• 제목/요약/키워드: Hospital Guidance

검색결과 361건 처리시간 0.024초

물리치료사에 대한 의사의 "지도"의 목적론적 해석 (A Teleological Interpretation of a Doctor's "Guidance" for Physical Therapist)

  • 이주일
    • 대한물리의학회지
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    • 제13권2호
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    • pp.147-156
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    • 2018
  • PURPOSE: The law pertaining to medical service technologists does not discuss the scope and limits of doctors' guidelines. My paper aims to discuss these topics. METHODS: This study was based on a review of literature and an analysis of judicial precedents. RESULTS: Physical therapists have often noted the need for independent practitioners in their articles on health care. Their continued discussions on professional and educational differences have centered round this issue, but their ideas have not been accepted. Practitioners have continued to interpret doctors' guidelines in hospitals without discussing their scope. However, the Supreme Court presented a meaningful decision outlining the conceptual limits and the scope of medical practice. The court suggested, basing its interpretation in the goal of clarifying the concept of medical activities smoothly, was to follow a specific judgment on the levels of education, testing, and professionalism. CONCLUSION: The role of physical therapists is expanding in this country, in order to meet the needs of the ultra-aged society. Education is already responding to rising training needs. By dividing the doctors' guidelines into indirect and direct types, if there's no medical risk near or around the health center or hospital, it is a good idea to allow the management of physical therapy partially, while understanding the scope and limitations of these guidelines clearly. A teleological interpretation of the law is especially relevant, and can be implemented immediately by the authoritative interpretation on part of the health authorities without any legal amendments.

요통환자에서 경막외 유착 용해술에 의한 제통효과 (Epidural Adhesiolysis in Low Back Pain)

  • 이상철;오완수;김진경;노창준;손종찬
    • The Korean Journal of Pain
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    • 제10권2호
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    • pp.214-219
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    • 1997
  • Background: Epidural neural blockade with local anesthetics combined with steroids has been in clinical trials for patients with low back pain. But pain treatment of low back pain remains somewhat problematic. Many patients with low back pain have epidural fibrosis and adhesions proved with magnetic resonance imaging(MRI) examination. These findings might play an important role in the origin of back pain. Present study was aims to investigate the effect of epidural adhesiolysis in patients with low back pain. Methods: We investigated 76 patients suspected with epidural fibrosis and adhesion was suspected. Nerve pathology was demonstrated and epidural fibrosis suspected or proved with MRI examination. 17G needle specially designed by Racz was inserted at sacral hiatus and catheter was inserted untill its tip was located at lesion site under fluoroscopic guidance. Injection of contrast dye was achieved and prospected spread of agents. Injection of 0.25% bupivacaine, triamcinolone, and 10% hypertonic saline via catheter were carried out daily for 3 days. Evaluation included assessment of pain relief (Numerical Rating Scale; NRS) post-epidural adhesiolysis 3 days, 1 week, and 3 months. We also looked for complication of epidural adhesiolysis. Results: Statistical analysis(Friedman nonparametric repeated measures test and Dune's multiple comparison test) demonstrated NRS was significantly less during 3 months after epidural adhesiolysis(P<0.05). Especially, there is a extremely significance in post-epidural adhesiolysis 3 days (P<0.001). Only four patients reported any complications the most common symptom among three persistent headache but disappeared after a few months without residual sequelae. Conclusion: We conclude epidural adhesiolysis is a safe and effective method of pain therapy for low back pain with proven lumbo-sacral fibrosis and adhesion. A direct visualization by epiduroscopy may be more useful to the resulting functional changes after epidural adhesiolysis.

