• 제목/요약/키워드: Health Care Law System

검색결과 148건 처리시간 0.031초

병원감염 사건에서 증명책임 완화에 관한 입법적 고찰 - 개정 독일민법을 중심으로 - (Legislative Study on the Mitigation of the Burden of Proof in Hospital Infection Cases - Focusing on the revised Bürgerliches Gesetzbuch -)

  • 유현정
    • 의료법학
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    • 제16권2호
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    • pp.159-193
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    • 2015
  • 병원감염 사례에 관한 판결의 주류적 태도는 병원감염 발생으로 인한 손해의 분담을 사실상 환자 측에 전가하는 문제가 있다고 판단되므로, 손해의 공평 타당한 분담을 그 지도 원리로 하는 손해배상제도의 이념에 비추어 환자 측의 증명책임을 대폭 완화하기 위한 방법을 강구할 필요성이 있다. 이와 관련하여 진료계약을 민법상 전형계약으로 규정하고, 병원감염과 같은 의료 측이 전적으로 지배할 수 있었던 경우에는 일반적 진료상 위험이 실현된 때 진료자의 오류가 추정된다고 명문으로 과실추정규정을 둔 독일민법을 검토하였다. 진료계약은 매우 빈번하고 광범위하게 일반 국민의 실생활에서 체결되고 있으며, 그로 인한 분쟁도 다양하게 발생하고 있으므로, 진료계약을 독일과 같이 민법의 전형계약으로 규정함으로써 계약 내용과 분쟁 발생 시 증명책임 등에 관해 규율할 필요성이 있다. 병원감염 사건의 경우 법률에 의해 과실을 추정하고, 병원감염 예방을 위한 노력을 철저히 시행한 기관에 한하여 병원감염 사고로 인한 손해가 발생한 경우 그 비용을 지원하도록 사회보험을 통한 제도적 보완이 필요하다고 생각되며, 향후 이에 관한 면밀한 연구와 검토가 요구된다.

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재가 독신노인을 부양하는 주부가 인지하는 노인의 정신건강에 관한 연구 (A Study on Mental Health of Single Aged Persons in Home Perceived by Daughter-in-law)

  • 윤숙례
    • 한국보건간호학회지
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    • 제7권1호
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    • pp.31-48
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    • 1993
  • Nowaday, there have a lot of changes in the demands of the aged persons. Their problems also came to the fore with diverse forms under the influences of industrialization, urbanization and nuclear family. To make the matter worse, the aged population is mounting rapidly. Also, such structure as nuclear family is widely disseminating uncomfortable to the aged. People is mainly being guided by self interest above everything else. Indeed, they had, all together, bad effects on our traditional value system regarding 'respect for the aged and devotion to patients'. It seems unfortunately obvious that the family responsibility is gradually weakening to support the old who is a dependent family. The result is that the aged must have suffered all sorts of hardships in lightenning psychological, physical and economical difficulties. First, to grasp the situations and conditions supporting for single aged persons from each view of psychological, emotional, family-relational, healthy, social and economical standpoints, and second, to analyze their own recognition levels thinking of their health conditions and the relationships between the supporting environments of old family dependants and their psychological healths and then finally, to propose suggestions being able to be helpful for living comfortably in an old age and thereby, building up good family relation. The statistical techniques used to analyze 115 respondents living in Puchun city are frequency, $x^2$ test, t-Jest, ANOVA, Pearson's Correlation Coefficiency and Regression analysis (SPSS package), pertnent to prove the hypothesis suggested in this paper. Of course, it is needless to say that more data are needed on this point. However, several main research findings can be summarized as follows: First, the better single aged persons may be in the habit of eating a meal and the higher they may think of their physical health conditions and movement, the more they want to participate in economic activities to be free from economical dependence upon their children and to overcome lonliness. Second, single aged women appear to have had higher ability to take care their health for themself than single aged men do. It is why signle aged women do not, in general, have big problems to manage their health. But, as shown in this paper, single aged person"s were more liable to the diseases of the aged and, thereby, requiring special medical treatment badly to be healthy. Third. single aged persons revealed potential desires to free themself from socio economic dependence upon their children even in simple labor Job which can draw a monthly salary of about W200, 000. Fourth, they are generally satisfied with their children's filial piety toward them. Nonethless, most of them appear to be reluctantly dependent upon their children and live lonly lives very much. Fifth, they seem to have some hesitation in expressing their candid opinions as that then are some others along with family environmental factors for psychological and emotiona stability. Accordingly, it is safe to conclude by saying that much attention should' be paid no only to socio-economic supports and better medical services for the aged but also to political supports of the society and towards their children for the aged's emotiona support, for improving the quality of their lives in old age and promoting efficiency in suporting for old family dependants.

