• Title/Summary/Keyword: 일차 진료

Search Result 75, Processing Time 0.038 seconds

An Analysis of Health Counseling by the Internet (인터넷을 통한 건강 상담의 내용 분석)

  • Ahn, Ji-Young
    • Journal of Korean Academy of Nursing Administration
    • /
    • v.6 no.1
    • /
    • pp.83-96
    • /
    • 2000
  • With the increased use of computers in medical fields, we can consider introducing computer mediated communication into the area of patient care such as medical or health counseling and education. But little was known about what problems can be counseled, what is the main direction of counseling, and what difficulties are met during the computer mediated counseling. So I conducted this study. This is a fundamental study concerning the health counseling by the inter-net. In this study, medical counseling using a method of questioning -answering through a computer mediated communication system was carried out from June 1998 to May 1999. I analyzed the contents of questions and answers by the ICPC classification. The ICPC classification emerged as a standard for information categorization in Primary Health Care within a few years. One of the most prominent features of this classification is the inclusion of the complaints of the patients (symptoms & complaints) and the social problems (Chapter Z). Thus, and for the first time, the demand of patients may be assessed such as it is expressed in the reality. The ICPC list is now an international standard whose validity is not questioned any more. It is translated in more than twenty different languages. The data collected were analyzed by descriptive statistical method, c2 test by cross tabulations. Followings are the results of this study. 1. The 3,054 users composed of 64% of males and 36% of females. The highest number of users was showed in the age group of $25{\sim}29$ (39.4%). 2. During the one-year period, the average number of counseling per user was 2.5 cases and per day was 21.1 cases. 3. In classifying symptoms and complaints by 17 chapter, digestive(17.6%), general and unspecified (12.7%), skin(12.7%) and musculoskeletal system (9.6%) were most common questions. 4. The distribution of diagnosis by 17 chapter, general and unspecified (21.4%), digestive (15.3%), skin (11.9%) and mus- culoskeletal system (8.9%) were most common answers. 5. Many users wanted to know symptoms and complaints(3,609 cases), treatment principles (2,928 cases), prognosis and preventive methods for health problems which were previously diagnosed (284 cases).

  • PDF

Clinical Practice Guideline of Korean Medicine for Stroke : Preliminary Guideline and Recommendation (중풍환자에 대한 일차 한의임상진료 가이드라인)

  • Han, Chang-Ho
    • The Journal of Internal Korean Medicine
    • /
    • v.33 no.4
    • /
    • pp.347-366
    • /
    • 2012
  • The aim of this new statement is to provide comprehensive and timely evidence-based recommendations on stroke management for clinical practitioners. Many countries are already well engaged in developing and releasing their own clinical practice guidelines, whereas Korean Medicine (KM) is still beginning. It will take time and effort to develop evidence-based guidelines and recommendations of KM or other traditional medicine because they are weak in the area of scientific evidence. The clinical practice guideline of Korean medicine for stroke was formulated through extensive review of published literature and consensus meeting of Korean medicine specialists. This project was supported by a grant of the Oriental Medicine R&D Project, the Ministry of Health and Welfare. Referring to guidelines developed in other countries, the experts in the subject tried to organize and develop guidelines and recommendations adequate for domestic medical circumstances. In December, 2008, a multi-disciplinary team called the Evidence Based Clinical Practice Guidelines Development Group (EBCPGsDG) for Stroke was organized. The writing committee was comprised of experts in internal medicine, acupuncture, rehabilitation, and Sasang constitution. Outside specialists and associated panels were invited for consultation. The scope of the guideline encompasses acupuncture, moxibustion and herbal medicine (including Korean medicine, traditional Chinese medicine, Kampo medicine) as interventions for stroke patients. It includes statements about ischemic stroke (I63), stroke not specified as hemorrhage or infarction (I64), and sequelae of cerebrovascular disease (I69) according to the International Classification of Disease (ICD). The committee subdivided the description of herbal medications into acute stroke management, subacute stroke management, post-stroke management, and secondary prevention of stroke. Guidelines on the practice of acupuncture and moxibustion were described in order for acute stroke management, subacute stroke management, chronic stroke management, and post-stroke rehabilitation. Clinicians who are working in the field of stroke care can adopt this guideline for their practice.

