• 제목/요약/키워드: Clinical social work

검색결과 159건 처리시간 0.026초

한의학적 치료로 호전된 하지부 폐색성동맥경화증 환자 치험 1례 (The Clinical Study on 1 Case of Arteriosclerosis Obliterans Treated with Oriental Medicine)

  • 안재민;윤일지
    • 한방재활의학과학회지
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    • 제21권4호
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    • pp.269-279
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    • 2011
  • Objectives: The purpose of this study was to investigate the clinical application of blood-letting therapy and oriental medicine with arteriosclerosis obliterans. Methods: The patient in this case had been already treated by anticoagulation, percutaneous transluminal angioplasty and thrombolysis. But these methods didn't work on patient and condition had gone bad. Finally the patient's left limb was about to be amputated. Patient did not wall to cut off her lower limb, so she visited us to find a way for treating and preserving her lower limb. A drastic treatment was necessary in this situation. We treated the patient with Korean traditional treatment. Specially excessive blood-letting therapy and oriental medicine helped the patient to decrease the pain, numbness and frigidity. Results: After treatment the chief complaint and accompanying symptoms were subsided and improved. And personal and social performance scale was increased. Conclusions: According to this study, Korean traditional treatment such as blood-letting therapy, and oriental medication is effective for the cure of arteriosclerosis obliterans. During this period, foot necrosis was delayed and amputation is not needed any more.

Exploratory Study to Evaluate Changes in Serum Lipid Levels as Early Diagnostic and/or Prognostic Indicators for Oral Submucous Fibrosis and Cancer among Gutkha Consumers in India

  • Agarwal, Ankit;Saxena, Anshul;Rubens, Muni;Ahuja, Rinky;Tijare, Manisha
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권15호
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    • pp.6439-6444
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    • 2015
  • Background: In India smokeless tobacco users account for 25.9% of total tobacco use, Gutkha being the most common form. This study evaluated the association between serum lipid profile and Gutkha use as an early diagnostic and/or prognostic indicator for oral submucous fibrosis (OSMF) and oral cancer (Oral Ca) in non-smokers and non-alcohol consumers. Materials and Methods: A total of 163 participants were recruited from two sites in India. Participants were divided into four groups: individuals without any Gutkha chewing habit and without any oral lesions (control group), individuals with Gutkha chewing habit but without any oral lesions (GWL), patients with a confirmed clinical diagnosis of OSMF, and patients with a confirmed diagnosis of Oral Ca. Mixed linear modelling (MLM) was conducted to detect the change in mean serum lipid levels among four groups. Results: The sample consisted of 69% males and 31% females. Results of MLM show an inverse relationship between serum lipid levels in OSMF, and Oral Ca groups when compared to the control group. Conclusions: The results of our study demonstrated that GWL, OSMF and Oral Ca patients had lower serum lipid levels. Low serum lipid levels could be an indicator of initial neoplastic changes in oral cancer.

대학생의 가족건강성과 진로결정 어려움 간의 관계에서 진로자기조절의 매개효과 (Mediation effect of career self-regulation on the relation between family strength and career decision-making difficulties)

  • 신윤정;전주람
    • 한국가족복지학
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    • 제56호
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    • pp.105-133
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    • 2017
  • 본 연구는 대학생들이 인식한 가족건강성, 진로자기조절과 진로결정 어려움 세 변인간의 구조적관계를 탐색해보고자 하였다. 이를 위해 서울소재 4년제 대학교에 재학 중인 남녀대학생 172명을대상으로 가족건강성, 진로자기조절, 진로결정 어려움 척도로 구성된 설문을 실시하여, 진로자기조절의 매개효과를 가정한 부분매개모형인 연구모형을 검증하였다. 분석 결과, 첫째, 가족건강성은 진로결정 어려움에 직접적 영향을 미치는 것으로 나타났다. 둘째, 가족건강성과 진로결정 어려움 간의 관계를 진로자기조절이 유의미하게 매개하였다. 셋째, 부분매개모형이 완전매개모형보다더 자료에 부합함이 확인되었다. 이는 대학생들의 진로문제에 가족건강성이 미치는 직 간접적인영향력이 높음을 보여주는 결과로, 진로상담시, 가족환경에 대한 탐색 뿐 아니라 진로자기조절능력 증진을 위한 개입이 필요함을 시사한다.

