• 한국산업보건학회지
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• 제5권1호
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• pp.48-58
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• 1995

This study was performed to find out the exposure level of mixed organic solvents, excretion of urinary hippuricacid and subjective symptoms according to the exposure of organic solvents of female workers who works on 5 shoes manufacturing industries in Taejon City from 24, september to 20, october 1993. The studied groups were divided into 3 groups that were consist of direct exposure group(48 workers), indirect exposure group(49 workers) and non-exposure group(68 workers) to the organic solvents. The exposure levels of toluene of direct exposure group which $89.86{\pm}56.20ppm$ had higher than that of indirect exposure group which had $40.23{\pm}47.21ppm$. In the exposure level of mixed organic solvent(R-value), direct exposure group was $2.84{\pm}1.53$ and exceeded approximatly 3 times the R-value. Whereas, indirect exposure group was not exceeded the R-value as $0.80{\pm}0.61$. In the excretion level of urinary hippuric acid, direct exposure group was $1.78{\pm}1.25g/l$, indirect exposure group was $1.22{\pm}0.93g/l$ and non-exposure group was $0.51{\pm}0.18g/l$ respectively. Therefore both direct exposure group and indirect exposure group were significantly higher than non-exposure group(P<0.01). In the correlation between toluene levels and urinary hippuric acid level, the direct exposure group had positive correlation(R=0.8309, P<0.01), also indirect exposure group had positive correlation(R=0.5859, P<0.05) and also in the correlation between the R value of mixed organic solvents and the urinary hippuric acid levels, the direct exposure group had positive correlation(R=0.4492, P<0.05), and indirect exposure group had ositive correlation(R=0.7911, P<0.01). In the complain rates of the worker's subjective symptoms at work, both direct exposure group and indirect exposure group were higher than non-exposure group(P<0.05, P<0.01). But the sujective symptoms of "floating sensation" of direct exposure group had significantly higher than indirect exposure group. In the percent of subjective symptoms complaints during the worker's daily life, both direct exposure group and indirect exposure group had generally more statistical significance than nonexposure group(P<0.01), direct exposure group had not statistical significant difference from indirect exposure group. As the results mentioned above, it has been analysed that the indirect at the adjacent manufaturing process are exposed to the considerable amount of solvent. Therefore, I think that there should be the betterment of surrounding through the complete working environment management to the occurrence source of the organic solvent, the changes of health management system to the indirect-exposed workers, and the systematic management of the special medical examination and the like.

• 의료법학
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• 제14권2호
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• pp.261-280
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• 2013

Recently several hospitals have established a new nursing position so called, 'the nurse in charge of education (NCE).' The job description of NCE is to give a detail explanation on examination or test introduced to patients or a guide for those who are not familiar to hospital facilities at the out-patients level. The motivation of NCE position is the quality improvement in patient education on the sophisticated procedures or the follow up care for medical purposes to improve their compliances, as well in delivering services for outpatients or visitors in more informative and efficient way. The application of NCEA has been turned out positive and effective in patient satisfaction and unit management. However, special attention is brought to the scope and depth of the contents of education delivered by NCE which might overlap with the duty of physicians by the Medical Act. It is needed to clarify the role and job description of NCE in the context of Medical Act. The engagement of NCE to the Advanced Nursing Practitioner (ANP) is one of the possible solutions for a duty charge on patient education since ANP is a legislatively official position with higher license of RN at master level. Further discussion is needed to elaborate and arrange the details on the scope and content of patent education among health science professionals including RN, ANP and physicians.

• 대한장애인치과학회지
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• 제13권2호
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• pp.99-103
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• 2017

본 증례는 Pallister-Killian 증후군 및 뇌성마비, 외상성 뇌손상이 있는 환자의 보호자에게 구강위생 관리 교육 및 동기부여를 시행하기 위한 방법 중 QLF-D를 사용한 경우이다. 치과치료에 대한 접근성이나 협조도에 어려움이 있는 장애 아동에서 치아 우식의 조기탐지 및 회복에 대한 객관적인 진단 장비, 보호자 교육 및 동기부여에 대한 효과적인 시각적 교육 자료로서 QLF-D가 유용하게 사용될 수 있다. 더 나아가 구강 건강 증진을 통한 장애 아동의 삶을 질 개선을 기대할 수 있다.

