• 제목/요약/키워드: Care Facilities

검색결과 1,654건 처리시간 0.031초

대구지역 요양병원 입원노인의 식품선호도 및 영양소 섭취 실태 조사 (Survey of the Food Preferences and Nutrient Intakes of Elderly People Hospitalized in a Nursing Hospital in Daegu)

  • 박주연;김은정
    • 대한영양사협회학술지
    • /
    • 제30권1호
    • /
    • pp.41-60
    • /
    • 2024
  • The number of elderly in care facilities is increasing in parallel with a rapid increase in the elderly population in Korea. We analyzed the meal satisfaction ratings, food preferences, and nutritional intakes of 74 patients aged ≥65 years living in a nursing hospital in Daegu. Food preferences were high for cooked rice, rice gruel, meat soup, soybean paste stew, beef, frozen pollack, squid, egg, spinach, sea mustard, cabbage kimchi, apple, peanut, drinking yogurt, pickled perilla leaves, and salted squid. Preferences for duck (P<0.01) and vegetable (P<0.01) cooking method were significantly different for men and women, and preference for soybean paste stew increased with age (P<0.05). Regarding nutrient intakes, men had higher energy (P<0.01), carbohydrates (P<0.05), and zinc (P<0.05) intakes than women, while women had higher vitamin C (P<0.05) intake than men. Furthermore, energy (P<0.001), carbohydrates (P<0.001), protein (P<0.05), dietary fiber (P<0.01), vitamin B6 (P<0.01), phosphorus (P<0.05), and zinc (P<0.001) intakes significantly decreased with age. Men had a significantly higher nutrient adequacy ratios (NARs) for carbohydrates (P<0.05) and cal- cium (P<0.01) than women, while women had a significantly higher NARs for protein (P<0.05), vitamin A (P<0.01), vitamin C (P<0.05), thiamine (P<0.01), riboflavin (P<0.001), iron (P<0.001), and zinc (P<0.01). Mean adequacy ratios were 0.69 for men and 0.75 for women. In particular, NARs for carbohydrates (P<0.01), vitamin B6 (P<0.01), and calcium (P<0.05) decreased significantly with age. In summary, the study shows that supplementing vitamin C, vitamin B6, calcium, and iron, reducing sodium, and providing meals that reflect preferences will improve the nutritional statuses of elderly residents in a nursing hospital.

경상남도 합천군의 응급의료 현황을 토대로 본 대한민국 지방 응급의료의 현실과 과제 (The Reality and Challenges of Rural Emergency Medical Service in Republic of Korea Based on the Current Status of Emergency Medical Service in Hapcheon-gun, Gyeongsangnam-do)

  • 김영수;반명준;이승근;강애정;황혜경;정백근
    • 농촌의학ㆍ지역보건
    • /
    • 제49권3호
    • /
    • pp.216-234
    • /
    • 2024
  • Background: Hapcheon-gun, Gyeongsangnam-do, is designated as an emergency medical vulnerable area, facing significant challenges in transporting and treating emergency patients. A detailed analysis of the regional emergency medical system is required to identify effective solutions. Methods: This study employed a mixed-methods approach, combining quantitative data from the National Emergency Medical Information System and emergency activity logs with qualitative data from focus group interviews involving 24 stakeholders, including medical staff, paramedics, civil servants, and local residents. Results: Quantitative findings indicated an aging population in Hapcheon-gun, with a growing number of elderly emergency room users. Despite the utilization of local emergency medical institutions, a lack of trust and preference for urban hospitals led even patients with mild conditions to seek care at higher-level facilities. Following the COVID-19 pandemic, transport distances and times for patients using 119 emergency services increased. Qualitative analysis identified several issues: limited capacity of local institutions, challenges in patient transport due to misaligned emergency medical zones, an increase in severely ill patients, and the absence of a coordinated emergency medical consultative body. Recommendations include strengthening local institutions through government support, realignment of emergency zones, legal reforms, the establishment of a continuous consultative body, and enhancing the capacity of medical staff, paramedics, and residents. Conclusion: Improving the emergency medical system in Hapcheon-gun will require targeted efforts in institutional strengthening, legal and administrative support, and capacity-building initiatives.

