• 산업경영시스템학회지
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• 제39권2호
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• pp.82-87
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• 2016

As contemporary society has become more complicated, specialized, and segmented, people are experiencing more diverse types of stress. In particular, while several factors associated with job stress have been examined among nurses, who belong to a professional group, the existing research has made no quantitative assessments of stress that reflect temporal differences in individuals. Therefore, the aim of this study is to understand the effects of job stress on alpha-amylase with regard to the working hours of nurses, to assess the variations in jobs stress over time, and provide basic data to improve the quality of nursing services. Ninety nurses working in three shifts in general, emergency, and intensive care wards of a university hospital in D City participated in this study. Salivary alpha-amylase (SAA) was extracted and analyzed at two-hour intervals from 07:00 to 15:00 from nurses on the day shift and from 23:00 to 07:00 from those working the night shift. The SAA level was highest between 23:00 and 01:00 for nurses in general wards ($mean{\pm}S.D.\;39.00{\pm}14.88$) and between 11:00 and 13:00 for those in both intensive care units and emergency wards ($mean{\pm}S.D.\;67.50{\pm}62.93$ and $mean{\pm}S.D.\;39.67{\pm}35.96$, respectively). The characteristic variation in SAA was significant between 23:00 and 01:00 (p < 0.01) and for those in their fifties or older (p < 0.01). The activation ratio of alpha-amylase, a stress reactant, showed an increase when the sympathetic nervous system was activated by mental stress; in addition, job stress was manifested with the effect of awakening at different time segments and at different ages among the nurses. With the aim of raising the level of service based on the nurses maintaining their mental health, it is necessary to focus sharply on the time segment for critical control and to conduct repetitive studies to determine the divisions of eustress critical values as well as to expand the population.

• 디지털융복합연구
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• 제13권11호
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• pp.149-156
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• 2015

식생활의 변화로 인하여 고혈압, 심장병, 뇌출혈, 암 질환 등 다양한 질환을 앓고 있는 환자들이 점점 증가하고 있다. 그러나, 병원에서는 환자 치료에 앞서 환자들이 의료 서비스를 제공받기 위해서는 많은 병원 행정 업무를 처리해야 한다. 본 논문에서는 다양한 질환을 앓고 있는 환자 중 체내삽입장치를 부착한 환자를 대상으로 체내삽입장치에 RFID 칩을 이식하여 환자가 병원에 외래왔을 경우 RFID 리더를 통해 환자를 자동인식하여 병원 행정업무 처리를 간소화함으로써 환자가 불편없이 의료 서비스를 제공받을 수 있는 m-헬스케어 서비스 모델을 제안한다. 특히, 제안 모델은 응급상황의 환자가 환자의 질병 종류 및 상태를 의료 담당자에게 알려주지 않아도 자동으로 환자의 상태 정보를 확인할 수 있도록 의료담당자의 진료시간을 단축함으로써 기존 의료 시스템의 업무 효율성을 향상시킨다. 실험결과, 서비스 지연시간, 업무 효율성, 환자의 의료 서비스 만족도 등에서 기존 의료 시스템과 비교 평가한 결과, 제안 모델은 기존 모델보다 서비스 지연시간은 평균 16.5% 향상되었고, 업무 효율성은 27% 높았으며, 환자의 서비스 만족도는 평균 22.4% 향상되었다.

• 대한간호
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• 제36권3호
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• pp.49-69
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• 1997