• 대한한의학원전학회지
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• 제29권4호
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• pp.75-94
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• 2016

Objectives : The uterus plays an important role in the woman's body. In Korean Medical literature, the uterus is mentioned in various contexts according to different perspectives on its meaning and function. An examination of these various contexts is crucial in understanding the meaning of the uterus and to better understand and approach woman's body. Methods : Aside from the most widely used term Jagung(子宮), there were various terms used to refer to the uterus. Based on a list of these terms, the Siku Qianshu collection of medical literatures was investigated. Contents related to the definition, shape, location, function were extracted and examined. Results : Among the findings, first, there were various terms referring to the uterus similar to contemporary understanding. Some of them referred to the uterus as a whole, while others referred to specific parts, one of which is the placenta. Some reflected a broader perspective on the meaning of the uterus. Second, the functions of the uterus could be summarized as gate keeping, and the maintenance of uterine environment that is related to menstruation, pregnancy, and childbirth. Third, based on the examination of the meaning of the uterus and its functions, perspectives on the uterus in Korean Medicine could be summarized into two. Conclusions : One viewed uterus as an organ dedicated to reproduction, similar to today's common understanding. According to this view, uterus is a special organ specific to women, which functions as an incubator for the fetus. The other viewed the uterus as an intangible source of life in the woman's body. As a general source of life to all human beings, it is not a passive organ but functions as an active source in woman's life phenomena. The two perspectives are not in conflict, but rather reflect the broad range of thought on the concept of the uterus in Korean Medicine. In today's biomedical society, the diversity and flexibility of these perspectives could shed light on medical practices that have resulted from extreme views on the woman's body.

• 지역사회간호학회지
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• 제7권1호
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• pp.69-79
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• 1996

도시와 농촌지역의 폐결핵환자 순응도 및 치료에 관련된 요인을 조사하기 위하여 1992년 1월 1일부터 1993년 12월 31일까지 2년동안 도시지역 보건소에서 등록치료한 545명과 농촌지역 보건소 210명으로 총 755명을 대상으로 조사한 결과를 요약하면 다음과 같다. 폐결핵환자의 일반적 특성을 지역으로 나누어보면 도시는 545명중 $20\sim29$세가 150명(27.5%)이고 농촌은 210명중 $60\sim69$세가 45명(21.4%) $70\sim79$세가 45명(21.4%)으로 유의하게 많았고, 폐결핵환자의 폐결핵과 관련된 특성은 도시는 초회X-선 검진결과 경증이 54.5%, 농촌은 중등증이 44.3% 많았다(P<0.01). 추후X-선 검진은 도시지역이 94.3% 실시한 것으로 농촌지역 90.0%보다 잘하는 것으로 나타났다(P<0.05). 폐결핵 발견경위는 도시지역은 보건소 유료X-선 검진 56.7% 농촌지역은 보건소 무료X-선 검진 35.2%로 가장 많았다(P<0.01), 폐결핵환자의 완치자 수는 도시가 90.8% 농촌이 87.1%로 도시지역이 높았다. 폐결핵환자의 동거가족이 있는 경우는 도시지역이 79.1% 이고 농촌은 88.1%로 농촌이 유의하게 높았다(P<0.05). 폐결핵환자의 폐결핵과 관련된 특성별 치료효율은 배양검사결과 양성인자의 완치자수는 도시가 201명(93.5%)이고 농촌은 108명중 99명(91.7%)으로 음성인 도시 330명중 294명(89.1%) 농촌 102명중 84명(82.4%)으로 배양에서 양성으로 나온사람이 음성인자보다 완치율이 높았다. 일반적 특성별 수약협조에 관한 사항의 유의한 관련성이 있는 요인은 연령, 동거가족유무, 사회경제적상태 등이고 폐결핵과 관련된 특성별 수약협조에 관한 사항은 방사선 소견, 배양검사 등이었다(P<0.05). 생존분석에 의한 도시에서의 등록기간별 규칙수약 누적율은 추적 6개월째 92.5%이고 농촌은 88.1%였다. 규칙수약실패율은 도시가 2개월째 3.75%, 농촌은 4개월째 4.15%로 가장 높았다. 치료결과에 관련된 요인들에 대한 다변량분석결과(Logisric Regression) 도시는 X-선 검진과 수약협조가 유의한 관련성이 있는 것으로 나타났다(P<0.05). 농촌은 통계적으로 유의한 것은 없었다. 이는 sample size가 작아서 유의하지 않은 것처럼 나온 것이라 생각된다. 수약협조에 관련된 요인에 대한 다변량 분석결과 (Logistic Regression) 도시는 초회 X-선, 객담 배양검사결과와 동거가족 유무가 유의한 변수였다(P<0.05). 즉 가족이 있는 환자가 치료지시이행이 높은 것으로, 이는 장기간의 치료를 요하는 질병일수록 가족의 지지가 중요한 것임을 시사한다 하겠다. 따라서 동거가족이 있고, 규칙수약하는 환자는 문제가 없는 것으로 폐결핵환자의 치료 순응도를 높이기 위해서는 치료실시전 보건교육을 보다 철저히 하여 규칙수약토록 하여야 하며 특히 동거가족이 없는 환자에 더욱더 관심을 가져야 할 것으로 사료된다.

