• Title/Summary/Keyword: 환자 안전 및 질

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근골격계 질환 예방을 위한 시스템적 접근과 추진전략

  • 정은교
    • Bulletin of the Korean Institute for Industrial Safety
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    • v.3 no.1
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    • pp.18-24
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    • 2003
  • 최근 산업사회의 급속한 환경변화는 근로자의 상병구조에서도 나타나 작업이 단순반복화 되며 다양한 작업공구를 반복적으로 사용하게 되어 작업속도와 작업량이 많아지고 운동부족으로 인한 근력의 약화 등에 의해서 근골격계질환이 급속히 증가하고 있다. 이로 인한 근로자의 삶의 질은 물론 결근에 의한 노동력 손실, 제품불량 증가, 산재보상비용 지출증가 등으로 성장을 둔화시키고 사회$.$경제적으로 문제의 심각성을 더해주고 있다. 최근 노동부가 발표한 산업재해통계를 보면 2002년도 산업재해 중 업무상질병자는 5,417명으로 전년대비 136명 감소하였으나, 이중 직업성 근골격계질 환자(신체부담작업 및 요통)는 1,827명으로 전년대비 193명(11.8%) 증가한 것으로 나타났고, 그 발생양상이 집단적이라는 특성을 갖고 있다. 이처럼 직업성 근골격계질환의 업무상 질병에서 차지하는 비율이 증가추세에 있고 대부분의 선진국에서도 과거에는 각종 화학물질에 의한 직업병이 상위를 차지해 오다가 근래에는 동 질환이 업무상질병의 상당부분 이상으로 차지하고 있다. 미국의 경우 1998년 한해동안 253,300건(64.2%) 발생하였고 이 가운데 자동차 관련업종이 가장 많은 비율을 점유하고 있다.(중략)

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Implementation of multi-channel IPCC platform for RBAC based CRM service (RBAC기반의 CRM 서비스를 위한 멀티 채널 IPCC 플랫폼 구현)

  • Ha, Eunsil
    • Journal of Digital Contents Society
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    • v.19 no.9
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    • pp.1751-1758
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    • 2018
  • An integrated medical information system that integrates systems consisting of different environments centered on hospital information systems should be provided as a system that prioritizes the improvement of the quality of medical services, customer satisfaction, and patient safety. The RBAC-based medical information system is granted the access right according to task type, role, and rules. Through this, it is possible to use SMS channel, medical reservation and cancellation, customized statistics, and CRM / EMR interworking service using multi-channel to enable communication service without help of counselor and reduce the default rate of reservation patient, Operational improvement services can be extended to medical staff, patients and their families, as well as expanding to important decisions for patients.

Radiation Therapy in Recurrence of Carcinoma of the Uterine Cervix after Primary Surgery (자궁경부암으로 수술 후 재발암의 방사선치료)

