• 한국산학기술학회논문지
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• 제14권5호
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• pp.2293-2303
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• 2013

목적: 본 연구의 목적은 국내 환자안전지표 산출 가능성을 확인하는 것이다. 조사방법: 환자안전지표의 정의는 OECD에서 AHRQ에 근거하여 작성한 보건기술문서 19의 기준을 이용하였고, 이에 따라 2004-2008년 퇴원손상심층조사 875,622건에서 환자안전지표(PSIs)를 산출하였다. 로지스틱 회귀분석을 이용하여 환자안전지표별 비율의 변이요인을 확인하였다. 분석결과: 2004-2008년간 약 80만 건의 퇴원 중에서 8개의 환자안전지표에 해당하는 위해사건은 3,084건이었다. 욕창(PSI3, 4.88), 시술 중 이물질 체내 잔류(PSI5, 0.05), 수술 후 패혈증(PSI13, 1.32), 출생손상-신생아(PSI17, 7.92), 산과적 외상-도구를 이용한 질식 분만(PSI18, 32.81)의 퇴원 1,000건당 비율은 모두 OECD 환자안전지표 비율의 최소-최대 범위 내에 포함되었다. 그러나 내과적 치료에 의한 감염(PSI7, 0.22), 수술 후 폐색전증 또는 심부정맥혈전증(PSI12, 0.90), 우발적 천공 또는 열상(PSI15, 0.71)의 퇴원 1,000건당 비율은 OECD 환자안전지표 최소값에 못 미쳤다. PSI 18을 제외한 7개의 지표값 모두 부진단명의 개수와 유의한 상관관계가 있는 것으로 나타났다. 또한 환자안전지표 비율은 환자특성을 보정했을 때, 병상규모 및 병원소재지 등 병원특성에 따른 유의한 차이를 보였다. 결론: 본 연구는 국가적인 행정자료를 이용하여 위해사고를 스크리닝 하는 환자안전지표를 산출한 최초의 실증적 연구이다. 본 연구의 결과는 자료의 질, 임상 관련 변수 등의 결과에 영향을 미치는 요소가 여전히 있지만, 환자안전에 대한 국가적인 통계를 추계하는 기초자료를 제공하였다는데 의의가 있다. 향후 본 연구결과를 바탕으로 위해사건으로 인한 사망 규모 산출 등의 결과연구가 필요하다.

• 대한교통학회지
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• 제17권4호
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• pp.99-110
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• 1999

도시지역의 대기오염은 주로 자동차에 기인하며, 이는 보편적인 현상으로 나타나고 있다. 특히 서울시의 경우 자동차에 의한 대기오염 비중이 85.7%(1997년 기준)를 차지하고 있을 만큼 큰 비중을 보이고 있다. 이에 본 연구의 1차적 관심사는 서울시 대기오염의 주된 요인인 교통부문의 개별적 분석보다는 지속가능한 도시발전을 위한 새로운 패러다임의 적용이라는 관점에서 향후 서울시의 교통.환경부문의 통합연계 분석에 대한 공감대 형성 및 활용가능성 모색에 두었다. 서울시 통행 O-D자료를 바탕으로 환경주행세 부과를 고려한 단기교통혼잡관리모형 적용결과, 교통.환경부 문간 연계통합모형의 실제 유의성을 발견할 수 있었다. 즉 환경주행세의 시행전후 비교분석에 의하면, 유류소비 단위당 500원/${\ell}$과 1,000원/${\ell}$을 부과할 경우, 오전 첨두시간대의 대기오염물질 배출량은 시행후 10.7%와 17.3%씩 감소하는 것으로 나타났다. 이에 비하여 유류소비량 저감은 20.2%와 30.3%로서, 저감비율이 상대적으로 높게 반영되고 있다. 그러나 단위 유류소비량에 대한 차종별 오염물질 배출량 비중은 버스 46.4, 화물차 50.4, 승용차 14.4 등으로 산출되어, 환경주행세 500원/${\ell}$ 부과에 의한 승용차의 오염배출 비중은 비탄력적인 반면에 오염물질 배출량이 많은 버스 및 화물차의 비중은 오히려 증가하는 것으로 나타났다. 결과적으로 자동차 유발 대기오염의 비중을 낮추기 위해서는 차종별 오염물질 배출경향을 고려한 환경주행세의 차별부과 방식이 고려되어야 할 것이다. 예를 들면, 차종별 유류소비량에 대한 오염물질 배출비중을 균등화하는 방법, 또는 서울지역 오존오염의 원인이 되는 HC와 NOx 오염물질의 총량에 대한 차종별 기여도를 평균화하는 방법이 적용될 수 있다. 한편으론 환경주행세의 부과방식과 병행하여, 자동차 오염물질 배출을 저감할 수 있는 삼원촉매장치와 매연여과장치의 부착, 오염물질 과다배출 차량의 조기폐차 시행에 의한 인센티브 부여, 그리고 청정자동차 구입에 의한 버스업체의 환경주행세 감면 등과 같은 제도적 장치도 함께 고려되어야 한다. 그러나 본 연구에서 의도하였던 도로환경용량을 고려한 통행량 배분의 실제적 효과를 산출하기 위해서는 첫째, 통행비용의 절감과 대기질 개선이라는 공동선(共同善)을 추구하기 위한 교통.환경간 통합패러다임의 적용모형 개발과 활용가능성 모색, 둘째, 물리적 기준인 도로별 고통용량기준을 환경요소도 포함하는 도로환경용량으로의 전환, 셋째, 통행시간.환경비용.도로건설 및 유지비용뿐만 아니라 자동차 이용에 따른 연료소비 등을 포함하는 통행배분 모형 개발, 넷째, 단기혼잡프로그램을 활용하여 자동차 유발 대기오염물질 배출량 저감효과와의 연계시도 등과 같은 사항이 지속적으로 연구.개발되어야 할 것이다.

