• 한국산업보건학회지
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• 제26권2호
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• pp.198-209
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• 2016

Objectives: This study aimed to provide basic data for the improvement of the guidance services for the management of the workplace environment of the specialized health management institution, by making inquiries on the perception and extent of practice by health managers and workers in the workplace. Methods: Workplaces with officially noted environmental hazards of noise, organic compounds and/or dust-metals were selected in a South Korean metropolitan city in 2015. The workplace health managers(hereinafter referred to as 'manager') and workers at 97 workplace were interviewed. Managers are those who are in charge of health management at the corresponding workplace and the workers were subjected to in-depth interviews by sampling one worker for each of the workplace. Results: The majority of the managers acknowledged the guidance services of the specialized health management institution affirmatively. Regarding the extent of practice in accordance with the guidance on engineering improvement, only 23 managers(37.1%) responded. With respect to education, 40 managers(41.2%) responded that it was implemented along with 35 workers(36.1%) who responded that they received education, showing no significant difference between manager and worker. Regarding the actual wearing of the protective equipment, however, 83 of the manager(85.6%) insisted that workers wore the protective devices while only 44 workers(49.5%) responded that they actually wore the devices, thereby illustrating a significant difference between managers and workers. Conclusions: These results suggest the urgent necessity of improvement in the mechanism of guidance services of the specialized health management institution for the workplace environment management.

• Journal of Trauma and Injury
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• 제35권3호
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• pp.151-158
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• 2022

Purpose: There is a strong correlation between trauma and pain. Pain increases the rate of depression, posttraumatic stress disorder, and even mortality in trauma patients. Methods: This institution-based, provider-blinded and patient-blinded, observational study was conducted among trauma patients treated at Tikur Anbessa Specialized Hospital. Over the course of 3 months, this study included patients who had no prior pain management at other hospitals before presentation, and who presented within 24 hours of the traumatic event. Results: Of the 74 patients evaluated, none of the patients had their pain level scored. The researcher-provided pain scale showed a severe subjective pain score for 79.7% of the patients and a severe functional activity score for 59.5% of the patients. Analgesia was provided at an average of 55.4 minutes after presentation and all patients received either diclofenac or tramadol. Satisfactory pain reduction after analgesia was 28.8% for patients initially complaining of severe pain, 54.6% for moderate pain, and 66.7% for mild pain, with the difference being statistically significant (P<0.05). Forty percent of patients discharged home received no analgesia after the first dose provided upon presentation. Conclusions: Pain scoring was nonexistent during the course of the study. The poor utilization rate of analgesia combination and opioids led to unsatisfactory pain outcomes in patients evaluated and followed for 24 hours after presentation.

• 한국산업보건학회지
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• 제33권2호
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• pp.156-170
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• 2023

Objectives: This study conducted practical training to improve the proper usage of personal protective equipment(PPE), which greatly impacts workplace safety and health management. Personal protective equipment education was conducted through active participation, without theoretical modules, and aimed to identify the effects of repeated practical education and determine ways to increase participant satisfaction. Methods: Study data were analyzed using the IBM SPSS Statistics ver.29 software. First, participants' general characteristics were analyzed with frequency analysis. Second, the normality and equality of variances (Leven's test) were tested for the dependent variables prior to statistical analyses to determine the use of parametric tests. In general, normality is assumed when the sample size is 30 or more per the central limit theorem (Park et al., 2014). As our sample size of health management workers was 43, normality can be assumed. However, to ensure rigor of the study, we examined skewness and kurtosis. The results confirmed that the data were normally distributed. Third, the effects of repeated PPE training were analyzed using paired t-tests. Fourth, differences in satisfaction with PPE training according to the safety and health job position and safety and health certification were analyzed with t-test and Welch's t-test. For parameters that did not meet the assumption of equal variances, the Welch's t-test was performed. Results: Repeated PPE training improved the educational outcomes, and the improvements were significant in the 1st and 2nd respiratory PPE and safety and hygiene PPE training evaluations (p<.001). In terms of safety and health job position, repeated training led to improvements in educational outcomes, with significant improvements observed among supervisors and specialized health management institution workers in the 1st and 2nd training evaluations (p<.005). In terms of safety certification, repeated training led to improvements in educational outcomes, with significant improvements observed among both certified and non-certified individuals (p<.005). Regarding satisfaction with PPE training according to safety and health job positions, specialized health management institution workers showed greater satisfaction than supervisors, with significant differences in the satisfaction for expertise of lecture, work relevance, and lecturer's attitude (p<.001). Regarding satisfaction with PPE training according to safety and health certification, satisfaction was higher among certified individuals, with significant differences in satisfaction for work relevance and lecture attitude (p<.05) Conclusions: PPE education should be recommended to be provided as practical training. Repeated training can enhance educational outcomes for individuals with inadequate knowledge and understanding of PPE prior to education. For individuals with high levels of pre-existing knowledge and understanding of PPE, the results show that various training experiences should be provided to enhance their satisfaction. Therefore, it suggests that the workplace should actively seek educational media and methods to acquire expertise and skills in wearing personal protective equipment and improve the ability to use