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문신 및 반영구화장에 관한 체계적 문헌고찰 (A Systematic Review of the Literature on Tattoo and Semi-permanent Makeup)

  • 박소연;서은경;강성욱
    • 한국응용과학기술학회지
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    • 제40권3호
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    • pp.435-452
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    • 2023
  • 본 연구는 1979년부터 2022년까지 발표된 문신 및 반영구화장 관련 논문 198편을 대상으로 발표시기, 주제, 연구방법에 따라 체계적 문헌고찰을 수행하였다. 시기별로는 제1기(1979년~1994년), 제2기(1995년~2005년), 제3기(2006년~2012년), 제4기(2013년~2022년)로 나누었다. 제1기에는 보건의료적 측면의 연구가 주를 이루던 시기이며 제2기에는 예술, 문화 등 다양한 측면의 연구들이 나타나기 시작하였다. 제3기는 반영구화장에 관한 연구가 증가한 것이 특징이며 제4기는 문신 및 반영구화장의 연구가 급증하였다. 연구주제별로는 보건·의료, 미용, 패션·예술, 사회·문화, 법·제도로 나누어 분석하였다. 그 결과 소비자의 선호도와 인식도 등을 파악하기 위한 미용적 연구가 가장 활발하게 이루어졌으며, 보건의료적 연구가 두 번째로 많았다. 최근 법제화의 필요성이 높아짐에 따라 법·제도와 관련한 연구들이 급증하였으며, 문화, 역사, 패션 등에 관한 연구도 이루어졌다. 연구방법별로는 조사연구 방법을 가장 많이 활용하였으며 문헌연구, 사례연구 등 다양한 방법도 이용되었다. 본 연구로 향후 후속 연구가 더욱 촉진될 것이며 관련 산업의 발전에도 기여할 것으로 기대한다.

기혼간호사의 육아경험에 관한 현상학적 연구 (A Phenomenologic Study on the Married Nurse's Experience of Child Rearing)

  • 조정호
    • 여성건강간호학회지
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    • 제2권2호
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    • pp.182-201
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    • 1996
  • The purpose of this study is to examine a married nurse's experience of child rearing through being applied to phenomenological research method. By exchanging their experiences, helping and understanding one another, married nurses can work with delight considering their own present job as their lifelong job. In addition this study can help single nurses overcome the female crises such as marriage, childbirth, and child rearing they will experience in the future. The subjects of this research was 26 married nurses who work for a university hospital in affiliation in Seoul and have children. The period of materials collection was from Feb. 1st to Mar. 3, 1995. The method of materials collection was primarily to write down a questionary with openhearted contents. In collecting it, the respondents were allowed to say at their pleasure through further interview. The materials were analyzed by Giorgi's phenomenological analysis method. The findings of this study are as follows ; 1) The responses of married nurses' experience of child rearing-[pleasure] [family solidarity] [maternal-infant attachment] [understanding] [toilsome]-were induced. That is, at once affirmative experience and hard experience coexisted. 2) The method of married nurses' child rearing-[rearing politely] [raising understanding] [having the sense of family community] [rearing with praying the heart] [careless]-were induced. 3) The support system of married nurses' child rearing-[having help family] [having help from others]-were induced. According to the above findings, the married nursed showed affirmative responses about their experience of child rearing, but at the same time they expressed painful when stayed apart from their children on account of their job or when their children were sick. In the method of child rearing, they tried to grow their children polite because there was much time for them to stay apart from their children. And they tried to give a better explanation in order that their children can have an independence spirit. They tended to compensate through frequent physical touch with their children. As the support system of married nurses' child rearing, they asked their parents or their parents-in-law to take care of their children, hired a nursery governess in their houses, or used a children's home, if they can't afford to. That is, the only one who has a firm sense of her profession, tries to inspire her accomplishment, and is receiving her husband' love and understanding is considered to perform two things simultaneously with harmony, having an recognition of lifelong job. Suggestions 1. The method to solve mental troubles on child rearing should be groped. 2. Their economical burden should be reduced by establishing children's home in their working places, and the increase of maternal-infant interaction should be contrived. 3. The chance of education should be offered in order that married nurses themselves might inspire self-conceit and professionalism on clinical nursing. 4. The familiar mood should be created through planning the programs to be accompanied with children as an annual event in hospital. 5. The part-time nurse system should be suggested to utilize. 6. The system of circulation working should be converted into the system of fixing working according to the characteristic of each department. 7. Programs for special activities such as learning foreign languages and computer should be supported positively.