• Journal of Nutrition and Health
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• 제10권4호
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• pp.43-58
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• 1977

Kojedo is the second largest island in Korea and a total population of 115,500 is living on the island of 394.69 sq. km. Under the direction of three nutrition professors, nutrition surveys in two villages in Kojedo, namely Siljun Ri in Hachung Myon and Soowol Ri in Shinhyun Myon, were carried by 30 college senior students majoring in nutrition from August to 20 August 1977. From a total of 176 households of the two villages, 67 households were randomly selected and 390 family members of the households were subjcets of the nutrition surveys. The precise weighing method was used in evaluating the kinds of foods and nutrient intakes of the subjects for three consecutive days. Thirty-seven pre-school children aged between 3 to 6 years and 27 fertile women were examined for biochemical findings and physical status. The main purposes of the surveys are to provide baseline data on nutrition in Kojedo Island for the Kojedo Community Development Project and to compare the nutritional status of the villages of Siljun Ri and Soowol Ri. Siljun Ri is located in the pilot project area of the Koiedo Community Health Project sponsored since December 1970 by the Christian Medical Commission of the World Council of Churches. While Soowol Ri is a control village for comparison. The results obtained are summarized as follows: Food Intake The average food intake per person per day in Siljun Ri, 1064 grams (91.7% in vegetable foods and 7.6% in animal foods) was 90 grams more than that of Soowol Ri, 974 grams (92.8% in vegetable foods and 5.9% in animal foods). However, the food intake per pre-school child in Siljun Ri, 485 grams (92.6% from vegetable foods and 6.4% from animal foods) was 21 grams lower than that of the Soowol Ri, 506 grams (88.5% from vegetable foods and 6.5% from animal foods). The average intake of beans was 16 grams(1.5% out of the total food intake) in Siljun Ri and 21 grams(2.2% of the total food intake)in Soowol Ri. The villagers should be guided for more consumption of soybeans to improve the quality of protein intake from vegetable foods. Nutrient Intake The adult intake in Siljun Ri and Soowol Ri were 2,529 kcal and 2,511 kcal respectively. The average energy intake of pre-school childen in Siljun Ri was 948 kcal and that for adult and 1,500 kcal for childen aged between 4 to 6 years-given by the Korea FAO Association, the diets in both villages were not adequate. Average daily protein intake of the subjected adult in Siljun Ri was 78.4 grams and that of Soowol Ri was 76.2 grams, while pre-school children took 30.7 grams in the former village and 31.7 grams in the latter village per child per day. The protein intake in both villages were lower than the recommended allowances, 80 grams for adult and 45 grams for $4{\sim}6$ years childen, and animal protein intake of the all subjects was very much lower than the RDA. The main charecter of the diet has been found low in quality of protein and high in carbohydrate. The calcium intakes of the pre-school children in both villages, 251.9 milligrams in Siljun Ri and 218.8 milligrams in Soowol Ri, were very much lower than the recommended allowance of 500 milligrams per day. It is apparent that the diet for children should be supplemented with calcium. Among the vitamin group, the daily average intakes of vitamin A and $B_{2}$(thiamine), $B_{2}$(riboflavin), C(ascorbic acid), and niacin were not adequate for the children in both villages. Especially the intake of riboflavin, 0.4 milligrams in both village children, was much lower than the RDA, 0.9 milligrams per day. Physical Characteristics Average height, weight, chest and head circumference of the pre-school children in both villages were similar to those of the Korean standard given by the Korean Paediatrics Association except that the average height of pre-school boys in Siljun Ri was 8 cm higher than the Korean standard of 105 cm. The mean values of upper arm circumference and skinfold thickness of pre-school boys in both villages were the same, 15.4 cm for upper arm circumference and 6.8 mm for skinfold thickness, but the mean values of those of the girls in Siljun Ri were higher than those of pre-school grils in Soowol Ri. Biochemical Findings Avera ge hemogobin value of boys and girls in both villages was the same, 11.1 grams per 100 ml of blood. The incidence of anemia (Hb value below 11g/100ml) was similar in both viltagesr 36.4% for boys and 50% for girls in Siljun Ri and 37.5% for boys and 50% for girls in Soowol Ri. Average hemoglobin values of fertile women were 10.7g% in Siljun Ri and 10.8% in Soowor Ri. The incidences of anemia(Hb valre brlow 12g/100ml) were 100% in Siljun Ri and 86.7% in Soowol Ri. The anemia of these subjects may be caused mainty low intake of good quality protein and iron intake from vegetable food. Recommendation In general, the nutritional status of a community health pilot village is not higher than that of control village due to the lack of nutrition improvement guldance services. Nutrition education should be delivered to the villagers as a main part of the health education artivities. The emphasis should be on building better health through bttter food habits and better food production as well as on preventing malnutrition and diseasrs. It can be an invaluable part of community developnent. Since nutrition is considered to be at least one-half of MCH care, no village or home visits should be made without careful provision for teaching and demoastrating something simple and practical on nutrition. The nurse, midwife, and village health worker should be the chief promoters of nutrition.

