• 한국비블리아학회지
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• 제30권2호
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• pp.117-144
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• 2019

현 시대는 고령화 사회, 삶의 질에 대한 국민의 관심증대, 의료비 감소를 위한 국가의 관심 증대 등으로 건강정보에 대한 관심이 전반적으로 증가된 상황이다. 이에 문헌정보학계의 연구노력, 도서관계의 건강특화서비스 제공 노력, 그리고 국가차원에서의 노력이 이루어져 왔으나, 도서관계에서의 통합적 및 체계적으로 건강관련 정보를 제공하기 위한 정책이나 전략은 명확히 제시되지 못하고 있는 실정이다. 이에 본 연구에서는 기 수행된 선행연구 및 정책연구, 그리고 사례조사를 통해서 도서관에서 건강정보를 통합적으로 제공할 수 있는 방안을 제안하고자 하였다. 그 결과, 건강정보제공통합시스템 구축, 건강관련정보의 총체적 DB 구축, 건강특화 도서관 프로그램 개발 및 운영, 건강정보서비스 총괄지원센터 운영, 건강정보서비스관련 부처 및 기관 간 협력네트워크 구축을 제안하였다. 본 연구에서 제안하는 구체적인 내용은 이후 도서관이 우리나라 국민의 건강증진을 위해 서비스 개발에 기여할 수 있을 것으로 보인다.

• 간호행정학회지
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• 제3권1호
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• pp.119-133
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• 1997

Continuing shift service of clinical nurses can be not only the cause of occupational dissatisfaction by being connected with the change of circadian rhythm and the burden of duties to be applicable to such changes. But also of inviting the lowering of nursing quality by being affected to the resignation of the nurses as the threat to the health of the nurses. This study has selected 500 nurses at random under non-probability sampling who have been serving by shift in 7 general hospitals which have over 400 sickbeds for the purpose of cross-sectional survey design from Sep. 7 through 20, 1996. Standardized modification of the CMI has been used which was designed for Koreans with Cornell Medical Index developed by Broadman and his fellow workers as the study device. The structure of the device was composed of 35 questions on physical appeal(Chronbach's ${\alpha}=8507$) and 22 questions of mental appeal(Cronbach's ${\alpha}=.8166$ totalling 57 questions. The collected data has been computerrized by using SPSS. General character, present symptom, perceived symptom and others are sought by practical number and percentage, and the health condition comparison followed by general characters was conducted by t-test and ANOVA. The post test was by Duncan's test by the level of p<.05. 1) The items of the answer that they have the physical symptom presently by 50% or over of the nurses were as "Do you often have spells of severe dizziness", "Are your eyes often red or inflamed", "Does press or pain in the head often make like miserable", "Are your ankles often badly swollen", "Do pains in the back make it hard for you to keep up with your work". 2) The items of the answer by over 50% of the nurses as the mental symptom at present were "do you fell bad when criticized?", "Do you get angry when everything is against your will?", "do you get angry when ordered to do this and that?", "do you feel uneasy by such a trifle thing?", "do you tremble or are you freightened by sudden sound?". The mental and physical symptoms which have appeared presently in connection with the shift service have been agreed with each other. But the physical condition has been worse than the mental one. 3) In the physical health conditions followed by demosociological character, there were the significant differences by sex, religion and place of residence(p<.05), and in the mental health conditions, there were the significant differences by age, marital status, residence place and the required time for attending hospital(p<.05). 4) There was significant difference by the degree of satisfaction about the duty in both the physical and mental health conditions. In short, the higher the degree of duty satisfaction, the better the health conditions. 5) There were the significant difference according to the times of night duty and whether they take the drug or not or the kinds of the drugs in the physical health conditions related with the characters of night shift. Mental health conditions in the night shift case showed significant differences according to their taking drug or not or the kinds of the drugs(p<.05). I can confirm that the nurses have been affected continuously by the shift service mentally and physically. The maintenance of the physical and mental health of the nurses and its promotion are very important problem to guarantee the quality nursing in the performance of the nursing service continuously and effectively, so the hospital should make every effort to improve the duty conditions by finding out the causes affecting to their health. In the nursing management viewpoint, I think that elevating the satisfaction degree about the duty would be a great help to the promotion of physical and mental health conditions. But what is most important is that the nurses themselves should take care of themselves in maintaining the good conditions in their service in the hospital.