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의료행위 기준에 따른 치과위생사 직무 타당도 평가 (Evaluation of Dental Hygienist Job Validity according to Judgment Standard of Medical Practice in Medical Law)

  • 배수명;신선정;이효진;신보미
    • 치위생과학회지
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    • 제18권6호
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    • pp.357-366
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    • 2018
  • 본 연구는 치과위생사 직무를 다양한 각도에서 분석하고 검토하여 향후 치과 팀 내 치과진료업무를 효율적으로 분담하고 직무에 따른 교육 과정을 개발하는 데 기초 자료로 활용하기 위하여, 의료법에서 의료행위를 판단하는 기준에 따라 치과위생사 직무의 타당도를 평가하고자 하였다. 본 연구는 2017년 11월 10일부터 20일까지 강릉원주대학교 치과대학의 12명 교수를 대상으로 치과위생사 직무의 타당성을 평가하기 위해 자기기입 설문조사를 실시하였다. 치과위생사 직무가 질병예방과 치료, 환자요양지도, 보건 위생상 위해 발생 여부의 의료행위 판단기준에 해당하는지에 대한 전문가 일치율을 산출하였고, 각 행위를 의료행위 타당성 평가기준에 따라 점수화하여 level 1~4로 최종 분류하였다. 본 연구 결과에 따르면, 응답자의 50% 이상이 치위생 관리에 포함하는 치은출혈, 치주낭, 임상적 부착수준 측정 및 기록과 전문가 치면세균막 관리, 스케일링, 칫솔질 및 구강 관리용품 처방, 교육을 포함한 대상자별 구강보건교육과 치료 후 주의사항에 대한 상담이 세 가지의 의료행위 판단기준에 모두 해당된다고 응답하였다. 치과위생사가 치과임상에서 수행하는 행위는 의료행위 판단 기준에 따라 크게 4가지 범주로 분류하였고, 범주의 수준이 높을수록 수행난이도가 높고, 전문지식과 기술이 요구되는 직무로 판단할 수 있다. 치은출혈, 임상적 부착수준, 치주낭 측정 및 기록과 치면 연마, 전문가 치면세균막 관리, 스케일링, 치근활택술, 국소적 항균제 적용의 항목은 최종 점수 4.3으로 수행난이도와 전문성이 요구되는 Level 4 그룹으로 분류되었다. 우리나라 치과진료현장에서 환자의 안전과 건강권을 보장하면서 효율적으로 진료를 분담하기 위해서는 수행 행위에 따라 필요한 지식의 수준과 적절한 교육, 자격 기준 등에 대한 표준화된 지침이 개발되어 활용될 필요가 있다.