• 농촌의학ㆍ지역보건
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• 제25권2호
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• pp.353-377
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• 2000

보건진료소의 보건의료환경 및 근무여건, 업무현황과 개선에 대한 보건진료원의 의견을 파악하여 향후 보건진료소의 발전 방안을 제시하는데 도움을 주고자 경상북도 소재 보건진료소(1996년 330개소, 1999년 313개소)의 운영상황보고서에 의한 업무 변화량을 분석하였으며, 보건진료원 280명의 설문자료를 분석하였다. 운영상황보고서에 의한 보건진료소의 관할인구 추이는 1996년에 비해 1999년에 전반적으로 감소하였으나 노인인구는 증가하였다. 운영상황보고서에 의한 보건진료소의 업무 활동상황은 1996년도에 비해 전반적으로 증가하였고, 진찰 및 투약관리, 검사, 성인병 및 만성질환관리, 노인건강, 가정방문이 특히 증가하였으며, 전염병 관리와 결핵관리에서 부분적인 감소를 보였다. 재정운영상태는 50.4%가 운영이 잘된다고 하였고, 1.4%만이 운영하기 곤란하다고 하였는데, 현 근무지 근무연수가 많을수록(p<0.05), 그리고 도시근교일수확, 인구가 많을수록, 진찰 및 투약건수가 많을수록(p<0.01) 운영이 잘 된다고 하였다. 보건진료원의 직업적 긍지는 전반적으로 긍정적이었는데, 그 중 하는 일의 중요함이 94.6%로 가장 긍정적이었고, 역할과 임무에 대한 만족정도는 현 근무지 근무연수에 따라 차이가 있었다(p<0.05). 보건진료원들의 보건기관과 민간의료기관과의 협조정도는 대체로 긍정적이었는데, 보건소와 협조정도는 연령이 많을수록, 근무 경력이 길수록 긍정적인 응답률이 유의하게 높았으며(p<0.01), 현 근무지 근무연수에 따라 차이가 있었다(p<0.05). 보건진료원들은 운영협의회, 마을건강원, 지역사회조직과도 협조적이다는 응답이 모두 70% 이상이었다. 보건진료소 사업계획서는 96.4%가 적성하였으며, 제2기 지역보건의료계획서 작성에는 11.4%만이 참여하였다. 관할지역주민의 혈압과 흡연여부를 70% 이상 파악하고 있는 보건 진료원은 각각 88.2%, 63.9% 였는데, 혈압파악률은 보건진료원의 연령이 많을수록(p<0.01), 교육정도가 전문대학 이하인 경우(p<0.05)에서 높았다. 보건진료원의 지난 3년 동안에 보수교육외 교육 참여율, 연구사업 참여율은 각각 27.5%로 저조했으며, 보건진료소 수입으로 주민환원 사업을 실시한 경우는 65.4%였다. 보건진료원들이 생각하는 보건진료소의 필요 정도는 국가적 측면, 소속시군 측면, 관할지역 측면에서 모두 95% 이상이 매우 필요 또는 필요하다고 하였으며, 53.9%가 보건진료소의 역할이 증대되어야 한다고 하였다. 지금까지 폐쇄 및 폐쇄 예정된 보건진료소에 대하여 보건진료원은 담당 부서의 보건진료소 업무에 대한 인식부족 및 행정편의, 보건진료원의 신분이 법률로 보장되지 않은 별정직이어서, 단체장의 의지 등을 주된 이유로 제시하였다. 보건진료원은 향후 보건진료소에 대한 평가기준에 대해 노인 및 만성질환자 등의 보건의료서비스 대상자수, 주민의 의견, 인구 규모, 일상생활권을 고려한 교통상황 등의 순으로 제시하였으며, 보건진료원에 대한 평가기준으로는 보건사업실적, 주민과의 유대정도, 진료실적, 행정 및 업무처리 능력 등의 순으로 제시하였다. 객관적인 평가 후 일정기준이하의 보건진료소에 대한 향후 대처 방안에 대해서 보건진료원은 현 구조 유지하면서 업무개선, 도시 의료취약지역으로의 보건진료소 위치 조정 등을 많이 제시하였다. 보건진료소의 가장 필요한 개선부문으로는 절반 이상인 52.5%가 보건진료원의 업무조정이라고 하였으며, 향후 보건진료소가 중점적으로 추진하여야 한 사업으로는 당뇨 및 고혈압 관리, 방문보건사업, 노인보건사업 등이 중요하다고 하였다. 향후 보건진료소가 일차보건의료의 가치체계를 잘 반영하는 조직이 되기 위하여는 지역사회 보건의료요구에 부합하는 업무개선이 이루어져야 하겠으며, 만성질환관리사업, 방문보건사업, 노인보건사업 등이 활성화 되어야 하겠다.

