• 제목/요약/키워드: coefficient problems

검색결과 863건 처리시간 0.034초

종합병원의 비보험환자 처치행위 양상과 수가분석에 관한 연구 (An Analysis of Nursing Behavior and Unit of Treatment Cost of Non- Insurance Patients)

  • 오세영
    • 대한간호학회지
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    • 제10권1호
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    • pp.41-55
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    • 1980
  • The medical care insurance system, being put into practice nearly for three years, seem to have brought about some considerable problems as serious for the government as to consider a revision of that system. As one of the most serious problems of present system, the treatment cost of insurance patients is so remarkably low in comparison with than of non-insurance cases that normal operation of hospitals is threatened and care services of low quality are induced. The researcher carried out this survey to analyze and bring to light several aspects of treatment cost of non-insurance patients as a material for a re-assessment of the cost of insurance cases which shows a a considerable difference in amount at the standpoint of hospitals with than of non-insurance cases and further, hoping the significant blind spot of present insurance system(that is, the absence of regulations' for cost assessment by patterns or types of health care treatment) will be mended in near future. The survey was carried out with the treatment invoice sheets of total 902 in-hospital Patients of a general hospital in Seoul during the period of the 2 nd quarter of the year(1979). Among total 902 patients, 694 cases were used for analysis, because those disease or syndromes shared by less than 10% of the patients were put aside before procession. The data were analyzed by kinds or types of diseases, demographic characteristics of patients, hospitalization patterns, types of nursing treatment, etc. The result of analysis was as follows 1. Among all the non-insurance cases, those who received one or more kinds of nursing treatment mounted up to 96. 7 %. The invoice issue frequency per person was 7.2 times, while that frequency per day for a person was 0.8, : the treatment cosr per person was ₩22,650 while its daily average was ₩2,430, due to the average 9.3 in-hospital days per person. 2. As to the nursing treatment types by the demographic characteristics of patients and hospitalization patterns. a. The unit cost female patients was generally more expensive them that of males, and independent nursing service was more given than other types of treatment. As to age, higher age groups received independent nursing service most, while the youngest group received instrumental and integrated nursing services. b. As to room grade, the unit cost of I.C.U. cases was the highest : and the cast of private room patients was higher than that of public room patients. By in-hospital days, the curve of function showed L. type : that is, the longer stay, the lower function. 3. State of treatment types by kinds of disease were ; a. Dependent nursing service showed comparatively high availability in surgical and neurologic disease and independent nursing service was most received by medical, obstetrical and urological patients, while instrumental and integrated services were most available for respiratory disease and obstetrical and neurologic diseases next. b. The invoice issue frequency per day for a patient was highest in obstetrical disease 3.8 times, and the unit cost(per one invoice sheet) was also highest in obstertrical disease(₩10,880) and next in neurologic cases(₩ 4,690 ). 4. As to the pertained departments. a. Cost amount per person was highest in department of Psychiatries daily cost was highest in obstetrical cases : while the invoice issue frequency was highest in obstetrics and next in pediatrics. b. In departments in need of surgical operation, dependent nursing care was highly availabl : while in internal medicine and obstetrics, independent service was higher. Psychiatrics showed the highest the of integrate nursing while pediatrics and obstetrics higher of instrumental services. The variation co-efficien of treatment cost came out to be relatively in high in special surgery, opthalmology and internal medicine. 5. State of treatment cost by types of nursing behavior was. a. The average frequency of invoice issue was 3.5 (times). Among the type four types of treatment, instrumetal service (4.3) and independent nursing behavior(3.9) showed higher frequency than average respectively. But as to unit cost (per invoice). dependent (₩5,200) and integrated (₩5,340) nursing care services were higher than average and considerably higher than the other two types. b. In repect patient distribution. independent nursing behavior(80.3% ) was the highest and depend ent nursing (31.7% ) the lowest. The variation co-efficient of treatment cost appeared highest in dependent nursing be havior as a whole, and among that, doctor's diagnosis showed the highest coefficient value (100.7). In conclusion, the variaty of treatment cost(treatment itself ) by various characteristics and treatment types pro- that treatment various sort of patients and treatment cost of various types of nursing behavior cannot be uniform. Therefore, to attain the equalization of health care service and its cost both for insurant and non-insurant patients, a more specific provision for assessment of cost should be added to the present medical care insurance system and, in addition, the cost of nursing treatment is desired to be inserted into the treatment invoice.

