• 생물정신의학
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• 제14권1호
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• pp.21-27
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• 2007

Objectives : As a part of plan to develop evidence-based treatment guidelines for depression that is more suitable for Korean situation, we investigate the present status and client's requirements for non-pharmacological treatment of depression in Korean clinical situation. Methods : Subjects were patients with depression in 12 university hospitals which are located in metropolises in Korea. We analyzed the records from questionnaires about current clinical status and requirements for the non-pharmacological treatment of depression in Korea. Results : 50.8% of the subjects have experienced non-pharmacological treatments for their depression. The preference of non-pharmacological treatment method of depression is exercise/interesting activity, counseling by psychiatrists and psychotherapy, and the best effective treatment method is psychotherapy (Es=4.36). Actually, the mean consultation time by psychiatrist is $11.31{\pm}7.16$ min, and the appropriate consultation time for client's situation is $18.39{\pm}8.95$ min. During consultation, patients' satisfaction measurement for psychiatrist's explanation about pharmacological treatment is $64.17{\pm}27.11$, and satisfaction measurement for psychiatrist's counseling for their depression about personal problems, resent stress, interpersonal relationship is $61.66{\pm}26.63$. Conclusion : In Korea, many psychiatrists offered biologically oriented treatment to their patients with depression, and patients' satisfaction measurement about consultation by psychiatrists is low. Many patients wanted to combined pharmacological and non-pharmacological treatment for their depression, and aspired to information about complementary and self-help treatment methods. It is necessary to develop non-pharmacological treatment guideline for depression which reflect the clinical situation in Korea and meet Korean patients' need.

• 정신신체의학
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• 제27권2호
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• pp.130-137
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• 2019

연구목적 자살시도로 음독을 시도한 환자가 응급실에 내원했을 때, 응급의학과, 내과, 정신건강의학과가 서로 의사소통을 하고 우선순위에 따른 처치를 하는 것은 중요하다. 본 연구는 약물중독 환자에 대한 다학제 응급협진체계(이하 약물중독 응급협진체계)의 효용성을 검증하고자 시행되었다. 방 법 약물중독 응급협진체계 구축을 위해 정신건강의학과, 응급의학과, 내과의 전문의가 협의체를 구성하여, 응급실 내원 당시 복용 약물의 종류와 의식 수준에 따른 담당 진료과 및 협진의뢰과 배정, 각 과별 약물중독 환자 전담 교수 배정, 정기회의, 협진 응답 소요시간 제한, 원내 생명사랑위기대응센터 및 지역사회 자원 연계 등을 모두 프로토콜화하였다. 본 연구에서는 약물중독 응급협진체계가 시행되기 전인 2017년 7월부터 2018년 5월까지의 기간과, 시행 이후인 2018년 7월부터 2019년 5월까지의 의무기록 데이터를 후향적으로 통계분석하여, 약물 중독 응급협진체계의 효과를 검증하고자 하였다. 결 과 약물중독 응급협진체계 시행 후, 시행 전에 비해 중환자실보다 개방병동으로의 입원이 유의하게 증가하였다(χ²=8.567, p=0.014). 또한 타과로 입원한 환자 중 정신건강의학과로의 협진 비율이 증가하는 경향을 보였고χ²=4.202, p=0.053), 협진 응답 소요시간은 감소하였다(Z=-2.031, p=0.042). 한편, 협진 결과 전과된 환자의 비율이 증가였하고(χ²=4.692, p=0.043), 전과까지 소요된 시간은 감소하는 경향을 보였다(Z=-1.941, p=0.052). 결 론 약물중독 응급협진체계 시행 후 불필요한 중환자실 입원, 협진 응답 소요시간, 전과 소요시간이 감소하였으며, 협진 의뢰 비율 및 전과 비율은 증가하였다. 이는 다학제 협진체계가 환자에게 필수적인 의료서비스를 보다 적은 의료비용으로 신속하게 제공하였음을 의미한다. 향후 약물중독 이외의 자살시도에 대해서도 응급협진체계를 구축하여, 각 과 간 명확하고 책임있는 의학적 권고를 신속하게 공유한다면, 환자의 치료 및 의료비용 측면에서 긍정적인 효과를 보일 수 있을 것으로 기대된다.