• 호스피스학술지
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• 제1권1호
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• pp.46-69
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• 2001

Hospice Care is the best way to care for terminally ill patients and their family members. However most of them can not receive the appropriate hospice service because the Korean health delivery system is mainly be focussed on acutly ill patients. This study was carried out to clarify the situation of hospice in Korea and to develop a hospice care delivery system model which is appropriate in the Korean context. The theoretical framework of this study that hospice care delivery system is composed of hospice resources with personnel, facilities, etc., government and non-government hospice organization, hospice finances, hospice management and hospice delivery, was taken from the Health Delivery System of WHO(1984). Data was obtained through data analysis of litreature, interview, questionairs, visiting and Delphi Technique, from October 1998 to April 1999 involving 56 hospices, 1 hospice research center, 3 non-government hospice organizations, 20 experts who have had hospice experience for more than 3 years(mean is 9 years and 5 months) and officials or members of 3 non-government hospice organizations. There are 61 hospices in Korea. Even though hospice personnel have tried to study and to provide qualified hospice serices, there is nor any formal hospice linkage or network in Korea. This is the result of this survey made to clarify the situation of Korean hospice. Results of the study by Delphi Technique were as follows: 1.Hospice Resources: Key hospice personnel were found to be hospice coordinator, doctor, nurse, clergy, social worker, volunteers. Necessary qualifications for all personnel was that they conditions were resulted as have good health, receive hospice education and have communication skills. Education for hospice personnel is divided into (i)basic training and (ii)special education, e.g. palliative medicine course for hospice specialist or palliative care course in master degree for hospice nurse specialist. Hospice facilities could be developed by adding a living room, a space for family members, a prayer room, a church, an interview room, a kitchen, a dining room, a bath facility, a hall for music, art or work therapy, volunteers' room, garden, etc. to hospital facilities. 2.Hospice Organization: Whilst there are three non-government hospice organizations active at present, in the near future an hospice officer in the Health&Welfare Ministry plus a government Hospice body are necessary. However a non-government council to further integrate hospice development is also strongly recommended. 3.Hospice Finances: A New insurance standards, I.e. the charge for hospice care services, public information and tax reduction for donations were found suggested as methods to rise the hospice budget. 4.Hospice Management: Two divisions of hospice management/care were considered to be necessary in future. The role of the hospice officer in the Health & Welfare Ministry would be quality control of hospice teams and facilities involved/associated with hospice insurance standards. New non-government integrating councils role supporting the development of hospice care, not insurance covered. 5.Hospice delivery: Linkage&networking between hospice facilities and first, second, third level medical institutions are needed in order to provide varied and continous hospice care. Hospice Acts need to be established within the limits of medical law with regards to standards for professional staff members, educational programs, etc. The results of this study could be utilizes towards the development to two hospice care delivery system models, A and B. Model A is based on the hospital, especially the hospice unit, because in this setting is more easily available the new medical insurance for hospice care. Therefore a hospice team is organized in the hospital and may operate in the hospice unit and in the home hospice care service. After Model A is set up and operating, Model B will be the next stage, in which medical insurance cover will be extended to home hospice care service. This model(B) is also based on the hospital, but the focus of the hospital hospice unit will be moved to home hospice care which is connected by local physicians, national public health centers, community parties as like churches or volunteer groups. Model B will contribute to the care of terminally ill patients and their family members and also assist hospital administrators in cost-effectiveness.

• 한방재활의학과학회지
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• 제27권3호
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• pp.61-70
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• 2017

Objectives The purpose of this review is to analyse the trend in papers related with Korean Medicine Treatment after musculoskeletal disorder surgery. Methods We reviewed Korean Medicine papers by searching Korean web databases 'Korea Traditional Knowledge Portal', 'Scientific and Technological Information Integration Service (NDSL)', 'Academic Research Information Service (RISS)', 'Korea Medical Informati on Portal (OASIS)'. We classified the papers by the year of publishment, the title of journals, the type of study, surgery region, chief complain after surgery, main treatment, periods after surgery, assessment for outcomes. Results 1. Korean Medicine treatment after musculoskeletal disorder surgery has received more attention than in the past and there are attempts to do various studies besides the case reports. 2. 41 research papers were divided in to 3 original articles, 3 review articles, 35 case reports. But almost presented a low level of evidence. 3. Pain was the most common symptom after the musculoskeletal disorder surgery. Pain should be the primary goal of Korean rehabilitation treatment after musculoskeletal disorder surgery. 4. Assessment tools for outcome were concentrated in questionnaries, VAS and NRS. In order to evaluate better, it is necessary to evaluate the overall condition of the patient such as the quality of life evaluation and patient satisfaction. Conclusions In this study, we expect that the development and clinical application of Korean rehabilitation treatment program after musculoskeletal disorder surgery will be actively pursued.

