• Journal of Hospice and Palliative Care
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• 제19권1호
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• pp.11-25
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• 2016

목적: 본 연구는 응급실에서 임종을 맞이하거나 혹은 임종에 임박한 환자, 생애말기 환자를 돌보는 응급실 의료진의 죽음인식과 임종환자 돌봄 특성요인과 임종환자 돌봄 태도와의 관계를 확인하고, 임종환자 돌봄태도에 영향을 미치는 요인을 분석하고자 하는 것이다. 방법: 자료 수집은 2014년 06월 01일부터 2014년 06월 30일까지 4주에 걸쳐 수도권 소재의 3개의 상급종합병원 응급실 간호사 104명, 응급실 의사 41명을 대상으로 설문지 조사로 이루어졌다. 결과: 성별, 개인적 임종환자 돌봄 태도에 의해 응급실 의료진의 전문가적 임종환자 돌봄 태도는 28.1% 설명할 수 있으며, 죽음인식, 임종환자 돌봄 특성요인, 전문가적 임종환자 돌봄 태도, 임종환자 돌봄 교육 유무, 직종에 의해 응급실 의료진의 개인적 임종환자 돌봄 태도는 34.1% 설명할 수 있다. 응급실 임종환자 돌봄 특성요인으로는 응급실 의료진의 임종환자 돌봄은 응급실 환경에 영향을 받으며, 임종환자, 가족 및 동료 의료진과 관계와 관련이 있다. 결론: 응급실 의료진의 보다 나은 임종환자 돌봄 태도를 위해서 긍정적인 죽음인식을 이끌어낼 수 있는 효과적인 교육 프로그램 개발 및 임종환자 돌봄 특성요인에 따른 행정적, 실무적 정책 마련이 필요할 것이다.

• 대한예방한의학회지
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• 제22권1호
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• pp.61-67
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• 2018

Objectives : The purpose of this study was to examine the effectiveness and satisfaction of visiting Korean Medicine doctor program. Method : The senior center visiting Korean Medicine doctor program was conducted in ten senior centers in Seongnam city from April 2016 to December 2016. Korean Medicine doctors were assigned senior center one by one. The program consisted of health lectures and health counseling. The health lectures embraces stroke, musculoskeletal disease, dementia, depression and self care for the elderly Results : A total of 194 elderly persons participated the program. The self-health awareness level were changed from $50.86{\pm}25.31$ to $57.17{\pm}24.62$ (p-value=0.003). The physical pain level was decreased from $5.33{\pm}2.99$ to $5.04{\pm}2.86$. The quality of life were changed from $0.791{\pm}0.155$ to $0.792{\pm}0.144$ (p-value=0.923). Overall satisfaction of visiting Korean Medicine doctor program was $9.36{\pm}2.11$. The need for sustainability for visiting Korean Medicine doctor program was $9.76{\pm}0.60$. Conclusions : The study demonstrated that visiting Korean Medicine doctor program had a positive effect on the health awareness level. The overall satisfaction and further need were high. Further program for senior center will be needed.

• 보건교육건강증진학회지
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• 제13권2호
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• pp.1-23
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• 1996

This study was conducted to investigate health management and health awareness of industrial workers and use the information for the development of health education program and the guidline of health management for industrial workers. The survey was carried out on 1,200 workers who were selected from Incheon, Ulsan, Pohang, Masan, Changwon city from Oct. 2 to Oct. 31. 1995. The main results are summarized as follows. 1. With regard to health behavior after regular physical examination, 48.3% of subjests answered "consulting with medical doctors or health workers" and 7.9% answered "non action anything", 2. As for need of environmental control of work, of the total subjects, 96.1% answered "need". 3. As for participation of health education, 61.2% of the subjects were positive, which was higher in male, in higher age groups, in middle school graduates, in healthy group by self assessment than other groups respectively. 4. As for knowledge level of the disease, the average score was $4,97{\pm}1.41$ point to 7 point full mark (71 point to 100 point full mark), the score level was higher in male higher economic, in office workers, in higher education groups, in working period longer groups, in healthier groups, in higher age groups than other groups respectively. 5. As for attitude level of the disease, the average score was $4,70{\pm}1.25$ point to 7 point full mark (67.1 point to 100 point full mark), which was lower, in higher age group, in longer education level, in healthier groups in longer working period than other groups respectively, while the score was higher in male, in day-time workers, in urban residence than other groups respectively.han other groups respectively.

