• 대한감각통합치료학회지
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• 제13권2호
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• pp.1-19
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• 2015

목적 : 본 연구는 국내에서 시행되는 감각통합치료의 근무특성, 치료실 환경, 치료사의 지식수준을 파악하기 위하여 실시하였다. 연구방법 : 2014년 6월1일부터 2014년 8월 31일까지 감각통합치료 세팅에서 감각통합치료를 시행하는 치료사를 대상으로 설문지를 배포하여 수거한 232부를 분석하였다. 결과 : 국내에서 감각통합치료를 시행하는 전공자는 작업치료사의 비중이 크며, 사설기관, 복지관, 병원 순으로 많이 근무하고 있다. 주 치료대상은 영유아부터 학령기 아동이 대부분이지만 청소년과 성인까지 폭넓게 적용되고 있으며, 발달장애아동이 많았다. 대부분의 기관이 치료를 위한 공간과 도구를 구비하고 있고, 평가와 기록을 충실히 하고 있다. 감각통합 교육 및 연수를 열심히 참여하는 것으로 나타났지만, 평가 없이 치료를 진행하는 경우도 있었고 교육 이수 없이 전문적 중재프로그램을 실시하는 경우도 있어서 감각통합치료 이론에 대한 전문적 인식 및 이해가 부족함을 알 수 있었다. 결론 : 감각통합치료는 장애아동 재활치료에 중요한 치료이다. 전문적 치료사 양성을 위해서는 Ayres Sensory Integration(ASI) 이론을 정확히 교육하고 실습할 수 있는 전문교육과정이 필요하며, 수도권 외 지역에서 교육이 더 개최되어 지방에 근무하는 치료사들에게 교육의 기회를 확산하고 질적 수준을 높일 필요가 있겠다.

• Clinical and Experimental Pediatrics
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• 제51권5호
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• pp.506-511
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• 2008

목 적 : 폐기능 검사는 폐질환의 평가에 매우 중요하여 반복해서 검사를 시행하여 질병의 경과와 치료에 대한 반응을 객관적으로 평가할 수 있다. 소아에서는 협조와 이해 정도에 따라 수치의 변동이 크므로 풍선을 이용한 연습과 검사에 대한 이해가 결과에 어떤 영향을 미치는지 분석하고자 한다. 방 법 : 2006년 6월부터 10월까지 천식으로 순천향대학교병원 소아과 알레르기호흡기센터를 방문하여 폐기능 검사를 실시한 106명을 대상으로 하였다. 첫 검사 시행 후 풍선불기 연습을 시킨 후 다시 검사한 군, 연습과 검사의 필요성에 대한 교육을 시킨 후 다시 검사한 군, 교육만 시킨 후 다시 검사한 군, 그대로 다시 검사를 시행한 군 등 4군으로 나누어 검사 수치를 비교하였다. 결 과 : 연습 전후의 검사 결과는 통계학적으로 유의한 차이는 없었다. 연습과 교육을 시행하여 전후의 검사 결과를 비교했을 시에도 유의한 차이는 없었다. 교육만 시행하였을 경우 $FEV_1$, $FEV_1/FVC$, $FEF_{25-75%}$, PEFR의 평균치가 전반적으로 상승하였으며 $FEV_1$, $FEF_{25-75%}$, PEFR은 통계학적으로 의미가 있는 상승을 보였다. 교육이나 연습을 시행하지 않고 2회 검사 시행시 유의한 차이는 없었다. 결 론 : 폐기능 검사 시행시 풍선 등을 이용하여 연습을 시키거나 여러차례 반복하여 검사를 시행하게 될 경우 오히려 검사 결과에 나쁜 영향을 줄 수 있고 검사의 필요성에 대해 잘 이해를 시킨 후 검사를 하는 것이 정확한 결과에 더 큰 영향을 미치는 것으로 보여지며 이를 바탕으로 향후 폐기능 검사 시행시 체계적으로 검사에 대한 설명을 하여 환아가 충분한 이해를 하도록 하는 것이 필요하다고 할 수 있겠다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제30권3호
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• pp.121-126
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• 2019

Objectives: Awareness of attention-deficit/hyperactivity disorder (ADHD) in adults has significantly increased; however, clinical data specific to the Korean population are insufficient. Clinical experience of ADHD may differ based on whether psychiatrists have received pediatric psychiatry-specific training. In order to prepare a practice parameter for adult ADHD patients in Korea, we examined questionnaire data to observe how pediatric psychiatry training could affect clinical practice for adults with ADHD. Methods: A questionnaire about the diagnosis and treatment process was distributed to both general psychiatrists (GPsy) and child and adolescent psychiatrists (CAP) at the summer and winter workshop meetings of Korean Academy of Child and Adolescent Psychiatry. Results: In total, 142 psychiatrists participated in the survey (86 GPsy, 56 CAP). GPsy and CAP preferred pharmacotherapy (GPsy 82.40%, CAP 64.30%) as the primary treatment option and answered that the clinical psychiatric interview is the most necessary step in diagnostic assessment (GPsy 22.16%, CAP 19.00%). The GPsy responded with an optimal and average treatment duration that was shorter than that reported by CAP. Conclusion: Identification of the initial presenting symptom as the correct diagnosis and the optimal duration of pharmacotherapy differed between GPsy and CAP in practice, whereas concepts in diagnosis and treatment of ADHD in adults were similar for both groups. These results suggest the urgent need for the Continuing Medical Education program for psychiatrists treating adults with ADHD.

