• 한국의사학회지
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• 제36권2호
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• pp.1-12
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• 2023

Immediately after liberation, Shin Kwang-ryul served as the director of the Shinbukcheong People's General Hospital, and defected to South Korea alone in December 1945 with hostility to the Soviet military government. Later, he joined the political operation team (政治工作隊) and was dispatched to the Sinbuk Office as a member of Hamgyeong-do's committee. However, after this was revealed, his wife was taken to the security and tortured to death. Later, when he learned about this, he left a Wolnam Yuseo (越南遺書) and decided to commit suicide. He left politics and started a new family while running a pharmacy. In 1950, he fled Dangjin, Chungnam, during the Korean War and opened an East Asian medical clinic. In 1955, he passed the Korean Medical Examination and opened Cheongpa Oriental Medicine Clinic in Asan, Chungcheongnam-do. In 1969, he ran an East Asian medical clinic in Dohwa-dong, Mapo, Seoul, and moved to Hongeun-dong in 1972 to open Hamnam Oriental Clinic. At this time he wrote a Cheongpa Pharmacy Summary (靑坡驗方要訣). In his later years, he treated poor patients for free, and he continued to work even though he was unwell due to a broken spine. He died in 1980 leaving behind a "proud mind".

• Journal of Hospice and Palliative Care
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• 제1권1호
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• pp.56-64
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• 1998

목적 : 본 연구는 서울대학교병원의 말기암환자와 가족을 위한 집단상담 프로그램을 소개하고, 현황 및 문제점을 파악하고자 하였다. 방법 : 1996년 한 해동안 상담에 참석한 말기암환자 및 가족들의 상담기록지를 중심으로 연구자들이 상담한 내용을 분석하였다. 결과 : 참석자 312명은 가족(84%)이 환자(16%)의 4배 이상 참석했고, 대부분 1회만 참석하고 있음을 보여주었다. 참석한 환자 또는 가족이 돌보는 환자의 현황은 나이별로 60대, 50대, 40대가 많았고, 암의 종류는 폐암, 위암, 간암 순으로 많았다. 가족의 특성은 261명으로 배우자, 자녀, 며느리, 형제자매, 부모순으로 많았다. 프로그램에 오게된 경로는 의사의 권유(69%), 병원 포스터(26%), 기타 순이었다. 이것은 의사가 환자와 가족을 집단에 참여시키는데 중요한 역할을 담당하고 있음을 보여준다. 질문은 우선적으로 의료적인 정보에 대한 욕구가 많았다. 이것은 환자나 가족이 의료진으로부터 정보를 제대로 전달받지 못하고 있음을 보여준다. 또한 가족은 환자를 돌보는데 있어서 정보의 제공만으로 해결될 수 없는 여러가지 실제적인 어려움을 주고 있었다. 그 결과 계속적인 24시간 전화상담 서비스 호스피스 시설 가정간호 서비스의 확대, 3차 의료기관과 1,2차 의료기관과의 의뢰 체계 등을 필요로하고 있었다. 따라서 병원에서 제공될 수 있는 프로그램과 지역사회에서 제공될 수 있는 자원, 호스피스 시설과의 연계가 필요하며 이를 관리해줄 수 있는 환자 관리 전담 인력이 필요하다. 결론 : 본 프로그램은 1회(single-session)적인 성격이 강하지만 환자와 가족이 궁금해하는 점들을 만족시켜주므로서 암에 대한 인식이 증가하고 대처능력이 향상되고 있음을 볼 수 있다. 이것은 이 프로그램이 위기에 처한 말기암환자와 가족을 지지하는 프로그램으로서 활용가치가 높다고 볼 수 있다. 추후 연구는 프로그램의 효용성에 대한 평가가 검토되어야 할 것이며, 다른 병원에서도 각 병원의 특성과 참석자들의 특성을 고려하여 보다 발전된 프로그램이 나오기를 바란다.

