• 대한유전성대사질환학회지
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• 제18권2호
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• pp.50-54
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• 2018

Jehovah's Witnesses do not accept blood transfusions, because of their particular interpretation of the Old and New Testaments. When people with such religious convictions are in need of medical care, their faith and belief may become an obstacle for proper treatment, and pose legal, ethical, and medical challenges for the health care providers. We report two inherited metabolic disorder cases in South Korea where the infants died whilst under medical care because of parental refusal of blood transfusions for religious reasons. Case 1 had methylmalonic acidemia, Down syndrome and associated congenital cardiac anomalies requiring surgery. Case 2 had anemia and methylmalonic acidemia requiring dialysis to treat hyperammonemia and metabolic acidosis. For effective medical management, they needed life-saving blood transfusions. As a part of alternative treatment, Erythropoietin was administered in both cases. As a result, two babies died from their extremely low hemoglobin and hematocrit. The hemoglobin concentrations below 2.7 g/dL without cardiac problem and 5.4 g/dL with cardiac anomaly complicated by pulmonary hypertension are considered life-threatening hemoglobin threshold. The medical professional must respect and accommodate religious beliefs of the patients who can make informed decisions. However, when parents or legal guardians oppose medical treatment of their babies and incompetent care receivers on cultural and religious grounds, the duty to assist and save persons exposed to serious danger, particularly life-threatening events must come first.

• 대한정형도수물리치료학회지
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• 제27권3호
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• pp.1-15
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• 2021

Objective: The purpose of this study was to examine the differences in joint position sense (JPS), force sense (FS), and performance level of the upper extremities according to the injury and pain experiences of Korean elite archers. Methods: A total of 15 subjects were briefed about the purpose of this study and agreed to participate voluntarily. JPS was evaluated using the laser-point attached to the wrist while aiming at the target. The difference when relocating while aiming was used as JPS factor. FS was evaluated using load cell through reproduces same muscle strength. Fear-Avoidance Beliefs Questionnaire (FABQ) was used to evaluate psychosocial factors, Kerlan-Jobe Orthopedic Clinic overhead athlete scores (KJOC) and numerical rating scale (NRS) was used to evaluate pain. and performance was evaluated by tournament match score. Results: There is a strong correlation between the current pain and KJOC. Moreover, moderate correlation between KJOC and FABQ also current pain and both upper trapezius and lower trapezius in elite archers. The mean (SD) between groups based on current pain display relatively large margin in force sense than without pain group. The result presents that there is a significant difference in performance and pain. There is a significant difference in the force sense of the upper and lower trapezius and pain. Conclusions: Result present there is a significant difference in functional level in the average comparison between groups according to the presence of absence of current pain. There is a significant difference in the force sense of the upper trapezius as well as lower trapezius and without pain group present a relatively low joint position sense error compared to the groups.

• 한국융합학회논문지
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• 제13권2호
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• pp.281-291
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• 2022

본 연구는 간호대학생의 유방자가검진 수행에 미치는 영향 요인을 통계적으로 분석한 서술적 조사연구이다. 자료수집 기간은 2021년 4월 12일부터 4월 26일이었고, 간호대학생 240명을 편의 추출 후 구조화된 설문지를 이용하여 조사하였다. 수집된 자료는 SPSS/WIN 25.0 프로그램을 통해 Pearson's correlation coeffcients, 단계적 다중회귀분석을 이용하여 분석하였다. 본 연구결과, 유방자가검진 수행에 미치는 영향 요인은 유방자가검진 여부와 식행동이었고, 설명력은 14.2%이었다(F=19.53, 𝜌<.001). 간호대학생의 유방자가검진의 지속적인 수행을 도울 수 있는 교육과 프로그램이 요구되며, 간호대학생 스스로 올바른 식행동에 관심을 가지고 실천할 수 있도록 식생활을 평가하고, 유방암을 예방하기 위한 프로그램의 개발 및 효과에 대한 연구가 필요하다.

