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신생아 괸리의 지역화 및 전원시스템 (Regionalization of neonatal care and neonatal transport system)

  • 신종범
    • Clinical and Experimental Pediatrics
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    • 제50권1호
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    • pp.1-6
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    • 2007
  • In the United States, The concept of designation for hospital facilities that care for newborn infants according to the level of complexity of care provided was first proposed in 1976. The extent of perinatal health care regionalization varies widely from one area to the other. facilities that provide hospital care for newborn are classified into three categories on the basis of functional capabilities; level I-primary or basic care, level II-secondary or specialty care, level III-tertially or subspecialty care. These facilities should be organized within a regionalized system of perinatal care. The transport system of newborn infants should be organized for referral of high risk newborn to centers with the personnel and resources needed for their degree of risk and severity of illness. In Korea, The korean society of neonatology was established and articulated in the 1994. During the past decade, the number of neonatologist has increased and neonatal intensive care units have proliferated in Korea. However, no standard definitions exist for the graded levels of complexity of care that neonatal intensive care units provide and no uniform guideline or recommendation for regionalization and referral system of high risk neonate have been established. With the rapid changing neonatal care system in Korea, the optimal neonatal care demands regionalization of care in utilization of manpower resources and in efficient use of advanced technology and facility.

노인장기요양보험제도의 현금급여 도입 필요성 - WTA를 통한 적정 현금급여액 추정 - (Estimating the Willingness-To-Accept for Cash Benefit of Long-Term Care Insurance)

  • 신혜정
    • 한국노년학
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    • 제29권1호
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    • pp.177-194
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    • 2009
  • 본 연구는 일차적으로 노인장기요양보험 급여방식 중 현물급여와 현금급여의 선택에 있어서 비공식 가족수발자들의 현금급여 선호도를 알아보고, 이에 영향을 미치는 요인을 파악함으로써 현금급여 도입의 필요성을 인식하는데 목적이 있다. 이차적으로는 조건부 가치측정법을 이용하여 비공식적 가족수발에 대한 적정 현금급여액을 추정함으로써 미래 현금급여 도입 시 수가산정을 위한 기초 자료로 제시하고자 한다. 본 연구를 위한 조사는 서울시 소재 3차 의료기관 3곳에서 현재 환자를 돌보고 있는 환자의 보호자 300명을 대상으로 하였다. 경증과 중증 두 가지 유형의 가상의 시나리오 및 구조화된 설문지를 제시한 후 현금급여를 수용할 최소한의 보상금액(Willingness-To-Accept, WTA)을 이중경계 양분선택형 질문으로 구하였으며, 일대일 직접 면접법을 이용하였다. 연구결과, 경증노인에 대해서는 52.7%가, 중증노인에 대해서는 26.0%만이 현금급여 서비스를 선호하였다. 경증노인에 대한 적정 현금급여액은 월 평균 62.8만원, 중증 노인에 대한 적정 현금급여액은 월 평균 107.2만원인 것으로 나타났다. 본 연구는 비공식적 수발자가 직면하는 각기 다른 상황에 대한 실제 현금급여 선호도를 확인함으로써 현금급여 도입의 필요성을 인식하였으며, 잠재적 가족수발자들의 시간손실 보상액으로서 수발자가 받아들일 수 있는 주관적 수발비용을 적정 현금급여액으로 추정함으로써 현행 특별현금급여액의 적정성을 평가하는데 보다 현실적인 기준을 마련하였다는데 함의가 있다고 하겠다.