The urgent needs to establish hospice care systems in Korea arise from the following reasons: 0) a drastic increase in chronically ill patients with the increase of aged population: (2) rapid changes in living environment from the traditional habitation (e. g., Many Koreans living in apartment complexes, which is the most popular form of modern residence in recent years, prefer to die in the hospital.): the overall increase in patients with advanced cancer: (4) recent trends in early discharge of terminally ill patients from the limited hospital facilities to accomodate other medical insurance beneficiaries; (5) easy acceptance of euthanasia owing to the recent social atmosphere that belittles the dignity of human life; (6) medical and nursing care of AIDS patient in terminal stage; (7) and the problem associated with inhumane medical care system, overtreatment, and groundless fears against narcotics. Terminally ill patients were used to be treated in the hospital in the past. In these days, however, they are forced to have home cares with little assistance from the qualified medical personnel because of insufficient hospital facilities, which are even short for the need of emergency patients and provide priority cares to medical insurance beneficiaries with other acute problems. And yet, neither are there any administrative organizations nor systematic medical studies that deal with the level of terminally ill patient's need, their family's problems and resources of hospice care systems in Korea. Thus, most patients are not able to get appropriate medical care at the terminal stage of their lives. The objective of this study is to make comprehensive database for various hospice care organization currently in operation, link them through medical information system, and develop an easily accessible hospice care model that meets the need of most Korean people. Our survey results may be summarized as follows: Nationally there are 40 organizations that provide partial or full hospice care. However, these organizations are not linked to any formal medical service network. Furthermore, the objective of hospice care, care principles, personnel with appropriate training, educational programs, standard for care, costs, consulting service to patients' family members, the extent of medical care from professional staff members, status of hospice facility, and management of those institutions are neither clearly defined nor organized compared to the international hospice care standards. The surveys on patients of terminal stage. grouped in hospice and non-hospice care patients. reveal what they want visiting nursing care to help their pain control. psychological. social and spiritual demands. While the more than 90% of hospice care patients want to reduce their pains. the non-hospice care patients. in addition to their desire for pain control. demanded more psychological. social and spiritual helps as well. The results of this research could be utilized to 0) define the standard of hospice care. (2) provide the guidance for hospice medical care costs. (3) establish the database of hospice care systems. (4) develop softwares. (5) build communication network through Medinet. and (6) provide an organized visiting home nursing care system. These information should be a valuable resource to many medical staffs who are involved in cancer therapy. nursing care. and social welfare programs.

• The Korean Journal of Medicine
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• 제94권1호
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• pp.96-106
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• 2019

목적: 급성 심근경색증 환자에서 성별의 차이가 임상 경과에 미치는 영향은 잘 알려져 있다. 이전의 연구들은 여성 심근경색증 환자의 임상 경과가 남성에 비하여 비슷하거나 더 좋지 않았다고 보고되었으나, 급성 심근경색증을 가진 고령 환자에서 성별에 따른 예후의 차이에 대한 보고는 많지 않다. 방법: 2011년 11월부터 2015년 6월까지 한국인 급성 심근경색증 등록 연구 사업에 등록된 75세 이상의 고령인 환자 2,953예(80.2 ± 4.2세, 남자: 48.2%)를 대상으로 하였다. 결과: 여성 환자는 1,529 (51.8%)였으며, 평균 나이는 남성보다 유의하게 많았다(80.7 ± 4.4 years vs. 79.6 ± 4.0 years, p < 0.001). 심혈관질환의 위험인자인 고혈압은 고령 여성에서 남성에 비하여 유의하게 많았다(74.8 vs. 60.3%, p < 0.001). 흡연과 협심증, 심근경색증, 뇌졸중 등 과거력은 고령의 남성에서 여성과 비교하여 유의하게 많았다. 고령의 여성 환자는 남성에 비하여 응급 의료 서비스 이용 빈도가 유의하게 낮았다(11.5 vs. 15.4%, p < 0.001). 고령 여성의 PRU 값이 남성보다 유의하게 높았으나, 항 혈소판 제제 사용에는 유의한 차이가 없었다. 관상동맥중재술의 성공률은 고령 여성이 남성에 비하여 낮았다(p = 0.049). 병원내 사망률은 성별 간에 유사하였으며(7.1 vs. 8.4%), 단변량 콕스 회귀분석 결과 1년 추적 관찰 기간 동안 주요 심장 사건은 고령의 여성에서 고령의 남성보다 유의하게 낮았다(HR 1.19, 95% CI 1.00-1.41, p = 0.045). 주요 심장 사건에 영향을 주는 독립적인 인자는 나이, 흉통, 호흡곤란, Killip class, 심부전증 등이었다. 다변량 분석 결과 1년 추적 관찰 기간 중 주요 심장 사건 발생의 독립적인 인자는 고령의 남성(HR 1.37, 95% CI 1.14-1.65, p < 0.001), 연령, Killip class, 당뇨병 및 심부전증이었다. 결론: 심근경색증을 가진 고령의 환자에서 성별 간에 병원내 사망률과 시술 주위 합병에서는 유의한 차이가 없었다. 그러나 1년 추적 관찰 기간 동안 고령의 여성에서 남성보다 더 양호한 예후를 보였다.

