• 한국노년학
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• 제38권1호
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• pp.15-26
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• 2018

본 연구는 2013년 요양병원의 의무 인증제 이후 간호인력의 의료기관 인증제에 대한 인식과 환자안전관리 활동 정도를 조사하고, 인증제 인식과 환자안전관리 활동 간의 상관관계 및 환자안전관리 활동에 미치는 영향요인을 확인하여, 요양병원 간호인력의 환자안전관리 활동을 증진하기 위한 기초자료를 제공하고자 시행되었다. 본 연구는 서술적 조사연구로 서울, 인천, 부천 소재의 의료기관 인증을 획득한 6개 요양병원 소속 간호사 및 간호조무사 대상으로 2016년 4월 18일부터 4월 30일까지 구조화된 설문지를 활용하여 총 182명의 자료를 수집하였다. 수집된 자료는 SPSS/WIN 15.0 Program을 이용하여 t-test, ANOVA, Pearson's correlation coefficient, 다중 회귀분석을 실시하였다. 연구결과, 의료기관 인증제의 인식정도는 문항평균 3.60점(최고 5점), 환자안전관리 활동은 문항평균 4.39점(최고 5점)이었다. 의료기관 인증제의 인식과 환자안전관리 활동 간에는 유의한 양적 상관관계(r=.339, p<.001)가 있었고, 환자안전관리 활동에 가장 큰 영향을 미치는 변수는 '내부서비스 품질향상'(${\beta}=.362$, p<.001)이었고, 이외 '최종학력'(${\beta}=.194$, p=.005)이 유의한 영향을 미쳤으며, 이들 변수의 설명력은 16.4% 이었다. 따라서 요양병원 간호인력의 환자안전관리 활동이 증진되기 위해서는 의료기관 인증제에 대한 인식, 특히 '내부서비스 품질향상' 인식을 높이기 위한 기관의 인증제 교육프로그램 운용의 정규화 및 활성화를 위한 제고방안이 포함되어야 한다.

• Journal of Acupuncture Research
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• 제34권3호
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• pp.49-58
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• 2017

Objectives : The purpose of this study is to provide data to guide dementia health-care policy in Korea and to establish the position of Korean medical specialists in long-term care hospitals by analyzing the data of dementia inpatients. We analyzed the actual condition of dementia patients in care hospital and the effect of Western-Korean cooperative medicine on the progress of dementia. Methods : From January 1, 2016 to December 31, 2016, inpatients who were diagnosed with dementia at Mungyeong municipal long-term care hospital and admitted for more than 3 months were enrolled. Their medical records and simple tests were analyzed retrospectively. Results : We examined the detailed diagnosis, including both main and sub diagnosis, and Alzheimer disease dementia, at 97%, was the most common. At the time of admission, Korean Version of the Mini-Mental State Exam (K-MMSE) analysis showed that severe dementia affected 52%, and most were rated as Geriatric Depression Scale (GDS) 6. Based on the admission date, the results of a simplified test applied to the dementia patients every 6 months showed an maintain in the K-MMSE and GDS scores in 83%. Conclusion : The results of this study show that the rate of progression of dementia is somewhat lower in inpatients with moderate to severe Alzheimer's who have received Western-Korean cooperative treatment. However, due to institutional limitations, long-term inpatients such as those with dementia do not receive active traditional Korean medical treatment; hence, it is necessary to improve the national institution of traditional Korean medicine in long-term care hospitals.

