• 제목/요약/키워드: Advanced general hospital

검색결과 296건 처리시간 0.036초

Late-term effects of hypofractionated chest wall and regional nodal radiotherapy with two-dimensional technique in patients with breast cancer

  • Yadav, Budhi Singh;Bansal, Anshuma;Kuttikat, Philip George;Das, Deepak;Gupta, Ankita;Dahiya, Divya
    • Radiation Oncology Journal
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    • 제38권2호
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    • pp.109-118
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    • 2020
  • Purpose: Hypofractionated radiotherapy (RT) is becoming a new standard in postoperative treatment of patients with early stage breast cancer after breast conservation surgery. However, data on hypofractionation in patients with advanced stage disease who undergo mastectomy followed by local and regional nodal irradiation (RNI) is lacking. In this retrospective study, we report late-term effects of 3 weeks post-mastectomy hypofractionated local and RNI with two-dimensional (2D) technique in patients with stage II and III breast cancer. Methods: Between January 1990 and December 2007, 1,770 women with breast cancer who were given radical treatment with mastectomy, systemic therapy and RT at least 10 years ago were included. RT dose was 35 Gy/15 fractions/3 weeks to chest wall by two tangential fields and 40 Gy in same fractions to supraclavicular fossa (SCF) and internal mammary nodes (IMNs). SCF and IMNs dose was prescribed at dmax and 3 cm depth, respectively. Chemotherapy and hormonal therapy was given in 64% and 74% patients, respectively. Late-term toxicities were assessed with the Radiation Therapy Oncology Group (RTOG) scores and LENT-SOMA scales (the Late Effects Normal Tissue Task Force-Subjective, Objective, Management, Analytic scales). Results: Mean age was 48 years (range, 19 to 75 years). Median follow-up was 12 years (range, 10 to 27 years). Moderate/marked arm/shoulder pain was reported by 254 (14.3%) patients. Moderate/marked shoulder stiffness was reported by 219 (12.3%) patients. Moderate/marked arm edema was seen in 131 (7.4%) patients. Brachial plexopathy was not seen in any patient. Rib fractures were noted in 6 (0.3%) patients. Late cardiac and lung toxicity was seen in 29 (1.6%) and 23 (1.3%) patients, respectively. Second malignancy developed in 105 (5.9%) patients. Conclusion: RNI with 40 Gy/15 fractions/3 weeks hypofractionation with 2D technique seems safe and comparable to historical data of conventional fractionation (ClinicalTrial.gov Registration No. NCT04175821).

아토피 피부염 증례 연구 분석 - 한약 처방을 중심으로 - (Analysis of Case Studies of Treating Atopic Dermatitis - focusing on Korean Herbal Medicine Used in Cases -)

  • 한창이;박중군;강동원;박소영;김봉현;김윤범;김규석
    • 한방안이비인후피부과학회지
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    • 제32권3호
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    • pp.151-163
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    • 2019
  • Objectives : The purpose of this study is to investigate the use of herbal medicine for the treatment of atopic dermatitis in cases and to find the general tendency of herbal medicine treatment and to establish the primary treatment direction of Atopic dermatitis. Methods : In the domestic databases, Oriental medicine Advanced Searching Integrated System(OASIS), Korean Traditional Knowledge Portal(KTKP), National Discovery for Science Leader(NDSL), Research Information Sharing Service(RISS), we selected among the papers published in the last 20 years using search terms related to "Atopic dermatitis & Cases". Reports based on Sasang constitutional medicine and Six meridian pattern identification were excluded and a total of 21 papers were finally selected. Results : 113 herbal medicines were retrieved from 21 papers. The most commonly used herbs are Scutellariae Radix(黃芩), Rehmanniae Radix(地黃), and Glycyrrhizae Radix et Rhizoma(甘草). Atractylodis Rhizoma(蒼朮), Akebiae Caulis(木通), Smilacis Rhizoma(土茯?), Paeoniae Radix(芍藥) used mostly when Oozing exists, Trichosanthis Radix (瓜蔞), Asparagi Radix(天門冬), Persicae Semen(桃仁), Carthami Flos(紅花) used mostly when Dryness, Lichenification, and Pigmentation exist. The average score of SCORAD index was improved after Herbal medicine treatment. Conclusion : Through this study, we could find out the tendency of herbal medicine to treat Atopic dermatitis along with Symptoms.