• 호스피스학술지
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• 제2권1호
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• pp.58-74
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• 2002

This paper constitutes a descriptive investigation and used a structured questionnaire to investigate nurses' and doctors' recognition of cancer patients. The subjects were extracted from the medical personnel working at the internal medicine, the surgery ward, the obstetrics and gynecology department, the pediatrics department, the cancer ward, and the emergency room of five general hospitals located in Seoul and Gyeonggi Province. The research lasted from August, 2001 to September 2001. Total 137 nurses and 65 doctors were included and made out the questionnaires directly distributed by the investigator. The study tool was also developed by the investigator and consisted of such items as the demographic and social characteristics, the medical personnel's recognition degree of cancer and cancer patients, their recognition of the management of cancer patients, and their participation in a hospice. The results were analyzed using the SPSS Window program in terms of technological statistics, ranks, t-test, and ANOVA. The reliability was represented in Cronbach' α=.75. The nurses' and doctors' recognition degree of cancer and cancer patients had an overall average of 3.86 at the 5 point-scale. The items that received an average of 4.0 or more included 'Medical personnel should explain about the cancer cure plans to the cancer patient and his or her family', 'A patient whose case has been diagnosed as a terminal cancer should be notified of it, 'If I were a cancer patient, I would want to get informed of it,' and 'Cancer shall be conquered whenever it is'. In the meantime, the items that received an average of 3.0 or less was 'My relationship with the cancer patient's family has gotten worse since I announced his or her impending death.' And according to the general characteristics and the difference test, the recognition degree of cancer and cancer patient was high among the subgroups of nurses, females, married persons, who were in their 30s, who had a family member that was a cancer patient, and who received a hospice education. The biggest number of the nurses and doctors saw 'a gradual approach over several days'(68.8%) as a method to tell a cancer patient about his or her cancer diagnosis or impending death. Those who usually tell tragic news were the physician in charge(62.8%), the family members or relatives(32.1%) and the clergymen(3.8%) in the order. The greatest number of them recommended a cancer patient's home as the place where he or she should face death because they thought 'it would stabilize his or her mentality'(91.9%) while a number of them recommended the hospital because they 'should give the psychological satisfaction to the patient'(40%) or 'should try their best until the last moment of the patient's death'(30%). A majority of the medical personnel regarded 'smoking or drinking' and 'diet' as the causes of cancer. The biggest symptom of a cancer patient was 'pain' and the pain management of a cancer patient was mostly impeded by the 'excessive fear of drug addiction, tolerance to drugs and side effects of drugs' by medical personnel, the patient, and his or her family. The most frequently adopted treatment plan of a terminal cancer patient was 'to do whatever the patient or his or her family wants' to resort to a hospice' and 'to continue active treatment efforts' in the order. The biggest reasons why a terminal cancer patient went to see a doctor were 'pain alleviation' 'control of symptoms other than pain(intravenous supply)' and 'incapability of the patient's family' in the order. Terminal cancer patients placed their major concern in 'spiritual(religious) matter' 'emotional matters' their family' 'existence' and 'physical matters' in the order. 113(58.5%) of the whole medical personnel answered they 'would recommend' an alternative treatment to a terminal cancer patient mostly because they assumed it would 'stabilize the patient's mentality.' Meanwhile, 80(41.5%) of them chose 'not to recommend it mostly due to the unverified effects and high cost of it(78.7%). A majority of them, I. e. 190(94.1%) subjects said they 'would recommend' a hospice to a terminal cancer patient mostly because they thought it would help the patient to 'mentally prepare'(66.6%) Only 17.3% of them, however, had received a hospice education, most of which was done through the hospital duty education(41.4%) and volunteer training(34.5%). The follows are results of this study: 1. The nurses and the doctors turned out to be still passive and experience confusion in dealing with a cancer patient despite their great sense of responsibility for him or her. 2.Nurses and Doctors realize the need of a hospice, but an extremely small number of them participate in a hospice education or performance. Thus, a whole recognition of a hospice should be changed, for which purpose a hospice education for nurses and doctors should be provided. 3.Terminal cancer patients preferred their home to a hospital as the place to face their impending death because they felt it would bring 'mental stability.' And most of nurses and doctors think it would be unnecessary for them to be hospitalized just for control of their symptoms. Accordingly a terminal cancer patient can be cared at home, and a home hospice care needs to be activated.