간호·간병통합서비스 병동 간호사의 환자안전 간호 경험 (Patient Safety Nursing Experiences of Nurses in Integrated Nursing Service Wards)

  • 김은혜;이현진;임숙빈
    • 산업융합연구
    • /
    • 제22권9호
    • /
    • pp.103-112
    • /
    • 2024
  • 본 연구의 목적은 간호·간병통합간호서비스 병동에서 근무하는 간호사의 환자안전간호 경험을 심층적으로 이해하는 것이다. 이 연구의 목적을 달성하기 위해 E대학교병원 간호·간병통합서비스 병동에서 근무하는 임상간호사 9명을 대상으로 2019년 10월 1일부터 2019년 12월 22일까지 일대일 심층 면접을 통해 자료를 수집하였다. 면접은 사전 준비된 반구조화된 질문지를 이용하였으며, 면접 후 녹취 내용을 필사하였다. 필사된 내용은 Colaizzi(1978)의 현상학적 방법을 적용하여 분석되었다. 연구 참여자들의 심리적 부담감, 역할 갈등, 그리고 환자 안전 간호 경험을 반영하여 123개의 의미 단위가 발견되었고, 이를 9개의 주제와 4개의 주제모음으로 도출하였다. 주제모음은 '안전간호의 양면성', '안전사고와 관련된 압박감', '원칙사수를 보완하는 실무경험으로 진보하는 환자안전', '환자와 함께 이루는 안전 간호'로 요약되었다. 결론적으로 간호·간병통합서비스 병동은 환자 안전의 양면성을 가지고 있으며, 이러한 병동에 적합한 환자 안전 체계의 필요성을 인식할 필요가 있다.

어린이급식관리지원센터 직원의 업무만족, 직무만족, 조직몰입 및 이직의도 (Task Satisfaction, Job Satisfaction, Organizational Commitment, and Turnover Intension of Center for Children's Foodservice Management Employees)

  • 박은혜;이영은
    • 한국식품영양과학회지
    • /
    • 제44권12호
    • /
    • pp.1881-1894
    • /
    • 2015
  • 본 연구는 전국의 어린이급식관리지원센터 중 총 30개 센터, 227명의 직원을 대상으로 2013년 12월 27일부터 2014년 1월 30까지 업무에 대한 만족도, 전반적 직무만족, 조직몰입, 이직의도를 조사하고 이들의 관계를 규명함으로써 어린이급식관리지원센터 사업의 효과를 높이고 직원들의 직무만족을 높일 수 있는 방안을 제시하고자 하였으며, 연구의 결과를 요약하면 다음과 같다. '어린이 대상 방문교육'의 업무만족도가 4.24점으로 가장 높았고, '재정관리' 업무만족도가 2.92점으로 가장 낮았다. 직무만족 조사도구의 타당도 분석을 위해 탐색적 요인분석을 실시한 결과 총 9개의 요인이 도출되었다. 직원의 직무만족에 대한 응답 결과 전반적 직무만족의 전체 평균값은 3.45점으로 나타났고, '동료와의 관계' 요인이 평균 3.99점, '직무성취감' 요인이 평균 3.98점, '회원 어린이급식소와의 관계'가 평균 3.45점으로 높게 응답되었다. 직무만족이 가장 낮게 응답된 요인은 '보수'로 2.45점이었으며, '업무의 양' 요인도 2.66점으로 낮게 응답되었다. 직원의 조직몰입에 대한 응답 결과 조직몰입의 전체 평균값은 3.54점으로 이직의도의 전체 평균값은 3.07점으로 나타났다. 전반적 직무만족, 조직몰입, 이직의도에 영향을 끼치는 단면적 직무만족 요인 회귀분석 결과 전반적 직무만족, 조직몰입, 이직의도에 공통적으로 상사와의 관계, 직무성취감, 고용안정성 및 복리후생 요인이 유의적인 영향을 끼쳤다. 센터의 공통적인 대표 업무 6가지로 영양순회지도 업무, 위생 안전순회방문지도, 어린이 방문교육, 조리원 방문교육, 집합교육, 재정관리를 선정하여 업무만족도, 근무하는 센터의 개소시기, 직원의 직위와 직무만족, 조직몰입, 이직의도 간의 관계를 보기 위하여 6개의 모형의 경로분석을 실시하였다. 6개의 모든 모형에서 업무만족도는 직무만족에 유의적인 영향을 끼치는 것으로 나타났으며, 조직몰입이 직무만족에 비해 이직의도에 직접적으로 더 강한 상관을 보였고, 직무만족과 이직의도 사이에 조직몰입이 매개하는 것으로 나타났다. 업무에 대한 만족도가 높은 위생 안전순회방문지도 업무(업무만족도 3.88점), 어린이대상 방문교육 업무(4.24점), 조리원대상 방문교육 업무(3.80점)는 경로모형에서 업무만족도가 직무만족도와 조직몰입에 유의적인 영향을 끼치는 것으로 나타났다. 타 업무에 비해 업무만족도가 4.24점으로 확연히 높게 응답된 어린이대상 방문교육 업무의 경우 업무만족도가 이직의도에도 유의적으로 영향을 끼치는 것으로 나타나, 업무만족이 이직의도에 미치는 영향력을 알 수 있었다. 따라서 업무만족도가 낮은 업무를 수행하는 직원을 대상으로 업무가 센터 업무 수행에 있어 중요한 역할을 함을 상기시킴으로써 조직몰입을 높이거나 업무만족이 낮은 업무와 높은 업무를 센터의 상황에 맞게 적절히 혼합하여 업무를 배정하는 방법을 통해 업무만족도를 높이는 방안을 찾는 것이 필요하다. 또한 직무만족이 조직몰입과 이직의도 모두에 유의적인 영향을 끼치므로 직무만족에 유의적인 영향을 끼치는 '상사와의 관계', '담당기관과의 관계', '직무성취감', '고용안정성 및 복리후생' 요인에 해당하는 직무환경을 개선하여 최종적으로 이직의도를 감소시키고 센터에 필요한 유능한 인재를 안정적으로 확보할 수 있도록 해야 할 것이다.

