• Title/Summary/Keyword: 의료 영역

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충북지역 보건진료원이 업무 분석적 연구

  • Kim, Hui-Ja
    • Research in Community and Public Health Nursing
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    • v.1 no.1
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    • pp.174-175
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    • 1989
  • 본 연구는 보건진료원의 업무를 분석하기 위하여 충북에서 활동하고 있는 보건진료원 136 명을 대상으로, 설문지를 흥해 자료수집을 하였으며 백분률, 평균값, 표준편차로 자료처리를 하였다. 조사기간은 1968 년 8월 1일부터 11월 20일까지 했으며 그 결과를 요약하면 다음과 같다. 1. 보건진료원의 일반적 특성과 업무에 관련 된 배경을 살펴보면 다음과 같다. 보건진료원의 일반적 특성으로 연령 분포는 30 - 34세가 30.1 %로 가장 많았고 결혼 상태는 기혼자가 61.8 % 였다. 종교는 기독교가 42.6% 로 많았고 학력은 3 년제 간호전문대학 과정졸업 자가 78.9 %로 많았다. 현 가족과 동거상태에서 배우자와 자녀가 함께 사는 경우가 76.5% 였고, 보건진료원의 경력은 1 년 마만이 41.2 %로 가장 많았다. 보건진료원의 업무에 관련된 배경을 살펴보면, 근무지역조건은 갑지가 65.3 % 였고, 현 거주지는 보건진료소내 숙소가 대다수 였다. 보건진료소는 신축된 건물이 대다수였고, 보건진료소 시설은 '그저 그렇다'고 대답한 수가 가장 많았다. 보건진료소 운영협의회 수당은 월 $5\sim7$만원인 경우가 85.6 % 였다. 2. 보건진료원의 보건의료제공 실태는 다음과 같다. 보건진료원이 현재 담당하는 주민수는 $501\sim1,000$ 명이 35.3 % 이고, 1,500 명 이상의 주민을 담당하는 경우도 32% 였다. 보건진료소를 이용한 주만은 연평균 1,956 명이고, 보건진료소 평균 이용건수는 1,812건이다. 보건진료원의 직업만족도는 만족한다가 40.6%로 대체로 긍정적으로 나타났다. 3. 보건진료원과 보건의료 관련기관과의 관계는 다음과 같다. 지역주민의 보건의료자원 이용 정도는 보건소 진료소가 1 위로 가장 많았고, 약국, 약방, 의원, 보건지소의 순위로 나타났다. 보건의료 관련기관과의 협조가 잘 되고 있지 않다고 응답한 경우도 있는데, 보건소(19.7 %), 보건지소( 20.2%) 민간보건 의료기관(22.4 %)이며, 그 이유를 알아서 협조가 잘 이루어지도록 노력해야겠다. 원하는 감독체계는 보건소장(47.3 %), 보건간호 전문가(37.2 %)로 나타났으나 이는 현재있는 감독체제내에서 생각한 것이며 간호전문가에 의한 새로운 감독체제를 원하고 있었다. 많이 이용하는 의뢰 기관은 병원(52 %), 의원(24.4 %), 보건소(10.2 %) 순이었다. 4. 보건진료원의 업무 영역별 수행정도를 살펴보면 다음과 같다. 보건진료원의 업무 영역을 7개 영역으로 구분하여 수행평균 평점을 보면통상질환 관리가 3.70점, 사업운영 관리 및 지도가 3.44 점, 사업계획 수립이 3.19 점, 지역사회 조직 및 개발이 3.17 점, 모자보건 및 가족계획이 3.14 점, 지역사회 보건관리가 3.09 점, 보건 정보체계 개발이 3.02 점으로 나타났다. 위의 결과에서 지역사회 보건관리가 3.09점으로 통상질환 관리 3.70 점 보다 낮게 나타났는데 이는 일차보건의료 사업 정착의 과도기적인 현상으로 생각하며, 이 부분을 더 많이 수행해야 할 것으로 사려된다. 5. 보건진료원의 업무 영역별 수행 소요시간의 평균은 다음과 같다. 지역사회 조직 및 개발 3.48 시간, 사업계획 수립 3.55 시간, 지역사회보건 관리 6.74 시간, 모자보건 및 가족계획 5.55 시간, 통상잘환 관리 15.94시간, 사업운영 관리 및 지도 4.39시간, 보건정보체계 3.62 시간으로 나타났다. 보건진료원이 통상질환 관리와 더불어 예방활동을 효율적으로 할 수 있도록 적절한 행정적, 교육적 지원이 있어야 한다고 생각한다.