• International Journal of Advanced Culture Technology
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• 제8권2호
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• pp.1-5
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• 2020

As the world gradually advances to an aging society, the quality of human life is valued. Among them, 'quality of sleep' is very closely related to quality of life. Recently, Korea expanded health insurance coverage for "sleep disorders". Particularly, as the number of sleep multiple tests and prescriptions for sleep aids has increased rapidly, much attention has been focused on the related medical service environment. Therefore, this study looked at an in-depth interview of 11 hospitals to see what treatment delivery system is being established when the government applies health insurance for 'sleep disorders'. In conclusion, the organizations with the most average number of sleep polyp tests per day were found to have more sleep polyp labs (hardware) and more full-time specialists. Also, the polysomnography lab (hardware) and the specialist's full-time status (software) did not necessarily result in a "positive pressure regulator prescription" that can solve "sleep apnea" caused by "sleep ailments". Rather, it was found that the number of days of sleep multiple laboratories (hardware), the number of full-time specialists (software) or the specialty majors (software) had a greater impact. In particular, the higher the specialist's full-time personnel (software) index (=6.000), the higher the sleep-inducing agent prescription rate(=1.000), and the lower the specialist's full-time personnel (software) index (=1.000), the higher the sleep-inducer's prescription rate(= 0.010) Was low. In addition, even if the professional full-time personnel(software) index was the same (=1.000), the hospital type was lower as it was closer to the public hospital(=0.067) and higher at the specialized hospital (= 0.933). In the case of university hospitals, when the full-time specialists (software) are in the same condition (= 1.000), the frequency of use of the sleep laboratory (=1.000) and the sleep test rate (= 1.000) were all the same.

• 노인간호학회지
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• 제20권3호
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• pp.217-228
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• 2018

Purpose: This study was done to examine the effect on turnover intention (TI) of terminal care stress (TCS) on nurses working in long-term care hospitals (LCH). Methods: Participants were 182 nurses from 6 Seoul LCH. Data were collected from October to December, 2017. Self-report questionnaires were used to collect data on general characteristics, TCS, and TI. Results: Subjective satisfaction on the job (r=.52, p<.001), number of monthly terminal care elders (r=.16, p=.043), TCS (r=.16, p=.027), and sub-categories of TCS, 'difficulty for assigning timetable to care for terminally ill patients' (r=.17, p=.025), 'feeling a burden of caring for terminally ill patients' (r=.23, p=.002), and 'conflict with terminally patients' (r=.16, p=.034) showed statistically significant correlation with TI. Multiple regression analysis showed significant influence of subjective satisfaction with job (${\beta}=.52$, p<.001) and TCS (${\beta}=.23$, p=.001) with a 30.3% explanatory power. When sub-categories of TCS were entered, subjective satisfaction with the job (${\beta}=.50$, p<.001) and 'feeling burden of terminally ill patients' (${\beta}=.28$, p<.001) were factors significantly influencing TI with explanatory power of 32.8%. Conclusion: Findings of this study suggest that it is needed to develop standardized practice guidelines and educational programs for terminal care in LCH as well as stress healing programs for nurses.

• 대한영양사협회학술지
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• 제16권4호
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• pp.378-396
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• 2010

The objectives of this study were to explore hospital foodservice management and to investigate conditions related to health insurance coverage of inpatient meals. A questionnaire was distributed to the nutrition departments of 44 hospitals in Seoul on July 2009. The average kitchen area was 0.5 $m^2$, and centralized distribution systems were in place. Partition walls from contamination zones, separate work tables to prevent cross-contamination, exclusive areas for preparing tube feeding, and split carts with refrigerated and convection heat settings were largely used in tertiary hospitals. Most dietitians did meal rounds (93.2%) and surveyed for patient satisfaction (86.4%). The major theme of QI (Quality Improvement) was menu management (31.8%). The health insurance fees for meals were (won)4,938.9 for a general diet, (won)5,199.8 for a therapeutic diet, (won)4,067.0 for tube feeding, (won)9,950.0 for sterilized diet, and (won)18,383.4 for diets not covered by health insurance. The prices for general and therapeutic diets were significantly lower in hospitals compared to tertiary or general hospitals (P<0.001). The cost composed of 48.3% food, 44.0% labor and 7.7% overhead for general diets and 47.9%, 44.5% and 7.6% for therapeutic diets. In the case of health insurance coverage for patient meals, the number of items applied to general diets averaged 2.8 out of 4 and for therapeutic diets it averaged 1.9 out of 3. To reform the health insurance coverage system for patient meals, it is urgent that the qualified level of patient meals is presented from a national viewpoint, and monitoring should be performed consistently by developing the evaluation tools.