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치위생과 학생의 취업가치관과 취업선호도에 관한 연구 (A study on the job values and job preference of dental hygiene students)

  • 김경미;정영란;한화진
    • 한국치위생학회지
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    • 제9권2호
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    • pp.1-11
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    • 2009
  • The purpose of this study was to examine the state of career and employment among dental hygiene students in an attempt to get an accurate grip on their preparation for career and employment. And it's also meant to help improve the efficiency of guidance by dental hygiene education institutions for career and employment. The subjects in this study were every dental hygiene student at three different colleges. After a self-administered survey was conducted, the following findings were given: 1. In regard to the future prospects of dental hygienist, 44.2 percent of the students investigated believed that there would be a bright future for dental hygienist, and 55.8 percent didn't agree to that or considered the prospects to be neither bright nor bleak. 2. As to the motivation of choosing the department of dental hygiene, 51.2 percent thought that it was easy for dental hygienists to get a job, and 22.2 percent wanted to be a professional. 3. Concerning preference for workplace, they hoped to work in a hospital-sized or larger institutions including dental hospitals. As to the reason why they wanted a job, 76.2 percent had their sight set on standing on their own feet. 4. As for the top priority for employment, they took interpersonal relationship into account the most(3.63), followed by aptitude(3.52) and working conditions/environments(3.51). 5. In terms of job values by academic year, all the freshmen, sophomores and juniors attached the most importance to interpersonal relationship. By academic standing in the previous semester, the students who got an A, B or C put more value on human relations, and those who got a D gave more weight to social status and fame. The gap between them was statistically significant. As for the impact of the high schools they graduated from, they took the most statistically significant consideration on interpersonal relationship irrespective of their alma mater.

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Endoscopic and Laparoscopic Full-Thickness Resection of Endophytic Gastric Submucosal Tumors Very Close to the Esophagogastric Junction

  • Kwon, Oh Kyoung;Yu, Wansik
    • Journal of Gastric Cancer
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    • 제15권4호
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    • pp.278-285
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    • 2015
  • Purpose: Gastric submucosal tumors (SMTs) located very close to the esophagogastric junction (EGJ) are a challenge for gastric surgeons. Therefore, this study reports on the experience of using endoscopic and laparoscopic full-thickness resection (ELFR) with laparoscopic two-layer suturing in such tumors. Materials and Methods: Six patients with gastric SMTs very close to the EGJ underwent ELFR with laparoscopic two-layer suturing at Kyungpook National University Medical Center. With the patient under general anesthesia, the lesser curvature and posterior aspect adjacent to the EGJ were meticulously dissected and visualized using a laparoscopic approach. A partially circumferential full-thickness incision at the distal margin of the tumor was then made using an endoscopic approach under laparoscopic guidance. The SMT was resected using laparoscopic ultrasonic shears, and the gastric wall was closed using two-layer suturing. Thereafter, the patency and any leakage were checked through endoscopy. Results: All the ELFR procedures with laparoscopic two-layer suturing were performed successfully without an open conversion. The mean operation time was $139.2{\pm}30.9$ minutes and the blood loss was too minimal to be measured. The tumors from four patients were leiomyomas, while the tumors from the other two patients were gastrointestinal stromal tumors with clear resection margins. All the patients started oral intake on the third postoperative day. There was no morbidity or mortality. The mean hospital stay was $7.7{\pm}0.8$ days. Conclusions: ELFR with laparoscopic two-layer suturing is a safe treatment option for patients with an SMT close to the EGJ, as major resection of the stomach is avoided.

외래 및 퇴원환아 부모의 전화상담과 간호중재의 내용분석 (Content Analysis of the Nursing Interventions and Telephone Calls to the Pediatric Nursing Unit)

  • 한경자;최명애;강화자;박승현;김영미;권원경;안혜영
    • 대한간호학회지
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    • 제26권3호
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    • pp.515-530
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    • 1996
  • A descriptive study was conducted to describe the content of nursing interventions and incoming telephone calls from the parents whose child was discharged to home or who has planned immunization during the period from March 15, 1995 to November 30, 1995. Detailed notes on 145 telephone calls and 243 nursing interventions were recorded by head nurses on pediatiric nursing units were entered to data collection and content analysis. The results of the study are as follows : 1. Six analysis categories for the records on incoming telephone calls were identified judgement-dependence, dependent -coping, self-initiated coping, support, adjustment and intermediation need. 2. Five analytic categories for the records on telephone interventions were identified : guidance, mediation, facilitating self -care abilities, support, instrumental use. 3. Problems related to physical signs and symptoms, medication, immunization, and vital signs were most often cited as concerns by parents and caregivers. 4. Instruction, suggestion, provision knowledge and information, reassurance related to physical problems, medication, immunization and clinic visits were most often used as an nursing interventions by head nurses on pediatric nursing units. In spite of the fact that the telephone calls were initiated by the parents, dependency of parents during the telephone calls was remarkable. The dependency of parents on judgement and decision making of the pediatric nurses should be understood in terms of the psychosocial content as well as cultural characteristics. Therefore, it is suppested that telephone interventions focus on facilitating the self-care ability of the parents whose children have chronic conditions. The results of this study will be useful as an essential reference in providing effective for children and their families after discharged from the hospital. The results can also be used as reliable data for extended pediatric nursing service in the health care delivery system as well as for the development of telephone intervention service program in responding to the current health care environment.