• 한국임상약학회지
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• 제21권4호
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• pp.311-318
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• 2011

Misinformation and inappropriate use of medication has become one of the most pressing concerns in drug safety. The purpose of this study was to survey public perception on drug safety as well as the channels most relied upon providing such information. The survey was performed for patients or their families visiting pharmacies in a local city in Korea. Analysis was performed from 367 respondents to the survey. The contents of this survey revealed that consumers were aware of the fact that medications should not be taken at any higher dosage or more often than directed by their prescriptions. The survey revealed a general awareness that symptoms might not be relieved immediately by their medications. However, the perception that there could be adverse drug reaction (ADR) at therapeutic dose was low except among the young or highly educated members. Respondents recognized that skin rashes were the most whereas drowsiness was the least common ADR symptom. There was a high awareness of drug-food or drug-drug interactions except in the case of certain nutraceuticals. Doctors and pharmacists were ranked as the most reliable resources to the consumer for providing drug related information. However, public relations or education programs were in need since there were still not negligible numbers of consumers depending on personal experience rather than health professionals.

• Asian Pacific Journal of Cancer Prevention
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• 제17권6호
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• pp.2901-2907
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• 2016

Background: Despite increasing debate about overdiagnosis and overtreatment of thyroid cancer in Korea, information to guide decisions on whether or not to undergo screening for and treatment of abnormal lesions of the thyroid is lacking. Moreover, studies have yet to outline what lay people know and want to know about thyroid cancer. The primary aim of this study was to explore general awareness of thyroid cancer among Korean women, their sources of information, and their satisfaction with the information they are provided. The secondary aim was to investigate information needs about thyroid cancer. Materials and Methods: A qualitative study using focus group interviews was conducted. Twenty-nine women were divided into four groups: (1) participants who had never undergone thyroid ultrasound screening; (2) those who had undergone screening, (3) those who continued to undergo regular check-ups with ultrasonography for benign nodules of the thyroid; and (4) participants who had undergone surgery for thyroid cancer. Results: A widespread lack of awareness of information on thyroid cancer was noted among participants in groups 1 and 2 who were not well aware of thyroid cancer and generally recognized it as a 'good cancer'. Surprisingly, instead of doctors and medical personnel, most participants reported obtaining information from acquaintances and media outlets. Moreover, most participants described dissatisfaction with their experience with screening and a lack of explanation on treatment and test results from medical personnel. Conclusions: Women in Korea seek reliable information on thyroid cancer that could help them to better understand the disease and make informed decisions regarding screening and treatment. More effort is needed from medical personnel to communicate the implications of thyroid cancer, screening results, and treatments thereof to lay people.

• 대한본초학회지
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• 제27권2호
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• pp.1-16
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• 2012