• 한국식품영양과학회지
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• 제45권9호
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• pp.1366-1374
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• 2016

노인은 면역취약집단으로 다른 인구 집단보다 만성질환과 식품매개 질병에 걸릴 위험이 크며 식행동은 오랜 세월 굳어져 왔기 때문에 변화하기가 쉽지 않다. 노인을 대상으로 건강신념모델을 적용하여 식품안전 영양교육 프로그램을 시범 적용하고 그 효과를 평가하였다. 식품안전 영양 시범 교육은 서울 마포, 충북 청주, 경북 의성, 충북 진천의 노인복지관을 이용하는 65세 이상 노인을 대상으로 2011년 7월 28일부터 9월 9일까지 총 5주간 매주 1회, 35~40분씩 교육을 시행하였다. 교육 전후 조사가 완료된 최종 연구대상은 교육군이 5회 교육 중 3회 이상 교육에 참여하고 교육 전후 평가를 마친 대상자로 137명, 대조군은 사후 설문조사를 하지 않거나 불성실한 응답자를 제외한 83명으로 총 220명이었다. 교육은 건강신념모델을 적용하여 노인들이 식습관을 변화하지 않을 경우 질병 가능성을 알려 심각성을 인지하도록 하였으며 노인들이 식행동 수정 시 얻게 되는 이들을 알려주고 행동을 실행할 수 있도록 자아효능감을 제공해주고자 하였다. 교육 후 식품안전 영양지식은 모든 항목에서 향상을 보였으며, 식품안전 영역 5문항 중 4문항, 영양 영역 3문항 중 2문항에서는 유의적인 향상을 보였다. 식행동은 교육군에서 '고기, 생선류는 조리 시 속까지 완전히 익힌다'를 제외한 모든 항목에서 유의적인 향상을 보였다. 건강신념은 식품안전의 영역에서는 인지된 심각성과 자아효능감, 영양 영역에서는 인지된 민감성, 인지된 장애, 자아효능감에서 유의적인 향상을 보였다. 지식, 식행동, 건강신념 변화량의 상관관계를 분석한 결과 건강신념의 변화량과 식행동의 변화 가능성 간의 유의적인 상관관계를 보였다(P<0.001). 본 연구의 참여 대상자들이 일반 재가 노인보다 복지관에서 봉사하거나 활동하는 노인이었기 때문에 표본의 대표성이 떨어져 결과를 일반화하기에 어려움이 있다. 또한, 교육기간이 5주로 비교적 짧았기 때문에 오랜 기간에 걸쳐 형성된 식행동이 쉽게 변화하거나 개선되기 어려우므로 장기간에 걸친 반복교육이 필요할 것으로 생각한다. 본 연구에서 개발된 교육프로그램을 향후 보건소나 복지관 등을 통해 지속해서 시행 된다면 노인의 식품안전 영양에 대한 인식을 높이고 바람직한 식행동 변화에 긍정적인 기여를 할 수 있을 것으로 생각된다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권19호
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• pp.8135-8142
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• 2014

Background: Breast cancer is the most common cancer in Iranian women and usually features delayed presentation and late diagnosis. Interpretation of symptoms, as the most important step, has a significant impact on patient delay in seeking treatment. There is a dearth of studies on symptom appraisal and the process leading to seeking help in breast cancer patients. This study explored the perceptions and experiences of Iranian women with self-detected possible breast cancer symptoms. Materials and Methods: A qualitative method was conducted involving in-depth semi-structured interviews with 27 Iranian women with self-discovered breast cancer symptoms. Participants were purposefully selected from women who attended Cancer Institute of Tehran University of Medical Sciences during June 2012 to August 2013. The audiotaped interviews were transcribed and analyzed using conventional content analysis with MAXQDA soft ware version 10. The trustworthiness of the study was verified by prolonged engagement, member validation of codes, and thick description. Results: The main concepts emerging from data analysis were categorized in four categories: symptom recognition, labeling of symptoms, interactive understanding, and confronting the fear of cancer. Symptom recognition through breast self-examination, symptom monitoring and employing prior knowledge distinguished normal from abnormal symptoms and accompanied with perception of being at risk of breast cancer led to symptom labeling. Social interaction by selective disclosure and receiving reassurance from a consultant led to confirmation or redefinition of the situation. Perceived seriousness of the situation and social meanings of breast cancer as a stigmatized and incurable illness associated with loss of femininity were reasons for patient worries and fear. Conclusions: This study emphasized that entangled cognitive, emotional and socio-cultural responses affecting understanding of symptom seriousness require further investigation. It is suggested that programs aimed at shortening patient delay in breast cancer should be focused on improving women's knowledge and self-awareness of breast cancer, in addition to correcting their social beliefs.

