• Title/Summary/Keyword: 환자의 접근

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Community Based Nursing Service As An Alternative Background Forces and Current Practice (지역사회에 기반을 둔 간호사업 그 배경과 실태에 관한 고찰)

  • Hong Yeo-Shin;Rhee Seon-Ja
    • The Korean Nurse
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    • v.19 no.1 s.104
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    • pp.68-84
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    • 1980
  • 간호사업은 1970년대 후반부터 이제까지의 병원중심-환자중심의 간호사업을 수행해 오다가 지역사회에 기반을 둔 간호사업인 건강간호사업으로 전환되기 시작하였다. 세계보건기구에서도 지역사회에 기반을 둔 간호사업인 일차건강관리사업을 중점적으로 지원하기 시작한 것이다. 이러한 역사적 전환의 배경과 실태에 관하여 문헌고찰을 하여 앞으로 국민건강사업 체계에 대한 논의에 참고자료가 되게 하고자 본 논문을 시도하였다. 본 논문에서 얻어진 결과를 다음과 같이 요약한다. 고도의 과학문명의 발달과 물질적 풍요로 특징짓는 현대사회속에서도 인류의 건강문제는 영원히 충족되지 못한 상태로 대두되고 있는 실정이다. 전통적으로 60년대 중반까지는 의료지식 및 기계공업의 발달과 이를 뒷받침할 재정적 지원속에 세계적으로 치료의학분야에 획기적인 발전을 가져왔다. 다른 한편으로는 건강을 태생의 권리라고 규정하여 여러나라에서 사회보장제대로써 의료시해의 균점을 위한 각가지 방도를 마련하기에 이르렀다. 그리하여 60년대말기부터 70년대로 넘어오면서 치료의학의 발달만으로는 의료수가가 앙등되어 모든 국민이 이용할 수 없을 뿐만 아니라 나아가서는 모든 국민의 건강문제를 해결하기는 어렵다는 사실을 발견하기 시작하였다. 또한 지역사회의 건강문제를 요인별로 따져보면 복잡하여 사회경제적, 문화적, 환경적, 유전적 제요인과도 밀접한 관계를 맺고 있기 때문에 신체적인 질병의 치료만이 지역사회 건강문제를 해결하는 길이 아님을 알게 되었다 그리고 지역사회의 건강문제를 해결하기 위해서는 일차보건의료사업에 중점을 두어 노력하는 것이 가장 합리적인 개선방안이라는 의견이 경험적으로 이론적으로 뒷받침되기 시작하였다. 이러한 사조는 지역사회 건강문제가 복잡한 것과 같이 그 접근방법에 있어서도 여러보건요원이 팀이 되어 임해야만 하며 그중에서도 간호팀의 활동이 중추적인 역할을 담당해야 한다고 여러 전문가들은 주장하고 있다. 따라서 앞으로의 간호사업의 방향은 지역 사회에 기반을 둔 간호사업이 실시되어야만 국민건강문제 해결에 기여하게 될 것으로 고찰되었다.

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A case of gastric trichobezoar causing psychiatric problems (정신적 문제로 인한 털위석 1례)

  • Seo, Ji Young;Kim, Min Young;Noh, Jae Ho;Kim, Chun Dong;Park, Jae Ock;Choi, Gyo Chang
    • Clinical and Experimental Pediatrics
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    • v.52 no.10
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    • pp.1167-1170
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    • 2009
  • Trichobezoar is characterized by the accumulation of hair in the gastrointestinal tract and usually occurs in those who have trichotillomania, other psychiatric disorders, or neurologic problems. Trichobezoar typically presents as gastric obstruction, including abdominal pain, vomiting, anorexia, and weight loss. A 9-year-old girl visited our clinic with the complaint of abdominal discomfort and vomiting. A review of her medical history revealed that she had trichophagia since the age of 5, and she felt that her parents had been strict with her. She underwent gastrotomy, during which a large trichobezoar was removed. This case highlights the importance of psychiatric and comprehensive approaches in patients with trichobezoar.