• 대한간호학회지
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• 제20권2호
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• pp.153-173
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• 1990

One of the important tasks for new parents. especially mothers, is to establish warm, mutually affirming interpersonal relationships with the new baby in the family, with the purpose of promoting the healthy development of the child and the wellbeing of the whole family. Nurses assess the quality of the behavioral characteristics of the maternal-infant interaction. This study examined the relationships between primiparas pereptions of their delivery experience and their maternal infant interaction. It compared to delivery experience of mothers having a normal vaginal delivery with those having a casearean section. The purpose was to explore the relationships between the mother's perceptions of her delivery experience with her maternal infant interaction. The aim was to contribute to the development of theoretical understanding on which to base care toward promoting the quality of maternal-infant interaction. Data were collected directly by the investigator and a trained associate from Dec. 1, 1987 to March 8, 1988. Subjects were 3 random sample of 62 mothers, 32 who had a normal vaginal delivery and 30 who had a non-elective cesarean section (but without other perinatal complications) at three general hospitals in Seoul. Instruments used were the Stainton Parent -infant Interaction Scale(1981) and the Marut and Mercer Perception of Birth Scale(1979). The first observations were made in the delivery room (for vaginally delivered mothers only), followed by day 1, day 2, day 3, and 2 weeks, 4 weeks, 6 weeks and 8 weeks after birth, for a total of 7-8 contacts(Cesarean section mothers were observed on days 4 and 5 but the data not used for analysis). Observations in the hospital were made during the hour prior to scheduled feedings. The infant was placed beside the mother. Later contacts were made at home. Data analysis was done by computer using as SPSS program and indulded X² test, paired t-test, t-test, and Pearson Correlation coefficient ; the results were as follows. 1. Mothers who had a normal vaginal delivery tended to perceive the delivery experience more positively than cesarean section mothers(p＝0.002). The finding supported the hypothesis I that perception of delivery would vary according to the method of delivery. Mothers' perceptions of birth were classified into three dimensions, labor, delivery and the bady. There was a significantly different and positive perception by the vaginally delivered mothers to the delivery experience(p＝0.000) but no differences for labor or the bady according to the delivery method(p＝0.096, p＝0.389), 2. Mothers who had a normal vaginal delivery had higher average maternal-infant interaction scores(p＝0.029) than mothers who had a cesarean section. There were similar higher scores for the 1st day(p＝0.042), 2nd day (p＝0.009), and the 3rd day(p＝0.006) after delivery but not for later times. The findings supported the hypothesis Ⅱ that there would be differences in maternal-infant interaction for mothers having vaginal and cesarean section deliveries. However these differences deccreased section deliveries. However these differences decreased over time . by eight weeks the scores for vaginal delivery mothers averaged 8.1 and for cesarean section mothers, 7.9. 3. The more highly positive the pereption of the delivery experience, the higher the maternal-infant interaction score for all subjects(F＝.3206, p＝.006). The findings supported the hypothesis Ⅲ that there would be correlations between perceptions of delivery and maternal-infant interaction. The maternal infant interaction was highest when the perception of the bady and deliery was positive(r＝.4363, p＝.000, r＝.2881, p＝.012). No correlations between perceptions of labor and maternal-infant interaction were found(p＝0.062). 4. The daily maternal-infant interaction score for the initial contact after birth to 8 weeks postpartum had the lowest average score 5.20 and the highest 7.98(in a range of 0-10). This subjects group of mothers needed nursing intervention to promote their maternal- infant interaction. The daily scores for the maternal-infant over the period of eight weeks. However, there were significantly different increases in maternal-infant interaction only from the first to second day(p＝0.000) and from the fourth to sixth weeks after birth(P＝0.000). 5. When the eight items of maternal-infant interaction were evaluated separately, “Expresses feelings about her role as mother” had the highest average score, 1.64(ina range of 0-3)and “Speaks to baby” the lowest, 0.9. All items, with the possible exception of “Expresses feelings about her role as mother”, suggested the subjects' need of nursing intervention to promote maternal-infant interaction. 6. There were positive correlations between certain general charateristis, namely, both a higher economic status(p＝0.002) and breast feeding(p＝0.202) and maternal - infant interaction. There were positive correlations between a mother's confidence in her role as a mother and the perception of the birth experience(p＝0.004). For mothers who had a cesarean section, a positive perception of the birth experience was related to the duration of her marriage(p＝0.010), a wanted pregnancy (P＝0.030) and her confidence in her role as a mother(p＝0.000). Pereptions of birth for mothers who had a normal vaginal delivery were positive than those for mothers who had a cesarean section. The level of maternalinfant interaction for mothers delivered vaginally was higher than for cesarean section mothers. The relationship between perception of birth and materanalinfant interaction was confirmed. Cesarean section has an impact on the mother's perceived experience of birth which, in turn, is positively related to maternal-infant in turn, is positively related to maternal-infant interaction. Nursing intervention to enhance maternal-infant interaction should begin in prenatal classes with an exploration of the potential impact of cesarean section on the perceptions of the birth experience and continue throughout the perinatal and post-natal periods to promote the mother's ability to control with this crisis experience and to mobilize social support. Nursing should help transform a relatively negatively perceived experience into an accepted, positively perceived and self affirming experience which enhances the maternal-infant relationship.

• 한국학교보건학회지
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• 제1권2호
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• pp.50-65
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• 1988

