• 한국산학기술학회논문지
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• 제19권1호
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• pp.311-320
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• 2018

본 연구는 간호대학생의 전공만족도, 임상수행능력, 진로결정 자기효능감, 진로결정 수준 간의 관계를 확인하고 이들 변수가 진로결정 수준에 영향을 미치는 영향과 경로를 파악하였다. 3개 간호대학 3,4학년 307명을 대상으로 자기기입식설문지를 사용하여 자료수집하였으며, IBM SPSS Amos 21을 이용하여 연구 모형과 변수간의 인과관계를 경로분석하였다. 연구결과 간호대학생의 진로결정 수준은 일반대학생에 비해 높았으며, 학년이 높고, 대인관계가 좋으며, 전공선택 동기가 적성과 취미에 맞을 경우 진로결정 수준이 높았다. 본 연구에서는 진로결정 자기효능감과 진로결정 수준이 전공만족도와 임상수행능력에 영향을 받고 있는 것으로 모형을 구성하였다. 초기모형의 적합도를 향상시키기 위해 모형을 수정하여 설명력을 향상시켰다. 수정모형의 모든 적합도 지수가 수용수준에 미치는 것으로 나타났다($x^2=2412$, GFI=.996, AGFI=.961, RMSEA=.068). 또한 총 5개 중 4개 경로의 계수가 통계적으로 유의미하였다. 진로결정 자기효능감과 진로결정 수준에 영향을 미치는 요인을 확인해 본 결과 전공만족도와 임상수행능력아 진로결정 자기효능감에 직접효과가 있었다. 전공만족도와 진로결정 자기효능감은 진로결정 수준에 직접효과가 있었으며, 임상수행능력은 진로결정 자기효능감을 통하여 진로결정 수준에 영향을 미치는 간접효과가 있는 것으로 나타났다. 진로결정 수준에 영향을 미치는 요인들의 전체효과는 진로결정 자기효능감, 전공만족도, 임상수행능력 순으로 높았다. 이상의 연구결과를 바탕으로 간호대학생의 특성에 맞는 진로지도 프로그램을 개발, 그 효과를 파악하는 연구를 제언한다.

• 대한간호학회지
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• 제49권3호
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• pp.329-339
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• 2019

Purpose: The purpose of this study was to investigate the frequency, patterns, and factors of reversals in decisions about life-sustaining treatment (LST) among older patients with terminal-stage chronic cardiopulmonary disease. Methods: This was a retrospective correlational descriptive study based on medical chart review. De-identified patient electronic medical record data were collected from 124 deceased older patients with terminal-stage cardiopulmonary disease who had made reversals of LST decisions in an academic tertiary hospital in 2015. Data were extracted about the reversed LST decisions, LST treatments applied before death, and patients' demographic and clinical factors. Multivariate logistic regression analysis was used to identify the factors associated with the reversal to higher intensity of LST treatment. Results: The use of inotropic agents was the most frequently reversed LST treatment, followed by cardiopulmonary resuscitation, intubation, ventilator therapy, and hemodialysis. Inconsistency between the last LST decisions and actual treatments occurred most often in hemodialysis. One-third of the reversals in LST decisions were made toward higher intensity of LST treatment. Patients who had lung diseases (vs. heart diseases); were single, divorced, or bereaved (vs. married); and had an acquaintance as a primary decision maker (vs. the patients themselves) were significantly more likely to reverse the LST decisions to higher intensity of LST treatment. Conclusion: This study demonstrated the complex and turmoil situation of the LST decision-making process among older patients with terminal-stage cardiopulmonary disease and suggests the importance of support for patients and families in their LST decision-making process.

• Clinical and Experimental Pediatrics
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• 제55권1호
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• pp.1-5
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• 2012

The need for evidence-based decision making in immunization programs has increased due to the presence of multiple health priorities, limited human resources, expensive vaccines, and limited funds. Countries should establish a group of national experts to advise their Ministries of Health. So far, many nations have formed their own National Immunization Technical Advisory Groups (NITAGs). In the Republic of Korea, the Korea Expert Committee on Immunization Practices (KECIP), established by law in the early 1990s, has made many important technical recommendations to contribute to the decline in vaccine preventable diseases and currently functions as a NITAG. It includes 13 core members and 2 non-core members, including a chairperson. Core members usually come from affiliated organizations in internal medicine, pediatrics, obstetrics, microbiology, preventive medicine, nursing and a representative from a consumer group, all of whom serve two year terms. Non-core members comprise two government officials belonging to the Korea Centers for Disease Control and Prevention (KCDC) and the Korea Food and Drug Administration. Meetings are held as needed, but at least twice a year, and sub-committees are formed as a resource for gathering, analyzing, and preparing information for the KECIP meetings. Once the sub-committees or the KCDC review the available data, the KECIP members discuss each issue in depth and develop recommendations, usually by a consensus in the meeting. The KECIP publishes national guidelines and immunization schedules that are updated regularly. KECIP's role is essentially consultative and the implementation of their recommendations may depend on the budget or current laws.

