• Title/Summary/Keyword: 시경학(詩經學)

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Activities to Reduce the number of No-Show Patients with Colonoscopy appointments (대장내시경 검사 부도관리를 위한 개선활동)

  • Kwon, Oh-Ryoun;Lee, Jung-Sun;Na, Eun-Shim;Kim, Hoon
    • Quality Improvement in Health Care
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    • v.15 no.1
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    • pp.89-100
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    • 2009
  • 문제: 소화기병검사실에서 대장내시경 검사의 부도건수가 최근 월 200명 정도로 예약인원의 16%에 달한다. 이는 본원 외래진료 부도율이 평균 10%인 것과 비교할 때 상당히 높은 결과이므로 대장내시경 예약환자를 대상으로 부도율 관리를 위한 활동이 필요하였다. 목적: 외래 및 입원환자의 부도건수 및 부도환자의 특성을 분석하고, 개선활동을 통하여 대장내시경 검사의 부도율을 줄인다. 의료기관: 서울 아산병원. 질 향상 활동: 부도관리를 위한 개선활동으로 SMS 횟수를 2주전, 4일전, 1일전 3회로 변경하고, 내용도 각 시기마다 차별화하였다. 대장내시경 검사 예약을 하고 기다리는 환자를 대상으로 처방일 순, 예약 날짜순서 등 필요한 항목 순으로 볼 수 있는 리스트가 필요하여 예약대기 프로그램을 개발하였고, 처방일로부터 2주 이내 자동예약을 금지하였다.(7월 10일부터 시작) 예약대기명단에 있는 환자를 대상으로 전화로 예약 변경을 하여 2주 이내에는 예약의 빈자리가 없도록 하였다. 미리 부도를 예측하여 추가로 예약하던 방법에서 정원조정을 하여 정원 외 추가 예약을 하지 않았다. 입원환자 일정관리를 위하여 일정관리 프로그램을 개발하여 타과의뢰 회신을 하는 전임의가 직접 날짜를 전산에 입력하여 회신과 동시에 검사실, 담당주치의, 담당 간호사가 모두 일정을 확인할 수 있도록 하였으나 프로그램이 늦어져 9월 12일부터 시행하였다. 개선효과: 부도건수가 개선 전 8주 동안 385건(예약인원 대비 16%) 에서 개선 후 6주의 평가기간 동안 256건(예약인원대비 14.1%)으로 129건이 감소하였으며, 검사 1-2일전 일정 변경 연락 환자 감소 및 검사 비용 수납 환자의 부도건수가 감소하였다. 대장내시경 검사 예약대기 프로그램 운영 및 예약 변경 전화 활동으로 2달씩 기다리던 환자의 예약일을 약 한 달 정도 단축하여 줄 수 있었다. 검사 정원 관리의 결과로 검사 예약 시 예약기준이 명확해지고, 부적절한 예약으로 인한 검사지연 등이 확실히 줄었다. 또한 입원환자 일정관리 프로그램 적용으로 입원환자의 검사일정과 관련된 전화업무는 확실히 줄어들 것으로 예상된다.

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A Study on Cultural Interpretation of the Plants in "The Book of Songs" - Based on Symbolic Elements and Landscape Elements - (시경(詩經)에 나타난 식물 소재의 문화적 해석 - 상징요소와 경관조성요소의 관점에서 -)

  • Yun, Jia-Yan;Son, Yong-Hoon
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.32 no.3
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    • pp.96-109
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    • 2014
  • The purpose of this study is to sort out the plants in "The Book of Songs", and to analyze the cultural significance of plants from the viewpoint of the symbolic elements and the landscape elements in the 3~11 century BC. The conclusions are as follows. First, there were 147 plant names and 136 plant species in "The Book of Songs", and these results can confirm that the plants were existed in the 3~11 century BC. Second, through analyzing the cultural significance of the plants, cattail, lotus, etc. are the symbol of lovers; peony and willow are the symbol of farewell; bamboo is the symbol of gentleman; and Japanese pepper is the symbol of fecundity. Third, at the viewpoint of the landscape elements, the poplar, dwarf elm, etc. can be used as a place of affection; reed and nepenthe can make a place of melancholy, hazel and chestnut tree, etc. can make a place of power and position, celery and water shield etc. can be used as a place of knowledge. Based on the research of "The Book of Songs", it can help to understand the plants culture in 3~11 century BC, and it will be a useful information for the plant design.

A Case of Endobronchial Hamartoma Treated with Rigid Bronchoscopy (경성 기관지내시경을 이용한 기관지내 과오종 치험 1예)

  • Kim, Ki-Hyun;Hong, Hyun-Suk;Koh, Eun-Suk;Koh, Yoon-Woo
    • Korean Journal of Head & Neck Oncology
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    • v.24 no.1
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    • pp.83-87
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    • 2008
  • Hamartoma is one of the most common benign lung tumors. Most of them are located in the lung parenchyme, but very rarely it can originate endobronchially. Endobronchial hamartoma may cause irreversible lung damage due to the bronchial obstruction if it is not diagnosed and treated properly. The most frequent clinical features are hemoptysis and obstructive pneumonia. Transbronchial endoscopic surgery is a good therapeutic choice and is recommended first for patients who have resectable small endobronchial hamartoma. Here, we report a case of endobronchial hamartoma treated with rigid bronchoscopy and various microforceps with a review of the literature.