Public Health Measures in Trematode Control in Asia (아세아(亞細亞)에 있어서 흡충류감염(吸蟲類感染) 방어(防禦)를 위한 공중보건학적(公衆保健學的) 조치(措置))

  • Rim, Han-Jong
    • Journal of agricultural medicine and community health
    • /
    • v.13 no.1
    • /
    • pp.82-87
    • /
    • 1988
  • 사람의 흡충류감염(吸蟲類感染)은 대부분(大部分) 열대(熟帶) 및 동부아세아지역(東部亞細亞地域) 여러 국가(國家)에서 발생(發生)한다. 주혈흡충증(住血吸蟲症), 간흡충증(肝吸蟲症), 태국간흡충증(泰國肝吸蟲症), 간흡충증(肝吸蟲症), 요꼬가와흡충증(吸蟲症), 이형이형흡충증(異型異型吸蟲症) 및 폐대흡충증(肺大吸蟲症)등은 어떤 일부(一部) 아세아국가(亞細亞國家)에 있어서 공중보건상(公衆保健上) 중요(重要)한 문제(間題)가 되어 있다. 이와 같은 패류매개성기생충감염(貝類媒介性寄生蟲感染)은 풍토병(風土病)을 일으키고 있다. 사람들의 생활습관은 풍토병을 일으키게될 원인이 될 뿐만 아니라 때로는 그 질병(疾病)을 유행(流行) 전파(傳播)시키는 기본적 요소가 되기도 한다. 주혈흡충을 제외한 흡충류감염은 우리가 중간숙주(中間宿主)을 먹었을때 그곳에 있었던 피낭유충(被囊幼蟲)에 의하여 감염이 이루어 진다. 식물(植物)의 생식(生殖)(간질(肝蛭), 폐대흡충(肺大吸蟲)), 게 및 가재 생식(폐흡충), 민물고기 생식(간흡충, 요꼬가와흡충, 이형이형흡충), 또는 우렁이 생식(극구흡충(棘口吸蟲)), 기타(몇가지 우연적감염(偶然的感染))등은 사람의 흡충류감염의 주 원인이 되는 것이다. 한편 주혈흡충 감염은 요염수원(汚染水源)에 접촉한 피부을 뚫고 들어온 쎌카리아 유충(幼蟲)에 노출되기 때문에 일어난다. 흡충류감염에 대하여 예방과 방어에 관한 공중보건학적 조치는 많다. 이들의 조치중에는 화학요법에 의한 감염원을 감소시키는 것, 패류숙주의 박멸, 만족할만한 위생시설의 비치, 급수시설, 보건교육, 진단기술의 보급, 환경관리 및 개선 등이 포함된다. 그러나 감염자들에 대한 화학요법은 가장 빠르고 효과적인 억제방법인 것으로 나타나고 있다. 흡충류감염을 예방하는데 있어서 가장 중요한 변화는 프라지콴텔과 같은 신약의 개발이었다. 프라지콴텔은 모든 종류의 주혈흡충, 간흡충, 폐흡충 및 여러가지 장내기생 흡충류등 사람의 병원성흡충류에 대한 치료제로서 가장 좋은 특효약이다. 흡충류감염이 중요한 보건문제가 되어 있는 곳에서는 그 예방과 억제책에 있어서 장단기계획(長短期計劃)을 수립하는 것이 좋을 것 같다. 단기는 집단화학요법을 조기에 실시하여야 하고 자기는 "비특이성 기구"로써, 예를들면 위생시설 및 급수시설의 설치, 보건교육등으로 감염을 감소시켜 감염유지 수준이하로 보지(保持)시키는 것이다. 이와같은 억제조치를 착실히 수행하기 위하여 많은일이 있다. 예를 들면 집단참여, 역학적 조사, 약물의 공급, 환경관리, 보건교육, 지역사회관련, 일차보건 진료와의 협조 및 재정후원등에 대하여 검토하고 연구하여야 할 것이다.