Objective : To investigate the current status of prescription drugs in Oriental medical institutes and to draw up a future plan for the revitalization of Oriental medical health insurance, this survey has been performed. Method : The survey has been made with 321 doctors working at Oriental medical institutes in Daegu and Kyungbuk areas for a period of 3 month from June 1, 2010 until September 1, 2010. Result : 1. When it comes to the current status of the use of herbal drugs in Oriental Health insurance, most of doctors surveyed prescribe insurance drugs, and they prescribe insurance drugs to patients, who are less than 20% of total patients visiting their clinics. 2. The awareness of Herbal Health Care Drugs is investigated. When it comes to the understanding of the difference between insurance drugs(powder type drugs) and granular type drugs, doctors admit that they differ only in one aspect, whether or not their being covered by health insurance. Based on the survey results on the understanding of insurance coverage of granular type drugs, doctors, even though they long for granular type drugs to be accepted as insurance drugs, are worrying whether the number of outpatients might dwindle due to increased insurance co-payments. They also point out that the biggest obstacles in the expansion of the granular type drugs as insurance drugs are the lack of understanding of the government and the objection of the Health Insurance Review and Assesment service (HIRA) for fear of increased insurance claims. 3. Upon investigation on Oriental medicine doctors' understandings of herbal pharmaceutical industry, it is found that doctors' responses on pharmaceutical industry are not all positive ones('new product development and neglect of R&D infrastructure' and 'smallness of industry'). When it is investigated what area needs the greatest improvement in herbal pharmaceutical industry, 'securing sufficient capital, good manufacturing, and strengthening quality control', is the highest. 4. When it is asked what are the most needed in order to improve herbal health insurance medicine, responses such as 'the increase in the accessibility to and the utilization of Oriental medical clinics through the diversification of the means of prescriptions', 'the improvement of insurance benefits(cap adjustments)', 'increase the proportion of high quality medicinal plants', 'the ceiling of co-payments(deductible) at 20,000 won or more', 'expansion of the choices of formulations', 'formulational expansions of tablets and pills', and finally 'admittance and expansion of granular type drug as insurance drug' are the highest. 5. Upon investigating the general characteristics of the current status of the usage of Oriental health care herbal drugs, the followings are observed. First, the frequency of use of health insurance drugs by the doctors who use health insurance with general characteristics shows similar differences in case of total monthly sales amount (p<0.001), average number of daily patients (p<0.05). Secondly, as to the willingness of the expanded usage of insurance drugs, similar differences are observed in case of total monthly sales amount (p<0.05). 6. Upon investigating the general characteristics of the perception of Herbal health care drugs, the followings are observed. First, inspecting general characteristics and insurance claims due to increased co-payments(deductible amount) reveals similar differences in case of working period (p<0.01) and in case of total monthly sales amount (p <0.01). Secondly, inspecting general characteristics and the obstacles that hinder granular type drugs from being accepted as health care insurance drugs shows similar differences in case of working period (p<0.05). 7. Upon investigating the general characteristics of the understanding of Oriental Herbal pharmaceutical companies, the followings are observed. First, opinions on the general characteristics of pharmaceutical companies, when examined with variance analysis, shows similar differences in case of total monthly sales amount (p<0.05). Secondly, when opinions are examined on general characteristics and the problems of herbal pharmaceutical companies, similar differences are found in case of working period (p<0.01) and in case of total monthly sales amount (p<0.001). Lastly, opinions on the general characteristics and reforms of pharmaceutical companies, similar differences are observed in case of working period (p<0.001). 8. Upon investigating the general characteristics of the improvement of insurance Herbal drugs, the followings are observed. First, regarding general characteristics and insurance benefits, similar differences are observed in case of working period (p<0.05), in case of total monthly sales amount (p<0.05), and in case of average number of daily patients (p<0.01). Secondly, opinions on the general characteristics and the needs for the improvement of Herbal insurance drugs are examined in 5 different aspects, which are the approval of granular type drugs as insurance drugs, the expanded practices of the number of prescription insurance drugs, the needs of a variety of formulations, the needs of TFT of which numbers of Oriental medical doctors are members for the revision of the existing system, and the needs of adjusting the current ceiling of the fixed amount and the fixed rate. When processed by the analysis of variance, the results show similar differences in case of average number of daily patients (p<0.01). Conclusion : From the results of this study the first measures to take are, to reform overall insurance benefit system, including insurance co-payment system(fixed rate cap adjustment), to expand the number of the herbal drugs to be prescribed matching with insurance benefit accordingly, and to revitalize herbal medicine insurance system through the change of various formulations. In addition, it is recommended to improve the effectiveness of herbal medicine by making plans to enhance the efficacy of herbal medicine and by enabling small pharmaceutical companies to outgrow themselves.

• Journal of Nutrition and Health
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• 제50권5호
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• pp.519-529
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• 2017

