• 문화기술의 융합
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• 제8권4호
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• pp.45-51
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• 2022

본 연구는 산업재해 피험자의 고통을 수반하는 장애나 질병이 개인의 사회경제적 활동과 직접적인 관련이 있으며 현재의 건강과 일상생활 만족도에 영향을 미치는 주요 변수라는 관점에서 사회경제적, 사회적 활동에 대한 기초자료를 제공하는 것을 목적으로 한다. 본 연구의 목적은 산업재해서비스와 삶의 만족도에 영향을 미치는 요인을 연계하여 산재보험 수혜자의 경제적, 심리적 재활을 위한 기초자료를 제시하고, 고통과 삶의 만족도 간의 관계를 규명하는 것이다. 연구 결과, 산재보험 급여 수급자는 산재 통증으로 인해 산재 환자가 된 후 일상생활 만족도에 영향을 미치는 것으로 나타났다. 재활서비스와 의료상담 서비스 간에는 양(+)의 관계가 있었다. 산업재해 통증은 개인의 특성인 자존감을 저하시키며, 현재의 건강이 좋아져도 일상생활에 대한 만족도가 떨어진다. 산업재해 관련 서비스의 중요성은 재활 서비스와 의료 상담 서비스를 통해 일상생활의 만족도를 높인다는 점에서 알 수 있습니다. 또한 산업재해 이후 다양한 문제와 상황에 처한 환자에게 적합한 자존감 향상을 위해 지속적으로 노력한 결과 재활서비스 및 건강에 대한 만족도가 향상될 수 있음을 간접적으로 확인하였다.

• 간호행정학회지
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• 제1권2호
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• pp.246-267
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• 1995

Recently the request of the patients to participate in the medical courses has been expanding due to the elevated sense of right on the people's health, merchandised medical treatment by mass supply, human right declaration of the patients, generalized medical informations by the mass media and the change of human relation between the medical personnels and the patients. Under these phenomena the patients have been in the thought of solving such accidents only by regulation of the laws which they think to be all powerful, Such trends are same in the area of nursing service. Also today the accident by the nurses have been increasing by the area of the nurses having been expanded and their independent roles having been increased. Such nursing accidents are the important subject which the professional occupation of the nurse has been facing but legal protective capability of the nurses has been very weak. Therefore this study has examined the degree of the experience of the nursing accident that happens in the clinical nursing scenes in the general hospital to provide the basic materials for the protection and the counter measures of the nursing accident. The following is the conclusion based by the above examination. 1) The experience degree of the whole nursing accidents has been appeared as 1.90 in average. And the degree according to service area has been 1.77 in the area of supervising management of patients, 1.54 in the area of the same management of patients by head-nurses, 1.84 in the area of doctors' treatment performances, 14 in the enforcement and education areas of the nursing technology, 2.04 in the area of observing patients and judgement and 2.07 in the area of nursing records and maintaining confidentials. Accordingly there has been higher degree of accidental experiences in the independent service areas of the patients than in the dependent ones directed by the doctors. 2) The perception of the nurses showed that the cause of the nursing accident has been due to the heavy work of the nurses with the 60.4% of the response rate, the highest rate. They report the accident to the head nurse first by 2/3 nurses after accident. And the hour of the accident has been frequently happened regardless of service hours with 48.1% in response rate, the highest rate, and the nursing accident happens in the night more than the daytime with the rate of 37.5% at night while 14. 4% daytime. 3) The nurses are in the perception that the patients are responsible for the accident with 48.2% response rate while 43.9% rate in response showed that it has been caused by many people. They are in the perception that 41.7% when the nursing power was lacking, 46.7% lower recognition of actual state about indivitual patient in the section of technical speciality and 35.8% when the patients were not cooperative and 37.8% when the wards were dirty and in disorder. 4) the attitude of the patients after the various nursing accidents has been violent words in 72.7%, violence in 17.4% and 3.9% in attending the court by the sue of the patient's side(18 nurses). 5) The action of the hospital has been : requesting the submission of the story of the accident in 22.8%, the report of the accidents in 14.4%, thus the written statement disposal was most, 4.5% was the transfer to the other departments when the accident was larger or the patients' guardians protested strongly and 0.6% of the dismissals of the nurses. 6) In regard to the responsiblity of the nurse accidents, 78.9% was the highest rate of supplying the nursing manpowers, 48.4% of mutual cooperation of the medical personnels, 37.2% of strengthening the education for the nurses and hospital facilities reformation in 32.7%. 7) The review of relation between the general characters of the object of the study and the degree of experience of nursing accidents showed the significant differences in ages (F=4.04, p=0.000).

