• 제목/요약/키워드: Health determinant

검색결과 235건 처리시간 0.023초

DACUM 직무분석 기법을 이용한 여성병원 간호단위관리자의 직무분석 (Job Analysis of the Nursing Unit Managers of Women's Hospital Using DACUM Analysis)

  • 손경숙;조경숙
    • 여성건강간호학회지
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    • 제25권3호
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    • pp.239-257
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    • 2019
  • Purpose: To analyze the job of nursing unit managers working at women's hospital, using DACUM (developing a curriculum), DACUM is a method for analyzing job-focused competency. Methods: This study involved a descriptive survey. A DACUM workshop was held to define women's hospital nursing unit managers' role and identify their duties and tasks. For the workshop, a committee was formed consisting of 5 women's hospital nursing unit managers. Finally, after validation, the developed contents were made into a survey asking about nursing unit manager's duties and tasks. Results: Sixteen duties and 83 tasks were identified on the DACUM chart. The importance, difficulty, and frequency of the tasks were ranked in terms of A, B, and C, with A being the highest degree. Eight tasks received A's all in importance, difficulty, and frequency of performance. The 8 tasks were: 'taking over', 'taking care of seriously ill patients on handover', 'ward rounding', 'analyzing and resolving demands identified during handover and patient tour', 'reporting patient status during rounding', 'promoting breast-feeding', 'uterine contraction, and training for breast-feeding'. The duty with the biggest determinant coefficient (DC) was 'patients complaint management' (DC=7.09). Based on tasks, the one with the biggest DC was 'solving patient and patient guardian's complaints' (DC=7.53), followed by 'making infection control guidelines' (DC=7.5). Conclusion: When expanding the nursing staff of the hospital, women's hospitals nursing unit managers also need to use administrative functions as intermediaries to focus on the operation management of the entire hospital rather than direct nursing to suit their role.

국내 Bordetella pertussis 분리균주에서 Agglutinogen과 Fimbriae 혈청형 변이 분석 (Serotype Variations of Agglutinogen and Fimbriae in the Korean Isolates of Bordetella pertussis)

  • 정상운;문유미;성화영;강연호;유재연
    • 미생물학회지
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    • 제44권3호
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    • pp.221-227
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    • 2008
  • Bordetella pertussis는 유아의 호흡기감염질환인 백일해의 원인균으로 배신도입에 의해 발생률이 크게 낮아졌다. 그러나 최근에 일부 백신접종률이 높은 국가에서 증가된 백일해 발생건수가 보고되고 있으며, 그 추정 원인 중에 하나는 백신주와 유행주 사이의 유전형 흑은 혈청형 변이 이다. 따라서 분리주에 대한 변이 현황을 유전형 혹은 혈청형 분석을 통하여 확인하는 것이 필요하고 국내에서 백일해 발병증가에 대한 가능성을 추정해야 한다. 이에 본 연구에서는 $1999\sim2006$년 사이에 분리된 국내 백일해 분리균주의 변이 양상을 agglutinogen과 fimbriae에 대한 혈청형 조사를 통해 확인하였다. 그 결과 agg 1과 fim 2가 국내 분리주에서 가장 많이 발견되는 혈청형이었고, 두 항원 모두 시대에 따른 혈청형 변이 현상이 확인되었으며, 특히 agglutinogen의 경우는 백신균주(agg 1,2)와는 다른 유형(agg 1)이 증가되는 유형으로 나타났다. 그러나 fimbriae의 경우는 백신균주(fim 2)와 동일한 유형이 증가되어 차이를 나타내었다. 이러한 결과는 백일해 발병증가가 나타나는 국가들에서도 확인되는 현상으로 국내에서의 백일해 발병증가에 대한 보다 정확한 예측을 위해서는 항원결정기 유전자에 대한 변이정도 및 정상인에서의 항체가 분포양상 등에 대한 연구가 필요할 것으로 사료된다.