Smart Device based ECG Sensing IoT Applications (스마트 디바이스 기반 ECG 감지 IoT 응용 서비스에 관한 연구)

  • Mariappan, Vinayagam;Lee, Seungyoun;Lee, Junghoon;Lee, Juyoung;Cha, Jaesang
    • Journal of Satellite, Information and Communications
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    • v.11 no.3
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    • pp.18-23
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    • 2016
  • Internet of things (IoT) is revolutionizing in the patient-Centered medical monitoring and management by authorizing the Smartphone application and data analysis with medical centers. The network connectivity is basic requirement to collect the observed human beings' health information from Smartphone to monitor the health from IoT medical devices in personal healthcare. The IoT environment built in Smartphone is very effective and does not demand infrastructure. This paper presents the smart phone deployed personal IoT architecture for Non-Invasive ECG Capturing. The adaptable IoT medical device cum Gateway is used for personal healthcare with big data storage on cloud configuration. In this approach, the Smartphone camera based imaging technique used to extract the personal ECG waveform and forward it to the cloud based big data storage connectivity using IoT architecture. Elaborated algorithm allows for efficient ECG registration directly from face image captured from Smartphone or Tablet camera. The profound technique may have an exceptional value in monitoring personal healthcare after adequate enhancements are introduced.

Considerations for the Migration of Electronic Medical Records to Cloud Based Storage (전자의무기록의 클라우드 기반 저장소 이동시 고려사항)

  • Yi, Myongho
    • Journal of Korean Library and Information Science Society
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    • v.47 no.1
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    • pp.149-173
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    • 2016
  • As cloud computing becomes more and more popular and ubiquitous, many organizations are deciding to move their whole information infrastructure to the cloud. The healthcare industry is one of those that is beginning to utilize cloud-based solutions en masse. Cloud based computing and storage offers numerous benefits including scalability, cost efficiency, and accessibility, which in turn have the potential to streamline hospital operations. Despite the potential benefits of acquiring this system, considerations must still be given to the migration of the massive amounts of personal and highly protected data to a cloud-based solution. Health care organizations must consider all matters of security, reliability, and availability, to ensure that patients' data remains compliant to the Health Insurance Portability and Accountability Act (HIPAA) compliant. This paper will examine the benefits and challenges of such operation to determine the best practices for the utilization of Electronic Medical Record (EMR) cloud based networking and storage for small to mid-sized hospitals.

An Approach to Urban Planning System for Disaster Prevention through Location/Allocation of EMS(Emergency Medical Service) - Focused on Optimum Location of Safety Centers in Jinju - (응급의료서비스 입지/배분을 통한 도시방재시스템의 도시계획적 접근 - 진주시 안전센터의 최적입지를 중심으로 -)

