• 제목/요약/키워드: neglected disease

검색결과 61건 처리시간 0.036초

Assessment of respondents' knowledge, attitudes, and practices toward rabies and associated risk factors in Shone Town, Southern Ethiopia

  • Teketel Gizaw Beresa;Teshita Edaso Beriso;Tesfaye Bekele Kassa;Isayas Asefa Kebede
    • Journal of Veterinary Science
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    • 제25권3호
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    • pp.46.1-46.11
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    • 2024
  • Importance: Rabies is a neglected tropical viral disease most often transmitted through the bite of an infected animal. Objective: This study assessed the level of knowledge, attitudes, and practices of the Shone Ttown community toward rabies. Methods: A survey-based cross-sectional study was conducted in Shone town, Ethiopia, from November 2022 to April 2023. Woreda was selected purposefully, while Kebeles and the study populations were selected by simple random sampling. Four hundred and sixteen respondents were interviewed using a semi-structured questionnaire. Results: All respondents had heard about rabies from different sources, with the majority hearing from informal sources (62%). Approximately 51.9%, 0.7%, and 47.4% of individuals were aware of saliva contact, rabid animal bites, and both as means of transmission, respectively. The survey showed that 64.4% of participants knew the 100% fatal nature of rabies once the clinical signs developed, and 35.6% did not. Approximately 51.4% of respondents agreed that killing stray dogs was an effective method for rabies prevention. In this study, 72.6% of the respondents had contact with pets, and 36.8% of the interviewees had vaccinated their dogs. Only the educational level (p = 0.03) was associated with knowledge of the transmission route. Age (p = 0.04) and educational level (p = 0.01) had a statistically significant association with knowledge of the risk of not vaccinating dogs. Conclusions and Relevance: A lack of formal education in the communities, low levels of education, and the majority of respondents acquiring their knowledge from unofficial sources are important contributors to the low levels of awareness.

가습기살균제 참사의 진행과 교훈(Q&A) (Questions and Answers about the Humidifier Disinfectant Disaster as of February 2017)

  • 최예용
    • 한국환경보건학회지
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    • 제43권1호
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    • pp.1-22
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    • 2017
  • 'The worstest environment disaster', 'World's first biocide massacre', 'Home-based Sewol ferry disaster' are all phrases attached to the recent humidifier disinfectant disaster. In the spring of 2011, four of 8 pregnant women including 1 adult man passed away at a university hospital in Seoul due to breathing failure. Epidemiologic investigation conducted by the Korean CDC soon revealed the inhalation of humidifier disinfectant, which had been widely used in Korea during the winter, to be responsible for the disease. As well as lung fibrosis hardening of the lungs, other diseases including asthma, rhinitis, skin disease, liver disease, fetal disease or cancers have been researched for their relation with exposure to the products. By February 9, 2017, 5,342 cases had registered for health problems and 1,131 of them were already dead (20.8% mortality rate). Based on studies by government agencies and a telephone survey of the general population by Seoul National University and civic groups, around 20% of the general public of Korea has used these products. Since the market release of the first product by SK Chemical in 1994, over 7.1 million items from around 20 brands were sold up to 2011. Most of the products were manufactured by well-known large conglomerates such as SK, Lotte, Samsung, Shinsegye, LG, and GS, as well as some European companies including UK-based Reckitt Benckiser and TESCO, the German firm Henkel, the Danish firm KeTox, and an Irish company. Even though this disaster was unveiled in 2011 by the Korean government, the issue of the victims was neglected for over five years. In 2016, an unexpected but intensive investigation by prosecutors found that Reckitt Benckiser manipulated and concealed animal tests for its own brand and brought several university experts and company employees to court. The matter was an intense social issue in Korea from May to June with a surge in media coverage. The prosecutor's investigation and a nationwide boycott campaign organized by victims and environmental groups against Reckitt Benckiser, whose product had been used by more than 70% of victims, led to the producer's official apology and a compensation scheme. A legislative investigation organized after the April 2016 national election revealed the producers' faults and the government's responsibility, but failed to meet expectations. A special law for the victims passed the National Assembly in January 2017 and a punitive system together with a massive environmental epidemiology investigation are expected to be the only solutions for this tragedy. Sciences of medicine, toxicology and environmental health have provided decisive evidence so far, but for the remaining problems the perspectives of social sciences such as sociology and jurisprudence are highly necessary, similar to with the Minamata disease and Wonjin Rayon events. It may not be easy to follow this issue using unfamiliar terminology from medical and chemical science and the long, complicated history of the event. For these reasons the author has attempted to write this article in a question and answer format to render it easier to follow. The 17 questions are: Q1 What is humidifier disinfectant? Q2 What kind of health problems are caused by humidifier disinfectant? Q3 How many victims are there? Q4 What is the analysis of the 1,112 cases of death? Q5 What is the problem with the government's diagnostic criteria and the solution? Q6 Who made what brands? Q7 Has there been a recall? What is still on sale? Q8 Was safety not checked by any producers? Q9 What are the government's responsibilities? Q10 Is it true that these products were sold only in Korea? Q11 Why and how was it unveiled only in 2011 after 17 years of sales? Q12 What delayed the resolution of the victim issue? Q13 What is the background of the prosecutor's investigation in early 2016? Q14 Is it possible to report new victim cases without evidence of product purchase? Q15 What is happening with the victim issue? Q16 How does it compare with the cases of Minamata disease and Wonjin Rayon? Q17 Are there prevention measures and lessons?