학위논문의 주요어 분석 (간호학 및 간호학관련 학위논문을 중심으로 : 1960-1991. 8) (A Statistical Study on the Key Words in the Titles of Nursing Related Theses)

  • 고옥자;김상혜;김희걸;이금재;이영숙
    • 대한간호학회지
    • /
    • 제24권1호
    • /
    • pp.58-69
    • /
    • 1994
  • In order to see the development of Nursing related research activities in Korea over the last three decades, abstracts of almost all of the Master and Ph.D theses that appeared from 1961 up to August 1991 were collected. The number of theses was 2354, from which an index of key words has been constructed. Key words were defined as those terms in each thesis title that convey major objectives of the given thesis study and the important nursing concepts dealt with in the thesis. Although all the key words were picked from the thesis title only, full use was made of the abstracts in deciding the principal objectives and essential contents of the thesis studies and their important concepts as well. In total, 539 kinds of key words were identified from the 2354 titles, and the identified words were all found to be in the International Nursing Index. On an average each title has two key words. Which key words were most frequently used, how they have changed with time, what kind of concept is preferably dealt with by each graduate school, and the concepts to which a given key word is likely to be connected were examined. The results are summerized below : 1) For each decade the theses numbers were as follows : 54(2.3%) from the 60’s, 413(17.5%) from the 70’s, 1523(64.7%) from the 80’s, and 364(15.5%) from the 90’s. Master’s thesis contributed 96% (2252) of the papers and Ph. D’s theses filled the remaining 4%(102). 2) A total of 539 key words were used, averaging about 2 for each thesis. The most frequently used key words were ‘Nurse’, ‘Anxiety’, ‘Knowledge / Attitude /Practice’, ‘Stress /Stressor’, ‘Attitude’, ‘Job-Satisfaction’, ‘Mental Disorder’, ‘Operation’, ‘Elderly’, ‘Nursing Role’. 3) Each decades key words can be classified as : the 60’s : ‘Nursing Education’, ‘Pulmonary Tuberculosis’, ‘Mother-Child Health’, ‘Growth & Development’, ‘Public Facilities’, ‘Mental Disorder’ : the 70’s : ‘Nurse’, ‘Family Planning’, ‘Attitude’ / ‘Knowledge, Attitude / Practice’, ‘Curriculum in Nursing Education’, ‘Clinical Practice in Nursing’, ‘Analysis of the Work of the Nurse’, ‘Health Education of School’, : the 80’s : ‘Nurse’, ‘Anxiety’, ‘Stress /Stressor’, ‘Operation’, ‘Nursing Role’, ‘Job Satisfaction’ : the 90’s : ‘Nurse’, ‘Elderly’, ‘Family-Support’, ‘Stress /Stressor’, ‘Home Care’. Key word ‘Nurse’ appears continuously and most frequently through the years, which indicates that there has been active study of the characteristics of nurses and related fields. The concept ‘Anxiety’ has been studied steadly from the 80’s and it shows that interest in health and disease are increasing Which comes as a result of society changing to an industrial and informational community. 