• 제목/요약/키워드: Health practitioners

검색결과 448건 처리시간 0.029초

보건소의 진료의뢰 양상과 의뢰환자들의 전문과목 요구도 (Referral Patterns and Needs for Specialist Care among Patient Referred from Health Center)

  • 황태윤;김창윤;강복수
    • Journal of Preventive Medicine and Public Health
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    • 제29권1호
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    • pp.133-143
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    • 1996
  • 본 연구는 경상북도 경주시 보건소에서 1995년 6월 10일부터 10월 17일까지, 성주군 보건소에서 8월 1일부터 9월 20일까지, 고령군 보건소에서 8월 5일부터 10월 17일까지 진료를 받은 환자 중에서 타 의료기관으로 의뢰된 환자 249명을 대상으로 설문조사를 통하여 보건소 이용자들의 타 의료기관으로의 진료의뢰 양상, 진료의뢰서 발급경위 및 보건소내 전문과목의 요구도를 파악하고자 실시되었다 환자 본인의 희망에 의해 진료의뢰서를 발급받은 경우와 의사의 판단에 의해 진료의뢰서를 발급받은 경우 모두를 포함하였으며 본인이 설문 조사에 응한 경우만을 분석대상으로 하였다. 자료수집 기간 중 3개 보건소의 전체적인 진료의뢰율은 보건소 이용자 13,652명 중 371명으로 2.7%였으며, 설문조사에 응한 249명 중 환자 본인의 희망에 의해 진료의뢰서를 발급받은 사람이 214명(85.9%)이었고, 의사의 판단에 의해 진료의뢰서를 발급받은 사람은 35명(14.1%)이었다. 환자 본인의 희망에 의해 진료의뢰서를 발급받은 사람 중에는 타 의료기관을 거치지 않고 바로 보건소를 방문한 사람이 98명 (45.9%)으로 가장 많았고, 개인의원을 들렀다가 보건소를 방문한 사람은 74명(34.6%), 평상시 진료는 개인의원에서 받고 있지만 진료의뢰서를 발급받기 위해 보건소를 방문한 사람이 42명(19.5%)인 것으로 나타났다. 대상자들이 보건소에 진료의뢰서를 발급받으러 온 이유로는 '보건소가 거리가 가까워서'가 74명(34.6%)으로 가장 많았고, '보건소에서는 진료의뢰서 발급을 잘 해주기 때문에'가 58명(27.1%), '개인의원에서 진료의뢰서를 발급해주지 않으려 해서'가 35명(16.4%) 그리고 '개인의원에서 진료를 받던 의사에게 진료의뢰서를 발급받기가 미안해서'가 30명(14.0%) 등의 순이었다. 진료의뢰된 환자들의 한국표준질병분류에 의한 질병별 분포는 진료의뢰된 환자 전체적으로는 근골격계 및 결합조직 질환이 43명(17.3%)으로 가장 많았고, 환자 본인이 진료의뢰서 발급을 원한 경우는 신경계 및 감각기 질환이 11.7%,의사가 판단하여 진료의뢰서를 발급한 경우에는 감염성 및 기생충성 질환이 11.4%로 전체 질병별 분포에 비해 상대적으로 높은 비율을 차지하였다. 진료의뢰 환자들의 진료의뢰서 발급 후 진료희망 의료기관은 환자 본인이 희망한 경우와 의사의 판단에 의해 진료의뢰한 경우 모두에서 종합병원 이상의 의료기관을 선호하였다. 보건소내 전문의 진료의 필요성에 대해서는 환자 본인의 희망에 의해 진료의뢰서를 발급받은 경우와 의사의 판단에 의해 진료의뢰서를 발급받은 경우에서 각각 161명(75.2%)과 26명(74.3%)이 전문의의 진료가 필요하다고 응답하였다. 전문의의 진료가 필요하다고 응답한 경우 필요한 전문과목의 종류는 내과 88명 (47.1%), 정형외과 19명(10.2%), 일반외과 병(9.1%) 순이었고, 보건소내 전문의의 진료 횟수는 상주 전문의를 원한 경우가 108명(57.8%)으로 가장 많았고, 1주일에 $2\sim3$회가 32명(17.1%), 1주일에 1회가 21명(11.2%), 1달에 1회가 17명(9.1%)순이었다. 이상의 결과로 보건소에서 진료의뢰서를 발급받은 사람의 대부분은 환자 본인이 원하여 진료의뢰서를 발급받고 있어 환자의뢰제도의 개선이 요망되며, 보건소에서 전문의 진료가 실시된다면 내과진료가 우선적으로 시행되고, 정형외과와 일반외과 등의 진료 요구가 높은 전문과목은 민간의료기관의 협조를 통하여 비상근 형태의 진료가 시행되는 것이 좋을 것으로 생각된다.