치과의사를 위한 노이즈 필터링 이어플러그의 청력 보호 효과에 관한 연구 (A Study on the Hearing Protection Effect of Noise-Filtering Earplugs for Dentists)

  • 조다영;김익환;이태양;신승호;정진세;박원서;송제선
    • 대한소아치과학회지
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    • 제50권3호
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    • pp.239-251
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    • 2023
  • 이 연구는 소음이 유발되는 진료 시 노이즈 필터링 기능이 있는 이어플러그를 착용하고 업무를 시행하여 노이즈 필터링 이어플러그가 치과의사의 청력에 미칠 수 있는 영향에 대해 조사하였다. 연구 대상자의 청력을 평가하기 위해 순음 청력 검사와 변조이음향방사 검사를 첫 내원 시와 1년 후 측정하였다. 연구 결과, 이어플러그를 착용하지 않은 군에 비해 이어플러그를 착용한 군의 순음 청력 역치 평균값이 유의미하게 감소하여 청력이 호전되는 모습을 보였다. 그러나 변조이음향검사의 신호대잡음비는 유의미한 차이를 보이지 않았다. 이러한 결과는 노이즈 필터링 이어플러그가 청력 손실을 예방하는 데 일부 효과적일 수 있다는 것을 보여준다. 그러나 1년간의 관찰 기간은 청력 변화를 충분히 확인하기에 어려울 수 있으므로, 추적 기간을 늘린 후속 연구가 필요할 것으로 보인다.

Analysis of the annual changes in dental institutions that claimed dental sedatives in Korea and the types of sedatives using health care big data

  • Minjae Lee;Seong In Chi;Hyuk Kim;Kwang-Suk Seo
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제23권2호
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    • pp.101-110
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    • 2023
  • Background: Dentists make various efforts to reduce patients' anxiety and fear associated with dental treatment. Dental sedation is an advanced method that dentists can perform to reduce patients' anxiety and fear and provide effective dental treatment. However, dental sedation is different from general dental treatment and requires separate learning, and if done incorrectly, can lead to serious complications. Therefore, sedation is performed by a limited number of dentists who have received specific training. This study aimed to investigate the proportion of dentists who practice sedation and the main sedatives they use in the context of the Republic of Korea. Methods: We used the customized health information data provided by the Korean National Health Insurance. We investigated the number of dental hospitals or clinics that claimed insurance for eight main sedatives commonly used in dental sedation from January, 2007 to September, 2019 at the Health Insurance Review and Assessment Service. We also identified the changes in the number of dental medical institutions by region and year and analyzed the number and proportion of dental medical institutions prescribing each sedative. Results: In 2007, 302 dental hospitals prescribed sedatives, and the number increased to 613 in 2019. In 2007, approximately 2.18% of the total 13,796 dental institutions prescribed sedatives, increasing to 3.31% in 2019. In 2007, 168 institutions (55.6%) prescribed N2O alone, and in 2019, 510 institutions (83.1%) made claims for it. In 2007, 76 (25.1%) hospitals made claims for chloral hydrate, but the number gradually decreased, with only 29 hospitals (4.7%) prescribing it in 2019. Hospitals that prescribed a combination of N2O, chloral hydrate, and hydroxyzine increased from 27 (8.9%) in 2007 to 51 (9%) in 2017 but decreased to 38 (6.1%) in 2019. The use of a combination of N2O and midazolam increased from 20 hospitals (6.6%) in 2007 to 51 hospitals (8.3%) in 2019. Conclusion: While there is a critical limitation to the investigation of dental hospitals performing sedation using insurance claims data, namely exclusion of dental clinics providing non-insured treatments, we found that in 2019, approximately 3.31% of the dental clinics were practicing sedation and that N2O was the most commonly prescribed sedative.

