• 한국노년학
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• 제30권4호
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• pp.1263-1280
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• 2010

본 연구의 목적은 조선족 간병인의 문화적응 경험에 관한 연구이다. 연구 분석은 Berry(1987)의 문화적응 단계를 인용하여 접촉단계, 갈등단계, 해결 단계로 나누어 조선족 간병인들이 각 단계에서 어떤 경험을 하는지 그 의미를 질적연구 방법을 통해 분석하였다. 접촉단계에서 조선족 간병인은 간병인에 대한 긍정적인 이미지 전환과 연륜의 직업에 의미를 부여하였다. 간병인을 시작하기 전 연구 대상자들은 주변사람들의 영향으로 간병인에 대한 인식이 긍정적으로 변화됐으며, 연령이 많아짐에 따라 간병인이 적합한 일자리가 되었다. 갈등단계에서 조선족들은 차별, 문화적 갈등, 힘든 업무, 부정적 이미지, 타지에서 외로움을 경험하였다. 차별의 경우 조선족이라는 이유만으로 거부와 임금 차별이나 근로조건 등에서 한국인 간병인보다 더 열악한 수준에서 일하는 경우가 많고, 육체적, 정신적으로 힘든 어려움을 경험하고 있었다. 게다가 주위 친지나 가족으로부터 간병인에 대한 부정적 이미지로 인해 내외적 갈등을 경험하기도 했으며, 중국에 거주하는 가족과 떨어져 있기 때문에 외로움을 경험하고 있었다. 이러한 어려움에도 불구하고 해결단계에서 간병인으로 종사하면서 얻는 직간접적인 사회경제적 정서적 혜택은 그들이 한국사회에 적응하는데 큰 역할을 하고 있는 것으로 나타났다. 그 이유로는 이들이 경제적 요인, 일의 보람, 환자 및 보호자 그리고 동료들과의 친분, 일의 자유로움, 일의 안정성, 자부심에서 찾을 수 있었다.

• Journal of Chest Surgery
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• 제56권5호
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• pp.346-352
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• 2023

Background: A significant proportion of cardiac surgery intensive care unit (CSICU) patients require long-term ventilation, necessitating tracheostomy placement. The goal of this study was to evaluate the long-term postoperative outcomes and complications associated with percutaneous dilatational tracheostomy (PDT) in CSICU patients. Methods: All patients undergoing PDT after cardiac, thoracic, or vascular operations in the CSICU between January 1, 2013 and January 1, 2021 were identified. They were evaluated for mortality, decannulation time, and complications including bleeding, infection, and need for surgical intervention. Multivariable regression models were used to identify predictors of early decannulation and the complication rate. Results: Ninety-three patients were identified for this study (70 [75.3%] male and 23 [24.7%] female). Furthermore, 18.3% of patients had chronic obstructive pulmonary disease (COPD), 21.5% had history of stroke, 7.5% had end-stage renal disease, 33.3% had diabetes, and 59.1% were current smokers. The mean time from PDT to decannulation was 39 days. Roughly one-fifth (20.4%) of patients were on dual antiplatelet therapy and 81.7% had anticoagulation restarted 8 hours post-tracheostomy. Eight complications were noted, including 5 instances of bleeding requiring packing and 1 case of mediastinitis. There were no significant predictors of decannulation prior to discharge. Only COPD was identified as a negative predictor of decannulation at any point in time (hazard ratio, 0.28; 95% confidence interval, 0.08-0.95; p=0.04). Conclusion: Percutaneous tracheostomy is a safe and viable alternative to surgical tracheostomy in cardiac surgery ICU patients. Patients who undergo PDT have a relatively short duration of tracheostomy and do not have major post-procedural complications.

• Journal of Korean Biological Nursing Science
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• 제11권2호
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• pp.120-127
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• 2009

Purpose: The study aimed at monitoring the immune status of health care workers (HCWs) of a tertiary hospital after accidental exposure to Hepatitis B virus (HBV). Methods: Between January 2004 and December 2006, 353 cases of exposure to Hepatitis B virus were reported. The HBV-exposed HCWs were required to undergo follow-up serum tests to analyze their immune status one year after the exposure. The obtained data were then analyzed to determine the incidence of exposure and of sero-conversion. Results: In this hospital, an average of 9.8 cases of Hepatitis B exposure among HCWs was reported in a month. Follow-up tests conducted after exposure revealed that 90.4% of the HBV-exposed HCWs were positive for Hepatitis B antibody and 66.9% of the HBV-exposed HCWs were reported to have antibody levels exceeding 10 mIU/mL. Results of serum tests for the HBV antigen conducted one year after exposure were negative for all the exposed HCWs. Conclusion: Among the 79.6% of the HCWs who underwent serum tests one year after exposure the HBV sero-conversion rate was 0.0%. However, a further investigation in the form of long-term and multi-center studies is required to confirm this result. Furthermore, an active system should be established to ensure that all exposed HCWs undergo follow-up serum tests.