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보완요법에 대한 보건진료원의 지식, 태도와 활용 경험 (The Knowledge, Attitude, and Utilization Experience of Community Health Practitioners on Complementary Therapies)

  • 황성호;박재용;한창현
    • 농촌의학ㆍ지역보건
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    • 제27권2호
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    • pp.87-105
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    • 2002
  • 보건진료원들의 보완요법에 대한 지식, 태도 및 활용경험을 알아보기 위하여 부산 경남 대구 경북 지역에서 연차보건의료 서비스를 제공하고 있는 보건진료원 393명을 대상으로 2002년 2월 1일부터 3월 31일까지 직접 면담 및 우편 설문조사를 실시하였다. 11가지 보완요법 각각에 대한 보건진료원의 관심률은 수지침이 75.3%로 가장 높았고 향기요법 71.0%, 한방요법 68.4%, 마사지 67.4%, 지압 64.6% 등의 순이었으며, 동종요법이 23.4%로 가장 낮았다. 치료효과에 대한 신뢰율은 한방요법이 92.6%로 가장 높았고 수지침 85.5%, 마사지 83.7%, 지압 81.7% 등의 순이었고, 동종요법은 18.1%로 가장 낮았다. 보완요법을 환자에게 권유한 경험은 한방요법 65.1%, 수지 침 50.4%, 마사지 44.8%, 지압 34.4%, 향기요법 27.5% 등의 순이었으며, 동종요법이 2.8%로 가장 낮았다. 보완요법의 학습 경험이 있는 응답자는 수지침 33.1%, 한방요법 13.2%, 향기요법 11.2%, 마사지 8.4%, 지압 5.6% 등의 순이었으며, 동종요법의 학습 경험자는 한명도 없었다. 지난 5년간 보완요법을 직접 이용한 경험이 있는 응답자는 한방요법 23.9%, 수지침 18.8%, 향기요법 5.9%. 마사지 5.3%, 지압 5.1% 등의 순이었고 동종요법은 이용 경험자가 없었다. 이용 경험이 있는 모든 보완요법에서 치료 효과가 있었다는 응답자가 압도적으로 많았으며 부작용의 사례는 매우 적었다. 각각의 보완요법에 대해 보수교육이나 공무원 교육 훈련시 하나의 교육과정으로 도입하기를 희망하는 비율은 수지침 78.1%, 한방요법 69.2%, 향기요법 67.9%, 지압 63.9%, 마사지 63.1% 등의 순이었다. 보건진료원들의 일차진료시 보완요법 사용 희망률은 수지침 63.6%, 마사지 52.9%, 향기요법 51.9%, 한방요법 50.1% 등의 순이었으며, 카이로프락틱과 동종요법은 각각 170%, 12.2%로 매우 낮았다. 대상 보건진료원의 지난 5년간 보완요법 시술경험률은 수지침 8.4%, 한방요법 4.6%, 마사지 2.5%, 향기요법 2.5% 등의 순이었고 봉침요법과 동종요법을 시술한 경험자는 없었다. 시술받은 환자의 반응은 대부분이 긍정적이라고 하였으며, 부작용의 사례는 매우 낮았다. 이상의 결과에서 볼 때 보완요법에 대한 보건진료원들의 관심, 신뢰, 권유 경험률 등은 높았지만 실제 학습 경험률은 매우 낮았다. 또한 실제 이용과 시술경험을 통해 부작용의 문제가 없었으며, 건강에 도움이 될 수 있는 보완요법에 대해서는 교육과정으로 도입하기를 희망하였다. 따라서 지역주민들에게 보완요법 선택과 관련하여 제공하고 건강에 도움이 될 수 있는 보완요법 관련 서비스를 제공하기 위해서는 보건진료원에 대한 체계적이고 합리적인 보안요업 교육과정을 개발하여 실시할 수 있도록 정책적인 관심과 지원이 필요하다고 생각된다.

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농어촌 개발과 의료보장 개혁에 따른 보건진료원의 책임 (The role and responsibility of community health practitioner based on the rural community development and the reform of health care system)

  • 김화중
    • 지역사회간호학회지
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    • 제5권2호
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    • pp.101-108
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    • 1994
  • This study was conducted by community survey of 215 community health practitiner's posts and literature review of official documents. The result was as follows ; 1. The role and responsibility of community health practitioner's post must be studied by the community health practitioner and the community health leader, and on the basement of community health needs, community development plan, and reforom of health care system. 2. Comprehensive health care of community is very important role and responsibility of community health practitioners. However, it was supervised by the senior community health practitioner in provincial government. 3. The community health practitioner must be trained by formal inservice educational program focused on comprehensive health care. 4. The community health practitoner must be the health guider and health leader as the member of community.