• 무역학회지
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• 제48권4호
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• pp.321-342
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• 2023

본 연구는 코로나 19 상황에서 ICT 스타트업의 해외진출을 지원하기 위한 정부의 비대면 수출 및 무역 상담 플랫폼에 참여한 한국 ICT 스타트업의 경험을 분석하여 정책적 시사점을 도출하는데 목적이 있다. 연구방법은 비대면 수출 및 무역 상담 플랫폼에 참여한 6개 스타트업의 담당자를 대상으로 실제 참여 경험에 대해 반구조화된 심층 인터뷰 결과를 Giorgi의 현상학적 방법론을 기반으로 플랫폼 경험의 시간적 순서에 따라 분석을 진행하였다. 분석 결과 5개 단계별 상위 범주와 단계별 2개의 총 10개 하위 범주를 도출하였다. ICT 스타트업의 비대면 수출 및 무역 상담 플랫폼은 시간, 공간적 제한이 적어 효율적이나, 실질적인 비즈니스 지속성에는 한계가 있는 것으로 분석되었다. 본 연구는 ICT 스타트업의 비대면 수출 및 무역 상담 플랫폼을 통한 ICT 스타트업의 실제 참여 경험에 대해 심층적인 분석을 통해 엔데믹 상황에서 시사점을 도출하였다는 학술적, 실무적 의의가 있다.

• Journal of Acupuncture Research
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• 제37권3호
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• pp.161-166
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• 2020

Background: The purpose of this study was to investigate the characteristics and direction of treatment for peripheral facial palsy (PFP) based on medical collaboration between Western and Korean medicine departments. Methods: There were 195 outpatients with PFP identified retrospectively by examining electronic medical records. These patients were treated with Korean and Western medicine from January 1^st, 2018 to December 31^st, 2018 at the Kyung Hee University hospital. Records were analyzed according to the patients' demographic characteristics and clinical features of the collaborative combined treatment. Results: According to the collaborative treatment pathway, the number of patients consulted from Western medicine departments was more than consulted from Korean department for the first time. The time taken by the Western medicine departments to consult with the patients at the Korean center for the first time was 14.9 days from the onset of symptoms. Acupuncture was the most frequently used Korean medicine treatment. The total treatment period for Korean medicine sessions and intervals were 91.9 days, 23 times and 3.6 days, respectively. When the Korean medicine center consulted with Western medicine departments, the time taken until the first consultation was 8.5 days from the onset of symptoms. Medication was the most used treatment, prescribed after 3.1 days. The most frequently used clinical test was an electromyogram, and this was performed after 20.5 days. The total treatment period, sessions and intervals were 21.2 days, 2.8 times and 5 days, respectively. Conclusion: The clinical status of collaborative treatment for PFP was determined including the timing and interval of consultation according to treatments.

• 대한소아치과학회지
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• 제44권4호
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• pp.403-411
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• 2017