• 농촌의학ㆍ지역보건
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• 제29권1호
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• pp.1-14
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• 2004

본 연구는 고령자들의 건강검진행동과 인구사회학적 및 일상생활습관의 여러 기본요인들과의 관련성에 대해서 사회적 배경이 다른 도시와 농촌지역간의 차이 및 남녀간의 차이를 검토하고자 하였다. 조사대상은 도시지역과 농촌지역으로 구분하여 층화집략무작위추출(stratified cluster random sampling)에 의하여 도시지역 236명, 농촌지역 228명 합계 464명을 추출하여 면접조사 하였다. 조사내용은 조사대상의 인구사회학적 특성, 일상생활승관, 주관적인 건강상태 및 의료이용상황, 청력, 시력 및 일상생활수행동작(ADL), 건강검진 수진여부 등을 조사하였다. 그 결과 조사대상자의 건강검진 수진율을 보면 도시지역은 남자가 54.5%, 여자가 46.9% 농촌지역은 남자가 59.8%, 여자가 42.7%로 도시 농촌 모두 남자가 여자보다 높은 수진율을 보였다. 남자에서의 수진자군은 비수진자군에 비해 자택 소요군, 비흡연군, 음주 중단군, 만성질환이 있는 군, 식생활습관이 좋은 군에서 높았다. 여자에서의 수진자군은 비수진자군에 비해 저연령군, 부부동거군, 자택소유군, 식생활습관이 좋은 군, 최근 3개월간 외래진료를 받은군, 건강에 대해 불안감을 갖고 있는군, 요실금이 있는 군에서 높았다. 지역별수진자군과 비수진자군의 차이는 연령, 가족유형, 현재하고 있는 일, 가게 월수입, 주택소유상황, 음주여부, 식생활습관, 관적인 건강상태, 최근 3개월간의 외래진료 유무, 건강에 대한 불안감 유무 IADL 상태 등이 항목에서 도시 농촌지역간에 유의한 차이를 보였다. 다변량회귀분석 결과 건강검진 수진행동에 영향을 미치는 요인으로는 도시지역의 경우 주택 소유여부, 단골의사 여부, 건망증 및 요실금 여부, 만성질환 유무 등이 선정되었으며 농촌지역의 경우는 단골의사 여부, 뇨실금 여부, 건강불안, 하력, 주택소유여부, 만성질환 유무 등이 선정되었다. 결론적으로 고령자들에서의 건강검진행동은 개인의 인구사회학적 특성에 따라 다양한 차이를 보이는 것은 물론, 이들의 일상생활습관, 주관적인 건강상태, 건강검진수진상황, 신체적 건강상태 및 ADL상태 등에 따라서도 많은 차이를 보이게 됨으로 향후 건강검진계획에는 이 같은 변수를 고려할 것이 요망되며, 또한 지역적인 특성을 고려할 필요가 있을 것으로 본다.

• 여성건강간호학회지
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• 제4권3호
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• pp.309-321
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• 1998

