• 한국산학기술학회논문지
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• 제14권11호
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• pp.5819-5826
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• 2013

연구목적: 본 연구는 미국심장협회 ACLS provider course의 시뮬레이션기반 전문심장소생술 교육이 간호학생의 지식 및 수행능력에 미치는 효과를 검증하기 위함이다. 연구방법: 연구대상은 D대학 졸업학년 간호학생 22명이다. 수집된 자료는 SPSS/WIN 18.0 program을 이용하여 분석하였다. 연구결과: 시뮬레이션기반 전문심장소생술 교육을 받은 후 교육 전보다 간호학생의 지식 및 수행능력 점수가 유의하게 높아졌다. 결론: 시뮬레이션기반 전문심장소생술 교육은 간호학생의 지식 및 수행능력을 향상시키는데 효과적임을 검증하였으므로 간호학생 대상의 표준화된 응급간호 교육프로그램 개발에 기초자료를 제공할 수 있다고 본다. 또한 전문심장소생술 교육에 다양한 학습방법을 적용한 후 비교분석하는 후속연구와 지식 및 수행능력 지속성 연구와 같은 종적연구를 제언한다.

• 한국응급구조학회지
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• 제9권2호
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• pp.111-128
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• 2005

Background: Cardiac arrest is one of the most critical diseases which can likely lead to severe cerebral disability or brain death when the cases can not recover their circulation within 10 minutes. Saving out-of-hospital cardiac arrest cases is a recent concern in Korea. Resuscitation has become an important multidisciplinary branch of medicine, demanding a spectrum of skills and attracting a plethora of specialities and organizations. The best survival can be achieved if all the following links have been optimized : rapid access, and early CPR, defibrillation and ACLS, Since the "Utstein Style" was advocated in 1991, many reports about out-of-hospital cardiac arrest have been published based on this guideline. These differences prevent valid inter-hospital and international comparisons. However, it is not known how effective resuscitation has become to the patients. In other words, there are no guidelines for reviewing, reporting, and conducting research on resuscitation in Korea. This dissertation aims to provide the basic data for a unified reporting guideline of resuscitation in Korea and evaluating the out-of-hospital factors associated with survival discharge of out-of-hospital cardiac arrest. Methods: As for this study, uses the collected data about Out-of-hospital cardiac arrests at 4 area, from January, 2005 to April. 2005. With a retrospective study, 174 cases were analyzed. The data was recorded based on the Out-of-Hospital Utstein Style. Results: Resuscitation was performed on 174 out-of-hospital cardiac arrest cases at the 4 area 14 patients(8.1%) recovered their spontaneous circulation. Overall, the ROSC of the out-of-hospital cardiac arrest patients was 8.1%, which was poorer than that of western countries. Gender distribution was 50 females(28.7%) and 124 males(71.3%), approximately twice as many males as females. ROSC of witnessed arrests was found out to be 97.7%. The ratio of the witnessed arrest groups showed higher results than that of unwitnessed arrest groups in the above-examined cases. Cardiac etiology consisted of cardiac(33.5%), non-cardiac(45.7%), trauma(20.1%), and unknown(6.0%). Cardiac was the best performance. Initial rhythm showed Ventricular Tachycardia/pulseless Ventricular Fibrillation in 8 patients(6.0%), asystole in 100(75.2%) and unknown in 25(18.8%). The results of the Ventricular Tachycardia/pulseless Ventricular Fibrillation showed higher results than the others cases, The proportion of the cardiogenic cause was 33.5%, which was only half of western countries. Ventricular Tachycardia/pulseless Ventricular Fibrillation is relatively rare. These differences were due to the prevalent pattern of Out-of-hospital cardiac arrest as well as prematurity of the EMSS. Bystander CPR was practiced on 13 patients(7.52%). ROSC was shown in 46.2% cases. CPR by EMT was carried out on 167 cases(96.5%). ACLS by EMf was rare. From collapse, 4 cases(2.6%) arrived to ED within 6 minutes. 13 (8.6%) within 10 minutes, and 49(32.5%) over 31 minutes. The sooner the patients arrived, the greater the ratio of ROSC and discharged alive became, and the same with collapse time to ROSC. As the results of the logistic regression analysis, ROSC was found out to be highly influenced by the time of ED arrival from collapse and Ventricular Tachycardia/pulseless Ventricular Fibrillation. Therefore, the ratio of ROSC depends on not any single factor but various intervention factors. Conclusion: This dissertation presents the following suggestions and directions of the study hereafter. First, the first step for a chain of survival should be taken to activate EMSS early with a phone as soon as cardiac arrests are witnessed. Second, it is keenly needed that emergency medical technicians should be increased through emergency education for living. Third, it is necessary to establish the emergency transportation system. Fourth, most of the Koreans have little understanding of EMT and the present operation systems have many problems, which should be fundamentally changed. Fifth, it is required to have an active medical control over Out-of-hospital CPR, And proper psychological supports should be given not only to patients themselves and their family but also individuals who are engaged in emergency situation. Finally, through studies hereafter on nationwide, comprehensive, and standard forms, it is needed to examine into the biological figures of human body, causes and trends of cardiac arrests, and then, to enhance the survival rate of Out-of-hospital cardiac arrests. Korean guidelines for Cardiopulmonary resuscitation need to be made.