• 디지털융복합연구
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• 제13권12호
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• pp.235-244
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• 2015

본 연구는 여대생의 인유두종바이러스 백신 접종에 영향을 주는 융복합적 예측요인을 알아보기 위해 시도되었다. 연구대상은 여대생 546명이며, 2013년 10월 5일부터 10월 30일까지 자료수집을 실시하였다. 연구결과를 살펴보면 백신을 접종한 여대생은 138명(25.3%)이었다. 백신 접종군과 미접종군은 종교, 자궁경부암, 인유두종바이러스 및 자궁경부암 백신에 대해 들어본 적이 있는 경우, 자궁경부암 선별 검사 경험, 인유두종바이러스 백신 지식, 건강 신념, 지각된 유익성과 장애성, 암 예방행위, 자궁경부암 예방행위에 따라 유의한 차이가 있었다. 인유두종바이러스 백신 접종에 영향을 주는 예측요인은 자궁경부암 검진 경험이 있는 군일수록(OR=34.67, 95% CI=17.19~69.92), 지각된 유익성이 높을수록(OR=1.45, 95% CI=1.17~1.81), 장애성은 낮을수록(OR=1.44, 95% CI=1.27~1.63) 백신 접종 확률이 높았다. 따라서 인유두종바이러스 백신 접종의 적정 연령을 대상으로 대국민 홍보가 필요하며, 백신 접종의 긍정적 효과를 강조하고, 장애요인을 감소시켜 백신접종을 높일 수 있도록 학교기반사업과 국가차원에서의 융복합적 지원과 중재방안이 마련되어야 할 것이다.

• 한국치위생학회지
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• 제7권4호
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• pp.535-551
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• 2007

Objectives: This study was conducted to know dental service and fear after research on reliability on dentists and satisfaction on dental hygienists. Methods: This study was conducted by the 325 persons who had the experience of visiting dental medical institution. Statistical analysis was conducted using the SPSS 12.0 with T-test, ANOVA and correlation. The obtained results were as follows: Results: 1. Internal consistency of Dental Beliefs Survey(DBS) and dental hygienists satisfaction questionnaire factors were 0.758~0.908(Cronbach' alpha). And the Cronbach' alpha's coefficients of the all subscales were more than 0.6. So high reliability and validity were identified. 2. As result of analysing fear from general feature, the men feel more fear than women and more fear was felt in the case of having worse teeth status. Fear was higher in case of visiting to dental clinic than in case of visiting dental clinic for precaution. And that was statistically related. 3. Dental fear was higher in the case of having the past pain experience, insufficient anesthesia experience, experience of seeing other persons pain and this was statistically related(P<0.01)(P<0.05). 4. Average of reliability on dentists was 37.9, person who has high reliability was 81.8%, person who has low reliability was 18.2%, average of satisfaction on dental hygienists was 31.5%(Satisfaction on dental hygienists was 51.1% and dissatisfaction on dental hygienists was 48.9%). 5. Higher dentists reliability and satisfaction on dental hygienists has lower fear considering general feature and dental clinic use behavior but person who has the dental clinic to go regularly has higher dentists reliability and satisfaction on dental hygienists where, however, fear was not low. 6. As result of analyzing correlation between dental service and dental clinic use behavior, satisfaction on dental hygienists was negatively related to reliability on dentists and fear. And, reliability on dentists was positively related to fear, pain experience in dental clinic, incomplete anesthesia experience, near person pain experience(experience on seeing person in pain), which were statistically related(p<0.01). Conclusions: In relation to general features and reliability on dentists and satisfaction on dental hygienists caused by dental clinic use behavior, dental fear was decreased when reliability and satisfaction are higher. Group with low dental fear had higher reliability on dentists and satisfaction on dental hygienists than group with high dental fear but only reliability on dentists was statistically related(p<0.05).

