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일개 지역 보건진료원들이 지각하는 간호연구 활용의 장애요인 (Community Health Practitioners' Perception of Barriers to Research Utilization)

  • 강희경;이은경;전경자;정선옥;김은숙;이수진;변혜민;박지연
    • 한국농촌간호학회지
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    • 제4권2호
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    • pp.110-119
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    • 2009
  • Purpose: This study was done to identify Community Health Practitioner's (CHP's) perception of barriers to research utilization Method: Participants were 153 CHPs working in Chungbuk Province. Modified Barriers Scale was utilized in the research, and 4 sub-scales were nurse factor, organization factor, research factor and communication factor. Data was analyzed by using SPSS/WIN12.0. Results: Research factor showed the highest barrier score among four sub-scales, and nurse factor was the lowest. CHPs with membership in any nursing academic society showed lower scores on the four sub-scales. Those who had taken a course related to research were less likely to see the research factor or communication as barriers. Barriers to research utilization were not associated with work experience years or to demographics. Conclusion: It is highly recommended that CHPs be trained in research methods and evidence-based practice and that research articles be written more clearly.

자활사업 실무자들이 경험한 자활사업의 맥락과 패턴: 지역자활센터 실무자들과 관련 공무원들을 중심으로 (Context and Pattern of Self-Sufficiency Program Based on the Experiences of Self-Sufficiency Program Practitioners: focusing on local self-sufficiency center workers and related public officers)

  • 권지성;조준용;정선욱;장연진
    • 한국콘텐츠학회논문지
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    • 제20권8호
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    • pp.232-250
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    • 2020
  • 이 연구의 목적은 자활사업 실무자들의 관점에서 자활사업을 이해하고자 하는 것이었다. 이를 위해 이 연구에서는 질적 연구접근 중 하나인 맥락-패턴 분석방법을 적용하여 연구진이 수집한 면접 자료를 분석하였다. 분석 결과, 자활사업의 맥락은 '시장경제', '사회서비스 체계', '자활제도', '자활사업', '자활 대상자들', '자활사업 과정경험' '자활사업의 성과', '자활의 의미' 라는 하위맥락 요소들로 구성되어 있었다. 자활사업의 패턴의 경우 '자활제도의 활력 저하', '서비스 흐름', '자활로 가는 여정', '작은 성공들로 이어지는 시퀀스' 등 자활사업에서 형성되는 다양한 수준에서의 패턴들이 발견되었다. 이러한 연구결과에 근거하여, 자활제도와 자활사업, 자활실무를 발전시키기 위해 고려해야 할 정책적, 실천적 함의, 그리고 후속연구에 대해 제언하였다.

일개(K) 병원의 누락 조직검사결과지에 관한 조사연구 (A Study on Loose Laboratory Reports in A Hospital)

  • 유연순;하은희
    • 한국의료질향상학회지
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    • 제2권2호
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    • pp.46-54
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    • 1996
  • Background : The medical record is a compilation of pertinent facts of a patient's life and health history, including past and present illness and treatment. It is written by the health professionals contributing to that patient's care. And the medical record is the permanent, legal document which must contain sufficient information to identify the patient, justify the diagnosis and treatment, and record the results. As such, it must be accurate and complete. So we try to analyze the medical record especially a kind of incomplete record, loose laboratory reports. Methods: During the one-year period(from January to December 1988), a medical record practitioner examine and analyze the record of laboratory reports at K Hospital in Seoul. A total of 320 loose laboratory reports for 3,818 admitted laboratory reports. And a medical record practitioner and a physician review and analyze the influencing factors for the various reasons of clinical and laboratory aspects. Result: The loose percentage by department is the highest in obstetrics(40.4%) but the highest loose rate is in pediatrics(25.0%). The most of omission is occurred in operation room(80.3%) than OPD(19.7%). The change of diagnosis is according to duration of laboratory and more changable in cancer patient. Conclusion : Regular analysis of the documentation in the medical record so it fulfills its purposes of communicating patient care information. So it serves as evidence of the patient's course of illness and treatment for various legal, reimbursement, and peer evaluation review. And it is very important aspect of quality assurance in medical activities.

