• Title/Summary/Keyword: 의료의 질 관리

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Research on the Interior Environment Planning of a Postpartum Care Center. (산후 조리원 실내 환경 계획에 관한 연구)

  • Lee, Jong-Hee
    • Archives of design research
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    • v.20 no.1 s.69
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    • pp.253-262
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    • 2007
  • The postpartum care center is a facility which made its debut only about 10 years ago but has now changed the nation's postpartum care culture. Women delivered of a child use the postpartum care center at this time since the low rate of childbirth has become a social phenomenon. However, while the postpartum care center is not supported legally and systematically, anybody can run it after they only file a report on businessman status with the tax office. So there are disordered wave of postpartum care startups which do not have basic facilities. Thus, this study is intended to suggest an interior environment plan considering an efficient space and users' benefits of a postpartum care center which has a characteristic difference from that of ordinary facilities in terms of targeted persons or operations but for which standards are not clear in terms of the Health and Welfare Law and the Medical Service Law. This study was conducted by investigating the actual condition of the entrance space, living space, common-use space, nursing space, administration and attached space in the six postpartum care centers selected from Seoul and Kyeonggi-do region and suggesting the direction of improvements, thus establishing the direction of interior designs and an interior environment plan. Hopefully, this study would be used as basic data on interior building plans, thus being helpful in enhancing the satisfaction of the postpartum care center user and operating the facility.

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Evaluation of Image Quality and dose with the Change of kVp and BMI in the Liver CT (CT 검사 시 관전압과 BMI 변화에 따른 화질 및 피폭평가)

  • Kim, Dong-Hyun;Ko, Sung-Jin;Kang, Se-Sik;Kim, Jung-Hoon;Choi, Seok-Yoon;Kim, Changsoo
    • The Journal of the Korea Contents Association
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    • v.13 no.6
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    • pp.331-338
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    • 2013
  • CT for follow-up visits because of liver disease, body mass index (BMI) and kVp according to the change of the image quality and radiation dose to evaluate for changes. March 2010 to June 2011 at Pusan P University Hospital, abdominal CT scans a patient BMI (Body Mass Index. Less BMI) index was less than 25 in the treatment of subjects had a 48-person Noise and SNR at 100kVp abdominal image is lager than the 120kVp image. CTDI volume value at by the analysis of the radiation dose is 4.47mGy(100kVp) and 9.01mGy(120kVp). So CTDIvol in 100kVp is smaller than CTDIvol in 120kVp(decrease by 44.1%). And, effective dose is 7.1mSv(100kVp) and 12.51mSv(120kVp). So effective dose in 100kVp is smaller than effective dose in 120kVp(decrease by 43%). Evaluation of image quality is that Unacceptable 0 person, Suboptimal 0 person, Adequate 0 person, Good 1 person, Excellent 47 person. In case of repeatly patient, we examinate abdomianl CT scan by using low kVp and body mass index less than 25. We can has good quality image and benefit of low radiation dose.

Institutionalization of a Patient-Sitter Program in Acute Care Hospitals (보호자 없는 병원 제도화 방안)

  • You, Sun-Ju;Choi, Yun-Kyoung
    • The Journal of the Korea Contents Association
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    • v.13 no.6
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    • pp.370-379
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    • 2013
  • In an effort to resolve the burden of patients hiring patient sitters, this study sought to review the Ministry-of-Health-and-Welfare-initiated pilot program of running hospitals without patient-sitter to identify its background, operation method, performance results, and limitations. Based on the review, the study derived the necessity of introducing a hospital system without patient-sitter as well as its operation and systemization methods. The ministry-initiated pilot programs were conducted twice: in 2007, and in 2010. A review of the 2007 pilot program revealed that the patients and families' satisfaction score with nursing services was 9.1 points (on a 10-point scale), their intention to reuse the service was 97.8%, and their intention to recommend the service was 98.0%, all high scores. Appropriate nursing manpower, derived from the 2007 pilot project, indicated 2.3 patients per nurse and 4.0 patients per nurse aid. The 2010 pilot project results indicated that the patients and families' satisfaction was high at 8.0-9.1 points (on a 10-point scale), and that the intention to reuse and recommend the service was also high. Compared with the 2007 pilot project, however, the types of medical institutions and the nurse to patient ratios were diverse, offering limitations. In conclusion, to systemize hospitals without patient-sitter, it is necessary to develop policies designed to establish criteria for the appropriate nurse to patient ratio and skill-mix, to standardize the work, to prepare finances for securing nursing staff, to evaluate the nursing demands, and to monitor the quality management.