Causal Inference Network of Genes Related with Bone Metastasis of Breast Cancer and Osteoblasts Using Causal Bayesian Networks

  • Park, Sung Bae;Chung, Chun Kee;Gonzalez, Efrain;Yoo, Changwon
    • 대한골대사학회지
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    • 제25권4호
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    • pp.251-266
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    • 2018
  • Background: The causal networks among genes that are commonly expressed in osteoblasts and during bone metastasis (BM) of breast cancer (BC) are not well understood. Here, we developed a machine learning method to obtain a plausible causal network of genes that are commonly expressed during BM and in osteoblasts in BC. Methods: We selected BC genes that are commonly expressed during BM and in osteoblasts from the Gene Expression Omnibus database. Bayesian Network Inference with Java Objects (Banjo) was used to obtain the Bayesian network. Genes registered as BC related genes were included as candidate genes in the implementation of Banjo. Next, we obtained the Bayesian structure and assessed the prediction rate for BM, conditional independence among nodes, and causality among nodes. Furthermore, we reported the maximum relative risks (RRs) of combined gene expression of the genes in the model. Results: We mechanistically identified 33 significantly related and plausibly involved genes in the development of BC BM. Further model evaluations showed that 16 genes were enough for a model to be statistically significant in terms of maximum likelihood of the causal Bayesian networks (CBNs) and for correct prediction of BM of BC. Maximum RRs of combined gene expression patterns showed that the expression levels of UBIAD1, HEBP1, BTNL8, TSPO, PSAT1, and ZFP36L2 significantly affected development of BM from BC. Conclusions: The CBN structure can be used as a reasonable inference network for accurately predicting BM in BC.

A Study on the Awareness of Dental Hygienists on Maternity Protection and Work-Family Balance Assistance Policy

  • Seon-Hui Kwak;Bo-Mi Shin;Soo-Myoung Bae
    • 치위생과학회지
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    • 제23권4호
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    • pp.396-407
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    • 2023
  • Background: This study investigated the awareness and utilization of maternity protection and work-family balance support policies among dental hygienists in dental hospitals and clinics. Methods: We surveyed 200 dental hygienists. Twenty-two who did not meet the inclusion criteria were excluded, leaving 178 participants for analysis. The self-administered 48-item questionnaire gathered information on demographics, workplace details, policy awareness, government knowledge, and suggestions for improvement. Results: Awareness of maternity and family support programs significantly differed with age, marital status, number of children, and clinical experience. Dental hygienists in general hospitals and university hospitals reported greater ease of utilizing these policies compared to those in dental clinics. Among the participants, 27.7% took pre- and post-maternity leave, 26.6% took parental leave, 16.9% had reduced working hours during pregnancy, 15.8% had reduced working hours during childhood,and 8.5% during family leave. To promote program uptake, participants suggested mandatory implementation across workplaces (68.4%), expanded support for substitute workers (48.6%), and increased education and promotion of government support (42.4%). Conclusion: While most dental hygienists were aware of the Maternity Protection and Work-Family Balance Assistance Policy, utilizing it proved challenging due to several factors. Organizational policies or practices may not fully implement this policy, while workplace culture could discourage its use. Unfair treatment and the lack of available substitutes further hindered access. To prevent career interruptions for dental hygienists due to pregnancy, childbirth, childcare, and family care, and to maintain career continuity, the dental community and government should establish a multifaceted social support system. This system should prioritize several key areas: strengthening policy promotion, fostering a family-friendly atmosphere, improving management and supervision of policy implementation and developing a robust support system for substitute personnel.