Inflammatory Breast Cancer: a Single Centre Analysis

  • Gogia, Ajay;Raina, Vinod;Deo, Suryanarayan Vishnu;Shukla, Nootan Kumar;Mohanti, Bidhu Kalyan;Sharma, Daya Nand
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권7호
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    • pp.3207-3210
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    • 2014
  • Background: Inflammatory breast cancer (IBC) is an aggressive form of locally advanced breast cancer characterized by rapidly progressive breast erythema, pain and tenderness, oedema and paeu d'orange appearance. It accounts for 1-3% of all newly diagnosed cases of breast cancer in the west. Data on IBC from India are lacking. The aim of our study was to assess the clinical-pathological parameters and outcome of IBC at, All India Institute of Medical Sciences, a large tertiary care centre. Materials and Methods: We screened 3,650 breast cancer cases registered from January 2004 to December 2012 and found 41 cases of IBC. Data included demographics as well as clinical, radiological and histopathological characteristics, and were collected from clinical case records using the International Classification of Diseases code (C-50). Patients who presented with IBC as a recurrence, or who had a neglected and advanced breast cancer that simulated an IBC were excluded from this study. Results: The median age was 45 years (range 23-66). The median duration of symptoms was 5 months. The American Joint Committee on Cancer stage (AJCC) distribution was Stage III - 26 and IV - 15 patients. Estrogen receptor (ER), progesterone receptor (PR) positivity and human epidermal growth factor receptor 2 (HER2/neu) positivity were 50%, 46% and 60%, respectively. Triple negativity was found in 15% of the cases. All the non metastatic IBC patients received anthracycline and/ or taxane based chemotherapy followed by modified radical mastectomy, radiotherapy and hormonal therapy as indicated. Pathological complete remission rate was 15%. At a median follow-up of 30 months, the 3 year relapse free survival and overall survival were 30% and 40%respectively. Conclusion: IBC constituted 1.1% of all breast cancer patients at our centre. One third of these had metastatic disease at presentation. Hormone positivity and Her2 neu positivity were found in 50% and 60% of the cases, respectively.

이해관계 선언 (Limitations of 99mTc-DMSA scan in diagnosing acute pyelonephritis in children)

  • 김병기;곽재령;박지민;배기수
    • Clinical and Experimental Pediatrics
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    • 제53권3호
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    • pp.408-413
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    • 2010
  • 목 적 : 소아에서 급성 신우신염 진단시 computed tomography(CT)와 비교하여 $^{99mTc}DMSA$ scintigraphy (DMSA)의 상대적 제한점이 있음을 확인하고자 하였다. 방 법 : 64채널 CT가 도입된 2006년 9월 이후 3년 동안 급성복증이나 발열성 급성병증으로 복부 CT검사를 받은 환아 중 급성 신우신염의 소견을 보였으나 후속으로 시행된 DMSA에서는 이상소견을 발견되지 않은 'DMSA 위음성 환자' 10명을 연구대상으로 선정하여 이들의 임상상과 CT 소견을 분석하였다. CT촬영에는 필립스사의 브릴리언스-64 모델을, DMSA 스캔에는 Siemens사의 Orbiter 75 기종을 사용하였다. 결 과 : 총 10명 중 남자가 8명, 영유아가 8명이었으며 내원당시 평균 1.1일간 발열이 있었고 말초혈액 백혈구 수, 적혈구침강 속도, C-반응단백 등의 급성반응표지가 증가된 상태였다. DMSA 정상 소견을 보였던 10명에서 CT 신장환부 소견은 국소적인 경우가 6례, 미만성인 경우가 4례였다. 대개 일측성이었으며 양측 신장 모두 침범된 경우는 2례였다. DMSA에서 확인되지 않은 CT상 병변 개수는 총 22개 확인되었다. DMSA 비교신기능 측정법은 신손상 정도를 가늠하는데 도움이 되지 않았다. 결 론 : 본 연구를 통하여 DMSA검사는 CT검사상 양성인 급성 신우신염의 신장환부를 밝혀내지 못하는 제한점이 있음이 확인되었다. DMSA 위음성 결과는 주로 질병초기에 영아 환자에서 흔히 발생하는 것으로 보이나, 그 정확한 이유와 발생 비율 등을 밝히기 위해서는 전향적인 추가조사가 필요하다.