4) Looking into each graduate school’s study area key words ‘Anxiety’, ‘Nurse’, ‘Mental Disorder’, ‘Stress /Stressor’, ‘Operation’, ‘Attitude’, ‘Hemo-dialysis’, were studied in the regular graduate school : ‘Family Planning /Contraception’, ‘Knowledge / Attitude /Practice’, ‘Physical Health-State /Physical Health Examination’, ‘Nurse’, ‘Using Clinical Facilities’, ‘Health Education of School’, were studied in the Graduate School of Public Health’ ; ‘Nurse’, ‘Anxiety’, ‘Stress / Stressor’, ‘Job-Satisfaction’, ‘Clinical Practice Education’, ‘Nursing Education’, were studied in the Graduate School of Education : ‘Nurse’, ‘Job Satisfaction’, ‘Nursing Role’, ‘Administration - Employment /Employment Management’, ‘Leadership’, ‘Personnel Profile’, ‘Nursing Manpower / Changing Working Place’, were studied in the Graduate School of Public Administration. 5) The Connection between key words were : ‘Nurse Job Satisfaction’, ‘Stress / Stressor ⇔ Coping / Ajustment’, ‘Nurse ⇔ Nursing Role’, ‘Anxiety ⇔ Giving Information’, ‘Nurse ⇔ Stress / Stressor’, ‘Anxiety ⇔ Operation’, ‘Nurse ⇔ Burnout’, ‘Knowledge, Attitude, Practice ⇔ Family Planning’, ‘Nurse Administration ⇔ Employment’, ‘Anxiety Muscle ⇔ Relaxation Technic’, ‘Anxiety ⇔ Mental Disorder’. From the above it can be noted that many nursing concepts were handled in the thesis titles. But there were more than enough papers on the characteristics of the nurse. It is suggested that in depth research be made on ‘Nursing Accidents’, t-‘Ethics’, ‘Nurse - Patient Interactions’, ‘Spritual Care’, ‘Dying’, ‘Hospice’, ‘Resident Helper’ and that there should be in depth research relating to the physical and mental development of youth and in particular physical concepts like ‘Drug - Abuse’, ‘Child -Abuse and Teaching’.

  • PDF

농촌지역 재가장애인의 재활서비스 이용실태 (The Rehabilitation Services Utilization of People with Disabilities in a Rural Area)

  • 최경진;김건엽;이덕희;한창현;최세묵
    • 농촌의학ㆍ지역보건
    • /
    • 제36권4호
    • /
    • pp.227-237
    • /
    • 2011
  • 농촌지역 재가장애인의 재활서비스 이용실태를 파악하고자 일개 농촌지역 재가장애인(3-6급 뇌 병변 지체장애) 101명을 대상으로 2011년 3월부터 4월까지 면접 조사를 실시하였다. 대상자는 여자가 65.3%였고, 70세 이상이 53.5%로 가장 많았고, 초등졸 이하가 72.3%이었다. 주관적 경제상태는 보통이상이 56.4%, 의료보장형태는 94.1%가 건강보험이었다. 대상자의 장애 및 건강관련 특성으로는 지체장애가 81.2%, 장애등급별은 3-4급이 41.6%로 가장 많았고, 동반 질환이 있는 경우가 74.3%였다. 본인이 생각하는 자신의 장애정도가 '심각하다'고 한 경우가 69.3%였다. 재가장애인의 70.3%는 퇴원 후 현재 재활서비스를 받고 있었다. 이용하지 않는 이유로는 치료의 효과성과 주변 서비스 기관의 부재, 경제적인 측면 등을 이유로 들었다. 재활서비스를 받기 위해 이용하고 있는 기관은 병의원, 재활의학과 병의원, 한의원 보건소 순으로 많았다. 현재 이용하고 있는 재활서비스 내용에 대해 19.7%가 만족한다고 하였고, 불만족의 이유로는 거리가 멀어서가 가장 많았다. 현재 재활서비스 이용여부에 영향을 미치는 유의한 변수로는 성별, 직업유무, 주관적 경제상태, 장애발생 원인이었다. 즉, 여자인 경우, 직업을 가진 경우, 경제상태가 좋은 경우, 장애발생이 후천적인 경우 재활서비스 이용이 높았다. 농촌지역 재가장애인의 70.3%가 현재 재활서비스를 이용하고 있으나 포괄성, 접근성, 지속성, 만족도 등에서 미흡한 것으로 나타났다. 현재 국가차원에서 추진되고 있는 지역사회중심재활사업을 중심으로 농촌지역 재가장애인을 위한 양적 및 질적으로 충분한 재활서비스 제공이 요구되며, 미이용 집단 및 미충족 집단을 우선 사업대상자로 선정하여 서비스를 제공하는 전략이 필요할 것으로 판단된다.