• 한국보건간호학회지
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• 제2권2호
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• pp.5-20
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• 1988

This study is a series of reviews in connection with the application of the Questionnaire THI, in order to intend to provide such datum to be of a help as the screening-test by means of getting through comparative analysis, and finding out existence of any disease appeared as a result of the general medical examinations, and the psychosomatic symptoms, through the questionnaire THI. This study had been researched through the 507 insureds of the life insurance residing in Seoul and in the suburbs of Seoul, during the period 5 Jan. 1987 to 27 Feb. through the questionnaires. Exception of the 88 insincere respondents out of the total objectives, the 419 questionnaires were nanlized through percentage, Mean, T-test, ANOVA test, and Discriminant Analysis. 1. The Subjective Health Problem of the Objectives: The average of the health problem appliation quorum appeared to be 1. 81, the articles of both nervousness and aggressiveness appeared to be each 2.25 and 2.04. It tells that the state of appliation is heavy. It was very significant statistically the relation between the elements of sex, ages, educational backgrounds and occupations. 2. The result of the General Examination of the Objectives: The number of the persons with abnormal findings was 300 persons among the total of 419 persons as a result of the general medical examinations, and it was applicable to $73.5\%$. By each age and marital state were statistically significant. 3. Comparison of the result of the General Examination and Subjective Health of those Objectives: As a result of discriminant analysis of the independent variables through the result of the general examination, the greatest element for influence appeared to be the age, and then, regular examination, sex, and the somatic complaints of the THI in order. Accordingly, it is considered to be able to function as the screening test of the general examination, the THI. In case of a greater unit of group required a medical examination, It is considered to be of a help for the health management service for more effective and precise in quality and economic, only if a medical examination is carried out after selecting the somatic subjective problem and research in advance to the application of the THI prior to the examination.

• 한국응급구조학회지
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• 제6권1호
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• pp.103-128
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• 2002

As a result of trying the various manufacturing methods considering the reality of manpower and equipments with this manual, the following standardized procedures and contents can be suggested. (1) Since tools presenting Rock-Drill data must formalize the order of explanation although explainers are different, it will be valid that it is configured by existing power point method rather than by web document type. Composition of contents are selected on the basis of defence card and survey and then 8 items including initial screen, peripheral conditions, mobilization route, general conditions, use and structure by floor, department of vehicle consideration in activities and end screen are included. (2) Making methods and cautions of data included and used in power point are as follows ; - It was most effective that objects of fire fighting and location of neighboring fire fighting water were expressed by electronic map and drawing of inner building was made by scanning it after paining general architecture drawing(plan by each floor) rather than using drawing tools of EXCEL program or CAD drawing. And it was helpful to simplify contents of architecture drawing to wall, stairs and gate in understanding them. - Photographing of video data should be taken to show available fire fighting facilities in fire, use of planned space and the whole inner structure of each floor from the inside of fire fighting buildings and to display play time between 10 sec. and 1 min, for obstacles to distance from adjacent buildings or passage of special vehicles and fire fighting water from the outside of the building. - File format of video data taken in this way is most suitable to use wmv(window media video) or asf(advanced streaming format) type in consideration of time required for export, screen quality, file capacity and play type in Rock-Drill through network. - Still screen(photo) is more effective to express the department of fire fighting vehicles or other equipments than using video. (3) In configuration work of power point, hyper link was used most and configured to see any part at any situation like web document and then uniformity of presentation order of power point was complemented. (4) In case of sales facilities with the area of $35.557m^2$, the time of 22 hours and 30 minutes for five days was taken with five persons. Therefore, when eight-hour works a day were calculated, the whole process of video work for Rock-Drill can be finished with three day works.