딥러닝 기반 소셜미디어 한글 텍스트 우울 경향 분석 (A Deep Learning-based Depression Trend Analysis of Korean on Social Media)

  • 박서정;이수빈;김우정;송민
    • 정보관리학회지
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    • 제39권1호
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    • pp.91-117
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    • 2022
  • 국내를 비롯하여 전 세계적으로 우울증 환자 수가 매년 증가하는 추세이다. 그러나 대다수의 정신질환 환자들은 자신이 질병을 앓고 있다는 사실을 인식하지 못해서 적절한 치료가 이루어지지 않고 있다. 우울 증상이 방치되면 자살과 불안, 기타 심리적인 문제로 발전될 수 있기에 우울증의 조기 발견과 치료는 정신건강 증진에 있어 매우 중요하다. 이러한 문제점을 개선하기 위해 본 연구에서는 한국어 소셜 미디어 텍스트를 활용한 딥러닝 기반의 우울 경향 모델을 제시하였다. 네이버 지식인, 네이버 블로그, 하이닥, 트위터에서 데이터수집을 한 뒤 DSM-5 주요 우울 장애 진단 기준을 활용하여 우울 증상 개수에 따라 클래스를 구분하여 주석을 달았다. 이후 구축한 말뭉치의 클래스 별 특성을 살펴보고자 TF-IDF 분석과 동시 출현 단어 분석을 실시하였다. 또한, 다양한 텍스트 특징을 활용하여 우울 경향 분류 모델을 생성하기 위해 단어 임베딩과 사전 기반 감성 분석, LDA 토픽 모델링을 수행하였다. 이를 통해 문헌 별로 임베딩된 텍스트와 감성 점수, 토픽 번호를 산출하여 텍스트 특징으로 사용하였다. 그 결과 임베딩된 텍스트에 문서의 감성 점수와 토픽을 모두 결합하여 KorBERT 알고리즘을 기반으로 우울 경향을 분류하였을 때 가장 높은 정확률인 83.28%를 달성하는 것을 확인하였다. 본 연구는 다양한 텍스트 특징을 활용하여 보다 성능이 개선된 한국어 우울 경향 분류 모델을 구축함에 따라, 한국 온라인 커뮤니티 이용자 중 잠재적인 우울증 환자를 조기에 발견해 빠른 치료 및 예방이 가능하도록 하여 한국 사회의 정신건강 증진에 도움을 줄 수 있는 기반을 마련했다는 점에서 의의를 지닌다.

심장 이식술을 받은 젊은 환자에서 발생한 2예의 지연성 칸디다 척추 골수염 (Late-Onset Candida Vertebral Osteomyelitis in Two Young Patients Who Underwent Heart Transplant Surgery)

  • 강민석;손인석;김태훈;이석하
    • 대한정형외과학회지
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    • 제54권1호
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    • pp.72-77
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    • 2019
  • 칸디다 척추 골수염은 드문 질환으로서 과거에는 마약 등 정맥 내 주사제 사용자들에서 발생하는 합병증으로 알려져 왔으나 최근에는 대부분이 병원 내 기회 감염의 형태로 발생되고 있다. 칸디다 척추 골수염의 임상적 및 영상학적 특징이 화농성 척추 추간판염과 유사하기 때문에 일반적인 임상에서 간과되는 경우가 흔하다. 칸디다 척추 골수염에서 다른 원인에 의한 척추 골수염과의 감별진단은 임상적, 영상의학적 및 생물학적 특성에 의존한다. 칸디다 척추염의 치료는 초기의 정확한 진단과 이를 바탕으로 신속하고 적절한 약물 요법, 임상경과의 지속적인 추적관찰로 이루어진다. 본 증례에서 심장 이식술을 받은 젊은 환자에서 수술 후 전신성 진균증 치료 3개월 후 발생한 지연성 칸디다 척추 골수염을 항 진균제 단독요법으로 치료한 2예를 경험하였기에 이를 보고하고 문헌고찰을 통해 상기하고자 한다.