농촌(農村)에 있어서 분만개조요원(分娩介助要員)의 봉사(奉仕)에 의(依)한 모자보건(母子保健)rhk 가족계획(家族計劃)에 관(關) 연구(硏究) (A Study on Maternity Aids Utilization in the Maternal and Child Health and Family Planning)

  • 예민해;이성관
    • Journal of Preventive Medicine and Public Health
    • /
    • 제5권1호
    • /
    • pp.57-95
    • /
    • 1972
  • This study was conducted to assess the effectiveness of service by maternity aids concerning maternal and child health in improving simultaneously infant mortality, contraception and vital registration among expectant mothers in rural Korea, where there is less apportunity for maternal and child health care. It is unrealistic to expect to solve this problem in rural Korea through professional persons considering the situation of medical facilities and the socioeconomic condition of residents. So, we intended to adopt a system of services by maternity aids who were educated formally among indigenous women. After the women were trained in maternal and child health, contraception, and registration for a short period, they were assigned as a maternity aids to each village to help with various activities concerning maternal and child health, for example, registration of pregnant women, home visiting to check for complications, supplying of delivery kits, attendance at delivery, persuasion of contraception, and invitation for registration and so on. Mean-while, four researchers called on the maternity aids to collect materials concerning vital events, maternal child health, contraception and registration, and to give further instruction and supervision as the program proceeded. A. Changes of women's attitude by services of maternity aid. Now, we examined to what extent' such a service system to expectant mothers affected a change in attitude of women residing in the study area as compared to women of the control area. 1) In the birth and death places, there were no changes between last and present infants, in study or control area. 2) In regard to attendants at delivery, there were no changes except for a small percentage of attendance (8%) by maternity aid in study area. But, I expect that more maternity sids could be used as attendants at delivery if they would be trained further and if there was more explanation to the residents about such a service. 3) Considering the rate of utilization of sterilized delivery kit, I am sure that more than 90 percent would be used if the delivery kit were supplied in the proper time. There were significant differences in rates between the study and the control areas. 4) Taking into consideration the utilization rate of the clinic for prenatal care and well baby care, if suck facilities were installed, it would probably be well utilized. 5) In the contraception, the rate of approval was as high as 89 percent in study area as compared to 82 percent in the control area. 6) Considering the rate of pre-and post-partum acceptance on contraception were as much as 70 percent or more, if motivation to use contraception was given to them adequately, the government could reach the goals for family planning as planned. 7) In the vital registration, the rate of birth registration in the study area was some what improved compared to that of the control area, while the rate of death registration was not changed at all. Taking into account the fact that the rate of confirmation of vital events by maternity aids was remarkably high, if the registration system changed to a 'notification' system instead of formal registration ststem, it would be improved significantly compared to present system. B. Effect of the project Thus, with changes in the residents' attitude, was there a reduction in the infant death rate? 1) It is very difficult problem to compare the mortality of infants between last and present infants, because many women don't want to answer accurately about their dead children especially the infants that died within a few days after birth. In this study the data of present death comes from the maternity aides who followed up every pregnancy they had recorded to see what had happened. They seem to have very reliable information on what happened in first few weeks with follow up visitits to check out later changes. From these calculaton, when we compared the rate of infant death between last and present infant, there was remarkable reduction of death rate for present infant compare to that of last children, namely, the former was 30, while the latter 42. The figure is the lowest rate that I have ever heard. As the quality of data we could assess by comparing the causes of death. In the current death rate by communicable disease was much lower compare to the last child especially, tetanus cases and pneumonia. 2) Next, how many respondents used contraception after birth because of frequent contact with the maternity aid. In the registered cases, the respondents showed a tendency to practice contraception at an earlier age and with a small number of children. In a comparison of the rate of contraception between the study and the control area, the rate in the former was significantly higher than that of the latter. What is more, the proportion favoring smaller numbers of children and younger women rose in the study area as compared to the control area. 3) Regarding vital registration, though the rate of registration was gradually improved by efforts of maternity aid, it would be better to change the registration system. 4) In the crude birth rate, the rate in the study area was 22.2 while in the control area was 26.5. Natural increase rate showed 15.4 in the study area, while control area was 19.1. 5) In assessment of the efficiency of the maternity aids judging by the cost-effect viewpoint, the workers in the Medium area seemed to be more efficiency than those of other areas.