This study was conducted in order to grasp the condition of about the school nurse's service and to offer the basic materials of improving the school health service. The objects were comprised of 98 volunteered school nurses who take service in the elementary school. The material of this study was the questionaire suited to the purpose of this research which has been made through studying references and this questionaire has been corrected and revised three times. All the questionaire written by school-nurses. The results are as follows; 1. General features of the objects of study Average age was 35.9 and average career was 9.2 years. Except working as school-nurse, the past career was that average clinical-field was 3.4 years and health service was 4 months. Their educational level was as high as 72.4% of the objects were graduated from above 3 years college and 89.8% were married. 76.5% have religions and 94.8% were working at with national and public schools. 99.0% were doing only nursing service. 2. The conditions of the school health resources. The ratio of school-nurse to students was one to 2630. School-nurse to classes, one to 49.3, and school-nurse to teachers, one to 54. For total amount of a year budget of school health, from three hundred thousands to fifty nine hundred thousands won was most common. Expenses for purchasing medicine were used most. 58.2% of school-nurses hasn't known a year budget. There was an organization for school health in 74.2% of schools. 42.9% of nursing rooms were in the center of school and 88.8% were on first floor. Nursing room were used alone without being used by another purpose and the room size of 71.6% was below 10 pyong. 3. The conditions of school health service Average users of nursing room were 413 a month. The most of them had digestive trouble. Sending letters to home was 15.9 times a year. The most contents of letters was about health education. Object spent much time managing nursing room. 4. The degree of school health service When 2 points was given to "perform" and 1 point was to "not perform" the total average was 1.75, health education 1.89, environmental management 1.86, plan of project and evaluation 1.83, management of nursing room 1.82, health management 1.78, run of school health organization 1.32. 5. Correlation between the school health services and variables (1) The part of project plan and evaluation of school health service has relationship to existence or none-existence of school health organization (P<0.01), past health service career (P<0.05), number of classes (P<0.01), number of students (P<0.01), sending letters to home about health education (P<0.01) and number of users (P<0.05). (2) The part of nursing room management has relationship to ages (P<0.05) past clinical career (P<0.05), number of classes (P<0.05), number of students (P<0.05) and sending letters to home about health education (P<0.01). (3) The part of health education has relationship to existence or none-existence of school health organization (P<0.05), past clinical career (P<0.05), the ratio of health management to school nurse's all work (P<0.05) and the ratio of health education to school nurse's all work (P<0.01). (4) The part of environmental management to ages (P<0.01), career as a school-nurse (P<0.01), salary step(P<0.01), sending letters to home about health education (P<0.01), sending all letters to home (P<0.001), the ratio of health management to school nurse's all work (P<0.05), the ratio of health education to school nurse's all work (P<0.05) and area of school-nurse's room to be used. (5) The part of school health organization management to number of classes (P<0.05). (6) The part of health management to number of classes (P<0.05), sending letters to home about health education (P<0.001), sending all of letters to home (P<0.01) and the ratio of health management to school nurse's all work (P<0.05). (7) The part of school health service to ages (P<0.05), past clinical career (P<0.05), past health career (P<0.01), number of classes (P<0.05), number of student (P<0.05), sending letters to home about health education (P<0.05), sending all letters to home (P<0.05), the ratio of health management to school nurse's all work (P<0.05), the ratio of health education to school nurse's all work (P<0.01) and area of school - nurse's room to be used (P<0.05). ## Suggestion for further studies are as follows. 1. School-nurse should exert herself to advance a quality to take care of school population's health. 2. It is necessary that systematic support required to keep school population's health. 3. Home, school and community should make efforts cooperatively and the proper roles of students, teachers, health team members and parents must be achieved.

