• 간호행정학회지
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• 제5권2호
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• pp.389-400
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• 1999

The purpose of this study is to examine a possibility of applying the ABC system to analyze the cost of nursing service on one obstetrics and gynecology (OB/GYN) unit in a major medical center. The activities of nurses on an OB/GYN unit were analyzed for 4 days for 96 hours. 2 week days and 2 days on weekend. Total cases included in the study were activities of 12 charge nurses and 12 staff nurses. Activities were categorized into direct and indirect activities in order to calculate the cost of activities. Nursing activities were defined multidimesionally in order to utilize the ABC system. The 60 nursing activities were classified into the direct nursing activities and the indirect nursing activities based on a literature review, interview, and survey results. The direct activities were further categorized into the single nursing activities and the multiple nursing activities. The indirect activities were classified into the indirect nursing service activities and the general management activities. The major findings of this study were as follows : 1. There were differences in activities according to the positions and duties of the nurses. The charge nurses mostly performed the indirect nursing service activities and the general management activities. Almost all of their indirect nursing activities spent on each patient were similar. The staff nurses performed the single nursing activities and the multiple nursing activities. 2. The activities of staff nurses included medication, patient assessment, rounding and organizing the unit. patient education, nursing treatment, admission and discharging of patients. There was no differences in types and amount of time spent between the nurses on day-time duty and evening-time duty, but the patient assessment activity increased during the night-time. 3. The cost of post partum nursing services for women who had a normal vaginal delivery using the ABC system included the cost incurred by direct nursing activities provided by the staff nurses (85.9%), indirect nursing activities incurred by the staff nurses(19.0%) and the nursing activities by the charge nurses and the head nurse(14.1%). The ABC system is a relatively new method of cost analysis. The results of this study can provide the nursing and hospital managers with useful information on cost control. It is suggested that more studies should be done using the ABC system and extend the scope of studies to include value analysis to aid the Activity-Based Management(ABM) and/or the reengineering of hospital process.

• 대한간호학회지
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• 제15권1호
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• pp.76-96
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• 1985

Postoperative pain is one of the most frequently occurred pain in hospitals, but it has been underestimated because it is only a part of postoperative physiological Process and may disappear in time. It is necessary that nurses me the relaxation technique, planning and implementing by themselves independently, to reduce this postoperative pain. This study is aimed at showing the effect of relaxation technique on reduction of postoperative pain, and exploring the factors influencing postoperative. pain Fifty-seven patients with abdominal surgery who admitted in attacked D Medical Center to K University in Daegu have been studied. Of them twenty-nine were experimental group and the remaining twenty-eight were control group. This study has been conducted for collecting data through interviews and observation from August 23 to October 24, 1984. The tools of this study were two kinds: Postoperative Pain Scale is obtained from a review of references by the researcher, and relaxation technique, designed to use postoperative setting adequately, is also obtained from a review of references by the researcher. After confiriming no significant differences between the two groups, the hypotheses were statistically verified by x²-test, t-test, and pearson Correlation Coefficient. The results of this study are summerized as follows; ＊ The nam hypothesis that the experimental group who use relaxation technique will have less degree of postoperative pain than the control group who don't use relaxation technique is devided into three sub-hypotheses. 1. The first sub-hypothesis that the experimental group will have less score of postoperative pain than control group was accepted (t=7.810, p <.01). Even with controlling pain threshold, showing difference in some degree between the two groups, the experimental group has less score of postoperative pain than the control group. Therefore this confirms the acceptance of the first sub-hypothesis more strongly. 2. The second sub-hypothesis that the expermental group will have less frequency of analgesics than the control group is accepted (x²=9.85, p <.01). 3. The third sub-hypothesis that the experimental group will have less variation of pulse, respiration, and blood pressure between pre End post operative periods than the control group is rejected. So this hypothesis is reverified through comparing the variation of pulse, respiration, and blood pressure between pre and post changing Position to measure the pure effect of relaxation technique. pulse and respiration is significantly lowered in the experimental group (t=7.209, p<.01, t=3.473, p<.01), but systolic and diastolic blood pressure is not different significantly between the two groups (t= 1.309, p＞.05, t=1. 727 p>.05). Therefore the third sub-hypothesis is partially accepted. Conclusively, the researcher thinks that it is necessary that nurses should provide patients with relaxation technique to reduce postoperative pain, and to increase independence of nursing.