고령화 사회에서 한국인의 건강과 삶의 질 (Health and quality of life for Korean people in ageing society)

  • 서경현
    • 한국심리학회지 : 문화 및 사회문제
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    • 제12권5호_spc
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    • pp.133-147
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    • 2006
  • 한국 사회가 빠르게 고령화 사회가 되고 있다. 한국인들은 자신의 부모들 세대보다 더 오래 살아야 한다. 기대 여명이 증가하고 사회구조가 변하면서 사람들은 삶의 질에 관심을 가지게 되었고, 한국 사회에는 웰빙 붐이 일었다, 그리고 한국인들에게 질 높은 삶을 위해서는 건강이 필수라는 인식이 자리 잡았다. 이런 건강에 대한 관심은 건강행동들로 이어진다. 한국인들의 건강관련지출은 다른 선진국들보다 훨씬 적지만 계속 증가추세에 있고, 앞으로의 초과 지출에 많은 부분이 질병예방과 장기요양시설의 확충에 투자될 것이다. 서양과는 다른 문화권에서는 사는 한국인의 삶의 질의 구성요인과 건강행동은 서양인과 다른 점이 있을 것이다 선행연구들에서 삶의 질에 대한 중요도로 건강이 최우선 순위로 나타나지 않은 것이 건강이 삶의 질에 결정적인 요인이 아니라는 것을 의미하지는 않는다. 건강은 삶의 질에 있어서 기본이다 .각종 질병에 의해 낮아진 삶의 질과 그것을 개선하기 위한 방법에 관한 다양한 연구들이 그것을 반증하고 있다. 건강 행동을 설명하는 모형들에서는 건강과 관련된 신념이나 태도 혹은 의도, 지각된 행동 통제력, 그리고 자기효능감 등이 중요한 요인으로 제시되었다. 나이가 들수록 신체적이고 생리적인 기능이 쇠퇴하고 만성질병에 걸릴 가능성이 높아지지만, 삶의 질은 그런 변화에 어떻게 반응하고 적응하느냐에 달려있다. 다른 어느 시기보다 노년기에서는 사회적 지원이 삶의 질을 위해 결정적인데, 특히 자녀로부터 지원이 중요하다. 자녀로부터의 지원은 한국 노인 개인의 자존감에 영향을 미치기 때문에 가정에서의 불화를 타인에게 노출하기 꺼려할 수 있다. 자기노출을 꺼리는 것은 다른 사회적 지원의 통로를 차단하기도 하고 그 자체가 건강을 해칠 수 있기 때문에 심리적 개입이 요구된다. 한국인의 기대 여명이 크게 증가하였기 때문에 정책적으로는 장기요양시설이 확충되어야 하겠지만 심리적 사회적 지원이 필요할 수밖에 없다. 그러나 한국에서는 개인 혹은 사회의 건강을 도모하고 삶의 질을 개선하는데 심리학자들이 크게 기여할 수 있다는 것이 국민들에게 충분히 알려져 있지 않다. 앞으로 심리학자들도 관심을 가지고 삶의 질과 관련하여 한국인의 건강에 적극적으로 개입할 수 있기를 기대한다.

고혈압 환자의 치료지시 이행에 관한 연구 (A Study on Hypertensive Patients Compliance to Medical Recommendations)

  • 최영희
    • 대한간호학회지
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    • 제10권2호
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    • pp.73-85
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    • 1980
  • The purpose of this study was to investigate the compliance behavior of hypertensive patients in light of their health belief model that explains an individual's compliance with health maintenance or getting well. Although there are many effective regimens and treatments for hypertension nowadays. the most important point to be taken to consideration in their behavioral aspect is their compliance with regard to the control of body weight. eating habits as to salt and cholesterol intake. stresses. activity patterns and smoking as related to their life style. The important reasons for the failure in the control of hypertensive patients are the complexity of regimens to be complied to. irregular medication and the life long restrictions in their own life style. The compliance of patients to medical regimens and rocommendations or failure to do so is an essential factor. Accordingly. the degree of the patient's compliance is an important determinant as to the success or failure of hypertension control. The subjects for this study were 187 hypertensive patients selected from admitted and out patients of the medical department at seven University Hospitals in Seoul. Data was collected from Dec. 1, 1979 to Feb. 15, 1980 using the questionaire method and was analysed by the use of means. standard deviations, coefficient of correlations, analysis of variance and multiple regression analysis. The results obtained are as follows A. Of the seven independent variables in light of health belief model. benefit. barrier and severity are closely related to patient's compliance behavior. Therefore these variables could be used as determinants to predict and modify the hypertensive behavior. 1. Benefit is the most important and significant of the variables for explaining the dependent variables. It accounts for the highest variance of patient's compliance. (23.62%) 2. Then taking the former together with barrier. the variance of compliance showed on increase. (26.59%) 3. And with the addition of severity to the first two. the variance of compliance was also increased. (28.l2 %) B. Except for susceptibility all the independent variables such as severity. benefit, knowledge. motivation and barrier are correlated to dependent variable compliance. C. Sex. marital status and religion appeared to have significant influence on the dependent variables. Therefore one could conclude that the more the patients are aware that hypertension is a threat to health. the more they understand the benefit of taking actions to prevent such a threat. and the less they perceive any barrier when taking action. the more compliant they become in following medical regimens and recommendations. Age. marital status and religion played a significant influence to their compliance. Accordingly. the selected structural variables and demographic variables which have influenced sick role behavior of the hypertensive patient must be integrated to teaching and counselling programs for better hypertension control.