농촌(農村) 주민(住民)들의 의료필요도(醫療必要度)에 관(關)한 연구(硏究) (A Study Concerning Health Needs in Rural Korea)

  • 이성관;김두희;정종학;정극수;박상빈;최정헌;홍순호;라진훈
    • Journal of Preventive Medicine and Public Health
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    • 제7권1호
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    • pp.29-94
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    • 1974
  • Today most developed countries provide modern medical care for most of the population. The rural area is the more neglected area in the medical and health field. In public health, the philosophy is that medical care for in maintenance of health is a basic right of man; it should not be discriminated against racial, environmental or financial situations. The deficiency of the medical care system, cultural bias, economic development, and ignorance of the residents about health care brought about the shortage of medical personnel and facilities on the rural areas. Moreover, medical students and physicians have been taught less about rural health care than about urban health care. Medical care, therefore, is insufficient in terms of health care personnel/and facilities in rural areas. Under such a situation, there is growing concern about the health problems among the rural population. The findings presented in this report are useful measures of the major health problems and even more important, as a guide to planning for improved medical care systems. It is hoped that findings from this study will be useful to those responsible for improving the delivery of health service for the rural population. Objectives: -to determine the health status of the residents in the rural areas. -to assess the rural population's needs in terms of health and medical care. -to make recommendations concerning improvement in the delivery of health and medical care for the rural population. Procedures: For the sampling design, the ideal would be to sample according to the proportion of the composition age-groups. As the health problems would be different by group, the sample was divided into 10 different age-groups. If the sample were allocated by proportion of composition of each age group, some age groups would be too small to estimate the health problem. The sample size of each age-group population was 100 people/age-groups. Personal interviews were conducted by specially trained medical students. The interviews dealt at length with current health status, medical care problems, utilization of medical services, medical cost paid for medical care and attitudes toward health. In addition, more information was gained from the public health field, including environmental sanitation, maternal and child health, family planning, tuberculosis control, and dental health. The sample Sample size was one fourth of total population: 1,438 The aged 10-14 years showed the largest number of 254 and the aged under one year was the smallest number of 81. Participation in examination Examination sessions usually were held in the morning every Tuesday, Wenesday, and Thursday for 3 hours at each session at the Namchun Health station. In general, the rate of participation in medical examination was low especially in ages between 10-19 years old. The highest rate of participation among are groups was the under one year age-group by 100 percent. The lowest use rate as low as 3% of those in the age-groups 10-19 years who are attending junior and senior high school in Taegu city so the time was not convenient for them to recieve examinations. Among the over 20 years old group, the rate of participation of female was higher than that of males. The results are as follows: A. Publie health problems Population: The number of pre-school age group who required child health was 724, among them infants numbered 96. Number of eligible women aged 15-44 years was 1,279, and women with husband who need maternal health numbered 700. The age-group of 65 years or older was 201 needed more health care and 65 of them had disabilities. (Table 2). Environmental sanitation: Seventy-nine percent of the residents relied upon well water as a primary source of dringking water. Ninety-three percent of the drinking water supply was rated as unfited quality for drinking. More than 90% of latrines were unhygienic, in structure design and sanitation (Table 15). Maternal and child health: Maternal health Average number of pregnancies of eligible women was 4 times. There was almost no pre- and post-natal care. Pregnancy wastage Still births was 33 per 1,000 live births. Spontaneous abortion was 156 per 1,000 live births. Induced abortion was 137 per 1,000 live births. Delivery condition More than 90 percent of deliveries were conducted at home. Attendants at last delivery were laymen by 76% and delivery without attendants was 14%. The rate of non-sterilized scissors as an instrument used to cut the umbilical cord was as high as 54% and of sickles was 14%. The rate of difficult delivery counted for 3%. Maternal death rate estimates about 35 per 10,000 live births. Child health Consultation rate for child health was almost non existant. In general, vaccination rate of children was low; vaccination rates for children aged 0-5 years with BCG and small pox were 34 and 28 percent respectively. The rate of vaccination with DPT and Polio were 23 and 25% respectively but the rate of the complete three injections were as low as 5 and 3% respectively. The number of dead children was 280 per 1,000 living children. Infants death rate was 45 per 1,000 live births (Table 16), Family planning: Approval