• 간호행정학회지
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• 제7권2호
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• pp.301-314
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• 2001

The main purpose of this research is to describe comprehensively the processes of clinical decision making in novice critical care nurses through clinical experience. This research was an exploratory, longitudinal study using a fieldwork approach incorporating "think-aloud" method and in-depth interviews with the study participants. The study participants consisted of 5 novice nurses assigned to critical care units at a tertiary medical center located in Seoul, among a group of 27 novice nurses who started at the same period at this hospital. The data were collected from March 1999 to April 2000. The major findings of the study is that the novice nurses followed the analytic linear model of clinical decision making in the beginning, but were changed increasingly to follow the comprehensive, integrated model of clinical decision making. Through repeated experience that resulted in increasing repertoire of clinical schema and familiarity of task environments of clinical practice the novice nurses expanded their ability to arrive at comprehensive integration of information and to arrive at accurate and time-efficient decisions. Both the analytic, linear model mostly used at the beginning period and the comprehensive, integrated model that seems to be the mode significantly dependent upon experience seem to have strengths and weaknesses as decision making processes in clinical situations. Hence, it is imperative to develop an effective orientation and training program for novice nurses through the use of clinical preceptors. In addition, students should be exposed to the process of clinical decision making early in their nursing education through an appropriate clinical experiences and clinical assignments.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제25권3호
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• pp.263-275
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• 2022

Purpose: The present international survey among healthcare providers aimed to collect data on theoretical knowledge and clinical practices in the diagnosis and management of cow's milk protein allergy (CMPA) and lactose intolerance (LI) in infants. Methods: A global survey was conducted in several countries with diverse health care settings. The survey consisted of multiple-choice questions in 3 main domains: (1) understanding and clinical practices around CMPA and LI; (2) case scenarios; and (3) disease-specific knowledge and potential educational needs. Results: Responses were available from 1,663 participants. About 62% of respondents were general practitioners or general pediatricians, and the remainder were pediatric allergists/gastroenterologists (18%) or other health practitioners (20%). The survey identified knowledge gaps regarding the types of CMPA (IgE-mediated vs. non-IgE-mediated) and the clinical overlap with LI. The survey suggested diverse clinical practices regarding the use of hypoallergenic formulas, as well as misconceptions about the prebiotic benefits of lactose in extensively hydrolyzed formulas in non-breastfed infants with CMPA. Responses to the two case scenarios highlighted varying levels of awareness of the relevant clinical practice guidelines. While respondents generally felt confident in managing infants with CMPA and LI, about 80% expressed an interest for further training in this area. Conclusion: The current survey identified some knowledge gaps and regional differences in the management of infants with CMPA or LI. Local educational activities among general and pediatric healthcare providers may increase the awareness of clinical practice guidelines for the diagnosis and treatment of both conditions and help improve clinical outcomes.

• 간호행정학회지
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• 제5권3호
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• pp.535-545
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• 1999

The purpose of this study is to investigate the nurses' needs in the general hospitals as a basic study to develop ICU clinical nurse from Aug. 3 to Sept. 26 1998 at 13 general or university hospitals that have ICU nurse training course and are accredited at KNA. The subjects of study were ICU nurses and nurse managers at the department of nursing. The questionnaire items were developed from literature review, interviews with 30 ICU nurses at an university hospital in Pusan. The results were as follows : The subjects of study educated in ICU nurse training course were 44.3% of total. The 93.1% responded the necessity of ICU CNS and 89.1% wanted to have ICU CNS certification. The 43.8% answered that ICU should be a center of CNS education and 32.0% answered the department of nursing. Most of subjects responded that the clinical experience of ICU should be needed prior to CNS education. Regarding the treatment of ICU CNS, the 34.2% of total subjects responded it would be suitable to pay additional allowance and the 28.3% answered to grade-up salary step, and then the 13.7% to promote level position. Concerning the assignment department, the 63.5% answered that the charge nurse would be proper than general nurse or head nurse. As to the working time of ICU CNS, the 93.2% responded that D-duty is needed, the 79.5% to E-duty and the 64.4% to N-duty. It is suggested that the consensus of ICU nurses for the concept, the role and the system of ICU CNS is needed.

