• Journal of Yeungnam Medical Science
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• 제8권1호
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• pp.107-126
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• 1991

일부 도시 영세지역 주민의 상병양상과 의료이용형태를 파악하기 위하여 1988년 12월 한달간에 걸쳐 대구시 남구 대명 8동 영세지역 677가구 2,591명과 대조지역 688가구 2,682명의 주민을 대상으로 면접조사를 실시하였다. 두 지역의 연령별 인구 구성은 0-4세, 65세이상의 인구가 영세지역이 높았으며, 성비는 차이가 없었다. 교육정도와 경제수준은 영세지역은 낮았고, 의료보호 대상자는 영세지역이 많았다. 15일간의 급성질환 이환율은 영세지역이 1000명당 57.1로 대조지역의 24.2보다 유의하게 높았다. 두 지역에서 9세 이하 연령에서의 이환율이 높았으나 연령 증가에 따른 이환율의 뚜렷한 증감현상은 보이지 않았다. 질병분류별 급성질환 이환건수는 두 지역 모두에서 남녀 공히 호흡기계 질환이 가장 많았으며, 영세지역의 경우 감염 및 기생충 질환이 두번째로 많아 대조지역과는 다른 양상을 보였다. 급성질환 이환자의 15일간의 평균 이환기간은 영세지역 6.6일, 대조지역 5.4일로 영세지역이 약간 길었다. 급성질환 이환자의 15일간 의료기관 이용은 1차 이용에서는 영세지역의 경우 약국이 58.1% 그리고 대조지역에서는 의원이 36.9%로 가장 많았으며, 2차와 3차 이용에서 영세지역은 약국과 한의원, 대조지역은 병원과 의원이 가장 많았고, 미치료율은 영세지역이 8.8%로 대조지역의 4.6%에 비하여 훨씬 높게 나타났다. 급성질환 이환자의 지역별 의료이용행태에서 1차 이용에 있어서는 동네내 이용이 영세지역 73.6%, 대조지역 64.6%로 가장 많았다. 급성질환 이환자의 의료기관 1차 이용시 병원을 이용하는 이유로 가장 많은 것이 영세지역은 '단골'이었으며, 대조지역은 '가까운 거리'였다. 의원, 보건소 및 약국을 이용하는 이유로 가장 많은 것은 두 지역 모두 '가까운 거리'였다. 1년간 만성질환 이환율은 1000명당 영세지역 83.0, 대조지역 28.0으로 유의한 차이를 보였으며, 연령이 증가함에 따라 이환율도 증가하는 경향을 보였다. 만성질환 이환건수는 영세지역에서는 남자의 경우 신경계 질환이 19.6%, 여자의 경우는 신경계 질환 18.3%, 근골격계 질환이 18.3%로 가장 많았고, 대조지역에서는 남자의 경우 심혈관계 질환이 23.1%, 여자의 겨우 위장관계질환이 27.3%로 가장 많았다. 조사 시점전 1년간 만성질환의 평균 이환기간은 영세지역 9.8개월, 대조지역 10.4개월로 대조지역이 약간 더 길었으며, 평균 활동 제한 기간도 영세지역 1.9개월보다 대조지역 2.1개월로 다소 길었다. 만성질환 이환자의 의료기관 1차 이용에 있어서 영세지역은 약국 이용이 24.2%, 대조지역은 병원외래 이용이 34.7%로 가장 많았으며, 2차, 3차 이용에 있어 영세지역에서는 각 의료기관을 고루 이용하였고, 대조지역에서는 병원 이용이 두드러지게 많았으며, 미치료율은 영세지역과 대조지역이 각각 34.7%, 16.0%로 영세지역이 월등히 높았다. 만성질환자의 지역별 의료이용행태에서 1차 이용에 있어서는 동네내 이용이 영세지역 38.3%, 대조지역 45.3%로 두 지역 모두에서 가장 많았다. 만성질환 이환자의 지역별 의료기관 1차 이용시 병원, 의원, 보건소 및 약국을 이용하는 주된 이유는 '가까운 거리'였으며, 한의원을 이용하는 이유는 '좋은 치료결과'와 치료의 명성'이었다. 이상의 결과로 영세지역의 사회경제적수준이 상병과 의료이용행태에 영향을 미친 것으로 생각된다. 따라서 영세지역 주민을 위한 보다 적극적인 보건의료 서비스의 개발과 합리적이고 적절한 의료이용을 위한 지도 및 계몽과 아울러 사회경제적인 요소들의 개선을 위한 노력을 병행해야 만이 효과적인 보건의료 사업이 될 것으로 생각된다.