• 한국산학기술학회논문지
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• 제16권6호
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• pp.4031-4039
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• 2015

저출산 고령화로 헌혈인구는 감소하고, 노년층의 혈액사용량은 증가할 것으로 예상되어 혈액부족과 수혈의 안정성 문제가 대두되고 있다. 이에 본 연구에서는 만성 퇴행성관절염인 슬관절과 고관절 전치환술 환자의 수혈에 영향을 주는 요인을 분석하고자 하였다. 이를 위해 건강보험심사평가원의 2011년 환자표본자료 중 입원환자 5,370명을 대상으로 하였으며, SPSS 20 프로그램을 이용하여 로지스틱 회귀분석을 실시하였다. 독립변수로 사용된 변수는 병원특성과 환자특성으로 병원특성은 의료기관 종류, 설립구분, 기관소재지와 가동병상수를, 환자특성으로는 성, 연령, 중증도, 전신마취유무, 주 진단, 빈혈유무와 의료보험종류로 구분하였다. 분석결과, 슬관절전치환술 환자의 수혈에 유의한 영향을 미치는 변수로는 의료기관 종류, 기관소재지, 성, 연령, 중증도, 주 진단, 빈혈유무였으며, 고관절전치환술 환자의 수혈에 유의한 영향을 주는 변수로는 의료기관 종류, 기관소재지, 성, 연령, 중증도, 전신마취유무, 빈혈유무였다. 수혈현황과 영향요인을 분석한 본 연구는 비용 효과적이며, 양질의 의료를 위한 기초자료로 활용될 수 있을 것으로 기대한다.

• 한국방사선학회논문지
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• 제11권2호
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• pp.123-130
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• 2017

암(caner)라는 중증의 질환을 가지고 있는 환자의 경우, 방사선 치료시 받을 수 있는 불안감, 폐쇄적 공포심을 알아보려 하였다. 연구의 대상은 각각 선형가속기의 치료, 토모테라피 치료를 받는 환자를 대상으로 하였으며 연구의 방법은 설문조사의 방법으로 시행을 하였다. 설문의 내용은 치료시간별로 조사 하였고, (5분 이내의 치료시, 10분이내, 20분 이상, 30분 이상), 장비의 고장으로 인한 치료실 및 치료기기 변경의 경험에 대한 설문조사를 시행하였다. 설문에 성실히 응답한 200개의 설문지를 연구한 결과 방사선치료의 경험이 없을수록 불안감이 많았으며 그 이유로는 치료시 고틍이 있을 것 같다는 의견이 지배적이었다. 치료기로는 선형가속기가 가장 불안감이 높았으며 이유는 환자의 테이블의 개방감 때문인 것으로 나타났다. 가장 안정적인 상태는 토모테라피 치료를 20분 이상 30분 미만 시행한 경우였으며 치료시 토모테라피 치료장비의 아늑함이 원인이었다. 30분이 초과된 경우는 외부와 분리에 대한 불안감으로 불안한 심리상태를 보였다. 본 논문을 통하여 임상에서는 환자의 만족도를 높이는 양질의 의료서비스를 제공하기 위한 제반 자료로 활용되길 기대해 본다.

• 한국병원경영학회지
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• 제7권4호
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• pp.57-101
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• 2002

