• 제목/요약/키워드: Clinical Skills

검색결과 691건 처리시간 0.028초

치과위생사의 직무만족도, 의사소통 능력이 조직 내 의사소통에 미치는 영향 (Effects of dental hygienist's job satisfaction and communication ability on communication within the organization)

  • 한수연;임애정;임희정
    • 한국산학기술학회논문지
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    • 제21권8호
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    • pp.154-159
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    • 2020
  • 본 연구는 치과위생사의 직무만족도와 의사소통능력을 살펴보고 그에 따른 조직 내 의사소통에 영향을 주는 요인을 규명하고. 이를 통해 임상현장에서 치과위생사의 효율적인 의사소통을 통하여 직무만족 향상에 도움을 줄 수 있는 의사소통능력 개발교육에 활용하는 기초자료를 제공하고자 시행하였다. 연구 대상은 서울과 경기지역 치과 병. 의원에서 근무하고 있는 치과위생사 200명을 대상으로 2019년 5월 18일부터 6월 12일까지 설문 조사하였다. 직무만족도와 의사소통, 조직 내 의사소통의 상관관계를 알아보기 위해 Pearson's 상관관계 분석을 시행하였고 직무만족도와 의사소통이 조직 내 의사소통에 미치는 영향을 알아보기 위해 다중회귀분석을 시행하였다. 연구 결과 직무만족도(r=0.193 p<0.05)와 의사소통능력(r=0.404, p<.001)은 조직 내 의사소통과 유의한 양의 상관관계로 나타났으며, 개인의 의사소통 능력(β=0.461, p<.001), 이 조직 내 의사소통에 유의한 영향을 미치는 것으로 나타났다. 따라서 치과 위생사의 의사소통 능력을 향상시키기 위해 전문 직업인으로 업무에 대한 자부심을 갖도록 직무만족을 높이고, 명확한 자기의사표현과 효과적인 의사소통이 이루어 질 수 있도록 치과 기관 내 교육과 관련 내용의 보수교육 참여 기회를 확대 제공하는 등의 노력이 필요 할 것이다.

아동 그룹 작업치료의 효과 : 체계적 고찰 (The Effect of Group Treatment Based on Occupational Therapy for Children : A Systematic Review)

  • 이가영;이지호;김보람;김경미
    • 대한감각통합치료학회지
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    • 제14권2호
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    • pp.33-45
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    • 2016
  • 목적 : 아동을 대상으로 실시한 그룹 작업치료에 대한 효과를 체계적 고찰을 통해 알아보고 이를 통해 아동 그룹작업치료에 대한 근거를 마련하고자 한다. 연구방법 : 국외 검색 데이터베이스는 Pubmed와 Ovid를 국내 검색 데이터베이스는 학술연구정보서비스(RISS), 한국학술정보(KISS), 디비피아(DBpia)를 사용하여 2014년까지의 국외/국내 학회지를 검색하였다. 국외/국내 검색어를 다르게 사용하여 총 14개의 연구를 선정하였으며 근거의 질적 수준에 따라 나누고 PICO(Patient, Intervention, Comparison, Outcome) 형식으로 정리하였다. 결과 : 대상자는 정상아동보다 진단을 받은 아동이 많았고, 감각통합장애 아동(28.6%)이 가장 많았다. 중재방법은 그룹감각통합치료(40%)가 가장 많았고, 중재 결과 분석을 위해 사용된 평가 영역 및 평가도구로는 사회성(31.0%)을 측정하기 위한 것이 가장 많았다. 중재 효과는 통계학적으로 유의한 결과가 전체의 40.7%이었다. 결론 : 앞으로 아동을 대상으로 실시하는 그룹 작업치료는 다양한 진단군을 대상으로 폭 넓은 중재내용을 통해 높은 근거수준의 효과가 입증 되어야 할 것이다.