방문간호사업에 대한 대상자의 인식에 관한 연구 (A Study on the Recognition of Client Home Visit Nursing Care Services in Public Health Centers)

  • 민영선;정연강;한승의
    • 지역사회간호학회지
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    • 제11권2호
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    • pp.399-410
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    • 2000
  • In this, analyzing the type of subjectivity in which people would have about home visit nursing services originating from public health care centers. I tried to research more effective ways to improve home visit nursing care services. and later. for the development of home visit nursing care. to supply basic data. The method for this study was the Q-method. created by William Stephenson. and was adequate for the study of subjectivity. For this study. through the deep interview. literature inquiry, and the discussion course. 206 Q-statement sentences were abstracted. and based on them, after Q-sample-selection. I then collected the Q-categorized-result from 32 subjects from Mar. 10. 2000 to Mar. 25. 2000. Through the statistic a analysis of PC-Qunal program. the subjectivity species were categorized and analyzed. The study results show that there are 3 sorts of recognition types. and they are analyzed in the following; The first type: the positively receiving type shows that they feel thankful and a trusting feeling about home visit nursing. The second type: the negatively mistrusting type shows that they had doubtful attitudes about the specialty of home visit nursing: they wanted medicine or nutrition remedies rather than health education and concerning the their own health care, they prefered the hospitals or clinics. The third type: the conditional receiving type shows that even though they had a positive receiving attitude about home visit nursing wanting to consult with the home visit nurses about the difficult problem which could not easily be settled, hoping that the home visit nurses could visit them more often, in their actual lives. they strongly indicated their attitudes concerning money as more important than home visits. The subjects in these 3 types commonly had a good feeling about the kindness of the home visit nurses: the first and third types also had a positive recognition about home visit nursing; however. in aspects of the evaluation and receiving attitudes, they showed a big difference. When all the above results are integrated. in the case of the first type the home visit nursing service, which satisfied the demand for health care of the medically weak people. should be continuously supplied. Additionally in case of the second type (negatively mistrust). continuous education and support should be supplied with enough interest to lead their concerns about their own health care as well as lead medical spending in a productive and effective direction in order to change their impressions. Through this study. I learned that the recognition of the objectives of home visit nursing services can be categorized in to 3 types and could be analyzed. Thus I wish that this study helps to present basic data which contributes to the development of the home visit nursing field.

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소아암 환아의 영적 케어

  • 신민선
    • 호스피스학술지
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    • 제5권2호
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    • pp.54-63
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    • 2005
  • The purpose of this study is to examine the requirement for child life support specialist and fetal education for children with cancer. This research presented was composed with three chapters : First chapter, I presented the purpose, scope and definitions of this research. Second chapter, I defined about hospice care service for children with cancer and kind of pediatric cancer. And general characteristics of children with cancer, a understanding character of death and dietary therapy. Lastly, I defined and investigated about spiritual care. Third chapter, I concluded with some of findings and final suggestions based on the results. According to the developmental stages children with cancer are disability of communication competence and more dependence on their parents, therefore parents' decision making were more difficulty. And parents with a child who suffers from a cancer needs a counseling in order to discover the meaning of life. Parents' psychological experience about the caring for their child suffering from pediatric cancer was equal to broken hearts due to shadow of the child's death from time to time. In other words a parents with a child who suffers from a cancer needs comprehensive services such as hospice, consultor as well as wide experienced pediatrician and nurse. Child life support specialist can help them recover and improve their o주 potential strength in behalf of overcoming their difficulties. And pastoral counseling can help them reduce the fear and anxiety about unknown world and death. The systematically developed a school-based counseling program would help children adjust to the difficulties after a perfect cure because of children adjusted to school well when they have good peer relationships.

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농촌 지역 노인의 전문 건강관리 체계 이용 행위에 관한 연구 (The Use of Professional Health Care Systems among the Elderly in Rural Communities)

  • 조명옥
    • 대한간호학회지
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    • 제33권6호
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    • pp.731-742
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    • 2003
  • Purpose: This ethnography is aimed at describing the health care seeking behavior of elderly details in their socio-cultural context. The research question is 'under what conditions did elderly informants decide to use certain professional health care services and how do they make use of all the available resources?' Method: 10 sessions of fieldwork were conducted in the two agricultural villages between Sep. 1999 and Oct. 2002. The data for this paper came from participant observation with 14 informants. In the process of analysis I used proxemic and taxonomic techniques. Result: Informants decided to use a certain health care system according to their folk definition of illness. They prefer to use the health services where they felt more comfortable and free. They wished to be care from intuitive and holistic healers. Social network and having health resources was also important factor. Conclusion: We need more comprehensive research model to reach a plausible explanation. Combined qualitative-quantitative research is needed to get practical data to develop effective health care systems for the elderly.

