• 한국응급구조학회지
• /
• 제14권3호
• /
• pp.57-69
• /
• 2010

Purpose: This study aims to examine perceived safety management in teachers working for young children with disabilities, to grasp the state and problems of safety management and first-aid education at daycare center for young children with disabilities, and to provide basic materials to develop programs for safety management and first-aid education. Results: 1. For the perception items of accident possibility in daycare centers, career with more than 10 years had higher response in 'very high' and 'moderately high' than 'moderately or very low' and statistically significant difference was found(p < .05). 2. For the perception items of accident prevention in daycare centers, no teaches with at least college education thought that 'it was not possible to prevent' and most of them thought that 'it was totally possible to prevent' and statistically significant difference was found(p < .05). 3. For the performance level of safety management and first-aid items, forty and over(4.73) showed higher than age of 20-29(4.32) and 30-39 of age(4.26) and statistically significant difference was found(p < .05). 4. For the knowledge level of safety management and first aid items, the highest religion was found as Christian(16.96), followed by Catholic(15.33), Buddhism(14.91), and no religion(15.81) and statistically significant difference was found(p < .05). 5. For the items of confidence in safety management and first aid, performance level, and knowledge level, teachers who competed safety management and first-aid education( 4,48) had higher performance score than those who did not (4.17) and statistically significant difference was found(p < .05). 6. For the items of confidence in safety management and first aid, performance level, and knowledge level, teachers who competed first-aid education(2.77) had higher confidence than those who did not(2.35) and statistically significant difference was found(p < .05). Conclusion: The results suggest that safety management and first-aid education in teachers working for daycare center for young children with disabilities was closely correlated with knowledge and performance levels. Thus, it is necessary to provide continuous safety management and first-aid education for teachers working for day care center for young children with disabilities through regular in-service training. Also further research should be conducted with all subjects and various regions who contact with young children with disabilities.

• 한국전자통신학회논문지
• /
• 제13권2호
• /
• pp.463-472
• /
• 2018

본 예비 연구는 국내 병원 작업치료실에서 상지 재활도구의 보유현황과 사용상 문제, 그리고 개선 필요성을 조사하고자 하였다. 연구자는 소셜 네트워크 서비스를 통하여 병원환경 작업치료실에서 근무하는 임상가를 대상으로 설문을 1차와 2차로 구분하여 실시하였다. 1차 설문은 72개를 분석하였으며, 2차 설문은 47개를 분석하였다. 1차 설문에서 16개의 상지 재활도구의 보유율은 29.2~97.2%로 확인되었으며, 2차 설문에서 9개의 상지 재활도구의 사용경험은 36.2~97.9%로 확인되었다. 또한 2차 설문에서 상지 재활도구의 사용상 문제는 47명 중 15명(31.9%)이 불편함을 호소하고 있었으며, 개선 필요성은 23명(49%)이 개선이 필요하다고 응답하였다. 개방형 설문형태로 취합한 9개의 상지 재활도구의 사용문제는 흥미, 내구성, 난이도, 다양한 방향에 대한 조절기능, 설치 및 편리성 부족으로 구분할 수 있었다. 개선사항은 디지털화, 내구성, 난이도, 조절기능, 편리성 증대로 구분할 수 있었다. 본 예비 연구는 국내 병원 작업치료실의 상지 재활도구의 보유현황과 사용경험을 확인할 수 있었으며, 추후 상지 재활도구의 문제점과 개선 필요성에 대한 폐쇄형 설문지의 개발에 근거자료가 될 것이다.

• 한국임상수의학회지
• /
• 제30권2호
• /
• pp.87-94
• /
• 2013

본 회고 연구에서는 동맥관 개존증에 이환된 개에서 심장중재술을 통한 치료증례의 임상적 특징과 치료예후를 조사하였다. 환축의 구성을 보면, 말티스와 암컷이 차지하는 비중이 컸다. Bounding pulse와 좌심저부의 심잡음이 가장 대표적인 신체검사 소견이며, differential cyanosis은 매우 드물게 관찰되었다. 심전도상 특징은 좌심종대소견과 동성빈맥이였다. 흉부방사선상 좌심실 종대와 대동맥 확장을 동반한 triple bumps가 대표적인 소견이 였다. 심초음파상 특징은 좌심실 종대를 동반한 폐동맥 단축단면상 심각한 와류 소견이였으며, 다수의 환자에서 이첨판 역류 소견도 관찰되었다. 37증례 중 32증례에서 thromboemolic coils (TCE)이나 Amplatz canine ductal occluder (ACDO)를 이용한 심장 중제술적 치료가 실시되었다. 일시적인 혈색소뇨가 관찰되었고 장착된 코일이나 ACDO가 이탈되는 부작용이 확인되었다. 하지만 장기 관찰이 가능했던 29증례에서 특별한 부작용은 관찰되지 않았다.

