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HOME NURSING CARE NEEDS IN RURAL KOREA (한국 농촌 지역의 가정간호 요구에 관한 연구)

  • KIM, SUNG SILL
    • Journal of Korean Academy of Nursing
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    • v.18 no.1
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    • pp.44-69
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    • 1988
  • 보건의료기술이 고도로 발달되었다 하더라도 의료의 혜택이 필요할 때 누구에게나 언제든지 제공될 수 없는한 전체 국민의 건강요구를 포괄적으로 충족시킬 수 있는 제도나 방법이 필요하게 된다. 본 연구는 사회 집단의 최소 단위인 가정을 중심으로 수행되고 있는 지역사회 가정간호의 합리적 수행에 필요한 기초자료를 얻기 위하여 가정간호 요구의 사정 및 가정간호 수행에 관하여 연구하였다. 가정 간호(Home Nursing Care, Home Health Care)는 추후관리를 받아야 할 대상자, 고령자, 만성질환자에게 규격화되어 있는 병원간호를 가정이라는 친숙한 분위기에서 개별적으로 제공되는 가정 중심의 심리적 안정은 물론 시간과 경비를 절감하는 효과적 간호수단이다. 본 연구의 목적은 첫째 우리나라 농촌가정의 가정간호의 요구는 무엇이며 그 요구의 원인은 무엇인가\ulcorner 둘째, 농촌가정에서 가지고 있는 상병에는 어떠한 것이 있으며 행하여 지고 있는 가정간호의 내용에는 어떤 것들이 있는가\ulcorner 셋째, 가정간호 수행자는 누구이며 이에 대한 수혜자의 만족도는 어느 정도인가\ulcorner 본 연구의 방법은 1985년 6월 18일 부터 8월 7일 까지 C군에 거주하는 주민중 11개소 보건진료소가 소재한 반의 주민 전체 1,027명 중 상병자 159명과 30세 이상의 인구 440명, 가구주 239명을 대상으로 가정방문을 통한 면접으로 질문지를 기록케 하여 자료를 수집하였다. 연구의 도구는 첫째 간호요구의 측정을 위한 도구로 Virginia Henderson의 기본간호활동 14가지를 기초로 지역주민 50명과 현직 간호원 50명에게 개방질문으로 얻은 내용을 중심으로 제작하였으며 둘째, 가정간호수행에 대한 도구로 Orem의 간호이론 중 간호방법 5가지를 근거로 개발하였다. 본 연구의 내용은 보건진료원에 의하여 사정된 간호요구와 그 원인들을 인간의 기본요구 영역별로 분류하여 가정간호진단을 위한 지역사회 가정간호사정 및 진단도구로 쓸 수 있도록 개발하였으며, 상병자에 대한 가정간호 수행은 수행빈도와 수행내용에 따른 수행자와 수행 만족도를 측정하였다. 1. 가정간호요구에 대하여 1) 가정간호요구 측정은 신체영역 중 몸을 청결히 하고 몸차림을 단정히 하여 피부를 보호하기 내용에서 더위나 추위에 대하여 옷을 맞추어 조절하기의 요구, 적절한 식사와 수분섭취하기 내용에서 배변의 요구, 또한 몸을 움직이고 바람직한 체위를 유지하기 내용에서 한가지 자세를 계속하기의 요구가 높았고 정상호흡하기 내용에는 일상활동시 호흡에 대한 요구가 높은 편이었다. 사회, 심리, 영적 간호요구 영역에서는 자신이 신앙에 따라 예배하기 내용에서 신앙으로 어려움을 극복하려는 요구가 높았으며 여러가지 오락의 형태를 취하여 이에 참여하기 내용에서는 취미생활의 요구가 높았다. 2) 가정간호요구는 연령이 높을수록 높았고 성별로는 여자의 가정간호요구가 남자보다 높았으나 내용별 요구의 차이는 없었다. 2. 가정간호수행에 대하여 1) 가정에서 수행되는 가정간호내용으로는 직접간호가 가장 많이 수행되었으며 내용으로는 구강청결, 옷 갈아 입기, 투약, 음식투여, 대ㆍ소변보기의 빈도가 많았다. 건강한 환경제공의 간호수행내용에서는 적당한 실내온도 유지하기의 빈도가 많았으며 안내와 지도내용에서는 투약요령 알기의 빈도가 많았으며, 보호와 지지내용과 교육의 간호수행내용에서는 현 상태 인정하기와 투약 방법에 대한 교육하기의 간호수행빈도가 가장 많았다. 2) 간호수행자에 있어서 직접간호 수행은 본인 스스로 하는 빈도가 가장 많았으며 안내와 지도 및 교육의 간호수행은 전문가가 많았고 보호와 지지간호는 가족이 많았고 건강한 환경제공간호는 배우자에서 더 많았다. 3) 간호수행자에 대한 만족도는 직접간호 방법에서는 가족이, 안내와 지도는 배우자가, 보호지지, 건강한 환경제공 및 교육에서는 전문가에 의한 간호수행 만족도가 높았다. 4) 상병상태에 따른 주 증상은 관절통 요통이 가장 많았고 상병자는 남자가 많았고 주 중상에 대한 성별간의 큰 차이는 없었다. 이상 가정간호요구와 정도 및 가정간호 수행의 내용을 기반으로 가정간호사업의 시행이 시급하다는 결론을 내릴 수 있었으며 가정간호사업의 시행을 위한 제도적 보완개선책이 요구된다고 결론을 지을 수 있다.