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의료서비스 마케팅을 위한 품질지각과 만족에 관한 연구 (A Study on Qulity Perceptions and Satisfaction for Medical Service Marketing)

  • 유동근
    • 간호행정학회지
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    • 제2권1호
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    • pp.97-114
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    • 1996
  • INSTRODUCTION Service quality is, unlike goods quality, an abstract and elusive constuct. Service quality and its requirements are not easily understood by consumers, and also present some critical research problems. However, quality is very important to marketers and consumers in that it has many strategic benefits in contributing to profitability of marketing activities and consumers' problem-solving activities. Moreover, despite the phenomenal growth of medical service sector, few researchers have attempted to define and model medical service quality. Especially, little research has focused on the evaluation of medical service quality and patient satisfaction from the perspectives of both the provider and the patient. As competition intensifies and patients are demanding higher quality of medical service, medical service quality and patient satisfaction has emerged as a critical research topic. The major purpose of this article is to explore the concept of medical service quality and its evaluation from both nurse and patient perspectives. This article attempts to achieve its purpose by (1)classfying critical service attibutes into threecategories(satisfiers, hygiene factors, and performance factors). (2)measuring the relative importance of need criteria, (3)evaluating SERVPERF model and SERVQUAL model in medical service sector, and (4)identifying the relationship between perceived quality and overall patient satisfaction. METHOD Data were gathered from a sample of 217 patients and 179 nurses in Seoul-area general hospitals. From the review of previous literature, 50 survey items representing various facets of the medical service quality were developed to form a questionnaire. A five-point scale ranging from "Strongly Agree"(5) to "Strongly Disagree"(1) accompanied each statement(expectation statements, perception statements, and importance statements). To measure overall satisfaction, a seven-point scale was used, ranging from "Very Satisfied"(7) to "Very Dissatisfied"(1) with no verbal labels for scale points 2 through 6 RESULTS In explaining the relationship between perceived performance and overall satisfaction, only 31 variables out of original 50 survey items were proven to be statistically significant. Hence, a penalty-reward analysis was performed on theses 31 critical attributes to find out 17 satisfiers, 8 hygiene factors, and 4 performance factors in patient perspective. The role(category) of each service quality attribute in relation to patient satisfaction was com pared across two groups, that is, patients and nurses. They were little overlapped, suggesting that two groups had different sets of 'perceived quality' attributes. Principal components factor analyses of the patients' and nurses' responses were performed to identify the underlying dimensions for the set of performance(experience) statements. 28 variables were analyzed by using a varimax rotation after deleting three obscure variables. The number of factors to be extracted was determined by evaluating the eigenvalue scores. Six factors wereextracted, accounting for 57.1% of the total variance. Reliability analysis was performed to refine the factors further. Using coefficient alpha, scores of .84 to .65 were obtained. Individual-item analysis indicated that all statements in each of the factors should remain. On 26 attributes of 31 critical service quality attributes, there were gaps between actual patient's importance of need criteria and nurse perceptions of them. Those critical attributes could be classified into four categories based on the relative importance of need criteria and perceived performance from the perspective of patient. This analysis is useful in developing strategic plans for performance improvement. (1) top priorities(high importance and low performance) (in this study)- more health-related information -accuracy in billing - quality of food - appointments at my convenience - information about tests and treatments - prompt service of business office -adequacy of accommodations(elevators, etc) (2) current strengths(high importance and high performance) (3)unnecessary strengths(low importance and high performance) (4) low priorities(low importance and low performance) While 26 service quality attributes of SERPERF model were significantly related to patient satisfation, only 13 attributes of SERVQUAL model were significantly related. This result suggested that only experience-based norms(SERVPERF model) were more appropriate than expectations to serve as a benchmark against which service experiences were compared(SERVQUAL model). However, it must be noted that the degree of association to overall satisfaction was not consistent. There were some gaps between nurse percetions and patient perception of medical service performance. From the patient's viewpoint, "personal likability", "technical skill/trust", and "cares about me" were most significant positioning factors that contributed patient satisfaction. DISCUSSION This study shows that there are inconsistencies between nurse perceptions and patient perceptions of medical service attributes. Also, for service quality improvement, it is most important for nurses to understand what satisfiers, hygiene factors, and performance factors are through two-way communications. Patient satisfaction should be measured, and problems identified should be resolved for survival in intense competitive market conditions. Hence, patient satisfaction monitoring is now becoming a standard marketing tool for healthcare providers and its role is expected to increase.