The purpose of this study was to analyze the contents related to health in the three major monthly women's magazine that was printed from March, 1997 to February, 1998. The unit of analysis was the section of health, living life, and reaing child. The total number of related story of health was 317. The analysis was done according to the target, health management, topics and the informer by using frequency and number. The findings are as follows : 1. The contents were categorized by target people. The number of items for women was 113(35.6%), child(17.4%), family(15.5), husband(4.7%) and others(26.8%). Others were the contents that are impossible to classify. 2. The number of items of contents by health management was the related to health maintenance and promotion 120(47.8%), health care when they were deviated from health 26(10.3%), and those of both attributes 105(41.8%). 3. The number of items of contents by topics was the related to the occurrence, prevention and treatment of various kinds of disease 41(12..9%), diet 37(11.7%), academic information 11.3%, women's disease 10.4%, the effect of foods 6.0%, child's growth & development and child care 5.75, various kinds of therapy for health care 5.7%, sexual life 5.4% and exercise 4.7%. 4. The number of items of contents by informer was medical doctor 215(49%), lay person's case report or report of a struggle against a disease 12.3%, relevant organization of a related story(eg. family therapy research institute, physical therapist's or teacher's) 11.2%, and the contents of existing books or lecture 8.9%. Among those contents, only the one case from nurse or Korean nurses association as informer was founded, which is related to "skinship child care." In conclusion, this finding showed that women's magazine took a role as a important resource providing informations of health to women. it provides a challenge to the health professionals to have concerns on women's needs, and the content, source, and accuracy of the health related information and take part in the process producing information through such as screening and examining so as to give accurate information to women. Then women's magazine can take a role as a major resource for maintaining and promoting women's health. Finally, nurses's, who are professional health care providers, important and active role as informers toward the lay persons, especially for the women who are non-professional care givers at the family unit should be stressed. More active and continual monitoring and analyzing the contents related health in the mass media including magazine and Internet network in detail, and participating in establishing the system of adequate and precise information for women and lay persons from the nursing profession are required absolutely.

• 의료법학
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• 제25권1호
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• pp.149-192
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• 2024

정신질환자는 대체로 병식이 전혀 없거나 자발적 치료의지가 없는데, 그에 따라 치료가 어렵고 그 고통은 주로 가족에게 전가된다. 그에 따라 환자를 직접 대면하여 진료하지 않고 가족과의 면담을 통해 예후를 관찰하여 진단하는 비대면진료 및 가족을 통해 몰래 투약이 이루어지는 비고지투약이 이루어질 수 있고, 이는 필요악으로 여겨지기도 했다. 이러한 정신건강의학과 진료의 특수성이나 가족들이 받는 고통 등 현실적인 측면을 고려하더라도 환자 몰래 약을 투약하는 등 동의 없는 치료는 의료법 위반은 물론 강제입원처럼 정신질환자에 대한 인권침해의 소지가 크다. 무엇보다도 이를 뒤늦게 환자가 알게 되는 경우에는 환자와 가족, 의사 사이의 신뢰가 완전히 깨지고 치료를 절대적으로 거부하는 상황이 발생한다. 여러 사정을 고려하여 그 예외적 허용요건을 제시한 일본의 치바(千葉)판결은 구체적 타당성을 도모하는 하나의 해결책이 될 수도 있다. 그러나 비고지투약을 예외적으로 허용하고 이를 일시적인 조치로서 허용하려는 의도와 달리 이는 현실적으로 장기적인 비고지투약으로 이어지고 치료적 대화를 통한 치료 및 투약은 완전히 단절될 수 있다는 점을 감안할 때 올바른 해결책이 아니다. 결국, 치료적 대화의 복원을 통해 이 문제를 근본적으로 접근하고 대안을 모색할 필요가 있다.

• 한국치위생학회지
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• 제23권6호
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• pp.431-439
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• 2023