• 대한치과교정학회지
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• 제34권1호
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• pp.63-70
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• 2004

상악에 미니스크류를 적용할 때 사용되는 정중 구개봉합부는 특별한 해부학적인 구조물이 존재하지 않으며 두꺼운 치밀뼈로 구성되고 각화치은으로 덮여 있는 장점이 있어서 미니스크류를 식립하기에 유리하다. 그러나 측모 두부 방사선 사진 상에서 보이는 정중 구개봉합부는 그 두께가 얇아 통상적으로 사용되는 미니스크류 식립시 골 천공의 위험과 안정성 에 문제가 있을 것으로 생각되기 쉽다. 본 연구는 미니스크류 식 립을 위 한 정중 구개봉합부의 수직골의 두께를 알아보기 위해 총 25명 (남 : 13, 여 : 12)의 20대 환자 전산화 단층촬영 상을 이용하였다. 전산화 단층촬영상의 횡단면으로부터 정중구개봉합부의 수직골 두께를 계측하였고 각 부위의 유의성을 조사하여 다음과 같은 결론을 얻었다. 1. 정중 구개 봉합부 골의 두께는 남녀간의 유의할 만한 차이를 보이지 않았다. 2. 관상단면에서 보았을 때 정중 구개 봉합부를 중심으로 좌우로 갈수록 두께가 감소하는 양상을 보였고 시상단면에서 보았을 때 절치공에서 후비극쪽으로 갈수록 두께가 감소하는 양상을 보였다. 3. 수평적으로 정중 구개 봉합부 좌우 3mm 이내, 전후방적으로 절치공 후방 25mm 까지는 골의 두께가 3-4mm이상으로 미니스크류 식립을 위한 수직적골 골의 두께가 충분하였다.

• 디지털융복합연구
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• 제11권5호
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• pp.371-384
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• 2013

본 연구에서는 한국 및 미국의 퇴원환자 자료를 이용하여 한국 및 미국의 중증도 보정 사망 모형을 개발하고 개발된 중증도 보정 사망모형에 따라 중증도 보정 사망률 지표를 산출 및 비교한 다음 이를 통해 국내 의료기관 사망률 관리 방안을 제시하고자 하였다. 한국 및 미국 의료기관의 중증도 보정 사망 모형은 데이터마이닝기법인 다중 로지스틱회귀분석 기법, 의사결정나무분석 기법을 이용하여 개발하였다. 개발된 의료기관의 중증도 보정 사망모형에 따라 한국 및 미국 의료기관의 중증도 보정 사망률을 산출한 결과 한국은 매년 증가하고 있는 반면 미국은 매년 감소하고 있는 것으로 나타나 한국과 미국간에 차이가 있었다. 의료기관의 병상규모별 중증도 보정 사망률의 변이 또한 한국이 미국보다 높았다. 국내 의료기관의 사망률 관리를 위해서는 의료기관 자체내에서 사망환자 관리가 가능한 대형 의료기관들의 경우 의료기관 중증도 보정 사망률 평가 결과 공개를 통해 지속적으로 사망률 관리를 유도하고, 의료기관 자체내에서 사망률 관리가 힘든 중소병원들은 국가 차원에서 파악한 국내 의료기관 사망환자 관리의 문제점 및 이를 개선할 수 있는 개선방안을 토대로 사망률 관리 컨설팅을 시행하는 등 의료기관 사망환자 관리 사업을 진행하여야 한다.