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Evaluation of a Tunneling Technique under the Latissimus Dorsi Muscle for Thoracostomy Tube Placement in Eleven Dogs (흉강 튜브 삽입을 위한 넓은 등근 아래 터널 만들기 방법에 대한 평가)

  • Yoon, Hun-Young;Jeong, Soon-Wuk
    • Journal of Veterinary Clinics
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    • v.29 no.5
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    • pp.368-371
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    • 2012
  • The present study evaluated the outcome of use of thoracostomy tube tunneling technique under the latissimus dorsi muscle for the evacuation of postoperative pneumothorax induced by thoracotomy in 11 dogs. A stab incision was made through the skin and the latissimus dorsi muscle over the rib in the fifth intercostal space caudal to a surgical window. The thoracostomy tube with a Kelly hemostat was advanced into the thoracic cavity in a cranioventral direction through the sublatissimal tunnel. After tube placement, a # 1 nylon horizontal mattress suture was placed around the skin incision. The thoracostomy tube was removed after creating a negative pressure in the thoracic cavity. Dogs were monitored after surgery for pneumothorax, subcutaneous emphysema, clinical signs including dyspnea, and tube kinking in a muscle tunnel using physical examination and postoperative radiography. There was no tube kinking in the sublatissimal tunnel in 11 dogs on introducing the tubes into the thoracic cavity. The mean (${\pm}SD$) follow-up period was $19{\pm}10$ months. On postoperative radiography, there was no evidence of pneumothorax in 11 dogs. Subcutaneous emphysema was identified around the stab incision in a dog postoperatively. The subcutaneous emphysema disappeared spontaneously within 3 days. On postoperative physical examination, there was no evidence of dyspnea in 11 dogs. Our results suggest that the sublatissimal tunneling technique for thoracostomy tube placement is effective to prevent air leakage around the thoracostomy tube while the tube remains in the thoracic cavity and along the thoracostomy tunnel after tube removal. Tunneling under the latissimus dorsi muscle should be considered the thoracostomy tube placement technique to prevent iatrogenic pneumothorax with first priority.