  • Choi, Jin Do;Kim, Yeong;Kim, Sung Duk
    • 한국방재학회:학술대회논문집
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    • 2011.02a
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    • pp.112-112
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    • 2011
  • 오늘날 우리 사회의 생활과 문화의 질이 향상됨에 따라 공공 및 개인의 안전과 건강에 대한 관심이 증대되고 있다. 특히, 재난과 비상사태는 생명에 대한 희생뿐만 아니라 훨씬 더 심각한 경제적인 결과를 초래한다. 이러한 응급사태에 개비하여 적절히 준비되지 않았거나 재난의 예방 및 완화시킬 방법을 가지고 있지 못한다면 도시의 발전적인 프로젝트는 예고 없이 도시를 강타하는 재난 및 비상사태에 의해 무산되고 만다. 이러한 여건 하에 재난과 응급사고를 효율적으로 대처하는 응급처치와 서비스에 대한 급격한 관심과 함께 일정한 결정적 대응시간 내에 각종사고와 재해로부터 방어할 수 있는 공공서비스에 대한 필요성이 크게 증가되었다. 본 연구에서는 신고, 응급구조, 환자이송 등 도시의 병원 전 단계 의료환경에 대해서 조사하였다. 본 연구의 목적은 반응시간과 출동거리를 분석함으로써, 응급사고에 즉시 응급구조서비스를 제공하기 위해 안전센터(119센터)의 최적 입지를 확인하는 것이다. 이를 위해서 사고발생, 반응시간, 출동거리 등을 응급의료 활동과 관련된 연구논문, 대상지 전역의 소방기록물과 출동일지 등의 통계자료를 활용하여 신속한 응급의료 서비스를 위한 패턴을 분석 하였다. 또한 응급구조대의 조직과 활동의 분석을 통해 응급의료시설의 최적 입지설정을 위한 제도적 개선대안을 마련해 보았다. 대상지 연구를 위해, 구조활동 및 소방서비스의 최근 통계자료의 조사를 통해 진주시의 모든 119센터의 입지와 응급의료서비스 및 사고발생 현황을 나타내었다. 자료 분석을 위해서 SPSS14.0을 사용하였으며, 지역의 특성 분포, 안전센터별 대응시간, 이송시간 등을 소방 GPS시스템과 입지할당모형 중 Center Point Model(CPM)을 적용하였다. 결과적으로 본 연구를 통해 대상지역의 119안전센터의 서비스 질이 나쁜 지역을 지리학적인 관점에서 최적 입지/배분 패턴의 설정을 통해 확인할 수 있었으며, 이를 통해 미래 응급의료서비스의 효율적인 입지/배분을 통해 공공 및 개인의 안전과 건강에 기여할 수 있을 것으로 기대된다.

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A Case Report of a Right-sided Hemichorea Patient Diagnosed with Chorea Hyperglycemia Basal Ganglia Syndrome : A Combined Western-Korean Medicine Approach (우반신 무도증을 호소하는 Chorea Hyperglycemia Basal Ganglia Syndrome 환자에 대한 증례보고 : 양한방 복합치료적 접근으로)

  • Kim, Sung Yoon;Park, Jun Hyeong;Ahn, Jae Hyun;Jo, Jung Jae;Lee, Seung Min;Kang, Jung Won;Nam, Dong Woo
    • Journal of Acupuncture Research
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    • v.33 no.1
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    • pp.117-125
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    • 2016
  • Objectives : The purpose of this report is to introduce a rare case of a patient with Chorea Hyperglycemia Basal Ganglia syndrome (C-H-BG) whose initial medical interventions were started 2 weeks after the onset, and to suggest the possibility of treatment using a combined Western-Korean medicine approach. Methods : A 75-year-old female C-H-BG patient complaining of persistent right-sided hemichorea was treated with a therapy that combined Korean and Western medicine from April 4, 2015 to April 29, 2015. Improvements of symptoms were measured by a motor assessment of Unified Huntington's Disease Rating Scale (UHDRS), Visual Analog Scale (VAS) and the number of involuntary movements. Results : Motor assessment of UHDRS, VAS and the number of involuntary movements all showed a gradually improving tendency during 26 days of admission treatment. However, the patient's hemichorea persisted. Conclusion : Rapid blood sugar control is the most important treatment for C-H-BG, because pathologic changes of basal ganglia seem to become irreversible as time goes by. A combined Western-Korean medicine approach to treating C-H-BG seems effective not only in reducing hemichorea, but also in the management of accompanying symptoms such as muscle pain and general weakness.