• 보건행정학회지
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• 제23권4호
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• pp.434-444
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• 2013

Background: Regional Cardiocerebrovascular Centers (RCC) were established for the prevention and treatment of cardiocerebrovascular disease and funded by the Ministry of Health and Welfare. The purpose of this study was to develop and validate the measurement tool of public benefits in RCC. Methods: Through the intensive literature review, experts surveys and their repetitive feedback, we selected the 46 items about the public benefits in RCC. Development of measurement tool involved content validity test using Content Validity Index (CVI), construct validity test through factor analysis and reliability test. Results: Thirty-five items were selected by content validity test, which CVI was 0.08 or higher. Through the construct validity test, 32 items in 7 factors were derived. And Cronbach's alpha was 0.951. Finally, public benefits measurement tool is composed of 32 items in 7 factors which are comprehensiveness of health care services, market complement, emergency care, cost, governance, quality improvement, and government control. Conclusion: Though we developed the measurement tool of public benefits in RCC, it would be utilized to measure the public benefits of various health agencies.

• 한국화재소방학회논문지
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• 제21권2호
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• pp.87-97
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• 2007

본 연구는 현행 소방재원의 조달여건의 문제점을 조명해보고 지방자치시대에 부응하는 주민의 소방수요에 안정적으로 대처할 수 있는 소방재원의 조달방안을 강구하고자 하는 목적을 갖고 이루어졌다. 분석결과는 다음과 같다. 대다수의 소방공무원들은 우리나라 소방재원의 조달여건이 아직 미성숙단계로 조달여건의 개선이 필요하다 인식하였으며, 소방본부 공무원들이 일선소방관서의 공무원들보다 부정적으로 인식하고 있는 것으로 나타났다. 또한 소방재원의 조달방안을 분석한 결과, 소방재원 조달시 추진계획에 있어서는 장기추진계획을 선호하였으며, 소방재원조달의 추진주체는 새롭게 신설된 소방방재청과 중앙정부가 가장 선호되었다. 재정제도의 개선방안으로는 현행 공동시설세를 현실화하고 운용방법을 개선하여야 한다는 의견이 가장 긍정적이었다. 구체적인 재원확보방안으로는 두집단 모두에서 공동시설세 세율을 인상하자는 의견이 가장 긍정적이었으며, 현행 재정 조정제도를 개편하여 소방재원을 확보하자는 의견과 소방병원 및 소방정비고를 신설하여 소방재원을 확보하자는 의견이 뒤를 이었다.

• 한국인터넷방송통신학회논문지
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• 제9권4호
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• pp.9-15
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• 2009

최근에 노령화에 따른 질병의 증가와 핵가족화에 따른 사생활에 대한 보호욕구가 증가하면서 최근 u-Healthcare에 대한 관심이 높아지고 있다. 지금까지 우리는 개별 의료기관의 오프라인의 건강관리로 추후 진단, 치료가 이루어지는 시공간 제한적 의료서비스를 받아왔다. 앞으로는 모바일 의료단말기기를 통하여 자신의 건강관리를 실시간 온라인으로 개인성, 이동성, 실시간성, 맞춤형 의료서비스를 받을 수 있게 될 것이다. 그러므로, 본 본문에서는 PDA를 기반으로 노약자 및 환자를 신체 신호 측정기를 통해 건강상태를 체크한 뒤 병원 환자관리 시스템에 통보하여 위급 상황 발생이 발생하면 응급 처치를 하도록 하거나 측정 결과에 대한 진단 및 관련 정보를 제공하는 건강관리 모니터링 시스템을 설계하고 구현하였다.