• 간호행정학회지
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• 제5권3호
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• pp.477-500
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• 1999

Korean labor market has showed remarkable change of the increase in the amount of unemployment and contingent employment since IMF bailout agreement. There is a theoretical position to explain this increase in contingent employment at hospitals with the notion of flexibility. The high flexibility of employment due to the increase of contingent employees is becoming very important part in new business strategy of hospitals. The types of contingent employment of the nurse are part-time employment temporary employment, fixed-term employment, and internship which was introduced in early 1999. Recently, Korean health care industry managers have paid attention to the customer oriented service, rationalization of business administration, service quality control so that they can adjust their business to outer environment. Especially their efforts concentrate on the wage reduction through efficient and scientific control of man power because wage shares about 40% of total cost. This dissertation aims at verifying the phenomena of the contingent employment of the nurse and analyzing the related factors and problems. To rephrase these aims in ordinal: First, verifying the phenomena of contingent employment of the nurse. Second, verifying the problems of that phenomena. Third, analyzing the related factors of the contingent employment of the nurse. To accomplish these research goals, a statistical survey was executed. in which 384 questionnaires-66 for manager nurses, 318 for contingent nurses - were given to nurses working at 66 hospitals-which have at least 100 beds-in Seoul. Among them, 187 questionnaires-38 from manager nurses, 149 from contingent nurses'- 'were returned. Then, the data coded and submitted to T-test, $X^2$ -test, variance analysis(ANOVA), correlation analysis, multiple regression analysis, Logistic Regression with SAS program. The research results of the contingent nurses are followings: 1. The average career term at the present hospital 8.4 months: duty-on days per month are 24.2 days: working time per day is 7.9 hours. These results showed little difference from regular nurses. 2. Their wage level is about 70% of regular nurses except for internship nurses whose wage level is 41% of regular nurses. To break down the wage composition, part-time nurses and internship nurses get few allowance and bonus. And contingent nurses get very low level of additional pay except for fixed-term nurses who are under similar condition of employment to regular nurses. These results show that hospital managers are trying to reduce the labor cost not only through the direct way of wage reduction but through differential treatment of bonus, retirement allowance, and other additional pay. 3. The problem of contingent employment: low level of pay; high level of turn-over rate: weakening of union; low level of working condition: heavy burden of work; inhuman treatment. The contingent nurses consider these problems more seriously than manager nurses do. What manager nurses regard problematic is the absence of feeling-belonged and responsibility of the contingent nurses. 4. The factors strongly related with the rate of the number of contingent nurses for the number of regular nurses; gross turn-over nurses; average in-patients per day; staring wage of graduate from professional college: the type of hospital ownership; the number of beds; the gap between gross newcomer nurses and gross turn-over nurses. The factors related with their gross wage per month; the number of beds; applying of health insurance; applying of industrial casualty insurance; applying of yearly-paid leave; the type of hospital ownership; average out-patients per day; gross turn-over nurses. The meaningful factors which make difference by employment type: monthly-paid leave; physiological leave. The logistic regression analysis using these two factors shows that monthly-paid leave is related with the type of hospital ownership; the number of beds; average out-patient per day, and physiological leave is related with the gross newcomer nurses; gross turn-over nurses; the number of beds.