Research on Impacts of Depression Among the Aged in the Long-Term Care (장기요양기관 노인들의 우울증에 영향을 미치는 요인에 관한 연구)

  • Kim, Kyung-Woo;Choi, Kun-Sik
    • Journal of the Korea Society of Computer and Information
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    • v.17 no.11
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    • pp.179-188
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    • 2012
  • This research study was to examine the relationships of social supports and depression among long-term care center residents. Depression of long-term care center residents is the most common mental health problem confronting older adults. It is estimated that 13 percent of people aged 65 years and over have a major depressive disorder in Korean Society of Welfare for the Aged. Social support is a key ingredient in dealing with emotional distress and a critical in helping people to cope with all kinds of extreme circumstance. As the result of this research, Perceived social support was found to be related to depression. However, network size was not a predictor of depression, and high health status is accounted for a lower portion of the variance in depression., the poor health status was one of the most powerful predictors of depression, From results of this research study, for social workers who are employed institutional-based agencies.

Sedation at Sedation Clinic of Department of Dentistry in Hanyang University Medical Center (II) (한양대학교 치과 진정요법클리닉에서의 진정요법(II))

  • Chun, Jae-Yoon;Bing, Jung-Ho;Park, Chang-Joo;Hwang, Kyung-Gyun;Shim, Kwang-Sup
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.7 no.1
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    • pp.13-17
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    • 2007
  • At Sedation Clinic of Department of Dentistry in Hanyang University Medical Center, total 92 dental treatments under intravenous conscious sedation using midazolam alone for 80 patients were carried out from March 2006 to February 2007. Following the previous article concerning our sedation protocol, the retrospective analyses of our cases were presented in detail. By the evidence-based approach, we hope that our study will help the general dental practitioners perform the intravenous conscious sedation using midazolam alone safely and effectively.

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TREATMENT AND PATHOLOGIC STUDY OF PLEOMORPHIC ADENOMAS (다형성 선종의 치험 및 병리조직학적 연구)

  • Kim, II-Kyu;Lee, Seong-Jun;Ha, Soo-Yong;Chu, Young-Chae
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.2
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    • pp.167-176
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    • 1991
  • This is three case-reports of pleomorphic adenomas arising from one parotid gland and two minor salivary glands treated by total parotidectomy and complete enucleation. We conclude as follows : 1. During the parotidectomy, we tried to preserve the facial nerve by retrograde approach to the trunk from the mandibular branch where it passes over the posterior facial vein. Although the paresis of the lower lip following the operation was seen, it disappeared in about 3 months. 2. Microscopically, the tumor of the first patient (case 1) contained equally myxoid and cellular components and showed well encapsulation. 3. In the second patient (case 2), the tumor revealed large areas of hemorrhage, cystic change, dystrophic calcification and stromal hyalinization, but no definite evidence of carcinoma, therefore we labeled this tumer as "atypical mixed tumor". 4. In the third patient (case 3), the tumor showed principally myxoid component and incomplete capsule, but the tumor was well demarcated.

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POST OPERATIVE EVALUATION FOR RETROMANDIBULAR APPROACH OF SUBCONDYLAR FRACTURES (하악골 과두하 골절 시 후하악접근법 통해 ORIF 시행한 환자들의 술 후 추적조사)

  • Lee, Seul-Ki;Song, Kyoung-Ho;Kim, Jwa-Young;Song, Sang-Hoon;Yang, Byoung-Eun;Choi, Won-Cheul;Kim, Seong-Gon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.6
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    • pp.631-635
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    • 2007
  • Purpose: The classic technique for open reduction of subcondylar fractures is the submandibular approach. The aim of this study was to evaluate clinical result of retromandibular approach to displaced subcondylar fractures. Material and methods: During a period of 24months we perfomed a prospective study with a retromandibular approach in 23 patients with displaced subcondylar fractures. In this article we describe clinical result in 23 patients with follow ups for 3 months after surgery. Preoperatively all patients had malocclusion and radiology demonstrated displacement. Result: The retromandibularl approach for ORIF was good in all case. Mouth opening(M/O) was 49mm. Occlusion was good too. Permanent facial nerve palsy was not detected. Conclusion: Our findings indicate that the retromandibular approach is a safe technique for subcondylar fractures.