• 사물인터넷융복합논문지
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• 제6권1호
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• pp.45-53
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• 2020

본 연구는 일 종합병원 간호사의 임종기 치료, 연명치료, 사전의료의향서에 대한 지식과 사전의료의향서 작성에 대한 교육요구도의 상관관계를 확인하는데 그 목적이 있다. 연구의 대상자는 서울시 소재 일 종합병원에 근무하는 임상경력 3개월 이상의 간호사 169명이다. 자료수집기간은 2018년 7월 19일부터 7월 26일까지였고, 수집된 자료는 SPSS/WIN 23.0을 이용하여 분석되었다. 간호사의 임종기 치료에 대한 지식은 8.56±1.61점(11점 만점), 연명치료에 대한 지식은 5.11±0.94점(6점 만점), 사전의료의향서에 대한 지식은 8.02±1.33점(9점 만점)이었고, 사전의료의향서 작성에 대한 교육요구도는 4.31±0.58점(5점 만점)이었다. 사전의료의향서 작성에 대한 교육요구도는 연명치료에 대한 지식수준이 높을수록 높았고(r=.182, p=.018), 사전의료의향서에 대한 지식수준이 높을수록 높은 것으로 나타났다(r=.234, p=.002). 본 연구결과는 향후 사전의료의향서 교육프로그램 개발을 위한 기초자료를 제공하는데 그 의의가 있다.

• 대한임상검사과학회지
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• 제47권2호
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• pp.83-89
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• 2015

결핵(Mycobacterium tuberculosis, MTB) 감염은 아직까지 전 세계에서 높은 유병률과 사망의 주요 원인이 되고 있으며 비정형 결핵(nontuberculous mycobacteria, NTM)은 최근 후천성 면역결핍증(AIDS)이나, 종양, 이식 등으로 면역력이 저하된 환자들의 임상 검체에서 분리빈도가 증가함에 따라 분리 균주의 임상적 의의가 중요시 되고 있다. 이에 항산균 염색을 이용한 객담 도말검사는 결핵균과 비정형 결핵균을 구별할 수 없다는 제한점이 있고, 균 분리배양검사는 시간이 오래 걸린다는 단점이 있어, 본 연구에서는 이러한 제한점을 가진 기존의 검사법을 대신하여 분자생물학적 방법인 중합효소 연쇄반응(polymerase chain reaction, PCR)을 이용하여 균 분리배양 검사와 비교하여 보았다. Mycobacteria를 동정하는데 항산균 염색과 3% ogawa 배지를 이용하였고, 균 분리배양 후 M. tuberculosis를 확인하기 위해서 niacin test를 실시한 결과 집락의 DNA를 추출하여 PCR후 동정된 M. tuberculosis와 niacin 양성이 일치함을 확인할 수 있었다. 또, 이 실험에서 항산성균 염색이 2+ 이상인 객담검체와 집락검체 각각에서 DNA를 추출하여 결핵균을 동정하는 방법으로 M. tuberculosis complex에 특징적으로 존재하는 insertion sequence (IS) 6110의 특정부위인 547 bp와 285 bp 부분을 증폭한 two-tube nested polymerase chain reaction을 시행하였고, 비정형 결핵균 동정법으로는 mycobacteria에 공통적으로 존재하는 rpoB 유전자 중 일부인 360 bp 부분을 증폭한 후, 제한효소 Msp I을 첨가 PCR-restriction fragment length polymorphism (RFLP)을 시행하였으며, 결핵균과 비정형 결핵균 모두 동정율에 거의 차이가 없었다. 1+인 경우는 객담검체에서 PCR한 결과가 31.2%에서 집락검체의 PCR한 결과 93.7%까지 결핵균과 비정형결핵균의 동정율이 높아졌고, trace인 경우 객담검체에서 PCR 결과가 2%에서 집락검체에서 PCR한 결과가 97.9%까지 결핵균과 비정형 결핵균의 동정율을 높일 수 있었다. 이 실험에서 항산성균 염색 1+이하 일때 객담검체와 집락검체로 PCR을 실시하면 결핵균과 비정형 결핵균의 동정율에 차이가 있고, 배양만으로는 결핵균의 동정은 가능하지만 비정형 결핵균의 동정이 가능하지 않으므로 배양검사와 PCR 검사 모두를 병행하므로써 보다 신속하고 정확한 검사결과를 내는데 도움 될 것이다.