  • PDF

Enhancement of Korea medical delivery system : Two policy proposals and healthcare policy making governance (의료전달체계 정립을 위한 두 가지 정책 제안과 보건의료정책 거버넌스에 관한 연구)

  • O, Dongil
    • Journal of the Korea Academia-Industrial cooperation Society
    • /
    • v.17 no.4
    • /
    • pp.340-350
    • /
    • 2016
  • The Medical Service Act of Korea describes a clinic as providing services primarily to outpatients, while a large general hospital provides specialized medical services requiring a high level of expertise for treating serious diseases. The portion of medical revenue for clinics has been decreasing gradually compared with large hospitals. This article proposes two fundamental medical policies to fix the distorted medical delivery system of Korea. Firstly, uniform additional medical remuneration rates based on the type of medial institution should be divided into outpatient additional rates and inpatient additional rates. Secondly, to normalize the function of clinics and large general hospitals, an outpatient medical target budget system should be introduced. Finally, to properly implement the proposal, it is important to establish healthcare policy-making governance. The success of policy implementation strongly depends on the participation and incentives of the government, suppliers, and patients. Healthcare policy-making governance must be designed to encompass this fact and improve quality of care.

Beginnings of the Community Health Practitioner (CHP) System in Republic of Korea (한국 보건진료원 제도의 시작)

  • Yi, Ggod-Me
    • Journal of Korean Academy of Rural Health Nursing
    • /
    • v.4 no.1
    • /
    • pp.31-40
    • /
    • 2009
  • Purpose: This research was done do identify and analyze the beginnings of the community health practitioner system in the Republic of Korea (ROK) around 1980. Method: Primary sources were collected and analyzed, mainly newspapers around 1980, the act for health service for rural areas, and other relative publications. Results: The government of the ROK was trying to solve the problem of doctorless villages and regarded the introduction of primary health care (PHC) services using registered nurses (RNs) to be an economic solution to this problem. The Korean Nurses' Association presented 'a plan for community health service' to the government party and medical association in 1976. In this plan, RNs would provide primary care at the sub-county (myun) level, and hospital would provide secondary care. The Korean Public Health Development Research Center was awarded the project 'RNs and nurse aids as CHP for primary care service and their training'. In 1977, 25 RNs began to work as PHC in 3 areas, and interim findings showed that RNs were very capable of doing PHC. The Ministry of Health and Welfare announced long term plans for health and welfare administration including a tertiary health care delivery system. RNs after training were posted to rural areas with no medical services to do medical treatment for mild cases. The Act for health services for rural areas was enacted on December 31, 1980. Enforcement Ordinance and Enforcement Regulations were enacted in 1981. In 1981, 257 CHP were selected, trained, and deployed. In 1983, the president of the ROK announced continuation of the CHP system for residents of medically vulnerable areas. The number of CHP increased from 257 in 1981 to 2038 in 1989.

The value and sharing of medical research data (의학연구데이터의 가치와 공유의 의미)

  • Kim, Na Won
    • Proceedings of the Korean Society for Information Management Conference
    • /
    • 2017.08a
    • /
    • pp.104-104
    • /
    • 2017
  • 연구 데이터란 과학적 연구에서 사용된 일차 자료와 연구자에 의해 직접 작성된 연구의 결과로서 수치, 문자, 이미지, 음성 등의 사실적 기록을 의미한다. 이 연구의 주제 분야인 의학은 잠재적 가치와 활용 가능성이 높고 공익적 성격을 가지고 있는 학문 분야로 의학 연구 데이터의 종류와 관리의 필요성을 통해서 그 가치와 공유 의미를 찾아보고자 한다. 또한 연구 데이터의 대표적인 임상 시험 기록과 연구 논문의 발표와 공유 현황에 대해서도 살펴보고 그 안에서 도서관의 역할이 어떤 것인가를 짚어보고자 한다. 의학 연구 데이터는 환자 진료기록, 건강 검진 기록, 임상 기록, 사망 기록, 임상 시험 기록, 유전체 정보, 연구 논문 등 그 종류와 형태가 다양하며 대용량인 경우가 많다. 의학 연구는 개인 정보보호와 윤리적인 문제 등 연구 수행 과정에서 어려운 점이 많은 성격을 가지고 있으나 질병 치료나 예방 나아가 인류의 건강과 직접적으로 관련된 학문 분야로 의학 연구 데이터의 보존과 공개, 공유를 위한 관리는 큰 의미가 있다. 의학 연구 데이터관리는 새로운 연구의 밑받침이 될 뿐만 아니라 중 저개발 국가의 연구자들에게도 큰 기회를 부여하여 세계적인 의학 발전에 기여할 수 있다. 또한 임상 시험 결과에 대한 은폐와 거짓 연구 방지에도 의미가 있어 미국뿐만 아니라 전세계적으로 학술 연구 논문 발표에 사용된 데이터는 등록하도록 규정하고 있다. 임상 시험 등록으로 공인된 사이트는 NIH의 ClinicalTrials.gov, ICTRP의 Primary Registry 등이 있으며, 우리나라에도 질병관리본부 국립보건연구원에서 관리하는 CRIS 등이 있다. 의학 연구자들은 연구의 시작부터 연구 데이터를 수집, 사용, 보존, 공유의 문제를 고려해야 하나 시간적 물리적인 문제 등으로 어려움을 겪고 있으며, 이를 지원하는 서비스는 도서관에서도 관심이 높아지고 있는 분야로 Virginia Commonwealth 대학 도서관과 Emory 대학 도서관 등에서 시도되고 있다. 이 서비스는 연구 과정에서 사서의 지원이 가능한 새로운 기회로 연구자의 데이터관리를 위한 단계별 스토리를 조직하고 DMP 작성 지원 및 교육 등을 통해서 학술 커뮤니케이션에서 새로운 역할자로 자리잡을 수 있을 것이다.