• Journal of Hospice and Palliative Care
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• 제18권4호
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• pp.285-293
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• 2015

목적: 본 연구는 호스피스 완화의료 전문인력의 죽음에 대한 태도의 임종 돌봄 스트레스에 대한 효과를 탐구하고, 이 두 변수와 관련된 우울, 대처전략들의 변수와의 상관관계를 분석하기 위해 시도되었다. 방법: 연구 대상자는 호스피스 완화의료 전문인력 131명이며, J도를 중심으로 2개의 상급종합병원과 2개의 종합병원 암병동, 2개의 호스피스 시설, 2개의 전문요양병원 및 2개의 노인병원에서 실시되었다. 자료는 2015년 3월부터 6월에 수집되었으며, 자료 분석에는 SPSS/WIN 21.0과 AMOS 18.0 programs을 사용하였고, t-test, factor analysis, ANOVA ($Scheff{\acute{e}}$), Pearson's correlation 및 path analysis를 실시하였다. 결과: 죽음에 대한 태도는 낮았으며(2.63점), 우울 점수는 0.45점이였으나 15.0%의 대상자는 우울관리가 요구되었다. 임종 돌봄 스트레스가 높고(3.82점), 그 중 의료 한계에 대한 갈등이 가장 높았다(4.04점). 스트레스 대처는 낮았으며(3.13점), 대인관계 기피(4.03점), 간식이나 잠을 취하는 기본욕구 충족(3.65점)과 같은 소극적인 방법을 사용하였다. 죽음에 대한 태도는 임종 돌봄 스트레스에 직접적으로 부적 영향을 주었으며, 우울과 기본 욕구 충족(CS2)을 통한 간접적인 영향을 주었다. 결론: 호스피스 완화의료 전문인력들에게 죽음에 대한 태도를 향상시키고 효과적인 대처전략을 활용하게 하는 인지적 지지와 정서적 지지를 제공하는 프로그램 제공이 요구된다.

• International Journal of Advanced Culture Technology
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• 제9권1호
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• pp.16-21
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• 2021

As the average age of national veterans has increased from 69 years old(2011) to 71 years old(since 2015) over the past five years, the overall medical service cost of veterans has increased by about 20%. The main cause of this phenomenon is 'ultra-aging', which accounts for 67% of veterans, while the proportion of health insurance patients aged 70 or older is 9%. Therefore, it is judged that the analysis of the trend of use of medical services at veterans hospitals in each region that is in charge of severe medical services of national veterans can serve as an opportunity to seek countermeasures for the severe medical system of national veterans. First of all, based on the details of major medical expenses (hospitalization, outpatient, pharmaceutical expenses) by region for the last 10 years(2010-2019), data significance was performed through a chi-square test, and the Central Veterans Hospital and Non-Central Veterans Hospital using EXCEL. 'Expected frequency' was calculated by year. By applying the CHITEST(observation frequency, expected frequency) function again, the p-value(p<0.05) was calculated, and the profit bias of each region's veterans hospital could be determined. The specific research method is for the last 10 years(2010-2019) for state-sponsored patients_outpatient treatment income, state-sponsored patients_hospitalization income, exempt patients_outpatients at the Central Veterans Hospital, Busan Veterans Hospital, Gwangju Veterans Hospital, Daegu Veterans Hospital, and Daejeon Veterans Hospital. A one-way analysis of variance was conducted to verify the significance of the difference between group averages on the status of 5 medical revenues of veterans hospitals in each of the 5 regions, including medical treatment income, reduced patients_hospitalization income, and reduced patients_medicine expenses. It was found to be significant(p<0.05) at all levels, including region and type. Finally, the bias in the profit structure of regional veterans hospitals was the highest in 2017(p=0.0004) and the lowest in 2013(p=0.0349). In addition, in the profit structure of the Veterans Hospital, the year in which the'regional' variable worked the most was 2019, and the year with the least affected was 2010. The order of the former is Jungang(=31,674,713), Busan(=12,314,614), Gwangju(=11,957,038), Daegu(=10,168,015), and Daejeon(=6,991,034), and the order of the latter is Jungang(=57,868,791), and Busan(=19,183,194). Gwangju(=17,904,712), Daegu(=15,656,034), and Daejeon(=14,377,395). In conclusion, the profit bias of veterans hospitals repeatedly raced the lowest(p=0.01986) and highest(p=0.03499) for the past five years(2010-2014) year by year, with the 'regional' variable being the most in the veterans hospital's profit structure It was identified as a major influence factor. On the other hand, for the last 5 years (2015-2019), the influence factors of the'regional' variable every year were in 2015(p=0.02015), 2016(p=0.01741), 2017(p=0.00045), and 2018(p=0.00394). in 2019(p=0.00227), a significant difference was confirmed at a very low level.