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의료복합시설 개발을 위한 시설용도별 이용자 선택기준에 관한 연구 (A Study on the Consumer Choice Criteria based on Facility Purpsoe for Multi-Mixed Complex Medical Care Facility Development)

  • 성나영;이상엽
    • 한국건설관리학회논문집
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    • 제17권4호
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    • pp.28-39
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    • 2016
  • 소득수준 향상 및 인구특성 변화에 따라 증가하는 복합의료서비스 수요에 대응하여 본 연구는 의료복합시설을 부동산개발을 위한 독립적인 대상으로 고려하여 의료복합시설 개발을 위한 시설용도별 이용자 선택기준에 대한 분석을 실시하였다. 이를 위해 개발수요분석을 위한 기초자료로서 시설선택기준을 정의하고 AHP분석을 통해 중요도와 우선순위를 도출하였다. 의료복합시설을 구성하는 '의료관련시설', '지원시설', '보건 및 편의시설' 및 '기타시설'의 네 가지 시설용도에 따라 중요도를 비교 분석한 결과, '시설의 수준', '이용가격', '이용 편리성', '병원의 수준', '서비스', '인접성', '교통의 편리성' 등의 기준들이 서로 다른 차이를 보여 복합 시설 용도 별 이용객의 선택속성에 대한 시사점을 제공하였다. 연구결과를 통해 향후 의료복합시설 개발 시 타당성 분석 및 평가를 위한 기초적인 자료를 마련하고 용도 간의 최적의 조합을 통한 시설구성 대안을 도출하여 효율적인 개발을 위한 자료로 활용되고자 한다.

간호학생의 대상자 교육후 교육경험 만족도, 실습만족도 및 자기효능감 정도 (The Relationships between Patient Education Experience, Satisfaction with Clinical Nursing Practice and Self-Efficacy in Nursing Students)

  • 심미정
    • 문화기술의 융합
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    • 제4권1호
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    • pp.17-25
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    • 2018
  • 본 연구는 일개 대학의 간호학생을 대상으로 모성간호학 실습시 대상자에게 제공한 교육경험의 만족도, 실습만족도 및 자기효능감과의 관계를 분석하여, 실습의 질 향상을 위한 개선방안을 제시하고자 하였다. 연구결과, 간호학생들은 대상자 교육시 문제점으로는 대상자와의 접근, 교육시간 확보의 어려움 및 자신감 부족 등 이었다. 교육실시후 교육경험만족도는 3.84점, 임상실습만족도 4.00점, 자아효능감 2.68점으로 나왔다. 일반적 특성에 따른 대상자 교육경험의 만족도는 교육방법과 실습시기, 이론교육의 만족도에 따라, 임상실습만족도는 실습자의 태도, 실습만족도, 실습장소에 따라, 자아효능감은 성적, 이론교육의 만족도, 교육장소에 따라 차이가 있는 것으로 나왔다. 따라서 모성간호학 실습의 어려움과 한계를 극복하기 위해 병원관계자와 긴밀한 협력관계 유지하고, 간호학생의 요구를 반영한 교육방법과 실습지도 방안을 다각적으로 모색할 필요가 있다.