  • PDF

Psychophysiological Characteristics of Insomnia Patients Measured by Biofeedback System (바이오피드백을 이용하여 측정한 불면증 환자의 정신생리적 특징)

  • Huh, Sung-Young;Lee, Jin-Seong;Kim, Sung-Gon;Kim, Ji-Hoon;Jung, Woo-Young
    • Sleep Medicine and Psychophysiology
    • /
    • v.22 no.2
    • /
    • pp.70-76
    • /
    • 2015
  • Background and Objectives: Insomnia is the most prevalent sleep disorder in the general population and is considered to be a disorder of hyperarousal. The aim of this study was to measure the psychophysiological responses in insomnia patients using a biofeedback system, and to compare them with results from normal healthy subjects. Materials and Methods: Eighty patients with primary insomnia (35 males and 45 females, average age $49.71{\pm}12.91years$) and 101 normal healthy controls (64 males and 37 females, average age $27.65{\pm}2.77$) participated in this study. Electromyography (EMG), heart rate (HR), skin conductance (SC), skin temperature (ST), and respiratory rate (RR) were recorded using a biofeedback system during 5 phases (baseline, stress 1, recovery 1, stress 2, recovery 2) of a stress reactivity test, and average values were calculated. Difference in values between the two groups in each corresponding phase was analyzed with independent t-test, and change in values across phases of the stress reactivity test was analyzed with paired t-test (all two-tailed, p<0.05). Results: Compared to normal controls, insomnia patients had higher EMG in all 5 phases (baseline : $7.72{\pm}3.88{\mu}V$ vs. $4.89{\pm}1.73{\mu}V$, t = -6.06, p<0.001 ; stress 1 : $10.29{\pm}5.16{\mu}V$ vs. $6.63{\pm}2.48{\mu}V$, t = -5.84, p<0.001 ; recovery 1 : $7.87{\pm}3.86{\mu}V$ vs. $5.17{\pm}2.17{\mu}V$, t = -5.61, p<0.001 ; stress 2 : $10.22{\pm}6.07{\mu}V$ vs. $6.98{\pm}2.98{\mu}V$, t = -4.37, p<0.001 ; recovery 2 : $7.88{\pm}4.25{\mu}V$ vs. $5.17{\pm}1.99{\mu}V$, t = -5.27, p<0.001). Change in heart rate across phases of the stress reactivity test were higher in normal controls than in insomnia patients (stress 1-baseline : $6.48{\pm}0.59$ vs. $3.77{\pm}0.59$, t = 3.22, p = 0.002 ; recovery 1- stress 1 : $-5.36{\pm}0.0.59$ vs. $-3.16{\pm}0.47$, t = 2.91, p = 0.004 ; stress 2-recovery 1 : $8.45{\pm}0.61$ vs. $4.03{\pm}0.47$, t = 5.72, p<0.001 ; recovery 2-stress 2 : $-8.56{\pm}0.65$ vs. $4.02{\pm}0.51$, t = -5.31, p<0.001). Conclusion: Psychophysiological profiles of insomnia patients in a stress reactivity test were different from those of normal healthy controls. These results suggest that the sympathetic nervous system is more highly activated in insomnia patients.

