• 대한전자공학회:학술대회논문집
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• 대한전자공학회 2000년도 제13회 신호처리 합동 학술대회 논문집
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• pp.959-962
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• 2000

A heart sound algorithm, which separates the heart sound signal into four parts; the first heart sound, the systolic period, the second heart sound, and the diastolic period has been developed. The algorithm uses discrete intensity envelopes of approximations of the wavelet transform analysis method to the phonocard-iogram(PCG)signal. Heart sound a highly nonstation-ary signal, so in the analysis of heart sound, it is important to study the frequency and time information. Further more, Wavelet Transform provides more features and characteristics of the PCG signal that will help physician to obtain qualitative and quantitative measurements of the heart sound.

• Journal of Preventive Medicine and Public Health
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• 제29권2호
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• pp.311-329
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• 1996

This study was designed to compare the level of medical utilization between the urban and rural areas of Korea and to explain the differences between the two regions. Data from the National Health Interview Survey performed by the Korean Institute of Health & Social Affairs in 1992 were used for this study utilizing a sample size of 21,841 people. The level of medical utilization such as the number of physician visits and the number of hospital admissions was compared between the regions with ANOVA. Various determinants for medical use were also compared by univariate analysis. Statistical models which included enabling factors, predisposing factors, need factors and region were constructed for bivariate analysis in order to further elucidate the level of medical utilization. The results were as follows: 1. There was greater medical use, both in terms of physician visits and inpatient care in the rural areas in spite of insufficient health resources. The particular reasons for higher medical utilization in rural areas were attributed to a higher number of initial physician visits as well as a longer the length of stay per hospital admission. Therefore, indicators representing the degree of met need (utilization/need) showed no significant difference between rural and urban areas in spite of the fact that the medical need is larger in rural areas. 2. Use of public health facilities received a significant portion of physician visits in the rural area. The government's effort to enhance primary health care through health centers, health subcenters and the nurse practitioner's post in rural areas has contributed to the increase of access to medical care in the rural areas. 3. There were some differences in the socio-demographic characteristics between two regions ; There were more elderly people over the age of 65: unstable marital status, less education and lower incomes also characterized the rural areas. Therefore, among rural people, there were more predisposing factors for medical use. Additionaly, need factors such as poor self-reported health status and high morbidity level were also high in the rural area. 4. In contrast it was learned that, the supply of health resources was mostly concentrated in the urban areas except for public health facilities. Therefore, geographical access to medical care was lower in the rural area both in terms travel time and travel cost. 5. The coefficient of the region variable was insignificant in the regression model which controlled the supply factor only. However, utilization was significantly higher in urban areas if the model included predisposing factors and need factors in addition to the supply factor. The results were interpreted as rural people have greater medical needs.

• 한국의료질향상학회지
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• 제9권2호
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• pp.116-133
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• 2002

Background : It is very common in Korea to take care of non-acute patients in an acute setting, due to the lack of long-term facilities. Long term hospitalization increase medical expenses and decreases the bed utilization, which can affect the urgent and emergent admissions, and eventually jeopardize the hospital financially. In this study, strategies for effective transfers to the lower levels of care, and to decrease the length of stay were presented by surveying and analyzing the patient's knowledge of the transfer needs, and the willingness to transfer those whose hospital length of stay was more than 30days. Method : The survey is subject to a group of 251 patients who have been hospitalized over 30 days in a general hospital in Seoul. Excluding those that were in the Intensive Care Unit and psychiatric ward, 214 in-patients were used as participants. They were surveyed from April 9, 2002 to April 17, 2002. One hundred and thirty seven out of 214 were responded which made the response rate 64%. Data were analyzed by SAS and SPSS. Result : Multi-variable Logistic Regression Analysis showed a significant effect in medical expenses, knowledge of referral system and the information of the receiving hospital. The financial burden in medical expenses made the patient 10.7 times more willing to be transferred, knowledge of the referral system made them 5 times more willing to be transferred, and the information of receiving hospital makes 6.5 times more willing to be transferred. Reasons for willing to be transferred to a lower level of care were the phase of physical therapy, the distance from home, the attending physician's advice and being unable to be treated as an out patient. Reasons for refusing to be transferred were the following. The attending physician's competency, not being ready to be discharged, not trusting the receiving hospital's competency due to the lack of information, or never hearing about the referring system by the attending physician. Conclusion : Based on this, strategies for the effective transfer to the lower levels of care were suggested. It is desirable for the attending physician to be actively involved by making an effort to explain the transfer need, and referring to the Healthcare Coordinating Center, which can help the patient make the right decision. Nationwide networking for the referral system is the another key factor that may need to be suggested as an alternative to decrease the medical expenses. Collaborating with the Home Health Agency for the early discharge planning and the Social Service Department for financial aid are also needed. It is recommended that the hospital should expedite the transfer process by prioritizing the cost and the information as medical expenses, knowledge of referring system and the information of the receiving hospital, are the most important factors to the willingness to transfer to a lower level of care.

