral density. Bone mineral density was measured at the Lumbar spine, femoral neck, femur Ward's triangle, and femur trochanter using dual x-ray absorptiometry. The data was analyzed by using a frequency, t-test, Chi-square, ANCOVA with SPSS PC program. The results could be summarized as follows : 1) There was a significant difference in age and breast feeding period between RA patients and normal women. 2) RA patients took less calcium in the past and practiced less regular exercise in past and present than normal women. 3) There was no difference in lumbar bone mineral density between RA patients and normal women. 4) There was a significant difference in femur Ward's triangle and femur trochanter between RA patients and normal women after adjustment for age and breast feeding period. 5) The prevalence of osteoporosis of all subjects was the highest in femur Ward's triangle. In summary, our findings suggest that the bone mineral densities of femur Ward's triangle and trochanter in postmenopausal women with RA is significantly lower than normal women. Also the exercise participation rate of postmenopausal women with RA is lower than normal women. For the further study, we recommend to develop exercise program that improve the bone mineral density in femur Ward's triangle and trochanter and to test the effect of that exercise program.

• 의료법학
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• 제18권2호
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• pp.195-218
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• 2017

요양병원에 대한 진료비의 증가폭이 비정상적으로 늘어나고 있어 건강보험재정에 막대한 부담을 주고 있다. 이는 요양병원 특수성이 급속한 노령화라는 사회적인 현상과 맞물리면서 나타나게 된 현상인데, 이 중 요양병원에 대하여 입원일당 정액수가제에 의하여 비용이 지급되는 점은 일부 요양병원이 환자를 돈벌이 수단으로 이용하는 유인이 되었다. 이러한 요양병원들은 일당정액수가를 지급받고도 그에 합당한 진료비용의 지출을 줄이기 위해 의도적으로 입원 환자를 타병원에서 정기적으로 진찰을 받게 하거나 주요 약제를 처방받게 하는 등 건강보험재정이 이중으로 지출되게 하였다. 이러한 재정누수를 방지하기 위하여 심사평가원은 위와 같은 환자들에 대하여 기존의 환자군을 부정하고 '신체기능저하군'으로 환자군을 조정한 다음 요양급여비용을 삭감하였다. 그렇지만 위결정은 규정상근거가 없음을 이유로 법원으로부터 취소판결을 받았다. 그러나 위 사건을 계기로 요양병원 수가제도의 문제점을 도출하고 제도를 정비하는 기회가 될 수 있다고 생각한다. 현재의 정액수가제를 수정하여 약제비 및 진료자체에 대한 행위별 청구를 일부 도입하면 요양병원의 의료적 기능을 강화할 수 있다고 생각한다. 또, 현재의 환자군 중 비슷한 군들은 통합하고 신체기능저하군은 입원이 부적절하므로 환자군에서 제외하는 것이 타당하다고 보인다. 다만, 사회적 필요에 의해 신체기능저하군을 입원대상으로 인정하게 된다 하더라도 장기요양대상과의 형평성, 건강보험재정의 건전성 등을 고려하여 건강보험대상에서는 제외되어야 한다고 생각한다.

• 근관절건강학회지
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• 제8권1호
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• pp.27-50
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• 2001

Rheumatoid arthritis is a chronic systemic autoimmune disease. Although the joints are the major loci of the disease activity, fatigue is a common extraarticular symptom that exists in all gradations of rheumatoid arthritis. Fatigue is defined as a subjective sense of generalized tiredness or exhaustion and has multiple dimensions. Therefore fatigue is a common and frequent problem for those with rheumatoid arthritis. In fact, 88-100% of individuals with rheumatoid arthritis experience fatigue. Especially the degree of fatigue is higher in women than men with rheumatoid arthritis. Despite the importance of fatigue among the patients with rheumatoid arthritis, the mechanism that leads to fatigue in rheumatoid arthritis is not completely understood. This study was intended to test and validate a model to predict fatigue in women with rheumatoid arthritis. Especially it was intended to identify the direct and indirect effects of the variables of pain, disability, depression, sleep disturbance, morning stiffness, and symptom duration to fatigue. Data were collected by questionnaires including Multidimensional Assesment of Fatigue(Tack, 1991), numeric scale of pain, graphic scale of joints, Ritchie Articular Index, Korean Health Assessment Questionnaire(Bae, et al., 1998), Inventory of Function Status(Tulman, et al., 1991), Center for Epidemiologic Studies-Depression, and Korean Sleep Scale(Oh, et al 1998). The sample consisted of 345 women with a mean duration of rheumatoid arthritis for 10.06 years and a mean age of 49.64 years. SPSS win and Win LISREL were used for the data analysis. Structural equation modeling revealed the overall fit of the model. Pain predicted fatigue directly and indirectly through disability, depression, and sleep disturbance. Disability, sleep disturbance predicted fatigue only directly, while depression only indirectly through disability and sleep disturbance. Also morning stiffness and symptom duration predicted fatigue through disability and depression. All predictors accounted for 65% of the variance of fatigue. Depression, pain, and disability predicted sleep disturbance. Depression had reciprocal relationship with disability and they both were predicted by pain directly and indirectly. In summary, pain, depression, disability, sleep disturbance, morning stiffness, and symptom duration contributed to the fatigue of patients with rheumatoid arthritis. The best predictor of fatigue was pain. This finding indicates that the modification of pain, depression, disability, sleep disturbance, morning stiffness could be nursing intervention for relief or prevention of fatigue.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제23권2호
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• pp.27-35
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• 2017