폐암의 방사선치료 결과 (Result of Radiation Therapy for the Lung Cancer)

  • 김주영;최명선;서원혁
    • Radiation Oncology Journal
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    • 제7권2호
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    • pp.213-225
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    • 1989
  • An analysis has been made of two hundred seven patients who were treated at the department of Radiation Oncology of Korea University Hospital for lung cancer from January 1981 through December 1986. There were 137 patients of nonsmall cell carcinoma (137/207, 66%), 26 patients of small cell carcinoma (26/207, 12.5%) and 44 patients of unproven histology. By aims of treatment, there were 104 patients (104/207, 50%) treated for cure, 89 patients (89/207, 42.9%) for palliation and 14 patients treated postoperatively. In 22 out of 207 patients, chemotherapy was done with radiotherapy, 12 of which were patients with small cell carcinoma. Stage II patients were 49 (49/207, 23.6%), stage III patients were 157 (157/207, 75.8%) and one patient had an occult cancer The tumor was initial Iy measured by CAT scan and chest X-rays in the 165 (165/207, 79.7%) patients, among which 117 patients had tumor diameter more than 5cm and 48 patients less than 5cm. Radiation therapy was given with Cobalt 60 teletherapy unit and the treatment volume encompassed primary tumor and the mediastinum. For curative aim, daily tumor dose of 180 cGy was given up to the range of 5,400~6,120cGy/30~34F/6~7 week period and for palliative aim, daily tumor dose of 300 cGy was given up to the range of 3,600~4,500 cGy/12~15F/2~3 week period. Postoperatively, mediastinum was treated for total dose of 5,040 cGy/28F/5.5 week period. 123 patients (123/207, 59%) were followed up after completion of radiotherapy for 14 months to 7 years. Local tumor response to the irradiation was measured by chest X-ray taken at one month follow up and was evaluated for response rate, if they were regressed more than 50% or less than 50% of the initial tumor size. The treatment results were as follows; 1. The median survival time was 8.5 months and survival rates for 1 year, 2 year and 5 year was 25%, 3.5% and 1% of nonsmall cell lung ca of 74 evaluable patients. 2. More than 50% of local tumor response rate was obtained in about half of overall cases; 90.5% for small cell ca, 50% for squamous cell ca, 25% for adenoca and 57% for large cell ca. 3. Response rate more than 50% was seen in the 50% of the patient group with tumor diameter more than 5cm and in the 55% of those with tumor diameter less than 5cm. 4. By total raidation dose given, patient group which was given 5,400~6,120 cGy equivalent dose or higher showed tumor response rate more than 50% in 53% of the patients, whereas the group with dose less than 5,400cGy equivalent, in 25% of the patients. 5. Survival rate for 6 month, 1 year and 2 year was compared between the group of local tumor response rate more than 50% vs. group with response rate less than 50%; 74% vs. 43%, 33% vs, 23%, 10% vs. 1%, respectively. 6. Local failure was seen in 21%(44/207) of the patients, which occured mostly within 15 months after completion of radiation therapy. Distant metastases were seen in 49.7%(103/207) of the patients, of which 43 cases were found before initiation of radiotherapy. The most common metastatic sites were bone and brain. In this sutdy, 1 year,2 year and S year survival rates were somewhat poor compared to the other studies. It mainly seems to be due to the poor general status of the patients and the far-advanced stage of the disease. In nonsmall cell cancer patients who had limited local disease and had small primary tumor size, we observed better local response. In addition, dose higher than 6,000 cGy group showed better tumor control than lower dose group. Survival rate was better for the local control group. For imporvement of local control of the lung cancer and hence, the survival of the patients with lung cancer, proper radical radiotherapy with high dose for localized disease is needed. New modality of treatment such as high LET beam in radiation therapy or drugs for the advanced disease as well as early diagnosis is also needed.

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한.중 간호교육제도 및 교육과정 비교연구 (Comparative Study on Nursing Education System of Korea and China)