rate of married women for family planning was as high as 86%. The rate of experiences of contraception in the past was 51%. The current rate of contraception was 37%. Willingness to use contraception in the future was as high as 86% (Table 17). Tuberculosis control: Number of registration patients at the health center currently was 25. The number indicates one eighth of estimate number of tuberculosis in the area. Number of discharged cases in the past accounted for 79 which showed 50% of active cases when discharged time. Rate of complete treatment among reasons of discharge in the past as low as 28%. There needs to be a follow up observation of the discharged cases (Table 18). Dental problems: More than 50% of the total population have at least one or more dental problems. (Table 19) B. Medical care problems Incidence rate: 1. In one month Incidence rate of medical care problems during one month was 19.6 percent. Among these health problems which required rest at home were 11.8 percent. The estimated number of patients in the total population is 1,206. The health problems reported most frequently in interviews during one month are: GI trouble, respiratory disease, neuralgia, skin disease, and communicable disease-in that order, The rate of health problems by age groups was highest in the 1-4 age group and in the 60 years or over age group, the lowest rate was the 10-14 year age group. In general, 0-29 year age group except the 1-4 year age group was low incidence rate. After 30 years old the rate of health problems increases gradually with aging. Eighty-three percent of health problems that occured during one month were solved by primary medical care procedures. Seventeen percent of health problems needed secondary care. Days rested at home because of illness during one month were 0.7 days per interviewee and 8days per patient and it accounts for 2,161 days for the total productive population in the area. (Table 20) 2. In a year The incidence rate of medical care problems during a year was 74.8%, among them health problems which required rest at home was 37 percent. Estimated number of patients in the total population during a year was 4,600. The health problems that occured most frequently among the interviewees during a year were: Cold (30%), GI trouble (18), respiratory disease (11), anemia (10), diarrhea (10), neuralgia (10), parasite disease (9), ENT (7), skin (7), headache (7), trauma (4), communicable disease (3), and circulatory disease (3) -in that order. The rate of health problems by age groups was highest in the infants group, thereafter the rate decreased gradually until the age 15-19 year age group which showed the lowest, and then the rate increased gradually with aging. Eighty-seven percent of health problems during a year were solved by primary medical care. Thirteen percent of them needed secondary medical care procedures. Days rested at home because of illness during a year were 16 days per interviewee and 44 days per patient and it accounted for 57,335 days lost among productive age group in the area (Table 21). Among those given medical examination, the conditions observed most frequently were respiratory disease, GI trouble, parasite disease, neuralgia, skin disease, trauma, tuberculosis, anemia, chronic obstructive lung disease, eye disorders-in that order (Table 22). The main health problems required secondary medical care are as fellows: (previous page). Utilization of medical care (treatment) The rate of treatment by various medical facilities for all health problems during one month was 73 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 52% while the rate of those who have health problems which did not required rest was 61 percent (Table 23). The rate of receiving of medical care for all health problems during a year was 67 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 82 percent while the rate of those who have health problems which did not required rest was as low as 53 percent (Table 24). Types of medical facilitied used were as follows: Hospital and clinics: 32-35% Herb clinics: 9-10% Drugstore: 53-58% Hospitalization Rate of hospitalization was 1.7% and the estimate number of hospitalizations among the total population during a year will be 107 persons (Table 25). Medical cost: Average medical cost per person during one month and a year were 171 and 2,800 won respectively. Average medical cost per patient during one month and a year were 1,109 and 3,740 won respectively. Average cost per household during a year was 15,800 won (Table 26, 27). Solution measures for health and medical care problems in rural area: A. Health problems which could be solved by paramedical workers such as nurses, midwives and aid nurses etc. are as follows: 1. Improvement of environmental sanitation 2. MCH except medical care problems 3. Family planning except surgical intervention 4. Tuberculosis control except diagnosis and prescription 5. Dental care except operational intervention 6. Health education for residents for improvement of utilization of medical facilities and early diagnosis etc. B. Medical care problems 1. Eighty-five percent of health problems could be solved by primary care procedures by general practitioners. 2. Fifteen percent of health problems need secondary medical procedures by a specialist. C. Medical cost Concidering the economic situation in rural area the amount of 2,062 won per residents during a year will be burdensome, so financial assistance is needed gorvernment to solve health and medical care problems for rural people.