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병원직원의 노동조합 몰입에 영향을 미치는 요인 (Factors Influencing Hospital Employees' Commitment in Labor Union)

  • 남철식;유승흠;손태용;박웅섭
    • 한국병원경영학회지
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    • 제9권3호
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    • pp.98-127
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    • 2004
  • The purpose of this study was to provide basic materials needed to enhance quality of organizational life by identifying the improvements of labor union management in the perspective of hospital organization management. The subjects of this study were 510 employees in 1 University Hospital and 3 General Hospitals in Metro Capital including Seoul. Materials were collected from administrators, nurses and medical technicians in target hospitals from April 26 to May 7, 2004 through survey questionnaires. The main results of this study were as follows: First, From the results of multiple regression analysis to identify major influencing factors of labor union commitment level, In University hospitals, males than females, and those who had senior officer posts in labor union showed higher positive correlation with the attitude of their colleagues. In general hospitals, those who had served in Union for shorter period showed higher commitment in union. Second, When looking into the major influencing factors on the level of commitment in labor union according to their jobs, male administrators showed higher positive correlation in the level of commitment in labor union and the relationship with union. Among nurses, those who had lower education level, those who had higher job satisfaction, those who had higher emotional attachment to their job, those who had better relationship with union and better satisfaction in union showed higher commitment level. In medical technicians, those who had higher emotional attachment to their job showed higher commitment level. To summarize study results, the level of commitment in labor union depends on job satisfaction, managers' attitudes, emotional attachment to their jobs, union satisfaction factors, their colleagues attitudes toward union and thee atmosphere of employer-employee relationship. Therefore hospital managers should have democratic and flexible attitudes toward labor union. Additionally, as job satisfaction is important determinant in union commitment, hospital managers should have countermeasures to enhance the job satisfaction level of hospital employees. Moreover, as managerial factors of the principal of hospital influence union commitment directly, the attitudes of hospital managers toward union and transparency of hospital management should be improved.

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일개 농촌지역의 초등학생과 주민에서 다환성 방향족 탄화수소와 톨루엔 노출이 요중 Thiobarbituric Acid Reactive Substance 농도에 미치는 영향 (Effects of the Exposure to Polycyclic Aromatic Hydrocarbons or Toluene on Thiobarbituric Acid Reactive Substance Level in Elementary School Children and the Elderly in a Rural Area)

  • 김대선;이철호;엄상용;강택신;김용대;김헌
    • Journal of Preventive Medicine and Public Health
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    • 제41권1호
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    • pp.61-67
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    • 2008
  • Objectives : Polycyclic aromatic hydrocarbons (PAH) and toluene have been reported to induce reactive oxygen species and oxidative stress. This study was performed to investigate the effects of low level exposure to PAHs or toluene on the lipid peroxidation level in elementary school children and the elderly in a rural area. Methods : Forty seven elementary school children and 40 elderly people who were living in a rural area and not occupationally exposed to PAH or toluene were the subjects of this study. Information about active or passive smoking and diet was obtained using a self-administered questionnaire. The urinary 1-hydroxypyrene (1-OHP), 2-naphthol, hippuric acid and thiobarbituric acid reactive substance (TBARS) concentrations were measured, and these values were corrected with the urinary creatinine concentration. Results : In school children, the geometric means of the urinary 1-OHP, 2-naphthol, hippuric acid and TBARS levels were $0.02\;{\mu}mol/mol$ creatinine, $0.47\;{\mu}mol/mol$ creatinine, 0.14 g/g creatinine and $0.95\;{\mu}mol/g$ creatinine, respectively. Those values for the elderly were $0.07{\mu}mol/mol$ creatinine, $1.87{\mu}mol/mol$ creatinine, 0.11 g/g creatinine and $1.18\;{\mu}mol/g$ creatinine, respectively. The mean levels of urinary 1-OHP, 2-naphthol and TBARS were significantly higher in the elderly subjects than in the children. The urinary TBARS level was not correlated with the urinary 1-OHP, 2-naphthol and hippuric acid, but they were correlated with the age of the subjects. Conclusions : These results suggest that low level inhalation exposure to PAH or toluene does not markedly increase lipid peroxidation, and age is a significant determinant of lipid peroxidation.

