• 제목/요약/키워드: Nursing assistant

검색결과 101건 처리시간 0.031초

의학적 충고에 반한 퇴원의 특성과 퇴원결정 요인에 관한 연구 - 사회사업가의 개입사례와 역할을 중심으로 - (A Study on the Characteristics of DAMA(Discharge Against Medical Advice) Case and Causal Factors of DAMA - Perspective of Medical Social Worker's Role and Intervention -)

  • 강흥구;이상진;조경기
    • Journal of Korean Neurosurgical Society
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    • 제29권12호
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    • pp.1620-1627
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    • 2000
  • Objectives : DAMA cases were analyzed to examine what the main casual factors of DAMA were and how to deal with these cases effectively in hospital with the DAMA interdisciplinary team including medical social worker whose role is to perform psycho-social assessment, family counsel, to evaluate family's DAMA need. Patients and Methods : The content analysis of medical record and social work record were reviewed in 37 cases referred by medical doctor to DAMA team. These cases were reported by patients' self discharge request or family's request for discharge from September 1998 to February 2000. The DAMA team consists of Assistant Director of Hospital as team leader, medical staff in-charge, social worker, QI nurse, other staff members who are not involved in direct treatment for patient, and administrative clerk. Results : The results of content analysis are as follows : 1) The most causal factors of DAMA consist of combination of more than 2 factors. 2) The major decision-maker is revealed to be son and daughter of patient. 3) In 59.4% of cases, family was not informed of patients' prognosis, alternatives, the consequence of DAMA at all. 4) In cases of DAMA report, the rapid intervention of social worker is carried out. Conclusion : In this study, we propose the interdisciplinary team approach to make decision legitimately and ethically for DAMA. The suggestions from this study are as follows : 1) To deal with DAMA case properly, the interdisciplinary team approach should be considered. 2) The criteria for DAMA case should be formed carefully. For the explicit selection of DAMA case, preliminary system for high-risk patient screening is recommended. 3) The medical social worker is available for the psycho-social problems of the patient once family members. For the effective family counselling, discharge planning and nursing home placement, the participation of medical social worker should be mandatory.

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The Effect of Exposure to Mixed Organic Solvents on Lipid Peroxidation in Ship Building Painters

  • Park, Jun-Ho;Cha, Bong-Suk;Chang, Sei-Jin;Koh, Sang-Baek;Eom, Ae-Yong;Lee, Kang-Myeung;Jung, Min-Ye;Choi, Hong-Soon
    • Molecular & Cellular Toxicology
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    • 제4권4호
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    • pp.360-365
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    • 2008
  • In the last several years, studies on the association of oxidative stress damage with exposure in the work place have been conducted. Xenobiotics create an imbalance of the homeostasis between oxidant molecules and antioxidant defense. By monitoring oxidative stress biomarkers, information was obtained on damages induced by oxidative stress and the toxicity of xenobiotics. In the present study, a Job Exposure Matrix (JEM) was constructed using the data from the Working Environment Measurement (WEM) of painters in the shipyard industry from the past 3 years to assess the exposure status. Additionally, by measuring the concentration of urinary malondialdehyde (MDA), the effect of lipid peroxidation was examined. The subjects consisted of 68 workers who were exposed to mixed organic solvents in the painting process and 25 non-exposure controls. The exposure indices of the exposure groups were significantly different (sprayer: 0.83, touchup: 0.54, assistant: 0.13, P<0.05). The urinary MDA concentration of the exposure group was 48.60${\pm}$ 39.23 ${\mu}mol$/mol creatinine, which was significantly higher than 18.03${\pm}$16.33 ${\mu}mol$/mol creatinine of the control group (P<0.05). From the multiple regression analysis of urinary MDA, the regression coefficient for exposure grade was statistically significant. In future studies, evaluation of the antioxidant levels of subjects should be performed simultaneously with quantitative exposure measurements.