• 보건행정학회지
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• 제19권1호
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• pp.49-61
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• 2009

Background: The appropriate management of diabetes mellitus(DM) can help reduce its relapse and economic burden, but the level of management of DM in Korea is reported to be insufficient. This study aims to identify the management level of DM by figuring out the HbA1c examination performance rate of the diabetics and analyzing the variation according to the characteristic of a diabetic. Methods: This study used the Korean National Health Insurance Database which includes E10-14(ICD-10 code) as a primary or secondary disease as of 2006. Study population is 1,892,062 diabetics excluding 393,784 patients with the first attack of DM in 2006, 33,440 diabetics who died in 2006, and 21,299 patients with DM having no record of ambulatory care among the 2,340,585 DM patients in total. Results: The HbA1c examination performance rate of all DM patients in our country is estimated to be 41.5% as of 2006 and shows variation according to the characteristic of individual DM patients. The highest performance odds was shown by the patients who were below 19 of age, insured for health insurance, attended more than 3 ambulatory care providers, made ambulatory care visits more than 10 times annually, attended a specialized general hospital as their main attending medical institution, had a record of hospitalization or had co-morbidity. Conclusion: This study propose that is necessary to make politic preparations for the appropriate management of diabetes at a national level, and particularly, the patients with advanced age, the ones dependent on Medical Aid, and the ones using hospitals or clinics, whose appropriate management seems vulnerable, demand a careful management.

• 보건행정학회지
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• 제20권2호
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• pp.128-143
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• 2010

Objectives : This study aims to estimate the oral antihyperglycemic medications adherence among ambulatory care with adult type 2 diabetes patients and to identify factors affecting the medication adherence in Korea. Methods : This study used the Korean National Health Insurance Database. Study population was 40,082 patients who were 20 years of age or older and first diagnosed with type 2 diabetes (ICD-10: E11) in 2004. The patients were followed up for two years in order to measure adherence with oral antihyperglycemic medications. The level of medication adherence was measured by the medication possession ratio (MPR). Results : The average MPR in the study population was 49.5%. The appropriate adherence rate (MPR$\geq$80%) was 29.4% and showed variation according to the characteristics of individual patients. Multiple logistic regression analysis revealed that the odds of appropriate adherence increased with female (OR:1.21, CI:1.14-1.27), older age, increasing ambulatory care visits, health insurance (OR:1.53, CI:1.33-1.76), decreasing ambulatory care providers, using a specialized general hospital as their main attending medical institution (OR:10.08, CI:8.96-11.33), having co-morbidity, using polytherapy (OR:1.07, CI:1.01-1.13). Conclusions : The medications adherence for patient with type 2 diabetes is low in Korea, and shows variation according to the characteristics of patients. For proper management of diabetes, health care policy is expected to be enacted to improve medications adherence continuously. In particular, more intensive management is needed for patients with low medications adherence. Also, health care policy makers need to develop the program to induce health care utilization by a patient to be more concentrated with the same provider.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제26권2호
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• pp.94-103
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• 2015

Objectives : The purpose of this study was to examine the results of the 2013 students' mental health school-community cooperative model. This study investigated teachers' awareness of change in school environment and analyzed the follow-up conditions of students. Methods : The sample consisted of 55 schools which participated in the 2013 students' mental health school-community cooperative model. Two questionnaires were used : one was composed of items about mental health resources, school policy and practice, school climate and community referral, and the other was on management of follow-up conditions for high risk students. Results : First, teachers' awareness regarding school mental health resources, school policy and practice, school climate, and community referral showed positive change. That is, the 2013 students' mental health school-community cooperative model works for improving teachers' interest, awareness and effort regarding mental health. Second, students, who were found by screening test and observation, were managed continually. Most students received follow-up interventions at school, and half of the students were referred to a specialized institution such as a mental health clinic, Wee center, personal counseling center, community welfare center, and so on. Conclusion : This study was a preliminary research, therefore follow-up studies are required in order to accomplish the 2013 students' mental health school-community cooperative model.