  • Kim, Jin-Hee;Kim, Ok-Bae
    • Radiation Oncology Journal
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    • v.21 no.2
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    • pp.143-148
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    • 2003
  • Purpose: The purpose of this study was to evaluate treatment results in terms of the survival and failure patterns subsequent to radiation therapy in recurrent cervical cancer, fellowing primary surgery. Material and Methods: Between January 1990 and December 1999, 27 patients, with recurrent cervical cancer following primary surgery, were subsequently treated with radiation in the Department of Radiation Oncology, at the Keimyung University Dongsan Medical Center. Their median age was 48, ranging from 31 to 70 years old. With regard to the Initial FIGO stage on presentation, 20 and 7 patients were stages I and II, respectively. Twenty three patients had squamous cell carcinomas and 4 had adenocarcinomas. The time interval from the primary surgery to the recurrence ranged from 2 to 90 months with a median of 29 months. The recurrent sites were the vaginal cuff alone, the pelvic cavity and combined recurrence in 14, 9 and 4 patients, respectively. Radiation was peformed, with external and vaginal intracavitary radiation in 13 patients, external radiation alone in 13 and vaginal intracavitary radiation alone in another one. The median follow-up period was 55 months, ranging from 6 to 128 months. Results: The five year disease free survival (5y DFS) and five year overall survival (5y OS) rates were 68.2 and 71.9$\%$, respectively. There was a marginal statistically significant difference in the 5y DFS in relation to the recurrent site (5y DFS, 85.7$\%$ in vaginal cuff recurrence alone, 53.3$\%$ in pelvic cavity recurrence, p=0.09). There was no difference in the survival according to the time interval between the primary surgery and a recurrence. There was only a 7$\%$ local failure rate in the patients with a vaginal cuff recurrence. The major failure patterns were local failure in the patients with pelvic cavity recurrence, and distant failure in the patients with a combined recurrence. There were no complications above grade 3 after the radiation therapy. Conclusion: Radiation therapy was safe and effective treatment for a recurrent carcinoma of the uterine cervix following primary surgery, especially the external beam radiation and vaginal intracavitary irradiation achieved the best results in the patients with a vaginal cuff recurrence following primary surgery.

Quality of Life and Related Factors in Caregivers of Attention Deficit Hyperactivity Disorder Patients (주의력결핍 과잉행동장애 환아 보호자의 삶의 질과 관련요인)

  • Jeong, Jong-Hyun;Hong, Seung-Chul;Han, Jin-Hee;Lee, Sung-Pil
    • Korean Journal of Psychosomatic Medicine
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    • v.13 no.2
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    • pp.102-111
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    • 2005
  • Objective : The purpose of this study was to investigate the quality of life and it's related factors in caregivers of attention deficit hyperactivity disorder patients. Methods : The subjects were 38 attention deficit hyperactivity disorder patients' caregivers(mean age : $37.5{\pm}6.5$, 38 women). Patients were diagnosed with DSM-IV-TR ADHD criteria. Korean version of WHOQOL-BREF(World Health Organization Quality of Life assessment instrument Abbreviated Version) was used for assessment. Results : 1) No significant differences were found in the score of WHOQOL-BREF, overall QOL, physical health domain, psychological domain, social relationships domain and environmental domain between caregiver and control group. 2) The score of Activity of daily living facet$(3.0{\pm}0.7\;vs.\;3.6{\pm}0.7)(p=0.008)$ and self-esteem facet $(2.8{\pm}0.7\;vs.\;3.3{\pm}0.7)(p=0.049)$ were significantly decreased in caregivers of ADHD. 3) Total score of WHOQOL-BREF(r=0.437, p=0.007) and physical health domain(r=0.370, p=0.024) were correlated with caregiver's educational age. 4) In the psychological domain, the score of self-esteem facet(r=-0.337, p=0.039) and thinking, learning, memory & concentration facet(r=-.341, p=0.036) were decreased with caregiver's age. 5) The score of environmental domain were significantly increased with caregiver's educational age (r=0.482, p=0.003), but decreased with patient's age(r=0.328, p=0.044). Conclusion : Although the quality of life in caregivers of ADHD patient had not significantly decreased than control, the quality of lift were positively correlated with educational age of caregives, and negatively correlated with chronological age of caregivers and children. Above results suggest that physicians should consider integrated approaches for caregiver's subjective quality of life in the management of ADHD.

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Design of Operating room Patients Location System for u-Hospital (u-Hospital 환경에서의 수술실 환자 위치추적 시스템 설계)

  • Kim, Seokhun;Jung, Jinyoung;Kim, Sookyun
    • Journal of the Korea Society of Computer and Information
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    • v.18 no.1
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    • pp.103-110
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    • 2013
  • RFID is estimated to have great potential for hospitals to reduce various costs, reconsider patients' safety, and provide high quality medical service. As the ubiquitous technology allows the medical market to expand, medical centers all around the country are fiercely competing against one another. In order to increase the hospital's competitive edge by reducing IT expenses and concentrating on medical practice, the need to establish a u-Hospital using advanced IT technology is rapidly rising. This paper implements an RFID based u-Hospital system by using ubiquitous computing technology to design a location tracking device for all surgical patients, which can secure the patients' safety and increase the quality of medical service through interlocking hospital information systems.