These days, the environment of hospital marketing is changing rapidly. The level of expectation and demand of patients have become greater and more diversified, and patients have more alternatives in selecting hospitals. The standard of hospital selection and the type of using hospital have been changed, and competition among hospitals has been accelerated due to the opening of the medical market through globalization. Accordingly, differentiation strategies are critical in hospital marketing. The quality of medical service oriented toward patient satisfaction becomes a strong strategic weapon to secure a hospital's competitive advantage. Therefore, marketing and communication strategies should be focused on patient-oriented, rather than hospital-oriented. Considering the changes in the hospital environment and the increase in the patients' expectation level, this study categorizes doctors' communication styles into four different ones: trust-type, professional-type, cooperation-type, and control-type. The effects of these communication styles on patient satisfaction were empirically examined. The moderating roles of the patient's characteristics and clinical characteristics between the doctors' communication styles and patient satisfaction were also investigated to find out managerial implications for hospital management. To achieve such goals, data were collected from patients of 12 general hospitals in Busan. The data were analyzed to test research hypotheses that examine 1) the relationships between doctors' communication styles and patient satisfaction, 2) the moderating roles of the patient characteristics and clinical characteristics in the research model, and 3) the impact of patient satisfaction on positive word-of-mouth and repurchase. The following summarizes the major results of this research. First, the data showed that patient satisfaction varied across doctors' communication styles. Trust-type style had the strongest impact on patient satisfaction while control-type style had the weakest influence on patient satisfaction. Professional-type style and cooperation-type style also had positive effects on patient satisfaction but the impact of the two are not statistically different. Second, significant differences in terms of patient satisfaction were found depending upon demographic variables such as gender, marital status, age, occupation, and education. Patient satisfaction, however, was consistent across varying income groups. Third, patients' medical insurance types were also related to patient satisfaction. It implies that a doctor may need to use different communication styles depending on a patient's medical insurance type. Fourth, out-patient and in-patient showed a different level of satisfaction with varying communication styles. Fifth, highly professional knowledge and strong control can influence patient satisfaction depending on the characteristics of the patient treatment field. Sixth, patient satisfaction were proved to have significantly positive effects on word-of-mouth and repurchase. The implications drawn from this study must be tempered by its limitations. First of all, the subjects used in this study were patients in Busan and small- and medium-size hospitals were excluded from the research. Therefore, future research should examine the research model by using a variety of hospitals and clinics throughout Korea. Another research agenda has to do with finding more determinant and moderating variables which will increase an explanatory power of the model. In short, this study may be the first empirical research that investigates the effects of doctors' communication styles on patient satisfaction. Interestingly enough, the results showed that each communication style had a unique impact on patient satisfaction. The findings from this research can be very useful in developing hospital marketing strategies.

• 대한간호학회지
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• 제28권4호
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• pp.958-969
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• 1998

In this study, we attempted to investigate the needs and problems of the terminal cancer patients and their family caregivers to provide them with nursing information to improve their quality of life and prepare for a peaceful death. Data was collected from August 1, 1995 to July 31, 1996 at the internal medicine unit of S hospital in Seoul area with the two groups of participants who were family members of terminal cancer patients seventy four of them were in-patients and 34 were out-patients who were discharged from the same hospital for home care. The research tool used in this study has been developed by selecting the questionnaires from various references, modifying them for our purpose and refining them based on the results of preliminary study. While general background information about the patients was obtained by reviewing their medical records, all other information was collected by interviewing the primary family caregivers of the patients using the questionnaire. The data collected were analyzed with the SPSS PC/sup +/ program. The results of this study are summarized as follows ; 1) Most frequently complained symptoms of the terminal cancer patients were in the order of pain(87%), weakness(86.1%), anorexia(83.3%) and fatigue (80.6%). 2) Main therapies for the terminal cancer patients were pain control (58.3%), hyperalimentation(47.2%) and antibiotics(21.3%). 3) Special medical devices that terminal cancer patients used most were oxygen device (11.1%), and feeding tube(5.6%). Other devices were used by less than 5% of the patients. 4) The mobility of 70.4% of the patients was worse than ECOG 3 level, they had to stay in bed more than 50% of a day. 5) Patients wanted their medical staffs to help relieve pain(45.4%), various physical symptoms(29.6%), and problems associated with their emotion(11.1%). 6) 16.7% of the family caregivers hoped for full recovery of the patients, refusing to admit the status of the patients. Also, 37% wished for the extension of the patient's life at least for 6 months. 7) Only 38.9% of the family members was preparing for the patient's funeral. 8) 45.4% of family caregivers prefer hospital as the place for the patient's death, 39.8% their own home, and 14.8% undetermined. 9) Caregivers of the patients were mostly close family members, i.e., spouse(62%), and sons and daughters or daughter-in-laws(21.3%). 10) 43.5% of the family caregivers were aware of hospice care. 46.8% of them learned about the hospice care from the mass media, 27.7% from health professionals, and the rest from books and other sources. 11) Caregivers were asked about the most difficult problems they encounter in home care, 41 of them pointed out the lack of health professionals they can contact, counsel and get help from in case of emergency, 17 identified the difficulty of finding appropriate transportation to hospital, and 13 stated the difficulty of admission in hospital as needed. 12) 93.6% of family caregivers demanded 24-hour hot line, 80% the visiting nurses and doctors, and 69.4% the volunteer's help. The above results indicate that terminal patients and their family caregivers demand help from qualified health professionals whenever necessary. Hospice care system led by well-trained medical and nursing staffs is one of the viable answers for such demands.