발달지연 아동 및 뇌성마비 아동의 평가실태와 물리치료사들의 평가에 대한 인식도 조사 (Physical Therapist's Understanding and the Usage of Assessment Tools for Children With Delayed Development and Cerebral Palsy)

  • 박혜정;이충휘;조상현;권혁철
    • 한국전문물리치료학회지
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    • 제7권1호
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    • pp.1-21
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    • 2000
  • The purposes of this study were to research the current state of evaluation of children with delayed development and cerebral palsy and determine pediatric physical therapists' knowledge of assessment tools and their use. The subjects were 130 pediatric physical therapists (general hospitals, university-related hospitals, rehabilitation centers, etc.). Data was obtained from August 24, 1999 to October 18, 1999 by means of a survey questionnaire. The results were as follows: 1. The current state of pediatric physical therapist evaluation of children with delayed development and cerebral palsy. 1) Tools used to assess functional areas of children with cerebral palsy were: subjective description format-128 (47.1%); the GMFM-58 (21.3%); facility-generated tool-51 (18.8%); and DDST-15 (5.5%). 2) Tools used to assess developmentally delayed children were: subjective description format-121 (50.6%); the GMFM-43 (18.0%); facility-generated tool-41 (17.2%); and DDS T-14 (5.9%). 3) After their college or university study, therapists who had attended lectures on evaluation were 113 (86.9%); 13 (10.0%) therapists had not attended any lectures on evaluation 2. Test scores of physical therapists' professional knowledge of evaluation procedures: high (more than 36 points)-74 (56.9%); moderate (18~35 points)-39 (30.0%); and low (below 17 points)-none. 1) For therapists treating cerebral palsied children, 73 (65.2%) were in the high range, 39 (34.8%) were in the moderate range and none were in the low range. 2) For therapists treating children with delayed development, 71 (65.7%) were in the high range, 37 (34.3%) were in the moderate range and none were in the low range. Although the general degree of professional knowledge of evaluation was quite high, there was a lack of variety in the assessment tools used With a large number of therapists depending on subjective description. Possible reasons for the low rate of objective asses sment tool use: 1) Poor clinical environment: too many clients and lirnited treatment time. 2) Lack of any medical insurance fee category for specific assessment tools. 3) Lack of continuing education opportunities in pediatric evaluation skills during or after either college-based (3 year) or university-based (4 year) education programs. Based on the study results, provision of more extended educational opportunities would promote the use of a greater variety of objective assessment tools by pediatric physical therapists.

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윤리교육이 간호사의 도덕판단에 미치는 영향 (Effect of Ethics Education on Nurse덕s Moral Judgement)

  • 김용순
    • 대한간호학회지
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    • 제30권1호
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    • pp.183-193
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    • 2000
  • This main purpose of this study was to assess the effects of two different types of ethics education on the moral judgement of clinical nurses. One type was free discussions among nurses with given specific moral issues and the other type was discussions guided by experts on specific moral issues. The study employed a quasi-experimental, nonequivalent pre test-post test design using two different control groups. The conceptual framework of the study was derived from the Kohlberg′s Moral Development Theory (1969) and the Greipp′s Ethical Decision-Making Model (1992). The data was collected during the period of October 14 through December 15, 1998. Sample consists of 32 nurses working in the ICU who met research criteria. 16 nurses were assigned to the free discussion group and 16 nurses to the group for the guided discussion with experts group. For the pre-test, the DIT which was developed by Rest (1984) and JAND by Ketefian (1998) were used with some modification by the author. After the education, only JAND was used to assess the changes in moral judgement. The collected data was analysed using SPSS PC program. The findings are as follows: 1. There was no significant difference between two groups in their general characteristics. Only difference which was statistically significant between two groups was that realistic score on Case 3/Medical Research and Autopsy was higher in the free discussion group. 2. Hypothesis 1: "There will be a difference on the moral judgement of nurses before and after they receive an ethics education". This hypothesis was supported partially. Those who had low scores on moral judgement before the education tended to have higher scores after the education on the same issues. And, after the education, the nurses tend to give lower scores on the dilemmas they had experienced frequently at work; while giving higher scores on those dilemmas they had no prior experience. 3. Hypothesis 2: "The effect of education may differ depended upon the moral development index [P(%)] score of nurses". The effect of education was different depend on moral development level. The group who′s P(%) scores was low at the pretest has higher scores in realistic moral judgement after the education, while the groups with middle or high P(%) scores went down after the education. These changes were statistically significant in some cases, thus, the Hypothesis 2 was partially supported 4. Hypothesis 3: "The method of ethics education will have different effects on the moral judgement of nurses". Even though several nurses attended the guided discussion stated that the education program broadend their perspectives the difference between two groups was not significant and this hypothesis was not supported. In conclusion, both types of ethics education had helped the nurses to acquire the skills to deal some nursing dilemmas. The effects of ethics education may differ according to the moral development index - P(%) score. However, because of some of the limitations of this study, mainly small sample size, short term education, unable to control other variables which may affect moral judgement of nurses, further research is warranted.er research is warranted.

