• 제목/요약/키워드: Hospitalization program

검색결과 167건 처리시간 0.025초

지역사회 치매관리 모형 개발 : 광명시의 경우 (Development of Dementia Care Model in a Community)

  • 배상수;김동현;우영국;오진주;민경복;이수현;이미라;이상숙;표옥정
    • 보건행정학회지
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    • 제9권1호
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    • pp.30-71
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    • 1999
  • There has been a dramatic increase in public awareness regarding dementia during recent years. However, dementia remains a family affair and patients do not receive adequate care in Korea. This study aims to assist patients and their caregivers by establishing Home and Community based Long-Term Care in a city. The data collected for analysis include five main categories: dementia prevalence, limitations of daily activities of patients, burden of caregivers, the services that patient's family want to utilize, the resources that handle dementia in the community. Major findings can be summarized as follows: 1)The prevalence rate of dementia for elderly people is 13.1 per 100 persons. Alzheimer's disease amount to 38.9% of dementia patients and vascular dementia account for 36.7% of them 2)Eight out of ten patients have mild dementia. Almost all patients have normal ADL. IADL, however, shows different picture. In every items of IADL, about 60% of patients reveals some limitations. 3)The proportion of patients who had medical diagnosis is as low as 20%. Families of patients think dementia as normal aging process and medical doctors in the community do not give special concern to dementia patients. 4)Caregivers does not have proper social support. They suffer from long care time, experience large obstacles in respect of health, daily living, and social activity. 5)Health center and Community welfare center have launched some programs-consultation, home-visiting nursing, day care center, voluntary force mobilization and so on-for dementia patients. But they do not perform expected roles and functions because of lack of skilled personnels and inadequate coordination of relevant organizations for dementia care. 6)Families of dementia patients prefer home helper and home-visiting nurse to hospitalization. For the future, however, demand for institution-based long-term services will increase. We develope community dementia care model based on above findings as follows: 1)Health center execute community cardiovascular control program for the prevention of vascular dementia. 2)Refer to epidemiologic characteristics of patients and preference of family, the most urgent task for dementia care in this city is to expand and organize Home and Community based Long-Term Care. 3)For the continuous and comprehensive care, care plan for a patient must be prepared. Case management team should be builded to prepare this plan and coordinate relevant resources. 4)Special long-term care unit for dementia will be needed in a near future. This unit should have multiple functions, such as day-care center, short stay facility, training center for relevant personnels, besides long-term nursing home considering effective care of dementia and efficient operation of the facility. 5)Voluntary workers deserve their due efforts. Incentive mechanisms must be developed to activate voluntary activities.

모자동실제 유형에 따른 산모피로도 및 모유수유율 비교 (A Comparative Study on the Level of Postpartum Women's Fatigue and Breast Feeding Rate according to the Types of Rooming-in care)

  • 김영미;김성희;조갑출
    • 한국산학기술학회논문지
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    • 제18권5호
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    • pp.445-455
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    • 2017
  • 본 연구는 모자동실 유형에 따른 산모의 피로도와 모유수유율에 차이가 있는지를 확인하기 위해 시도되었다. 서울소재 일 종합병원의 모자동실제 정책이 전일모자동실제에서 부분모자동실제로 전환된 후 두 제도 간에 산모의 피로도와 모유수유율에 차이가 있는지 비교하기 위해 수행되었으며, 평가내용은 출산 후 산모의 피로도와 모유수유율을 비교분석하여 관련성을 파악하는 것이다. 전일모자동실제의 산모 64명을 대상으로 자체 평가한 2012년 10월의 분석결과와 부분모자동실제로 전환운영한 2014년 6- 7월까지의 산모 43명을 대상으로 수집한 자료를 비교분석하였다. 자료처리 및 분석방법은 SPSS 22.0을 이용하여 빈도, 백분율, $x^2-test$, t-test, 피어슨상관관계분석을 통해 4개의 가설을 검정하였다. 그 결과 '전일모자동실군이 부분모자동실군보다 하루 수유횟수가 많은 것'으로 나타났으며, '전일모자동실군과 부분모자동실군 간에 모유수유율은 차이가 없었다'. '전일모자동실군이 부분모자동실군보다 피로도가 높았으며', '산모의 피로도와 입원기간동안의 모유수유율은 관련이 없게' 나타났다. 따라서 본 연구 결과를 토대로 모자동실제 유형에 따라 모유수유율에는 차이가 없으므로 산모의 피로도가 높은 전일모자동실제로 운영하는 것 보다 산모와 신생아의 상태를 고려하여 개별화된 부분모자동실제로 운영하는 방안을 고려해 볼 수 있다.