Kinematic Analysis of a Mastication Model Employing the 6-DOF Parallel Mechanism (6자유도의 병렬기구를 사용한 저작 모델의 기구학적 분석)

  • Khang, G.;Tsutsumi, Sadami
    • Journal of Biomedical Engineering Research
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    • v.20 no.4
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    • pp.479-484
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    • 1999
  • 본 연구에서는 사람의 턱 운동과 턱 사이에 작용하는 힘(혹은 압력)을 그대로 나타낼 수 있는 저작로봇을 개발하는 것을 궁극적인 목표로 한다. 이러한 저작로봇이 개발되면, 치과의사가 환자의 턱운동에 나타나는 병변을 진단하고 치료하는데 큰 도움이 될 것으로 사료된다. 또한 , 본 연구에 채택한 병렬기구(parallel mechanism)에대한 순기구학적( forward kinematics)분석은 일반적인 병렬기구의 실계에도 응용될 것으로 기대된다. 본 연구진이 1차적으로 설계한 모델은 베이스와 플랫폼(platform), 그리고 이 둘을 연결하는 3개의 다리로 구성되어 있다. 다리와 플랫폼은 3자유도의 관절로 다리와 베이스는 1자유도의 경첩 관절로 연결되어 있으며, 이 3개의 경첩 관절은 베이스 위의 수평면에서 직선을 따라 움직인다. 경첩 관절의 수평 변위와 세 다리의 길이가 주어졌을 때 플랫폼의 위치와 오리엔테이션을 구하는 순기구학의 해( 解)를 계산해내는 알고리즘을 개발하였다. 이 알고리즘의 특징은 매 순간 오차를 계산하여 이 오차가 줄어드는 방향으로 나아가도록 시간간격(time step)을 조절하는 것이다. 본 알고리즘은 현재 가장 보편적으로 사용되고 있는 뉴튼-렙슨 방법에 비하여 3가지 장점을 나타내고 있다. 우선 , 초기치(initial guess)에 관계없이 수렴한다는 것이다. 또한, 본 알고리즘은 뉴튼-렙슨 방법에 비하여 수렴속도가 훨씬 빠르며, 연산 시간이 매우 짧아져 실제적인 실시간 적용에 적합하다. 마지막으로, 뉴튼-렙슨 방법에서는 여러 개의 해 가운데 어느 곳으로 수렴할 지 예측 할수 없으나 본 알고리즘에서는 초기치에 가장 가까운 해로 수렴한다. 이러한 순기구학의 다중성(multiplicity)문제를 해결하기 위하여 두 개의 조건을 제시하였으며, 이를 적용한 시뮬레이션 결과에 의하면 항상 원하는 해(true solution)에 수렴할 수 있었다.발생량의 감소를 기대 할 수 있는 친환경기술로 유지관리비를 최소화할 수 있는 장점이 있었다. 않은 사람들 중 미래의 검진실행의지에 건강소식지가 영향을 미친 경우는 48.7%였다. 보건교육을 받은 후 유방암 자가검진 실천율은 사업군에서 53.9%로 받기 전의 27.3%보다 증가하였으나 대조군의 경우는 별 차이가 없었다. 연령별로는 60대가 가장 높았고 사업군에서 검진율의 증가분은 30대가 가장 컸다. 교육수준별로는 사업군은 고졸이, 대조군은 전문대졸이 가장 높았고 사업군에서 검진율의 증가분은 고졸에서 가장 컸다. 보건교육 후 유방암과 관련된 건강지식의 정도는 사업군이 3.7점으로 대조군보다 유의하게 높았으며, 유방암 자가검진법을 실천하는 사람들의 동기는 ‘일반 대중매체의 영향’이 가장 많았으며 건강소식지가 동기인 경우도 20.4%였다. 사업군에서 건강소식지가 유방암 자가검진법 실천에 영향을 미친 경우가 79.6%였으며 유방암 자가검진법에 관한 보건교육을 받고 실천하지 않은 사람들 중 미래의 실천의지에 건강소식지가 영향을 미친 경우는 43.6%였다. 이상의 소견에서 지역주민을 대상으로 인쇄매체를 통한 보건교육은 인쇄물만으로도 쉽게 실천 할 수 있는 유방암 자가검진법이 가장 효과적이었으며, 자궁암검진에 관해서도 검진을 받을 수 있도록 지역사회의 보건의료의 하부구조를 정비하여 제도적 장치를 마련하고 정보를 제공한다면 자궁암검진 실천율도 증가할 것이다.고 12.9% 의 발달율을 보여 유의적인 차이를 보이지 않았다. 이상의 결과로 보아 핵이식 수정란을 효율적으로 생산하기 위하여 수핵난자의 세포질에 ionomycin 과 DMAP 의 혼합처리로 탈핵난자의 활성화를 유도하는 것이 효율을 증진시킬 수 있었다고 본다. 또한 공핵수정란을 수정 후 90시간과 114시간 개별 배양하여 할구를 공핵체로 핵이식에 이용하였을 때도 그룹배양에 비하여 효율이 떨어지지 않음을 알 수 있었으며, 수정란의 할구