저소득층 방문간호 관리를 위한 제안 - 강북구 방문간호 대상자를 중심으로- (A Proposal on a Management Model Applicable to Visiting Nursing Program for a Low-income Group)

  • 고미자
    • 한국보건간호학회지
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    • 제10권1호
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    • pp.118-138
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    • 1996
  • Because of accelerated urbanization public body visiting nursing project that started according as matter of health on urban class in the lower brackets of income was concentrated on Social interests has a unsatisfied points to propel project efficiently from the lack of rating materials. Therefore centering around written contents in documentary literature of citizen health by household in five years from starting year of project to now. visiting frequency by medical manpower was evaluated quantitatively and qualitatively in aspect of management hereupon. for the sake of giving a basic materials for public health project of this field. This research presents documentary literature of citizen health which become materials is that as one person's charged region of nurse in duty scale. district is Kang-Buck Gu. the object is resident in the lower brackets of income grounded livelihood protection law and who is admitted by the head of organ~chief of health care). and the number of material centering around the head of a household is 415 copy. The result of research is summarized. as follow. 1. Average visiting frequency examinated by medical manpower show difference according to valuables of supervision characteristics namely average visiting. Frequency of nurse has long term residence in case registration season is early and supervision season is the first year and is high incase a kind of house is unlicdnsed mountain town. Average visiting frequency with doctor is high incase supervision season is the first year and the medical insurance system is admitted by chief of health care. That shows that a man of discomfort behavior left alone are yet many in local society. The meaning of this result shows that the continuity of official relation about class in the lowest brackets of income of long term residence goes well between househole who is a user of visiting nursing service of the object according to midway income under management influences a given duty of nurse s and so causes quantitative decrease. 2. In case behavier and condition of health that nurse diagnoses are bad. as the type matter is a lack of health and the number of patient is large. the average visiting frequency of nurse is high. because average visiting frequency with doctor is high as the condition of health is bad and the number of patient is large. That is similar with that of nurse. CD Average visiting frequency of nurse s seen by matter of disease is very high only in apoplexy by 39.50 and is confined within limits from 7.63 to 11.36 in other disease. But average visiting frequency with doctor is double as many as that of nurse but defined in apoplexy hypertension and articulate. (1) Average visiting frequency of nurse by existence in inoculation of hepatitis is low by 6.73 in unidentified group and very high by 26.89 in group of non-inoculation and the case of the antigenic positive man of B type hepatitis or epileptic who can't be inoculated shows 13.00 and that even family nursing service is needed to them. That result shows that though one person nurse of local charge has a large scale of duty. as visting nursing service is given a class who has a large demand preferentially by respectively accurate nursing diagnosis. the number of diagnosis service is similar with it. 3. During five years. average visiting frequency of nurse is 10.84 and average visiting frequency with doctor is 76.50 seeing from the official scale of nurse. visiting by household is performed two more per year to the average. Seeing this by type of service. average visiting frequency of nurse is higher in indirectly nursing than in directly nursing and that suggests that at the time of visiting household nurse performs education of protection lively save patient but at the time of contrastedly visiting with doctor. directly nursing is more contents of service show no difference by man power and medication dressing by demand is 14.3 and 18.6 the aid of hardship term of doctor and nurse is high by 18.7 and 17.00 in the request of hospitalization when seeing by demands. 4. Action by turns exemplified 1994 is well in sequence of 2/4 turn. 3/4 turn. 1/4 turn. 4/4 turn. When seen by average visiting frequency of nurse but gradually is even. Without difference by turns. average visiting frequency of doctor is much higher in 1/4 turn than other turns. Type of service by turns is all even but directly nursing is inactive in 4/4 and indirectly nursing. Very increases in 4/4 and so. Nurse's quantity of duty is plentiful that shows that by evaluation of last turn and plan of project. Contents of service follows that medication and dressing is the highest by' 5.57 in 1/4turn. goes down gradually by turn. becomes 3.57 in 3/4 turn. and increases again by 4.83 in 4/4 turn. the rest service is higher in 2/4 turn than other turns. 5. Total visiting frequency of nurse is explained to total $37.5\%$ by six valuables of visiting frequency of doctor. nursing demand. demand of diagnosis. condition of behavior. year. Special terms and magnitude of influential power is the same as sequence of enumerated valuables. Namely. the higher the visiting frequency of doctor. the bigger nursing and demand of diagnosis is. the worse the condition of behavior is. the older the object is and the more the household of special terms is. the high total visiting frequency of nurse is.

