• 한국사회복지학
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• 제66권4호
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• pp.181-205
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• 2014

본 연구는 발달장애아동 부모의 상호작용과 이를 통한 성장과정에 대한 이론적 모형을 제시하고자 포털사이트에서 운영되는 온라인 공동체의 게시글 중 총 250개를 근거이론방법을 활용하여 분석하였다. 연구결과에 따르면 발달장애아동 부모들은 도움이 필요하고 동질감을 갖고자 하는 인과적 조건에서 상호작용을 시작하였다. 게시자, 댓글자간의 상호작용이라는 중심현상은 각 게시자의 태도가 개방적인가, 폐쇄적인가라는 맥락적 조건과 게시자와 댓글자가 상대방을 존중하고 친밀하게 대화하는가, 일방적이고 평가적 대화인가라는 중재적 조건에 따라 주고받음이 활발해지기도 하고 숨어버리는 양상이 나타나기도 하였다. 상호작용의 중심전략으로는 의지다짐, 구체정보, 공감과 지지라는 세 개의 범주에 7개의 하위범주가 포함되었다. 건강한 성장을 이룬 발달장애 부모들은 자기 수용과 강한 유대감을 가지게 되고, 부정적 철수를 하게 되는 부모들은 신세한탄을 하거나 숨어버리는 결과를 보인다. 부모성장 과정은 세 개의 상호작용 모형인 '의지다짐', '구체정보', '공감과 위로' 모형을 통하여 설명되었고 부모성장을 위한 지원으로 경험자를 통한 신뢰와 격려 제공, 지속적인 상호작용 격려하기 그리고 비공식적 지원체계와 공식적 지원체계의 협력적 보완 등을 제언하였다.

• 대한장애인치과학회지
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• 제5권1호
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• pp.12-17
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• 2009

Background : To do dental treatments successfully for dentally disabled patients who are unable to cooperate to procedures needs deep sedation (DS) or general anesthesia (GA). But there are some difficulties in selecting DS because of some disadvantages such as airway problem etc. But, if we select appropriate cases, DS would be better than GA. Methods : We reviewed total 238 cases of patients who had received dental treatments under GA or DS at the clinic for the disabled in Seoul National University Dental Hospital from November 2007 to February 2009. To compare anesthesia condition between DS and GA, we reviewed preanesthesia evaluation sheet, anesthesia or sedation records and PACU sheets retrospectively. Results : The number of DS cases was 25 (11%) and that of GA was 218 (89%). To maintain DS, intravenous propofol was infused with syringe pump (100%), and sevoflurane (134 cases) or propofol (13 cases) were used for sedation induction. Mean total treatment time for DS was 36 min and 2 hour 25 min for GA. The recovery time at PACU was 44 min for DS and 80 min for GA. There were no severe complications in DS, but 18 cases showed nausea and vomiting in GA. Conclusion : Deep sedation for disabled dental patients should be selected for effective behavioral control in conjunction with general anesthesia, considering duration and pain-evoking potentials of dental treatment and type and severity of patients' disabilities altogether.

• Child Health Nursing Research
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• 제8권4호
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• pp.435-448
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• 2002

Accidents are important causes of death and disability in children. They also have enormous financial implications. Young children become an victim of accidents easily because of their physical fragileness and their coping behavior being vulnerable to any actions taken by accidents. Once they have a accident, the children whose not fully developed, suffer from devastating long-term after-effects. Lee, Lee, Kang and Han(1995) reported that ninety percent of accidents can be prevented. But there is no national system to manage, evaluate and analyse the information about child accidents, even though it is necessary for accident prevention policies and health promotion of the general public. The purpose of the study was to determine how often children have accidents and define the accident prevention strategies in children. The investigator conducted a descriptive study by performing the surveys, interviews, and workshops for the 2,458 young children, 10 teachers, and 1,494 parents. The data collection for the study began on September 2000 and completed on April 20, 2001. The analysis of the data was done with Window SPSS 10.0 for descriptive statistics. Among those children, 1,298 children(52.8％) injured from accidents. The children who had accident answered that they injured from traffic accident(27.3％), inside the home(26.3％), on the playground(17.0％), during playtime(13.6％), in the school(5.9％) and food poisoning(7.1％). To define accident prevention strategies for the school children, the parents and the teachers who had a special interest in this topic formed a special task force under the guidance of the investigator. The team was charged to prepare the basis of content materials by identifying the problems, setting standards for the program, prioritizing the process, and selecting the methods of implementation and evaluation. Eight issues and concerns identified by the team were: 1)allowing young children to learn undesirable habits and behaviors that would bother others without knowing; 2) not guarding young children from car accident; 3)unattended accident at playground; 4) considering home places safe; 5)unattended accident at school. These issues were found to be coinciding with the actual child accident cases occurred recent years in Korea. Greater efforts are required to reduce unnecessary deaths and disability from childhood accidents. This study gave a very useful and important data to prepare accident prevention educational program and to prepare accident prevention strategies.