• 사상체질의학회지
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• 제8권2호
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• pp.41-68
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• 1996

This thesis is a try for examining the historical characteristics of Constiutional medicine. For this purpose, I have examined their theory, and made a comparison carefully. Through this study, I have obtained several results as following. Both Chang and Lee lived in the time of change, which was unstable and uncertain. Under the condition, they both rejected following the existing trends of learned circles, and developed new thoughts and clinical techniques. They rejected superstitious beliefs and fatalism, and conducted the pursuit of experimental knowledge and rationale idea. Clinical experience was the very base of their study. They both criticized the bad habits of abuse of tonifing medication and health seeking. Especially Lee regarded control of emotion and regulation of a way of life as the best way for preservation of one's health. Chang regarded pathogenic factors as the ultimate factor of diseases, and strived for eliminating pathogenic factors, but L brought to a conclusion that the final factor of diseases was what is called "heart" itself, and emotional changes were the most essential causes of disease. It can be said that the pathogenesis insisted by Chang can be called The insistence that pathologic factors are the very etiology of all the disease (邪氣致病論), or all the diseases result from pathologic factors. And his whole remedy can be summarized as following, A study on the method of eliminating pathogenic factors. But the purpose of Constitutional medicine is to correct imbalance intrinsic to one's internal organs. In this aspect, Constitutional medicine is a "regulatory medicine". Depending on the classification of six vital substances, Chang classified all disease into six categories. These were based on symptoms and sings represented. While classification of diseases made by Lee was likely to rely upon constitutional characteristics. Chang thought that the three remedies made up of perspiration, purgation, vomiting were the most efficient way of eliminating pathogenic factors. Lee, however, thought those weren't methods of eliminating pathogenic factors but the best ways restoring one's self-regulation power. Chang thought that all the febrile disease essentially has a tendency in properties to belong to "heat", but Lee pointed out that pathologic processes are variable in accordance with constitutional features. They both regarded pathogenesis of diabetes as fire. That is to say, fire is the most essential factor of diabetes. And there are many risk factors such as inappropriate foods, drugs, climate, etc., but Lee thought what is most important is heart. Putting all accounts together, medical characteristics of Chang are similar to those of T aiyinjen and Shaoyangjen, and have no relation to those of those of Shaoyinjen. Therefore we can conclude that Chang understood pathologic processes of disease of T aiyinjen and Shaoyangjen, whether he knew about constitutional features or not.

• 한방재활의학과학회지
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• 제23권4호
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• pp.95-115
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• 2013