• 가정∙방문간호학회지
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• 제7권1호
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• pp.58-72
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• 2000

This study was an attempt to encourage the development of a rehabilitation delivery system and programs as a substitute service for hospitalization on the case of car accident patients, such as hospital based home health care nursing services. Various substitute services for hospitalization are required to curtail the length of stay for inpatients who were hospitalized with car accident compensation insurance. It focused on developing an estimation an early discharge day for car accident inpatients based on detailed statements of treatment for 111 inpatients who were hospitalized at the General Hospital in 1997. This study had four specific purposes as follows. First. to find out the utilization of medical services. Second, to estimate the time of early discharge and income increasing effect based on early discharge for those patients. Third, to identify the factors affecting total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze the length of stay and medical expenditure for inpatients who were hospitalized due to car accidents, the authors conducted micro- and macro-analysis of medical and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria, such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the test consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, and stable conditions. In addition to identifying variables affecting medical expenditure, and the length of stay and income effect due to early discharge day, the data was analyzed with a multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study were as follows. First. the mean length of stay was 50.3 days. whereas the mean length of stay due to early discharge was 34.3 days at the hospital. The estimation of time of early discharge depended on the length of stay. The longer the length of stay, the longer the length of time of early discharge : for instance a length of stay under 10 days was estimated as correlating to a mean length of stay of 6.6 days and early discharge of 6.5. The mean length of stay was 217.4 days and the time of early discharge was 110.1 respectively. The mean medical expenditure per day was found to be 169.085 Won and the mean medical expenditure per day showed negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to being discharged 16 days early was around 2,244,000 won per bed. However. this sum does not represent the real benefits resulting from early discharge, but rather the income increasing amount without considering medical prime cost in the general hospital. Therefore, further analysis is required on the cost containments and benefits as turn over rate per bed as the medical prime costs. The length of stay was most significant and was positive to the total medical expenditure, as expected. Surgery and patient's residential area was also an important variable in explaining medical expenditure. The level of complications was the most significant variable in explaining the length of stay. There was a high level for need a home health care nursing service which further supports early discharge for accident patients. In addition, when the patient was discharged. they needed follow up care for complications suffered during the car accident. $86.8\%$ of discharged patients responded that they needed home health services after early discharge. From these research findings, the following suggestions have been drawn. Strategies on a health care delivery system must be developed in order to focus on the consumer's needs and being planned for 21 century health policy in Korea. Community based intermediate facilities or home health care should be developed for rehabilitation services as a substitute for hospitalization in order to shorten the length of stay would be. A hospital based home health care nursing service. it would be available immediately to utilize by patients who want rehabilitation services as a substitute for hospitalization with the cooperation of car insurance companies.