A Case of Pulmonary Intravascular Lymphomatosis (폐를 침범한 혈관내 림프종증 1예)

  • Park, Sang-Jong;Bae, Sang-Su;Cheon, Eun-Mi;Kwon, O-Jung;Rhee, Chong-H.;Han, Yong-Chol;Kim, Jin-Guk;Lee, Kyung-Soo;Ko, Young-Hye
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.6
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    • pp.1390-1395
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    • 1997
  • Intravascular lymphomatosis(IVL) which was first described by pfleger and Tappeiner in 1959 is rare malignancy characterized by neoplastic proliferation of lymphoid cell lineage within the vascular lumen with little or no adjacent parenchymal involvement Its usual sites of involvement are central nervous system and skin or infrequently heart, lungs, pancreas, liver, spleen, kidney, adrenal glands, genitourinary tract, and bone marrow. Pulmonary involvement of IVL is not common. Symptoms of pulmonary involvement include dyspnea, cough and fever. Radiologicially, the disease is manifested with diffuse interstitial infiltrates. We report a recently experienced case of pulmonary intravascular lymphomatosis which was manifested with fever and chest pain.

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EXPERIMENTAL RECONSTRUCTION OF LARYNX WITH STERNOMASTOID MYOPERIOSTEAL FLAP (흉유돌근골막 피판을 이용한 후두 재건)

  • 조재식;안병현;김선태;이종원
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1991.06a
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    • pp.28-28
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    • 1991
  • 후두암의 수직절제 수술후의 후두 재건 목적은 기관절개를 통하지 않고 후두를 통한 호흡이 가능하도록 하면서 연하시 기도흡인을 피하기 위한 sphincter 능력의 보존, 그리고 발성이 가능하도록 성대진동 mechanism을 재건하는데 있다. 오늘날 수많은 후두학자들에 의해서 고안 개발된 다양한 재건 방법이 있다. 연자는 광범위한 후두절제에 따른 큰 결손을 메우기 위해 bulky하면서도 점막 상피의 재생이 용이한 재건 피판으로 흉유돌근골막 피판을 이용하여 후두 결손부를 재건하여 보았다. 방법은 성견 3마리를 대상으로하여 thiopental sodium 정맥주사로 전신마취를 시행한 후 설골에서부터 흉골상까지 경부 정중앙의 피부를 절개하고 후두를 노출시켜 후두 수직절제술을 시행하였다. 흉유돌근과 흉골에 부착된 골막을 박리하여 흥유돌근골막 피판을 제작한 후 골막이 후두강 안쪽으로 되도록하여 골막연과 후두점막을 봉합하였다. 그리고 3, 5, 9개월에 후두적출술을 시행하여 병리조직학적 및 수술후 경과를 관찰하였다. 3실험견 모두 기관절개술 없이 후두를 통한 호흡이 가능하였고 흡입성 폐렴이나 피하기종등의 합병증없이 창상이 치유되었으며 발성도 양호하였다. 이식된 골막위로 신생혈관의 출현과 함께 점막재생이 잘되 있었다. 단지 봉합사 주위에 소량의 육아종이 관찰되었다. 조직학적으로는 섬유조직위로 편평상피가 재생되었으며 성문하부에서는 일부 섬모가 있는 호흡기 점막도 관찰되고 골막하부에 신생골 형성은 관찰할 수 없었다. 골막 피판은 그 유연성 때문에 결손부위의 점막연에 맞춰도 tension이 없고 공기 누출이 되지 않게 봉합이 가능할 뿐 아니라 점막이 재생할 수 있는 frame-work의 역할을 하는 것으로 사료되었다. 이상과 같은 사실로 미루어 흉유돌근 자체가 견실하고 골막에 혈류공급이 잘되어 창상치유에 좋을 뿐 아니라 큰 후두결손부의 재건이 가능하리라고 사료되었다.로서 몇가지 앞으로의 치료지침에 도움이 되는 결과를 얻었기에 보고하는 바이다. 1) 성별 분포는 남자 16(39 %), 여자 25 (61%)이었으며 1 : 1.5의 빈도를 보였다. 2) 연령 분포는 20대와 30대에서 남녀 모두 25명으로 대부분을 차지하였다. 3) 부식제의 종류는 빙초산이 26명 (63.4 %)으로 대부분을 차지하였고 염산 7 (17.1 %) Lye 3 (0.7 %) 의 순이었다. 4) 음독후 12시간내에 식도경술을 받은 환자가 3명(0.7 %) 12-24시간에 받은 환자가 17명(41.5 %), 24 - 48시간에 받은 환자가 11명(26. 8%)으로 48시간 내에 시행받은 환자가 전체의 75.6%를 차지하였다. 5) 식도경 검사상 나타난 식도화상은 Grade I 11명 (26.8%) G.ade II 18(43.9%) Grade III 7명(17.1%) 이었으며 Grade II 인 경우가 18명(43.9%)로 가장 많았으며 Grade I 11명(26.8 %), Grade III 7명 (17.1 %) Normal 5명 (12.2 %) 순이었다. 6) 조기 식도경 검사에서 41명중 oral cavity burn이 없었던 경우가 15명(36. 1 %) 이었으며, oral cavity burn이 있었던 26명중 5명(19 .2 %)에서 Esophageal burn이 없었다 특히 Esophageal burn의 Grade II, III 25명 중 9명(29.6 %)에서 oral cavity burn이 없었다. 7) 식도 부식중 환자의 치료 원칙으로 Grade I, II, III에서 항생제 및 보존적 치료를 하였으며 Grade I에선 oral feeding을 시켰고 Steroid는 경우에 따라 투여하였으며 Grade III에선 원칙적으로 사용치 않았다. 식도조영술은 Grade I II III에서 3주 후에 모두 시행하였다. 8) 3주 후 식도조영술을 실