  • PDF

뇌성마비아 어머니의 경험 (Lived experience of mothers who have child with cerebral palsy)

  • 이화자;김이순;이지원;권수자;강인순;안혜경
    • Child Health Nursing Research
    • /
    • 제2권1호
    • /
    • pp.93-111
    • /
    • 1996
  • The purpose of the study is to identify the lived experience of mothers who have children with cerebral palsy in order to understand their agony. Moreover, the result of study was to find some nursing intervention for disabled children and their mothers. For this purpose, ten mothers who are willing to cooperate with this research were selected at random from those who have children with the cerebral palsy, currently using the municipal facilities for the handicapped with cerebral malfunction. Data collection was done from October 4, 1994 th December 31, 1994. The data were collected by asking the mothers mentioned above with some unstructured open-ended questions, recorded on the tapes with permission by the interviewee in order to prevent missing of the interviewed contents. These collected data have been substantiated and properly analyzed on the basis of phenomenological approach initiated by Colaizzi's method. The results and validity are proved to be credible by means of the individual checking of the interviewed mothers. The results of this study are as follows : 1. When the mother is first informed of the diagnosis of cerebral palsy on her child, she usually misses the crucial timing needed for proper treatment of the child's disorder because she is notified through the doctor's indifference and his apparently inactive, matter-of-fact attitude. At first she suspects the doctor's diagnosis and tries to attribute it to the unknown cause from a certain genetic problem and then she quickly wants to deny the whole situation that her child is really suffering from the cerebral palsy. The reality is too much for her to accept as it is and she would not believe her child is abnormal. Therefore, she even attempts depend on the power of God for its solution. 2. The mother, who goes thorough this kind of uncommon experiences, is totally devoted to the treatment and care of the child and completely ignores her own life and happiness. At the same time, she feels sorry for her other normal children she believes having not enough care and concern. Also, she feels sorry for the sick child when the child's brothers or sisters show special concern for the patient out of sympathy. It is sorry and not satisfied for her that the child is growing with abnormality and neighbor other around have inappropriate attitudes. Likewise, she is discontent with her husband's lack of concern about the child's treatment. She believes that the health care system in this society isn't fulfilling its due purpose. In the state of her utmost distress and anxiety, she always feels the need of competent consultants, and is angry about that her child is treated as an abnormal being, she is trying to hide the child from other people and to make him or her disappear, if possible. Although she doesn't have harmonious relation with her husband, she id happy when he shows his affection for the child and she feels relieved and thankful when the relatives don't mention about the child's condition Since the child's overall status of health is continuously in unstable conditions, requiring her all-time readiness for an emergency, she feels guilty of her child's illness toward the fEmily members as if it was her own fault to have borne such an abnormal child and she feels responsible for the child morally and financially if necessary Because her life is centered on taking care of the child, she cannot afford to enjoy her own life and happiness. She is a lonely mother, fatigued, with no proper relationship with other people around her. With this sense of guilt and responsibility as a mother of an unusual disease, she has no choice but to grieve her destiny from which she is not allowed to escape. 3. Nevertheless, the mother with the child suffering from the cerebral palsy does not easily give up the hope of getting her child cured and she believes that in the long run, though slower than hoped, her abnormal son or daughter will be eventually cured to become a normal sibling someday. This kind of hope is sustained by the mother's strong faith coming from observing the progress of other similar children getting better. Sometimes she is encouraged to have this faith by other mothers who share the same painful experiences, believing that her child will improve even more rapidly than others with the same palsy. Full of hope, she painstakingly waits for the child's healing. Moreover, she plans to have another child. she thinks that the patient child's brothers and sisters only can truly understand and look after the patients. However, when she notices that the progress of other children under the treatment does not look so hopeful, she is distressed by the thoughts that her child may never get well. Too, she is worried that the patient's brother or sister will be born as the same invalid with the cerebral disease. She is discouraged to have another baby as much as she is encouraged to. She is also troubled by the thought that in case she has another baby, she will have to be forced. to neglect the patient child, especially when she does have an extra hand or some reliable person to help her with taking care of the patient.

