• 디지털융복합연구
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• 제14권9호
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• pp.331-339
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• 2016

경제성장과 함께 생활습관 변화로 인한 만성질환이 지속적으로 증가하고 있다. 그 중 심뇌혈관질환은 사망원인의 약 20%를 차지하는 우리나라의 주요 사망원인이다. 심장의 이상을 측정하는 검사는 심전도검사로, 심장의 리듬을 전기적으로 측정하여 평가하는 방법이다. 심전도 검사에서 가장 영향을 미치는 것은 전극의 부착 위치인데, 간호사를 대상으로 연구한 결과에 따르면 모두 정확하게 부착한 것은 2.6%로 나타났다. 따라서 본 연구는 이러한 문제를 해결하기 위해 프로젝션 기반의 증강현실 기술을 사용하여 환자 본인의 Chest X-ray 사진을 흉부에 중첩시켜 투영시킴으로써 정확한 전극 부착위치를 쉽게 알 수 있는 시스템을 개발하였다. 기존의 방법으로 측정한 결과와 개발한 시스템으로 측정한 결과를 비교하였더니 2.6cm의 오차를 보였다. 그에 따른 심전도 결과에서도 V1, V2, V3위치에서 눈에 띄는 파형의 차이가 있었다. 본 시스템으로 정확하게 측정된 심전도는 의료진들의 환자관리 및 임상적 의사결정에 크게 도움이 될 것이다.

• Journal of Korean Biological Nursing Science
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• 제23권3호
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• pp.170-179
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• 2021

Purpose: The aim of this study was to identify core keywords and topic groups in the 'Diabetes mellitus and mobile applications' field of research for better understanding research trends in the past 20 years. Methods: This study was a text-mining and topic modeling study including four steps such as 'collecting abstracts', 'extracting and cleaning semantic morphemes', 'building a co-occurrence matrix', and 'analyzing network features and clustering topic groups'. Results: A total of 789 papers published between 2002 and 2021 were found in databases (Springer). Among them, 435 words were extracted from 118 articles selected according to the conditions: 'analyzed by text network analysis and topic modeling'. The core keywords were 'self-management', 'intervention', 'health', 'support', 'technique' and 'system'. Through the topic modeling analysis, four themes were derived: 'intervention', 'blood glucose level control', 'self-management' and 'mobile health'. The main topic of this study was 'self-management'. Conclusion: While more recent work has investigated mobile applications, the highest feature was related to self-management in the diabetes care and prevention. Nursing interventions utilizing mobile application are expected to not only effective and powerful glycemic control and self-management tools, but can be also used for patient-driven lifestyle modification.

• 간호행정학회지
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• 제13권3호
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• pp.352-361
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• 2007

Purpose: The purpose of this study was to develop roles and organizational policy of advanced practice nurses (APNs) in an acute hospital setting. Method: The design of the study was to descriptive-exploratory. Sample consisted of 43 participants who included 13 nurses, 18 nurse managers and 12 physicians. Survey, interview and focus group interview were performed to obtain the data. Results: The expected roles of APNs were education and counseling, direct management patient care with advanced skills, research, and collaboration and coordination among several departments. The expected outcomes were patient satisfaction, improved access to care, decreased the rate of complications, and speedy provision of services. Based on research, a proposal of APNs roles and organizational policy in a hospital setting was developed, which included definition of APNs, qualification, roles and specific roles, specialty areas, accountability, recruitment and affiliation, privileges, and expected outcomes. Conclusion: This study gives a guideline on how to introduce and use APNs in acute care tertiary settings.

• Archives of Plastic Surgery
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• 제43권3호
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• pp.242-247
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• 2016

Background Median cleft lip is a rare anomaly consisting of a midline vertical cleft through the upper lip. It can also involve the premaxillary bone, the nasal septum, and the central nervous system. In our current report, we present the clinical features of 6 patients with a median cleft lip and their surgical management according to the accompanying anomalies. Methods From December 2010 to January 2014, 6 patients with a median cleft lip were reviewed. Five of these cases underwent surgical correction; alveolar bone grafting was performed in a patient with a median alveolar cleft. The surgical technique included inverted-U excision of the upper lip and repair of the orbicularis oris muscle. The mean follow-up period was 20.4 months (range, 7.4-44.0 months). Results The study patients presented various anomalous features. Five patients received surgical correction, 4 with repair of the median cleft lip, and one with iliac bone grafting for median alveolar cleft. A patient with basal sphenoethmoidal meningocele was managed with transoral endoscopic surgery for repair of the meningocele. Successful surgical repair was achieved in all cases with no postoperative complications. Conclusions Relatively mild forms of median cleft lip can be corrected with inverted-U excision with good aesthetic outcomes. In addition, there is a broad spectrum of clinical features and various anomalies, such as nasal deformity, alveolar cleft, and short upper frenulum, which require close evaluation. The timing of the operation should be decided considering the presence of other anomalies that can threaten patient survival.