• 한국조경학회지
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• 제47권2호
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• pp.88-99
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• 2019

본 연구는 '수단-목적 사슬(Means-End Chain: MEC) 이론'을 토대로 경주 도심 고분 인근에 거주하는 지역주민과 관광객에 대한 경주 도심 고분의 방문에 관련한 심층적인 동기 및 가치를 분석하고자 하였으며, 이를 위해 소프트 래더링(soft laddering)과 하드 래더링(hard laddering) 방법론을 적용하였다. 이를 통하여 경주 도심 방문에 관련된 항목요인(속성, 혜택, 가치)과 인지구조(속성, 혜택, 가치의 연결 관계)를 파악하여 '가치단계도(Hierarchical Value Map)'의 상호 연관 관계모형을 구축함으로써 지역주민과 관광객의 가치체계를 비교하였다. 본 설문조사는 하드 래더링의 연계방식기법(Association Pattern Technique: APT)의 구조화된 설문지를 활용하여 지역주민과 관광객의 속성, 혜택, 가치에 기반한 수단(mean)-목적(end) 가치사슬 구조를 분석하였다. 연구결과, 경주 도심 고분을 방문하는 지역주민은 '휴식(휴양) 및 산책'을 수단으로 고려하고 있었으며, 이를 통해 결과적으로 그들은 '스트레스 해소'를 경험함과 최종적 목적 상태로 '역사 문화 보호 의식 배양'에 가치를 두고 있는 것으로 나타났다. 관광객 또한 '휴식(휴양) 및 산책'을 수단으로 고려하고 있었으며, 이를 통해 결과적으로 그들은 '스트레스 해소'를 경험함과 최종적 목적 상태로 '자기성찰 및 치유'에 가치를 두고 있는 것으로 나타났다. 이러한 결과를 중심으로 향후 "경주 도심 고분공원" 조성에 있어 우리는 고분의 문화유산 가치 보존 및 관리계획과 더불어 고분 지역주민과 관광객의 행동에 영향을 미치는 방문 가치에 관한 연구를 통해 보다 합리적인 고분 역사 문화 활용계획 방안 수립에 기초적인 자료로 활용이 가능할 것으로 기대된다.

• 지역사회간호학회지
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• 제13권1호
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• pp.182-196
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• 2002

The purpose of this study was to provide the basic resources for developing a parish nursing program. We did this by investigating what demands were made on the parish nursing service by the parishes or churches under review. The subjects of this study were 96 pastors located throughout the City of Busan. NP (New paragraph) $\gg$ We conducted our research by utilizing a modified version of the study created by Hwang (2000) and by using the help of prior research and professionals gathered from the parish nurse questionnaire by Djupe (1990). The data in this study were collected from July 1 to Oct. 31, 2001, using the questionnaire method. The Data were analyzed by: (a) frequency: (b) percentage: (c) mean: (d) standard deviation, and x^2-test$ with SPSS/PC program. The study has found the follows: 1. For subjects making demands on the parish nursing service, 95.8% were in need of using the services of parish nurses. On the demands of parish nursing service for the subjects, 95.8% the necessity of parish nursing services. And they answered by their intention of asking for parish nursing service practice. 2. Of the subjects under review, 71.9% were part-time workers and 28.1% were full-time employees 71.9% of part time and 28.1% of full times duty. In terms of the method of pay for work, 41.8% were pay free or freelance while 51.2% were on salary. And engagement intention of parish nurse as preacher was 88.5%. 3. The demand for nursing services in various categories were as follows. (a) hospice care: (4.02 1.11), (b) health screening: (3.98 1.09), (c) home visiting: (3.97 1.16), (d) group health education: (3.81 1.12), (e) organization of volunteer groups: (3.75 1.12), (f) individual health education: (3.75 1.14), (g) advice on choosing hospital or hospital consultation: (3.69 1.21) and (h) individual counseling: (3.51 1.31). 4. In terms of the specific services rendered by parish nurses. our study found that services were needed for the following: physical symptom management; preparation before death in spiritual preparation for death, blood pressure check in health examination, home visiting where the patient makes phone call, management of chronic disease in group health education, disease management in individual health education, advice on choosing hospital, or hospital consultation: and physical problems in individual counseling. 5. With respect to whether there was a correlation between what church a pastor came from and the types of demands made, there was NO significant difference found. 6. In relation to the characteristics of the subjects and their church and the hope demands (duty pattern and method of payment and engagement intention of parish nurse as preacher) for parish nurses, these had non significant differences. In conclusion, the perception of parish nursing service is very high. Moreover, we found that there is a great demand for well ordered parish nursing services to promote the health of each congregation. Before doing so, it would be better to make things known and to consider the relevant characteristics shown in the researched results.