A Case of Huge Vocal Polyp in a Patient With Difficult Laryngeal Exposure Treated by Fiberoptic Laryngeal Laser Surgery Under Local Anesthesia (전신마취 하 후두미세수술이 불가능한 경추 손상 환자에게서 국소마취 하 굴곡내시경 후두 레이저 수술로 치료한 거대한 성대 폴립 1예)

  • An, You Young;Lee, Jeong Hyun;Park, Ki Nam;Lee, Seung Won
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.32 no.3
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    • pp.153-156
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    • 2021
  • Indications of fiberoptic laryngeal laser surgery (FLS) procedure have broadened by the development of flexible fiberoptic endoscopes and flexible laser systems. FLS procedure performed under local anesthesia and it is the unique value of FLS. The surgery can be performed on patients who are impossible to undergo general anesthesia and difficult to be exposed by laryngeal microsurgery. Main indication of FLS procedure was small to moderate sized hemorrhagic vocal polyp, but we experienced a case of huge vocal polyp with difficult laryngeal exposure treated by FLS procedure under local anesthesia. The vocal polyp was removed successfully without vocal fold scar through fiberoptic laryngeal laser surgery under local anesthesia.

Effects of a Simulation-based Educational Program for Gastroendoscopic Surgery Patients (위내시경 수술을 받는 조기 위암 대상자를 위한 동영상 시뮬레이션 교육 프로그램의 효과)

  • Kwon, Su Young;Lee, Jia
    • Korean Journal of Adult Nursing
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    • v.25 no.5
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    • pp.494-503
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    • 2013
  • Purpose: The purpose of this study was to examine the effects of a simulation-based educational program on anxiety and discomfort in patients with early stage of stomach cancer or stomach adenoma undergoing gastroendoscopic surgery. Methods: The study employed a non-equivalence control group and non-synchronized design to prevent diffusion of treatment. Data were collected from 110 patients (experimental group=55, control group=55) admitted to a department of gastroenterology to undergo gastroendoscopic surgery for early stage of stomach cancer or stomach adenoma. The program was conducted as a 30-minute simulation-based education including 12 processes which patients would experience. Outcome variables were state anxiety, objective discomfort, and subjective discomfort. Results: The scores of state anxiety in the experimental group significantly decreased over time compared to those in the control group. The scores of objective and subjective discomfort after surgery in the experimental group were significantly lower than those in the control group. Conclusion: The study findings suggested that the simulation-based educational program making a person feel sense of real experiences could reduce anxiety and discomfort in gastroendoscopic surgery patients.

The Effect of Music Therapy on Reduction of Anxiety before Gastroscopy (음악요법이 위내시경 대상자의 검사전 불안에 미치는 효과)

  • Park, Kyung-Sook;Na, Muyng-Joo
    • Korean Journal of Adult Nursing
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    • v.15 no.2
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    • pp.247-255
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    • 2003
  • Purpose: This study examined the effect of music therapy on the pre-exam anxiety of gastroscopy clients. Method: The research period is from June 17 2002 to August 30 2002, and the subjects were 60 individuals, 30 for the experimental and 30 for the control group among adult clients. The data were analyzed by using the SPSS program. Result: The results of this study were as follows: The score of the experimental group was lower than the score of the control group for the situational anxiety (t=-12.56, p=0.000) and systolic blood pressure (t=-3.97, p=0.000) before the examination was supported. The vital sign was partially supported. There was no significant difference(t=-1.05, p=0.297) in the diastolic blood pressure (t=-1.05, p=0.297) and pulse rate(t=-1.30, p=0.199) before the examination of the experimental group and lower than the score of the control group. Conclusion: Music therapy could be useful in the nursing practice, and be utilized as a way of nursing intervention to reduce anxiety of the patients in specific clinical situations. Finally, it is recommended that further studies be conducted on this therapy by utilizing different musical selections.

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Effects of a Colonoscopy based Simulation Education Program on Knowledge and Clinical Performance in Nursing Students (대장내시경 사례 기반 시뮬레이션 교육 프로그램이 간호학생의 지식과 임상수행능력에 미치는 효과)

  • Kim, Hyo-Youn;Kim, Hae-Ran
    • Korean Journal of Adult Nursing
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    • v.27 no.2
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    • pp.135-145
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    • 2015
  • Purpose: The purpose of this study was to evaluate the effects of a colonoscopy simulation program on knowledge and clinical performance among nursing students. Methods: The program consisted of a scenario with three objectives: health assessment, nursing before/after colonoscopy and emergency care for bleeding following the colonoscopy. A nonequivalent control group pretest-posttest design was used. The sample was 149 nursing students recruited from H University in G city from August, 2013 to December, 2014. The treatment group (n=71) received the simulation and the comparison group (n=78) received the usual lecture program. Data were analyzed using descriptive statistics, ${\chi}^2$ test, t-test and repeated measure ANOVA using the SPSS/WIN 20.0 program. Result: Participants in the treatment group had significantly increased reported scores on both knowledge and clinical performance. Conclusion: Results indicate that the simulated program is a useful strategy for improving knowledge and clinical performance among nursing students. The development of simulation practice programs in a variety of fields are needed in order to promote the practical competence of nursing students.