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Acupuncture, an Adjunct Therapy for Asthma: a Pilot Study Protocol of Randomized Controlled Trial (본 임상시험을 대비한 천식 침치료 무작위 대조군 예비 임상시험 프로토콜)

  • Choi, Jun-Yong;Oh, Dal-Seok;Roh, Young-Lae;Jung, Hee-Jae;Jung, Sung-Ki;Choi, Sun-Mi
    • Korean Journal of Acupuncture
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    • v.25 no.3
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    • pp.43-51
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    • 2008
  • 배경 : 최근까지 이루어진 천식의 침치료 무작위 대조군 연구들에 의한 결과는 뚜렷한 효과를 보여주지 못하고 있다. 이러한 요인의 하나로 적절한 피험자 수를 정하기 위한 예비 임상시험의 부재가 거론되고 있다. 따라서 천식에 대한 침치료의 본 임상시험에 앞서 이의 실행 가능성 및 규모를 예측하는 예비임상시험이 필요한 상황이다. 목적 : 예비임상시험을 통해 서양의학적 치료를 받고 있는 천식환자들에 대한 침치료의 부가적 효과를 검증하기 위한 본 임상시험의 실현 가능성을 예측하기 위함. 방법 : 본 시험은 무작위 단일 맹검 대조군 평행 설계 예비 임상시험이다. 1차 평가변수는 최대 호기량 검사기로 집에서 아침, 저녁으로 매일 측정한 수치로 구해진 최대 호기 유속 일중 변동률의 1주간 평균치 변화이며 2차 평가변수는 의료기관에서 시행하는 폐기능 검사, 기준시점 호흡곤란 지수, 호흡곤란 변화에 대한 지수, 천식환자들의 삶의 질 평가를 위한 설문 등이다. 피험자 수는 총 45명으로 선정 및 제외기준을 통해서 참여하게 되며 1주간의 최대 호기 유속 기저치 평가 기간을 거친 후 진짜침 처치 군, 가짜침 처치 군, 대기군 세 군에 각각 무작위로 15명씩 할당된다. 모든 피험자에게 기존의 천식관련 약물의 사용을 허용하며, 진짜침 처치군 및 가짜침 처치군은 주 3회 4주간 해당 처치를 받고 2주 후에 각 평가 항목에 대하여 추적, 관찰하게 된다. 대기군은 기존의 천식관리를 유지하면서 2주마다 방문하여 총 6주간 평가를 받고 진짜침 처치를 4주간 받게 된다. 고찰 : 본 연구는 국내에서 최초로 이루어지는 천식에 대한 침 무작위 대조군 예비 임상시험으로 향후 적절한 피험자 수와 실행가능성을 예측할 수 있으리라 기대된다.