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A Research to Decrease Airborne Microoganism the Train (전동차내 부유 미생물 저감방안에 관한 연구)

  • Choi, Sung-Ho;Choi, Soon-Gi;Son, Young-Jin
    • Proceedings of the KSR Conference
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    • 2011.10a
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    • pp.2895-2901
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    • 2011
  • SeoulMetro(line number 1 to 4) for the first half of the year. Therefore air quality in the subway is very important. It is passengers, such as sneezing and respiratory vital activities, Suspended due to skin keratin microbial action, and Microbial contaminants such as viruses. Hypersensitivity disorders, an atopic dermatitis, infectious diseases, allergic diseases, and can cause respiratory diseases. Ministry of Environment and National Institute of Environmental Research is managed so the life bacteria. It is emerging as the occupational health problems. Introduction of an appropriate ventilation system for cooling and dehumidification is needed. In line number 2, commuting and normal trains are measured in-room floating microbes. Suspended bacteria and fungi suspended in 2011 for 85 ~ 385$cfu/m^3$, 67 ~ 98$cfu/m^3$ is lower than baseline. Suspended to prevent microbial contamination and air conditioning equipment performance is a substantial improvement. Suspended micro-organisms and the impact on passenger room ventilation is increased. Electric car how to improve air quality substantially investigated.

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Driver's Status Recognition Using Multiple Wearable Sensors (다중 웨어러블 센서를 활용한 운전자 상태 인식)

  • Shin, Euiseob;Kim, Myong-Guk;Lee, Changook;Kang, Hang-Bong
    • KIPS Transactions on Computer and Communication Systems
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    • v.6 no.6
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    • pp.271-280
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    • 2017
  • In this paper, we propose a new safety system composed of wearable devices, driver's seat belt, and integrating controllers. The wearable device and driver's seat belt capture driver's biological information, while the integrating controller analyzes captured signal to alarm the driver or directly control the car appropriately according to the status of the driver. Previous studies regarding driver's safety from driver's seat, steering wheel, or facial camera to capture driver's physiological signal and facial information had difficulties in gathering accurate and continuous signals because the sensors required the upright posture of the driver. Utilizing wearable sensors, however, our proposed system can obtain continuous and highly accurate signals compared to the previous researches. Our advanced wearable apparatus features a sensor that measures the heart rate, skin conductivity, and skin temperature and applies filters to eliminate the noise generated by the automobile. Moreover, the acceleration sensor and the gyro sensor in our wearable device enable the reduction of the measurement errors. Based on the collected bio-signals, the criteria for identifying the driver's condition were presented. The accredited certification body has verified that the devices has the accuracy of the level of medical care. The laboratory test and the real automobile test demonstrate that our proposed system is good for the measurement of the driver's condition.