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STRICTA 권장안에 기초한 침 연구방법론의 적절성 평가;새로운 평가지수를 이용한 5편 Systematic Review와 그 대상인 58편 무작위대조시험의 고찰 (The Assessment of Appropriateness of Acupuncture Methodology Based on STRICTA Recommendations;The Discussion of 5 Systematic Reviews and Their Objects 58 Randomized Controlled Trials Using the New Tool)

  • 김우영;이승덕;임병묵;김갑성
    • Journal of Acupuncture Research
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    • 제24권5호
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    • pp.151-170
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    • 2007
  • Backgraounds : Recent studies provide the evidences that the efficacy of acupuncture may be no better than placebo or inconclusive. These results are very different from those of the actual clinical situations in many acupuncture medical institutions. Objectives : The present study was designed to evaluate the influencing factors which affect the efficacy of acupuncture scale(FEAS) as the methodological assessment tool of acupuncture for examining acupuncture interventions and to demonstrate the importance of it in randomized controlled trials of acupuncture. Data sources : Electronic data were retrieved from NDSL, Pubmed, sciencedirect, LWW, OVID, Black-Well Synergy, Wiley Interscience, EBSCO HOST, springer, PML, and Kluwer. No electronic data were collected from MEDLIS and MEDLAS. Study selection : The inclusion criteria were five systematic reviews included in Alberta study and all randomized controlled trials obtained from their references. Study analysis : The acupuncture rationale, methods of stimulation, treatment regimen, and the practitioner's background were rated by FEAS, and the scores were compared with those by other methodological assessment tools. Results : The number of positive conclusions of high-rank RCTs by FEAS was the same as or higher than that of high-rank RCTs by other methodological assessment tools. Conclusions : We have analysed 5 systematic reviews and their objectives 58 RCTs using FEAS. Practitioner's background has been described slightly in some reviews and studies. It may directly influence the effectiveness of acupuncture negatively in the systematic reviews.

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Prognostic Value of Peritoneal Washing Cytology in Gynecologic Malignancies: a Controversial Issue

  • Binesh, Fariba;Akhavan, Ali;Behniafard, Nasim;Zabihi, Somayeh;Hosseinizadeh, Elhamsadat
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권21호
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    • pp.9405-9410
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    • 2014
  • Purpose: To evaluate the prognostic impact of peritoneal washing cytology in patients with endometrial and ovarian cancers. Materials and Methods: We retrospectively identified 86 individuals with ovarian carcinomas, ovarian borderline tumors and endometrial adenocarcinomas. The patients had been treated at Shahid Sadoughi Hospital and Ramazanzadeh Radiotherapy Center, Yazd, Iran between 2004 and 2012. Survival differences were determined by Kaplan-Meier analysis. Multivariate analysis was performed using the Cox regression method. A p<0.05 value was considered statistically significant. Results: There were 36 patients with ovarian carcinomas, 4 with borderline ovarian tumors and 46 with endometrial carcinomas. The mean age of the patients was $53.8{\pm}15.2years$. In patients with ovarian carcinoma the overall survival in the negative cytology group was better than the patients with positive cytology although this difference failed to reach statistical significance (p=0.30). At 0 to 50 months the overall survival was better in patients with endometrial adenocarcinoma and negative cytology than the patients with positive cytology but then it decreased (p=0.85). At 15 to 60 months patients with FIGO 2009 stage IA-II endometrial andocarcinoma and negative peritoneal cytology had a superior survival rate compared to 1988 IIIA and positive cytology only, although this difference failed to reach statistical significance(p=0.94). Multivariate analysis using Cox proportional hazards model showed that stage and peritoneal cytology were predictors of death. Conclusions: Our results show good correlation of peritoneal cytology with prognosis in patients with ovarian carcinoma. In endometrial carcinoma it had prognostic importance. Additional research is warranted.

