• 기본간호학회지
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• 제23권2호
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• pp.172-183
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• 2016

Purpose: The purpose of this study was to explore the subjective experience of life-sustaining treatment care among nurses in intensive care units. Method: A phenomenology was used for the study. Data were collected from October to December, 2015 using open-ended questions during in-depth interviews. Participants were nurses working in intensive care units and were contacted through purposive techniques. Eight nurses participated in this study. Results: Four categories emerged from the analysis using Colaizzi's method: (a) difficulties due to life-sustaining treatment care, (b) dilemma of extension or cessation of life-sustaining treatment, (c) repressed feelings and emotional exhaustion, and (d) forming values for life-sustaining treatment from nursing experience. Conclusion: Provision of clearer guidelines on life-sustaining treatment which reflect a family-oriented culture is important for nurses in ICU and will promote nurses involvement in the decision-making process of life-sustaining treatment of patients.

• 대한간호학회지
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• 제45권4호
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• pp.595-603
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• 2015

Purpose: The purpose of this study was to identify the factors relating to resilience for adolescents with leukemia and examine the relationship between these factors. Methods: From June to September in 2014, 199 adolescents aged 11 to 21 participated in the study as they visited the out-patient clinic at C university hospital for follow-up care. To verify the predictors and the effects of resilience, uncertainty, symptom distress, perceived social support, spiritual perspective, defensive coping, courageous coping, hope, and self-transcendence were measured. Collected data were analyzed using hierarchical regression analysis with the SAS statistics program. Results: The final regression model showed that courageous coping, hope, and self-transcendence were significant predictors related to resilience in adolescents with leukemia and explained for 63% of the variance in resilience. Conclusion: The findings indicate that adolescent-oriented intervention programs enhancing courageous coping, hope, and self-transcendence should be provide for adolescents with leukemia in order to overcome illness-related stress and support physical, psychological and social adjustment.

• Physical Therapy Rehabilitation Science
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• 제6권4호
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• pp.202-207
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• 2017

Objective: The self-decisions of the client regarding the meaningful work as a therapeutic approach of client-orientation. The Cognitive Orientation to daily Occupational Performance (CO-OP) is an occupation-oriented problem-solving approach. The purpose of this study was to describe the goals and intervention protocols of CO-OP in those affected by stroke. Design: A systematic review. Methods: Using EBSCOhost, PubMed, and ProQuest databases, we searched studies published in the past decade that utilized the CO-OP intervention. An initial search revealed 71,171 potential articles. After applying our search criteria to screen the titles, abstracts, and full-text, we included 7 articles that met our inclusion and exclusion criteria. In this study, we used the patient, intervention(s), comparison, outcome method to analyze the 7 selected studies. We analyzed the frequency of goals and intervention protocols. Results: Seven articles met our selection criteria; these studies included participants with an almost normal cognitive function from inpatient and outpatient rehabilitation facilities. CO-OP was used for 237 goals; the most used goal was the instrumental activities of daily living. The training procedure used 3 types of self-selecting goals in the activities. One of the goals was not trained, but was only evaluated to determine the generation effect. The most common outcome measurements included the Canadian Occupational Performance Measure and the Performance Quality Rating Scale. Conclusions: This research provided information about the effectiveness of CO-OP and selecting the correct evaluation tool to assess the efficiency of the intervention. This study suggests that treatment with CO-OP in occupational therapy is effective and that it outlines common protocols.

• 대한통합의학회지
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• 제2권3호
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• pp.15-22
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• 2014

Backround : The paradigm of recent education has been shifting from existing style of professor-oriented, passive and rote teaching to learner-centered education. Rather than mere delivery of knowledge, today's idea of education uses various audiovisual media to let learners gain more problem-solving skills, judgment, cognitive thinking ability, and creativity to apply to real practice. Also, while current trends and change in policy ask for related industry to require practice-centered teaching learning model, Problem-Based Learning (PBL) is quite effective that it activates problem-solving skills as well as application of National Competency Standards (NCS). Purpose : The purpose of this study was to suggest a teaching learning model article as an approach to apply web-based PBL for patient & medical charge management practices. Discussion & Conclusion : This paper the cases on PBL and presents the teaching learning model on web-based PBL as an approach to applying web-based PBL, which fits Medical Information System Department that combines health-medical treatment and computer applications, to practical health administrative affairs.

• 의료법학
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• 제11권2호
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• pp.75-112
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• 2010

This article analyses the concept of medicine in the legal context. It is not easy to define the concept of medicine because medical practice has various dimensions and the situation in which the practice is performed has a broad variety. The duty of medical law is to build the boundary of protection in that the nature of medicine would not be distorted by the factors of social systems like industry or governmental authorities. Without understanding the various dimensions - especially the dimension of Humanities and Sociology - of the medicine it is not possible to draw the limit on the performance of medicine appropriately. Concerning the medical practice (especially in the context of the regulation of medical licence), the enacted law (Medical Act) defines the concept just for form's sake and it finally depends on the interpretation of the legal enforcement authorities. Moreover, between the judgments of the courts there exists no coherent principles for the regulation and the interpretation of the Medical Act depends often on the riskiness, the abstract concept, which finally leads the interpretation to depend on the subject of the practice. On the contrary, the development and scientific movement of the technology tends to tighten the range of the medical professionals of medical practice and the perspectives of the medicine. Medical act is actually oriented at the patient's understanding of him- or herself. The above-mentioned tendency of the interpretation and the legal policy could lead the medicine away from its nature.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1995년도 추계학술대회
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• pp.86-89
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• 1995

A clinically oriented 32 channel Electroencephalogram (EEG) and evoked potential (EP) mapping system has been developed. The EEG and EP signals acquired from 32-channel electrodes are amplified by the pre-amplifier located near patient and are then tither amplified by main amplifier. An automatic artifact rejection scheme is employed using a neural network by which examination time is reduced substantially. Auditary and visual stimuli are used for the evoked potential mapping. A user-friendly graphical interface based on the Microsoft Window 3.1 is developed for the operation of the system. Statistical databases for the poop and individual comparisons are also included to support statistically based diagnosis.