독일의 수발보험제도 도입에 따른 주간보호시설의 공간계획 기준에 관한 연구 (A Study on the space standards of daycare facilities with the introduction of Care Insurance in Germany)

  • 남윤옥
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제13권4호
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    • pp.25-35
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    • 2007
  • In Germany, community based daycare facilities has been supported by long term care policies since the 1970s. With the legislation of Care Insurance, those policy has been developed further. As the use of daycare facilities decreased and the financial burden for consumers increased, administrators of facilities has been seeking for innovative programs and management methods in order to improve the service. For the same reason, policy makers have been pursuing new regulations of architectural standards of facilities. By looking at legislations (i.e., Law of Care Insurance, Law of Heim, and DIN18025) that stipulate architectural standard of facilities in Germany, this study will identify the development process of architectural change of daycare facilities. In addition, the study aims to contribute to the discussion on the use of day care facilities in Korea in terms of the legislation of Care Insurance soon to be introduced.

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우리 나라 가정.방문간호 사업을 위한 가정간호요구 사정도구 개발 - 자가간호개념에 근거한 가정간호진단을 중심으로 - (Development of a Home Care Need Assessment Tool - Focused on Home Care Nursing Diagnoses based on Self Care -)

  • 소애영;조병희
    • 지역사회간호학회지
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    • 제13권3호
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    • pp.433-443
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    • 2002
  • Objectives; The purpose of this study was to develop a framework for home care and a Home Care Need Assessment Tool. Method 1. Identifying common domains in the provision of home care. 2. Charts of 253 home care clients were reviewed to obtain a classification of the nursing diagnoses. 3. A focus group methodology was used to develop the domains. 4. The tool was applied to 439 home care clients.(Kappa value=0.460-1.000, sensitivity, 0.444-1.000: specificity, 0.743-1.000). 5. Some refinements and extractions of the defining characteristics and related factors were made based on the results of the focus group. Results Home Care Need Assessment Tool consists of three parts; -Part I : factors related to basic conditions -Part II : a screening component that enables home care nurses to assess 30 multiple domains of 53 nursing diagnoses. -Part III : summative nursing diagnoses and nursing need intensity for the clients. Conclusion This tool provides a comprehensive assessment that helps the recognition of many strengths as well as problems of the clients. It will be usefully utilized in scheduling home care nursing plans and evaluating client outcomes.

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Clinical Experience of Nurses in a Consultative Hospice Palliative Care Service

  • Sinyoung Kwon;Jinyee Byun
    • Journal of Hospice and Palliative Care
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    • 제27권1호
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    • pp.31-44
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    • 2024
  • Purpose: The purpose of this qualitative study was to employ Colaizzi's phenomenological research method to elucidate and understand the essence of practical experiences among consultative hospice palliative care nurses working in hospice institutions. Methods: The participants in the study were 15 consultative hospice palliative care nurses with over 1 year of work experience in institutions located in S City, I City, and K Province in South Korea. Data were collected from 23 in-depth interviews and analyzed using Colaizzi's phenomenological qualitative method. Results: The practical experiences of consultative hospice palliative nurses were categorized into five categories, 10 theme clusters, and 25 themes. The five categories included "being aware of patients' situations at the time of transition to hospice palliative care," "empathizing with patients and their families by putting oneself in the other's shoes," "providing patient and family-centered end-of-life care," "experiencing difficulties in practical tasks," and "striving to improve hospice service quality." Conclusion: This study is significant in that it provides practical data for understanding the experiences of consultative hospice palliative care nurses caring for terminally ill patients. This could enhance our understanding of care solutions that effectively tackle the challenges consultative hospice palliative care nurses encounter while fulfilling their roles.