  • 문희자;김광주;박신애;김일원;박화순
    • 동서간호학연구지
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    • 제7권1호
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    • pp.32-47
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    • 2002
  • This study is a descriptive comparative investigated one to analyze nursing education system and curriculum of Korea and China trans-culturally. 1) Education System The basic level of nursing education in Korea consisted of 65 3-year- junior college of nursing (7379 students) and 48 4-year-bachelor of nursing college (2345 students) in 2000 showing more 3-year-junior college of nursing and its students. In China, western nursing as well as Chinese nursing education system were operating. In 2000, 501 western school of middle technical nursing, 29 school of middle technical nursing of middle level education, and 89 3-year western and 24 Chinese junior college of nursing, and 42 4-year western bachelor of nursing college and 10 Chinese of high level education have been established. The presence of Chinese school of middle technical nursing system seemed to be in slower development in nursing than Korea, but that of Chinese nursing education seemed to be advanced with its national identification prior to Korea. Post graduate continuous education for RN-Diploma and RN-BSN program has been opened as in Korea. The Hosa(護士) system in school of middle technical nursing in China reflects lower level of education than Korea. But it can be a merit, other than in Korea, without nurses aids, when they are acting under supervision of nurses and led by them, and there presents a special course for promotion up to high level education. Graduate school in Korea is divided into general type opening a curriculum for MS in 1960 and as of 2000, 21 general types for majoring in nursing. The PhD course in Korea was established in 1978, and after that the PhD courses have been opening in 14 universities at present. China established master degree course in 1991 and as of 7 colleges are ongoing, and the doctoral course is now under planning, resulting slower development than Korea. 2) Education of theory and clinical practice in Korea and Chine (1) Korea's 3-year junior nursing college have 51 subjects, 49 subjects in China, which was not different. China was following education of ideology and medical. 4-year Bachelor of Science College has 92 subjects in Korea with cultural subjects and essential major studies/elective in theory education in Korea, while 63 subjects in China, showed wider selection in Korea's education. (2) Korea's 3-year and 4-year nursing colleges performed clinical practice education parallel with theoretical education for a certain period, block or theory/practice system. While China's 3-year and 4 or 5-year-colleges educated the theory first and then practice for one year in the last grade, integrating each situation of the departments and the theory. (3) Korea's oriental nursing theory in nursing education was performed in 28 colleges of 65 nationwide ones of 3-year junior nursing colleges, but only one school was educating clinical practice. In 4-year bachelor of nursing colleges, the oriental nursing theory was done in 14 among 48 investigated. And 1-4 subjects of them were doing, and 4 schools performed of clinical practice, showing more reinforced than the junior colleges. China's 3-year and 4-5-year western nursing colleges taught two subjects of Chinese medicine nursing. China's 3-year & 4-5-year College of Chinese medicine nursing, theory of Chines medicine nursing education taught eight subjects. (4) 5-year colleges of Chinese medicine western integrated nursing, theory of Chinese medicine nursing education consisted of twelve Chinese medicine nursing subjects and two of Chinese medicine western integrated nursing subjects. China was tempting a new development of a pattern of Chinese medicine nursing subjects reinforced. 3) The verification of Korean and Chinese nurse's license. The verification test of Chinese nurses license is differentiated at the level of education other than in Korea. Expire date is 2 years and a qualified test must be done to a renewal. And the continuing education hours are 72 per year, which is more enforced than Korean nurses (10 hours a year). In accordance with WTO regulations, we should prepare for opening foreign hospital, educating oriental nursing subjects. And on this, it is recommendable to settle a basic frame research to run the oriental nursing practice ongoing. 1. It is desirable to develop the oriental nursing subjects to apply its idea to the western nursing and differentiate Korean nursing. 2. It is desirable to certify oriental nurse's characters, to expand and develop the nursing areas to practice it, and to establish the oriental nursing system. 3. It is expectable to promote Korean nursing specialization to develop the oriental nursing as a professional and to create its demand.

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중환자실 간호사들의 DNR에 대한 윤리적 태도 (ICU nurses' ethical attitudes about DNR)