대입준비생들의 치과위생사에 관한 인식도 조사 (Recognition of college-preparatory students for dental hygienist)

  • 김동열;이승훈
    • 한국치위생학회지
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    • 제12권1호
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    • pp.103-111
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    • 2012
  • Objectives : The purpose of this study was to survey the recognition of college-preparatory students who interested and prevented themselves in oral health diseases for dental hygienist in Yeungnam South Korea. Methods : The subjects in this study were 328 students who was seriously worried for career and entrance into a school. The survey period was from August 16th 2011 to November 26th 2011, and the data was collected from the high school students in Yeungnam and the preparatory students who visited S college in Gyeongju. This study was conducted by using the self-reported questionnaire. Results : The result of this study are as follows. 87.2% of the subjects have recognized about the name of dental hygienist, 51.5% have distinguished dental hygienist in the clinic, and 67.4% have recognized about education of dental hygienist that was more than a college graduate. The received services from dental hygienist was scalling(15.6%), assistant of treatment(14.7%), tooth brushing instrument(11.5%), Reception & receipt(11.0%), and etc. The majority of the subjects have recognized that dental hygienist was the professional(4.82 points), the important role in oral health(4.88 points), and the intermediary between patients and dentists(4.60 points). And they were friendly(4.64 points), responsible(4.81 points), and worthwhile job(5.01 points). However their appellation has not been established yet(4.00 points), they was difficult to distinguish from nursing assistants(4.37 points), and their task did not differs from AN(4.53 points). Also they compared to other job was not stressful job(3.58 points). Conclusions : Refer to these results, those will be the basis for professional development and status establish of clinical dental hygienists and for the upright role as a professional medical personnel of dental hygiene students. In addition, those will help to patients in the future, and become an effective instrument to learn knowledge, skill, and service that needed to conduct business.

결핵환자의 재입원에 미치는 융복합적 영향요인 (Convergence Factors of affecting Rehospitalization of Tuberculosis Patients)

  • 이화선;이현주
    • 디지털융복합연구
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    • 제13권5호
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    • pp.259-267
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    • 2015
  • 본 연구의 목적은 결핵환자 재입원에 영향을 미치는 요인을 파악하는 것이다. 결핵병동을 보유하고 있는 서울소재 1개 공공병원에서 2012년 7월 1일부터 2012년 12월 31일 사이 결핵병동에서 퇴원한 환자 총 360명을 연구대상으로 선정하였다. 자료는 '간호정보조사지'에서 추출하거나 병원 의무기록부서의 '퇴원분석정보 DB'를 활용하였다. 연구결과 직업이 없을 때, 의료급여가입자, 월 10일 이내로 술을 마실 때, 입원경로가 직접내원일 때, 주보호자가 환자의 배우자일 때, 자의퇴원일 때, 폐결핵이 아닌 다른 호흡기계 질환이 주진단인 경우에 재입원 가능성이 더 높은 것으로 확인되었다. 따라서 처음 결핵환자가 입원했을 때부터 이 경우에 해당하는 환자에 대해 집중적으로 중재를 실시한다면 재입원을 보다 효과적으로 줄일 수 있을 것으로 사료된다.

아동의 수술 후 통증사정을 위한 부모용 통증행동관찰척도의 타당성에 대한 연구 (A Study on the Preliminary Validation of a Postoperative Pain Measure for Parents for Children's Pain Assessment after Surgery)

  • 신희선;정연이
    • 대한간호학회지
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    • 제30권4호
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    • pp.847-856
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    • 2000
  • Parents are primary care taker for the children and have an important role for the assessment and managent of children's pain following surgery. The purpose of the present study was to examine the validity and clinical utilization of the Postoperative Pain Measure for Parents (PPMP) developed by Chambers et al. Subjects were 52 children aged 4-12 years admitted for tonsillectomy and other minor surgery and their mothers. Faces Pain Scale, State Anxiety, and Postoperative Pain Measure for Parents were used. The data were collected by two research assistant on the operation day and 1st day after surgery at hospital during the period of July 20 to August 28, 1998. The results are as follows: 1. Eta correlation coefficient between 15 items of PPMP and child rated pain were calculated. Correlation coefficients were more than .2 for both day. 2. Internal consistency for PPMP were .82 and .83. 3. The scores of the PPMP were 10.73 (SD=3.71) and 9.27(SD=4.07) on the operation day and 1st day after surgery and there was no significant difference between two days(p=.056) On the other hand, there was a significant difference on the child rated pain by Faces Pain Scale between operation day and 1st day after surgery(p=.001). 4. The correlation(Spearman Rho) between PPMP and child rated pain were .40(p=.003) and .56(p=.000). The score of the PPMP and the children's state anxiety were highly correlated on the operation day and 1st day after surgery (.60, .52, p=.000). 5. Partial correlation between PPMP and child rated pain except state anxiety were .18(p=.23) and .48(p=.001) on the opration day and 1st day after surgery. 6. Using a cut-off score 10 out of 15, the measure showed excellent sensitivity (>80%) and moderate specificity (46.15%, 60% ). This study provides preliminary evidence for the use of the PPMP as a valid pain assessment tool with children between the ages of 4-12 years following surgery. It is suggested to explore the validity with a different subjects with other surgery and to examine the validity for infant and younger children.