• 대한두개안면성형외과학회지
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• 제18권2호
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• pp.97-104
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• 2017

Background: Nasal bone fracture is one of the most common facial bone fracture types, and the surgical results exert a strong influence on the facial contour and patient satisfaction. Preventing secondary deformity and restoring the original bone state are the major goals of surgeons managing nasal bone fracture patients. In this study, a treatment algorithm was established by applying the modified open reduction technique and postoperative care for several years. Methods: This article is a retrospective chart review of 417 patients who had been received surgical treatment from 2014 to 2015. Using prepared questionnaires and visual analogue scale, several components (postoperative nasal contour; degree of pain; minor complications like dry mouth, sleep disturbance, swallowing difficulty, conversation difficulty, and headache; and degree of patient satisfaction) were evaluated. Results: The average scores for the postoperative nasal contour given by three experts, and the degree of patient satisfaction, were within the "satisfied" (4) to "very satisfied" (5) range (4.5, 4.6, 4.5, and 4.2, respectively). The postoperative degree of pain was sufficiently low that the patients needed only the minimum dose of painkiller. The scores for the minor complications (dry mouth, sleep disturbance, swallowing difficulty, conversation difficulty, headache) were relatively low (36.4, 40.8, 65.2, 32.3, and 34 out of the maximum score of 100, respectively). Conclusion: Satisfactory results were obtained through the algorithm-oriented management of nasal bone fracture. The degree of postoperative pain and minor complications were considerably low, and the degree of satisfaction with the nasal contour was high.

• 보건행정학회지
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• 제21권2호
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• pp.195-212
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• 2011

Objectives: This study investigates the relationship between nurse staffing levels and differences in patient outcomes in terms of average length of stay, in-hospital mortality rate and 30-day death rate in order to evaluate the effectiveness of a policy that differentiates fees for inpatients on the basis of nurse-to-bed ratios. Methods: We obtained information on inpatients from health insurance claims data published by the Health Insurance Review and Assessment Service(HIRA) in 2008, organizational factors(type of hospital, ownership) from the records of the hospital report system in 2008, and nurse staffing levels, which were graded on a scale of 1 to 7, from data compiled between December 15, 2007, and September 20, 2008. The data were segregated according to type of hospital and quarter and finally 3,517 records of 1,182 hospitals were analyzed using multi-level analysis. Results: The average length of stay in grade 1~6 hospitals was lower than that in grade 7 ones, but the difference was much below one day. No significant difference was found among different grades in tertiary hospitals. Further, variations in staffing levels did not result in any significant difference in the in-hospital mortality rate and 30-day death rate. Conclusions: High nurse staffing levels did not result in better patient outcomes compared with low staffing levels. We therefore recommend modifying the above nurse staffing policy so as to make it more effective in improving patient outcomes.

• 융합보안논문지
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• 제7권2호
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• pp.101-106
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• 2007

최근 유비쿼터스 컴퓨팅 기술을 활용한 다양한 분야중 uHealthcare는 인간의 건강을 보다 효과적으로 관리할 수 있는 기술로서 각광을 받고 있다. 기존의 Healthcare 기술에서 환자와 의사를 원격으로 연결하여 진료행위를 하던 단순한 체계에서 센서 기술의 발전과 휴대기기의 발달로 환자가 진료행위를 인지하지 못하는 환경으로 급격하게 발전하고 있다. 하지만 uHealtcare에서의 인프라가 급성장함에 있어 생성되는 수많은 센서 상황정보를 처리 및 관리하기 위한 방안에 대한 연구가 미비한 상황이다. 상황인식 기술은 사용자로부터 상황정보를 획득하여 정보를 인식하고 관리하기 위한 방안이다. 하지만 인식한 상황정보를 어떻게 관리하고 효과적으로 제공할 것인지에 대한 연구가 부족한 상태이다. 개인화된 사용자로부터 발생하는 수많은 상황정보를 효율적으로 관리 및 보호하기 위한 연구가 요구된다. 기존 연구에서 상황정보를 정의 하고 인식하기 위한 연구를 중심으로 진행되었다면 인식된 수많은 상황정보를 안전하게 제공하기 위한 연구가 필요하다. 특히, 이러한 연구는 상황정보의 활용도가 매우 높은 의료환경을 중심으로 연구할 필요성이 있다. 따라서 본 논문에서는 환자로부터 의료 행위에 관련된 정보를 RFID를 사용하여 입원관련 정보, 입원실 위치, 환자의 이동 경로, 습도, 온도, 진료현황 등에 대한 상황정보를 전달받아 저장 및 관리 방법으로 태그 매칭을 도입하여 정보를 관리하기 위한 방안을 제시한다.