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가정용 인공호흡기를 사용하는 서울 및 경기 지역 환자의 실태 (Survey of Current Status of the Patients with Home Ventilator in Seoul and Kyunggi Province)

  • 안종준;이기만;심태선;임채만;이상도;김우성;김동순;김원동;고윤석
    • Tuberculosis and Respiratory Diseases
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    • 제49권5호
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    • pp.624-632
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    • 2000
  • 서론 : 최근 발달된 기술로 작고 기능이 뛰어난 가정용 인공호흡기가 개발되어 구미에서는 장기간 기계환기가 필요한 만성호흡부전 환자를 대상으로 그 사용아 점차 보편화 되어 가고 있다. 우리나라에서도 가정에서 기계환기치료의 적용이 최근 확산되고 있으나 이 치료법에 대한 임상 경험 보고나 그 실태 조사 자료가 거의 없어 이에 대한 기초 자료의 조사가 필요한 상태이다. 본 연구는 장기간 기계환기 보조가 필요하여 가정용 인공호흡기를 사용하는 환자에서 간호 관리의 문제점과 가정용 인공호흡기 사용 실태를 조사하기 위하여 연구를 시행하였다. 연구대상 및 방법 : 서울 및 경기 지역에서 가정용 인공호흡기를 사용하고 있는 환자 92명의 명단을 인공호흡기를 공급 관리하는 업체에서 제공 받아 전화 통화를 시도하여 방문에 동의하는 29명을 대상으로 하였다. 대상 환자의 집을 방문하여 병력 청취와 신체 검사를 시행하였고, 환자 간호 관리에 대한 설문을 실시하였다. 설문의 내용에는 간호 관리에 대한 사전 교육 여부, 의료인의 가정 방문 여부, 인공호흡기 이상의 경험 여부, 인공호흡기 및 부가 장비의 구입 경비, 환자 간호와 연관된 문제점 및 개선을 위한 제안 등이 포함되어 있었다. 가정용 인공호흡기의 설정 요소들을 확인하고, 측정되는 일회호흡용적(tidal volume), 최대 기도압, 산소포화도 등을 기록하였다. 연구결과 : 1) 방문을 마친 환자 29명중 남자는 26명(90%)이었고, 나이는 48.0(${\pm}$20.1)세였다. 환자들의 기저 질환은 신경근 질환 21명(72.4%), 척수 손상 2명(6.9%), 만성 폐질환 6명(20.7%)이었다. 2) 간호 관리자는 배우자가 14명(48.3%)으로 가장 많았으며, 가정 간호 관리를 위한 사전 교육은 주로 입원 중 간호사로부터 배우고 있었다. 3) 인공호흡기를 구입하여 사용하는 경우는 23명으로 압력달성양식(pressure targeted type)은 745(${\pm}$329)만원, 용적달성양식(volume targeted type)은 1,428(${\pm}$313)만원이 각각 소요되었다. 장비 구입에 소요되는 총 비용은 1,13l(${\pm}$653)만원이었다. 환자를 간호 관리하는데 1개월간 소요되는 평균 비용은 112(${\pm}$136)만원이었다. 4) 29명의 환자 중 25명 (86%)은 기관절개술을 시행한 상태로 기계환기를 시행하고 있었다. 인공호흡기는 용적달성양식이 20명(69%)으로 압력달성양식(9명, 31%)보다 더 많았다. 결론 : 우리나라에서 가정용 인공호흡기를 사용하는 환자는 신경근 질환 환자가 가장 많았고, 대부분 기관절개술을 시행한 상태로 경보 기능을 가진 용적달성양식을 많이 사용하고 있었다. 환자와 가족들은 장비 구입 및 유지와 연관된 경제적인 어려움을 당연한 문제로 제시 하였으며 환자들 중 일부는 가정간호사들의 도움을 받고 있었으나 의사들의 지속적인 감시를 받지 못한 채 방치되어 있었다.