임상가를 위한 특집 4 - CBCT 검사법의 정도관리 및 선량 (Radiation Doses and Quality Assurance in Cone Beam CT(CBCT))

  • 최용석;김규태;황의환
    • 대한치과의사협회지
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    • 제52권3호
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    • pp.153-163
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    • 2014
  • 3-dimensional information for anatomic stucture plays a role as integral part in clinical aspect of dental practice. CBCT(cone beam computed tomography) has been accepted as useful diagnostic tool offering Volume data and images for evaluating teeth and jaws in lower radiation dose than conventional CT. CBCT equipment is essential for the quality assurance of it to ensure continued satisfactory performance and result of adequate images. Dental practitioner and oral and maxillofacial radiologist should have a responsibility and critical thinking to deliver this technology to patients in a responsible way, so that diaganostic value is maximised and radiation doses kept as low as resonably achievable. CBCT imaging modality should be used only after a review of the patient's health and imaging history and the completion of a thorough clinical examination. Clinical guidelines are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances Dental practitioners should prescribe CBCT imaging only when they expect that the diagnostic yield will benefit patient care, enhance patient safety or improve clinical outcomes significantly. Knowledge of patient dose is essential for clinicians who are making the decision regarding the justification of the exposure. There are some limitation in the measurement of patient dose in CBCT for the approval and adaptation of conventinal methodolgy in CT. It is also important to ensure that doses are optimised and in line with any national and international guidelines. The higher radiation doses of CBCT compared with conventional radiography, mean that high standards must be maintained. The Quality Assurance(QA) programme should entail surveys and checks that are performed according to a regular timetable. QA programme should be maintained by staff to ensure adherence to the programme and to raise its importance among staff.

침구 치료 이상반응 설문지 개발과 타당도 평가 (Development and Validation of a Survey Form for Adverse Events Associated with Acupuncture and Moxibustion)

  • 김서연;이준환;육태한;박지민;임정태;이향숙
    • Korean Journal of Acupuncture
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    • 제32권4호
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    • pp.177-189
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    • 2015
  • Objectives : To develop and validate a survey form for adverse events(AEs) associated with acupuncture and moxibustion treatment. Methods : The 1st version of a survey form consisting of 9 categories was developed and modified based on the analysis of questionnaires from previous studies on AEs. To evaluate content validity of the 1st version, a Delphi survey where experts in acupuncture and moxibustion, and research methodology were invited, was conducted alongside a separate content validity questionnaire. The content validity indices for each item and total scale were calculated as the proportion of the number of experts judging each item or scale valid to the number of total experts. Results : After the Delphi round 1, the content validity of 2 items and total scale was rated as inadequate. The 1st version was modified accordingly, and the 2nd version of the survey form was developed. The content validity of the 2nd version was assessed in the Delphi round 2 and the final version was completed after incorporating the expert comments. The final version consists of 13 questions regarding practitioner/patient information, condition/disease, intervention, treated body parts, safety issue and AE occurrence related with practitioner's behavior or instruments, AEs associated with treatment and emergency actions taken if necessary, time to AE occurrence, outcomes, serious AEs or death, and time to AE disappearance. Conclusions : This newly developed and validated survey form will serve to collect AEs associated with acupuncture and moxibustion treatments in Korea and contribute to establishing the evidence on safety of Korean acupuncture treatment.

