• 가정∙방문간호학회지
• /
• 제10권1호
• /
• pp.58-72
• /
• 2003

The purpose of this study was to describe the perceived burden of the terminally III patients's caregiver and to analyze relationship between the perceived burden and the various demographics, illness characteristics, family relationships, and economic factor of the family & patients. The sample of 132 caregivers who care for the terminally III patients Kyung-Gi province, Seoul, Korea. The period of this study was from August to September, 2002. The perceived burden of the family caregiver was measured by the burden scale(20 items, 4 point scale) developed by Montgomery et al. (1985). The Data was analyzed using SAS-program by t-test and ANOVA. The results were as follows; 1. The mean of the family caregiver's burden score was 3.02. The score showed that caregivers perceive severe the level of burden. The hight items of the family caregiver's burden were' I feel it is painful to watch patient's diseases'(3.77). 'I feel afraid for what the future holds for my patients'(3.66), 'I feel it reduced to amount of privacy time'(3.64). 2. The caregiver's burden was significantly related to patient's gender(F=3.17, p= 0.0020), patient's job(F=2.49, p=0.0476), caregiver's age(F=4.29, p=0.0030), and caregiver's job(F=2.49, p=0.0476). 3. The caregiver's burden according to illness characteristics showed no significant difference. 4. The caregiver's burden was significantly associated with patient's family relationship (F=4.05, p=0.0041), patient's care mean period in a day(F=47.18,

• 한국의료질향상학회지
• /
• 제10권1호
• /
• pp.8-19
• /
• 2003

Background : There have been many studies and efforts about quality management in health services, but there were not founded quality assessment on social services. This study was designed for understood level of quality on social service, identified for correlation factors of quality assessment on social services in general and teaching hospitals in Korea. Methods : The subjects of this survey were 80 leaders of social service units. The survey data from each subjects were measured to evaluate level of quality that service provider perceived of sample hospitals. Social worker's attitude of quality assurance activities, perception of quality assurance system in that hospitals were measured. Under the method of one-way ANOVA, t-test and correlation, associated factors of quality assessment in social work service was analyzed. Results : The major findings were as following ; First, the level of quality perceived showed less score, especially the lowest was the score of quality of outcome. Second, social worker's attitude of quality assurance activities showed high score, but quality assurance system of hospitals showed less score. Third, the level of quality assurance system of hospitals, social worker's attitudes of quality assurance activities. Conclusion : The quality of social work service correlated positive hospitals's quality assurance system, social worker's attitudes of quality assurance activities. Therefore, to assure the proper level of quality, qualified for hospitals system of quality assurance, and needed to a educational program for enhanced social workers's attitudes in quality assurance activities.

• Journal of Preventive Medicine and Public Health
• /
• 제44권3호
• /
• pp.101-110
• /
• 2011

Objectives: Screening for colorectal cancer is considered cost effective, but is underutilized in the U.S. Information on the efficiency of "tailored interventions" to promote colorectal cancer screening in primary care settings is limited. The paper reports the results of a cost effectiveness analysis that compared a survey-only control group to a Centers for Disease Control (CDC) web-based intervention (screen for life) and to a tailored interactive computer-based intervention. Methods: A randomized controlled trial of people 50 and over, was conducted to test the interventions. The sample was 1224 partcipants 50-70 years of age, recruited from Kelsey-Seybold Clinic, a large multi-specialty clinic in Houston, Texas. Screening status was obtained by medical chart review after a 12-month follow-up period. An "intention to treat" analysis and micro costing from the patient and provider perspectives were used to estimate the costs and effects. Analysis of statistical uncertainty was conducted using nonparametric bootstrapping. Results: The estimated cost of implementing the web-based intervention was $40 per person and the cost of the tailored intervention was $45 per person. The additional cost per person screened for the web-based intervention compared to no intervention was $2602 and the tailored intervention was no more effective than the web-based strategy. Conclusions: The tailored intervention was less cost-effective than the web-based intervention for colorectal cancer screening promotion. The web-based intervention was less cost-effective than previous studies of in-reach colorectal cancer screening promotion. Researchers need to continue developing and evaluating the effectiveness and costeffectiveness of interventions to increase colorectal cancer screening.