• Journal of Trauma and Injury
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• 제34권3호
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• pp.212-217
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• 2021

Various medical scenarios have arisen with the prolonged coronavirus disease 2019 (COVID-19) pandemic. In particular, the increasing number of asymptomatic COVID-19 patients has prompted reports of emergency surgical experiences with these patients at regional trauma centers. In this report, we describe an example. A 25-year-old male was admitted to the emergency room after a traffic accident. The patient presented with stuporous mentality, and his vital signs were in the normal range. Lacerations were observed in the left eyebrow area and preauricular area, with hemotympanum in the right ear. Brain computed tomography showed a contusional hemorrhage in the right frontal area and an epidural hematoma in the right temporal area with a compound, comminuted fracture and depressed skull bone. Surgical treatment was planned, and the patient was intubated to prepare for surgery. A blood transfusion was prepared, and a central venous catheter was secured. The initial COVID-19 test administered upon presentation to the emergency room had a positive result, and a confirmatory polymerase chain reaction (PCR) test was administered. The PCR test confirmed a positive result. Emergency surgical treatment was performed because the patient's consciousness gradually deteriorated. The risk of infection was high due to the open and unclean wounds in the skull and brain. We prepared and divided the COVID-19 surgical team, including the patient's transportation team, anesthesia team, and surgical preparation team, for successful surgery without any transmission or morbidity. The patient recovered consciousness after the operation, received close monitoring, and did not show any deterioration due to COVID-19.

• 식품보건융합연구
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• 제8권6호
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• pp.11-17
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• 2022

Emergency transport is directly related to the life of the patient, and rapid transport to the hospital is crucial. However, external environmental factors such as traffic or weather, interfere with hospital transport. In this study, we investigated the external environment affecting hospital transport time. We examined the transfer time and patient treatment time of emergency patients in an area of northern Gyeonggi-do from 2018 to 2020. Diagnosis after arrival at the hospital was used, and on-site treatment time was measured from paramedic arrival time at the scene to departure. Furthermore, we examined whether there was a correlation between the time paramedics left the scene and hospital arrival time through the reason for the delay as recorded in the emergency log. Traffic jams had the greatest impact on patient transport, while transport delays occurred due to heavy rain, but not snow. Among injured patients, electrical accidents were the most problematic in terms of on-site treatment time. This was because a lot of first aid is needed in electrical accidents. It must be necessary to mobilize two ambulances in an emergency through the expansion of infrastructure, prepare a plan for rapid transport in heavy rain, and implement strong laws against transport obstruction.

• 의료법학
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• 제19권2호
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• pp.3-40
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• 2018

예전부터 일본에서 의료사고가 형사사건으로 취급되는 경우는 드물었다. 하지만 요코하마시립대학병원과 같은 중대한 의료과오가 발생한 이후 검사가 의료과오를 기소하는 태도를 보이고 있다. 의료사고는 의료관계자간 역할분담의 형태가 과실 인정에서 중요한 하나의 요소가 된다. 요코하마시립병원사건에서는 환자의 동일성확인에 관하여 의료관계자 사이에 역할분담이 확립되지 않은 경우에는 관계자 전원이 환자의 동일성을 확인하여야 할 의무가 있다고 하였다. 또 사이타마 의과대학병원사건에서는 치료에 신중할 필요가 있는 중대한 증례에 관해서는 그 증례를 담당하는 주치의 뿐 만 아니라 대학병원의 과장도 치료방침에 관하여 확인할 의무가 있다고 하였다. 현립 오오노병원사건에서 무죄판결이 내려진 이후는 형사소추에 신중을 기할 필요가 있다는 목소리가 강해지고 있다. 이러한 상황 속에서 후생노동성은 의료사고방지를 위해 의료사고조사제도를 도입하여 의료사고에 제3자기관에 의한 검증의 강화를 도모하고 있다.

• Journal of Yeungnam Medical Science
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• 제26권1호
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• pp.74-77
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• 2009

말초에서부터 야기된 행동장애가 존재하는지 아니면 말초 신경 손상 후의 행동장애가 심리적인 것으로 인한 것인지에 대한 논의가 계속되고 있다. 말초 신경 손상에 의해 야기된 상지의 진전에 대한 증례를 보고하고자 한다. 25세 남자환자는 자동차 사고 이틀 후 상지의 통증과 진전이 발생하였다. 뇌 및 경추의 자기공명영상 촬영상 특이소견이 없었다. 과거력상 특이 소견 없었으며 행동장애에 대한 가족력 또한 없었다. 그는 하루에 약 네 차례에서 여섯 차례 십분 이상 지속되며 악화되는 진전으로 고통 받았다. 약물 치료, 경막외주사 주입, 경추의 신경차단술, 통증유발부위 주사요법 등으로 통증 조절을 하였다. 그 결과 통증이 반 정도 줄었으며 진전의 강도, 시간, 빈도가 줄어들었다.