  • 유은영;양유정
    • 한국산학기술학회논문지
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    • 제16권4호
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    • pp.2691-2703
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    • 2015
  • 본 연구는 중환자실 간호사들의 DNR에 대한 윤리적 문제의 인식과 태도를 파악하여 DNR 환자간호에 도움이 되는 기초자료로 활용하고자 시도하였다. G광역시 상급종합병원 1개소, 전라 남 북도 700병상이상 종합병원 각각 1개소 중환자실에 근무하는 간호사를 대상으로 2014년 8월 1일 부터 9월 5일까지 설문조사하여 154부를 최종분석 하였다. 첫째, DNR 결정 태도는 치료를 거부하는 환자의견에 반대, 예후가 좋지 않은 환자라도 생명의 연장에 찬성, 환자가 원했을 경우 어떠한 상태라도 DNR 미실시, 보호자의 요구에 의한 치료와 가망 없는 환자의 CPR실시에 반대하였다. 둘째, 환자가족에 의한 인공호흡기 및 다른 치료의 적극적 실시에 반대, 보호자의 중환자실 입실에 대립적인 입장을 보였다. DNR 환자에 대해 의사의 인공호흡기의 소극적 사용에 찬성, 환자의 신체적 심리적 안정을 위해 기본적인 간호도 줄여야 하고, 무균술을 지키지 않은 처치에 묵인하는 입장이며, 가족에 의한 환자의 상태변화를 주치의에게 여러 차례 보고하는 것에 반대하였다. 셋째, 의사의 관심감소를 인정하고, 이에 보호자의 항의가 있을 때 의료팀을 옹호하며, DNR 결정을 주치의가 내린 것에 대립적인 입장이며, DNR 지침에 따른 결정에 반대하였다. 예후가 좋지 않은 환자에게 그대로 설명하는 것에 반대 또는 중립적이며, 환자나 보호자에게 환자상태를 있는 그대로 설명하는 것과 사망에 가까운 경우 환자나 보호자에게 상태를 그대로 설명하는 것에 반대하였다. 결론적으로 DNR 주체는 환자이며, 환자의견이 충분히 반영 되어야 하며, 의료행위의 범위와 결정과정에서의 갈등을 최소화하고 환자중심의 윤리적 의사결정이 되도록 DNR 결정에 대한 표준과 지침이 필요하며, 충분한 설명을 근거로 한 동의가 이루어 져야하겠다.

일체형 방어벽 제작을 통한 이동형 엑스선 발생기의 차폐능 평가 (Shielding Capability Evaluation of Mobile X-ray Generator through the Production assembled Shield)

  • 김승욱;안병주
    • 한국방사선학회논문지
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    • 제12권7호
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    • pp.895-908
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    • 2018
  • 의료방사선의 관리에서 가장 중요한 사항은 진료의 적정성을 확보하면서 방사선위해를 최소화하는 것이다. 국제원자력기구는 진단방사선 분야의 선량 감소 방법에 대한 지침서를 만들어 환자피폭선량을 측정하여 각 국가에 사용하도록 권고하고 있다. 또한 국내에서도 우리나라의 실정에 맞게 각 촬영마다 환자 피폭 선량값을 연구하여 진단참고준위를 제시하였다.환자가 질병 때문에 방사선 진료를 받는 것은 방사선 때문에 일어날 수 있는 위해보다 그것으로 얻어지는 이익이 크기 때문이다. 병실 이동검사와 같이 자신의 질병과 무관하게 방사선에 노출되는 환자 및 보호자들의 피폭을 줄이기 위해서는 환자, 방사선사, 의사 및 의료기관의 노력이 가장 중요하다.이에 본 연구에서는 개선방안의 일환으로 MG로 병실의 이동 검사에 대한 문제점을 제시하고 이 문제점을 근거로 하여 산란선으로 예상되는 공간선량률을 분석하였다. MG에 자체 개발한 방어벽을 설치하여 방어벽 설치 전후의 공간선량률을 측정하여 그 감소율을 분석하였다. 최종적으로 이 자료들을 종합하여 MG에 방어벽을 부착하여 방사선사의 병실이동에 대한 부담감의 최소화, 병실 이동검사로 인한 방사선사, 환자 및 보호자를 방사선 노출로부터 보호하고, 검사로 인한 주위 환자 및 보호자의 불편을 최소화하는데 의의가 있다. 이와 같은 개선안에 대해 보다 효율적인 시행을 위하여 MG에 대한 새로운 법 제도가 마련되면, 향후 예상되는 비용, 인력, 고객만족도 및 더욱 더 안정적인 피폭감소방안이 정착될 것이라 사료된다.