• 디지털융복합연구
• /
• 제13권10호
• /
• pp.425-436
• /
• 2015

본 연구는 우리나라의 고혈압 의료비의 지역별 변이와 지역의 사회학적, 의료공급, 건강행태 등의 변이 요인을 규명함으로써 이를 기반으로 지역별 고혈압 관리 사업 방안 마련에 기초자료를 제시하는 것이다. 이를 위해 전국 시 군 구 247개 지역을 대상으로, 2012년 지역별 의료이용 통계자료(국민건강보험공단), 지역사회건강조사(질병관리본부) 및 국토해양부 자료를 이용 분석하였다. 연구결과 전국 247개 시 군 구의 고혈압 건강보험진료비는 평균 6만2천원이었고 변동계수는 30.0으로 지역 간 높은 고혈압 의료비 변이를 보였다. 주요 변이 요인으로는 인구밀도, 유배우자율, 평균가구원수입, 인구십만명당병원수, 관외의료비비율, 월간음주율, 중증도이상신체활동실천율, 평생의사진단율 등으로 나타났다. 의사결정나무를 이용한 분석 결과 평생의사진단율, 평균가구원수입, 유배우자율, 인구십만명당병원수, 비만율, 월간음주율에서 유의한 차이가 있었다. 본 연구의 결과 고혈압 의료비의 지역 간 변이요인으로는 의료공급이나 인구사회학적 특성뿐만 아니라 건강행태에 있음을 확인하였고 이는 고혈압의료비 절감을 위한 지역보건사업 정책 결정에 참고가 될 수 있을 것이다.

• 한국산학기술학회논문지
• /
• 제11권10호
• /
• pp.3808-3819
• /
• 2010

본 연구는 장기요양보험 인정자로 판정받은 노인들의 삶의 질 수준을 알아보고, 삶의 질에 영향을 미치는 관련요인들을 규명해 보고자 시도하였다. 조사대상은 65세 이상 노인 중 2008년 7월부터 실시된 노인장기요양보험제도에 의해 장기요양인정자로 판정받은 노인 958명(1등급 305명, 2등급 323명, 3등급 330명)으로 하였으며, 조사는 2009년 3월 1일부터 5월 31일까지의 기간 동안에 표준화된 무기명식 면접조사용 설문지를 사용하여 면접조사를 실시하였다. 연구결과, 전체 조사대상자의 삶의 질 평균점수는 $55.4{\pm}15.62$점이었으며, 장기요양등급별로는 1등급이 $49.7{\pm}14.17$점, 2등급이 $56.8{\pm}14.62$점, 3등급이 $59.4{\pm}16.36$점으로 등급이 높을수록 삶의 질 점수는 유의하게 낮은 것으로 나타났다. 노인들의 장기요양등급별 삶의 질에 영향을 미치는 변수를 알아보기 위해 다중 회귀분석을 실시 한 결과에서는 교육정도, 월수입, 주관적 건강상태, 우울 및 인지기능장애가 1, 2, 3등급에서 공통으로 유의하게 영향을 미치는 것으로 나타났으며 45~62%로 비교적 높은 설명력을 보였다.

• 한국화재소방학회논문지
• /
• 제30권3호
• /
• pp.133-137
• /
• 2016

본 연구의 목적은 전국 소방서에 근무하는 소방공무원 중 2011년부터 2013년까지 근골격계 질환으로 공상을 신청 한 510명을 대상으로 자료를 분석하여 그 특성에 대해 알아보고, 공상 예방을 위한 대책을 제시하는 것이다. 2011년 1월부터 2013년 12월까지 공상을 신청한 1596명의 공상신청자의 정보를 국민안전처로부터 제공받아 주병명을 기준으로 근골격계 질환을 판별하여 이 중 510명을 최종 연구대상으로 하였다. 공상신청자는 남성이 92%로 여성보다 월등히 많았고, 공상발생 연령은 40대 초반이 가장 많았다. 공상이 발생한 시기는 5월과 6월이 가장 높았다. 지역별로 공상신청이 가장 많은 지역은 서울이었고 공상 발생만인율이 가장 높은 곳은 전북이었다. 공상신청이 가장 잦은 부위는 허리가 제일 많았고 무릎이 그다음 이었다. 신체구조는 인대가 가장 많고 추간판과 뼈 순이었다. 공상발생 당시 직무는 화재진압 38.3%, 구급 37.7%, 구조 12.4%, 기타 순이었다. 앞으로 지역 간 공상신청 빈도차이를 좀 더 세밀히 조사할 필요가 있고, 소방 직부별 부상기전과 예방방안에 대한 연구가 필요하다.