• Tuberculosis and Respiratory Diseases
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• 제71권6호
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• pp.400-407
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• 2011

Background: There were a few studies which were conducted to know about the behavior of the chronic obstructive pulmonary diseases (COPD) patients. The aims of this study was to explore the behaviour of COPD patients, such as awareness and impact of disease, the pathway of visiting doctors, and the treatment pattern and preference. Methods: A face-to-face interview of 300 subjects with COPD was conducted. Results: The most concerned symptom which made the respondents to visit the hospital was 'breathlessness' (78%). Only 58% of them knew the exact diagnosis. Seventy-three percent of them visited the hospital 'once a month' or 'once every 2 month'. They have made 12.8 prescheduled visits to the hospital in the past 1 year. Unscheduled visits and hospital stay figured to two in the past year. Only 11% of respondents felt they were currently in good health. 'Severe' and 'very severe' COPD patients perceived their health to be in a worse condition than 'mild' and 'moderate' COPD patients. When conditions worsened, 42% of patients were hospitalized. The most common prescription treatment was a fixed combination of inhaled corticosteroids and long-acting ${\beta}2$ agonists (48%), followed by a long acting anticholinergics (38%). Conclusion: Over forty percent of the patients didn't know exactly about their condition. Most of them had a negative attitude toward their current health status. Doctors need to know more about COPD patients in terms of their attitude toward the disease, impact of the disease, interaction with healthcare professionals and treatment related problems.

• 대한한방부인과학회지
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• 제30권2호
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• pp.93-106
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• 2017

Objectives: This study is aimed to figure out Korean medicine doctors' recognition of Korean Medicine clinical practice guidelines (CPG) and clinical fields of treating primary dysmenorrhea before developing CPG for dysmenorrhea. Methods: We conducted a questionnaire survey targeting 515 Korean medicine doctors belonging to the Association of Korean Medicine by e-mail and analyzed the answers. Results: 81.2% of the respondents knew the concepts and contents of CPG, and 98.7% agreed about the necessity of CPG. 94.2% were willing to use CPG for dysmenorrhea in learning and treating. Average number of patients visiting the respondents' clinics for dysmenorrhea was 3.9, the main age group was 20s (63.1%), and the treatments the patients given before were mostly Western treatments such as pain killers and hormonal drugs. The respondents answered that they diagnosed patients with dysmenorrhea mainly with pattern diagnosis (41.6%), and treated them with herbal medicine (39.2%), acupuncture (31.6%) and moxibustion (22.6%) for 2-3 months. They answered that the acupoint they use most was San yin jiao, and the prescription was Gui-zhi-fu-ling-wan, They answered that the field considered to need further study was decoction of herbal medicine most (27.4%), and the field considered to need insurance coverage was also decoction of herbal medicine most (40.2%). Conclusions: We figured out Korean Medicine doctors' recognition of CPG, clinical diagnosis, treatment, cost for treating dysmenorrhea, and fields of clinical research and policy they required.