Renal Lymphoma with Mesenteric Lymphomatosis in a Cat

  • Jeon, Jin-ha;Song, Doo-won;Ro, Woong-bin;Kim, Heyong-seok;Lee, Ga-won;Cho, Jun-ho;Jeong, Woo-chang;Kim, Soo-hyeon;Sur, Jung-hyang;Park, Hee-myung
    • 한국임상수의학회지
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    • 제37권4호
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    • pp.208-212
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    • 2020
  • A 6-year-old castrated male Russian Blue cat was presented for evaluation of dyschezia. Abdominal ultrasound revealed hyperechoic nodules in both kidneys, heterogeneous mass in abdomen, and extensive mesenteric thickening with multiple hypoechoic nodules. Computed tomography showed multiple hypodense lesions in both kidneys and diffuse nodular infiltration around the mesentery. Fine needle aspirates (FNA) acquired under ultrasound guidance from the mesentery consisted of large lymphocytes which have round to irregular nuclei with granular chromatin, prominent nucleoli and a small amount of basophilic cytoplasm. Polymerase chain reaction (PCR) for antigen receptor gene rearrangement result of FNA sample revealed a T-cell malignancy. The cat died from acute renal failure after 1 cycle of modified Madison-Wisconsin L-CHOP protocol. Postmortem examination revealed bilaterally enlarged lumpy-bumpy shaped kidneys. Histopathologic examination showed an infiltration of malignant lymphocytes into the renal parenchyma and mesentery. Immunohistochemical staining of the renal sample displayed a negative expression of CD3, PAX5, MUM-1, and CD79. The clinical features and prognosis of the cat with renal lymphoma with mesenteric lymphomatosis have been described in this report.

Phenotypic and Genotypic Detection of Metallo-β-Lactamase Producing Pseudomonas aeruginosa

  • Yang, Byoung-Seon;Hong, Keun-Seok;Jung, Seung-Bong;Kwon, Young-Hoon;Jeong, Jong-Yoon;Lee, Min-Joo;Lee, Hye-In;Park, Mi-Seon;Choi, Seung-Gu
    • 대한임상검사과학회지
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    • 제44권2호
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    • pp.81-85
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    • 2012
  • This study was undertaken to evaluate phenotypic and genotypic methods for detection of Metallo-Beta-Lactamases (MBLs) among nosocomial Pseudomonas aeruginosa. Of the 50 P. aeruginosa isolates from clinical specimens, 20 were evaluated for carbapenem resistance and screened for MBL by double-disk synergy test and combined-disk test. Nineteen strains (95%) were found to be MBL producers among the 20 P. aeruginosa. MBL positives were further confirmed by Polymerase Chain Reaction (PCR). For the IMP and VIM types of MBLs, PCR analysis was performed on 19 of the 20, and 10 were positive for VIM MBL type. This study reports the validation of a simple and accurate MBL detection method that can be easily incorporated into the daily routine of a clinical laboratory. Early detection of MBL-carrying organisms, including those with susceptibility to carbapenems, is of paramount clinical importance, as it allows rapid initiation of strict infection control practices as well as therapeutic guidance for confirmed infection.Key Words : Hepatitis A virus (HAV), Anti-HAV, Hospital workers, Prevalence, Vaccination

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간호대학생의 지역 중소병원 선택 예측요인 (Predictors of Regional Small and Medium Hospitals Choice among Nursing Students)

  • 정효주;채민정
    • 융합정보논문지
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    • 제9권11호
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    • pp.55-61
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    • 2019
  • 본 연구는 간호대학생을 대상으로 취업선호도, 중소병원에 대한 인지도를 파악하여 지역 중소병원 선택의 예측요인을 파악하기 위하여 시도되었다. 광주광역시와 전라남도 소재 4개 대학교에 재학 중인 간호대학생을 대상으로 2018년 9월부터 2018년 10월까지 자료를 수집하였으며, 부적절한 응답지를 제외한 476명의 설문지를 SPSS/WIN 24.0 프로그램을 이용하여 분석하였다. 연구결과, 간호대학생이 지역 중소병원을 선택한 경우는 66.0%였고, 중소병원 선택의 예측요인은 고등학교 졸업지역, 학업성취도, 중소병원에 대한 인지도였다. 본 연구결과를 통해 간호대학생이 지역 중소병원으로의 취업률을 높이기 위해서는 간호교육자들은 중소병원취업을 희망하는 학생들에게는 역량을 고려한 맞춤형 진로지도 및 상담을 해야겠으며, 병원 관계자들은 중소병원에 대한 인지도를 높이기 위한 다양한 홍보활동 및 마케팅 전략을 수립해야겠다.