• 농촌의학ㆍ지역보건
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• 제42권1호
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• pp.1-12
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• 2017

지역보건의료계획서에서 비전은 각 지역의 보건의료계획을 나타내는 핵심요소임에도 불구하고 작성방법에 대한 구체적인 지침이 부재하여 각 지역의 비전은 매우 다양하게 표현되어 있다. 이에 이 연구에서는 제6기 지역보건의료계획에서 제시한 비전 문구를 보건소 유형별, 권역별로 분석하였다. 전국 229개 지역의 제6기 지역보건의료계획서의 비전 문구와 이와 관련된 미션, 전략체계도, 중장기 추진과제 등을 대상으로 하였다. 지역을 권역별 4개, 읍 면 동 구성에 따른 보건소 유형을 4개로 분류하였고, 각 지역 비전의 글자 수, 문장 평가, 단어 빈도, 문구 평가를 빈도분석과 카이제곱검정, 일원배치분산분석을 이용하여 분석하였다. 비전의 글자 수가 17자 이하인 보건소가 172개소(75.1%)였고, 보건소 유형별로 유의한 차이가 있었다(p<0.05). 문구에 대한 수사표현에서 비유법(37.1%)이, 한글 외에 표현 언어 사용에서는 특수문자(43.2%)가 많았으며, 보건소 유형별로 유의한 차이가 있었다(p<0.01). 비전에 사용된 단어들은 '건강', '행복', '함께', '군민' 또는 '시민', '도시', '100세' 등이었다. 문구 평가 점수에서는 특 광역시 및 수도권에서 가장 높았으며, 보건소 유형 및 권역별로 유의한 차이를 보였다(p<0.05). 보건소 유형별로 과정 및 평가 영역, 공유가능성 등에서 유의한 차이가 있었다(p<0.01). 방향성은 충청권, 수도권 순으로 권역별로 유의한 차이가 있었으며(p<0.01), 미래지향성 및 공유가능성은 영남권이 가장 높아 권역별로 유의한 차이가 있었다(p<0.01). 비전은 지역보건의료계획에 가장 중요 요소 중 하나이다. 이 연구는 지역사회 특성별로 비전의 설정이 다름을 확인하였으며, 이러한 결과를 통하여 지역보건의료계획 등 보건소 비전 수립시 참고가 될 수 있는 기초적인 자료가 될 것으로 판단된다.