  • PDF

한국에서 자궁경부알 방사선치료의 Patterns of Care Study 진행을 위한 문헌 비교 연구 (Literature Analysis of Radiotherapy in Uterine Cervix Cancer for the Processing of the Patterns of Care Study in Korea)

  • 최두호;김은석;김용호;김진희;양대식;강승희;우홍균;김일한
    • Radiation Oncology Journal
    • /
    • 제23권2호
    • /
    • pp.61-70
    • /
    • 2005
  • 목적: 한국인의 여성암 중에서 호발하는 암 중의 하나인 자궁경부암의 검사 및 치료 형태와 치료 결과가 발표된 연구 논문을 통해 분석하고 미국과 일본 자궁경부암의 Patterns of Care Study (PCS)와 비교하여 한국 실정에 맞는 PCS 문항 개발의 진행을 위한 기본 자료를 제시하기 위해 문헌 비교 연구를 시행하였다. 대상 및 방법: 외국의 PCS 관련 자료는 PCS 홈페이지에 소개된 212편의 논문 및 초록 중에서 자궁경부암 및 PCS 구조부분의 논문(42편)과 최근에 발표된 논문을 대상으로 하였으며 한국에서 연구된 것은 Korean Pub Med에서 자궁경부암과 방사선치료에 관한 자료를 구하고(99편) 외국 잡지에 발표된 것을 포함하여 PCS의 비교 대상을 선정하여 PCS의 구조(Structure), 진행(Process), 결과(Outcome) 의 순서에 따라 비교 분석하였으며 시대에 따른 PCS의 패턴을 분석하기 위해 1980년대 이전과 1990년대 이후의 연구 결과로 나누어서 분석 하였다. 결과: 미국과 일본에서 자궁경부암의 PCS에 관한 논문이 각각 28편과 10편이 분석 가능하였고 한국은 73편이 PCS에서 다루는 항목을 포함하여 분석 가능하였다. 미국과 일본의 PCS는 공통적으로 치료기관의 규모, 의사 및 환자 수, 그리고 치료기관의 성격에 따라 계층화된 3~4개의 구조로 나누고 연구 대상 환자를 엄격하게 제한하였다. 그리고 연구의 진행을 위해 치료 전 병기 결정과정의 요소들을 나누고 시대에 따른 병기결정의 요소들을 분석하였으며 치료와 관련된 여러 가지 인자들을 다루고 FIGO 병기 이외의 예후인자들도 자세히 분석하며 기계에 대한 비교분석이 잘 되어 있다. 그러나 미국과 일본의 PCS도 그 나라의 특성상 미국은 인종간의 특성, 사회경제적 계층에 대한 분류를 시도하고 있으며, FIGO 병기에서 다루지 않은 종양의 크기(6편), 자궁방 또는 골반벽 침범이 한쪽 또는 양쪽으로 진행된 것에 따른 치료 결과의 분석이 활발하였고(5편), 일본은 종양표지자에 대한 연구가 포함되어 있다. 그리고 병기 결정 과정에서 공통적인 시대적 변화는 초창기의 림프과조영술, 바륨 관장술이 점차 사라지고 나중에 CT, MRI의 비중이 높아졌다. 한국 자료는 주로 단일 기관에서 한 연구로 구조(Structure)에 대한 언급이 없으며 기계적 특성에 따른 차이도 거의 분석하지 않았다. 그러나 최근의 연구 주제는 미국, 일본의 PCS에서 잘 다루지 않던 항암제의 병용 요법(9편), 치료기간(4편) 종양표지자(8편), 비전형적 분획 등을 다루고 있다. 결론: 여러 나라의 문헌을 비교 분석하여 한국에서 필요한 자궁경부암의 PCS를 이용한 문항개발이 이루어졌다. 그리고 후속적인 연구로 진행될 근접치료기 사용 및 치료의 결과, 부작용 등의 비교 분석을 포함하여 한국형 자궁경부암 PCS에서 필요한 항목을 합의 도출하여 완성하였으며 이 내용을 토대로 향후 표준화된 치료 모델 개발을 위한 PCS가 진행될 수 있으며 환자의 치료에 있어서 부족했던 분야에 대해 교정할 수 있는 교육적인 목적도 제시할 수 있을 것이다.