• Clinical and Experimental Pediatrics
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• 제63권8호
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• pp.284-290
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• 2020

Korea currently has the world's lowest birth rate but a rapidly inreasing number of preterm infants. The Korean Neonatal Network (KNN), launched by the Korean Society of Neonatology under the support of Korea Centers for Disease Control, has collected population-based data for very low birth weight infants (VLBWIs) born in Korea since 2013. In terms of the short-term outcomes of VLBWIs born from 2013 to 2016 registered in the KNN, the survival rate of all VLBWIs was 86%. Respiratory distress syndrome and bronchopulmonary dysplasia were observed in 78% and 30% of all VLBWIs, respectively. Necrotizing enterocolitis occurred in 7%, while 8% of the VLBWIs needed therapy for retinopathy of prematurity in the neonatal intensive care unit (NICU). Sepsis occurred in 21% during their NICU stay. Intraventricular hemorrhage (grade ≥III) was diagnosed in 10%. In terms of the long-term outcomes for VLBWIs born from 2013 to 2014 registered in the KNN, the post-discharge mortality rate was approximately 1.2%-1.5%, mainly owing to their underlying illness. Nearly half of the VLBWIs were readmitted to the hospital at least once in their first 1-2 years of life, mostly as a result of respiratory diseases. The overall prevalence of cerebral palsy was 6.2%-6.6% in Korea. Bilateral blindness was reported in 0.2%-0.3% of VLBWIs, while bilateral hearing loss was found in 0.8%-1.9%. Since its establishment, the KNN has published annual reports and papers that facilitate the improvement of VLBWI outcome and the formulation of essential healthcare policies in Korea.

• 한국한의학연구원논문집
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• 제10권1호
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• pp.107-117
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• 2004

Each Local public heal public health service center is in difficult situation on programing and performing of local public health service. The purpose of research is to inquire of the present state of local public health service and search long-term developmental methods. The first, in order to accomplish this purpose, I distributed questionnaires to Korean medical doctors, who are worked in public health service center and researched that. The second, based on these findings, I proposed planning for upcoming project for activating local public health service on Korean medicine.

• Clinical and Experimental Reproductive Medicine
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• 제43권4호
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• pp.215-220
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• 2016

Objective: To evaluate the efficacy and safety of dienogest treatment in patients who had received dienogest for 12 months or more to treat endometriosis. Methods: We analyzed the clinical data of 188 women with endometriosis who had been treated with 2 mg of dienogest once a day for 12 months or more at a single institute. We evaluated changes in endometriosis-associated pain and endometrioma size, recurrence rate, and adverse events following dienogest administration. Bone mineral density (BMD) was measured in patients who were prescribed dienogest for more than 18 months. Results: Pain was significantly reduced at 12 months after dienogest medication. In those treated with dienogest due to recurrent endometrioma, the size of the endometrioma was significantly decreased at the 12-month and 18-month follow-ups. We found only one case of sonographic recurrence during dienogest administration among those who were treated postoperatively to prevent recurrence (1 of 114, 0.9%). The most common adverse drug reaction was uterine bleeding (3.2%), and other adverse events were generally tolerable and associated with low discontinuation rates (5.2%). Among the 50 patients in whom BMD was measured, 10 patients (20%) had a Z-score below the expected range for age. Conclusion: The administration of dienogest for a year or more seems to be highly effective in preventing recurrence after surgery, reducing endometriosis-associated pain, and decreasing the size of recurrent endometrioma, with a favorable safety and tolerability profile. However, BMD should be checked in patients on long-term medication due to possible bone loss in some women.

• 성인간호학회지
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• 제19권5호
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• pp.1-11
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• 2007

Purpose: The purpose of this study was to examine the effects of a cognitive behavioral stress management program on diabetic self-care and glycemic control with type 2 diabetic patients. Methods: Thirty three diabetic patients who were older than 40 were recruited from a public health center and conveniently assigned into both experimental(n=16) and control groups(n=17). Participants in the experimental group had attended the weekly cognitive behavioral program for 8 weeks. Data were collected from June 2005 to August 2006 and analyzed by independent t-test using the SPSS WIN program. Results: After an 8 week intervention, participants in the experimental group reported on increasement of diabetic self-care behaviors and an increasement of blood glucose levels, which were significantly different from those in the control group. Conclusion: On the basis of those findings, we concluded that the cognitive behavioral stress management program has positive effects on diabetic self-care and glycemic control for the patients with DM. Further research is needed to identify the long-term effects of the cognitive behavioral program.