정신병적 우울증 양상을 나타낸 Sheehan씨 증후군 1례 (A Case of Sheehan's Syndrome Mimicking Psychotic Depression)

  • 정종현;홍승철;이성필;한진희
    • 정신신체의학
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    • 제5권1호
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    • pp.118-122
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    • 1997
  • 저자들은 13년전 심한 산후 출혈 후에 서서히 진행된 성선, 갑상선, 부신피질호르몬결핍증상과 함께 피해망상, 환청과 이에 따른 행동, 심한 불면증, 정신운동의 지체, 사회적 철퇴 등의 증상을 보인 51세 여자환자의 증례를 경험하였다. 환자는 일견 심한 정신병적 우울증의 양상을 보여 정신과에 입원하였으나 자세한 병력 청취 및 임상양상의 관찰로 내과적 질환에 의한 정신증의 가능성이 고려되었고, 호르몬 검사상 범뇌하수체기능 부전소견과 저혈당증 및 저나트륨혈증 등을 나타내 Sheehan시 증후군의 진단이 가능하였다. 갑상선과 부신피질호르몬의 투여 기타 보존적인 치료에 의해 정신과적증상을 포함한 제반 임상증상이 1주이내에 호전되었다. 저자들은 본 증례의 보고를 통해 정신과 환자에 대한 임상적 접근에서 간과되기 쉬운 내재된 내과적 문제의 감별의 중요성을 다시 한 번 강조하고자 한다.

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한방병원 입원환자의 진료비와 이에 영향을 미치는 요인 분석 (An Analysis of Medical Expenses for In-patients in an Oriental Medical Hospital and Factors Affecting Them)

  • 고민석;최준영
    • 대한예방한의학회지
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    • 제15권1호
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    • pp.71-87
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    • 2011
  • Objective : The present study is aimed at providing basic data to help oriental medical hospitals devise efficient operational plans by analyzing the medical expenses of in-patients in an oriental medical hospital and the factors affecting such expenses. Methods : PASW 18.0 was used to analyze the medical insurance program data of 929 patients who were discharged from a university oriental medical hospital(with 105 sick-beds) during the period from January 1 to December 31, 2010 after treatment under the coverage of health insurance and medical aid. Results : 1) Of all the patients hospitalized, 63.3% were females, their mean age was 52.73 years old, and 87.7% was covered by the health insurance program. The biggest number or 31.2% of the patients were treated by the department of acupuncture, 31.5% suffered mainly from the diseases of musculoskeletal system and connective tissues, and the average length of stay at the hospital was 19.49 days. 2) There were statistically significant differences in total medical expenses by age, clinical department in charge, principal diagnosis, and number of days hospitalized while daily average medical expenses differed depending on age, type of medical security, clinical department, principal diagnosis, and number of days staying at the hospital. 3) Total medical expenses were found significantly influenced by age, type of medical security, clinical department, principal diagnosis, and number of days hospitalized(explanatory power : 95.9%), whereas type of medical security, clinical department and principal diagnosis turned out to exercise significant influence on the daily average medical expenses(explanatory power : 26.9%). Conclusion : Oriental medical hospitals are suggested to make efforts to ensure geographical and economical accessibility for their main clients, the elderly and middle-aged, as well as to improve satisfaction of the clients with the medical service provided. They are also encouraged to work out systems to specialize in treatment with a focus on chronic degenerative and adult diseases. In addition, they are expected to try to enhance people's awareness of oriental medicine in an attempt to diversify the brackets of clients and increase frequency of their utilization.

호스피스완화의료 사회복지사 e-learning 교육과정 개발 (Development of e-learning Education Programs for Social Workers in Hospice and Palliative Care)