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Delphi방법을 이용한 일차의료 고혈압 진료지침 개발 및 적용 (Establishment and Application of the Guideline for Hypertension by Delphi Method in the Field of Primary Medical Care)

  • 양윤준;홍명호
    • 한국의료질향상학회지
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    • 제2권1호
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    • pp.68-84
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    • 1995
  • Background: Guideline for practice is useful because it can be the standard for assessment and way to improve quality. We need to take account of expert opinion and consensus as well as scientific evidences to develope practice guideline because it should be practical. Delphi method has been developed to gather opinions from experts fairly. This study was designed to develop practice guideline and apply it to practices as a method to improve quality in primary medical care. Methods: Hypertension(in adults over 18 years old) was selected as a target problem. Self questionnaires about management of hypertensive patients were developed by a researcher with advice of 11 experts. The questionnaires were designed to response as a 5 pont scale. The results of previous questionary were given to respondents in second and third questionnaires. If needed, the questionnaires were changed on the previous responses. The items with medium greater than or equal to 4 point in 1st and 2nd responses were accepted in guideline. The items with medium lesser than or equal to 3 point were questioned again about whether they can be excluded or not. The criteria for assessment was made with reference to guideline and applied to 85 hypertensive patients of 9 family practitioners. At 3 months after practice guideline had been given to family practitioners, performance of same practitioners was assessed with 36 new hypertensive patients. Results: 23 professors in family medicine, 22 family practitioners and 6 cardiologists, responded among 50, 50, 15 respectively. Practice guideline with 33 items was developed as a result of 3 times questionaires. The difference of responses between professors in family medicine, family practitioners and cardiologists was not significant. Performance of practice was improved in diagnosis, history taking about 6 fields, laboratory examination and decision making about time of pharmaceutical prescription. It was not improved in physical examination, life style modification, method of pharmaceutical prescription, choice of initial antihypertensives and history taking about duration of disease and diet habit. It was decreased in history taking about psychosocial factors. The assessment scores were low in history taking, physical examination and life style modification before and after use of practice guideline. Conclusion: Practice guideline for hypertension could be developed by Delphi method. Performance of practice improved partially after use of guideline.

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치과 병·의원 이용 환자의 만족도 관련요인 (Related factors to satisfaction of patients visiting dental hospital and clinics)

  • 김창숙;윤영주;이경수
    • 한국치위생학회지
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    • 제13권3호
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    • pp.411-418
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    • 2013
  • Objectives : The quality of service is considered as the difference between services that customers perceive and expect by using SERVQUAL model and the basic data for the efficiency of management of dental hospital and clinics, the differentiation strategies of dental medical institutions and the improvements on quality of service are provided. Methods : Subjects were 469 patients who visited six dental hospitals and clinics in Daegu-Gyeongbuk regions. Questionnaire consisted of five items such as type, reliability, responsiveness, certainty and empathy properties. Data were analyzed using SPSS 12.0 program in this study. Results : Women had high satisfaction scores of medical services in certainty and empathy properties. 40s and higher had the highest score in the type property. 30s had high score in the certainty property. For expected service satisfaction, 30s had the highest score in dental practitioners and administrative staffs. For reuse of current medical institution and intent for recommendation, certainty property and factor of dentist and dental practitioners had high scores. Additionally, reliability and responsiveness properties were statistically significant. Conclusions : Medical institutions should make every effort to get the dentists or dental practitioners have the medical knowledge at a high level, a kindness for patients and trust from patients.

Engineering Theory: A Conversational Bridge Between Theoreticians and Practitioners in Discussion of Curriculum Development and Dissemination as Used in the DASH Program

  • Pottenger III, Francis M.;Son, Yeon-A;Kim, Joo-Hoon;Park, Hyun-Ju
    • 한국과학교육학회지
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    • 제24권4호
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    • pp.758-773
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    • 2004
  • This paper advances the thesis that the barrier separating curriculum theorists and practitioners is more than a difference in experiential and methodological orientation and is in part a product of a lack of appreciation of the complexities involved in curriculum development and dissemination. Discussed here is the possible use of engineering theory to facilitate meaningful communication and understanding about products and development. This work is an extension of the observation that curriculum development and dissemination can be characterized as an engineering process and shows how engineering theory provides connectivity between the multiple embedded domains of theory and of practice. To illustrate the thesis this paper offers an analysis of the Developmental Approaches in Science, Health, and Technology (DASH) program that has employed engineering theory in curriculum construction and dissemination. In this study, the role and place of engineering theory as applied to the DASH program is discussed to show how the components were designed and assembled into a fully functional curriculum and dissemination system. Engineering theory is presented as an interfacing organizer with the potential to facilitate meaningful communication between theorists and practitioners.