Purpose: This study analyzed the status of general hospitals as an expanded concept of medical resources including medical staff and equipment. The purpose of this study is to provide a basic for the feasibility study of the scale and establishment of facility guidelines at the planning stage of general hospitals. Methods: The subjects of this study were limited to general hospitals. The status of medical resources was based on the data of the Health Insurance Review and Assessment Service. The number of beds, doctors, nursing grades and major medical equipment were surveyed in 335 general hospitals. Results: 1) The characteristic of general hospitals varies depending on the number of inpatient beds. To be concrete, there were differences in the number of medical staffs and equipments in general hospitals based on 300 500 800 1,000 beds. 2) As the number of hospital beds increases, the number of medical staff increases more than medical equipment and facilities. Medical equipment and facilities remain constant, even when the number of beds increases. On the other hand, the number of medical staff increased about 1.5 times in each level. Implications: Architectural plans for medical staff should be considered differently depending on the number of beds. In particular, architectural planning and facility guidelines should be applied differently based on 300 and 500 beds.

• 한국식품영양학회지
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• 제28권4호
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• pp.517-526
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• 2015

This study was carried out to determine the depression symptoms and nutritional status of elderly females that ate congregate meals at lunch in rural Pocheon. The subjects were 18 elderly females aged over 65 ($75.7{\pm}4.6$ years) and information on smoking, subjective health status, depression symptoms and malnutrition risk were collected using a questionnaire administered with the help of trained research assistants. Measurements included mid-arm circumference and calf circumference. Food consumption for 3 days during breakfast and supper were determined by 24-hour recall and food consumption at lunch was determined as the difference between the amounts served and the plate waste. All data were compared between two age groups (${\leq}75$ and > 75). The subjects had the lowest nutrient adequacy ratio (NAR) for vitamin $B_6$ (0.523), followed by calcium and niacin and the lowest index of nutrient quality (INQ) for calcium (0.738). The older elderly had significantly lower NAR for vitamin $B_1$, vitamin $B_2$, vitamin $B_6$ and niacin as well as significantly lower mean adequacy ratio (MAR) compared to the young elderly. They also had significantly lower INQ for vitamin $B_1$ and vitamin C and significantly thinner arm circumference (28.3 cm vs. 31.3 cm). They consumed more than 40% of their daily intake for each nutrient at lunch. Higher proportions of nutrient intake from lunch provided evidence of the importance of congregate meals, suggesting that the government and society should support congregate meals to improve nutritional status.

• 의학교육논단
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• 제21권1호
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• pp.41-50
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• 2019

The aim of this study is to analyze the current status and performance evaluation systems of faculty in Korean medical colleges and professional graduate medical schools (called medical schools). We developed a research tool based on previous studies and distributed it to 40 medical schools from July to October 2017. The response rate was 100%. We calculated the number of faculty members and analyzed the faculty evaluation systems and awareness according to national and private medical schools. As of 2017, the number of medical faculty in Korea was 11,111 (4,973 faculty were employed by their alma mater, which is 44.76% of the total), with non-medical doctor faculty accounting for 754 of the total. The medical schools reflect research achievements as most important for re-appointment and screening to promote faculty, and the area of education is secondary excepting clinical faculty of private medical schools. However, important issues in the faculty evaluation deal with the relevance of research achievement and the need for qualitative assessment. Some medical schools revised or have been revising the faculty evaluation system in areas such as minimum standards of education for promotion and separation of promotion and tenure review. Opening non-tenure track lines for faculty show positive effects such as increasing the number of positions for hire and easing the financial burdens of medical schools. Downfalls include inconsistencies between the responsibilities and actual practices of tenure not being available and the instability of faculty's status. In conclusion, medical schools need to prepare a faculty evaluation system that fits the position of faculty members and attempt to establish a reasonable compensation system.

• Clinics in Shoulder and Elbow
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• 제26권2호
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• pp.182-190
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• 2023

Elbow traumas represent a relatively common condition in clinical practice. However, there is a lack of evidence regarding the most accurate tests for screening these potentially serious conditions and excluding elbow fractures. The purpose of this investigation was to analyze the literature concerning the diagnostic accuracy of clinical tests for the detection or exclusion of suspected elbow fractures. A systematic review was performed using the Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies (PRISMA-DTA) guidelines. Literature databases including PubMed, Cumulative Index to Nursing and Allied Health Literature, Diagnostic Test Accuracy, Cochrane Library, the Web of Science, and ScienceDirect were searched for diagnostic accuracy studies of subjects with suspected traumatic elbow fracture investigating clinical tests compared to imaging reference tests. The risk of bias in each study was assessed independently by two reviewers using the Quality Assessment of Diagnostic Accuracy Studies 2 checklist. Twelve studies (4,485 patients) were included. Three different types of index tests were extracted. In adults, these tests were very sensitive, with values up to 98.6% (95% confidence interval [CI], 95.0%-99.8%). The specificity was very variable, ranging from 24.0% (95% CI, 19.0%-30.0%) to 69.4% (95% CI, 57.3%-79.5%). The applicability of these tests was very high, while overall studies showed a medium risk of bias. Elbow full range of motion test, elbow extension test, and elbow extension and point tenderness test appear to be useful in the presence of a negative test to exclude fracture in a majority of cases. The specificity of all tests, however, does not allow us to draw useful conclusions because there was a great variability of results obtained.