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Structural Equation Modeling을 통한 노인(老人)의 구강건강(口腔健康) 관련요인(關聯要因) 분석(分析) (Oral Health and Related Factors for the Elderly)

  • 성정희
    • 치위생과학회지
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    • 제4권3호
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    • pp.91-95
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    • 2004
  • 본 연구는 구강보건실태와 관련요인을 분석하고 관련요인의 인자구조모델을 구축하는데 그 목적이 있다. 연구 대상자는 2002년 1월부터 12월까지 국민건강보험공단이 실시한 지역가입자 건강검진(1차)을 받은 65세 이상 노인 9,340명이다. 대상자는 구강검진을 포함한 모든 검진을 받고 문진표를 작성한 노인들이다. 분석의 주요결과는 다음과 같다. 1. 구성개념타당성에 대한 검토체위검사, 요 검사, 혈액검사, 식 습관, 음주 흡연, 치료 예방, 구강증상, 구강건강상태 등 인자구조모델의 구성개념타당성은 적합도 지수 GFI, CFI, TLI, RMSEA를 이용하여 분석한 결과 모두 적합한 범위에 있었으므로 구성개념타당성은 인정되었다. 2. 각 요인과 구강건강상태와의 관련성을 보기 위한 구조방정식 모델을 분석한 결과 요 검사를 제외한 모든 요인이 구강건강상태에 영향을 미치고 있음이 확인되었으며 이를 설명할 종합적인 구조모델을 구축할 수 있었다. 이상의 결과, 치과 방문과 치면세마 경험이 적은 농촌지역이 도시지역에 비해 치아우식증, 치아 결손을, 의치필요자율이 높았으며, 음주 흡연이 치아우식증, 치주질환, 치아결손율에 부정적인 영향을 주고 있음을 확인할 수 있었다. 또한 치주질환은 전체의 3.2%에서 관찰되었으며 낮은 연령에서 많이 확인되었다. 대부분의 구강질환은 올바른 구강건강행동의 실천으로 예방 가능하므로 전국 각 지역 보건소를 중심으로 구강보건전문가에 의해 바른 식 습관과 구강건강관리에 관한 노인구강보건교육이 체계적으로 이루어져야 하며, 경제적, 지리적인 장애로 인해 치과기관을 방문하지 못하거나 치면세마, 의치장착 등의 구강 건강행위를 소홀히 하지 않도록 하기 위한 치과 의료서비스 접근도를 높히는 정책전환이 요구된다. 또한, 구강건강상태와 전신건강과의 관련성을 설명하기 위해 구조모델을 구축하기 위해서는 보다 정확한 검사방법과 효과적인 지표 개발이 선행되어야 한다. 이 연구에서는 국민건강보험공단에서 개발한 항목을 그대로 적용하였기 때문에 모델 구성에 한계점이 있었다. 향후 계속적인 연구가 필요할 것으로 사료된다.

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간호개념에 대한 기초조사 (The Empirical Exploration of the Conception on Nursing)