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일부 중학생의 성에 대한 지식, 태도 및 성교육 요구도에 관한 조사연구 (A Survey of Sexual Knowledge, Attitude, and the Need for Sex Education in Middle School Students)

  • 오윤정;김정남;하숙영
    • 지역사회간호학회지
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    • 제9권2호
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    • pp.467-481
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    • 1998
  • The purpose of this survey, in which 2754 students from 35 middle schools from Taegu city participated, was to identify the degree and the relationship of sexual knowledge, sexual attitude and need for sex education. This information will provide useful data, and promote a more systematic, desirable and practical sex education. The data was collected from September 1 to November 8, 1997. Data was analyzed using the statistical computer package, SPSS to manipulate the data along with percentage, mean, $X^2$-test. t-test, F-test and Pearson correlation coefficient. The results from this study were summarized as follows: 1. The mean score of sex related knowledge showed significant differences between boys and girls in general knowledge(boys: 10.85 girls: 11.71, p=0.000), in the area of physical development(boys : 5.29 girls: 5.72, p=0.000), pregnancy & physiology (boys: 3.23 girls: 3.57, p=0.000) and venereal disease (boys: 2.33 girls: 2.42, p=0.000). 2. The mean score of sex related attitudes showed a significant differences between boys and girls on the whole(boys : 57.68 girls: 58.92, p=0.000), in the area of psychological differences of the other sex (boy: 26.13, girls: 28.08, p=0.000), and sexual delinquency and its prevention(boy: 14.28, girls: 13.68, p=0.000). However, in the area of other sex friendships (boy: 17.28, girls: 17.16, p=0.274). There were no significant differences between boys and girls. 3. Those who had a higher sex related knowledge score showed more positive attitudes towards sex, but was of no statistical significance(r= 0.312, p=0.000). 4. The majority of subjects wanted to learn about friendship with the other sex(40.1%), about physical and psychological differences in adolescence(24.0%), about prevention of sexual violence(15.0%), about pregnancy and delivery (7.5%), about venereal disease and medical cures(7.3%), about contraception methods (4.3%), as well as other aspects of sexual knowledge (1.8%), 5. The mean score of sex related knowledge generally was higher when one paid a lot of attention to health (F= 3. 148, p=0.014), when one's father was alive(t=3.930, p=0.000), and when one's mother was alive(t=2.807, p=0.005), Hobby activities also showed a significant difference(F=9.092, p=0.000). The mean score of sex related knowledge generally according higher when one had sex education(F=9.470, p=0.000), when one obtained sexual knowledges from a teacher (F = 5. 742, p=0.000), and when one had middle grade problems with sex(F=13.58 4, p=0.000). 6. The mean score of sex related attitudes generally showed significant differences when re ligion(F=2.691, p=0.03), hobbies (F= 3.499, p= 0.002) were considered. Those who had a father also had higher scores(t=2.538, p= 0.011). The mean score of sex related attitudes generally with respect to a subject's sex was higher when one had sex education(t=5.338, p= 0.000), when one had high grade problems with sex(F=6.023, p=0.002), and when one had the experience of friendship with the other sex(t= 8.106, p=0.000), The following suggestions are based on the above results, 1. Systematic sex education must be performed in middle schools in order to establish responsible attitudes toward sex, 2. Sexual knowledge, attitude, and general sex education classes must be performed seperately for early, middle, and late adolescents, In other words sex education programs are needed for each adolescent development stage.