• 대한간호학회지
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• 제30권4호
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• pp.847-856
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• 2000

Parents are primary care taker for the children and have an important role for the assessment and managent of children's pain following surgery. The purpose of the present study was to examine the validity and clinical utilization of the Postoperative Pain Measure for Parents (PPMP) developed by Chambers et al. Subjects were 52 children aged 4-12 years admitted for tonsillectomy and other minor surgery and their mothers. Faces Pain Scale, State Anxiety, and Postoperative Pain Measure for Parents were used. The data were collected by two research assistant on the operation day and 1st day after surgery at hospital during the period of July 20 to August 28, 1998. The results are as follows: 1. Eta correlation coefficient between 15 items of PPMP and child rated pain were calculated. Correlation coefficients were more than .2 for both day. 2. Internal consistency for PPMP were .82 and .83. 3. The scores of the PPMP were 10.73 (SD=3.71) and 9.27(SD=4.07) on the operation day and 1st day after surgery and there was no significant difference between two days(p=.056) On the other hand, there was a significant difference on the child rated pain by Faces Pain Scale between operation day and 1st day after surgery(p=.001). 4. The correlation(Spearman Rho) between PPMP and child rated pain were .40(p=.003) and .56(p=.000). The score of the PPMP and the children's state anxiety were highly correlated on the operation day and 1st day after surgery (.60, .52, p=.000). 5. Partial correlation between PPMP and child rated pain except state anxiety were .18(p=.23) and .48(p=.001) on the opration day and 1st day after surgery. 6. Using a cut-off score 10 out of 15, the measure showed excellent sensitivity (>80%) and moderate specificity (46.15%, 60% ). This study provides preliminary evidence for the use of the PPMP as a valid pain assessment tool with children between the ages of 4-12 years following surgery. It is suggested to explore the validity with a different subjects with other surgery and to examine the validity for infant and younger children.

• Restorative Dentistry and Endodontics
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• 제31권2호
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• pp.119-124
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• 2006

본 연구는 새로이 개발된 근관세정제 (MTAD)가 근관 충전이 이루어지고 난 치근단 누출에 미치는 영향을 평가해 보고자 하였다. 일반적인 방법의 근관 성형과 세정 그리고 충전을 시행하는데 있어 실험군 들에서는 NaOCl만, NaOCl과 EDTA, NaOCl과 MTAD를 사용하였고 10일 동안 표준전극과 시편 근관 내에 위치시킨 실험전극 사이의 전기저항을 측정하여 시간에 따른 치근단 누출의 변화를 비교 평가하였다. 실험결과 측정 시간 30분에서 7일 사이에서 smear layer 제거한 군들 (Group 4와 5)에서 제거하지 않은 군(Group 3)에서 보다 적은 치근단 누출을 보였지만 통계학적인 유의성있는 차이를 나타내지는 않았다 실험군들 사이에서 모든 시간 대에 걸쳐 치근단 누출의 유의성 있는 차이를 관찰할 수 없었다.

• 간호행정학회지
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• 제5권3호
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• pp.547-561
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• 1999