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청소년 임신과 스트레스 (Adolescents Pregnancy and Stress)

  • 김만지
    • 한국사회복지학회:학술대회논문집
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    • 한국사회복지학회 2000년도 춘계학술대회 자료집
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    • pp.615-628
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    • 2000
  • 스트레스란, 개인과 환경간의 특별한 관계가 개인의 안녕을 위협하고 개인이 가진 자원을 초과하는 것을 말한다. 븐 연구는 청소년 임신과 스트레스에 관한 문헌연구를 통하여 청소년 임신과스트레스와의 관계에 대해서 살펴봄으로써 임신력 있는 청소년들을 위한 스트레스 관련 임상사회 사업 서비스 개입 방안을 제시하고자 하는데 목적이 있다. 임신으로 인한 부모됨의 변화가 청소년기 자체의 인생 주기 상에서의 스트레스와 중복될 때, 누적된 스트레스는 보다 커진다. 변화의 중첩은 개인 역할의 애매함을 초래하여 스트레스를 가중시키고 발달 과업의 우선순위에 혼란을 가져온다. 청소년기의 임신은 성인기로 이동하는 청소년 당사자, 그 자녀, 사회이 부정적인 영향을 미친다. 이러한 부정적인 영향은 단기간에 끝나지 않으므로 임신한 청소년들의 대처 기술과 적응력을 향상시키기 위한 개입의 노력이 필요하다. 임신한 청소년들의 경우에는 개인 상담 접근만으로는 불충분하며 효과적인 예방 프로그램은 보다 나은 대안이자 동시에 목적이 될 수 있다. 이러한 개입은 임신한 청소년들을 출산 이후에 노출되기 쉬운 디스트레스로부터 보호해주고 성인으로 성장하게 될 청소년들의 건강한 정신건강 도모이 기여하는 것으로 나파났다. 이는 결국, 임신한 청소년들을 대상으로 한 스트레스 대처 능력을 향상시키고 긍정적인 인지를 발달시킬 수 있는 스트레스 관리 프로그램의 필요성을 암시하고 있다. 이러한 연구 결과가 갖는 결론과 함께 앞으로 실천적 개입방안에 대한 더욱 정교한 연구가 요구된다.

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Introduction of Medical Simulation and the Experience of Computerized Simulation Program Used by $MicroSim^{(R)}$

  • Lee, Sam-Beom;Bang, Jae-Beum;SaKong, Joon
    • Journal of Yeungnam Medical Science
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    • 제24권2호
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    • pp.148-153
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    • 2007
  • 배경 : 의학시뮬레이션 교육방법이 새로이 도입되면서 다양한 방법이 개발되었다. 특히 컴퓨터와 인터넷을 이용한 시뮬레이션 교육이 학생들에게 사전에 임상수기 교육 및 임상경험을 가능하게 하여 많은 도움을 주고 있다. 본 연구는 $Microsim^{(R)}$ 프로그램을 이용한 학생들의 첫 경험을 보고하고 컴퓨터와 인터넷을 이용한 시뮬레이션 교육에 대하여 소개하고자 한다. 대상 및 방법 : 의학과 3학년 학생을 대상으로 임상의학입문 과정의 일환으로 $Microsim^{(R)}$ 프로그램을 이용하여 2주간의 실습후 획득한 점수를 산정하여 통과여부를 알아보고자 하였다. 모듈 1은 기도 및 호흡, 모듈 2는 심정지, 모듈 3은 심장 부정맥, 모듈 4는 흉통으로 정하였으며, 4개의 모듈에서 미리 지정된 각각의 증례하나를 선택하여 반복하여 실습하고 최종적으로 각각 통과점수가 70% 이상이 되어야 인정되도록 하였다. 결과 : 전체 75명의 학생이 참가하여 이중 56명(74.7%)이 4개의 모듈을 모두 통과하였다. 각각의 모듈의 평균 통과율은 모듈 1이 86.7%, 모듈 2가 85.3%, 모듈 3과 4가 각각 84.0%였으며, 4개 모듈의 평균점수는 88.6이었다. 결론 : 의학시뮬레이션이 비록 완전하게 통과되지는 않았지만 학생들로 하여금 실제적인 임상경험을 가능하게 하였다. 하지만 이는 아직은 기존의 교육방식의 보조적인 역할을 담당한다고 할 수 있으며 향후 좀 더 다양한 방법으로 반복된 시뮬레이션 교육과 이에 대한 평가가 필요할 것으로 사료된다. 아울러 의학시뮬레이션의 다양한 교육방법에 대하여 소개를 하고자 하였다.