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노인이 지각한 가족지지와 자아존중감 및 예방적 건강행위 이행과의 관계 (Correlations among Family Support, Self-Esteem and Compliance with Preventive Health. Behavior in Elderly People)

  • 최영아;박점희
    • 기본간호학회지
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    • 제6권1호
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    • pp.141-152
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    • 1999
  • 본 연구는 노인이 지각한 가족지지와 자아존중감 및 예방적 건강행위 이행정도와 각각의 관계를 파악하여 노인의 질적인 삶을 유지, 증진시키는 간호중재를 위한 기초자료를 제공하기 위하여 실시되었다. 연구대상은 재가노인 191명으로 K시 소재 1개의 노인학교와 8개의 노인정을 중심으로 조사하였다. 연구도구는 강현숙(1984)이 개발한 가족지지 측정도구, Rosenberg(1965)의 자아존중감 측정도구, 강윤숙(1989)이 개발한 예방적 건강행위 측정도구를 이용하여 구조화된 질문지를 이용한 면담을 통해 자료수집을 하였으며, 자료수집 기간은 1998년 9월17일부터 9월31일까지였다. 자료분석은 SAS 프로그램을 이용하여 대상자의 일반적인 특성은 실수와 백분율, 대상자의 가족지지, 자아존중감, 예방적 건강행위 이행정도는 최소값, 최대값, 평균, 표준편차를 산출하였고 일반적인 특성별 가족지지, 자아존중감, 예방적 건강행위와의 관계는 t-test와 ANOVA로 가족지지와 자아존중감 및 예방적 건강행위와의 관계는 Pearson Correlation Coefficients를 이용하였다. 연구결과는 다음과 같다. 1. 노인이 지각한 가족지지 정도는 평균 40.49점이었고, 일반적 특성에 따른 가족지지 정도는 연령, 배우자 유무, 동거유형, 경제상태, 한달 용돈 등에서 유의한 차이를 보였다. 2. 노인의 자아존중감 정도는 평균 29.01점이었고, 일반적 특성에 따른 자아존중감 정도는 교육정도, 배우자 유무, 동거유형, 경제상태, 한달용돈 등에서 유의한 차이를 보였다. 3. 노인의 예방적 건강행위 이행정도는 평균 53.15점이었고, 일반적 특성에 따른 예방적 건강 행위 이행정도는 경제상태, 한달용돈에서 유의한 차이를 보였다. 4. 노인이 지각한 가족지지와 자아존중감 및 예방적 건강행위 이행과의 상관관계에서 노인이 지각한 가족지지와 자아존중감은 유의한 순상관 관계를 보였고(r=.57, P<.001), 가족지지와 예방적 건강행위 이행정도와도 유의한 순상관 관계를 보였으며(r=.44, P<.001), 자아존중감과 예방적 건강행위 이행정도와도 서로 순상 관관계를 나타내어(r=.51, P<.001), 노인이 지각한 가족지지와 자아존중감 및 예방적 건강 행위 사이에는 유의한 상관관계가 있었다.

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분업적 의료행위에 있어서 주의의무위반 판단기준과 그 제한규칙들 (Standards of Due Diligence and Separation of Responsibilities in the Division of Labor in Medicine)