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농산물(農産物) 건조(乾燥) 및 저장(貯藏)을 위(爲)한 태양열(太陽熱) 저장고(貯藏庫)의 개발(開發)에 관(關)한 연구(硏究) (Development of Solar Warehouse for Drying and Storing the Agricultural Products)

  • 김만수;장규섭;김성래;전병선
    • 농업과학연구
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    • 제9권1호
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    • pp.357-370
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    • 1982
  • 태양열(太陽熱)을 이용(利用)한 곡물(穀物)의 건조(乾燥)와 저장(貯藏)을 겸할 수 있는 농가용(農家用) 태양열(太陽熱) 저장고(貯藏庫)의 개발(開發)에 필요(必要)한 기초자료(基礎資料)를 얻기 위(爲)하여 구조(構造)가 간단(簡單)하고 가격(價格)이 저렴한 콘크리트 벽체의 저장고(貯藏庫)와 그 지붕을 대신(代身)한 태양열집열기(太陽熱集熱器)를 설계(設計) 제작(製作)하여 집열기(集熱器)의 성능(性能)을 실험(實驗)에 의(依)하여 구(求)하였으며 집열기(集熱器)에서 가열(加熱)된 공기(空氣)와 상온통풍(常溫通風)에 의(依)한 벼의 건조특성(乾操特性)을 비교(比較) 분석(分析)하였다. 건조(乾操)된 곡물(穀物)의 저장시(貯藏時)에 그 온도(溫度)를 예측(豫測)할 수 있는 simulation model을 개발(開發)하여 그 적합성(適合性)을 검정(檢定)하고 저장곡물(貯藏殺物)의 각(各) 부위(部位)에 대(對)한 온도(溫度)의 변화(變化)를 분석(分析)한 결과(結果)들을 요약(要約)하면 다음과 같다. 1. 본(本) 실험(實驗)에 설계(設計) 제작(製作)된 태양열집열기(太陽熱集熱器)의 효율(效率)은 평균(平均) 26%였으며 총열전달계수(總熱傳達係數)는 약(約) $25kJ/hr.m^2\;^{\circ}K$였다. 2. 태양열(太陽熱)을 이용(利用)한 건조(乾燥)에서는 공시(供試)벼의 함수율(含水率) 23.5%에서 15.0%까지 건조(乾燥)시키는데 7일(日)이 소요(所要)되었으며 상온통풍건조(常溫通風乾燥)에서는 함수율(含水率) 20.0%에서 15.5%까지 건조(乾燥)시키는데 12일(日)이 소요(所要)되었다. 3. 건조소요시간(乾燥所要時間)은 태양열(太陽熱)을 이용(利用)한 건조(乾燥)가 배(倍) 정도(程度) 빠르나 하층부(下層部)의 곡물(穀物)의 과건현상(過乾現象)의 방지책(防止策)이 철저히 구명(究明)되어야 할 것이다. 4. 저장곡물(貯藏殺物)의 온도(溫度)를 예측(豫測)할 수 있는 simulation model을 finite difference method에 의(依)해 개발(開發)하였으며 검정(檢定) 결과(結果) 실측치(實測値)와 잘 일치(一致)되었다. 5. 저장곡물(貯藏殺物)의 온도(溫度) 변화(變化)는 벽체와 접촉(接觸)하고 있는 부위(部位)에서 컸으며 곡물(穀物)의 손상(損傷)도 이곳에서 심(甚)할 것으로 사료(思料)된다.

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컴퓨터 교학분석기인 T-Scan II를 이용한 측방운동시 구치부 이개시간에 관한 연구 (Study of Disclusion Time during Mandibular Eccentric Movement in Myofascial Pain Syndrome Patients by T-Scan II, Computerized Occlusal Analysis System)