노인장기요양보험 재가서비스 이용자의 시설서비스 이용 결정요인 (A Study of Determinants on Institutionalization of Elderly using Home Care Services)

  • 한은정;강임옥;권진희
    • 한국노년학
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    • 제31권2호
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    • pp.259-276
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    • 2011
  • 다른 사람의 도움을 받아야 하는 노인도 적절한 재가서비스를 받으면서 가능한 오래 가정에 머물 수 있다면 그들의 삶의 질을 향상시키고 비용을 절감할 수 있다고 알려져 있다. 이 연구는 노인장기요양보험제도를 시행한 후, 재가서비스 이용자가 시설서비스로 전환하여 입소하는 것에 대한 결정요인을 살펴보고자 한 종적 연구이다. 이 연구는 장기요양급여 이용자와 주수발자를 대상으로 한 '2009년 노인장기요양서비스 만족도 조사' 자료를 활용하였다. 이 연구의 분석대상자는 총 1,230명으로, 이들은 시도별, 장기요양등급별, 의료보장형태별로 비례할당으로 추출된 것이다. 종속변수는 연구대상자가 재가서비스를 이용하다가 시설로 입소하는 데까지 걸린 시간이고, 이것은 노인장기요양급여DB를 연계하여 파악하였다. 또한 이 연구는 Cox Proportional Hazard Model을 이용하여 hazard ratio를 산출하였다. 연구결과에 의하면, 다른 변수들을 보정한 후에도 이용자가 골절을 앓고 있는 경우에는 시설에 입소할 확률이 유의하게 높은 것으로 나타났다. 또한 통계적으로 유의하지는 않았지만 저하된 인지기능의 항목수가 많을수록 시설에 입소할 확률이 높은 것으로 나타났다. 이러한 영향요인들을 감안하여 향후에는 이용자의 욕구를 충족시키는 재가서비스 이용체계를 구축하고 보완하는 정책개발이 필요하다.

교사의 구강보건교육 실천과 자기효능감이 구강보건교육 태도에 미치는 영향 (Effect of Oral Health Education Practice and Self-efficacy of Teacher on Oral Health Attitude)