본 연구의 목적은 치과적 외상이 있는 소아청소년 입원환자의 치과 협진 의뢰에 대한 본원의 현황을 분석하고 발전 방향을 모색하는 것이다. 이에 2011년 3월부터 2017년 2월까지 6년간 원주세브란스기독병원 의과에 입원한 소아청소년 환자의 치과 협진 의뢰에 대한 후향적 분석을 하였다. 조사 항목으로 협진 의뢰 주소와 치과적 진단명, 협진 의뢰과, 치과적 외상 후 협진 의뢰 시기, 입원 기간과 치과적 외상 후 협진 의뢰 시기의 관계, 외상으로 의과에 입원하는 것과 치과적 외상 발생의 관계, 치과적 외상의 원인과 발생 나이, 치과적 외상에 대한 치료, 치과적 외상 환자의 퇴원 후 치과 외래 재내원 등이 있었다. 협진 의뢰 주소와 치과적 진단명에서 치과적 외상이 차지하는 비율이 가장 높았고, 협진 의뢰과는 외과 계열의 진료과가 가장 높은 비율을 보였다. 입원 기간과 치과적 외상 후 협진 의뢰 시기는 양의 상관 관계를 보였다. 외상을 이유로 의과에 입원하는 것과 치과적 외상 발생은 통계적으로 유의하게 연관이 있었고, 교통 사고로 인해 의과에 입원한 환자의 경우 100% 치과적 외상이 동반되었다. 입원실에서 발생한 치과적 외상 환자의 나이는 유의하게 적었다. 치과적 외상과 입원 중 치료, 치과적 외상과 퇴원 후 치과 외래 재내원은 각각 통계적으로 유의한 연관이 없었다. 교통 사고에 의해 의과에 입원한 소아청소년 환자에 대해서 치과적 외상이 동반될 가능성이 크고, 치과 협진 의뢰 시기가 지연될 수 있다. 어린 소아 환자의 경우 입원실에서 치과적 외상의 발생 가능성이 크다. 또한, 치과적 외상 환자의 입원 중 치료와 퇴원 후 치과 외래 재내원이 잘 이루어지지 않고 있다. 이와 같은 결과들에 대해 협진 의뢰 체계의 개선, 입원 병동 내 전담 인력 배치와 치과 시설 및 장비 구비, 의과 주치의에 대한 교육, 주치의 간의 원활한 의사소통 등이 대안이 될 수 있다. 본 연구는 의과와 치과의 교육 및 연구 자료로 활용되어 치과적 외상이 있는 소아청소년 입원환자의 치과 협진 의뢰에 관한 발전에 기여할 것으로 기대된다.

• International Journal of Computer Science & Network Security
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• 제24권3호
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• pp.83-92
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• 2024

It is a common observation that whenever any patient arrives at the front desk of a hospital, outpatient clinic, or other health-associated centers, they have to first queue up in a line and wait to fill in their registration form to get admitted. The long waiting time without any status updates is the most common complaint, worrying health officials. In this paper, UrNext, a location-aware mobile-based solution using Bluetooth low-energy (BLE) technology, is presented to solve the problem. Recently, a technology-oriented method has been gaining popularity in solving the healthcare sector's problems, namely the Internet of Things (IoT). The implementation of this solution could be explained through a simple example that when a patient arrives at a clinic for her consultation. There, instead of having to wait in long lines, she will be greeted automatically, receive a push notification telling her that she has been admitted along with an estimated waiting time for her consultation session. This will not only provide the patients with a sense of freedom but would also reduce uncertainty levels that are generally observed, thus saving both time and money. This work aimed to improve clinics' quality of services and organize queues and minimize waiting times in clinics, leading to patient comfortability and reducing the burden on nurses and receptionists. The results demonstrated that the presented system was successful in its performance and helped achieve high usability.

• 생물정신의학
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• 제6권1호
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• pp.49-66
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• 1999

Polypharmacotherapy, both psychotropic and nonpsychotropic, is widespread in various situations including psychiatric hospitals and general hospitals. As the clinical practice of using more than one drug at a time increase, the clinician is faced with ever-increasing number of potential drug interactions. Although many interactions have little clinical significances, some may interfere with treatment or even be life-threatening. The objective of this review is evaluation for drug-drug interactions often encountered in psychiatric consultation. Drug interactions can be grouped into two principal subdivisions : pharmacokinetic and pharmacodynamic. These subgroups serve to focus attention on possible sites of interaction as a drug moves from the site of administration and absorption to its site of action. Pharmacokinetic processes are those that include transport to and from the receptor site and consist of absorption, distribution on body tissue, plasma protein binding, metabolism, and excretion. Pharmacodynamic interactions occur at biologically active sites. In psychiatric consultation, these two subdivisions of drug interactions between psychotropic drugs and other drugs are likely to happen. We gathered informations of the drugs used in physically ill patients who are consulted to psychiatric department in Korea University Hospital. And we reviewed the related literatures about the drug-drug interactions between psychotropic drugs and other drugs.