  • 신준한;권정승;김성택;박형욱;최종훈
    • Journal of Oral Medicine and Pain
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    • 제36권3호
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    • pp.187-197
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    • 2011
  • 측두하악관절장애는 저작근, 측두하악관절, 주변 구조물 또는 모두를 포함하는 다수의 임상문제를 포함하는 용어이다. 근막동통은 측두하악관절장애 중 저작근 장애의 한 종류로, 근막 발통점에 의해 발생하는 감각, 운동, 자율신경 증상이다. 측두하악관절장애와 근막동통의 원인에 대한 논쟁이 지속되어왔다. 특히 교합 원인은 오랫동안 논쟁의 핵심이었으며, 많은 노력에도 불구하고 교합원인에 대한 연구는 상반된 결과를 보였다. 이런 논쟁은 대부분이 측두하악관절장애 본연의 복잡성에서 기인하지만, 부적절하고 부적당한 연구설계, 선정기준, 연구방법 또한 중요한 역할을 한다. 최근에 교합분석시 시간과 상대적 힘이 측정가능한 컴퓨터 교합분석 기기인 T-Scan II가 소개되었다. 일부 저자들은 T-Scan II를 이용하여 이개시간 개념 및 연장된 구치부 이개시간과 근막통증의 연관성에 대하여 제안하였다. 그러나 T-Scan II를 이용한 기존의 연구들은 근막통증에 대한 정확한 진단 기준을 제시하지 못하였으며, 대조군과의 비교 부재 및 다른 많은 문제점을 가지고 있었기 때문에 신뢰할 만하지 못하다. 이번 연구의 목적은 컴퓨터 교합분석 기기인 T-Scan II을 이용하여 30명의 실험군을 선택하고 이를 38명의 대조군과 비교함으로써, 근막통증과 구치부 이개시간과의 연관성을 평가하는 것이다. 통계적으로 분석된 결과는 다음과 같다: 1. 반복 측정한 이개시간의 Cronbach ${\alpha}$ 계수는 0.92 였다. 2. 반복 측정한 이개시간 평가시 양측에서 실험군과 대조군 사이 유의성 있는 차이를 보이지 않았다. 3. 이개시간 평가시 좌측 우측 사이에 유의성 있는 차이를 보이지 않았다. 이상의 결과로부터 근막통증과 이개시간 사이에는 관련성이 없는 것으로 판단된다. 따라서 근막통증을 치료하기 위하여 이개시간을 줄이는 비가역적인 치료는 적절치 않다. 향후의 연구에 있어서, 여러 교합요소와 헬키모 지수 등을 이용하여 증상의 정량화를 고려한 보다 통제된 대규모 환자 집단에 대한 연구가 필요할 것으로 사료된다.

사례분석을 통한 효율적 상향수압(Up-Lift Pressure) 처리공법 적용방안에 관한연구 - ◯◯ 상업지역 현장사례 중심으로 - (A Case study and Analysis on the Up-Lift Pressure Treatment Evaluation of Underground Installations for their Efficient Adoption)

  • 고옥렬;권오철;심재광;박태은
    • 한국건축시공학회지
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    • 제9권4호
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    • pp.119-129
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    • 2009
  • 최근의 건축활동은 초고층화 대형화 복잡화 되고 있으며 도심지내에 근접 시공되어 짐에 따라 건축물의 지상층 높이증가와 더불어 지가의 앙등, 토지이용의 극대화로 지하구조물의 중요성이 증가되고 있으며 지하층의 면적 및 층수가 증가되어 가는 추세이다. 이에 따라 지하굴착심도가 깊어지고 있으며 토지 이용의 효율극대화 측면에서 우리나라의 경우 해안매립지등 매립지반에서의 건축활동이 급증하는 추세로 연약지반에 대한 대책과 아울러 지하수위에 대한 영향을 신중하게 검토해야할 필요성이 증대되고 있는 실정이다. 일반적으로 지하굴착 후 시공되는 건축물은 지층의성상과 토질, 수압 등에 대한 고려로 건물의 최하층 바닥슬라브 하부에 위치하게 되는 지하수위와의 수두압차에 의한 정수학적 압력(Hydrostatic Pressure), 즉 부력(Uplift Water Pressure)이 건물저면에 작용하게 되므로, 이러한 부력(浮力)합리적으로 대처할 수 있는 설계 및 시공법의 개발과 이를 적용하기 위한 노력은 지하층공사에 있어서 안전, 공기, 비용, 건축의질 측면에서 필수적이라고 할 수 있다. 그러나 이제까지의 지하층 공사는 부력 처리방법 등에 대한 연구가 미흡하며 기존의 공법 중 대상 프로젝트의 합리적인 수행을 위한 설계초기단계에서의 지반에 대한 사전조사와 면밀한 분석이 이루어지지 않고, 경험에 의존하는 경향이 크다. 본 연구는 상기와 같은 문제점을 바탕으로 O O 건설현장 실 사례를 중심으로 현장은 한강에 인접한 지리적 요인에 의해 지하수위가 한강의 수위와 연계되어 있는바 최초 계획되었던 Rock anchor System 대신 Drain mat System을 적용하여 유입되는 지하수를 유도, 배수함으로써 지하수위에 따른 상향수압을 통제할 수 있는 최적공법 선정을 통해 직접공사비 406,702,000원 및 Life Cycle Cost 차원에서 검토한 결과 건물수명 50년 기준 절감액 운용수익률 년 4% 절감의 효과로 이는 건설초기단계에서의 과다설계에 따른 투입 공사비의 과다책정, 공기의 증가 등에 따른 채산성 문제를 합리적으로 제어하여 건설공사의 원가절감을 위한 성공사례로 평가되고 있다.