• 대한장애인치과학회지
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• 제15권1호
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• pp.45-49
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• 2019

Bartter 증후군은 심각한 헨레고리 비후 상행각(TAL)에서의 일차적인 염류(NaCl) 수송 장애로 인하여 심각한 저칼륨혈증을 특징으로 하는 질환이다. 만성 구토로 인한 치아의 부식, 교모, 마모의 구강 내 소견을 보여 구토와 관련된 적절한 칫솔질 및 식이 습관 등에 대한 정기적인 교육과 관찰이 권장되며 교합고경의 회복을 위해 전장관 수복이 추천된다. 치과 치료 시의 스트레스로 인하여 전해질 수치의 불균형이 초래될 가능성이 있어 전신마취 하 치료가 유리할 수 있으며, 전신마취 시 과환기되어 저칼륨혈증이 심화되지 않도록 지속적인 감시를 해야하고 술 후에도 전해질 불균형이 초래되지 않도록 지속적인 감시가 필요하다.

• 산업융합연구
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• 제20권11호
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• pp.49-55
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• 2022

본 연구는 중증장애인의 대리응답 여부에 따른 심리적·지지적 요인의 응답 차이를 확인하기 위한 연구로 2020년 장애인 실태조사 원시자료를 활용한 이차자료분석 연구이다. 만 19세 이상 성인 중 주장애가 지적장애가 아니고 장애의 정도가 심한 장애인으로 등록된 738,169명을 최종 분석대상으로 하였다. 자료 분석은 IBM SPSS Statistics 26.0을 이용하여 실수, 백분율, 평균과 표준오차를 확인하였고 χ²-test와 t-test를 실시하였다. 분석결과, 대리응답군이 자가응답군에 비해 슬픔이나 절망감(χ²=952.20, p<.001), 자살 생각(χ²=369.45, p<.001), 주관적 건강상태(t=30.61, p<.001)에서 더 부정적인 응답을 보였으며, 일상생활을 하는데 타인의 지원이 더 많이 필요하고(t=209.43, p<.001) 의료서비스 이용 시 의사소통에 어려움이 더 많다(t=41.74, p<.001)고 응답하였다. 대리응답을 허용하는 경우 연구자는 대리응답자가 취해야 할 관점을 명확히 명시하고, 대리응답은 다양한 요인에 의해 영향을 받을 수 있음을 고려하여 연구결과를 해석해야 한다.

• Tuberculosis and Respiratory Diseases
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• 제46권2호
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• pp.204-214
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• 1999