• 한국의료질향상학회지
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• 제3권1호
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• pp.126-143
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• 1996

Background : Little work has been carried out regarding quality assessment research in a primary care setting, comparing with that of hospitals. This study aims to evaluate the process of diagnosis and management of hypertension by public health doctors on the basis of pre-established clinical guideline, and to identify several modifying factors associated with them. Methods : Hypertension was selected as the target disease, because it is a chronic disease which is of great public health importance. Self-administered questionnaires were mailed to public health doctors practicing at health centers and health subcenters across the nation. The response rate was 20.9%. The questionnaire included the diagnosis and management process such as measuring blood pressure, history taking, physical examinations, and treatment approches and potentially modifying factors such as level of training, duration of practice as a public health doctor, and education on management of hypertension. Results : Public health doctors pay little attention in measuring BP, hypertension related history taking, performing physical examination and laboratory examination. But they devoted much effort in diagnosing hypertension exactly and giving nonpharmacological treatment. Among various antihypertensive drugs, calcium-channel blockers were the most preferred agent(50.9%). Level of training, duration of practice ad a public health doctor, and education on management of hypertension made no difference on quality of care(p>0.05). Conclusion : These public health doctors showed poor compliance with the pre-established clinical guidelines, which leaves much to be desired in diagnosing and managing hypertensive patients by public health doctors. This study might be able to contribute to develop some strategies, such as educational programs, which would be able to improve the process of care in hypertensives.

• Journal of Preventive Medicine and Public Health
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• 제53권4호
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• pp.236-244
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• 2020

Objectives: Although the World Health Organization (WHO) initiative "My 5 Moments for Hand Hygiene" has been lauded as effective in preventing hospital-associated infections, little is known about healthcare workers (HCWs)' hand hygiene behavior. In this study, we sought to assess knowledge and attitudes towards the concepts in this initiative, as well as associated factors, among Vietnamese HCWs at a general hospital. Methods: A structured questionnaire was administered to HCWs at a central Vietnamese general hospital in 2015. Multiple logistic regression analysis was used to identify factors associated with HCWs' knowledge and attitudes towards hand hygiene. Results: Of 120 respondents, 65.8% and 67.5% demonstrated appropriate knowledge and a positive attitude, respectively, regarding all 5 hand hygiene moments. Logistic regression indicated better knowledge of hand hygiene in workers who were over 30 years old, who were direct HCWs (rather than managers), who had frequent access to clinical information, and who received their clinical information from training. Those who worked in infectious and tropical disease wards, who had frequent access to clinical information, and who received information from training were more likely to have a positive attitude towards hand hygiene than their counterparts. Conclusions: Although many Vietnamese HCWs displayed moderate knowledge and positive attitudes towards the WHO hand hygiene guidelines, a key gap remained. Regular education and training programs are needed to increase knowledge and to improve attitudes and practices towards hand hygiene. Furthermore, a combination of multimodal strategies and locally-adapted interventions is needed for sustainable hand hygiene adherence.

• Perspectives in Nursing Science
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• 제8권2호
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• pp.121-128
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• 2011

Sensitive issues are both common and problematic for health care providers because sensitive issues may interfere with the future provider-client relationship and effective care. Most current training for providers focuses on a particular issue, but this is inadequate because many issues may be sensitive, and which issues will be sensitive is unpredictable. We argue that issues become sensitive when they activate one or more of three common triggers, fear, stigma, and taboo. A cycle of negative internal and interpersonal responses to the sensitive issue often leads to unresolved health issues for clients and stress and feelings of inadequacy for providers. We recommend integrated pre-service and in-service skill building to help individual health care providers respond appropriately to a wide variety of sensitive issues. We also identify specific policies and procedures to strengthen organizational support for caregivers so that providers can address these sensitive issues effectively with their clients.

• 한국직업건강간호학회지
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• 제20권1호
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• pp.65-73
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• 2011

Purpose: This study investigates nurses' organizational commitment, internal marketing, and occupational satisfaction depending on their age, martial status, clinical experience and income. Methods: The subjects of this study were 350 nurses from six hospitals in Jeolla-do. The t-tests were used to analyze the differences in internal marketing, occupational satisfaction, and organizational commitment depending on their age, marital status, career, and income. The relationships among internal marketing, occupational satisfaction, and organizational commitment were analyzed by the path analysis. Results: The results of this study showed that organizational commitment was correlated with age, clinical experiences, and income, but not significantly associated with martial status. Education and training policy, benefit system, and fairness of the internal marketing were influencing factors on occupational satisfaction. These factors were correlated with organizational commitment through occupational satisfaction. Conclusion: This study addressed the relationships among nurses' internal marketing, occupational satisfaction, and organizational commitment. Based on the results, it is suggested that hospital organizations introduce more diverse incentive policies to enhance nurses' occupational satisfaction and organizational commitment.