연구목적: 연구자는 아동 치과 주치의 프로그램에서 필수 서비스와 중요도, 검진 주기, 치과위생사의 역할을 알아보고자 한다. 연구방법: 최종연구대상자는 치과위생사, 치과의사, 치위생과 학생으로 총 124명이고, 자기기입식 설문지를 작성했다. 수집된 자료는 독립 t-검정, ANOVA로 일반적인 특징에 따라 그 차이를 비교했고, 이들의 관계는 Pearson 상관관계분석으로 분석했다. 연구결과: 검진 대상자에게 구강 검사와 방사선사진 촬영 등은 꼭 필요한 검사항목이고, 칫솔질과 구강용품 사용, 정기 검진의 중요성을 교육해야 하며, 대구치 실런트와 치면세마와 같은 예방 처치를 제공해야 한다고 생각했다. 또한 치료 서비스에서는 광중합형 레진과 GI 충전이 필요하다고 응답했다. 검진 주기를 치료보다는 교육과 예방을 더 짧게 해야 한다고 생각했다. 치위생과 학생이 치과의사와 치과위생사보다 검진, 교육, 예방, 치료 서비스가 더 중요하다고 응답했다. 구강검진과 교육 및 치료 간의 상관관계가 높았고, 필수 서비스와 중요성도 정(+)의 상관관계를 가졌다. 결론: 필수적이고 중요하다고 생각하는 구강 검사, 교육, 예방, 치료 서비스를 치과주치의 프로그램으로 어린이에게 제공해야 한다. 구강보건 교육과 예방관리는 치료보다 더 자주 제공되어야 하고, 그 중요성을 치위생과 학생뿐만 아니라 서비스의 주체인 치과위생사와 치과의사에게도 강조할 필요가 있다.

• 한국보건간호학회지
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• 제11권1호
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• pp.82-92
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• 1997

Cerebrovascular diseases in Korea is an important health problem since mortality and mobidity have been increased rapidly. It marked the 2nd cause of specific death rates in 1993. The subjects of the study were seventeen citizens who are using to the Oriental Medicine. The data were collected from Apr. to Oct. 1996. The researcher as a caregiver and volunteer made confidence of them and asked for their agreement on the purpose of the study. The subjects expressed their experience as openheartedly as possible. The researcher described closely the experiences of using to the Oriental Medicine with there words themselves and under the observation of the reseacher. A tape-recorder was used under the permission of the subjects to prevent the leakage of the spoken information and communication. The analysis of the data was made through the phenomenological analytic method suggested by Van Kaam, which is as follows; as an unit of description which include the subject' expressions and the researcher's observation. The conclusions of this study was as follows : one hundred eighteen descriptive expression found and they were grouped eighteen common factors. These are ${\ulcorner$to effect needle${\lrcorner}$ ${\ulcorner$to effect Chinese medicine${\lrcorner}$ ${\ulcorner$treatment method${\lrcorner}$ ${\ulcorner$attitude of herb doctor${\lrcorner}$ ${\ulcorner$recommendation of family and other person${\lrcorner}$ ${\ulcorner$what one sold to${\lrcorner}$ ${\ulcorner$traditional custom${\lrcorner}$ ${\ulcorner$experience of the past use${\lrcorner}$ ${\ulcorner$to be desolate${\lrcorner}$ ${\ulcorner$negative recognition${\lrcorner}$ ${\ulcorner$Ineffective drug${\lrcorner}$ ${\ulcorner$Unfaithful of doctor${\lrcorner}$ ${\ulcorner$positive recognition${\lrcorner}$ ${\ulcorner$Oriental medical hospital surroundings${\lrcorner}$ ${\ulcorner$to build up one's health${\lrcorner}$ ${\ulcorner$to be clear blood${\lrcorner}$ ${\ulcorner$economic burden${\lrcorner}$ ${\ulcorner$deficit of profession${\lrcorner}$ Finally. eighteen common factors were grouped under six highter categories. These are ${\ulcorner$Belief to oriental medicine${\lrcorner}$ ${\ulcorner$motivation of use${\lrcorner}$ ${\ulcorner$distrust to western medicine${\lrcorner}$ ${\ulcorner$stability of emotion${\lrcorner}$ ${\ulcorner$Alteration of positive physical function${\lrcorner}$.