  • 조영식;황유진;배현숙;김서연
    • 치위생과학회지
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    • 제9권1호
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    • pp.99-108
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    • 2009
  • 본 연구는 교사의 구강보건교육 실천과 자기효능감이 구강보건에 대한 인식에 미치는 영향을 파악하기 위해 주요 관련 변인인 지식, 태도, 자기효능감, 실천의 관계에 대한 몇 가지 인과모형을 설정하였다. 서울시에 있는 특수학교 교사 376명을 대상으로 설문조사를 실시하였으며, 217명의 응답자 가운데 198명을 대상으로 t-검정, 일원배치분산분석, 상관분석, 경로분석을 하였다. 1. 교사의 성별, 연령, 경력에 따라 교사의 구강보건지식, 구강보건교육 교육에 대한 자기효능감, 구강보건교육에 대한 태도 수준을 비교한 결과, 교사의 성별에 따른 유의한 차이는 나타나지 않았으나, 교사의 연령에 따라 구강보건교육에 대한 자기효능감(p = 0.001)과 태도(p = 0.013)에 유의한 차이가 나타났다. 또한 교사의 경력에 따라 구강보건지식, 구강보건교육에 대한 자기효능감과 태도는 유의한 차이가 나타나지 않았다. 2. 교사의 구강보건지식, 구강보건교육에 대한 태도, 자기효능감, 구강보건교육 실천에 대한 상관관계를 분석하였다. 구강보건교육 태도, 자기효능감, 실천 사이에는 통계적으로 유의한 정(+)의 상관관계가 나타났으나, 교사의 구강보건 지식와 실천 사이에는 유의한 상관관계가 나타나지 않았다. 3. 교사의 구강보건 지식이 직접적으로 교사의 구강보건교육 실천에 직접적인 정(+)의 영향을 미치며, 교사의 구강보건교육에 대한 태도의 매개에 의해 교사의 구강보건교육 실천에 영향을 미치는 부분매개 모형(모형1)의 검증 결과, 지식과 태도 사이의 경로(Estimate=0.183, C.R.=0.294, p=0.003)와 태도와 실천 사이의 경로(Estimate=0.398, C.R. =3.090, p=0.002)는 통계적으로 유의하였으나, 지식과 실천 사이의 경로는 유의하지 않았다. 이 경로를 제외한 지식, 태도, 실천 사이의 완전매개 모형(모형1-1)은 모든 적합도 지수의 기준을 총족하였으나($x^2$=0.081, df=1, p=0.776, GFI=1.000, AGFI=0.998, NNFI= 1.178, NFI=0.996, CFI=1.000), 실천의 분산은 지식과 태도에 의해 충분히 설명되지 않았다(SMC=0.05). 4. 교사의 구강보건교육 실천이 구강보건교육에 대한 태도에 직접적인 정(+)의 영향을 미치며, 구강보건교육에 대한 자기효능감의 매개에 의해 교사의 구강보건교육 태도의 매개에 의해 영향을 미치는 부분매개 모형(모형2)의 검증 결과, 실천과 태도 사이의 경로(Estimate=0.273, C.R.=5.734, p<0.001)와 교사효능감과 태도 사이의 경로(Estimate=0.242, C.R.=4.426, p<0.001)는 통계적으로 유의하였으나, 실천과 태도 사이의 경로는 유의하지 않았다. 이 경로를 제외한 실천, 교사효능감, 태도 사이의 완전매개 모형(모형2-1)은 모든 적합도 기준을 충족하였으나($x^2$=2.081, df=1, p=0.149, GFI=0.993, AGFI=0.958, RMSEA=0.074, NNFI=0,942, NFI=0.965, CFI=0.981), 태도의 분산은 실천과 교사효능감에 의해 충분히 설명되지 않았다(0.136). 5. 지식태도실천 모형(모형2-1)에 교사의 구강보건교육에 대한 자기효능감을 매개변인으로 추가한 지식태도 자기효능감실천 모형(모형3)은 적합하게 나타났으며 ($x^2$=3.971, d.f.=3, p=0.271, RMSEA=0.039, GFI=0.990, AGFI=0.967, NNFI=0.971, NFI=0.944, CFI=0.986), 실천의 분산 중 14.3%가 지식, 태도, 자기효능감에 의해 설명되었다.

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폐경 후 류마티스 관절염 여성의 골량감소 판별요인 (Determinants of Reduced Bone Mass in Postmenopausal Women with Rheumatoid Arthritis)