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분만관련 불가항력적 의료사고 보상제도에 있어 분담금부과에 관한 연구 -헌법재판소 2018. 4. 26. 선고 2015헌가13 사건을 중심으로- (A Study on Imposing Contribution in the Compensation for Uncontrollable Medical Malpractice during Delivery)

  • 범경철
    • 의료법학
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    • 제19권2호
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    • pp.139-171
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    • 2018
  • 「의료사고 피해구제 및 의료분쟁 조정 등에 관한 법률」(이하 '의료분쟁조정법'이라 한다)에서는 보건의료인이 충분한 주의의무를 다하였음에도 불구하고 분만 중 불가항력적으로 발생한 의료사고에 대하여 국가가 예산의 범위 안에서 그 피해자에게 보상하도록 하고 있다(의료분쟁조정법 제46조). 지금까지 의료사고 피해자가 소송을 통해서만 피해회복을 기대할 수 있었던 것에 비한다면 획기적인 법률이라 할 수 있다. 그런데, 이러한 의료사고보상사업에 드는 비용의 100분의 30은 보건의료기관개설자 중 분만 실적이 있는 자가 부담하고 있는 바(의료분쟁조정법 시행령 제21조), 이 분담금 부과 조항이 분만 과정에서의 산모·신생아 사망 등의 사고가 의사의 과실이 없이 불가항력적으로 발생했음에도, 의사들에게 책임을 묻는 것은 아닌지 문제가 되어 왔다. 그러나 최근 헌법재판소에서 분담금 부과와 관련한 의료분쟁조정법법 제46조 제3항 중 '보건의료기관개설자의 범위' 및 '보상재원의 분담비율' 부분에 대하여 합헌 결정을 내린 바 있다(헌법재판소 2018. 4. 26. 선고 2015헌가13 결정, 이하 '이 사건 결정'이라 한다). 이 사건 결정에서는 법률유보원칙 및 포괄위임입법금지원칙에 의하여만 판단하였으나, 본고에서는 실질적인 판단도 가미하였다. 이 사건 분담금운 과잉금지원칙에 비추어 보더라도 보건의료기관개설자들의 재산권을 침해하지 않는 점을 논증하였다. 불가항력 의료보상제도의 분담금 부과가 민사책임의 중요 원칙인 과실책임원칙에 거스르는 측면이 존재한다. 그러나 의료사고보상사업은 의료사고 피해자를 위한 국가정책으로 합리성이 있으며, 동시에 의료분쟁의 조기종결 효과로 의료계 역시 이익을 얻는 측면이 분명 존재한다. 분담금의 납부를 통한 보상재원의 확충은 이러한 의료사고보상제도를 빠르게 정착시킴으로서 분만과정에서 발생한 의료사고 피해자의 고통과 오해를 경감시키고 의료인의 안정적 진료환경 구축에 큰 도움이 될 것이다.

여성 베이비부머의 부양지원 제공과 우울 (Providing family support and depression: Focussing on babyboom women)

  • 이여봉
    • 한국가족관계학회지
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    • 제21권4호
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    • pp.51-74
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    • 2017
  • Objectives: This study observes how providing family support - financial, emotional, and instrumental - is related to depression in babyboom women. Method: I analysed data from the Korean Longitudinal Survey of Women and Families 5th wave, collected by the Korean Women's Development Institute. The analysis was conducted using regression, t-test, Chi-square test, frequency analysis, and Pearson's correlation analysis. Results: Financial support for grown-up children, either married or unmarried, increases depression in babyboom women. In the dimension of instrumental support, caring for grandchildren reduces babyboom women's depression. It implies that contact with grandchildren is perceived as an emotional support rather than a physical burden. The results of this study also show that babyboom women are comforted by living with their own parents, but not by living with parents-in-law. The most impressive observation, however, is in the dimension of emotional support, which showed that the conversation with elderly parents reduces baby-boom women's depression, but that the conversation with married children increases it. The opposite directions in the effects seem to be related to the subjects of the conversations. The subjects of the conversation with children are mostly about problems and agenda of the children, while those with elderly parents are mainly about parents' health and care for each other. Conclusions: The results of the analyses suggest that babyboom women should become less involved with their grown-up children's lives. It also calls for the societal efforts to be put into building up the support system, especially for eco-boom generation, to reduce babyboomer's burden of supporting the children.