• 대한한방소아과학회지
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• 제21권3호
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• pp.177-188
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• 2007

Objectives The purpose of this study is to investigate the effects of simultaneous treatment with supplementary therapy and treatment interval for improving symptoms and satisfaction rate by treating child rhinitis or paranasal sinusitis patients. Methods 41 rhinitis or paranasal sinusitis patients who visited the clinic between April 2004 and April 2006 were involved for this study. The patients were classified into Group A(2 sessions per week, simultaneous supplementary therapy), Group B(1 session in 2 weeks, simultaneous supplementary therapy) and Group C(1 session in 2 weeks, no supplementary therapy). After the experiment, the improvement rates of symptoms and satisfaction rate were surveyed by the questionnaires. Supplementary therapies used in Group A and B were aroma spray, Saengbit-patch, cutaneous acupuncture, nebulizer and Chuna manipulation. Results From 41 of the rhinitis or paranasal sinusitis patients, the Group A(simultaneous treatment group, 2 sessions of intensive care per week with supplementary therapy) showed the remaining symptoms score of $12.1{\pm}10.0$ in average. This score was the lowest comparing with the average of $25.7{\pm}12.9$ in Group B(1 session in 2 weeks, simultaneous treatment group with supplementary therapy) and the average of $21.0{\pm}20.1$ in Group C(1 session in 2 weeks, no supplementary therapy). Nose symptoms and sleep scores were significantly lower in Group A(p<0.01). The satisfaction score was the highest in Group B that had the most remaining symptoms and it had no significant relationship with the symptom improvement. Additional analysis showed that among many factors such as treatment interval, treatment method, cost, accessibility of the clinic, family history and satisfaction with the doctor; the satisfaction with their doctor was the most closely related to the satisfaction rate of the patients. Conclusions In this study with 41 of rhinitis or paranasal sinusitis patients, the 2 sessions of intensive care group showed the best results in improving symptoms. Supplementary treatments were also used simultaneously; aroma spray, cutaneous acupuncture, Saengbit-patch, Chuna manipulation and nebulizer. The questionnaires showed that the satisfaction rate of the patients(care taker) was not related to the symptom improvement. Additional analysis of the factors that influence the satisfaction rate showed that it was more closely related to the satisfaction with their doctors.

• 대한예방한의학회지
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• 제16권3호
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• pp.89-105
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• 2012

Objectives : This study was carried out to know the status of clinical utilization of Korean medical knowledge and the Korean medical knowledge system which Korean medical doctors want. Methods : Questionnaires were distributed to Korean medical doctors registered for the Association of Korean medicine via the email and 249 answered questionnaires were analyzed. Results : 50.6 % of Korean medical doctors utilized the textbooks for Korean medicine when they treated their patients. The reason why they did not utilize the textbooks for Korean medicine was mostly that 'it could not be applied directly into clinical application with only contents of textbook because clinical approach (diagnosis and treatment methods) was not clearly described in the textbook'. 48.6 % of Korean medical doctors utilized the EBM materials when they treated their patients. EBM materials that they referred included domestic articles, other EBM materials excluding papers and international academic papers based on PubMed in order. The reasons why they did not utilize the EBM materials were mostly that 'it was difficult to find the evidence' and 'EBM materials were not actually helpful for the clinical practice.' It was found that Korean medical doctors approached the disease in aspects of Korean and Western Medicine concurrently upon the diagnosis of patients and performed the diagnosis and treatment of Korean medicine on the diseases which seemed to be effective with Korean medicine. It was also found that they thought that they needed to know the Western medical knowledge as much as general doctors who have a doctor's license or family medicine specialists who comprehensively treat the general diseases know. Korean medical doctors wanted to have the systematic summary of modern research performance in fields of acupoint, acupuncture, herbal drugs and formula. They thought that constitutional medicine and Sa-am acupuncture therapy were representative characteristics in Korean medicine differentiated from Traditional Chinese medicine and Kampo medicine. Conclusions : Korean medical doctors wanted to establish the Korean medical knowledge system based on evidence focusing on clinical and practical contents. New Korean medical knowledge system should be established based on these requirements in the future.