The purpose of this study was to determine which nursing activities are performed for patients in each of the nine KDRGs and to examine common nursing activities between patients with the nine KDRGs and special nursing activities which were not common to patients with the nine KDRGs. The study will provide basic data for estimation of nursing fees. The nine KDRGs in model project are Lens procedures, tonsillectomy, &/or adenoidectomy, appendectomy &/or not complicate principal diagnosis, vaginal delivery, cesarean section, anal & stomal procedures, inguinal & femoral hernia, uterine & adneza procedure for nonmalignancy, and simple pneumonia & pleurisy. To determine the nursing activities for each of the nine KDRG, checklists of nursing activities in each nine KDRG were developed from the literature and a total of 115 records of patients 'who were diagnosed and discharged between January and April, 1999 from a tertiary medical center. Nursing activities for each of the nine KDRG were verified through two consecutive content analyses. The results of study are followed as: 1. The checklists of nursing activities developed included direct and indirect nursing activities, for a total of 241 nursing activities. Direct nursing consisted of physical, educational, emotional-socioecomomic-spiritual nursing in 17 areas. Indirect nursing had four areas. 2. Through the two consecutive content analyses, 197 nursing activities were selected, having item CVIs of .83 or more. Those included 81 nursing activities for Lens procedures, 95 for Tonsillectomy &/or Adenoidectomy. 93 in Appendectomy &/or not complicated principal diagnosis, 155 for vaginal delivery, 172 for cesarean section, 89 for anal & stomal procedures, 93 for inguinal & femoral hernia, 108 for uterine & adneza procedures for non-malignancy, and 68 for simple pneumonia & pleurisy. 3. Nursing activities for each of the nine KDRG were compared. Activities with 80% or higher commonality within the nine KDRGs consisted of 86 of 197 nursing activities for the total designated common nursing activities, 30 common nursing activities for patients in the operation group, 45 common activities for patients in the delivery Group. Special nursing activities not common within the nine KDRGs were : 3 for Lens procedures, 1 for Tonsillectomy &/or Adenoidectomy. 2 for Appendectomy &/or not complicated principal diagnosis, 27 for vaginal delivery, 21 for Cesarean section, 6 for anal & stomal procedures, 3 for inguinal & femoral hernia, 16 for uterine & adneza procedure for non-malignancy, 8 for simple pneumonia & pleurisy. In this study, nursing activities for each of the nine KDRGs verified through two consecutive content analyses are those that are performed in the hospital. And, nursing activities for each of the nine KDRGs included all nursing activities from hospital admission to discharge. So. the checklists consisted of nursing activities that allow for an estimation of nursing fees under PPS. The classification of nursing activities in the study will provide a reference for the development of a nursing activity classification.

• 간호행정학회지
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• 제12권1호
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• pp.76-93
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• 2006

Purpose: The purpose of this study was to define the core components required of nurses to provide quality nursing care to patients and analyze the significance of these components in the hospital's various units to maintain a high level of competence among nurses. Method: The study evaluated 3 categories included 35 subcategories with 148 core components that were derived from literature review and interviews of nursing professionals. The nursing professional category included 18 subcategories with 98 components, the organizational culture category included 4 subcategories with 16 components, and the temperament-attitude category included 13 subcategories with 34 components. The study included 335 nurses with more than one year of hospital experience and measured disparities among different hospital units. The data was analyzed with SPSS-Win 10.0, differing perceptions of the importance of general traits among the participants were measured using standard deviation, and differing perceptions of the importance of professional traits among the participants were assessed using ANOVA and subsequently with the Bonferroni Test. The reliability of the aforementioned research tools were evaluated using the Cronbach's ${\alpha}$. Result: The results of the study were as follows: 1. Among the three categories, temperament-attitude category was perceived to be the most important, followed by nursing professional category and organizational culture category. Among the ten most important subcategories within the three categories, safety and infection prevention as well as responsibility were perceived to be the most important, followed by promotion of physiologic adaptation, document management and presentation, self-control, ethics, observance law, coping with emergency, humanity, and medication. 2. The relative importance of category associated with the core competencies within the hospital unit were as follows : 1) The units that rated nursing professional category as being the most significant were: internal medicine, surgical unit, mother-child unit, emergency room, intensive care unit, and operating room, in that order. 2) The units that rated the organizational culture competencies as being the most significant were: mother-child unit, internal medicine, surgical unit, emergency room, operating room, and intensive care unit, in that order. 3) The units that rated temperament-attitude category as being the most significant were: internal medicine, surgical unit, emergency room, mother-child unit, operating room, and intensive care unit, in that order.