• 한국산학기술학회논문지
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• 제12권11호
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• pp.4914-4923
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• 2011

본 연구는 PA(전담)간호사의 직무스트레스가 직무만족도에 미치는 영향을 파악하기 위하여 시도된 서술적 조사연구로 2010년 9월 1일부터 2011년 1월 10일까지 PA(전담)간호사 104명을 대상으로 시행하였다. 수집된 자료는 SPSS PASW Stastistics 18.0 Program으로 분석하였다. 직무스트레스에 대한 평균점수는 여성 45.07(${\pm}9.78$)점, 남성 43.47(${\pm}13.77$)점이었다. 직무만족도에 대한 평균점수는 2.72(${\pm}0.30$)점이었다. 일반적인 특성과 직무만족도 간의 통계적 유의성은 없었다. 직무스트레스의 하부영역 중 미혼에서 조직체계(p<.05)와 보상부적절(p<.01)에 대한 스트레스가 통계적으로 유의하게 높은 것으로 나타났다. 다중회귀분석결과 회귀모형에 대한 수정된 $R^2$ 값이 0.567로 회귀모형이 56.7%로 적합하며, 직무자율성이 적고 조직체계가 합리적이지 못할 때 직무만족도가 감소하였으며, 3교대 근무자에 비해 2교대 근무자의 직무만족도가 높은 것으로 분석되었다. 그러므로 직무만족도를 높이기 위해 PA(전담)간호사의 직무자율성과 조직체계에 대한 직무스트레스를 감소시키기 위한 병원정책이 필요하다.

• 의료법학
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• 제9권1호
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• pp.505-534
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• 2008

Aesthetic plastic surgery rarely has the lifesaving, the medical necessity, and the emergency, because it was executed in order to acquire personal satisfaction in the external features. In addition, aesthetic plastic surgery has the strong commerciality in that it is based on the attraction of a client through medical advertisement and the range of uninsurance. These characteristics cause whether aesthetic plastic surgery is included in medical procedure and the legal contract between physician and client is controversial issue. Also, attention and explanation in aesthetic plastic surgery are more emphasized than those in general medical procedure. According, this document presents the various characteristics of aesthetic plastic surgery, which differs from that of general medical procedure.

• Journal of Preventive Medicine and Public Health
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• 제28권3호
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• pp.576-587
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• 1995

Authors purposed to observe activities of occupational health nurses and it's related factors, and to suggest the way that induct better occupational health nurses' activities with questionaire to 87 occupational health nurses who individually work as health manager in the plant. The questionaire included type of plant and number of workers, general characteristics, work conditions, activities, etc. Major findings are as follows. 1. 82.8% of occupational health nurses were third decade. 93.1% graduated junior college or college. And 82.8% were not married. 2. General work conditions: 40.2% were belonged to safety-health section, 98.85% were mere clerks. 60.9% worked less than weekly 44 hours, and an annual salary of 50.6 % was between 10 million and 14 million won. 3. Work condition related to health manager work: there was separated health care room in 94.3%, working period as health manager(occupational health nurse) was less than 5 years in 70.1%, 49.4% had the out-of-health manager work. In 87.4%, occupational physician was appointed, only 6.9% of them were full time, 52.9% of them worked little in the plants. The problems related to workers' health were discussed with industrial nurses in 88.5%. 4. Attitude for their work: 88.5% were thought that their work is important for workers' health care, 57.5% satisfied to work as health manager. In 51.7%, motive to being industrial nurse were the appropriate aptitude. 5. Activities: General medical care in 100% were carried out, in 97.7% works related to general health examination, in 100% works related to special health examination were carried. But works related to use of protective apparatus were carried out in 20.8%. 6. Factors related to level of activities: In cases who solved the health related problems by themselves, the level of activites was significantly higher than in others. In cases there were full time occupational physician, the level of activities was significantly lower. 7. Occupational health nurse's needs: 100% wanted regular education, 89.7% wanted the qualifying examination. As the results, author suggests that the right of self-control is given to occupational health nurses and the work of occupational physician is clearly defined for the induction of the better activities of occupational health nurses.

• 대한간호학회지
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• 제44권3호
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• pp.328-338
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• 2014

Purpose: This study was done to explore experiences of persons living through the periods of cancer diagnosis, treatment, and self-care. Methods: With permission, texts of 29 cancer survival narratives (8 men and 21 women, winners in contests sponsored by two institutes), were analyzed using Kang's Korean-Computerized-Text-Analysis-Program where the commonly used Korean-Morphological-Analyzer and the 21st-century-Sejong-Modern-Korean-Corpora representing laymen's Korean-language-use are connected. Experiences were explored based on words included in 100 highly-used-morphemes. For interpretation, we used 'categorizing words by meaning', 'comparing use-rate by periods and to the 21st-century-Sejong-Modern-Korean-Corpora', and highly-used-morphemes that appeared only in a specific period. Results: The most highly-used-word-morpheme was first-person-pronouns followed by, diagnosis treatment-related- words, mind-expression-words, cancer, persons-in-meaningful-interaction, living and eating, information-related-verbs, emotion-expression- words, with 240 to 0.8 times for layman use-rate. 'Diagnosis-process', 'cancer-thought', 'things-to-come-after-diagnosis', 'physician husband', 'result-related-information', 'meaningful-things before diagnosis-period', and 'locus-of-cause' dominated the life of the diagnosis-period. 'Treatment', 'unreliable-body', 'husband people mother physician', 'treatment-related-uncertainty', 'hard-time', and 'waiting-time represented experiences in the treatment-period. Themes of living in the self-care-period were complex and included 'living-as-a-human', 'self-managing-of-diseased-body', 'positive-emotion', and 'connecting past present future'. Conclusion: The results show that the experience of living for persons with cancer is influenced by each period's own situational-characteristics. Experiences of the diagnosis and treatment-period are negative disease-oriented while that of the self-care period is positive present-oriented.