연구배경: 만성폐질환자가 일상생활에서 느끼는 호흡곤란정도, 안정상태에서 시행된 폐기능검사 및 심폐운동검사사이에 어떤 관계가 있는지, 안정시 폐기능검사와 심폐운동검사가 호흡곤란의 정도를 잘 반영하는지 등을 연구하고자 만성폐질환자에서 기초호흡곤란지수, 안정시 폐기능검사 및 심폐운동능력을 조사하여 다음과 같은 결과를 얻었다. 연구방법: 최근 2개월내에 악화되지 않은 만성폐질환자 50명을, 기존의 안정시 폐기능검사 및 증상 제한적 심폐운동검사결과를 이용하는 폐기능손상/장애 평가기준과 baseline dyspnea index의 초점점수에 따라 저자들이 임의로 정한 기준으로 비중증군과 중증군으로 분류후 각 군간의 안정시 폐기능검사, 심폐운동검사, 초점점수를 비교하였으며, 각 기준의 상호 민감도 및 특이도를 비교하였다. 연구결과: 안정시 폐기능검사치상 중증군에서 max WR(%), $VO_2$max, $VO_2$max(%) 및 초점 점수가 유의하게 낮았고(p<0.01), $VO_2$max으로 구분하였을 때는 중증군에서 안정시 폐기능검사치 중 $FEV_1$(%)만 유의하게 낮았다(p<0.05). Max WR, max WR(%) 및 초점 접수는 중증군에서 유의하게 낮았다(p<0.01) $VO_2$max(%)이 60% 미만인 경우를 중증군으로 하였을 때 $FEV_1$, $FEV_1$(%), MVV(%), max WR와 max WR(%), 초점 점수 등이 중증군에서 유의하게 낮았다(p<0.05). 초점 점수의 중위수 혹은 5점보다 낮은 경우를 중증군으로 분류하였을 때, 중증군에서 안정시 폐기능치들은 비중증군과 차이가 없었으나(p>0.05), max WR와 max WR(%), $VO_2$max와 $VO_2$max(%)는 유의하게 낮았다(p<0.01). 초점점수와 $VO_2$max의 상관계수는 0.51(p<0.01), $VO_2$max(%)은 0.52(p<0.01)이었으며, 안정시 폐기능 검사치 중 $FEV_1$(%)은 0.41(p<0.01)였다. 초점 점수의 $VO_2$max에 대한 결정계수는 0.26(p=0.0002)였고, $VO_2$max(%)에 대한 결정계수는 0.06(p=0.0001)였다. $FEV_1$은 각각 0.08(p=0.01), 0.38(p=0.0189)였다. 안정시 폐기능검사치 $VO_2$max, $VO_2$max(%)를 기준으로 중증 폐기능손상을 구분하였을 때 선택기준에 따라 민감도와 특이도가 차이가 있었고, 초점 점수의 중위수 및 5점을 기준으로 중증 폐기능 손상을 분류했을 때의 민감도 및 특이도와 큰 차이가 없었다. 결 론: 이상과 같은 결과로 안정시 폐기능검사만으로는 $VO_2$max를 정확하게 예측하기 힘들며, 특별한 금기사항이 없는 한 안정시 폐기능검사상 정상 혹은 경미한 손상을 보이는 환자뿐만 아니라 중증손상을 보이는 환자에서도 심폐운동검사를 시행하여 폐기능 손상 평가의 정확도를 높이는 것이 좋을 것으로 여겨지며, 폐기능 손상평가의 기존 기준들에 호흡곤란정도를 반영할 수 있을 것으로 여겨진다.

• Journal of Acupuncture Research
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• 제23권1호
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• pp.165-177
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• 2006

Objectives : 1. Clinical trial for the efficacy evaluation of Korean acupuncture techniques in treating frozen shoulder. 2. Development of the standard clinical guidelines of the acupuncture treatment for the frozen shoulder. 3. Development of the new clinical protocol for the acupuncture treatments. 4. Verification of the hypothesis that treating at both the remote and the nearby acupoints according to the meridian theory is more effective than treating at only the nearby acupoints. Methods : 1. Research designed as Single blind, Randomized, Sham acupuncture controlled clinical Trial. 2. Assignment of 86 patients to one of three groups treated at nearby acupoints(group A), remote & nearby acupoints(group B), and sham points(group C) respectively. 3. Trial conducted at KIOM CRC of Dunsan oriental medical hospital, Daejeon Univ. 4. Estimation of the recovery rate of the frozen shoulder in subjects aged over 40. 5. Efficacy evaluation using VAS, SPADI, ROM and Improvement rate. Results : 1. There was no significant difference in VAS among the three groups. 2. Pain related scores in SPADI of the group B were significantly lower than those of the group A. 3. There was no significant difference in disability related scores of SPADI among the three groups. 4. External rotation of upper arm in the group B was significantly improved in comparison with that in the group C. 5. Abduction of upper arm in group A was improved with weak statistical significance in comparison with that in the group C. Conclusion : Acupuncture at both the remote and the nearby acupoints according to the meridian theory is effective to improve external rotation of frozen shoulder, and acupuncture at the nearby acupoints is effective to improve adduction of frozen shoulder. However it is not clear that acupuncture treatment at both the remote and the nearby acupoints according to the meridian theory is more effective than treating at only the nearby acupoints in the treatment of frozen shoulder. Since our study was a short term trial, a long term trial for a more precise evaluation of acupuncture treatment for frozen shoulder will be needed in the future.