• 한국응급구조학회지
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• 제8권1호
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• pp.149-160
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• 2004

Background : To save out-of-hospital cardiac arrest cases is a major concern for Korea. Cardiac arrest is a very common problem, with > 18,000 cases dying each year in Korea. Overall, survival to hospital discharge remains poor. Resuscitation has become an important multidisciplinary branch of medicine, demanding a spectrum of skills and attracting a plethora of specialities and organizations. Since the "Utstein Style" was advocated in 1991, many reports about out-of-hospital cardiac arrest have been published based on this guideline. These differences prevent valid inter-hospital and international comparisons. However, we do not know the true effectiveness of resuscitation. There are no guideline for reviewing, reporting, conducting research on resuscitation in Korea. This study evaluated the out-of-hospital factor associated with survival discharge of out-of-hospital cardiac arrest, was especially to provide basic data for the unified reporting guideline of resuscitation in Korea. Methods : From January 1990 to July 2004, we collected data about out-of-hospital cardiac arrest at Wonju Christian Hospital(WCH-CAD), Ewha Women University Mokdong Hospital(Ewha-CAD), I used same record form based on the "Utstein Style". The "Utstein Style" is internationally recommended guidelines for reporting outcome data from resuscitation events. Results : Resuscitation was performed in 1443 out-of-hospital cardiac arrest patients at 2 hospitals. Five hundred eighty(40.25%) patients recovered the spontaneous circulation at least once and One hundred sixty eight(11.66%) patients discharged alive. Initial EKG showed Ventricular Tachycardia/Ventricular Fibrillation in One hundred thirty five(9.33%) patients, asystole in one thousand nine(69.73%) patients and other rhythms in one hundred thirty nine(20.94%) patients. Among one hundred two cardiogenic cardiac arrest patients, two(2.0%) patients was discharged alive. Conclusion : Overall survival rate of out-of-hospital cardiac arrest patients was 11.66% which was poorer than that of the western country. The proportion of the cardiogenic cause was 33.38% which was only half of the western country. VT/VF is relatively not common ac a initial EKG rhythm. These differences might be to due difference in the prevalence pattern of out-of-hospital cardiac arrest as well as prematurity of the EMSS. It is needed that the best survival can be achieved if all following links have been optimized : rapid access, early CPR, early defibrillation, early ACLS.

• 한국임상보건과학회지
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• 제2권1호
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• pp.35-45
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• 2014

Purpose: This study analyzes occupational therapy interventions to improve activities of daily living (ADL) in dementia patients and the instruments used to verify their effects through a systematic review and attempts to use the results as preliminary data in selecting further interventions and instruments. Method: The databases searched included NDSL, DBpia, RISS, KISS and National Assembly Library with search words including 'Alzheimer's disease', 'Alzheimer', 'daily living' and 'ADL.' The subjects of analysis were a total of 7 studies, and a frequency analysis was used for the usage count of the interventions used in each study. In order to provide evidence, PICO Method was used for sorting. Result: As a result of this study, there were 7 occupational therapy interventions applied to improve ADL in dementia patients, which were used 7 times total. As for the instruments used to validate the effects of the interventions for the ADL, it turned out that '3 studies used AMPS (42.9%),' which was the most, followed by 'Allen Cognitive Level Screen' (ACLS) and Functional Independence Measure' (FIM), respectively used in 2 studies (28.6%); and 'Modified Barthel Index' (MBI) and 'Philadelphia Geriatric Center IADL' (PGC IADL), respectively used in 1 study. Regarding the qualitative level of evidence, it turned out that 4 studies were Level III (57.1%), followed by 2 studies at Level IV (28.6%) and 1 study at Level I (14.3%). Conclusion: This study suggested the kinds and frequencies of usage of the interventions and instruments of occupational therapy for the improvement of ADL in dementia patients, and the studies of evidence were presented by the PICO Method. It is judged that the results of this study can be used as preliminary data in selecting interventions and instruments to improve the ADL in dementia patients. In the future, studies should be carried out on the ADL in other areas related to dementia.