  • 이은남
    • 재활간호학회지
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    • 제2권2호
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    • pp.193-205
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    • 1999
  • This study was carried out to identify the important risk factors for reduced bone mass of postmenopausal RA patients and to develop discriminant function which can classify postmenopausal RA patients with either reduced or normal bone mass. Through the literature review, individual characteristics such as age, body weight, height, age of menarche, duration of menopause, gravity, parity, and breast feeding period and factors of life style such as milk consumption exercise habit, alcohol intake, cigarette smoking, coffee consumpt ion , disease activity, corticosteroid therapy were identified as influencing factors of reduced bone mass in RA patients Sixty eight postmenopausal women with rheumatoid arthritis aged between 42 and 76 were selected among those who checked bone mineral density in lumbar spine and femur from october, 1998 to Apr il, 1999 at Dong-a university hospital in Pusan. Assessment of disease activity, duration of disease and corticosteroid therapy were made by the same rheumatologist and included Ritchie articular index, erythrocyte sedimentation rate, and C-reactive protein on measuring bone mineral density. Cumulative steroid dosage was calculated from the daily dosage multiplied by t h e number of days received. The information of other risk factor including health assessment score, individual characteristics and life style factors were collected by questionnaire. Bone mineral density(BMD) was measured using DXA at lumbar spine and femoral Ward's triangle. Discriminant function(regression equation) was developed for estimating the likelihood of the presence or absence of reduced bone mass. The results are as follows: Among the subjects, thirteen(19.1%) exhibited osteoporosis in lumbar spine and twenty four(35.3%) exhibited osteoporosis in femoral Ward's triangle. For lumbar spine, the variables significant were age, body weight, health assessment score, while for femoral Ward's triangle, age, body weight, duration of disease. But disease activity and corticosteroid therapy were not signigicant to distinguish reduced bone mass from normal bone mass. When the discriminant function was evaluated by comparing the observed out come with predicted out come, the discriminant function correctly classified 85.4% of patients with reduce bone mass and 63.0% of patients with normal bone mass in the lumbar spine and 100% of patients with reduced bone mass and 9.1% of patients with normal bone mass in the femoral Ward's triangle. In summary, we found that osteoporosis in postmenopausal women with RA is more evident at the femur than the lumbar spine. Also the important discriminant factors of reduced bone mass postmenopausal women with RA were age, body weight , duration of disease and health disability. In nursing situation, the efforts to improve of functional capacity of postmenopausal women with rheumatoid arthritis should be considered to prevent osteoporosis and fractures. Also we recommend those postmenopausal women with RA who are classified as a group of the reduced bone mass in the discriminant function should examine the bone mineral density to further examine the usefulness of this discriminant function.

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종합병원 직원의 노동조합성격에 따른 노조몰입 결정요인 (Determinants Influencing Labor Union Commitment of General Hospital Employees' by the Characteristics of Unions)

  • 김욱수;하호욱;손태용
    • 보건의료산업학회지
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    • 제2권1호
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    • pp.56-83
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    • 2008
  • The purpose of this study was to provide basic materials needed to enhance quality of organizational life by identifying the improvements of labor union management in the perspective of general hospital organization management. The subject of this study were 686 employees in 12 General Hospitals in Metro Capital including Seoul. Materials were collected from administrators, nurses and medical technicians in target hospitals from March 20 to May 10, 2005 through survey questionnaires. The main results of this study were as follows: 1. the commitment level of the subjects according to their characteristics was higher in older employees than the younger ones, large family to support than small family to support and those who had higher positions in labor union. 2. The commitment level of the subjects according to the job and role related variables were higher those who had higher satisfaction level to their job and manager, role conflict in all hospitals. 3. The commitment level of the subjects according to union related variables, variables jointly controlled by union and employer was satistically significant positive correlation. In other words, the commitment level of the subjects according to the subjects' labor union involvement was higher in those who had higher satisfaction in labor union and perceived their colleagues' attitudes more positively in all hospitals. Regarding the atmosphere of the relationship between union and employer and the level of commitment in labor union, the better the atmosphere of the relationship between union and employer was, the higher the level of commitment in labor union was in all hospitals. 4. The results of multiple regression analysis shows that formal and informal socialization, union participation to the union management cooperation program, job satisfaction, satisfaction with the labor union's were all found as important antecedents of labor union commitment. 5. Job and role-related variables, union-related variables, variables jointly controlled by union and employer, and labor union commitment level were all found significantly different in accordance with the characteristics of unions concerned. To summarize study results, the level of commitment in labor union depends on job satisfaction, manager's attitudes, satisfaction to their jobs, union satisfaction, their colleagues attitudes toward union and the atmosphere of employer-employee relationship. Therefore hospital managers should have democratic and flexible attitudes toward labor union. Additionally, as formal and informal socialization, union participation to the union-management cooperation program is important determinant in union commitment, hospital managers should have countermeasures to enhance the colleague attitude and job satisfaction level of hospital employees. Since this study deals with psychological nature of workers not a few drawbacks and shortcomings may be detected in the finding. Nevertheless, the finding of this study, to become a momentum that will stimulate further research to detect all the cues of labor union commitment and to provide valuable reference in forming logical union commitment and labor union-management cooperation.

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