• 대한간호학회지
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• 제42권7호
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• pp.1070-1078
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• 2012

Purpose: The purpose of this study was to examine the effects of a face-to-face self-management educational program on knowledge, self-care practice and kidney function in patients with chronic kidney disease (CKD) before kidney replacement therapy. Methods: This study employed a nonequivalent control group, non-synchronized design. Data were collected from 61 patients with CKD visiting an outpatient department of nephrology in a university hospital in Seoul, South Korea. The experimental group (n=31) took the pre-test, then after 3 weeks, face-to-face education and individualized consultation (1st intervention), after a week of self-practice, the 1st post-test, followed by re-enforcement education and consultation (2nd intervention), and 4 weeks later, the 2nd post-test. The control group (n=30) took the pre-test and post-tests at 4 and 8 weeks. Results: Scores for knowledge of CKD and self-care practice over time improved significantly in the experimental group compared to the control group. Kidney function did not improve significantly in the experimental group. Conclusion: Health care providers can identify various and individualized needs, and provide effective education and consultation through face to face self-management for patients with chronic irreversible illnesses. Nurses can coordinate for these program by designing and providing systematic and effective education.

• 한국컴퓨터정보학회논문지
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• 제21권7호
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• pp.23-30
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• 2016

In this paper, we propose a portable art therapy content. The proposed content makes counseling clients get a psychical cure at least cost regardless of time and place Counseling clients express their psychological state as pictures through the proposed content. And Counselors analyze and interpret the figures based on the database which is built into the server system. Due to the development of advanced technologies, various adjustment disorders and addictions have increased in the rapidly changing modern society. This causes the increase of counseling clients who want a psychical cure. And also counseling time, counseling place and counseling cost are emerging as a social issues. Psychotherapy specialists use the proposed content at the stage of the psychoanalysis which needs a lot of time and effort. The proposed content exploits the sever system to make the right decisions quickly and accurately. Counseling clients who are the medical underprivileged get visit consultation and online consultation can detect a psychological high-risk in an early stage and prevent this psychological high-risk. Preventive treatment service using the proposed content will make the social and medical cost savings.

• 정신신체의학
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• 제2권1호
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• pp.22-33
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• 1994

The author presented several points of experienced materials obtained from the joint meetings of consultation-liaison Psychiatric division with oncologic department in Kyung Hee University Hospital. The joint meetings which have been held regularly every other week were very helpful not only for the psychiatrist but also for the cancer department stags to manage the cancer patients actively. The joint meetings have been progressed into more cohesive and active communication as time goes by. Most of the subjects discussed in the meeting was focused on the psychological and behavioral problems of the cancer patients. Besides, the difficulties arising from the chemotherapy were discussed. Probably the most difficult task for the treatment team was to provide complete information while respecting the patient's right to deny their situation The liaison psychiatrist usually gave comments to the charge doctor and/or nusing staff how to evaluate the patient's behavior and what would be the influential factors in developing the doctor-patient relationship. It was found that many cancer patients and their family members had their own peculiar illness behavior and disease concept which led patients to take non-medical or moreover, anti-therapeutic care. The family members were found to play an influential role in the choice of treatment method and progression of the disease. Another role of the liaison psychiatrist in the oncology ward was to encourage the treatment team members. In the practical point of view, it was not easy for the liaison psychiatrist to have time regularly for the cancer patients to encourage the liaison activities. And it seems to be fundamental that the consultation fee for the liaison psychiatrist should be set up at the resonable level.