  • 백혜자
    • 대한간호학회지
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    • 제11권1호
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    • pp.65-87
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    • 1981
  • The study is aimed at exploring concept held by clinical nurses of nursing. The data were collected from 225 nurses conviniently selected from the population of nurses working in Kang Won province. Findings include. 1) Nurse's Qualification. The respondents view that specialized knowledge is more important qualification of the nurse. Than warm personality. Specifically, 92.9% of the respondents indicated specialized knowledge as the most important qualification while only 43.1% indicated warm personality. 2) On Nursing Profession. The respondents view that nursing profession as health service oriented rather than independent profession specifically. This suggests that nursing profession is not consistentic present health care delivery system nor support nurses working independently. 3) On Clients of Nursing Care The respondents include patients, family and the community residents in the category of nursing care. Specifically, 92.0% of the respondents view that patient is the client, while only 67.1% of nursing student and 74.7% of herself. This indicates the lack of the nurse's recognition toward their clients. 4) On the Priority of Nursing care. Most of the respondents view the clients physical psychological respects as important component of nursing care but not the spiritual ones. Specially, 96.0% of the respondents indicated the physical respects, 93% psychological ones, while 64.1% indicated the spiritual ones. This means the lack of comprehensive conception on nursing aimension. 5) On Nursing Care. 91.6% of the respondents indicated that nursing care is the activity decreasing pain or helping to recover illness, while only 66.2% indicated earring out the physicians medical orders. 6) On Purpose of Nursing Care. 89.8% of the respondents indicated preventing illness and than 76.6% of them decreasing 1;ai of clients. On the other hand, maintaining health has the lowest selection at the degree of 13.8%. This means the lack of nurses' recognition for maintaining health as the most important point. 7) On Knowledge Needed in Nursing Care. Most of the respondents view that the knowledge faced with the spot of nursing care is needed. Specially, 81.3% of the respondents indicated simple curing method and 75.1%, 73.3%, 71.6% each indicated child nursing, maternal nursing and controlling for the communicable disease. On the other hand, knowledge w hick has been neglected in the specialized courses of nursing education, that is, thinking line among com-w unity members, overcoming style against between stress and personal relation in each home, and administration, management have a low selection at the depree of 48.9%,41.875 and 41.3%. 8) On Nursing Idea. The highest degree of selection is that they know themselves rightly, (The mean score measuring distribution was 4.205/5) In the lowest degree,3.016/5 is that devotion is the essential element of nursing, 2.860/5 the religious problems that human beings can not settle, such as a fatal ones, 2,810/5 the nursing profession is worth trying in one's life. This means that the peculiarly essential ideas on the professional sense of value. 9) On Nursing Services. The mean score measuring distribution for the nursing services showed that the inserting of machine air way is 2.132/5, the technique and knowledge for surviving heart-lung resuscitating is 2.892/s, and the preventing air pollution 3.021/5. Specially, 41.1% of the respondents indicated the lack of the replied ratio. 10) On Nurses' Qualifications. The respondents were selected five items as the most important qualifications. Specially, 17.4% of the respondents indicated specialized knowledge, 15.3% the nurses' health, 10.6% satisfaction for nursing profession, 9.8% the experience need, 9.2% comprehension and cooperation, while warm personality as nursing qualifications have a tendency of being lighted. 11) On the Priority of Nursing Care The respondents were selected three items as the most important component. Most of the respondents view the client's physical, spiritual: economic points as important components of nursing care. They showed each 36.8%, 27.6%, 13.8% while educational ones showed 1.8%. 12) On Purpose of Nursing Care. The respondents were selected four items as the most important purpose. Specially,29.3% of the respondents indicated curing illness for clients, 21.3% preventing illness for client 17.4% decreasing pain, 15.3% surviving. 13) On the Analysis of Important Nursing Care Ranging from 5 point to 25 point, the nurses' qualification are concentrated at the degree of 95.1%. Ranging from 3 point to 25, the priorities of nursing care are concentrated at the degree of 96.4%. Ranging from 4 point to 16, the purpose of nursing care is concentrated at the degree of 84.0%. 14) The Analysis, of General Characteristics and Facts of Nursing Concept. The correlation between the educational high level and nursing care showed significance. (P < 0.0262). The correction between the educational low level and purpose of nursing care showed significance. (P < 0.002) The correlation between nurses' working yeras and the degree of importance for the purpose of nursing care showed significance (P < 0.0155) Specially, the most affirmative answers were showed from two years to four ones. 15) On Nunes' qualification and its Degree of Importance The correlation between nurses' qualification and its degree of importance showed significance. (r = 0.2172, p< 0.001) 0.005) B. General characteristics of the subjects The mean age of the subject was 39 ; with 38.6% with in the age range of 20-29 ; 52.6% were male; 57.9% were Schizophrenia; 35.1% were graduated from high school or high school dropouts; 56.l% were not have any religion; 52.6% were unmarried; 47.4% were first admission; 91.2% were involuntary admission patients. C. Measurement of anxiety variables. 1. Measurement tools of affective anxiety in this study demonstrated high reliability (.854). 2. Measurement tools of somatic anxiety in this study demonstrated high reliability (.920). D. Relationship between the anxiety variables and the general characteristics. 1. Relationship between affective anxiety and general characteristics. 1) The level of female patients were higher than that of the male patient (t = 5.41, p < 0.05). 2) Frequencies of admission were related to affective anxiety, so in the first admission the anxiety level was the highest. (F = 5.50, p < 0.005). 2, Relationship between somatic anxiety and general characteristics. 1) The age range of 30-39 was found to have the highest level of the somatic anxiety. (F = 3.95, p < 0.005). 2) Frequencies of admission were related to the somatic anxiety, so .in first admission the anxiety level was the highest. (F = 9.12, p < 0.005) 0. Analysis of significant anxiety symptoms for nursing intervention. 1. Seven items such as dizziness, mental integration, sweating, restlessness, anxiousness, urinary frequency and insomnia, init. accounted for 96% of the variation within the first 24 hours after admission. 2. Seven items such as fear, paresthesias, restlessness, sweating insomnia, init., tremors and body aches and pains accounted for 84% of the variation on the 10th day after admission.

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