• 한국응급구조학회지
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• 제14권2호
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• pp.13-24
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• 2010

Objective : The purpose of this study is to understand the status of continuing education of the EMTs of the Korean fire department, to identify demand of them for content, method, and forms of the education, and to present basic data for developing more efficient, effective continuing education programs. Methods : The subjects of this study were 850 of the EMTs of the Korean fire department who work for fire stations located in Seoul and part of Gyeonggi-do and directly provide critical care in the field. The data was collected between February 8 and 28, 2010. Using SPSS 17.0 program, we obtained frequencies percentages, means, and standard deviations, and performed independent two sample t-test, one way ANOVA, and Cronbach's ${\alpha}$. Results : 1) As for status of the existing continuing education for of the EMTs of the Korean fire department, in general, the hour of each education was "less than four hours" (51.2%), the instructors of the education were "doctors" (65.2%), the method of the education was "lecture" (83.3%), the material for the education was "educational materials and slides" (97.2%), and the results from the education were "not helpful in job" (55.1%). 2) The effects of the EMTs of the Korean fire department were mean 2.44(${\pm}.51$), the ability was mean 2.40(${\pm}.50$), and the attitude was mean 2.49(${\pm}.57$) points. 3) As for the demands of the EMTs of the Korean fire department on the next continuing education, they preferred "the advanced cardiac life support(ACLS)" ($2.64{\pm}.62$) most in subject content, "investigating the demands of 119 emergency medical technicians annually" (44.1%) in methods to select subjects of the continuing education, "doctors and professors of Department of Emergency Medical Technology" in instructors of the education (190 persons, or 39.9%), "lectures with practices" in methods of the education (30.1%), and "One per year" (41.6%) and "less than four hours" (67.2%) in the period and hours of the text continuing education they hope. Conclusion : The continuing education for the EMTs of the Korean fire department conducts without accepting the demands of the technicians, In planning of the next continuing education, the results of this study suggest that it is needed to develop more various and professional educational program by active acquisition of the demands of the technicians.

• 한국응급구조학회지
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• 제1권1호
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• pp.28-41
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• 1997

The purpose of this study was to identify the change of perceptions related to E.M.T. profession of E.M.T. student and to provide the basic data for development of curriculum. The subjects of the survey were 216 students from 3 junior college by questionaire from November 25 to November 29, 1996 in Kwang-Ju, Cheong-Ju, and Kong-Ju. The results were analyzed using the SAS and can be summerized as follows : 1. The view on profession was a statistically significant difference inspecial knowledge & skill training (t=-1.686, P<.001), high income (t=-0.753, P<.05) 2. The view on competence as a E.M.T. was a statistically significant differncein sufficient professional knowledge on the E.M.T. (t=-1.144, P<.001), own's health (t=-0.808, P<.001), sincerity and responsibility (t=-1.429, P<.01), satisfaction and effort (t=-1.335, P<.01), boundary of affairs (t=-1.356, P<.01) 3. The view on E.M.T. profession was a statistically significant difference inprotect of pt. life & to relieve the pain (t=-2.388, P<.001) 4. The view on necessary knowledge of E.M.T. was a statistically significant difference in patient assessment (t=-2.168, P<.001), ACLS (t=1.678, P<.001), hemorrhage & shock (t=-3.252, P<.001), trauma (t=-4.284, P<.001), cardiopulmonary disturbance (t=-2.897, P<.001), acute abdomen (t=-4.284, P<.001), neonatal disease (t=-4.032, P<.001), OBGY disease(t=-4.151, P<.001), emergency delivery (t=-2.825, P<.001), infectious disease (t=-2.930, P<.001), environmental emergency (t=-3.123, P<.05), recording(t=2.22, P<.05) 5. The view on ideology of E.M.T. was a statistically significant difference in belief & faith (t=-2.344, P<.001), knowing of own (t=-2.142, P<.01), humanity (t=-2.581, P<.05), knowing of patient (t=-2.079, P<.05).