임상영양서비스에 대한 의사의 인식과 임상영양사 요구도에 대한 의사의 인식에 대한 인과관계를 명확하게 파악하기 위해 매개효과를 분석하고 부트스트래핑으로 매개효과를 검증한 이 연구의 결과물을 요약하면 다음과 같다. 연구목적을 달성하기 위해 5가지 가설을 다음과 같이 세웠다. 가설 1. '의사가 인식하는 임상영양서비스의 실행에 대한 의사의 인식'은 '임상영양서비스의 중요도에 대한 의사의 인식'에 정(+)의 영향을 줄 것이다. 가설 2. 의사가 인식하는 '임상영양서비스의 질병 치료 효과에 대한 의사의 인식'은 '임상영양서비스 중요도에 대한 의사의 인식'에 정(+)의 영향을 줄 것이다. 가설 3. '임상영양서비스의 중요도에 대한 의사의 인식'은 '임상영양사 요구도에 대한 의사의 인식'에 정(+)의 영향을 줄 것이다. 가설 4. '임상영양서비스 중요도에 대한 의사의 인식'은 '임상영양서비스 실행에 대한 의사의 인식'과 '임상영양사 요구도에 대한 의사의 인식' 사이에서 매개역할을 할 것이다. 가설 5. '임상영양서비스 중요도에 대한 의사의 인식'은 '임상영양서비스의 질병 치료 효과에 대한 의사의 인식'과 '임상영양사 요구도에 대한 의사의 인식' 사이에서 매개역할을 할 것 이다. 가설검증 결과와 매개효과 분석 결과 가설 1~5까지의 가설이 모두 지지되었다. 결론적으로 1) '임상영양서비스의 중요도에 대한 의사의 인식'이 완전 매개로 작용한 경우는 임상영양서비스 실행 횟수에 상관없이 의사가 임상영양서비스의 중요도를 인식해야만 임상영양사 요구도를 인식한다는 것이며, 2) 임상영양서비스의 중요도에 대한 의사의 인식이 불완전 매개로 작용한 경우는 임상영양서비스의 질병 치료 효과에 대한 의사의 인식과 임상영양서비스 요구도에 대한 의사의 인식 사이에서 프로세스 역할을 수행하지만, 임상영양서비스의 질병 치료 효과에 대한 의사의 인식이 임상영양서비스 요구도에 대한 의사의 인식에 더 큰 영향을 준다는 것이다. 따라서 임상영양서비스에 대한 의사들의 긍정적인 인식은 임상영양사 요구도에 대한 의사의 인식을 높이지만, 단순히 임상영양서비스의 양적 횟수 즉 임상영양서비스의 실행에 대한 의사의 인식이 아니라 환자 치료에 있어서 도움이 되는 질적 효과 즉 임상영양서비스의 질병 치료효과에 대한 의사의 인식과 임상영양서비스의 중요도에 대한 의사의 인식이 의사들에게서 임상영양서비스에 대한 긍정적인 인식을 이끌어 낼 수 있다. 이러한 의료진의 긍정적인 인식을 높이기 위해서는 추가적으로 임상영양서비스를 수행하는 임상영양사의 전문성이 요구된다. 이상의 결과를 근거로 임상영양서비스에 대한 의사의 인식이 임상영양사 요구도에 영향을 준다고 여겨진다. 더불어 영양학 분야의 유사연구에서 사회과학 분야 통계기법을 활용하여 명확한 인과관계를 규명하는데 본 연구가 발판이 되어 질 것으로 기대하는 바이다.

• Journal of Oral Medicine and Pain
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• 제30권2호
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• pp.163-199
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• 2005