  • 최호진
    • 의료법학
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    • 제19권2호
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    • pp.41-72
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    • 2018
  • 분업적 의료행위에 있어서 관여자들에 대한 의료과실을 인정함에 있어서는 그의 형사 책임을 제한하거나 또는 형사책임을 적절히 분배할 필요성이 있다. 본 논문은 분업적 의료행위에 있어서 의료인의 주의의무위반에 대한 판단기준과 이를 제한하는 규칙을 다루고 있다. 의료행위에 있어서 주의의무위반에 대한 판단기준으로 객관설이 타당함을 논증하였다. 주의의무를 판단함에 있어서 행위자 개인에게 최상의 주의의무 또는 완벽한 주의의무를 요구하는 것도 도덕적 요청으로는 의미가 있을지 모르지만, 법질서가 요구하는 수준은 사회적으로 상당한 수준 또는 '정상의' 주의의무라고 해석하는 것이 타당하다. 과실기준을 객관화함으로 개인이 책임을 지는 한계의 상한을 설정해줌으로써 개인에게 지나친 부담을 안겨주는 것을 방지하고 평등의 원칙에도 부합한다. 구체적 사례에 있어서 의료과실을 판단하는 경우에도 고려해야 할 표지를 설명하였다. 의료행위는 일반적 과실과는 다르게 전문성, 재량성과 같은 특수성, 정보의 편중성과 독점성이 있기 때문이다. 일반적 의학수준, 긴급성과 의료설비와 같은 의료환경과 조건, 의료행위의 전문성, 의료행위의 재량성에 대하여 검토하였다. 주의의무를 제한하는 규칙으로 허용된 위험의 이론과 신뢰의 원칙을 검토하였다. 수평적 분업관계에서는 신뢰의 원칙이 적용된다. 같은 병원 의사들이 각각 전문분야를 가지는 경우, 다른 병원 의사들 사이의 관계의 경우에는 원칙적으로 신뢰의 원칙이 적용된다. 그러나 예외적으로 신뢰의 원칙이 적용될 수 없는 경우도 존재한다. 수직적 분업관계에서는 신뢰의 원칙이 적용되지 않으며 상급자는 하급자를 신뢰할 수 없다. 이 경우 상급자는 하급자에 대한 위험감독의무로 전환된다. 관리의무는 임의적·간헐적 심사(stichprobenartige Überprüfungen)를 하는 것으로 충분하다고 생각한다.

폐경에 대한 적응 과정 (Adaptation Process to Menopause)

  • 이미라
    • 대한간호학회지
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    • 제24권4호
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    • pp.623-634
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    • 1994
  • Although the average menopausal age has not changed, women's life span has increased. Today's women live longer after their menopause than those in the past, and this calls for attention in both nursing and medical fields. Many studies have revealed how women reacted to menopause and suffered from it. But they did not discriminate the menopausal meaning and effects from the climacteric phenomena. So, this author tried to clarify what menopause itself meant to the climacteric women, by means of grounded theory methodology. The interviewees were 21 women, whose ages were between 46 and 60 years. They were selected by theoretical sampling technique, and the author tried to include all levels of important variables such as age, educational background, religion and job. Data were collected by the author through in -depth interviews and observations in July, 1994. The interviews were mostly done in the homes of the subjects, or in some cases at the author's office or in a hospital. Interviews took from 30 minutes to 2 hours. Interviews were tape recorded and transcribed later by a research assistant. Data were analyzed as gathered, by the constant comparative method proposed by Strauss and Corbin. Eleven concepts were discovered from the data, and they were grouped under six higher order categories. These six categories were "to give menopause a meaning", "to experience value change", "to have self-help strategies", "to have no strategies", "to live a life worth living", "to have a sense of powerlessness" Among these "to experionce value change" was . selected as the core category. Five major categories were systematically integrated around the core category. Women's adaptation to menopause was defined as proceeding as follows : Most women felt relief and sorrow at the same time when they faced menopause, and some only sorrow or agony. Then, they consulted with others about menopausal symptoms, or tried to think of them by themselves. Finally, they gave menopause a meaning, which was that menopause and its symptoms were natural phenomena. But menopause made women reflect on them-selves and their past lives. As they reflected on themselves, their value on life began to change. As their value changed, some women seeked self help strategies. Those self help strategies were what they had learned from collegues, professionals or mass media. The quality of their lives depended on whether they practiced self help strategies or not. Three types of lives were found. Twelve women enjoyed a life worth living, and practiced the self help strategies, because they accepted menopause a chance to change. They were characterized by a high educational level, having a professional job and a sincere faith in God. Seven women were living as usual, because they did not have the necessity to change. They were high school graduates and house wives. Two women recognized menopause a chance to change, but they did not try self help strategies. Their characteristic was low educational level. Those who did not try self help strategies complained of powerlessness to varying degrees. The educational background, full-time jobs and faith helped women adapt to menopause positively. But social support was not helpful to women's adaptation to menepause. Three hypotheses were derived from the analysis. (1) The higher the educational level, the more theneed to change. (2) Women with higher educational background will practice self help strategies more than those with lower edcational background. (3) The more women practice self help strategies, the worthier lives they will live. Suggestions for further studies are as follows. (1) Studies to test hypotheses are needed. (2) A study to find the relationship between the degree of practicing self help strategies and locus of control. (3) Spiritual approaches would better be applied to help menopausal women. (4) Education through mass media should be given mere frequently.