Nitromethane 분해를 위한 초임계수 산화(SCWO) 공정 최적화 (Optimization of Supercritical Water Oxidation(SCWO) Process for Decomposing Nitromethane)

  • 한주희;정창모;도승회;한기도;신영호
    • Korean Chemical Engineering Research
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    • 제44권6호
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    • pp.659-668
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    • 2006
  • 실험계획법을 이용하여 nitromethane을 초임계수산화(SCWO)로 분해시키는 공정의 최적화 연구를 진행하였다. Lab scale 반응설비를 이용하여 처리수의 COD와 T-N을 최소화하는 SCWO 공정의 최적 운전조건을 도출하였으며, scale-up 문제점을 파악하기 위해 SCWO pilot plant 실험 결과와 lab scale 최적화 실험 결과를 비교하였다. 처리수의 COD와 T-N을 최적화 목적 변수(KPOV)로 설정하였으며, 예비실험을 통해 반응 온도(temp)와 nitromethane과 암모니아수의 몰 비(NAR)를 주요 운전 변수(KPIV)로 설정하였다. 최적화 실험은 통계적 실험계획법인 중심합성설계법을 사용하였으며, 실험결과의 해석은 반응표면법을 활용하였다. 주 효과 분석결과 처리수의 COD는 Temp 증가에 따라 급격하게 감소하며, NAR 증가에 따라 약간 감소하는 것으로 나타났으며, T-N은 Temp 와 NAR 증가에 따라 감소하였다. Temp가 $420{\sim}430^{\circ}C$로 낮을 때에는 NAR 증가에 따라 T-N이 급격히 감소하였으나, $450^{\circ}C$ 이상으로 높을 때에는 큰 변화가 없었다. 최적화 실험 결과를 회귀분석 하여 처리수의 COD와 T-N 을 예측할 수 있도록 Temp와 NAR이 변수인 2차식으로 회귀식을 도출하였으며, 결정계수($r^2$)와 표준화잔차의 정규성을 분석하여 회귀식이 실험결과를 잘 모사하는 것을 확인하였다. 회귀식을 이용하여 COD < 2 mg/L, T-N<40 mg/L를 동시에 만족시키며 부식 위험이 적은 nitromethane 분해 최적 운전 조건은 Temp $450-460^{\circ}C$, NAR 1.03-1.08로 설정하였다. SCWO pilot plant를 이용하여 nitromethane 분해 최적 조건을 검증하고, SCWO 공정의 scale-up 문제점을 파악하는 연구를 실시하였다. SCWO pilot plant 실험 결과를 lab scale 반응설비에서 도출한 COD와 T-N의 회귀식과 비교한 결과 오차가 증가하지만 회귀식이 pilot plant 실험결과도 잘 나타내는 것을 확인할 수 있었다. Pilot plant 실험결과에 대한 회귀식의 적합성은 실험값과 예측값의 비교도와 표준화잔차의 정규성으로 검증하였다.

Edge Activator 에 따른 병풀추출물 함유 트렌스퍼좀의 물리화학적 특성과 피부흡수 (Physicochemical Characteristics and Skin Absorption of Transfersomes Containing Centella asiatica Extract According to Edge Activators)