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Relationship between Periodontal Disease and Chronic Kidney Disease: A Systematic Review of Cohort Studies (치주질환과 만성신장질환의 연관성: 코호트 연구에 대한 체계적 고찰)

  • Lee, Eun-Sun;Do, Kyung-Yi
    • Journal of dental hygiene science
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    • v.17 no.2
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    • pp.160-167
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    • 2017
  • The purpose of this systematic review was to investigate the association between periodontal disease and chronic kidney disease. A search of Embase, PubMed and The Cochrane Library databases was performed up to April 17, 2016. Article selection was based on cohort study design and the study subjects were patients with periodontal disease or severe periodontal disease. The final result was development of chronic kidney disease and kidney function decrease based on the estimated glomerular filtration rate values. The quantitative synthesis of the final selected articles was assessed using Review Manager statistical analysis software. A fixed-effects model meta-analysis was performed to estimate the degree of association between periodontal disease and chronic kidney disease. The search strategy identified 3,018 potentially eligible articles, of these, four studies were finally selected for meta-analysis, revealing that periodontal disease was significantly associated with the risk of developing chronic kidney disease (odds ratio, 1.65; 95% confidence interval, 1.44~1.90; p<0.001). In order to prevent the development of chronic kidney disease and kidney function decrease it is important to prevent periodontal disease, as well as minimizing the traditional risk factors known to reduce the quality of life of patients and increase disease burden.

Study on Factors Affecting Life Satisfaction of the Disabled Seniors (장애노인의 삶의 만족도 영향요인 연구)

  • Kim, Seong Hee
    • 재활복지
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    • v.20 no.3
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    • pp.17-43
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    • 2016
  • This study is on understanding the reality of disabled seniors and investigation of factors that affect overall life satisfaction, making a proposal to improve their life quality. Situation data for the disabled, gathered by Korea Institute for Health and Social Affairs (KIHASA) in 2014, was used to perform the study, and the target group is 3,181 people with disability, above the age of 65. Descriptive statistics was presented for data analysis and logistic regression analysis was performed to investigate factors that affect life satisfaction. It was concluded from the analysis that gender, age, presence of spouse (demographic factors), house income, possession of house, presence of pensioner, registration to public pension plan, social discrimination (social-economical factors), level of disability, subjective health status, level of help needed for daily living, presence of care-giver, sufficiency of help, ability to go out by oneself, difficulty of using public transportations, and presence of medical checkups (disability and health factors.) make meaningful effects to life satisfaction of disabled seniors. Based on the derived results, this study suggests intensive interests and care-giving service for disabled seniors that live alone, institutional complementations to guarantee income security, including public or private pensions, improvements to social recognition and environments for discrimination of the disabled, organization of health and medical treatment service and health care system, comprehensive service provision to social welfare for both the disabled and seniors, and comprehensive service provision to both health care and social welfare.

Occupational Therapists' Perception and Communication of the Elderly (작업치료사를 대상으로 한 노인 인식 및 의사소통 현황)