• Journal of Korean Biological Nursing Science
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• 제24권4호
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• pp.243-252
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• 2022

Purpose: The purpose of this longitudinal study was to identify the relationship between the readiness for hospital discharge and self-care changes in an early stage of liver transplantation after discharge. Methods: Data of 75 liver transplant recipients within one year of surgery from a transplantation center from May 2019 to May 2020 were collected for this study. Their readiness for discharge was measured before discharge. Self-care after liver transplantation was evaluated at one week, one month, and three months of discharge at outpatient visits. Linear mixed model was used to evaluate the statistical relationship. Results: The readiness for hospital discharge was significantly higher when the caregiver was a spouse (p=.027), with fewer post-transplantation days (p=.027), absence of acute rejection (p=.004), or high self-efficacy (p<.001). As a result of the linear mixed model analysis, the higher the discharge readiness score, the higher the self-care score (β=0.29, p<.001). However, after three months, their self-care had decreased regardless of their level of readiness for hospital discharge compared to one week after discharge. Conclusion: Improving the readiness before discharge is essential to enhance self-care. Also, active intervention at 3 months of discharge should be performed to check and promote their long-term self-care.

• 한국콘텐츠학회논문지
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• 제19권11호
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• pp.603-618
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• 2019

본 연구는 재가장기요양기관 방문간호사의 간호 경험의 의미와 본질을 탐구하기 위해 van Manen의 해석학적 현상학 연구방법론을 적용하였다. 연구 참여자는 방문간호 경력 1년 이상인 10명의 방문간호사들로 목적적 표집과 편의 표집, 눈덩이식 표집 방법을 통해 선정하였다. 자료 수집은 2017년 1월 7일부터 2018년 10월 12일까지 진행되었으며, 연구 참여자와의 면담은 총 23회에 걸쳐 이루어졌다. 자료 분석은 van Manen이 제시한 해석학적 현상학 방법론에 근거를 두고 전체론적(holistic) 방법과, 선택적(selective) 방법, 그리고 세분법(detailed)을 사용하였다. 연구 결과, 재가장기요양기관 방문간호사의 간호 경험은 6개 본질적 주제와 20개 하위주제로 도출되었다. 본질적 주제는 '대상자 및 보호자와 친밀한 관계를 형성함', '주도적 간호수행으로 방문간호의 기반을 다져감', '지원체계 미비로 원하는 만큼의 간호를 제공하기 어려운 현실에 직면함', '간호의 진정성이 전달되지 않을 때 속상함', '내 환자라는 책임감을 가지고 돌봄의 소명을 다함', '방문간호사로서 보람과 의미를 느끼며 오래도록 일하고자 함'이다. 본 연구는 재가장기요양기관 방문간호사들의 간호 경험을 탐색함으로써 지역사회 내에서 노인장기요양보험 방문간호사의 역할과 중요성을 이해하였다는데 의미가 있다.

• Tuberculosis and Respiratory Diseases
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• 제52권4호
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• pp.376-384
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• 2002

연구배경: 급성호흡곤란증후군(ARDS)환자에서의 고용량 및 단기간이 스테로이드의 사용은 사망률은 감소시키지 못하나 최근 섬유증식기로 진행한 후기 급성호흡곤란증후군 환자의 일부에서 스테로이드의 투여가 환자의 예후를 개선시킨다는 몇몇 연구 보고가 있었다. 이에 후기 급성호흡곤란증후군 환자에게 투여한 스테로이드가 사망률 및 호흡 역학에 미치는 영향을 후향적으로 분석하였다. 방 법: 1998년 1월부터 2001년 7월까지 서울중앙병원 내과계 중환자실에 입원한 급성호흡곤란증후군 환자들 중 일주일 이상 기계호흡을 했고 이전에 스테로이드를 쓴 적이 없으면서 기계환기, 복와위, 폐포모집술(recruitment maneuver), 산화질소 흡입 요법 등의 치료에도 급성호흡곤란증후군 진단 8일째 PF ratio가 200이하인 48명 중 스테로이드 치료군 14명과 비치료군 34명의 임상적, 생리적 지표들을 비교 분석했다. 평균${\pm}$표준편차로 표기했다. 결 과: 스테로이드 치료군과 비치료군 사이의 급성호흡곤란증후군의 원인, 연령, 급성호흡곤란증후군 진단 당시와 8일째 PF ratio, LIS, 폐 정적 탄성(static compliance), SAPS II score들의 통계학적 차이가 없었다. 스테로이드 치료군과 비치료군의 생존군만 비교시 치료 후 7일째 PF ratio, GOCA, APACHE III score가 스테로이드 치료군에서 의미 있게 호전되었고 사망률 역시 치료군에서 유의하게 낮았다(42.4% vs 73.5% p=0.02). 결 론: 후기 급성호흡곤란증후군 환자에서 스테로이드의 사용은 호흡역학 및 예후를 개선시킬 것으로 사료된다.