  • 이은희;윤경섭
    • 대한화장품학회지
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    • 제49권2호
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    • pp.147-157
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    • 2023
  • 병풀추출물은 다양한 효능으로 인하여 화장품 원료로 많이 사용되지만, 분자량이 크고 용해도가 낮아 피부에의 흡수 효과를 기대하기 어렵다. 이러한 문제점을 해결하기 위하여 지질 기반 다양한 형태의 리포좀을 개발하여 피부흡수율을 높이고자 하였다. 이에 본 연구에서는 기존 리포좀에 edge activator로서 계면활성제를 사용하여 트렌스퍼좀을 제조함으로써 피부흡수율을 높이고자 하였다. 리포좀과 Span 80 및 Tween 20, 60, 80, 85를 각각 함유한 트렌스퍼좀을 high-pressure homogenizer를 이용하여 제조하였고, 입자크기, 다분산지수, 제타전위, 피부흡수율에 대하여 평가하였다. 그 결과, 25 ℃에서 60 d까지 입자크기, 다분산지수 및 제타전위의 물성변화가 거의 없었으며, 45 ℃에서는 60 d 경과 후에 Tween 20, 60, 80을 함유한 트렌스퍼좀의 입자크기가 증가하였다. Franz diffusion cell을 이용한 피부흡수율은 병풀추출물의 주요 성분 중 하나인 madecassoside를 지표 성분으로 사용하여 계산하였다. 그 결과, Tween 20을 함유한 제형에서 가장 흡수율이 높았으며, 반면에 Span 80을 함유한 제형에서 가장 적었다. 흡수계수(Kp) 값에 의하면 모든 제형에서 'very fast'로 나타났고, Span 80을 함유한 제형을 제외하고 리포좀보다 흡수 속도가 유사하거나 크게 나타났다. 이를 통하여 비이온성 계면활성제의 HLB 값이 클수록 트렌스퍼좀의 입자크기가 작았으며, 베시클 막의 유연성 향상으로 피부흡수율이 증가함을 확인하였다. 본 연구를 통해 edge activator로서 계면활성제를 사용한 트렌스퍼좀은 화장품 원료나 제품으로서뿐만 아니라 피부흡수율 증가로 피부의 국소적 문제 해결 가능성을 기대할 수 있다.

류마티스 관절염 환자의 지식, 자기효능감 및 치료이행과의 관계연구 (A study on knowledge, self-efficacy and compliance in Reumatic arthritis Patients)

  • 김순봉
    • 근관절건강학회지
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    • 제5권2호
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    • pp.238-252
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    • 1998
  • Reumatic arthritis is a disease with joint pain being one of the key symptoms. The patient suffers from the pain, stiff sensation and edema due to the inflammation taking Place In one or more joints. Accompanying these problems are fatigue, unusual exhaustion, fever, tachycardia and weakness. Inaddition, joints are often deformed and muscles shrink along with the progress of edema, coupled with depression and psychological instability resulting from the loss of the mobile function and limitations on the daily life. Some patients become fed up with the long and hard flight with the disease and just give up, which aggravates the symptoms. Others come to the hospital only when the conditions have become serious. We need to prevent these and guide the patients in the right direction. Against this backdrop, this study aims to look into the relations between the knowledge on the part of the patients together with their feeling of self-efficacy and the compliance. The results are expected to help the patients improve their life, In addition to providing useful materials for setting up appropriate plan for nursing intervention. The study was conducted by distributing questionnaire to 88 patients selected from the out-patient department of a university hospital in Inchon, from April 6 to 27, 1998. The following tools were used the yardstick of self-efficacy, developed in 1997 by the Society for the Health of Rheumatism Patients, was used for measuring the levels of knowledge and the feeling of self-efficacy. The degree of compliance was measured by the data collected from documents in addition to the results of the analysis of the interviews with the patients. The reliability of the tools was confirmed. In the analysis, the general characteristics were expressed in figures and percentages. The levels of knowledge, feeling of self-efficacy, and compliance were expressed in the average values and standard deviations. The relations among the variables following the general characteristics were analysed by the t-test and one-way ANOVA. The Pearson correction coefficient was used for the analysis of factors. Multiple-loop analysis was used to identify the variables affecting the compliance. The following are the results of this study. 1. Among the 88 patients, 18 were men and the remaining 70 were women, with a ratio 1 : 3.87. Regarding the age groups, 23 were between 50 and 59 years old, with those between 50 and 69 accounting for 51.1% of the total. High school graduates or higher amounted to 58%. Religious patients was 67% or 59 persons. Fifty nine percent were unemployed, and 58.3% (49 persons) had two children or fewer. The period of suffering from rheumatism varied between 2 months and IS years, with 70% less than years. 2. The average figure In relation to the of knowledge was 17.63 points over 30 or 58. 76%, which means a medium level. 3. The average figure of the feeling of self-efficacy was 60.06 points. 4. The level of compliance was 3.26, which was above average. 5. The relation between the feeling of self-efficacy and compliance showed an "r" value of 0.37, which was significant. It means that the higher the feeling, the greater the compliance points. 6. The analysis of the knowledge level revealed that the difference is found only between the college graduates and junior-high graduates or lower. 7. The feeling of self-efficacy varied along with the age and education level. 8. The general characteristics of patients as discussed above did not show significant difference with the compliance. 9. Regarding the elements influencing the compliance, the number of children, period of suffering, income, age, feering of self-efficacy, knowledge, and compliance had 54% of significance. In conclusion, rheumatism victims can lead a better life if they are appropriately educated, based on efficient training program from the early days of the disease ; if they become able to manage themselves thanks to the training ; and if they are helped by a program focusing on the increase of the feeling of self-efficacy aimed at changing patient's behavior.