• Journal of Korean Neurosurgical Society
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• 제59권3호
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• pp.310-313
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• 2016

Intracranial tuberculous subdural empyema (ITSE) is extremely rare. To our knowledge, only four cases of microbiologically confirmed ITSE have been reported in the English literature to date. Most cases have arisen in patients with pulmonary tuberculosis regardless of trauma. A 46-year-old man presented to the emergency department after a fall. On arrival, he complained of pain in his head, face, chest and left arm. He was alert and oriented. An initial neurological examination was normal. Radiologic evaluation revealed multiple fractures of his skull, ribs, left scapula and radius. Though he had suffered extensive skull fractures of his cranium, maxilla, zygoma and orbital wall, the sustained cerebral contusion and hemorrhage were mild. Eighteen days later, he suddenly experienced a general tonic-clonic seizure. Radiologic evaluation revealed a subdural empyema in the left occipital area that was not present on admission. We performed a craniotomy, and the empyema was completely removed. Microbiological examination identified Mycobacterium tuberculosis (M.tuberculosis). After eighteen months of anti-tuberculous treatment, the empyema disappeared completely. This case demonstrates that tuberculosis can induce empyema in patients with skull fractures. Thus, we recommend that M. tuberculosis should be considered as the probable pathogen in cases with posttraumatic empyema.

• 한국컴퓨터산업학회논문지
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• 제8권4호
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• pp.289-294
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• 2007

최근에 고령화 사회와 정보화 사회에 따른 운동량의 부족으로 인한 근육질환과 뇌졸중, 치매, 파킨슨병, 운동신경 질환 등 근질환 발생률이 급증하고 있으며 발생률을 조사한 결과, 남성경우 2배이상 증가했고, 파킨슨병과 운동신경질환 등 사망률은 남녀가 약 50%씩 늘어난 것으로 나타났다. 환경적 요인이 크게 작용하며 특히, 우려할 것은 급속히 증가하는 노인인구로 인한 노인성 질환 및 근질환의 대책이 무엇보다 요구되는 실정으로 발병하면 치료가 어렵고, 후유증이 심각하므로 무엇보다 예방이 중요하다 위험인자와 발생위험을 조기에 예방할 수 있도록 간접운동을 확인할 수 있는 시 저주파-초음파 장비를 통해 시중에 나와있는 장비의 기준을 정하고 특성시험과 모델링화 하여 성능의 우수성을 입증하여 정리하였다. 차후 시스템을 보완하면 다른 질병의 근질환 환자에도 적용이 될 것이고, 본 연구에서는 시제품을 직접 제작하여 비정형화 특성을 연구하고 접근해 보고자 노력하였다.

• 대한상한금궤의학회지
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• 제6권1호
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• pp.1-25
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• 2014

Objective : The purpose of this study is exploring value of Shanghanlun six diagnostic system as Narrative Medicine by analyzing cases. Methods : In the article, we examined the theory of narrative medicine and current studies. And then key elements of narrative medicine was defined. On the basis of these, two medical cases were analyzed by reordering in accordance with time sequences and causality for confirming narrative factors. Results : The narrative approach to analyzing cases shows us that different diseases could be the result of same pathological patterns based on Shanghanlun. This tells us following four aspects. [1] Shanghanlun is the causes-oriented records and the text includes narrative factors. [2] Shanghanlun six diagnostic system is a process of constructing plot of medical case history through the clinical interpretation of contextual meaning of patient's life. [3] In the process of diagnosis, Schemata and script are engaged in assuming and confirming six patterns diseases. [4] The subjective factors of an individual can be applied universally through the provision of Shanghanlun. Conclusions : Narrative factors of Shanghanlun six diagnostic system suggest the possibility and value of Shanghan Medicine as Narrative Medicine in terms of Medical Humanities, essence of medical diagnosis and therapeutic action.

• 보건교육건강증진학회지
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• 제32권4호
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• pp.59-65
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• 2015

Objectives: Health screening in Korea is very active in both the public and private sector. However, primary prevention for health promotion has not been activated yet. Quaternary prevention is the prevention of unnecessary medical interventions or the prevention of overmedicalization. Methods: Data was collected after a search of the literature focusing on keyword. The curriculum guidelines for family medicine residents were collected from the homepage of the American Academy of Family Physicians. Results: This quaternary prevention is just beginning. The first step to enhance the health promotion services in the community is to identify the barriers pertaining to the delivering of health promotion activities. These barriers are related to the patient, the physician, attitudes, health promotion programs and the healthcare system. The second step is to establish new changes, such as expansion of insurance coverage, improvement of medical payment system, provision of consumer-oriented services, connection and integration of providers, and the service provider education and training. Conclusions: In order to enhance the health promotion services in the community we need to identify the barriers and to establish several changes to overcome them.