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Delirium Management: Diagnosis, Assessment, and Treatment in Palliative Care (섬망의 돌봄: 완화의료 영역에서의 진단, 평가 및 치료)

  • Seo, Min Seok;Lee, Yong Joo
    • Journal of Hospice and Palliative Care
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    • v.19 no.3
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    • pp.201-210
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    • 2016
  • Delirium is a common symptom in patients with terminal cancer. The prevalence increases in the dying phase. Delirium causes negative effects on quality of life for both patients and their families, and is associated with higher mortality. However, some studies reported that it tends to remain unrecognized in palliative care setting. That may be related with difficulties to distinguish the symptom from others with overlapping characteristics such as depression and dementia, and a lack of knowledge regarding assessment and diagnostic tools. We suggest that accurate recognition with validated tools and early diagnosis of the symptom should be highly prioritized in delirium management in palliative care setting. After diagnosing delirium, it is important to identify and address reversible precipitants such as medication, dehydration, and infection. Non-pharmacological interventions including comfortable environment for the patient and family education are also essential in the management strategy. If such interventions prove ineffective or insufficient to control hyperactive symptoms, pharmacologic interventions with antipsychotics and benzodiazepine can be considered. Until now, low levels of haloperidol remains the standard treatment despite a lack of evidence. Atypical antipsychotics such as olanzapine, quetiapine and risperidone reportedly have similar efficacy with a stronger sedating property and less adverse effect compared to haloperidol. Currently, delirium medications that can be used in palliative care setting require more clinical trials, and thus, clinical guidelines are not sufficiently available. We suggest that it is warranted to develop clinical guidelines based on well-designed clinical studies for palliative care patients.

Initial Assessment and Care Planning in Palliative Hospice Care: Focus on Assessment Tools (호스피스 완화의료에서의 초기평가와 돌봄 계획의 수립: 평가도구를 중심으로)

  • Park, Eun Ju;Koh, Su Jin;Cheon, Jae Kyung
    • Journal of Hospice and Palliative Care
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    • v.22 no.2
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    • pp.67-76
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    • 2019
  • For hospice palliative care that provides comprehensive and general care, it is necessary to use assessment tools to objectively list issues and detail care plans. The initial assessment is a process of establishing an overall direction of care by identifying the patient's symptoms, social and spiritual issues and palliative care needs on the admission day or within one day of admission. This process is also used to identify the patients' and families' awareness of the illness, prognosis, treatment options and if the Physician Orders for Life-Sustaining Treatment (POLST) has been drafted. Consisting of 13 simple questions regarding the physical, mental, social, and spiritual domains, the Needs at the End-of-Life Screening Tool (NEST) is recommended as an initial assessment tool. Using specific assessment tools, a care plan is established for the issues identified in the initial assessment within three days of admission. A multidisciplinary assessment tool can be helpful in the physical domain. The psychosocial domain evaluates psychological distress, anxiety and depression. The social domain examines an ability to make decisions, understanding of the socioeconomic circumstance, family relationship, and death preparedness. A spiritual evaluation is also important, for which the Functional Assessment of Chronic Illness Therapy-Spiritual WellBeing Scale (FACIT-Sp) or the Spiritual Health Inventory (SHI) can be used. The use of an assessment tool could not only contribute to pain mitigation a better quality of life for patients, but also provide systematic training for a multidisciplinary team; And the process itself could be a stepping stone for the better care provision.

3D Visualization of Brain for MRI Image (MRI영상에서 뇌 영역의 3차원 가시화)

  • 김영철;문치웅;최흥국
    • Proceedings of the Korea Multimedia Society Conference
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    • 2003.05b
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    • pp.389-392
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    • 2003
  • MRI 영상은 뇌의 해부학적 정보와 기능적인 정보를 제공하는 유용한 도구이다. MR 뇌 영상은 2차원 영상뿐만 아니라 3차원 영상도 임상적으로 중요하다. MR 영상에서 뇌영역의 추출방법으로는 형태학적인 방법, 히스토그램을 이용한 방법, 에지 정보를 이용한 방법, 지식 기반을 이용한 방법들이 있다. 본 논문에서는 region growing을 이용하여 MR 영상에서 뇌 영역을 추출하였다. 3차원 가시화를 위하여 오픈 소스인 VTK를 이용하여 Ray Casting 알고리즘으로 구현하였다. 그리고 의료영상에서 사용되는 각종 단면을 3차원 뇌 영상에서 재구성하였다. 256×256 크기의 71 뇌MR 영상 70장을 이용하여 실험하였다. 향후 연구과제로 MR 영상에서 뇌 영역추출방법과 원영상의 전처리 과정의 연구가 필요하다.