Classification of Atopic Dermatitis into Digestive and Respiratory Disorders on the Basis of a Literature Study (문헌적 근거를 기반으로 한 아토피 피부염의 소화기계·호흡기계로의 변증분류)

  • Park, Sung-Gu;Noh, Hyeon-Min;Hwang, Chung-Yeon;Hong, Seok-Hoon;Park, Min-Cheol;Jang, Hyun-Chul;Kim, Ho-Kyoung
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.29 no.3
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    • pp.106-123
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    • 2016
  • Objectives: This study aimed to verify the classification of atopic dermatitis into the digestive and respiratory disorder on the basis of a literature study.Methods: We searched for the term "atopic dermatitis" in KISS, RISS, NDSL, DBPIA, and OASIS. On further filtering the searched paper further by including the terms "Korean medicine", "literature study" and excluding "acupuncture", we found eight papers relevant to the literature study of atopic dermatitis. The reviewed papers included keywords of Oriental medicine such as Sub-yeol (濕熱), Bi-heo (脾虛), Poong-sub (風濕), Hyeol-heo (血虛). We classified keywords as "digestive system" or "respiratory system" and compared the clinical symptoms of classified Each category keywords.Results: Atopic dermatitis was classified into four categories : acute digestive disorder, chronic digestive disorder, acute respiratory disorder, and chronic respiratory disorder. The four categories of atopic dermatitis showed differences based on region, dermal symptoms, associated symptoms, and affected age group.Conclusions and Discussions: This study suggests a new theory of Atopic dermatitis classification. The theory is similar to that stated in former classification; however, it focuses on the digestive and respiratory disroder. All of atopic dermatitis into digestive disorder show both digestive symptoms and dermal symptoms. However, atopic dermatitis into respiratory disorder shows only respiratory symptoms. Thus, this study can establish a relationship between Western and Oriental medicine's study of atopic dermatitis using keywords such as "digestive disorder" and "respiratory disorder".

The Statistical Analysis on Outpatients Who Had Visited Chuncheon Oriental Medical Hospital with Otolaryngology and Respiratory Diseases (춘천한방병원에 내원한 이비인후과 및 호흡기계 질환 외래 환자의 통계적 고찰)

  • Heo, Eun-Jung;Kim, Ji-Hyon;Kang, Da-Hye;Kwon, Kang
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.23 no.3
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    • pp.202-215
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    • 2010
  • Objective : This study was performed to investigate the prevalence of otolaryngology and respiratory diseases and characteristics of the outpatients who had visited Chuncheon oriental medical hospital which located in Gangwon province with the diseases. Methods : We analyzed data from 627 patients, who had visited to the Department of ophthalmology & otolaryngology & dermatology of Chuncheon oriental medical hospital from November 1st, 2007 to May 31th, 2010. The data were analyzed and demonstrated by age, gender, season, period between the onset of disease and the first examination, times of treatment, and treatment methods. Results : The results of this study are summarized as follows. 1. Among the 627 outpatients, male patients outnumbered female patients, and the most frequent age group was 0-10 year-old group(24.9%) and it is followed by 31-40 and 41-50 year-old groups. The majority of outpatients, 79.7% of them were from Chuncheon, and Hongcheon and Gapyeong residents were respectively 4.7% and 3.8% of the patients. 2. The shares of outpatients by department were 47.4% in Rhinology disease, 29.8% in respiratory disease, 14.5% in Otology disease, and 8.3% in Laryngology disease. The seasons with the most frequent prevalence by department were spring and winter for otology group, autumn and spring for rhinology group, summer and spring for laryngology group, and winter and spring for respiratory disease group. Overall, most outpatients had visited the hospital for 1-5 times or 6-10 times. Acupuncture and herbal medicine were the most frequent treatment methods that these patients received. 3. The most prevalent diseases were rhinitis, common cold, tinnitus, and sinusitis. The most frequently visited age groups for tinnitus and hearing loss were 41-50 and 51-60 year-old groups, and for rhinitis and sinusitis 0-10 and 11-20 year-old groups. Irritation in larynx was almost evenly prevalent among 31-40, 41-50 and 51-60 age groups. Regarding the period between the onset of disease and the first medical examination, outpatients with tinnitus, rhinitis, sinusitis, and irritation in larynx came to the hospital after one year since the onset and outpatients with common cold first visited the hospital within one week since the onset of disease. Conclusions : This study shows that the most frequent diseases were rhinitis, common cold, sinusitis, tinnitus, and cough. In order to do better treatment for these diseases in the future, there is a need to investigate long-term, multifaceted studies, connected studies with other hospital in Gangwon province.