치의학계에서는 의료사고를 일으킬만한 중환자나 응급환자의 빈도가 상대적으로 낮아 의료분쟁에 휘말리는 경우가 적었기 때문에, 이에 대하여 비교적 안전지대로 인식되어 왔다. 그러나 요즈음은 남의 일로 보아 넘기기에는 어려울 정도로 의료분쟁이 증가하고 있다. 이런 연유로 최근에 이르러서는 비교적 다양한 의료사고와 분쟁에 관한 연구가 이루어지고 있으며, 적당한 대처를 위하여 관련된 사항을 분석하고 있으나, 자료가 부족한 실정이다. 본 연구는 2004년 현재 서울시치과의사회 소속 개원치과의사 3684명중, 설문지가 회수된 1882명을 연구대상으로 하며, 치과의사를 대상으로 하는 의료배상책임보험이 시행되고 있는 최근의 개원 치과에서 일어나는 의료사고 및 분쟁의 실태와, 일반적인 치과의사들의 의식을 분석하고, 전체적인 흐름을 파악하여 향후대책의 자료를 제시하는 것을 연구목적으로 한 것으로 다음과 같은 결과를 얻었다. 1. 응답자의 98.47%가 향후 의료사고 및 분쟁 발생에 대한 의구심을 가졌다. 2. 응답자의 27.42%가 의료분쟁을 경험하였으며, 전공의 수련여부와 의료분쟁 경험률 사이에는 유의한 차이가 나타나지 않았다. 3. 의료사고 중 치주.보존 관련 사고가 20.50%로 가장 높았으며, 임프란트 관련사고도 6.17%로 나타났다. 4. 응답자의 43.02%만이 치료 전 충분히 설명을 하였으며, 환자의 정확한 동의없이 치료를 시작하는 경우도 25.90%로 나타났다. 5. 설명 및 동의를 시행하지 않아 의료분쟁이 발생한 것은 16.55%이며, 의무기록 관련자료가 부족하여 문제해결에 어려움을 당한 경우는 10.26%로 나타났다. 6. 응급조치를 시행할 수 있다고 생각하는 경우는 49.73%였으며, 이중 정확한 지식을 갖춘 경우는 23.60%로 나타났다. 7. 의료분쟁 발생시 88.09%가 치과의사에게 조언을 구하였으며, 또한 단체로는 구치과의사회에 주로 자문을 구했다. 8. 의료분쟁과 관련하여 소비자보호원으로부터 자료 제출 요구를 받은 경우는 5.26%로 나타났으며, 이들 중 75.61%는 이에 성실히 대응하였다. 9. 의료분쟁을 해결한 후 83.63%는 비교적 안정적인 심리상태를 회복하였다. 10. 응답자의 99.46%가 의료분쟁처리기구가 필요하다고 느꼈으며, 78.58%는 매우 시급하다고 생각하였다. 11. 66.70%의 치과의사가 의료분쟁 경험이 없이도 의료배상책임보험에 가입하였다. 그러나 응답자의 73.36%는 이 상품에 대하여 잘 몰랐으며, 가입자의 93.36%는 분쟁처리과정을 잘 알지 못했다. 12. 79.00%의 응답자가 의료배상책임보험에 가입한 후에는 의료분쟁이 발생하여도 당황스러우나 가입 이전보다는 비교적 안심할 수 있다고 느끼고 있었다. 13. 의료배상책임보험에 의한 분쟁의 해결시 치과의사는 71.92%가 보통이상으로 만족하였으나, 환자는 35.61%만이 만족하였다. 14. 의료배상책임보험의 보완점으로 53.22%가 분쟁의 신속한 해결을 위해서 보험사, 의사, 환자 모두가 합의 유도에 동참해야 한다고 생각하였으며, 또 29.08%의 응답자가 합의과정에서 환자측의 업무방해를 보험사에서 방어해 주기를 바라고 있었다. 이상의 결과들을 볼 때 증가하는 의료분쟁에 대한 인식을 제고하고 이에 대한 교육 및 해결 장치의 보완이 필요할 것으로 사료된다.

• 의학교육논단
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• 제19권3호
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• pp.121-128
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• 2017

When a new educational system for college students in South Korea was established in 1946, the National Committee for Educational Planning adopted a 6-year curriculum of medical education, consisting of a 2-year premedical component and a 4-year medical component. For more than half a century, the premedical curriculum has received little attention. However, it is very important for premedical students to have a range of experiences that could be useful in their future medical careers. In 2005, another change was made to the system of medical education, in which medical schools without a 2-year premedical curriculum were established. This began to stimulate interest in premedical education, and more and more professors have become interested in premedical education as 6-year medical colleges have become more popular than before. Since 2015, the Education and Cultural Center of the Korean Association of Medical Colleges has annually hosted a workshop for redesigning premedical education; these workshops quickly fill up with registrants, reflecting the participants' lively interest in premedical education. The problems of premedical education are mostly due to students' and educators' attitudes. A more effective approach will be needed in the educational system of the future to train highly competent medical doctors. To judge whether an educational program is successful, its aims must be clearly articulated. For this reason, medical colleges must prepare premedical education curricula based on their educational aims. It is expected that the system of premedical education will be strengthened in the future due to the growing awareness of its importance.

• Child Health Nursing Research
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• 제25권4호
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• pp.528-540
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• 2019

Purpose: This study was conducted to design services for improving the quality of care of hospitalized children with acute diseases. Methods: The service design process had four phases: discovery, definition, development, and delivery. The participants were 23 mothers of hospitalized children with an acute disease, and seven nurses and three doctors working at a pediatric hospital. Data were collected through self-report questionnaires, in-depth interviews, and observations. The data were analyzed using content analysis and descriptive statistics. Results: The participants reported needs for explanations about the treatment, skillful nursing, and environmental improvements. The concept of the services was familiarity and enjoyment, aimed at solving the problems of unfamiliarity and boredom. A six-guideline was presented for improving the quality of care of hospitalized children with acute diseases: improvement of awareness, development of educational materials, improvement of skills, environmental improvements, play activities, and evaluations of user satisfaction. Conclusion: These findings indicate that nursing services should deliver familiarity and enjoyment to hospitalized children and their families. The findings of this study emphasize that the service design methodology can be used to improve the quality of care of hospitalized children with acute diseases.