• 한국직업건강간호학회지
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• 제13권1호
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• pp.5-18
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• 2004

This study aims to investigate the use state of the health service computerization system in the occupational nursing field and the occupational nursers' satisfaction level, and provide basic data to promote the development of the health service computerization system for the nursing field. For this study, a questionnaire was provided to 118 occupational nurses who belong to Busan and Gyeongnam branches of KAOHN(Korean Association of Occupational Health Nurses) for 2 months (from Dec. 1, 2002 to Jan. 31, 2003). A tool of Choi Yong-Heui(2000) was used to investigate the satisfaction level of using the health service computerization system. The collected materials were analyzed in real number and percentage, average and standard deviation, t-test and ANOVA by using the SPSS WIN 10.0 program. This study is summarized as follows: 1. The average age was $31.99{\pm}5.58$ old in this study. The married were 54.2%. Participants who graduated from a junior college was 76.9%. The average service period was $4.48{\pm}4.68$ years. In service types, 79.7% of participants served in a health care center. The average service period was $3.22{\pm}2.89$ years. The service place which had 1000 workers or more was 35.6%. 2. Only 20.3% of participants in this study had a computer use education. 3. The field who participants used mostly was communication/internet, $3.29{\pm}.85$ hours in average. 4. 97.1% of occupational fields had computers and peripheral devices: 71.4% in pentium computer, 42.8% in the hard disk capacity of 20-29GB, 60.0% in 15 inch monitors, 86.2% in printers, 18.1% in digital cameras, 12.4% in LAN, and 9.5% in scanners. 80.1% of the occupational fields which were objects of study could use communication. 5. The occupational fields which did not introduced the health service computerization system were 62.8%. The main cause was attributable to entrepreneurs' insufficient recognition 66.6%. 51.5% of the entrepreneurs did not have an introduction plan. 37.2% of participating companies had the health service computerization system. 56.4% of them introduced it since the year 2000. 81.6% of the introduction motivation aimed to the efficiency of health service. The most issue upon introduction was insufficient understanding of a person in charge - 25.6%. The in-house development of the system covered 56.4%. 61.5% of the participants accepted their demands from the first stage of development. The direct effect of computerization showed the increase of 25.9% in the quickness and continuity of service treatment, and 25.9% in the serviceability of statistical treatment. 6. 22.0% of the participants had a computerization system use education. 69.2% of them had a in-house education. An educational method by nurses who used the computerization system was 76.9%. 92.3% of the education was helpful for practical duties. 7. An analysis of the computer use by health service fields showed that the medicine management in a health management field was 15.9%. the work environment measuring management in a work environment filed was 32.9%. the employment. general and special examination management in a heal th management field was 61.1 %. the various reports management in an administrative field was 64%. the health education data preparation management in an educational field was 58.0%. and the medicine and expendables management in an equipment management field was 51.6%. An analysis of the computerization system use showed that the various statistical data manage in a health management field was 13.0%. the work environment measuring management in a health management field was 34.8%. the personal disease management in a health management field was 51.9%. the heal education data preparation management in an educational field was 54.5%. and the equipment management of health care centers in an equipment management field was 52.6%. 8. 31.6% of the participants wanted that health service computerization system would include the generals of health services. 42.4% of the participants thought that first of all. the aggressive interest and investment of employers were required to build the health service computerization system. 9. The participants' satisfaction level on the computerization system use was $3.51{\pm}.57$ points. An analysis by each factor showed $3.62{\pm}.68$ points in a service change factor. $3.15{\pm}.63$ points in a computer program use factor, and $3.45{\pm}.71$ points in a continuous computerization use factor. 10. An analysis of the computerization system use by general characteristics of participants showed that the married (p = .022) had the satisfaction level higher than the unmarried. 11. The satisfaction level of the computerization system use by participants' computer use ability tended to be higher in proportion to the increase of computer use abilities in spreadsheet (F=2.606. p=.048). presentation (F=3.62. p=.012) and communication/internet(F=2.885. p=.0321. Based on the study results mentioned above. I will suggest as follows : The nationwide enlargement and repetition study is required for occupational nurses who serve in occupational nursing fields. The computerization system in a health service field is inferior comparing with other fields. The computerization system standard by business types and characteristics should be prepared through employers's aggressive participation and national support. Therefore various statistical data which occurs in occupational fields will be managed systematically and efficiently. A regular and systematic computer education plan for occupational nurses in charge of health services in the filed is urgently required to efficiently manage and improve the health of on-site workers.