• 정보처리학회논문지C
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• 제19C권1호
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• pp.19-28
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• 2012

무선 센서 네트워크는 언제, 어디에서든, 때와 장소를 가리지 않고 사용자가 원하는 서비스를 제공해주는 시스템이다. 특히, 바이오 센서를 이용한 의료센서네트워크는 생명공학, 의료공학 분야에서 활발하게 활용이 되고 있다. 의료센서네트워크에서는 사용자가 시간적이나 공간적 제약을 받지 않고 집에서 건강을 모니터링 할 수 있는 환경이다. U-healthcare환경에서 긴급 상황이 발생 했을 때 빠르게 환자를 도와줄 수 있으며, 병원에서도 손쉽게 환자를 관리 할 수 있다는 장점을 갖는다. 이 환경에서는 개인의 건강과 생명에 직결된 데이터가 송수신되므로 개인의 프라이버시 보장과 데이터의 보안이 가장 중요한 요소이다. 본 논문에서는 휴대폰을 이용한 사용자 인증 방안과 데이터의 종류에 따라 긴급모드와 일반모드의 구분을 두어 안전하면서도 빠르게 데이터를 전송하는 방안을 제안하였다.

• Journal of Preventive Medicine and Public Health
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• 제39권4호
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• pp.309-316
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• 2006

Objectives: Korean epidemiological studies have used reduced samples according to the subject's characteristics, such as the health services provided, the historical note with asthma, and age, to examine the acute effect of air pollution on asthma using the Korean National Health Insurance records. However, there have been few studies on whether the effects shown in these reduced samples are different from those of all samples. This study compared the effects of air pollution on asthma attacks in three reduced samples with those of entire samples. Methods: The air pollution data for $PM_{10},\;CO,\;SO_2,\;NO_2,\;and\;O_3$, and weather conditions including temperature, relative humidity, and air pressure in Seoul, 2002, were obtained from outdoor monitoring stations in Seoul. The emergency hospital visits with an asthma attack in Seoul, 2002 were extracted from the Korean National Health Insurance records. From these, the reduced samples were created by health service, historical notes with asthma, and age. A case-crossover design was adopted and the acute effects of air pollution on asthma were estimated after adjusting for weather, time trend, and seasonality. The model was applied to each reduced sample and the entire sample. Results: With respect to the health service, the effects on outpatients were similar to those for the total sample but were different for inpatients. These similar effect sizes were also observed in the reduced samples according to the historical note with asthma and age. The relative risks of $PM_{10},\;CO,\;SO_2,\;NO_2,\;and\;O_3$, among the reduced and entire samples were 1.03, 1.04-1.05, 1.02-1.03, 1.04-1.06, and 1.10-1.17, respectively. Conclusions: There was no clear evidence to show a difference between the reduced samples and the entire samples.

• 대한통합의학회지
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• 제10권2호
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• pp.49-59
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• 2022

Purpose : The purpose of this study is to directly understand the health condition of residents of mental health sanatoriums nationwide, which has been difficult to ascertain in surveys conducted to date. The study presents specific measures for improving the health of these residents. Methods : A "physical examination questionnaire for residents of mental health sanatoriums" was developed to check the basic physical condition of residents, and 20 out of 59 mental health sanatoriums nationwide were randomly selected. Medical personnel visited the sanatoriums, interviewing and examining the residents in person. A total of 396 health surveys were completed. Results : Many of the residents were underweight but had abdominal obesity. It was confirmed that chronic diseases among the residents were not diagnosed early or were not properly managed. Among the subjective symptoms complained of by the residents, musculoskeletal symptoms were the most common. Oral examinations revealed a serious level of oral health problems among the residents, including dental caries and missing teeth. Basic physical examinations found health problems that required additional examination or medical treatment. Blood pressure abnormalities made up the highest percentage of the health problems. Conclusion : Regular health surveys are needed to determine the health condition of residents of mental health sanatoriums. Access to and quality of primary medical services within the sanatoriums need to be dramatically improved. A delivery system for severe diseases and emergency medical care in the sanatoriums should also be specifically presented. The residents should be notified upon admission and during their stay that they have the right to the enjoyment of the highest attainable standard of mental and physical health. The issue of health rights should be addressed within a larger framework of reorganizing management plans for people in the community - not only residents - with chronic mental illness.