• Asian Pacific Journal of Cancer Prevention
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• 제15권14호
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• pp.5593-5596
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• 2014

Background: The objective of this study was to determine a diagnostic classification scheme using a decision tree based model. Materials and Methods: The study was conducted as a retrospective case-control study in Imam Khomeini hospital in Tehran during 2001 to 2009. Data, including demographic and clinical-pathological characteristics, were uniformly collected from 624 females, 312 of them were referred with positive diagnosis of breast cancer (cases) and 312 healthy women (controls). The decision tree was implemented to develop a diagnostic classification scheme using CART 6.0 Software. The AUC (area under curve), was measured as the overall performance of diagnostic classification of the decision tree. Results: Five variables as main risk factors of breast cancer and six subgroups as high risk were identified. The results indicated that increasing age, low age at menarche, single and divorced statues, irregular menarche pattern and family history of breast cancer are the important diagnostic factors in Iranian breast cancer patients. The sensitivity and specificity of the analysis were 66% and 86.9% respectively. The high AUC (0.82) also showed an excellent classification and diagnostic performance of the model. Conclusions: Decision tree based model appears to be suitable for identifying risk factors and high or low risk subgroups. It can also assists clinicians in making a decision, since it can identify underlying prognostic relationships and understanding the model is very explicit.

• 보건의료기술평가
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• 제6권2호
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• pp.81-87
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• 2018

With the recent change of healthcare environment including rapid technological development, evidences are more and more important and necessary to support relevant policies in health technology assessment to provide safe and effective health services, utilizing medical resources efficiently. Despite of the emphasis on the importance of real world data and real world evidence in health care research, current infrastructure supporting clinical research is considerably weak due to absence of legal and institutional basis. However, in accordance with the Article 26 of the Health and Medical Technology Promotion Act, there is a limited legal apparatus that can be used only in public data with other dataset for the purpose of healthcare technology assessment at the National Evidence-based Collaborating Agency. Although the use of linked data from various sources was often required in the field of clinical research, it was not yet working well due to insufficient environmental conditions. In order to support the decision-making of medical practice and health care policies, data-linking platform for clinical research is needed. If the legal system that can link up to the data of the private institutions without violating the significant value such as the protection of private informations is established, it will be a decisive foundation reinforcing the researches and policy making processes for the improvement of the national health care system.

• 대한간호학회지
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• 제29권4호
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• pp.841-854
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• 1999

This study tried to the answer to the question : “How does the human communication happen between clinical nurse and patient\ulcorner” To answer that, a micro-ethnographic research method was used and I performed field work at the orthopedic ward in one Korean metropolitan city. After analysis of interview data, observational data and field notes, I could understand that clinical nurse-patient communication performed for clinical decision making, providing patient education and emotional support. Prepared nurse communicate with patient more effectively, eventually can establish more trust relationship with patient. Conclusively I discussed about the way of nurse's skill acquisition, need of collaborative conference with doctor and nurse, and curriculum development to promote nurses's understanding of human.

• 한국임상보건과학회지
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• 제1권2호
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• pp.49-57
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• 2013

Purpose. This study was purposed to seek for a way to enhance the self-efficacy of students in dental hygiene department at deciding their careers by analyzing the relationship between the self-efficacy and the major satisfaction. Methods. The investigator conducted a survey targeting 253 students attending on dental hygiene departments in two 3-year-graduate colleges and 1 university located in Busan from May 1st to May 30th, 2013. The used research instruments were the major satisfaction questionnaire and the Career Decision-Making Self-Efficacy Scale Short Form(CDMSES-SF). The survey was conducted in self-administered questionnaire. The data was analyzed with SPSS (ver 12.0) and also conducted t-test, ANOVA and multi-regression analysis. Results. It was found that self-efficacy level of students in dental hygiene department was $3.22{\pm}0.38$ point, and their major satisfaction level was $3.27{\pm}0.47$ point. The factors enhancing the self-efficacy of students in dental hygiene department at deciding their careers were identified as the curriculum satisfaction, the relationship satisfaction, and the recognition satisfaction. It was identified that more these elements were increased, the higher the self-efficacy level was enhanced. Conclusions. In order to enhance the self-efficacy of students in dental hygiene department at deciding their careers, it is considered that the curriculum should be organized carefully under reasonable plan, and there should be more active communication between professors and students as well as students each other. Besides there needs some educational programs to inspire the pride and sense of duty for the dental hygiene department.