• 보건행정학회지
• /
• 제30권2호
• /
• pp.185-191
• /
• 2020

Background: From January 2018, a policy was applied to differentially apply the co-payment for medical expenses of 15,000 won or more from 30% to 10%-30% for each medical fee. This policy lowers the burden on the medical use of the elderly, and it is necessary to analyze the effect of the policy by confirming changes in medical use and supply behavior after 2 years. Methods: The National Health Insurance Service's national medical use database was used. As for the analysis method, first, the medical use and medical supply behavior change over the age of 65 years were confirmed, and second, in order to check the net effect of the policy, the 66-year-old as the experimental group and the 63-year-old as the control group were selected as the control group. The propensity score matching was performed using the variables of age, living alone, income quartile, residence, disability, chronic disease, and co-morbid disease scores, and then it was analyzed using the difference in difference analysis method. Results: The share of the number of treatments under 15,000 won decreased from 37.0% in 2017 to 20.2% in 2018, while the share of the number of treatments under 15,001-20,000 won increased from 8.0% to 22.7%. It was confirmed that the reason for the increase in the cost of treatment per treatment was the result of the increase in the amount of physical therapy and examination. As a result of the policy effect, the burden of co-payment per person was reduced, and as a result, the number of hospital visits per person and the total medical cost per person increased. Conclusion: The self-pay rate differential policy reduced the burden of medical expenses for the elderly and confirmed the increase in medical use. However, the interpretation of the increase in medical use was not able to distinguish whether the unsatisfactory medical care was satisfied or the inducement demand. Efficient allocation of resources is a more important point in the future when the super-aged society is in front. It is necessary to prepare a plan to induce rational medical use within a range that does not impair the medical accessibility of the elderly.

• Journal of Preventive Medicine and Public Health
• /
• 제11권1호
• /
• pp.86-97
• /
• 1978

The mobile medical service has been operated for many years by a number of medical schools and hospitals as a most convenient means of medical service delivery to the people residing in such area where the geographical and socioeconomic conditions are not good enough to enjoy modern medical care. Despite of official appraisal showing off simply with numbers of outpatients treated and medical persons participated, however, as well recognized, the capability (in respect of budget, equipment and time) of those mobile medical teams is so limitted that it often discourages the recipients as well as medical participants themselves. In the midst of rising need to secure medical service of good quality to all parts of the country, and of developing concept of primary health care system, authors evaluated the effectiveness of and problems associated with mobile medical servies program through the community diagnosis of a village (Opo-myun, Kwangju-gun) to obtain the information which may be halpful for future improvement. 1. Owing to the nationwide Sae-Maul movement powerfully practiced during last several years, living environment of farm villages generally and remarkably improved including houses, water supply and wastes disposal etc. Neverthless, due to limitations in budget time and lack of knowledge (probably the most important), these improvements tend to keep up appearances only and are far from the goal which may being practical benefit in promoting the health of the community. 2. As a result of intensive population policy led by the government since 1962, there has been considerable advances in understanding and the rate of practicing family planning through out the villages and yet, one should see many things, especially education, to be done. Fifty eight per cent of mothers have not received prenatal check and the care for most (72%) delivery was offered by laymen at home. 3. Approximately seven per cent of the population was reported to have chronic illness but since only a few (practically none) of the people has had physical check up by doctors, the actual prevalence of chronic diseases may reach many times of the reported. The same fact was observed also in prevalence of tuberculosis; the patients registered at local health center totaled 31 comprising only 0.51% while the numbers in two neighboring villages (designated as demonstration area of tuberculosis control and mass examination was done recently) were 3.5 and 4.0% respectively. Prevalence rate of all dieseses and injuries expereinced during one month (July, 1977) was 15.8%. Only one tenth of those patients received treatment by physicians and one fifth was not treated at all. The situation was worse as for the chronic patients; 84% of all cases either have never been treated or discontinued therapy, and the main reasons were known to be financial difficulty and ignorance or indifference. 4. Among the patients treated by our mobile clinic, one third was chronic cases and 45% of all patients, by the opinion of doctors attended, were those who may be treated by specially trained nurses or other paramedics (objects of primary care). Besides, 20% of the cases required professional managements of level beyond the mobile team's capability and in this sense one may conclude that the effectiveness (performance) of present mobile medical team is quite limitted. According to above findings, the authors would like to suggest following for mobile medical service and overall medicare program for the people living in remote country side. 1. Establishment of primary health care system secured with effective communication and evacuation (between villages and local medical center) measures. 2. Nationwide enforcement of medical insurance system. 3. Simple outpatient care which now constitutes the main part of the most mobile medical services should largely be yielded up to primary health care unit of the village and the mobile team itself should be assigned on new and more urgent missions such as mass screening health examination of the villagers, health education with modern and effective audiovisual aids, professional training and consultant services for the primary health care organization.