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Correction of Rotated Objects in Medical Images Using the Mojette Transform (모젯 변환을 이용한 의료 영상의 회전 물체 보정)

  • Jung, Hyang-Mi;Kim, Ji-Hong
    • Journal of Korea Multimedia Society
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    • v.15 no.11
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    • pp.1341-1348
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    • 2012
  • In this paper, an efficient scheme for correcting rotated objects in medical images using the Mojette transform is presented. The Mojette transform is a kind of discrete Radon transform, where the transform domain is represented by a set of projections. The Mojette transform currently studied in the image compression area is modified for detecting the rotation angle of objects in medical images. First, in order to find accurate rotation angle, the projection value in the Mojette transform is determined by using pixels on the projection line and in addition the linear interpolation of pixels adjacent to the line. Second, at each projection angle, only one projection is implemented for reducing the amount of the calculation in the process of the Mojette transform. Finally, the projection in the Mojette transform is carried out at the predetermined ROI(Region Of Interest) at which the objects are not cropped or added by rotating the image. The simulation results show that the proposed method has good performance for correcting the rotation angle in medical images.

The Knowledge and Attitude of Prehospital Care among Emergency Medical Technicians Working at 119 Fire Safety Centers for Patients with Acute Drug Intoxication (약물중독 환자의 병원 전 단계 처치에 관한 119 응급구조요원의 지식과 수행 태도)

  • Lee, Hyo-Cheol;Lee, Young-Sook
    • Journal of agricultural medicine and community health
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    • v.35 no.3
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    • pp.301-313
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    • 2010
  • Objectives: The purpose of this research is to provide foundational data for reeducation concerning prehospital emergency care in order to improve the performance of emergency medical technicians (EMTs) working at 119 fire safety centers. Methods: Data were collected using a mail-in questionnaire developed by researchers from 288 subjects, who were EMTs working at 119 fire safety centers and local units in the Gwangju Metropolitan City and South Jeolla Province, from March 1, 2009 to April 31, 2009. Results: The mean score for EMTs' knowledge on drug intoxication was7.04 out of a total of 10 points. The mean score for EMT's attitude of emergency treatment performance on drug intoxication was 2.96 out of a total of 4 points. The level of EMT's knowledge is relatively high regarding prehospital care for drug intoxication. The EMT's attitude of performances demonstrated an understanding of the patients' conditions. However EMTs did not actively explain the prognosis and medical conditions for their patients. Conclusions: This research will contribute to making plans for reeducating emergency crew working at 119 fire centers so that can they have a more active attitude towards prehospital emergency medical care.

The research about the influence of medical service when choosing the dental clinic. (의료서비스가 치과의료기관 선택에 미치는 영향 조사)

  • Lee, Gyu-Sun;Min, Byung-Kuk
    • Journal of dental hygiene science
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    • v.8 no.2
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    • pp.51-56
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    • 2008
  • This research surveyed, from 17 March 2008 to 25 March 2008, 261 students, 1,2,3 grade, who study in the a dental laboratory technology of college placed in Suwon. We sent them out each three questionnaire and surveyed their family and friends including themselves. We got back 584 paper out of 783 paper which we sent out and used as data of analysis. When choosing a dental clinic, we used a Pearson Correlation to understand a relation of variables connected with a medical service. The result showed that every each fields have a positive correlation and especially a correlation between a physical environment and an ability of dentist is showed most highly and a correlation between a basic element of clinic and a traffic convenience is showed a meaningful positive in that order.

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From 'Medicalization' to 'Biomedicalization': the Case of Mental Disorder ('의료화'에서 '생의료화'로: 정신장애의 사례)

  • Kim, Hwan-Suk
    • Journal of Science and Technology Studies
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    • v.14 no.1
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    • pp.3-33
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    • 2014
  • Over the last forty years, the dominant perspective of social science on medicine has been the medicalization theory. It indicates the social process of expanding power of medical professionals by (re)defining the problems which were treated as non-medical phenomena(e.g. homosexuality, alcoholism, obesity, etc.) into "diseases" and thus the spheres of medical intervention. Meanwhile, rapid technoscientific changes in the medical field owing to the diffusion of biological sciences and information technologies since the mid-1980s and the accompanying emergence of new social arrangements such as bioeconomy and biological citizenship have led to the rise of a new social scientific perspective called the biomedicalization theory. This paper attempts to compare the two theories and assess their merits and demerits as a basic work to deepen the understandings of sociology and STS on contemporary medicine. And it also attempts to analyze their relative relevance through the case of mental disorder. The analysis on the case of mental disorder clearly shows that the medicalization in that area seems to have continuously proceeded since the early 19th centiry to the present. Furthermore, it also seems true that the five central processes of biomedicalization(except for risk surveillance technologies of mental disorder) have been observed and realized since the late 20th century. These results indicate that although medicalization has consistently proceeded, it has not been limited to the quantitative expansion of the medical field but been extended to the qualitative transformation asserted by the biomedicalization theory. Therefore, while the concept of medicalization is valid and significant even today, we can recognize that the concept of biomedicalization allow us to capture the new phenomena which cannot be properly and sufficiently captured by that of medicalization.

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