• 지능정보연구
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• 제26권1호
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• pp.23-45
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• 2020

기업의 경쟁력 확보를 위해 판별 알고리즘을 활용한 의사결정 역량제고가 필요하다. 하지만 대부분 특정 문제영역에는 적합한 판별 알고리즘이 어떤 것인지에 대한 지식은 많지 않아 대부분 시행착오 형식으로 최적 알고리즘을 탐색한다. 즉, 데이터셋의 특성에 따라 어떠한 분류알고리즘을 채택하는 것이 적합한지를 판단하는 것은 전문성과 노력이 소요되는 과업이었다. 이는 메타특징(Meta-Feature)으로 불리는 데이터셋의 특성과 판별 알고리즘 성능과의 연관성에 대한 연구가 아직 충분히 이루어지지 않았기 때문이며, 더구나 다중 클래스(Multi-Class)의 특성을 반영하는 메타특징에 대한 연구 또한 거의 이루어진 바 없다. 이에 본 연구의 목적은 다중 클래스 데이터셋의 메타특징이 판별 알고리즘의 성능에 유의한 영향을 미치는지에 대한 실증 분석을 하는 것이다. 이를 위해 본 연구에서는 다중 클래스 데이터셋의 메타특징을 데이터셋의 구조와 데이터셋의 복잡도라는 두 요인으로 분류하고, 그 안에서 총 7가지 대표 메타특징을 선택하였다. 또한, 본 연구에서는 기존 연구에서 사용하던 IR(Imbalanced Ratio) 대신 시장집중도 측정 지표인 허핀달-허쉬만 지수(Herfindahl-Hirschman Index, HHI)를 메타특징에 포함하였으며, 역ReLU 실루엣 점수(Reverse ReLU Silhouette Score)도 새롭게 제안하였다. UCI Machine Learning Repository에서 제공하는 복수의 벤치마크 데이터셋으로 다양한 변환 데이터셋을 생성한 후에 대표적인 여러 판별 알고리즘에 적용하여 성능 비교 및 가설 검증을 수행하였다. 그 결과 대부분의 메타특징과 판별 성능 사이의 유의한 관련성이 확인되었으며, 일부 예외적인 부분에 대한 고찰을 하였다. 본 연구의 실험 결과는 향후 메타특징에 따른 분류알고리즘 추천 시스템에 활용할 것이다.

• 치위생과학회지
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• 제18권6호
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• pp.340-348
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• 2018