• Clinical and Experimental Reproductive Medicine
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• 제28권3호
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• pp.225-233
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• 2001

Objective : To evaluate the efficacy of low-dose aspirin on IVF outcome and endometrium in patients undergoing IVF-ET. Materials and Methods : From February, 2001 to Jun, 2001, 60 infertile patients were randomly divided into study group (28 cycles) and control group (32 cycles). The study group received a daily oral dose of 25 mg of aspirin for at least 2 weeks from first visiting day. Controlled ovarian hyperstimulation was initiated in all patients with the GnRH agonist starting in the midluteal phase of the previous cycle. Results: There were no significant differences in age of the patients, basal serum E2, LH, FSH level and endometrial thickness among two groups. There were no statistically significant differences between the study group and the control group respectively in dosage ($26.5{\pm}4.8$ vs $26.2{\pm}5.3$ amples) and duration ($10.4{\pm}4.2$ vs $9.8{\pm}5.3$ days) of gonadotropin administration, serum E2 level on the hCG administration day ($1823{\pm}342$ vs $1854{\pm}543$), LH ($14.5{\pm}2.7$ vs $14.8{\pm}3.1$), FSH ($16.7{\pm}3.4$ vs $18.3{\pm}4.7$), the number of follicles > 15 mm ($13.2{\pm}6.3$ vs $12.8{\pm}5.9$), the number of oocytes retrieved ($9.2{\pm}2.4$ vs $8.4{\pm}1.7$), the number of embryos transferred ($4.7{\pm}2.0$ vs $4.7{\pm}2.0$), fertilization rate (68.4% vs 64.5%), implantation rate (21.3% vs 17.6%), and clinical pregnancy rate (28.4% vs 26.2%). The endometrial thickness and the percentage of endometrial trilaminar pattern on hCG day were significantly higher in study group than control group ($12.9{\pm}3.7mm$ vs $10.4{\pm}2.8mm$, 78.3% vs 64.5%). Conclusion: Many reports suggest that low-dose aspirin improve ovarian response, implantation rate, fertilization rate, implantation rate, and pregnancy rate by increasing the blood flow, but we couldn't prove the significant effect of low-dose aspirin on the IVF outcome except on endometrium. This may be affected by dose of aspirin, duration, and number of patients studied. This trial is small, so our results highlight the need for a large randomized controlled trial to identify the effect of low-dose as pirin on IVF-ET outcome.

• 한국수학교육학회지시리즈A:수학교육
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• 제56권3호
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• pp.301-318
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• 2017

This paper explores students' question generation process and their study in small group discussion. The research is based on Anthropological Theory of the Didactic developed by Chevallard. He argues that the savior (knowledge) we are dealing with at school is based on a paradigm that we prevail over whether we 'learn' or 'study' socially. In other words, we haven't provided students with autonomous research and learning opportunities under 'the dominant paradigm of visiting works'. As an alternative, he suggests that we should move on to a new didactic paradigm for 'questioning the world a question', and proposes the Study and Research Courses (SRC) as its pedagogical structure. This study explores the SRC structure of small group activities in solving ill-structured problems. In order to explore the SRC structure generated in the small group discussion, one middle school teacher and 7 middle school students participated in this study. The students were divided into two groups with 4 students and 3 students. The teacher conducted the lesson with ill-structured problems provided by researchers. We collected students' presentation materials and classroom video records, and then analyzed based on SRC structure. As a result, we have identified that students were able to focus on the valuable information they needed to explore. We found that the nature of the questions generated by students focused on details more than the whole of the problem. In the SRC course, we also found pattern of a small group discussion. In other words, they generated questions relatively personally, but sought answer cooperatively. This study identified the possibility of SRC as a tool to provide a holistic learning mode of small group discussions in small class, which bring about future mathematics classrooms. This study is meaningful to investigate how students develop their own mathematical inquiry process through self-directed learning, learner-specific curriculum are emphasized and the paradigm shift is required.

• 한국산학기술학회논문지
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• 제19권1호
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• pp.355-367
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• 2018

본 연구는 C시에 소재한 보건소의 방문건강관리 대상 노인 중 만성 관절통증이 있는 65세이상 취약계층 재가 여성노인 234명을 대상으로 삶의 질에 영향을 미치는 주요 요인을 파악하기 위한 서술적 상관관계 연구이다. 본 연구의 자료는 일반적 특성, 통증양상, 통증정도, 지각된 건강상태, 일상생활능력, 수면양상, 우울, 삶의 질로 구성된 구조화된 설문지를 통해 2017년 2월 16일부터 3월 13일에 걸쳐 수집되었으며, t-test, ANOVA, 상관분석, 위계적 다중 회귀분석으로 분석하였다. 연구결과, 대상자의 일반적 특성을 포함하여 대상자의 삶의 질에 영향을 미친 변수는 우울(${\beta}=-.60$, p<.001), 통증정도(${\beta}=-.15$, p=.007), 의료보장 유형(${\beta}=.15$, p=.001), 지각된 건강상태(${\beta}=.14$, p=.007), 통증지속기간(${\beta}=-.10$, p=.019), 결혼상태(${\beta}=.10$, p=.024), 일상생활능력(${\beta}=.09$, p=.036)순으로 나타났으며, 모형의 총 설명력은 63.1%였다. 본 연구를 통해 만성 관절통증이 있는 재가 여성노인의 삶의 질을 향상시키기 위해서는 지역사회 중심의 체계적인 우울 예방 및 관리 프로그램 운영이 우선 실시되어야 하며, 특히 경제적으로 취약한 공적부조 대상 노인의 삶의 질에 관심을 기울여야 하고, 통증 발현 초기부터 통증에 대한 정확한 사정을 토대로 통증완화중재 개입을 시행해야 한다.