A Study on the State of Convenience Facilities for the Accessibility of a Disabled Person in Dental Institutions in the City of Cheongju (청주시 소재 치과의료기관의 장애인 접근성 확보를 위한 편의시설 실태조사)

  • Lim, Soon-Ryun;Kim, Sun-Ju
    • Journal of dental hygiene science
    • /
    • v.11 no.3
    • /
    • pp.235-241
    • /
    • 2011
  • The purpose of this study was to examine the state of convenience facilities for the disabled in dental institutions in an effort to provide some information on the improvement of the accessibility of disabled people to dental institutions. A survey was conducted on the licensed dental institutions in the city of Cheongju, North Chungcheong Province, from March to April, 2011. The findings of the study were as follows. The dental offices were the majority of the dental institutions investigated, and for the establishment of the dental institutions. Some of the offices were established before 1990, and some were established in 2011. The time period of establishment varied within the offices. As for the location of the dental institutions within the buildings, they were mostly on the second or third floor. Regarding the convenience facilities for the disabled, the most installed convenience facilities were boardwalks and elevators, and the least installed ones were parking lots and restrooms for the disabled. The hospitals and public dental centers were equipped with all the convenience facilities investigated in this study. Overall, the dental institutions that were established in and after 2006 were equipped with more convenience facilities than the dental institutions that were established before 1990. And the dental clinics that were on the third or higher floor were more equipped with elevators and outdoor slope ways than those that were on the first or second floor. Therefore the revision of the law is required to urge even the primary dental institutions to compulsorily install the convenience facilities. The findings of the study are expected to make a contribution to the improvement of the accessibility of disabled people to dental institutions.

Service Quality of Dental Institutes Measured by SERVQUAL Model and Intention to Re-visit (SERVQUAL 모형으로 측정한 일부 치과의원의 서비스 질과 재이용의도)

  • Jun, Mee-Jin;Noh, Eun-Kyung
    • Journal of dental hygiene science
    • /
    • v.10 no.1
    • /
    • pp.55-61
    • /
    • 2010
  • The main purpose of this study was to identify the service quality of some dental clinics located in Gwangju and find an association between service quality and patient's intention to re-visit the same dental clinic. The search objects were 197 patients from five dental clinics, and data collected by self-administered questionnaire which was composed general characteristics, characteristics relating to visit of clinics, quality of service, patients satisfaction and intentions to re-visit. The used statistical analysis to find the association between quality of service and intention to re-visit was multiple regression analysis. This study looked at relations between quality of dental service, service satisfaction and intentions to visit again, and found that quality of service including six service areas had a statistically significant positive correlations with satisfaction and intentions of re-visit. When this study conducted a multiple regression analysis to identify variables that influence intentions of re-visit, it found that patients revisited the dental clinic only when quality of service was included. In conclusion, quality of service evaluated by patients influenced on their intention of re-visit and especially. Therefore, this study concludes that improvement in satisfaction and intentions of re-visit relies on Accessibility, that is, providing of medical information, consultant telephone, how delivery the dental medical system is. Service quality of dental institutes measured by SERVQUAL model and intention to re-visit.

Patients' Perception of Quality of Health Service and Utilization considering convergence factors: A Survey of Elderly Patients of Public Health Centers, Seoul, Republic of Korea (융합적 요소를 고려한 의료서비스 질 인식도와 의료이용의 관련성: 서울시 보건소를 이용하는 노인을 대상으로)

  • Sohn, Minsung;Kim, Mi Sun;Kim, Joonsik;Moon, Sangsik;Choi, Mankyu
    • Journal of Digital Convergence
    • /
    • v.13 no.8
    • /
    • pp.345-356
    • /
    • 2015
  • Health service quality is increasingly emphasized, and primary care service is no exception in this. This study identified patients' perception of quality considering convergence factors associated with increased utilization among patients over the age of 65 using community health centers. A total of 307 respondents were included in the analysis. The results showed that positive perceptions on facility and environment, patient-centered care, technical knowledge and skills of physicians, and emotional support with nurses and non-medical workers were statistically and significantly associated with higher utilization. In order to increase utilization of primary care service at community health centers, they need to manage and improve these factors.