• Journal of Korean Biological Nursing Science
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• 제4권1호
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• pp.25-39
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• 2002

본 연구는 임상간호사의 심폐소생술에 대한 지식과 기술을 향상시키기 위해 웹 기반의 교육 프로그램을 개발하고 평가하는 데 목적이 있다. 2002년 2월 1일부터 4월 30의 기간동안 류세앙(1999)이 수정한 프로그램 개발과정에 의해 분석, 설계, 자료수집 및 개발, 프로그래밍 및 구현, 평가를 거쳐 웹 기반의 심폐소생술 간호교육 프로그램을 개발하였다. 본 연구의 결과는 다음과 같다. 1) 본 프로그램은 심폐소생술의 의의와 중요성, 기본심폐소생술, 장기심폐소생술, 소생술 후 간호를 학습내용으로 하여 텍스트 자료, 사진, 그림, 동영상 자료 등을 나모 웹 에디터, 스캐너, Adobe photoshop 등을 이용하여 인터넷 파일 제작과 이미지 수정단계를 거쳐 FTP(File Transfer Protocol)을 이용하여 웹에 올리고 시범운영을 통해 최종 수정하여 완성된 프로그램이 개발되었다. 2) 평가단계에서는 D시내에 소재한 K대학병원에 근무하는 간호사 36명을 임의표출하여 프로그램을 사용한 후의 반응을 조사하였다. 이에 대한 결과는 다음과 같다. 학습교재 관련특성의 평점은 $4.2{\pm}.67$, 학습 시스템 관련특성의 평점은 $4.0{\pm}.79$점, 학습자 만족도 관련특성에 대한 반응에서 학습자의 만족도는 $4.2{\pm}.58$점, 다른 교육 프로그램의 개발필요성은 $4.3{\pm}.62$점을 얻어 총평점은 $4.1{\pm}.45$점이었다. 특히, 멀티미디어 자료의 적절성은 $4.3{\pm}.68$점, 다른 교육 프로그램의 개발필요성은 $4.3{\pm}.62$점이었고, 화면구성과 배색의 적절성에서 $3.8{\pm}.81$점, 화면크기와 글자크기의 적절성에서 $3.7{\pm}.81$점이었다. 이상의 결과를 볼 때 프로그램 평가에 대한 분석작업을 거쳐 교육 프로그램의 지속적인 업그레이드 작업이 이루어진다면 본 웹 기반의 간호교육 프로그램이 간호사들의 계속교육과 평생교육에 활용될 수 있는 효과적인 교육 프로그램이 될 수 있으리라 사료된다.

• Investigative Magnetic Resonance Imaging
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• 제11권1호
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• pp.27-32
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• 2007

목적 : 슬관절 퇴행성 관절염으로 수술을 시행한 환자에서 앞십자 인대의 점액 변성을 MRI 소견과 병리 소견과 연관지어 알아보고자 한다. 대상 및 방법 : 슬관절 치환술 전 MRI검사를 시행한 17명의 환자 (평균나이 68.8세) 를 대상으로 하여 시상면과 관상면 양자 밀도 강조 영상에서 앞십자 인대의 두께와 신호강도를 평가하였다. 검사후 1-2일 이내에 편측 슬관절 치환술을 시행하였고 병리학적 검사를 통해 앞십자 인대의 점액변성을 세 단계로 구분하였다. MRI 검사상 두께와 신호강도는 정상과 증가로 구분하였다. 결과 : MRI 상 신호 강도의 증가 없이 두께가 증가된 예는 없었다. MRI에서 두께 증가를 보인 4예 모두에서 병리 소견상 점액변성이 관찰되었고, 신호강도의 증가를 보인 8예 모두에서도 점액변성이 관찰되었다. 하지만 MRI에서 정상 소견을 보였던 9예에서도 10% 이상의 단면적에서 점액변성이 관찰되었다. 5예에서는 조직학적으로 석회화를 보였다. 결론 : MRI상 앞십자 인대의 두께 증가나 신호 강도 증가를 보인 8예 모두에서 병리 소견상점액 변성이 관찰되었다. 하지만 MRI에서 정상 소견을 보인 9예에서도 점액 변성이 관찰되었으므로, MRI에서 소견이 보이지 않는다고 하여 점액변성이 없다고 판단할 수는 없다고 생각된다.