• 치위생과학회지
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• 제18권3호
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• pp.155-163
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• 2018

This study's aim was to investigate their opinions to improve the educational system for dental hygienists on the basis of their duties as dental hygienists. The qualitative study was conducted among 19 dental hygienists at Daejeon, Korea from July to August 2016. Two researchers followed each subject for working hours in a day and recorded all the tasks and time to take for each task. After one day, the researchers met each subject and conducted face-to-face interviews to investigate the opinions about the dental hygiene curriculum and national board examination. The main duties recognized by more than half of the subjects were oral disease prevention including scaling and dental treatment assistance. The subjects' minority opinion about the main duties included radiography, impression taking, dental implant surgery assistance, orthodontic treatment, patient counseling, dental management and staff management, and oral health education. The most important tasks perceived by the subjects were prosthetic and implant impressions, scaling and implant surgery assistance. The subjects' minority opinion about the most important duties included patient counseling and making temporary crowns. The most difficult tasks answered by the subjects were prosthetic and implant impressions and dental implant surgery assistance. The subjects' minority opinion about it included patient counseling, scaling, and making temporary crowns. They mentioned that their curriculum in college was different from the actual work and the national board examination was not reflective of their real duties. We found out Korean dental hygienists had a lot of roles as dental assistants, dental business managers, and so on. We suggest that the law, curriculum and national board examination for dental hygienists should be revised to be able to reflect the reality of the clinical field.

• 보건행정학회지
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• 제32권3호
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• pp.323-329
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• 2022

Background: This study aimed to identify the characteristics of the referral and return of patients to clinics in the endocrinology and cardiology departments at the National Health Insurance Service Ilsan Hospital to evaluate the "referral and return of patients to clinics" program and reduce the rate of returning patients. Methods: From May 2018 to December 2020, we identified the number of visits to referral hospitals and hospital usage status at Ilsan Hospital after returning to clinics. We also identified the patients who returned to Ilsan Hospital within 6 months, defined as "failure to transport," among those recommended to be transported to clinics of the Medical Cooperation Center. Additionally, we evaluated the characteristics of the "failure to transport" patients. Results: Among the returning patients, the rate of visiting Ilsan Hospital within 6 months was higher in cardiology than in endocrinology (25.1% vs. 16.7%). Older age, more severe disease, and more number of visits to the department were associated with a high rate of failure to transport. The rate of failure to return was low in cases diagnosed with hyperlipidemia/lipoprotein metabolism disorder. With respect to diabetes, the rate of failure to transport differed according to each type of diagnosis of diabetes. Conclusion: The success rate of the "referral and return of patient to clinics" program differed based on each patient's characteristics, department of visit, and diagnosis. Individualizing according to the visit department and diagnosis is required to ensure successful transfers, and infrastructure expansion and institutional arrangements must be facilitated.

• 지역사회간호학회지
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• 제33권4호
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• pp.357-371
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• 2022

Purpose: This study aims to investigate factors related to long-term length of stay (LOS) of patients with chronic diseases in Korean veterans hospitals. Methods: The subjects were 196 elderly patients with chronic disease staying in the hospital for more than 10 days, Data were collected by the survey of patients with structured questionnaires and medical records review by nurses from July 15 to August 10, 2019. Collected data were analyzed using t-test, ANOVA, Pearson's correlation coefficient and stepwise multiple regression. Results: The present and desired LOS were 37.78±32.66 days and 60.87±45.95 days, respectively. Factors affecting hospital LOS were found to be main disease (genitourinary) (p<.001), assistance in activities of daily living (p<.001), area of hospital (p<.001), payment of medical fees (p=.026), hospital satisfaction (p=.036) and the explanatory power of these variables was 26.4%. The most common health problems that need to be solved after discharge were symptom alleviation and health promotion. These problems can be solved using community-based facility services or visiting medical-welfare services (especially home care nursing). Conclusion: In order to reduce hospital LOS, the following measures are required: personalized self-management education, provision of transportation services for dialysis therapy of inactive patients, linking patients with visiting medical-welfare services including home care nursing and mobile healthcare services, operation of the case management system including the notice of the discharge date at admission, interim check of patient status, and connecting the patient with community resources or transferring the patient to long-term care facilities at discharge.