새천년의 여성건강을 위한 조산사의 역할 확대 방향 (A Direction for Nurse-Midwife's Expanded Roles for Women's Health in the New Millenium)

  • 유은광;김영희;이창은;김용분;이미영
    • 여성건강간호학회지
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    • 제5권1호
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    • pp.65-79
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    • 1999
  • The purpose of this study was to figure out a direction for midwifes' expanded roles for integrative woman's health care focused on health promotion & maintenance and primary prevention of women's health disorders including family health in the new millenium as a primary women's health practitioner. Data sources used for analysis were the book published from International Confederation of Midwives including role, code, situation and others from the international aspects : the empirical data from direct contact by participation in the ICM held in Manila, Philipine, May 22-26, 1999 : and documentation of Korean Midwives Association. Historical and current changing perspectives toward woman's health & nurse-midwifery and the reality women's health & nurse-midwifery and the reality of expand role that should be acquired toward the new millenium are discussed. In conclusion, Nurse-midwives are the very primary women's health care providers who can provide not only the exact needs of women who have health related problems, which are developed in the unique socio-cultural context women are belonged to, but also reproductive affairs including labor and delivery as it was midwive's traditional role, not just as practitioner, educator, counselor but conscious raiser for women's right. Futhermore, for this, thorough preparation through various kind of active and contemplated approach such as remodeling roles and education and continuing education system, training for high skilled & technical action, making laws and policy, and others is absolutely required.

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설명간호사의 현황과 법적 지위에 관한 고찰 (A Study on the Nurse in Charge of Education'S Current Status and Legal Status)

  • 백경희;안영미;김남희;김미란
    • 의료법학
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    • 제14권2호
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    • pp.261-280
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    • 2013
  • Recently several hospitals have established a new nursing position so called, 'the nurse in charge of education (NCE).' The job description of NCE is to give a detail explanation on examination or test introduced to patients or a guide for those who are not familiar to hospital facilities at the out-patients level. The motivation of NCE position is the quality improvement in patient education on the sophisticated procedures or the follow up care for medical purposes to improve their compliances, as well in delivering services for outpatients or visitors in more informative and efficient way. The application of NCEA has been turned out positive and effective in patient satisfaction and unit management. However, special attention is brought to the scope and depth of the contents of education delivered by NCE which might overlap with the duty of physicians by the Medical Act. It is needed to clarify the role and job description of NCE in the context of Medical Act. The engagement of NCE to the Advanced Nursing Practitioner (ANP) is one of the possible solutions for a duty charge on patient education since ANP is a legislatively official position with higher license of RN at master level. Further discussion is needed to elaborate and arrange the details on the scope and content of patent education among health science professionals including RN, ANP and physicians.

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재난 및 안전관리기본법 개정에 따른 재난안전분야 종사자 교육훈련 설계 및 운영 발전 방안 연구 (A Study on Development Plan of Design and Operation for Education Training of Disaster & Safety Field Workers with the Amendment of Framework Act on the Management of Disasters and Safety)

  • Nam, Sangwhun;Park, HaeJung
    • 한국재난정보학회 논문집
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    • 제9권4호
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    • pp.484-492
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    • 2013
  • 연구는 재난 및 안전관리기본법 개정에 따른 재난안전 분야 종사자의 재난안전 교육훈련을 위해 체계적인 교육과정의 설계 및 운영에 대한 발전 방안 제시를 목적으로 한다. 재난 및 안전관리기본법 개정으로 재난안전분야 종사자의 재난교육 의무화가 요구되고 있으며, 기존의 교육과정 설계 및 운영의 발전 방안이 필요하다. 이를 위해 재난안전의 24개 기능과 재난 관리의 13개 역량 항목을 기초로 재난안전 분야 종사자를 재난관리자, 재난실무자, 재난지휘자로 구분하여 역량의 우선순위를 도출하고 교육수요를 파악한 후, 선진재난관리 요소와 과정의 브랜드화를 고려하여 재난안전분야의 교육훈련 과정 설계 안을 도출 하였다. 기본법 개정에 따라 교육기관의 교육과정의 전문화와 함께 교육 효과와 교육 수요자의 요구 사항을 고려, 참여형 교육훈련 기법을 반영한 교육 운영 형태를 포함한 발전 방안을 제시한다.