• 융합정보논문지
• /
• 제9권7호
• /
• pp.41-47
• /
• 2019

본 연구는 요양보호사의 감정노동과 소진이 노인 돌봄 태도에 미치는 영향요인 파악하기 위한 서술적 조사이다. 2018년 12월 1일부터 30일까지 D시, K도에서 6개월 이상 노인 돌봄으로 근무한 요양보호사 142명으로 구조화된 설문지로 자가기입방식의 설문 조사를 시행하였다. 수집된 자료는 SPSS 21.0을 이용하여 t-test, ANOVA, Pearson 상관분석 및 다중회귀분석을 시행하였다. 본 연구결과는 요양보호사의 노인 돌봄 태도에 영향을 미치는 변수로 감정노동의 주의 정도, 건강상태, 근무형태이며, 설명력은 31%였다. 즉, 요양보호사는 노인의 행동을 그대로 이해하며 받아들여야 하는 감정표현의 주의 정도에 관한 요구가 높을수록, 자가건강상태가 좋지 않을수록, 근무형태가 불안정할수록 노인 돌봄 태도에 부정적인 영향을 미치는 것으로 확인되었다. 따라서 요양보호사의 노인 돌봄 태도를 높이기 위하여 요양보호사의 안정적인 근무 환경과 더불어 사회적 인식 개선을 위한 교육프로그램의 적용이 필요하다.

• 농촌의학ㆍ지역보건
• /
• 제48권4호
• /
• pp.262-274
• /
• 2023

본 연구는 달구벌건강주치의사업에 참여하고 있는 기관의 실무자와 서비스 이용자들의 경험을 토대로 질적연구를 통하여 보건의료·복지 서비스의 통합적인 지원의 성과와 개선방안을 살펴 보았다. 분석 결과 달구벌건강주치의사업은 의료취약계층의 복합적 수요 해결에 효과적이었다. 의료와 복지 사각지대에서 삶의 희망을 잃어버리고 의료와 복지서비스 이용에 대한 두려움을 가진 이용자들에게 신속 간단한 대상자 선정과 자원연계를 통한 통합적 서비스 제공으로 복합적 수요 해결과 삶에 대한 긍정적인 태도 회복, 삶의 질 개선에 기여하였다. 달구벌건강주치의사업은 대상자 의뢰기관부터 서비스 제공기관까지 공공뿐 아니라 민간기관이 참여하는 포괄적 네트워크를 구축하였으며, 대구의료원을 중심으로 5개 상급종합병원의 참여로 경증부터 최중증까지 대상자의 중증도에 적합한 치료를 지원하는 모형을 구축함으로써 의료혜택에서 소외된 대상자를 적극적으로 발굴하고 실제 이들의 건강 문제를 해결함으로써 건강 형평성을 개선한 것으로 파악된다.

• 농촌의학ㆍ지역보건
• /
• 제40권1호
• /
• pp.9-20
• /
• 2015

지역사회 뇌졸중환자들의 치료 지속률과 약물 순응도에 대한 연구는 아직 많이 실시되지 않았다. 그러나 치료 지속률과 약물 순응도가 뇌졸중의 재발 및 사망과 밀접한 관련이 있다는 것은 많이 알려진 사실이다. 이에 본 연구는 지역에 거주하고 있는 뇌졸중환자들을 임의 추출하여 이들의 치료 지속률과 약물 순응도를 평가하고 이에 영향을 미치는 요인을 찾기 위하여 실시되었다. 연구대상자는 429명으로 이들의 뇌졸중 치료율과 현재 복용하고 있는 약물의 순응률을 파악하였으며 약물 순응도는 의도적 비순응군과 비의도적 비순응군으로 구분하여 조사하였다. 연구 결과 치료 지속률은 86.5%였으며 이들 중 약물 순응도는 41.2%였다. 치료 지속률에 영향을 미치는 요인으로는 보건교육 경험뿐이었으며, 비의도적 약물 비순응에 영향을 미치는 요인은 mRS와 보건교육 경험 그리고 의도적 약물 비순응에 영향을 미치는 요인은 mRS와 우울감 정도 그리고 약물에 대한 신념(필요성, 염려)이었다. 결론적으로 지역사회 뇌졸중환자의 재발방지와 사망률감소를 위하여 약물복용을 중요하게 교육하여야 할 것이며 순응도 향상을 위해서는 약물에 대한 필요성은 올리고 염려 수준을 낮추도록 교육하여야 할 것이다.