• 농촌의학ㆍ지역보건
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• 제23권2호
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• pp.193-204
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• 1998

Cardiovascular diseases are the leading cause of death and disability in Korea. Their risk factors can be classified as either modifiable or nonmodifiable and among modifiable factors are high bood pressure, elevated blood cholesterol, obesity and cigarette smoking. The purpose of this study was to evaluate the risk factors for the cardiovascular diseases in a rural community and to get basic data for the development of a community-based rick reduction intervention program. Evaluation involved population-based, cross-sectional samples of adult residents in a rurual community. We measured blood pressure, body fat percent by bioelectric impedance fatness analyzer and serum cholesterol and interviewed adult residents over 20-year-old age. Blood pressure was checked twice and hypertension was classified by the sixth report of the Joint National Committee on Detection. Evaluation, and Treatment of High Blood Pressure. The Cutpoints for high blood cholesterol was used National Cholesterol Treatment Guidelines and those for obesity was 25% in male. 30% in female. The results were as follows: 1. Prevalence of definitive hypertension was 59.7% in males and 54.4% in female. 2. Prevalence of hypercholesterolemia was 14.3% in male and 18.2% in female. 3. Prevalence of obese was 10.7% in male and 41.1% in female. 4. Among definitive hypertension, hypercholesterolemia, and obesity 52.1% possessed one risk factor, 12.6% two risk factors and 2.5% three risk factors in males. In females 41.4% possessed one risk factor and 27.6%. 5.7% respectively. 5. The smoking rate was 65.8% in males and 5.2% in females. Our results are used effectively for the community-based intervention towards cardiovascukr diseases risk reduction. However, because of limitations in our study design, further datas are needed including other risk factors and in-person clinical datas.

• Journal of Acupuncture Research
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• 제34권3호
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• pp.131-138
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• 2017

Objectives : This study examined the effects of miniscalpel acupuncture (MA) in three patients with cervicogenic headache. Methods : Patients were treated with MA, which was performed once per week for three weeks. A headache score, visual analogue scale (VAS), and neck disability index (NDI) were used for the evaluation of treatment effects. Results : In cases 1, 2, and 3, the headache score decreased from 4 to 1, 3 to 0, and 3 to 1, respectively. The VAS score decreased from 8.5 to 1.9, 5 to 0.4, and 5.3 to 2 in cases 1, 2, and 3, respectively. The NDI score decreased from 28 to 4, 50 to 4, and 38 to 16 in cases 1, 2, and 3, respectively. Conclusion : MA appears to be effective for the treatment of cervicogenic headache. Further data should be collected and a comparative study using other treatment methods should be performed.

• 대한정형도수물리치료학회지
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• 제17권1호
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• pp.35-44
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• 2011

Background: This study was to suggest the process of making strategy for effective intervention and evaluation on functional problems of the frozen shoulder patient applied International Classification of Functioning Disability and Health (ICF) Tools. Methods: The patient was 48years old woman with right shoulder adhesive capsulitis and calcific tendinitis. In first phase, therapists could list the information relating to functional problems used by the ICF Core set and then could confirm the interaction among the problems using the ICF assessment sheet. In second phase, therapist is needed to make the hypothesis and hypothesis testing and then set a primary functional goals and therapeutic goals in detail after prioritizing the problems to be managed based on the problem list. Lastly, after setting the confirmed problems as the purpose of intervention through the hypothesis testing, therapist could do some intervention after making a plan to solve these problems. Results: This report illustrates how to apply the process based on ICF concept into physical therapy practice. The decided hypothesis and goal that are to solve the problems the client faced were remarkably meaningful. Conclusions: Clinical decision making for the most effective intervention requires that therapists use the clinical reasoning process based on ICF concept.