• 한국융합학회논문지
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• 제8권6호
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• pp.121-130
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• 2017

본 논문은 간호대학생의 환자안전관리 수행자신감에 영향을 미치는 요인을 파악함으로써 간호대학생의 환자안전관리역량 증진 융합교육프로그램을 개발하는데 필요한 근거를 마련하고자 수행하였다. 본 연구는 간호학과 4학년 재학생 228명을 대상으로 하였다. 간호대학생의 환자안전관리 수행자신감에 영향을 미치는 요인을 규명하기 위해 다중회귀분석을 실시하였다. 간호대학생이 임상에서 경험한 환자안전 사고는 낙상(50.0%), 주사바늘 찔림(18.5%), 환자확인 오류(12.0%), 주사투약 오류(7.5%), 경구투약 오류(4.3%)순이었다. 간호대학생의 환자안전관리 수행자신감의 유의한 영향요인은 환자안전관리 태도(t=6.09, p<.001), 임상의사결정능력(t=3.97, p<.001) 및 성별(t=2.56, p=.011)로 나타났다. 이와 같은 연구결과를 근거로 간호대학생의 환자안전관리 수행자신감을 증진시키기 위해서는 환자안전관리 태도, 임상의사결정능력 및 성별을 고려한 융합교육 프로그램을 개발할 것을 제안한다.

• 한국융합학회논문지
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• 제9권10호
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• pp.159-165
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• 2018

본 연구는 치위생(학)과 학생들의 직업기초역량이 진로의사결정에 미치는 융합적 영향요인을 파악하고자 부산과 울산지역의 대학교 치위생(학)과에 재학중이며, 임상실습 경험이 있는 학생 196명을 조사하였다. 수집된 자료는 SPSS 24.0 프로그램을 통해 빈도분석, 상관분석, 선형회귀분석을 사용하여 산출하였다. 연구대상자의 직업기초역량 인식수준은 3.38점, 진로의사결정은 3.30점으로 나타났으며, 직업기초역량의 하부요인 중 직업윤리 인식 수준이 3.46점으로 가장 높게 나타났다. 직업기초역량이 진로의사결정에 미치는 영향요인으로 대인관계능력(p<0.01), 조직이해능력(p<0.01), 자원관리능력(p<0.01), 자기개발능력(p<0.05), 문제해결능력(p<0.05), 수리능력(p<0.05)에서 유의한 수준으로 나타났다. 따라서 치위생(학)과 학생들의 직업기초역량 강화는 진로의사결정을 하는데 중요한 기여요소이므로 치위생 교육이 전공역량과 더불어 직업기초역량을 골고루 갖출 수 있도록 학생개인, 학과, 대학차원의 융합적 노력과 교육과정 개발이 이루어져야 할 것이다.

• 간호행정학회지
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• 제10권4호
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• pp.449-457
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• 2004

Purpose: This study seeks to identify situations where nurses are required to consider alternatives, for the delivery of nursing care, appropriate to the needs of a medical care unit, surgical care unit, and intensive care unit in a university hospital. Method: Data was collected from 100 nurses using an open questionnaire, during a one week period in May, 2003. These nurses all had at least two years of experience within a medical care unit, surgical care unit, or intensive care unit at a university hospital. Results: The situations that nurses typically faced were categorized into 21 problems for nurses including : respiratory problems(26.8%), pain(23.6%), problems in relation to bowel habit(23.2%). In cases where nurses were faced with making decisions in relation to solving respiratory problems, the alternatives included ; applying oxygen(29.3%), physical assessment and monitoring(14.7%), refining and modifying order and suggestion order(9.3%). Ventilator care(9.3%), was chosen to solve pain problems ; doing pm orders(30.3%), placebo medication(27.3%), and to refine and modify orders and suggestions(18.2%). To solve problems in relation to bowel habits ; enemas accounted for 32.3%, and laxative medication 30.8%. Conclusion: To improve the quality of nursing, the outcome of nursing care associated with 21 problems for nurses including : respiratory problems, pain, and problems in relation to bowel habit, should be identified and the best alternative nursing care should be developed.