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정신과간호 실습에 대한 간호 학생들의 태도 조사연구 (A Study of the Attitudes of Nursing Students toward Their Clinical Affiliation in a Mental Hospital)

  • 김소야자
    • 대한간호학회지
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    • 제3권3호
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    • pp.15-26
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    • 1973
  • (Directed by Professor Hong, Shin Yong) Today, over seventy five Percent of the schools of nursing in Korea Provide a psychiatric experience in the basic curriculum. The psychiatric presents numerous major problems of adjustment to the student. The importance of positive attitudes toward the nursing care of psychiatric patients is recognized by the nursing profession. The purpose of this study was to determine the expressed attitudes of fifty-three nursing students toward their psychiatric affiliation. An attempt, also, was made to determine what implications these attitudes revealed relative to future program planning for students during the psychiatric nursing affiliation. A questionnaire, a Korean translation of the "psychiatric Nursing Attitude Questionnaire" by Milder Elizabeth Fletcher, was administered to fifty-three nursing students from three schools of nursing in Seoul, Who had completed a four-week psychiatric affiliation in a large mental hospital during Mar. 19, 1973 to May 19, 1973. The questionnaire of 100 statements was administered in the following way: (1) Part 1, Preconceptions. was. given in individual conferences with each subject, during the first few days of their affiliation, and again during the final week of the affiliation. The responses to Part Ⅰ were oral. (2) Part Ⅱ , Expectations, Part Ⅱ, Personal Relations, Part Ⅳ, Personal Feelings, and Part V , Attitudes and Activities of Patients were given to all of the subjects in a group meeting during the second week of the affiliation, and again. during the fourth week at the termination of the affiliation. Responses to Parts B, B, n, and f, wire written. Each of the 100 statements of the questionnaire was considered to be either Positive or Negative. A favorable response was assigned the Positive value of land an unfavorable response was assigned the Negative value of O. The coefficient of correlation was computed between the two sets of scores for the fifty-three nursing students., The mean score, the standard deviation, and the differences in the means on each of the five parts of the questionnaire were computed and the relationships calculated by a t-test. The results. of the study were as follows: 1. There was no significant correlation between the two sets of scores for the fifty-three nursing students during the four-week psychiatric affiliation. (r=573) 2. There was no significant difference in the mean scores between the first and final tests for any of the five parts of the questionnaire. 3. The Part.1, Preconceptions, data indicated nursing students enter the psychiatric affiliation with certain attitudes and preconceptions toward tile psychiatric affiliation which affect their psychiatric nursing experience, 4. The Part Ⅰ, Expectations, data indicated inappropriate expectations of students related to lack of experience, Lack of pre-psychiatric affiliation orientation, lack of social understanding, and feelings of insecurity. 5. The Part Ⅲ, Personal relations, data indicated some students have negative attitudes in personal relations with normal people in respect to psychological security and social responsibilities. 6. The Part Ⅳ, Personal feelings, data indicated nursing students have psychological insecurity & inappropriateness. 7. The Part Ⅴ, Attitudes and activities of patients, data indicated nursing students have negative attitudes of fear and frustration due to the psychotic behavior of certain patients in certain situations. 8. The data indicated preconceptions are predominate in unfavorable attitudes of students toward psychiatric nursing affiliation. Further researches indicated in the following areas: 1. Because of the limited number of students in this study, similar studies should be performed with larger groups for further validation of the results. 2. Because of the findings concerning the influence of the opinions of people in close contact with the students, similar studies of the attitudes of the staff in nursing schools, attitudes of graduate nurses and attitudes of the public should be done to determine weakness and strengths of present programs.

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