  • Park, Sung-Ji;Han, Hee-Won;Jung, Yu-Jin;Woo, Hee-Soon
    • The Journal of Korean society of community based occupational therapy
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    • v.10 no.3
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    • pp.15-26
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    • 2020
  • Objective : Due to the rapid aging of the country, the elderly population is increasing and the ratio of face-to-face meetings with the elderly in major areas of occupational therapy is high. The purpose of this study was to investigate the overall perception of the elderly and the status of communication with the elderly. Methods : This survey was conducted From April to June 2020. Occupational therapists who provide interventions for the elderly in hospitals and public health centers across the country were collected using online questionnaires. A total of 91 questionnaires were collected through a self-administered questionnaire, of which 82 were used for data analysis, excluding 9 with insufficient responses. Results : Occupational therapists generally had a lot of negative perceptions of the elderly. In addition, as factors that hindered communication with the elderly, they responded in order of hearing-related, language understanding related, and articulation related. Lastly, occupational therapists were found to induce smooth communication with the elderly in the order of conversation response management, emotional expression, understanding enhancement, and relationship control. Conclusions : Occupational therapists are health care professionals who play a major role in improving the subjects' social participation and quality of life. Therefore, it is necessary to provide professional therapeutic interventions and related education using improved communication skills along with an understanding of the elderly's communication skills and their level of communication.

Estimation of Employment Creation Center considering Spatial Autocorrelation: A Case of Changwon City (공간자기상관을 고려한 고용창출중심지 추정: 창원시 사례를 중심으로)

  • JEONG, Ha-Yeong;LEE, Tai-Hun;HWANG, In-Sik
    • Journal of the Korean Association of Geographic Information Studies
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    • v.25 no.1
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    • pp.77-100
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    • 2022
  • In the era of low growth, many provincial cities are experiencing population decline and aging. Population decline phenomena such as reduction of productive manpower, reduction of finances, deterioration of quality of life, and collapse of the community base are occurring in a chain and are being pushed to the brink of extinction of the cities. This study aims to propose a methodology to objectively estimate the employment creation centers and setting the basic unit of industrial-centered zoning by applying spatial statistical techniques and GIS for the application of the compact city plan as an efficient spatial management policy in a city with a declining population. In details, based on reviewing previous studies on compact city, 'employment complex index(ECI)' were defined considering the number of workers, the number of settlers, and the area of development land, the employment creation center was estimated by applying the 'Local Moran's I' and 'Getis-Ord's Hot-Spot Analysis'. As a case study, changes in the four years of 2013, 2015, 2017, and 2019 were compared and analyzed for Changwon City. As a result, it was confirmed that the employment creation center is becoming compacted and polycentric, which is a significant result that reflects the actual situation well. This results provide the basic data for functional and institutional territorial governance for the regional revitalization platform, and provide meaningful information necessary for spatial policy decision-making, such as population reduction, regional gross domestic product, and public facility arrangement that can respond to energy savings, transportation plans, and medical and health plans.

Effect of a coconut oil intervention on the periodontal health of smokers

  • Yun-Jeong Kim;Jin-Ju Yang;Seon-Yeong Kim;Ah-Young Choi;Woo-Jung Noh
    • Journal of Korean society of Dental Hygiene
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    • v.23 no.1
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    • pp.25-31
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    • 2023
  • Objectives: This study performed a comparative evaluation of the effects of oil pulling on the periodontal health of smokers. Methods: The experimental (15 subjects) and control (15 subjects) were provided coconut oil and distilled water, respectively. We evaluated the pocket depth (≥4 mm), bleeding on exploration, and Patient Hygiene Performance (PHP) index in both groups following the interventions. Clinical parameters were assessed at baseline, after 4 weeks, and after 8 weeks. Dry mouth and oral health-related quality of life were evaluated at baseline and after 8 weeks. Results: Bleeding on exploring in the control group decreased from 26.17 to 18.33 and from 26.07 to 12.53 in the experimental group (p=0.030), with significant differences in measurement time (p<0.001), and the interaction between group and measurement time (p=0.002). The PHP index in the control group decreased from 24.50 to 16.17 and from 24.00 to 9.83 in the experimental group (p=0.027), with significant differences in measurement time (p<0.001), and the interaction between group and measurement time (p=0.001). Furthermore, the experimental group showed a significant decrease in dry mouth (p<0.001) and a significant increase in oral health-related quality of life (p=0.025). Conclusions: The coconut oil intervention positively affected the periodontal health of smokers.