Comparative Study on Exposure Factors for Risk Assessment in Contaminated Lands and Proposed Exposure Factors in Korea (토양오염 위해성평가를 위한 국가별 노출인자 비교분석 및 국내 노출인자 연구)

  • An, Youn-Joo;Lee, Woo-Mi
    • Journal of Soil and Groundwater Environment
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    • v.12 no.1
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    • pp.64-72
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    • 2007
  • Humans are exposed by a range of pollutants in soil via exposure routes such as ingestion, inhalation, and dermal contact. Risk assessment is a process of evaluating the adverse health effects of chemicals as a result of exposure to stressors, and it is a very useful tool to establish the cleanup goals in contaminated lands. In the exposure assessment that is one of main process in risk assessment, exposure factor plays a significant role to quantify the intake of soil pollutants. However there is a very limited study about the exposure factor applicable to Korea. In this study, we compared the exposure factors applied by the developed countries including the United States and representative European countries, and suggested the exposure factor that might be suitable in our situation. The exposure factors considered in this study include average lifetime, body weight, (exposed) skin surface area, life time, skin absorption, soil-skin adherence factor, and soil ingestion rate. This information is needed to quantitatively estimate the intake of soil pollutants in contaminated lands.

Application of Oryza sativa (Rice) Bran Oil as an Anti-pollution Cosmetic Material (쌀겨오일의 안티폴루션 화장품 소재로써의 응용)

  • Kang, Hae-Ran;Jung, So Young;Heo, Hyojin;Cha, Byungsun;Brito, Sofia;Lee, So Min;Yeo, Hye Lim;Yoo, Kyung Wan;Kwak, Jun Soo;Kwak, Byeong-Mun;Lee, Mi-Gi;Bin, Bum-Ho
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.47 no.3
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    • pp.237-245
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    • 2021
  • Particulate matter and ultra-particle matters generally refer to very small floating dust, such as 1/6 to 1/7 and 1/20 to 1/30, respectively, compared to the thickness of human hair, and contain various types of heavy metal ions. In addition to breathing, particle matters (PM) that flows in through the gaps in the pores of the skin can induce health problems in the body's tissues and skin, so it must be removed by blocking the inflow or by washing. Through this study, we confirmed the possibility that heavy metal ions can be adsorbed and removed by using Oryza sativa (Rice) bran oil (OSBO). In addition, the cell viability is much higher than that of grain-derived components through cytotoxicity experiments, and the cytoprotective effect of an external stimulus source can be expected. It was confirmed that the expression amount of COL1A1 mRNA increased, and accordingly, it was believed that wrinkles that might be caused by moisture lost by heavy metal ions in fine dust could be alleviated. Based on the results of these experiments, we tried to present a cosmetics containing OSBO, which is a wash-off formulation, in order to finally remove heavy metals.