• 디지털융복합연구
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• 제16권12호
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• pp.533-540
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• 2018

이 연구는 건강보험 심사평가원 자료를 이용하여 동일 환자의 동일 질환에 대하여 서로 다른 의료기관이 부여하는 질병 코딩의 불일치성을 분석하여 국가 보건 통계 질 향상을 위한 기초 자료로 활용하고자 시행하였다. 건강보험심사평가원 2014년 전체 환자 데이터셋(HIRA-NPS)에서 9,976,826건의 진료비 명세서를 연구 대상으로 하였다. 연구결과 의료기관의 이동 경로에 따라서 질병 코딩 불일치의 차이가 존재 하였고 불일치율은 보건기관 이외의 타 의료기관에서 보건기관으로 이동하였을 때 높아지는 경향이 발견되었고, 상급종합병원 간 이동하였을 때는 불일치율이 현저하게 낮았다. 본 연구의 의료기관 간 질병 코딩 불일치 현황 분석은 국내 의료기관에서 일관성 있는 질병 코딩이 이루어지기 위한 제도적 보완의 필요성을 시사하고 있다.

• 한국치위생학회지
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• 제16권4호
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• pp.499-506
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• 2016

Objectives: The purpose of the study is to investigate the participation motivation and satisfaction of continuing education in the dental hygienists. Methods: A self-reported questionnaire was completed by 900 dental hygienists in Seoul and Gyeonggido in continuing education 2015. The questionnaire consisted of general characteristics of the subjects (7 items), continuing education requirements (6 items), and continuing education evaluation (9 items). Cronbach's alpha was 0.859 in participation motivation and 0.901 in satisfaction. Likert five point scale was used. Data were analyzed by SPSS 22.0 program. Results: The priorities of the contents were as follows; patient care and counseling(49.0%), the latest information and technology(43.9%), middle management roles(23.3%), health care management(17.6%), and lecture studies(4.4%) in order by multiple responses survey. The favorite instructors were specialized dental hygienist(52.3%). The ideal pay for education fee was 50 percent supported by the institution. The best official announcement of education was e-mail. The participation motivation of education was 4.45 points and was focused on the education completion issue. The lowest score was 2.77 of development of human relationships between participants. The choice for instructor was 3.43 and the lowest score was 2.49 of education fee. Overall satisfaction score was 3.04. Conclusions: Diversification of the continuing education is very important. It is necessary to develop and implement the education methods and to train the dental hygiene specialists for the education.

• 디지털융복합연구
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• 제14권12호
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• pp.65-72
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• 2016

개인건강기록(PHR) 서비스는 기본적인 병원 진료 환경 외에 특수한 통원 치료 관리가 필요한 당뇨나 암환자 관리에 적절한 시스템이다. 본 논문에서는 항암화학요법 진행 중인 암 환자의 치료 과정에 맞춘 PHR 수집 및 분석 시스템을 개발하여 항암 치료 과정의 효율성을 효과적으로 향상할 수 있는 방법을 제안한다. 제안하는 암 PHR 서비스 플랫폼은 스마트 디바이스의 애플리케이션을 활용하여 항암화학요법 진행 중인 환자로부터 치료와 관련성이 가장 높은 통증 및 부작용 데이터를 입력 받고, 실제 병원에서 사용하는 의무 기록 형태로 정리한 통계 자료로 요약하여 의료진에게 제공한다. 의료 차트와의 연계에 적합한 형태로 제공되는 최종 분석 자료로 환자는 빠른 시간 내에 가장 적절한 처방을 받을 수 있다. 또한 통증 및 부작용 상태에 대한 정보를 의사에게 전할 수 있다. 의료진은 약물처방과 요양급여 등에 필요한 주요 객관적 자료들을 확보함으로 환자 진료의 질을 개선하는 효과가 있다.

• 대한영양사협회학술지
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• 제20권4호
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• pp.235-246
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• 2014

The purpose of this study was to evaluate nurses' perception of clinical nutrition services. A cross-sectional survey design was performed. The research was accomplished by using questionnaires developed for this study and administered from September 12 to December 31, 2013 to 343 nurses at 43 tertiary hospitals and 20 general hospitals. The percentage of nurses who recognized clinical nutrition certificate as issued from nation was 27.8%. The mean scores of perceived usefulness on clinical nutrition services was 4.23/5.00, whereas that of perceived implementation was 3.76/5.00. The mean scores of necessity of disease-specialized clinical dietitian at capital hospitals were significantly higher for obesity (P<0.01), cancer (P<0.05), and infant & childhood disease (P<0.01) than at local hospitals. The rates of nurses' experience in group education on cancer at capital hospitals (21.7%) was significantly higher than that at local hospitals (10.3%) (P<0.05). The mean scores of perceived importance of clinical nutrition services were 4.46/5.00 for 'group nutrition education', 4.46/5.00 for 'individual consultation', and 4.40/5.00 for 'nutrition management for enteral nutrition (EN) patients'. The most common reason why clinical nutrition services are important was 'improving malnutritional status'. To activate clinical nutrition services especially at local hospitals, clinical dietitians should give systematic assistance to patients and also institutional supports are needed.