본 연구는 치과위생사 의료인화에 대한 요구와 논의가 있는 현 시대적 상황에서 치과의료인력을 대상으로 치과위생사를 위한 선행과제와 의료인이 되었을 때의 긍정적 부정적 효과, 확장 가능한 전문업무에 대해 파악하고자 하였다. 치과위생사 259명, 치과의사 128명을 대상으로 치과위생사 의료인화에 대한 인식과 선행 과제, 긍정 및 부정적 효과와 확장 가능한 전문업무 등에 대해 조사 분석하여 다음과 같은 결론을 얻었다. 치과위생사 의료인화에 대해 치과위생사의 94.2%, 치과의사의 46.9%가 인지하였고, 치과위생사는 협회매체(52.5%), 치과의사는 치과신문(23.4%)을 통해 인지하는 경우가 많았다. 찬성도는 치과위생사의 95.0%, 치과의사의 64.1%였으며, 당위성은 치과위생사가 84.9%, 치과의사 51.6%였다. 당위성의 근거로 치과위생사는 업무 전문성과 교육과정 부합성이 높았고 업무 부합성이 낮았으나 치과의사는 의료체계 유사성이 높았고 교육과정 부합성이 가장 낮았다. 의료인화를 위한 선행 과제 중 직업적 영역에서 치과위생사와 치과의사 모두 직업의식과 윤리의식이 높았다. 제도적 영역에서도 두 직종 모두 치위생교육 질 관리가 가장 높았으며, 학제 일원화가 가장 낮았다. 사회적 영역에서 치과위생사는 중앙정부설득과 국민공감대 형성이 높았고, 치과의사는 유관단체 협력과 중앙정부 설득이 높았다. 치과위생사 의료인화 시 긍정적 효과는 치과위생사 인식 확장이 치과위생사와 치과의사 모두 가장 높았고, 부정적 효과는 치과위생사의 경우 임금상승 심화와 위임진료 증가가 높았고, 치과의사는 임금상승 심화와 구인난 심화가 높았다. 의료인화 시 확장 가능한 전문업무로는 독자적 치주관리프로그램 운영으로 치과위생사(79.9%)와 치과의사(69.6%) 모두에게 가장 높게 나타났다. 치과위생사는 치주관리를 위한 진단(44.4%)과 전신질환자 구강건강관리(44.0%), 비외과적 치주처치(41.3%), 근육 정맥주사(27.4%) 순이었고, 치과의사는 근육 정맥주사(44.1%), 비외과적 치주처치(34.3%), 전신질환자 구강건강관리(29.4%), 치주관리를 위한 진단(13.7%) 순이었다. 이상의 결과를 통해 치과위생사 의료인화가 가지는 의미에 대한 충분한 검토와 논의가 필요할 것으로 생각되고, 의료인화와 관련하여 치과위생사의 업무가 합리적으로 조정되고 합법화하는 데 본 연구가 활용되기를 기대한다.

• 지역사회간호학회지
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• 제13권3호
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• pp.513-522
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• 2002

This study investigated stress and the extent of climacteric symptoms in mid-life men, and examined their relationship in order to better understand the stress and climacteric symptom experiences of mid-life men, and thereby attempted to offer basic materials for the development of a health improvement program that may help increase the quality of life of mid-life men. Three hundred mid-life men whose ages were between 40 and 59 and resided in the Seoul area were subjects of this study. The data were analyzed with the SAS PC program using descriptive statistics to analyze subjects' general characteristics and variables of stress and the extent of climacteric symptoms of the subjects. The relationship between stress and climacteric symptoms were examined by the Pearson Correlation Coefficient, and stress and the extent of climacteric symptoms in relation to the general characteristics were analyzed by T-test and ANOVA. The study conclusions are as follows: 1. Subjects general characteristics The average, age of the subjects was 46 and 47.0% of them reported ages between 40 and 45. Of the subjects, 98% were married. In marriage satisfaction, those who were generally satisfied with their married life comprised 62.0% of the subjects. In terms of level of education, 95.7% were educated above the high school level. In occupational background, 59.7% had occupations related to technologies. As for religion, 42.7% had no religion. In number of children, 67.3% had 2 children. In residential status, 79,3% were living in their own homes. In terms of living arrangements, 87.7% of the subjects were living in the form of nuclear families. 2. Stress and the extent of climacteric symptoms The level of stress was scored as $2.94{\pm}0.74$, and considering that the overall examination score is $27.16{\pm}1.32$, the subjects' stress level was not viewed as particularly high. The average score of the extent of climacteric symptoms was $35.37{\pm}0.27$. The extent of sub-domains of climacteric symptoms included skeleton symptoms ($39.37{\pm}2.81$), joint pain ($39.16{\pm}3.66$), vasomotor symptoms ($35.39{\pm}3.01$), other symptoms ($36.99{\pm}3.02$), psychological symptoms ($34.68{\pm}3.01$), urogenic symptoms ($35.03{\pm}3.27$), and cardiovascular symptoms ($33.70{\pm}2.78$). 3. General characteristics in relation to the stress level The subjects' general characteristics that were significantly related to the level of stress were marriage status (F=4.38, p=.001), marriage satisfaction (F=4.56, p=.001), educational background (F=2.68, p=.012), and age (F=2.48, p=.033). 4. General characteristics in relation to the level of climacteric symptoms The subjects' general characteristics that were significantly related to the level of climacteric symptoms were educational background (F=3.26, p=.007), age (F=2.58, p=.027), marriage status (F=2.62, p=.025), and marriage satisfaction (F=2.78. p=.032). 5. The correlation between stress and climacteric symptoms The subjects' level of stress and climacteric symptoms were significantly related to each other (r=0.578, p=0.000). The subjects' level of stress was correlated with sub-domains of the climacteric symptoms including psychological symptoms (r=0.579, p=0.000), joint pain (r=0.479, p=0.000), skeleton symptoms (r=0.477, p=0.000), other symptoms (r=0.467, p=0.000), vasomotor symptoms (r=0.4615, p=0.000), cardiovascular symptoms (r=0.458, p=0.000), urogenic symptoms (r=0.401. p=0.000). In summary, the climacteric symptoms suffered by mid-life men are positively correlated with their level of stress. In addition, the climacteric symptoms were affected by the level of stress.