Effects of CO-OP Interventions on Affected Upper Extremity Use, Execution Function and Occupational Performance in Patients With Stroke (CO-OP 중재 적용이 뇌졸중 환자의 상지 기능과 실행기능 및 작업 수행 증진에 미치는 영향)

  • Kim, Gyeong-Sil;Kim, Hee
    • Therapeutic Science for Rehabilitation
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    • v.10 no.2
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    • pp.141-150
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    • 2021
  • Objective : In this study, the upper extremity use, executive function, and occupational performance effects of cognitive orientation to daily occupational performance (CO-OP) interventions for patients with stroke were assessed. Methods : The study was designed as a single-group pre-post test with 20 sessions. The participants were five hospitalized patients with stroke who were present in a rehabilitation setting, and their onsets were more than 3 months previously. Outcomes were measured using the Canadian Occupation Performance Measure (COPM), Performance Quality Rating Scale (PQRS), Executive Function performance Test - Korean version (EFPT-K), and Motor Activity Log (MAL). The Wilcoxon signed-rank test was conducted to determine the difference between the pre-and-post of CO-OP interventions. The statistical significance level was p<.05. Results : The upper extremity function showed significant changes and the execution function showed significant changes in preparation, sequencing, judgment and safety, and closing, except for items to be started. The performance of the task also showed significant changes. Conclusion : Through 20 sessions of CO-OP interventions, especially in patients with chronic stroke, the upper extremity function, execution function, and task performance were improved. We found that CO-OP intervention had a positive effect on the improvement of detailed task elements as well as the performance of tasks overall, in patients with stroke.

Safety and Efficacy of the Mandibular Advancement Device 'Bioguard' for the Treatment of Obstructive Sleep Apnea : A Prospective, Multi-Center, Single Group, and Non-Inferiority Trial (폐쇄성 수면무호흡증의 치료에 사용되는 하악전방이동장치-'바이오가드'의 안전성과 유효성 검증을 위한 전향적, 다기관, 단일군 및 비열등성 연구)

  • Kim, Hyoung Wook;Hwang, Chungpoong;Eun, Hun Jeong
    • Sleep Medicine and Psychophysiology
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    • v.23 no.2
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    • pp.84-92
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    • 2016
  • Objectives: The purpose of this study was to estimate the safety and efficacy of a mandibular advancement device (MAD), 'Bioguard,' for the treatment of obstructive sleep apnea (OSA). Methods: In this 5-week prospective, multi-center, single group, and non-inferiority trial, patients who chose 'Bioguard' as their treatment option were evaluated using both questionnaires (Pittsburgh Sleep Quality Index (PSQI), Epworth sleepiness scale (ESS)) and polysomonography (PSG) (apnea hypopnea index (AHI), oxygen saturation). All patient data, including clinical records, PSG studies (both pre- and post-treatment), and adverse events (AEs), were reviewed and analyzed. Results: Results were obtained for 59 of 62 patients (95.16%). No significant difference in success rate was found between the MAD treatment and surgical treatment (95% CI). AHI, PSQI, ESS and oxygen saturation demonstrated significant improvement (p < 0.001) after MAD treatment, and 39 of 62 patients (62.9%) reported 85 AEs. 79 of the 85 AEs (91.8%) were mild cases, and there were no severe AEs related to the MAD treatment. Conclusion: The MAD 'Bioguard' should be considered as an alternative treatment option for OSA patients.