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현장중심 교육과정을 적용한 방사선과 재학생의 직무수행도 평가 -일반촬영 (Evaluation of Job Performance of Radiology Students by using Field-based Radiography Course)

  • 권순무;김경아;박창희
    • 한국방사선학회논문지
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    • 제10권7호
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    • pp.551-557
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    • 2016
  • 국가직무능력표준(National competency standards, NCS)은 산업현장에서 직무를 수행하기 위해 요구되는 지식, 기술, 태도 등의 내용을 국가가 체계화한 것이다. NCS기반 현장중심 교육과정을 적용한 방사선과 재학생 3학년을 대상으로 일반촬영에 대한 방사선사 직무수행도를 평가하였다. 평가 결과, 모든 촬영방식에서 우수 및 충족 비율이 93% 이상으로 현장중심 교육과정이 재학생의 직무수행도 향상에 긍정적인 영향을 끼친 것으로 판단된다. CR 방식은 전체적으로 가장 우수한 평가를 받았으나 대상자 간 편차가 크고 영상기기조작능력이 부족한 것으로 평가되었고 Film 방식은 노출조건 설정 및 현상작업이 문제점으로 평가되었다. DR 방식은 우수한 평가를 받았으나 영상기기조작능력, 부속기자재운영능력이 부족한 것으로 평가되었다. 각 촬영에서 성취수준 이하의 평가요소를 교과목 운영에 보완한다면 재학생의 학업성취도 향상뿐만 아니라 졸업 후 임상에서 방사선사 직무수행도 향상에 도움이 되리라 판단 한다.

만성 뇌졸중 환자들의 지역사회 보행 수준 구별을 위한 일어나 걸어가기 검사, 8자 모양 경로 보행 검사, 네 막대 스텝 검사, 스텝 검사의 변별력과 예측 타당도 (Discriminant and predictive validity of TUG, F8WT, FSST, ST for community walking levels in chronic stroke survivors)

  • 이동건;안승헌;이규창
    • 대한물리치료과학회지
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    • 제27권2호
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    • pp.25-35
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    • 2020
  • Background: There are many situations where walking in an actual community needs to change direction along with walking on a straight path, and this situation needs to be reflected in assessing walking ability of the community. Therefore, in this study, we tried to determine whether the assessments can distinguish the level of walking in the community. Design: Retrospective cohort study. Methods: Fifty-two survivors with chronic stroke have participated in the study. According to the evaluation result of 10mWT, the subjects of 0.8m/s and above were classified as the group who could walk in the community (n=22), and the subjects of 0.4m/s~0.8m/s were classified into the group who could not walk in the community (n=30). Modified Rivermead Mobility Index, Postural Assessment Scale for Stroke, Fugl-Meyer Assessment, Berg Balance Scale, 10-meter Walk Test (10mWT) were used to evaluate the motor skills. Furthermore, Activities-specific Balance Confidence Scale was used to evaluate psychological factors, and Timed Up & Go Test (TUG), Figure-of-Eight Walk Test (F8WT), Four Square Step Test (FSST), Step Test (ST) were applied to evaluate dynamic balance and mobility. Results: As a result for distinguishing walking levels in the community, TUG was 14.25 seconds, F8WT was 13.34 seconds, FST was 19.43 seconds, and ST of affected side and non-affected side were 6.5 points and 7.5 points, respectively. TUG (AUC=0.923), F8WT (AUC=0.905), and FST (AUC=0.941) were highly accurate, but the ST of affected side and non-affected side (AUC=0.806, 0.705) showed the accuracy of the median degree, respectively. Conclusion: To distinguish walking levels in the community of survivors with chronic stroke, TUG and FSST have been found to be the best assessment tool, and in particular, FSST could be very valuable in clinical use as the most important assessment tool to distinguish walking levels in the community.