• 성인간호학회지
• /
• 제15권1호
• /
• pp.94-104
• /
• 2003

Purpose: This study was performed to identify the factors which affected exercise and the perceived exercise behaviors in women according to Q-methodology and to provide basic strategies for health promotion of middle-aged women in Korea. Method: Q-methodology provides a scientific method for identifying perception structures that exist within certain individuals or groups. Thirty subjects in Seoul, Incheon, Chung-buk classified 35 selected Q-statements in to 9 points standard. The collected data was analyzed by using a QUANL pc program. Result: Principal component analysis identified 3 types of exercise behavior of middle-aged women in Korea and named by the researcher. They are called persistent activity preference type, living-exercise preference type, exercise mania type. In persistent activity preference type, the middle-aged women thought activity was very helpful to achieving health and releasing stress or fatigue. Also, they recognized the relationship between physical health and psychological health. In living-exercise preference type, the middle-aged women preferred maintaining stability or nonactivity to intended exercise or activity for health. In exercise mania type, the middle-aged women thought there was no other way to keep her health than to exercise. Conclusion: The findings of this study will provide the health care provider including nurse with useful information. It's very important to offer appropriate exercise intervention to the middle-aged women of each type by taking into consideration the characteristics of individual types.

• 한국융합학회논문지
• /
• 제10권11호
• /
• pp.543-555
• /
• 2019

본 연구의 목적은 만성질환자의 공유의사결정에 대한 개념의 속성을 명확히 정의하기 위함이다. 개념분석의 절차는 Walker and Avant의 방법에 근거하여 학제간 융합적 분석을 시도하였다. 분석결과, 만성질환자의 공유의사결정의 속성은 자기돌봄 전문가로서 인정, 자기 결정권, 번복 가능한 협상, 환자중심 돌봄으로 정의되었다. 선행요인은 비슷한 치료방법 중 선택해야 할 필요성이 있는 상황, 의사결정 갈등, 환자, 가족, 의료제공자의 참여 의지, 충분한 시간과 기회이다. 만성질환자의 공유의사결정의 결과는 의사결정 갈등 감소, 환자결과와 만족도 및 삶의 질의 향상, 장기적인 환자의 자기관리 및 자기 효능감 향상, 질병을 수용하는 삶의 태도이다. 본 연구는 만성질환자의 공유의사결정에 대한 명확한 개념을 제공하고, 관련 간호중재 개발을 위한 이론적 근거 형성에 기여할 수 있을 것이며 만성질환자를 위한 공유의사결정 측정도구 개발 연구의 수행을 제언한다.

• Imaging Science in Dentistry
• /
• 제35권4호
• /
• pp.185-190
• /
• 2005

Purpose: Once the decision has been made to adopt an integrated medical information system (IMIS), there are a number of issues to overcome. Users need to be aware of the impact the change will make on end users and be prepared to address issues that arise before they become problems. The purpose of this study is to investigate the benefits and unexpected problems encountered in the implementation of IMIS and to determine a useful framework for IMIS. Materials and Methods: The Yonsei University Dental Hospital is steadily constructing an IMIS. The vendor's PACS software, Piview STAR, supports transactions between workstations that are approved to integrating the healthcare enterprise (IHE) with security function. It is necessary to develop an excellent framework that is good for the patient, healthcare provider and information system vendors, in an expert, efficient, and cost-effective manner. Results : The problems encountered with IMIS implementation were high initial investments, delay of EMR enforcement, underdevelopment of digital radiographic appliances and software and insufficient educational training for users. Conclusions: The clinical environments of dental IMIS is some different from the medical situation. The best way to overcome these differences is to establish a gold standard of dental IMIS integration, which estimates the cost payback. The IHE and its technical framework are good for the patient, the health care provider and all information systems vendors.

• 중환자간호학회지
• /
• 제14권2호
• /
• pp.42-56
• /
• 2021

Purpose : The purpose of this study was to understand and describe the experiences of the advanced nurse practitioner (APN) system used by healthcare providers including APNs, doctors who worked with APNs, and APN master's course professors at a graduate school. Methods : Qualitative data were collected via snowball sampling. The participants were nine APNs, six doctors, and three professors. They were divided into three focus groups, each of which consisted of all three types of healthcare providers. Data were collected via interviews with the three focus groups conducted from September to October 2019. All interviews were audiotaped and transcribed verbatim. The transcribed data then underwent qualitative content analysis. Results : Based on the data, we extracted four themes and 14 categories. The themes were "Role and system of APNs started according to healthcare environment changes", "Optimal healthcare provider to ensure quality of care", "Confused role and system of APNs due to incomplete medical law", and "Tasks for the stable operation of the APN system." Conclusion : For quality treatment and safety of patients, a legal basis must be established for the APN system. For its stable operation, social consensus regarding legislation about APNs' scope of practice is required. Finally, a discussion is necessary about the integration of APNs' 13 fields.