• 한국실내디자인학회논문집
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• 제24권3호
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• pp.165-175
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• 2015

Korean medical welfare facilities for the elderly provide the conveniences to care geriatric illness such as dementia and stroke. The medical welfare facility categorizes elderly care facilities, nursing homes, and geriatrics hospitals based on the Korean welfare of the aged act. The government makes an effort to secure feed rate and finances of medical welfare facilities. However, the qualitative improvement of facilities is inadequate. The purpose of this study is to analyze the conditions and problems of existing facilities using an environmental evaluation and to discuss the improvement direction related to the daycare centers for the elderly. The method of this study is literature review and field survey. Firstly, we analyzed the previous studies to develop the tool, evaluating the environment of day care centers for the old. Secondly, the items of environmental evaluation are deduced. Thirdly, we select the facilities to conduct field survey and analyze the results of field survey. Lastly, We discussed the problems and improvement directions through the results. It is judged that this study is an useful as the basic guideline to strengthen the minimum legal standards of day care center for the elderly due to the suggestion of insufficient environmental evaluation items.

• 한국생활과학회지
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• 제17권1호
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• pp.127-139
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• 2008

The purpose of this study is to examin wearing satisfaction and needs of the caregivers' uniforms. The questionnaire survey was conducted on 303 who are serving in the geriatric hospital and general hospitals in Seoul and Gyeonggi, Chungcheong region. It was coherently found on the whole that the irrelevance to the fitness of size system influenced the discomfort, and the relation between discomfort and satisfaction revealed negative-correlation, and the higher the discomfort is and the lower satisfaction is, the higher their improvement needs are. Particularly, the higher the discomfort on the fitness of size system is and the lower its satisfaction is, the higher the improvement needs on the size system and activities are. As a result, the clothing construction and the selection of materials for the complement of the fitness and discomfort's incongruity is required. Namely, the yoke of the back area and the various detail for the activity, the materials satisfying stretch, good-touch, antibiotic functionality, and the expansion of the size system are needed.

• 한국간호교육학회지
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• 제18권3호
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• pp.522-532
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• 2012

Purpose: The purposes of this study were to develop an elderly care nursing education program and evaluate its effect on knowledge, attitudes and nursing performance of nurses toward older adults. Methods: A quasi-experimental study with a non-equivalent control group pretest-posttest design was used. Participants were recruited from two geriatric hospitals. The sample consisted of an intervention group (n=29) that participated in the educational program and a control group (n=30). The data were collected prior to and 6 weeks after the intervention using self-administered questionnaires. Data analyses utilized $x^2$-test, Fisher's exact probability test, and t-test. Results: After the intervention, knowledge and nursing performance about the elderly care increased significantly in the experimental group compared to the control group. However, there was no statistically significant difference between the groups in their attitudes toward the elderly. Conclusion: Findings indicate that to provide better nursing care to the elderly, nurses need to be able to practically apply the knowledge they have acquired from the elder-care nursing education programs in hands-on situations. To achieve this, nurses should work to change their personal attitudes about the elderly. Also, evidence-based guidelines for elderly nursing care, administrative support of institutions, and multidisciplinary approaches are required.