중국(中國) 지방사회(地方社會)와 불교사원(佛敎寺院) 그리고 승인(僧人)의 상호(相互) 영향(影響)에 관한 일고(一考) (On the Influence Each Other Between the Monks in the Buddhist Temples and the Society in Towns or Villages)

  • 옌야오중
    • 헤리티지:역사와 과학
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    • 제45권3호
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    • pp.60-79
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    • 2012
  • 고대 중국 불교사원이 있는 환경은 향촌(鄕村), 명산(名山), 도시(都市) 세개의 유형으로 나눌 수 있다. 이는 또한 사원이 존재하는 환경의 차이를 만들며 이로써 불교의 발전에 영향을 미쳤고 또한 사원과 사회관계의 다른 유형을 만들었다. 본고는 향촌 사회가 사원과 승려뿐 아니라 불교의 존재와 발전에 가져온 각종 이해(利害)에 대해 설명한다. 사원이 사회구조 속에서 다른 환경적 위치, 즉 도시와 향촌에 놓였을 때 그들은 결국 다른 외재적(外在的) 내재적(內在的) 사회적 응성을 발생시킬 수 밖에 없다. 중국 고대 불교사원은 위에 말한바와 같이 향촌, 명산, 도시에 위치하고 있으나 동진십육국 이후 사원이 크게 늘고 명산이 사원과 승려의 집중지가 됨에 따라 명산과 도시의 사원은 비슷한 양상을 띠며 발전한다. 그러나 향촌의 사원은 이와는 좀 다른 영향을 받고, 비쳤으므로 그를 중심으로 서술하고자 한다. 향촌 지역의 사원과 승려들이 서로 미치는 영향은 크게 네가지가 있다. 첫째, 향촌의 승려들은 그 지역, 혹은 그 부근으로부터 왔기 때문에 사회와 비교적 친밀한 관계를 형성한다. 그러므로 향촌 지역의 세력은 사원 승려집단이 구성하는 영향력을 제한한다. 둘째, 향촌 사원은 지방경제에 의탁하며 서로 동고동락 하였다. 향촌의 사원은 그 사회의 공공장소가 되었고 종종 시장 소재지가 되기도 하였다. 사실 사찰의 축조와 존재는 원래 지역 경제에 있어 하나의 추동력이 되었다. 왜냐하면 사찰건물 축조에는 공장(工匠)과 재료가 필요하며 어떤 절은 향객(香客)과 향촉(香燭) 소비 등에서 모두 많게든 적게든 상품 경제를 대동하기 때문이다. 그리고 소재 향촌이 어떤 자연재해 혹은 인재를 만나거나 수확이 좋지 않거나 경제가 불황일 때는 승려들이 흩어져 사원 또한 존속할 수 없는 결과를 낳기도 하였다. 셋째, 향촌 사원과 신도들의 관계는 도시와 명산의 사원과 구별된다. 왜냐하면 중국에서 사원은 승려들이 수행하는 장소일뿐 아니라 일반 가신도(家信徒)들이 조배(朝拜)하는 장소이기 때문에 그 주위엔 항상 많은 신도 무리가 있었기 때문이다. 넷째, 향촌 불교와 지방 민간신앙의 결합은 꽤 큰 정도로 불교의 민간화를 주도하였다. 이것은 하나의 상호작용 과정이다. 불교가 가지고 있는 전국성(全國性) 종교로서의 우세(優勢) 때문에 종종 지방특색을 가지고 있는 숭배는 불교 신앙으로 바뀌거나 불교 적색채에 물들었다. 향촌의 사원은 현지 사회와 밀접한 관계를 유지하면서 지방의 영향을 받음과 동시에 또 영향을 주기도 하였다. 대표적으로 향촌에서 비교적 문화가 발달된 곳으로서의 각종 문화와 관련된 시설 - 예를들어 학교, 병원 등 - 의 역할을 대신하여 모범 행동을 보이기도 하였다. 사찰이 향촌의 장례(葬禮)에 미친 영향도 매우 컸다. 중국인의 분묘(墳墓)는 주로 향촌에 세워졌는데 도시에 사는 사람이더라도 죽은 후에는 본적(本籍)으로 돌아와 묻히거나 적어도 도시가 아닌 교외(郊外)에 묻혔다. 향촌의 사찰은 일반적으로 장사 치르는 일에 참여하였다. 이상은 대다수의 유명한 불교 사찰은 명산에 있는것이 아니라 도시에 있음에도 불구하고 사원의 다수는 오히려 광대한 향촌에 있으며 그들은 향촌 사회와의 상호 융합을 통하여 90%이상의 중국 민중과 연결되어 있으며 불교가 중국에서 가장 중요하게 존재하는 기초가 되었음을 표명한다. 향촌 사원과 현지 사회 민중간의 상호 영향은 전방위(全方位)적인 것이며, 많게 혹은 적게 사회 생활 각 방면에 파급되었다. 향촌 지역에 이렇듯 사묘(寺廟)가 시(時) 공간(空簡)적으로 광범위하게 분포해 있는 것은 불교 사원과 중국 고대 농촌 사회의 긴밀한 결합을 설명하기에 족하다.