• 한국의료질향상학회지
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• 제4권2호
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• pp.210-221
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• 1997

Background : Willingness to satisfy patients(WSP) among nurses is essential to promoting patient satisfaction which is a critical component in the quality of health care and its outcomes. This study was carried out to empirically find out the affecting factors of WSP among nurses in hospital settings. Methods : The model contains seven job relating determinants and two intervening variables as follows: i) job relating variables of professional status, task requirements, pay, physician-nurse interaction, nurse-nurse interaction, organizational policies, and autonomy, ii) intervening variables of job satisfaction and organizational commitment. Data were collected from 205 nurses in two general hospitals owned by one foundation located in Pusan, Korea, using a structured and self-administered questionnaire. Results : The major results were as follows: First, the results of ANOVA on WPS by personal characteristics showed a statistically significant relationships between WPS and hierarchical orders(p<.01) ana tenure(p<.10). Comparing with the lower orders and shorter tenure, the higher orders and the longer tenure showed better WPS. Second, the results of simple correlation analysis between WPS and determinants and intervening variables showed the following variables, in order of importance, were statistically significant(p<.01): work satisfaction(+), organizational commitment(+), task requirements(+), nurse-interaction(+), professional status(+), physician-nurse interaction(+). Third, the results of path analysis showed that two intervening variables of job satisfaction and organizational commitment, and three determinants of task requirements, professional status, and nurse-nurse interaction had a positively significant direct effect to WPS. Conclusion : The results suggest that nurses who are more satisfied with task requirements, status, nurse-nurse interaction, overall job satisfaction, and organizational commitment, will behave in ways that patients find more satisfied.

• 중환자간호학회지
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• 제11권1호
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• pp.15-27
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• 2018

Purpose : This study was intended to investigate the frequency of job performance of the Korean professional medical support staffs (PMSS). Method : The data of 1,666 PMSS from 36 hospitals and over 500 beds were analyzed. The participants were divided into 5 groups: advanced practice nurses (APN), clinical nurse experts, physician assistants (PA), coordinators, and others. Results : Among the 5 main domains of job performance, advanced clinical practice has the highest frequency (111.36 d/y), followed by consultation/collaboration (75.66 d/y), education/counseling (53.54 d/y), leadership (23.90 d/y), and research (19.14 d/y). There was a significant difference in the frequency of job performance between the 5 groups of participants. The invasive activities were more frequent in the PA group. In the education and counseling domain, APNs had a higher level of job frequency than others (p < .001). In the research and leadership domains, APNs and coordinators had more prominent performance frequency than other groups (p < .01). However, there are some ambiguities in the job performance of the 5 groups depending on institutional characteristics. Conclusion : To establish the scope of work of PMSS, organizational and individual efforts are needed to promote and expand the leadership and research domains. To resolve the ambiguities of PMSS' roles, it is necessary to reorganize their titles.

• Journal of Hospice and Palliative Care
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• 제24권3호
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• pp.184-193
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• 2021

Purpose: This study attempted to develop clinical guidelines to help patients use hospice and palliative care (HPC) at an appropriate time after writing physician orders for life-sustaining treatment (POLST) by identifying the characteristics of HPC use of patients with terminal cancer. Methods: This retrospective study was conducted to understand the characteristics of HPC use of patients with terminal cancer through decision tree analysis. The participants were 394 terminal cancer patients who were hospitalized at a cancer-specialized hospital in Seoul, South Korea and wrote POLST from January 1, 2019 to March 31, 2021. Results: The predictive model for the characteristics of HPC use showed three main nodes (living together, pain control, and period to death after writing POLST). The decision tree analysis of HPC use by terminal cancer patients showed that the most likely group to use HPC use was terminal cancer patients who had a cohabitant, received pain control, and died 2 months or more after writing a POLST. The probability of HPC usage rate in this group was 87.5%. The next most likely group to use HPC had a cohabitant and received pain control; 64.8% of this group used HPC. Finally, 55.1% of participants who had a cohabitant used HPC, which was a significantly higher proportion than that of participants who did not have a cohabitant (1.7%). Conclusion: This study provides meaningful clinical evidence to help make decisions on HPC use more easily at an appropriate time.