• 기본간호학회지
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• 제2권2호
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• pp.199-211
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• 1995

This study analyzed the practical education in fundamentals of nursing, for the 36 nursing schools including 12 4-year nursing schools and 24 junior college nursing schools. This survey was done from september 5th to october 5th in 1995. The results of this study were as follows : 1. Required credit in fundamentals of nursing. 1) The highest incidence of the total required credit was 7 in 4-year nursing school and 9 in junior college. 2) For the lecture course credit, the large number of 4-year nursing school gave 5 credit lessons and 6 credits provided in junior nursing colleges. 3) For the credit of practical education the major portion of 4-year nursing school gave 2 credits instruction, however junior nursing school provided 3 credits. 2. Laboratory practice in fundamentals of nursing. In laboratory practice, the ratio of instructor and student was 1 : 20 in 83.4% of the 4-year nursing school and in 66.7% of the junior nursing school. 3. Contents and hours of fundamental nursing practice. 1) In the area of health assessment and nursing process, the large number of schools allocated following hours : 6 hours for vital signs, 4 hours for nursing process, 2 hours for recording but practice for physical examination and communication was done in few schools. 2) In the area of functional health pattern, the large number of schools allocated practice hours like followings : 2 hours for I/O, 2 hours for gavage feeding, 2 hours for elimination, 6 hours for catheterization, 6 hours for bed making, 2 hours for positioning, 6 hours for personal hygiene, 2 hours for R.O.M, 4 hours for moving turning lifting, 2 hours for inhalation and suction. But C.P.R and terminally ill patient care were taught in smaller number of schools. 3) In the area of special nursing measures, the major portion of nursing schools allocated hours like followings. It consisted of 6 hours for asepsis, 16-18 hours for medication, 2 hours for heat and cold application, 2 hours for wound care. 4) 22.2% of the nursing schools had total review practice time and 36.1% of the nursing schools had the students clinical practice. Based on above mentioned results, 4-year nursing school had faithful practical education of fundamental nursing than junior nursing school. But for the contents and allocated hours for practice education, junior nursing schools were much more contents and hours than 4 year school.

• 대한한방내과학회지
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• 제27권2호
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• pp.510-520
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• 2006

Objectives: The aim of this study was to investigate the correlation between fatigue degree and Comprehensive diagnosis of Qui Xui Shui in patients with functional dyspepsia. There again, we investigated an association between scores obtained from Comprehensive diagnosis of Qui Xui Shui and state of skin sympathetic tone or cardiovascular reactivity. Methods: Subjects were 56 patients with Functional dyspepsia and 8 healthy People. Fatigue degree was assessed by questionnaires consisting of subjective complaints of fatigue. Comprehensive diagnoais of Qui Xue Shui was investigated by questionnaire and physical examination, total score and composition score were calculated from the symptom score. Skin sympathetic tone was measured by Ryodoraku Score(RS) and Cardiovascular Reactivity(CV Reactivity) was checked by Pulse diagnostic apparatus. All patients were divided into two groups by RS $40{\mu}A$(below and above) or by CV Reactivity(decreased and increased or not decreased). Results: There was highly significant correlation between Fatigue Degree and total score and each composition score of Comprehensive diagnosis of Qui Xui Shui. And total score of patients was significantly higher than that of health controls : in the patients, females than males. Significance related with the level of RS $40{\mu}Aor$ the state of CV Reactivity were not remarkable in both patients and health control group. Conclusions: Fatigue degree seems to have a special feature reflecting the state of Comprehensive Diagnosis of Qui Xui Shui in patients with functional dyspepsia.