1차 및 3차 진료기관 이용 만성질환자의 간호서비스에 관한 연구 (A Study on Nursing Service of Chronic Diseases by the First Step and Third Step Medical Treatment)

  • 조종숙
    • 한국보건간호학회지
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    • 제10권2호
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    • pp.103-118
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    • 1996
  • It is to be growing up the interest of community health affairs through visiting nursing care. The health medical treatment of Korea has been changed largely on the period. The juvenile population has decreased. This means that is has took the population consensus of advanced national organization to be increased by the old age. The transition of disease has changed from the contagious disease importance to the chronicity disease omportance because the domestic district population has experienced the sudden urbanization circumstance district population has experienced the sudden urbanization circumstance to be growing up $70\%$ of the whole population. When the nursing service has common function to be delivering from all direction to home, this study is getting the great important phase velocity in order to manage the kernel questional adult chronicity disease of health medical institution at the present age. (1) community over system or with people particularity (2) the first of third step medical treatments. The variety of medical treatments organization has quantity of the delivery manpower and specially between consumers and rdlated person. A qualitative difference is showed at the purpose to be seizing. That research related person is use at district health center in Seoul, by foundation on nurse registration book of H collage hospital and public health registration book. According the chronicity disease. age. and sex. nature agree-able standard 54 people took the content analysis on nurse registration book of total 108 people. The results of the study were as follows: 1. General background factors are houses or kind of medical facilities and number of patients in family. The first medical treatment is more patients than third medical treatment organization. The first medical treatment of economic environment os appering to be worse. 2. The chronicity disease frequency have been different speciality according to medical treatment organization. On case of the first medical treatment. Diabetes and High Blood Pressure were good but Cerebrum Vascular Accident(CVA) showed many for bed case. In addition. the number of family is comparative large exception of CVA on according for moving condition and health more than the first medical treatment. However. family condition. whole family percentage is decreasing preferably through the potential resource is increasing by the number of and the construction of family. The ability of real resource is considered to be low. 3. The average percentage of nurse service has appered to be differed two groups by the first step medical treatment(33.72 times) and third step medical treatment(45.70 times). However, the difference (the first step medical treatment and third step medical treatment) is to be limited to issue the medicine at the service. The condition of nurse care was the indirect nursing care. Supportiong area was to be related to volunteer service and administration support. 4. The various nursing care average percentage of the chronicity disease was increased by orders of Diabetes. High Blood Pressure. and CVA in examination result and the medical treatment. The indirect nursing care was also same. At third step medical treatment, orders of chronicity disease were same. The case of other area on service conditions were increased by order of Diabetes. High Blood Pressure, and CVA. However. it is never appearing the difference at bottleneck affairs nursing care. 5. When the visiting nursing care demand particularly. the average percentage of nursing care from the first step medical treatment that the time under a person is many more than the time over two people. However, there was no difference in statistic. Third step medical treatment is $49.81\%$ at the time under a person. The average nursing care service is appeared by more many when the visiting nursing care demand is a few by 12.83 at the time over two people. 6. By visiting nursing care percentage to be frequency that nursing care averaghe percentage and inter-relation are large. The related factor of the first medical treatment is 0.96. However, the related factor of third medical treatment has shown the decreased 0.49 for the condition of relation more than that. Therefore. the nursing care average percentage is related to the visiting times of a nurse. This result is be showing the obvious fact that the first step medical treatment is few more than third step medical treatment.

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