The Usefulness of Al Face Block Fabrication for Reducing Exposure Dose of Thyroid Glands in Mammography (유방촬영 시 갑상샘의 피폭선량 경감을 위한 Al Face Block 제작 및 유용성에 관한 연구)

  • Hong, Eun-Ae;Lee, In-Ja
    • Journal of radiological science and technology
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    • v.36 no.1
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    • pp.11-17
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    • 2013
  • Currently, there are many studies being conducted around the world to reduce exposure dose to radiation for patients to receive medical treatments in a safe environment. We developed and fabricated of this shield that the patients are protected from the radiation and are need of safety control during breast imaging. In this study, for breast imaging, GE Senography 2000D were used and set at SID 65cm, 28kVp, and 63mAs. The measuring instrument was Fluke's Victoreen 6000-529. And we performed Face Block on with 30 patients. The chamber on the actual thyroid glands to take CC and MLO and measure the dosage before and after wearing the Face Block. For the results, after wearing the Face Block, exposure was decreased by 53.8%-100% and 65.8% in average in CC View and by 50%-100% and 60.7% in average in MLO View. The development of the Face Block that practically decreased the exposure dose of thyroid glands, crystalline eyes during breast imaging and reduced the patients' anxiety during breast imaging. The Face Block is expected to improve patients' satisfaction and contribute to reducing patients' exposure dose, but more efforts should be made to reduce exposure dose to medical radiation.

Surgical Treatment of Gastric Cancer

  • Kim, Sang-Woon
    • Journal of Yeungnam Medical Science
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    • v.20 no.2
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    • pp.105-116
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    • 2003
  • Definitely, treatment for gastric cancer is primarily surgical. Detection in early stage of disease and complete surgical resection is the best way to cure gastric cancer. If surgery is planned, careful preoperative evaluation and corrections of physiologic and psychologic abnormalities are essential to reduce perioperative morbidity or mortality. Basic principle of gastrectomy for gastric cancer is an en bloc resection of tumor with adequate margins of normal tissue and with regional lymph nodes and omental tissues. To complete these principles, regional lymph nodes and all omental tissues should be removed altogether during performing various types of gastric resection. The lymph node dissection is one of the most effective procedures for gastric cancer to achieve curative resection. The basic types of gastric resection are distal subtotal gastrectomy and total gastrectomy according to the condition of primary lesions and the status of lymph node metastases. When the primary lesion is located near the esophagogastric junction, it is sometimes hard for a surgeon to select adequate surgical method. Postoperative quality of life in a patient has become a very important factor to be considered in every step of surgical therapy. With increasing incidence of early gastric cancer, a number of surgical trials for limited surgery or endoscopic procedures have been performed, but the long-term clinical results should be carefully analyzed to define the clinical relevance of these new techniques. For patients with disseminated gastric cancer, a palliative procedure can be performed to improve quality of life of patients and to avoid immediate death due to the cancer-related complications.

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Development of the Allergy Management Website (알레르기 관리 웹 사이트 개발)

  • Cho, Kyu Cheol;Shin, Ye Eun
    • Proceedings of the Korean Society of Computer Information Conference
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    • 2021.01a
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    • pp.157-160
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    • 2021
  • 식품 알레르기의 발생 빈도는 전 세계적으로 증가 추세에 있으며 한국에서도 중요한 공중 보건 문제로 대두되고 있다. 현재 가장 확실하고 유일한 식품 알레르기 치료법은 원인 식품의 섭취를 철저하게 제한하는 것이다. 그러나, 이 방법으로 치료를 진행하게 되면 환자에게 삶의 질 감소와 영양 불균형이라는 악영향을 가져다 줄 수 있다. 본 연구에서는 사용자가 입력한 정보들을 바탕으로 알레르기 원인을 분석하고, 증상 발생 통계 및 안전한 제품 정보를 제공하는 시스템을 개발하였다. 알레르기 관리 시스템을 통해 사용자의 편의성을 도모할 수 있고 기록된 식단, 증상 데이터들은 향후 알레르기 치료에 참고될 중요한 자료가 될 것으로 기대된다.

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