물리치료사의 근무실태와 직무만족 및 직장애착 (Working Conditions, Job Satisfaction and Organizational Commitment of Physical Therapists)

  • 안소윤;김원중;허영배
    • The Journal of Korean Physical Therapy
    • /
    • 제14권4호
    • /
    • pp.308-322
    • /
    • 2002
  • The main objective of this paper is to examine the working conditions of physical therapists and to investigate the level of job satisfaction and organizational commitment under different working conditions. A survey was conducted through structured questionnaire for the physical therapists working in Busan area, and data from 175 therapists were utilized in the final analysis. Survey items included general characteristics of the therapists(sex, age, education, marital status, religion, income, career years, etc.), their working conditions(kinds of organizations they work in, location of PT room, weekly working hours, average number of patients, number of co-workers, equipments/facilities, etc.), and organizational effectiveness measured in terms of job satisfaction and organizational commitment. Major results are as follows: 1) As for the general characteristics of the surveyed physical therapists, male(51.4$\%$) slightly exceeded female(48.6$\%$) and majority(more than 90$\%$) was 20-39 in age. Also, there were more single(57.7$\%$) than married(42.3$\%$), and 54.9$\%$ of the respondents had religion while 45.1$\%$ did not. In terms of the ranks in their organizations, only a few of them(6.9$\%$) were managers, and monthly salary mostly ranged from $\₩$1,000,000 to $\₩$2,500,000. More than half of them worked in various kinds of hospitals, with the remaining in health centers or social welfare institutions. 2) In regard to the working conditions of the respondents, 19.4$\%$ of PT rooms were located in basement areas while the remaining 80.6$\%$ in first to third floors. 34.3$\%$ of them treated 15 patients or less per day, whereas 25.1$\%$ treated 31 patients or more. Also, 52$\%$ recorded physical therapy charts periodically. As for the equipments and facilities, 25.1$\%$ felt 'sufficient' and 40$\%$'insufficient.' 3) The respondents provided various kinds of suggestions for the improvement of their working conditions, where the most important were 'salary raise' and 'reduction of working hours.' In addition, their requests to the PT Association included 'permission of opening of independent practice,' 'permission of legal specialty,' and 'vitalization of the Association.' 4) The comparative analysis of job satisfaction and organizational commitment among different characteristics of the respondents revealed that there was no significant difference between male and female, but in terms of age, the group of 40 or older was highest in both aspects. Besides, therapists who had 15 or more years of hospital career reported higher job satisfaction and organizational commitment than the others. It was also found that the level of organizational commitment increased as the rank of the respondents got higher. There were no significant differences in terms of marital status and religion. 5) Comparison with regard to working conditions showed that therapists employed in university hospitals, health centers and social welfare institutions felt higher job satisfaction and organizational commitment than those in community hospitals and clinics. Also, respondents who worked in basement areas had significantly lower job satisfaction than otherwise. The length of weekly working hours did not really affect the level of job satisfaction, but it was important to maintain 'regular working hours' for the hospitals to improve the employees' organizational commitment. As for the number of patients per day, 'medium level' (21-25 patients) had highest scores in both aspects. And, finally, sufficiency of equipments and facilities was found to be important for the improvement of organizational commitment.

  • PDF