• 한국산학기술학회논문지
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• 제12권1호
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• pp.301-311
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• 2011

본 연구는 사무직 남성 근로자들을 대상으로 이들의 직무스트레스 요인 및 사회심리적 요인과 피로수준 간의 관련성을 파악하며, 피로수준에 유의하게 영향을 미치는 요인들을 규명하고자 하였다. 조사대상은 50인 이상 300인 미만 중소규모 사업장 42개소에 근무하고 있는 사무직 남성 근로자 872명으로 하였으며, 자료수집방법은 2009년 2월 1일부터 2009년 4월 30일까지의 기간 동안에 자기기입식 설문조사를 실시하였다. 연구결과, 조사대상자의 직무스트레스 요인에 따른 피로수준은 업무요구도가 높을수록, 업무의 자율성이 낮을수록, 상사의 지지도가 낮을수록 유의하게 높았다. 사회심리적 요인에 따른 피로수준은 자기존중감이 높을수록 유의하게 높았다. 다중회귀분석을 실시한 결과, 피로수준에 영향을 미치는 요인으로는 연령, 주관적 건강상태, 근무경력, 결근횟수, 직장생활만족도, 규칙적 운동유무, 수면시간, 외래진료유무, 업무요구도, 상사의 지지도 및 자기존중감이 유의한 변수로 선정되었다. 위와 같은 연구결과를 볼 때, 직장인의 피로수준은 인구사회학적 특성, 직업관련 특성 및 건강관련행위의 실천여부 뿐만 아니라, 직무스트레스 요인 및 사회심리적 요인과도 유의한 관련이 있음을 시사하였다.

• 한국시뮬레이션학회:학술대회논문집
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• 한국시뮬레이션학회 2001년도 The Seoul International Simulation Conference
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• pp.170-202
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• 2001

Simulation is used to reduce a risk involved in the new project and decision-making in an organization and to save cost and time by forecasting different situations. The objectives of this research are to acknowledge the need of simulation through the real life sample and to encourage the use of the simulation method in the future consulting project by continuously making the necessary improvements. This research analyzed the effectiveness of the simulation based on the sample use of simulation method in 1994 and 1997 for the BPR project of certification issuance process at the Supreme Court. In order to evaluate the value of the proposed simulation model, we examined the gap, which existed between the simulation result and the operational data collected by visiting the actual sites where AROS (Automated Registry Office System: automation system developed by LG-EDS Systems) is being utilized. We also identified the causes for the existing gap. According to the analysis result, (1) the gap came from the status change of thinking that the concentration of certification issuance request has eased after the computerization, (2) the gap existed in the operational process because they failed to consider the situational factors of each registry office in the simulation model, and (3) lastly the gap came from the difficulty of formulating the mathematical model for predicting the complex and diverse behavior pattern of individuals requesting the certification issuance. In order to narrow the existing gaps, we made a proposal to improve the certification issuance process where software of certification issuance vending machine was upgraded in order to help the people to use the service conveniently, more part time workers were hared when there was a overload of certification issuance request, and the quality of the certification Issuance vending machine is improved, In this research, we examined an efficient way of resource allocation based on the simulation conducted in 1994 and 1997. By reflecting changes since the simulation of 1994 and allocating the clerk and machine based on the predicted results of the simulation, we maximized the efficiency of the certification issuance process. In conclusion, this research examined the future usability of simulation method based on the analysis result and identified the key issues to consider when using the simulation method in the future consulting project.