Objectives The aim of this review is to provide fundamental data for low back pain scales which can be used in clinical trial. Methods We investigated the latest studies on chronic low back pain via PubMed. And we also investigated domestic studies through "http://oasis.kiom.re.kr". 95 research papers were analyzed. Scales were classified into pain scale, function scale, generic health status scale and psychological scale. Results 1) According to foreign clinical studies, Visual Analog Scale (VAS) and Numerical Rating Scale (NRS) were used 18 times as pain scale. Oswestry Disability Index (ODI) was used 20 times as function scale, Roland-Morris Disability Questionnaire (RMDQ) was 17, and Hannover Functional Ability Questionnaire (HFAQ) was used 3 times. 36-item Short Form Health Survey (SF-36) was used 13 times as generic health status scale, Euroqol-5 Dimentions Questionnaire (EQ-5D) was 11, and 12-item Short Form Health Survey (SF-12) was used 3 times. Fear-Avoidance Beliefs Questionnaire (FABQ) was used 9 times as psychological scale, Pain Catastrophizing Scale (PCS) and Tampa Scale for Kinesiophobia (TSK-R) both were used 3 times. 2) According to domestic clinical studies, VAS was used 37 times as pain scale, NRS was 11, and Short Form McGill Pain Questionnaire (SF-MPQ) was used 6 times. ODI was used 30 times as function scale, RMDQ was 2 times only. SF-36 was used once as generic health status scale and Beck's Depression Inventory (BDI) was used 3 times as psychological scale. Conclusions We recommend VAS or NRS as a measure to evaluate pain, and ODI as a measure to evaluate functional disability. And we also recommend SF-36 or SF-12 and EQ-5D as a measure to evaluate generic health status. Finally, we recommend FABQ for use in measuring psychological scale.

• 치위생과학회지
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• 제15권2호
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• pp.138-144
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• 2015

본 연구는 치위생과 학생을 대상으로 B형간염에 대한 건강신념의 차이를 파악하고 HBV 예방접종에 영향을 미치는 요인을 규명함으로써 B형간염 예방에 대한 보건교육의 기초자료를 제공하고자 한다. 경상도 지역에 소재한 3개 대학에서 재학 중인 임상현장 실습을 앞 둔 2 3학년 281명을 대상으로 2013년 4월 22일부터 5월 3일까지 자기기입식 설문조사를 실시하여 수집한 자료를 분석하여 다음과 같은 결론을 얻었다. 일반적 특성 및 B형간염 관련특성에 따른 예방접종 상태를 알아본 결과 학년에 따라 예방접종주사를 맞은 경우는 3학년 129명(71.3%), 2학년 45명(45.0%)으로 3학년의 예방접종률이 높게 나타나는 것을 확인할 수 있었다(p<0.001). 과거 B형간염에 대한 교육경험에 따라 예방접종주사를 맞은 경우는 경험이 있는 경우 87명(71.3%), 경험이 없는 경우 87명(54.7%)으로 교육경험이 있는 경우 예방접종률이 높게 나타났다(p=0.017). 학년에 따른 B형간염에 걸릴 가능성이 있다고 믿는 감수성은 3학년이 2.54로 높았고, B형간염에 관한 장애감은 2학년이 3.50으로 3학년 2.88 보다 통계적으로 유의하게 높게 나타났다(p<0.05). 건강신념 중 심각성과 예방접종 간에는 유의한 양의 상관이 있었고(r=0.179, p=0.003), 장애감과 예방접종 간에도 통계적으로 유의한 음의 상관이 있어(r=-0.183, p=0.002) B형간염에 대한 심각성을 많이 느낄수록 그리고 장애감을 적게 느낄수록 예방접종 이행이 많은 경향이 있었다. B형간염 예방접종에 영향을 미치는 요인을 분석한 결과 학년에 따라서는 2학년이 3학년에 비해 예방접종 이행이 0.39배(95% CI=0.21, 0.71) 낮은 것으로 나타났다. B형간염에 대한 심각성이 1단위 높아질수록 예방접종 이행률은 1.80배(95% CI=1.29, 2.52) 증가하였으며 장애감은 1단위 높아질수록 0.61배(95% CI=0.41, 0.90) 감소하는 것으로 나타났다(p<0.05). 따라서 치위생과 학생들이 의무적으로 B형간염 예방접종을 실천하기 위해서는 1학년 때부터 교육할 수 있는 교육과정 안에 프로그램 개발이 시급하다 할 수 있으며 구체적인 교육이 필요할 것으로 생각된다. 또한 일회성 교육이 아닌 지속적인 교육으로 학년별로 매회 교육해야 할 것이며, 정확하고 철저한 교육이 되어 의무적인 B형간염 예방접종이 이루어 질 수 있도록 구체적인 방안이 모색되어야 할 것으로 생각된다.