  • 심혜영;장윤정
    • Journal of Hospice and Palliative Care
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    • 제18권1호
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    • pp.9-15
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    • 2015
  • 말기암환자 관리를 위해서 전문인력 교육은 필수적이다. 정부에서는 암관리법을 통해 호스피스완화의료의 양적 확대를 기반으로 전문 인력을 양성하기 위해 제2기 암정복 10개년 계획에서 전문인력 확충계획을 발표하였다. 그간, 호스피스완화의료 전문인력 훈련을 위한 표준교육 과정과 의사/간호사 e-learning에 이어 이번 사회복지사 e-learning을 개발하여 운영하게 되었다. 호스피스완화의료 현장에서 사회복지사는 호스피스완화의료 대상자들의 심리 사회적 문제를 해결하는 중추적 역할을 수행해왔으며, 우리나라 호스피스완화의료가 정착되고 제도화되기까지 현장에서 전문가의 책임과 역할을 다해오고 있다. 하지만 그간 사회복지사 직종을 위한 체계적인 교육 과정이 없는 실정으로 사회복지 실천 지식과 기술을 충분히 습득하는 데 어려움이 있었다. 이번 호스피스완화의료 사회복지사 e-learning 과정 개발을 통해 말기암환자를 돌보는 사회복지사의 정체성과 전문성, 임상현장에서의 실천능력이 함양되고 교육 접근성이 향상될 것이며, 향후 보수교육 과정을 통한 지속적인 전문성 보장을 위한 교육제도가 제도적으로 도입되어 더욱 발전하길 기대한다.

암환자의 외상후성장에 영향을 미치는 요인에 관한 연구 (Posttraumatic growth in patients with cancer)

  • 한인영;이인정
    • 사회복지연구
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    • 제42권2호
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    • pp.419-441
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    • 2011
  • 본 연구는 암환자의 심리사회적 고통에만 초점을 두는 기존의 병리적 관점에서 벗어나 생존을 위협하는 암이라는 외상적 경험 속에서 얻게 되는 긍정적 변화와 성장을 검토하고 이에 대한 예측 요인을 분석하여 그 결과를 바탕으로 암환자의 외상후성장을 도모할 수 있는 임상적 개입에 대한 기초 자료를 제공하는 것을 목적으로 하였다. 이를 위해 연구 참여에 동의한 암환자 206명을 연구대상으로 설문조사를 실시하였으며 암환자의 외상후성장에 대한 예측요인을 검토하기 위해 인구사회학적 변인, 질병관련 변인, 대처, 사회적 지지를 독립변인으로 하여 연구모형을 구성하고 위계적 회귀분석을 통해 자료를 분석하였다. 조사 결과 암환자들의 외상후성장에 대한 주 영향요인으로 대처, 사회적 지지가 도출되었다. 이중 대처의 하위요인인 긍정적 재구조화가 암환자의 외상후성장에 대한 가장 강력한 예측요인으로 밝혀졌으며 이러한 결과를 토대로 사회복지적 함의와 후속연구에 대한 제언을 제시하였다.

임상실천 평가를 위한 단일체계설계의 적용 -우울증 감소를 위한 인지행동치료에 대한 평가를 중심으로- (Use of Single-System Design to Evaluate the Effectiveness of Cognitive Behavioral Therapy of Depression)

  • 김용석;손동균
    • 한국사회복지학
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    • 제60권2호
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    • pp.175-209
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    • 2008
  • 임상실천의 평가를 위한 도구로 단일체계설계를 강조하는 본 연구는 우울증 치료를 위해 정신과 병원에 입원한 3명의 클라이언트들에게 인지행동치료를 제공하고 개입의 효과성을 평가하기 위해 AB 설계를 사용하였다. 본 연구에 참여하기로 동의한 3명의 클라이언트는 모두 약 2주간의 기초선 단계와 약 3주간의 개입단계에 참가하였다. 평가결과의 타당성을 높이기 위해 다각적 측정원칙을 적용하였고, 기초선 단계와 개입단계 동안 수집된 자료는 시각적인 방법과 통계적인 방법으로 분석되었다. 시각적 분석의 정확성을 높이기 위해 추세선, 추세지수 등과 같은 방법을 활용하여 분석한 결과, 클라이언트 3명의 우울증상이 개입단계에서 모두 나아진 것으로 나타났으며 이러한 개선은 통계적으로도 유의미하였다. 본 연구는 모니터링, 클라이언트를 실천과정에 적극적으로 참여시킬 수 있는 기회 제공, 자료분석의 용이성을 임상실천평가를 위해 단일체계설계를 사용함으로써 얻게 되는 장점으로 들고 있다.

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