Rome IV Clinical Criteria and Management of Functional Constipation: Indonesian Health Care Professionals' Perspective

  • Andy Darma;Khadijah Rizky Sumitro;Leilani Muhardi;Yvan Vandenplas;Badriul Hegar
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제27권2호
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    • pp.125-135
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    • 2024
  • Purpose: The updated ROME IV criteria for functional constipation (FC) in children were published in 2016. However, information on the use of these criteria is scarce. This study aimed to report the frequency of the use of the ROME IV criteria by Indonesian pediatricians and general practitioners (GPs) in FC management in infants and toddlers. Methods: An anonymous cross-sectional online survey was conducted between November 2021 and March 2022. Results: A total of 248 respondents (183 pediatricians and 65 GPs) from 24 Indonesian provinces completed the survey. Most respondents reported an estimated prevalence of FC to be less than 5% both in infants and toddlers. On average, only 64.6% of respondents frequently used the ROME IV criteria. Pediatricians used the ROME IV criteria more often than GPs did (p<0.001). The most frequently used criteria were painful or hard bowel movements (75.0%) and ≤2 defecations/week (71.4%). Lactulose as a laxative was the preferred treatment choice, followed by changing the standard formula to a specific nutritional formula. Most of the respondents carried out parenteral reassurance and education. Normal growth, as a marker of good digestion and absorption function, and normal stool consistency and frequency were the most reported indicators of gut health. Conclusion: The ROME IV criteria for functional constipation are not extensively used by pediatricians and GPs in Indonesia. Laxatives and specific nutritional formulas were the most used management approaches in infants and toddlers. Medical education, especially for general practitioners, should be updated.

농촌지역 공공보건기관의 보건사업 기능개편 방안 (Challenges in Public Health Programs for People Living in Rural and Remote Areas)

  • 전경자;나백주
    • 한국농촌간호학회지
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    • 제2권2호
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    • pp.145-152
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    • 2007
  • Purpose: The purpose of this study was to suggest new directions for public health programs in rural and remote areas. Method: For this purpose, a literature review was done including articles, research reports, and master theses and doctoral dissertations. Results: Public health programs in rural remote areas were found to be very insufficient in terms of professional personnel and program diversity. Especially, there is a lack of adequate manpower and infra-structure in the public health sub-centers at the township and sub county level. Although community health practitioners at the village level are providing public health service beyond medical care, their coverage rate is very low. Conclusion: The results suggest a need to strengthen the function of public health sub-centers to provide comprehensive public health service based on the life-cycle approach. For this new change, legal and political support must be developed.

Roles, job market, and evidence into practice of health education professionals in the UK

  • Green, Jackie
    • 한국보건교육건강증진학회:학술대회논문집
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    • 한국보건교육건강증진학회 2009년도 추계학술대회 자료집
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    • pp.18-29
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    • 2009
  • This paper reviews the position of health promotion in England and, in particular, how structural change and reorganisation within the NHS, along with the emergence of multidisciplinary public health, have been a challenge to its identity. It draws lessons from recent experience to emphasise the distinctive contribution of health promotion to public health and the need for proper recognition and career progression for health promotion staff. It argues that the specification of competences should be informed by a health promotion discourse and that as well as defining skills these should also include the values and ethical principles of health promotion. It argues that practice should be evidence-based and health practitioners have a responsibility to draw critically on evidence and also to generate the type of evaluation evidence which would inform dissemination.

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진단용 방사성동위원소 취급 시 L-block 차폐기구 사용에 따른 핵의학 종사자의 장기 선량평가 (Organ Dose Assessment of Nuclear Medicine Practitioners Using L-Block Shielding Device for Handling Diagnostic Radioisotopes)

  • 강세식;조용인;김정훈
    • 대한방사선기술학회지:방사선기술과학
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    • 제40권1호
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    • pp.49-55
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    • 2017
  • 의료기관 내 핵의학 종사자는 방사성동위원소 취급 시 사용하는 선원의 종류, 방사능량, 차폐기구의 사용 여부에 따라 종사자 개인별로 광범위한 피폭선량을 나타낼 수 있다. 이에 본 연구에서는 몬테카를로 기법을 기반으로 한 모의실험을 통해 진단용 방사선원 취급 시 종사자의 장기별 선량평가와 L-block 차폐기구 사용에 따른 선량감소효과를 분석하였다. 그 결과, 방사선원의 취급 위치에 근접할수록 높은 장기선량 분포를 나타내었고, ICRP 조직가중치에 따라 유효선량 분포가 상이한 양상을 보였다. 또한 L-block 두께에 따른 선량감소효과는 차폐두께 증가에 따라 지수함수 분포로 감소되는 경향을 나타내었으며, 방사선원별 선량감소효과는 방출하는 감마선 에너지에 비례하여 낮은 차폐효과를 보였다.