간호사와 간호조무사가 지각하는 방사선사 인식도 (Perception Level of Nurses and Auxiliary Nurses for Radiological technologist)

  • 신성규
    • 한국콘텐츠학회논문지
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    • 제11권8호
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    • pp.211-220
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    • 2011
  • 본 연구는 부산광역시 소재 대학병원에 근무하는 간호사와 간호조무사 321명을 대상으로 방사선사의 인식도를 조사하여 방사선사의 위상과 전문적 이미지를 향상시키기 위한 기초 자료를 제공 하고자 연구를 실시한 결과 인식도는 $3.02{\pm}0.42$점이며 영역별로는 직업적 이미지가 높았고 업무적 이미지가 낮았다. 문항별로는 '전문직이다'가 높았고 '환자의 문제를 잘 파악하고 있다'가 가장 낮았다. 교육과정, 시험주관기관을 정확히 알고 있고 의료법상 의료인, 의료기사라고 응답한 대상자들의 인식도가 높았고 호칭을 기사로 사용하는 대상자의 인식도가 낮았다. 방사선사 직업 선택을 찬성하고 의료기관내 위치가 높다는 대상자의 인식도가 높았다. 인식도를 높이기 위한 방안으로 환자에 대한 적극적인 관심과 친절한 태도로 부정적인 이미지를 개선하고 호칭을 정립하기 위한 개인과 협회차원의 홍보와 대책이 필요하며 과거 전문대학의 이미지에서 탈피하기 위한 노력과 학술대회와 보수교육 활성화, 전문방사선사제도의 법령 제정으로 방사선사의 자질과 위상을 높이고 대중매체를 통한 홍보와 모니터링으로 전문직업인으로서의 이미지 향상을 위한 개인과 협회의 노력이 필요할 것으로 생각한다.

행복 인식에 따른 호스피스 준비의 관심에 관한 연구 (A Study on the Interest in Hospice According to the Perception of Happiness)

  • 장경희;이서희;김광환
    • 한국산학기술학회논문지
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    • 제19권5호
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    • pp.489-498
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    • 2018
  • 본 연구는 일반인들 가운데에서 죽음을 어떻게 인식하고 있느냐에 따라 삶의 태도나 방식이 달라지기 때문에 행복에 따른 죽음인식에 차이가 있는지 알아보고, 행복지수가 높은 그룹과 행복지수가 낮은 그룹간의 호스피스 관심이 차이가 있는지 연구하고자 한다. 2017년 4월 22일 D 광역시에서 열린 걷기대회 행사에 참가한 20세 이상 성인 남녀 200명을 대상으로 설문조사를 실시하였다. 설문구성은 일반적 특성이 성별, 연령, 학력, 직업, 결혼상태, 가족 동거여부, 종교, 건강상태 8항목이었다. 행복에 관한문항은 총 29항목, 죽음 인식은 9항목으로 구성하였다. 통계 검정법으로는 설문지의 항목에 대하여 행복지수를 기준으로 카이제곱 검정, 독립표본 t-검정, 상관분석, 정준상관분석을 실시하였다. 연구결과, 임종하기 적합한 장소에 관한 문항에서 행복지수가 낮은 그룹은 "의료기관"이 46.3%로 가장 높았으며, 행복지수가 높은 그룹에서는 "살던 집"이 59.4%로 가장 높게 나타나 유의한 차이를 보였다. 병원에서 임종하는 경우가 훨씬 많은 우리나라의 현실에서 환자들이 원하는 편안하고 익숙한 장소인 집에서 임종을 맞이할 수 있는 방법인 가정형 호스피스의 이용률을 높일 수 있도록 전문 인력의 확보 및 교육 등 관리체계를 보완해야 할 것이라고 보여 진다. 그리고 대상자의 일반적 특성을 고려한 개별적이고 다양한 접근을 통하여 죽음인식을 높이고 호스피스를 효과적으로 이용할 수 있도록 하여야 할 것으로 사료된다.