• 지역사회간호학회지
• /
• 제9권2호
• /
• pp.280-290
• /
• 1998

This study was carried out to idenify the health problems and needs of crippled persons in order to develop a community based rehabilitation service program through public health center. Information on health problems and needs were obtained from 120 crippled persons staying at home by questionaire and a measuring ADL. The results were summarized as follows 1. Among 120 subjects, male crippled (70.3%) outnumbered female crippled (29.7%). Many crippled persons belonged to the 40-49 age group (33.6%) while others were over 60 years (17.4%). There were 36.8% crippled persons with an elementary education, 26.5% had completed high school, 14.5% had completed middle school. 31% of the crippled persons were employed but most of them had unskilled jobs. 80% of the respondents replied that their monthly income was under 800,000 won. 2. The major causes of their handicap were due to acquired factors(92%) such as accidents, in fectious & communicable diseases and chronic diseases rather than congenital factors(8%). Crippled persons who belong to the first grade of disabilities were 14.8%, the second grade 35.7%, the third grade 21.7%, the forth grade 12.2%, the fifth grade 12.2% and the sixth grade 3.5%. 3. This study measured the degree of the ADL of crippled persons by a modified Barthel Index including 11 items. 73.5% of them were fully independent, 8.5% required minimal help, 2.7% required moderate help, 6.0% required substantial help and 9.4% were unable to perform task. In response to the 11 items of ADL, crippled persons required more help in stair climbing, ambulation and bathing than in other items. 4. In responding to concerning health problems, 10.3% of the subjects replied with incontinence, 8.5% malnutrition, 7.6% fecal incontinence and bedsores 2.6%. Chronic diseases which needs treatment were chronic pain(61.0 %), hypertension(16.5%) and diabetes(16.5%) 5. To the question of what type of rehabilitation services subjects required, chronic diseases management(52.1%) and physical therapy (41.2%) were the highest. The most important social welfare services subjects required were economics support (51.3%) and introductions to job opportunities(42%).

• 한국산학기술학회논문지
• /
• 제11권6호
• /
• pp.2169-2177
• /
• 2010

본 연구는 공무원들의 스트레스나 피로수준과 같은 사회심리적 건강상태가 그들의 직급, 근무경력 등의 직업관련 특성이나 업무요구도, 업무자율성, 직장 내에서의 사회적 지지와 같은 직무스트레스 내용에 의해 영향을 받고 있는지를 구조방정식모형을 통하여 검토하고자 시도하였다. 연구대상은 대전광역시의 5개 정부 공공기관에 근무하는 일반 사무직 행정공무원 805명이었으며, 자료 수집은 2009년 10월 1일부터 11월 30일까지의 기간 동안에 표준화된 자기기입식 설문지(self-administered questionnaire)를 사용하여 실시하였다. 연구결과, 공무원들의 스트레스 및 피로수준은 직급, 근무경력, 업무만족도, 업무자율성, 상사의 지지도 및 동료의 지지도와는 유의한 음의 상관관계를 나타낸 반면, 년 간 결근일수, 업무요구도와는 유의한 양의 상관관계를 나타내었다. 구조방정식모형 분석 결과 연구대상자들의 직무스트레스 요인은 직업관련 특성 요인보다 사회심리적 건강상태에 더 큰 영향을 미쳤으며, 직무스트레스가 높을수록 사회심리적 건강상태를 나타내는 스트레스와 피로수준을 높여주는 것으로 나타났다. 한편, 직업관련 특성의 인지정도가 높을수록 직무스트레스 요인을 감소시키는 효과가 있는 것으로 나타났다. 따라서 공무원들의 스트레스나 피로를 감소시키기기 위해서는 직업관련 특성에 따른 직무내용의 개선을 위한 프로그램의 개발 및 시행이 필요할 것으로 생각된다.