20년간 정관정관문합술 1000례의 임상적 경험 (20 Years-experience of 1000 Consecutive Vasovasostomy)

  • 서호경;박남철
    • Clinical and Experimental Reproductive Medicine
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    • 제25권2호
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    • pp.189-198
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    • 1998
  • Since the male sterilization (vasectomy) has been performed on a large scale as an accepted family planning in Korea on 1980s and this, in turn, has been followed by an increase in the number of patients requesting vasovasostomy. We studies 1000 consecutive cases of vasovasostomy performed from January 1975 to July 1995 in Pusan National University Hospital. In this report, we are going to present serial studies of vasovasostomy through which we attempted to find out what factors are of impotence in influencing the successful outcome of vasovasostomy operation. We inquired the operative results data through the questionnaire and telephone interview with survey of medical records. A total of 259 cases was excluded due to the loss of follow-up. The overall patency and pregnancy rates of 741 cases were 86.9% and 51.1%, respectively. The age of man at the time of anastomosis ranged from 23 to 57 years old with an average of 34.9. The most frequent reason for requesting vasovasostomy was the desire to have more children (43.4%). The average obstructive interval was 60.6 months with range from 1 to 264 months. If the obstructive interval had been less than 5 years patency rate was 92.4% and pregnancy rate 64.8%, but 6 years or more 84.1% and 48.5% (p<0.01, p<0.01). Patency and pegnancy rates according to intraoperative vas fluid were 93.1% and 62.8% for presence and 83.7% and 53.1% for absence (p<0.01, p<0.05). Patency and pregnancy rates according to histologically proven sperm granuloma at vasectomy site were 87.7% and 49.2% for presence and 86.9% and 50.6% for absence (p>0.05, p<0.05). Patency and pregnancy rates were not significantly different between microscopic standard vasovasostomy (88.4%, 64.3%) and modified vasovasostomy (89.5%, 56.3%)(p>0.05, p>0.05). Both patency and pregnancy rates according to level of anastomosis were 89.8% and 59.8% in cases of straight vas and 91.5%, 60.1% in cases of convoluted vas (p>0.05, p>0.05). Patency and pregnancy rates according to the kind of suture materials were 91.5% and 56.2% for absorbable, 91.0% and 64.2% for non-absorbable and 93.3% and 53.3% for absorbable plus non-absorbable, respectively (p>0.05, p<0.05). Thus it is suggested that the important factor influencing the success rate of vasovasostomy is the interval of obstruction and vasal ooze with surgical skills.

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중환자실 간호사의 의사소통 난이도, 중요도 및 만족도에 관한 인식과 환자 가족과의 의사소통 장애에 대한 조사연구 (ICU Nurses' Perceptions of Communication Difficulties, Importance, Satisfaction and Communication Barrier with Patient Families)

  • 안정원;김금순
    • Perspectives in Nursing Science
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    • 제10권1호
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    • pp.12-23
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    • 2013
  • Purpose: This study was conducted to investigate ICU nurses' perceptions of communication difficulties, the importance of and satisfaction with communication with doctors, other nurses, patients, and family, as well as to explore communication barrier with patient families. Methods: Investigators developed a 15-item communication perception questionnaire and 58-item communication barrier questionnaire. Communication barrier included 4 domains: nurses, family, environment, and patient condition. A total of 151 ICU nurses with a minimum of one year of ICU experience participated. Results: ICU patients ($3.38{\pm}0.73$) were the most difficult group to communicate with, followed by family ($3.32{\pm}0.72$), senior nurses ($3.25{\pm}0.74$), doctors ($3.21{\pm}0.68$), and nurse colleagues ($2.64{\pm}0.73$). Doctors ($4.61{\pm}0.53$) were the most important group to communicate with, followed by nurse colleagues ($4.52{\pm}0.54$), patients ($4.49{\pm}0.58$), senior nurses ($4.44{\pm}0.55$), and family ($4.43{\pm}0.61$). Satisfaction with communication was the highest with colleague nurses ($3.60{\pm}0.68$), then senior nurses ($3.37{\pm}0.74$), family ($3.18{\pm}0.71$), patients ($3.09{\pm}0.75$), and doctors ($3.06{\pm}0.83$).The total score of the communication barrier was $2.83{\pm}0.52$, where each domain was scored as follows: patient condition $3.13{\pm}0.74$, nurses $2.83{\pm}0.60$, environment $2.81{\pm}0.66$, and family $2.76{\pm}0.57$. The ICU nurses reported that communication was difficult due to 'sudden deterioration in the patient's condition', 'being too busy', 'a noisy environment', and 'information not being shared between family members.' Significant differences were noted by age, clinical experience, and marital status of nurse respondents. Conclusion: The findings indicated that development of a protocol on communication between nurses and doctors as well as development of an educational program on communication skills are necessary.

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