• 대한간호학회지
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• 제19권1호
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• pp.40-62
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• 1989

This study was conducted to measure the effects of clinical application of a Nursing Diagnosis Protocol. The dependent variables were the degree of patient's satisfaction and the degree of nurse's satisfaction with the nursing activity. Analysis of the effect of the use of the nursing diagnosis protocol was based on the nursing record. The subjects for this study were 61 nurses(experimental group 31, control group 30) and 155 patients (experimental group 55, control group 100) on four internal medicine wards in K University Hospital in Seoul. Data collection was done from August to October 12,1988. The results obtained in this study can be summarized as follows, 1, Effect of the clinical application of the nursing diagnosis protocol. 1) The first hypothesis ; “nurses who use the nursing diagnosis protocol will have higher degrees of satisfaction than those who use traditional methods” was rejected (t＝.54, df＝58, p＝.59). 2) The second hypothesis ; “patients nursed by nurses using the nursing diagnosis protocol will have higher degrees of satisfaction than those nursed with traditional methods” was supported(t＝1.93, df＝154, p＝.05). 3) The third hypothisis : Major hypothesis ; “the nursing records of the experimental group, who used the nursing diagnosis protocol, will be more detailed than those of the control group” was supported (t＝6.40, df＝79.90, p＝.000). (1) The first subhypothesis ; “The recorded data collection of the experimental group will be more detailed than that of the control group” was rejected (t＝1.79, df＝118, p＝.07). (2) The second subhypothesis ; “The recorded patient's problem statement of the experimental group will be more detailed than that of the control group”, was supported. (3) The third subhypothesis ; “The nursing record of the experimental group will be more convenient for implementation than that of the control group” was supported. 2. Factors related to the nurse's degree of satisfaction with protocol. 1) No general characteristics(age, religion, education level, duty career, present duty career) were related to the nurse's degree of satisfaction. 2) Variables related to the nurse's degree of satisfaction were “satisfaction as a nurse” and “consider nursing as lifelong job” (t＝-2.6, df＝13.22, p＝.02, t＝2.41, df＝23.85, p＝.02). 3. Factors related to the patient's degree of satisfaction. 1) General characteristics related to the patient's degree of satisfaction with nurses using the protocol were age, educational level, and being married.(F＝5.17, df＝3/153, p＝.00, t＝ -2.39, df＝154, p＝,01, f＝5.91, df＝2/153, p＝.00) 2) The variables previous hospitalization, duration of hospitalization, the hospital unit presence of a relative, medical insurance, or medical diagnosis were not related to the patient's degree of satisfaction. 1. The experimental group's nursing record was more detailed than the control group's record with regard to the physical and psychological state of the patients. As noted above, the experimental group nurses, who use a nursing diagnosis had protocol were less satisfied than the control group who used traditional methods of the recording, but experimental group patients had a higher degree of satisfaction than the control group patients. The nursing records of experimental group, using the nursing, diagnosis protocol was more detailed than that of the control group. If the nursing diagnosis protocol is used in clinical nursing practice, the quality of nursing care may be improved.