• Journal of Acupuncture Research
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• 제38권2호
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• pp.134-139
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• 2021

Background: This study aimed to investigate the demographic characteristics of patients with knee pain caused by traffic accidents and test the effectiveness of Korean medicine (KM) treatment. Methods: The medical charts of 114 inpatients with knee pain caused by a traffic accident were reviewed from July 1, 2019 to October 31, 2019 at Bucheon Jaseng Hospital of KM. The patients' demographics including gender, age, period of hospitalization, and type of pharmacopuncture and herbal medicine prescribed were reviewed. The Numeric Rating Scale scores and Western Ontario and McMaster Universities Osteoarthritis Index scores were used to assess subjective knee pain. Results: There were more females (55%) than males in this study. Patients were more likely to be in their 30s (27.2%), be hospitalized for 11-14 days (41.2%), treated with Hwangryunhaedok pharmacopuncture (78.1%), and be prescribed Hwalhyeoljitong decoction (62.3%).The mean Numeric Rating Scale score for patients with knee pain caused by a traffic accident decreased significantly from 4.26 ± 1.39 to 2.53 ± 1.60 (p < 0.001), and the mean Western Ontario and McMaster Universities Osteoarthritis Index score also decreased significantly from 32.72 ± 18.36 to 23.40 ± 15.80 (p < 0.001) following KM treatment. Conclusion: As a result of analyzing 114 hospitalized patients with knee joint pain due to TAs, inpatients were more likely to be female (55%), a patient in their 30s (27.2%), and be a patient hospitalized for 11-14 days (41.2%). KM treatment of traumatic knee injury using pharmacopuncture therapy and herbal medicine can be an may be effective at reducing pain, and healing functional disorders of the knee.

• 대한한방내과학회지
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• 제44권5호
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• pp.1083-1091
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• 2023

Objectives: The purpose of this study was to report a case of a woman with intractable hiccups after a traffic accident through Korean medicine treatment. Methods: A combination of treatments, including herbal medicine (Soshiho-tang), pharmacopuncture, acupuncture, Chuna, cupping, and moxibustion, was administered to the patient for 21 days. The frequency and duration of hiccups, the degree of body shaking, and total sleep time were measured daily. The accompanying symptoms were measured daily using the Visual Analogue Scale. Results: After Korean medicine treatment, Hiccup symptoms disappeared. Further, the degree of clinical symptoms and QOL improved significantly after Korean medicine treatment. No adverse events were observed. Conclusions: This study suggests that Korean medicine treatment can be an effective treatment for intractable hiccups after traffic accidents.

• 대한간호학회지
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• 제35권2호
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• pp.399-406
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• 2005

Purpose: The purpose of this study was to investigate the factors that affect the psychological well-being in family caregivers of stroke patients. Method: The General Health Perception, short form 36, Health Survey Questionaire was used to measure health perception. The Caregiving Mastery Scale was used to assess the mastery, while the Psychological General Well-Being Index was used to examine the level of well-being. Result: Subjective health, caregiving mastery, patient's ADL and caregiving duration influenced on caregiver's psychological well-being. Subjective health had effect on psychological well-being both directly and indirectly. Caregiving duration and patient's ADL had indirect effect on psychological well-being through caregiving mastery. Conclusion: It is need to develop a health program for the caregivers of stroke patient's and to provide nursing intervention to improve the caregiver's ability, thereby improving the well-being of the family caregivers.