Cedrol 및 펩타이드 3 종 Complex 의 In Vitro 효능 및 적용 제형의 입술 주름 개선 및 Volumization 효과에 대한 연구 (In Vitro Efficacies of Complex of Cedrol and Three Peptides, and Wrinkle Improvements and Lips Volumization effects of Applied Formulations)

  • 강성수;전승현;이진용;안명진;강내규
    • 대한화장품학회지
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    • 제49권4호
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    • pp.365-373
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    • 2023
  • 입술은 인간의 매력을 표현할 수 있는 대표적인 안면부 부위로써, 이에 대한 미적 관심은 인류 역사에서 항상 존재해왔다. 그러나 입술은 노화가 진행됨에 따라, 주름이 형성되고, 얇아지고, 그 볼륨이 감소하는 경향을 가지며, 이를 대처하기 위해 필러나 지방 이식 등 시술이 시행되곤 한다. 본 연구에서는 립세린® 에 적용된 주 효능 컴플랙스인 cedrol과 펩타이드 3 종(acetyl hexapeptide-8, acetyl tetrapeptide-9, desamidocollagen)의 조합이 광노화 방어 및 입술 주름을 개선할 수 있음을 in vitro상에서 검증하였다. 피부 섬유아세포의 콜라겐과 엘라스틴 발현량을 향상, 광노화 조건에서 MMP 발현을 경감하는 효과를 검증하였다. 또한 지방 줄기 세포 분화 실험에서 지방 줄기 세포 분화 촉진 및 지방 생성량을 증대시킴으로, 입술 내 지방 조직량을 증가시킬 수 있음을 in vitro상에서 그 가능성을 확인하였다. 2 주간 사용된 인체 적용 시험에서도, 입술의 주름, 결, 탄력, 볼륨이 개선되는 효과를 확인하였다. 본 연구는 cedrol 및 펩타이드 3 종 조합이 입술의 다양한 노화 징후를 해결할 수 있는 효과적인 립케어 소재로써 활용 가능함을 검증하였다.

집중치료실 및 수술장 개선이 개심술후 흉골감염에 미치는 영향 (The Effect of Improved Operating Room and Intensive Care Unit on the Sternal Infection After Open Heart Surgery)

  • 이종태;이상철;김성완;이응배;조준용;김덕실;장봉현;김규태
    • Journal of Chest Surgery
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    • 제35권5호
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    • pp.375-380
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    • 2002
  • 배경: 개심술후 발생하는 흉골감염은 심각한 합병증일 뿐만 아니라 술후 사망률을 높이는 한 요인이 된다. 저자들은 1999년 7월 집중치료실 및 수술장 이전을 계기로 이를 전후로한 환자들의 흉골감염 발생현황을 비교 분석함으로써 집중치료실 및 수술장 개선이 흉골감염에 미치는 영향을 알고자 하였다. 대상 및 방법: 집중치료실 및 수술장 이전 시점을 전후로 하여 1997년 1월 1일부터 1998년 12월 31일까지 개심술을 시행받은 환자 237명을 Group I으로, 2000년 1월 1일부터 2001년 7월 31일까지 개심술을 시행받은 환자 216명을 Group II로 분류하여 총 453명을 대상으로 하였다. 만 15세 이상의 성인 환자에서 정중흉골절개술 및 심폐바이패스를 시행한 경우만을 포함하였고 흉골감염 이외의 원인으로 사망한 예는 포함하지 않았다. 결과: 흉골감염은 GroupI에서 18례(8.0%), Group II에서 1례(0.49%) 발생하였다. 흉골감염에 영향을 미치는 것으로 알려진 위험인자 중에서 응급수술여부, 심폐바이패스시간, 수술시간, 수혈량, 기관절개술유무, 재수술여부 등이 유의한 연관성이 있었으며, 이들을 대상으로 시행한 로지스틱 회귀분석에서 집중치료실과 수술장의 이전이 흉골감염에 유의한 영향을 미치는 것으로 나타났다.(p=0.029, 95% 신뢰구간 0.011∼0.788). 결론: 개심술후 흉골감염에 영향을 주는 여러 인자들이 알려져 있지만 집중치료실 및 수술장의 개선이 흉골감염의 발생을 줄일 수 있는 하나의 방법으로 생각된다.