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한.일 치위생(학)과 현황과 일부 대학의 교육 과정 비교 -일부 한국 학생 요구도를 중심으로- (Current Status of Dental Hygiene and Comparison of Some Curriculums in Korea and Japan)

  • 정현자;후지와라
    • 한국산학기술학회논문지
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    • 제11권12호
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    • pp.4896-4906
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    • 2010
  • 2010년 D대학 치위생과 3학년 200명을 대상으로 해외 진학 및 취업에 관심이 있는 아시아 국가를 조사한 결과, 일본이 114명(60.3%)으로 가장 높게 나왔고, '기회가 된다면 아시아권 해외 진학 및 취업을 희망하십니까?'라는 질문에 그렇다가 72명(38.1%)으로 가장 많았다. 가장 관심이 높았던 일본은 2년제 51개 대학, 3년제 101개 대학, 4년제 6개 대학으로 총 158개 대학에서 치위생학과가 개설되어 있었고, 학교 법인은 관동지방(간토)이 25개로 가장 많았다. 일개 학제별 한 일 교육과정을 분석한 결과, 동일하거나 유사한 교과목이 다수였으며, 3년제는 39개 4년제는 44개였다. 일본의 국가고시 교과목이 19개 과목으로 해부학 외 9개 과목이 100점, 치과임상개요의 치과임상개론 외 8개 과목이 50점, 치과진료보조 외 1과목이 50점으로 총 배점이 200점이였고, 일본의 4년제 치위생사양성과정은 졸업 후 치과위생사 면허와 함께 동경의과치과대학 치과구강보건학과에서 사회복지사, 히로시마대학 치과 구강건강과학과는 양호교사(보건교사) 1종 면허 등을 선택적으로 동시에 자격을 취득할 수 있도록 업무영역을 확대한 교육과정을 편성하고 있다.

보건분야 치과위생사들의 건강증진사업을 위한 전문교육 필요도 조사 (A Study on Dental Hygienists' Needs for Specialized Education in Health Promotion Projects)

  • 황윤숙
    • 한국치위생학회지
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    • 제7권4호
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    • pp.611-625
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    • 2007
  • The purpose of this study was to analyze dental hygienists' opinions on health promotion projects in public health and their needs for specialized education in the projects, so that it could help prepare specialized education program required for health promotion projects in the future. To meet the goals, total 364 dental hygienists working in public health were asked to join a questionnaire survey via e-mail in September 2007 for data analysis. As a result, this analysis came to the following conclusions: First, it was found that 29.9% of total respondents took in charge of health promotion projects, and 26.9% respondents considered it very necessary to be responsible for the health promotion projects(56.0% considered it necessary). Almost half respondents considered nonsmoking assistance most desirable task(48.4%) and foremost demanded(50.5%) out of all current health promotion projects, 39.8% respondents answered that they could carry on health promotion task, if assigned, after completing occupational training course. Second, it was found that 39.3% respondents acquired other licenses and qualifications than certificate of registered dental hygienist, and their medical licenses or qualifications included certificate of nursing assistant(18.7%) and certificate of social worker(11.8%) by category. Third, in terms of opinions on possible ways to facilitate health promotion projects, it was found that over half respondents considered it recommended to step up specialized education(56.9%) and prepare legal basis and administrative system(53.6%). Notably, 90.7% respondents considered it necessary to step up specialized education in health promotion. Fourth, in terms of opinions on participation in health promotion projects, it was found that almost half respondents(49.7%) considered it necessary and very positive for extending dental hygienists' works in the future. Moreover, in terms of reasons for sum positive answers, it was found that many respondents considered it helpful for appointment(41.8%) and contributing to capability development and job satisfaction(44.5%). In terms of opinions that sud, participation would be unnecessary, 29.7% respondents thought that nothing would be changed in their dental health projects even with reduced number of public health dentists, and 31.3% respondents thought that dental hygienists are professional manpower responsible only for dental health works. Finally, in terms of on-the-job training(OJT) related to health promotion, it was found that 92.9% respondents desired for OJT. In terms of experiences in OJT, 79.9% respondents answered that they never joined OJT course. In other words, only 20.1% respondents joined OJT courses for health promotion task, such as nonsmoking assistance(8.8%), health promotion FMTP training(2.2%), exercises(1.4%) and nutrition(0.6%).

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