기관지절개술 환자의 흡인시 사용하는 용액의 오염수준 변화 연구 (A Study on the Contamination of Solution with Suction used in Tracheostomy Patients)

  • 임윤희;유광수
    • 한국보건간호학회지
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    • 제12권2호
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    • pp.185-200
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    • 1998
  • It has been contributed to public health that the hospital has multiplied in the aspect of number and has been a large size with development of modern medical science, meanwhile the problem of hospital infection is coming out seriously. Respiratory hospital infection among hospital infections develops, very commonly from patients having taken the operation of intubation or tracheostomy, which results from a big factor that the infection developed from medical appliances used for respiration aids, contamination of solution and infection of medical staff. This study is separated into four steps-the time to use normal saline and distillation water for storaging catheter which are the cause of the infection of solution to store distillation water and catheter, not to say the catheter used when the patient who should get tracheostomy operation takes suction. The purpose of this study is to offer the basic data which are needed to check contamination degree as time goes by and nurse intervention and grope for a new nursing intervention. The target of this study is hospitalized 1D an intensive care unit having 700 sickbeds which is located in IKSAN city and it targeted patients before 7 days passed after an operaion of a tracheostormy. Materials collected were analyzed by SPSS PC+ figures program. The result of this study were as follows ; 1. The gradual contamination levels of the normal saline used In suction are showing that colony increase in proportion to the length of time. 2. while colony increases in normal saline with the lapse of time. distillation water mixed with 5cc of potadine did not show any sign of the formation of colony from its preparation until it was used for 8 hours. 3. Such variables as the period of intubation insertion. the length of hospitalization in I.C.U. the age and the level of contamination of normal saline have no inter-relationship. Therefore. as the length of normal saline used In suction. the contamination level increases with the excelleration of the contamination speed. 4. Regarding the number of suction and the contamination level of the normal saline. We can observe correlation contamination level in the 3 step of suction(mean value:13.4) and the saline which was used for one hours(r=0.702. P=0.00l). four hours(r=0.694. P=0.00l). eight hours(r=0.488. P=0.029). Further we can observe contamination in the 4 step of suction (mean value: 17 .8) well as saline used for eight hours; [for one hours (r=0.64l. P=0.002). four hours (r=0.670. P=0.00l). eight hours (r=0.57 4. P=0.008)]. Thesedays clinics use normal saline by changing it. three times a day. however. the timing of saline change and the current suction methoed should be changed given the one hour used normal saline contamination number 79.850. Regarding the number of suction and the contamination lend of the normal saline.

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병원마케팅 실태와 전략방안 -지역사회의 일 종합병원을 대상으로- (Hospital Marketing Condition and Strategy -Of a General Hospital-)

  • 백명;노소영
    • 한국간호교육학회지
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    • 제6권2호
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    • pp.233-246
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    • 2000
  • The purpose of this study was to investigate the real condition of hospital marketing and concrete strategy on medical consumers need for enhance the effectiveness of hospital management. The data were collected from January 27 to February 3, 2000 at a general hospital located in M city to 205 in-patients and out-patients by questionnaires. The research tool was based on literatures. The data was analysed by the use of percentage, mean, t-test and ANOVA by SAS(Statistical Analysis System) Package Program. The results of this study are summerized as follows: 1. Mean score of the marketing mix (4P 's) was 3.1 in total and each mean score was 3.6 in product, 2.5 in prices, 3.3 in place and 3.1 in promotion. The following are the items which received the highest scores in each: 'The hospital is clean' in service category; 'the prices of meals at the restaurant the patients' families use are reasonable ' in price sphere. In distribution, 'it is easy to locate the hospital' and in promotion,'we'll use this hospital again' and 'we'll recommend this hospital to others'. 2. Marketing mix factors(4P's) was significantly different on the general characteristics in terms of marriage status, occupations and the period of hospitalization. 3. The most important reason for choosing this hospital was 'This is a general hospital with good facilities' and the next were 'The hospital staffs are kind and the hospital is clean' and 'The traffic is convenient to come'. The most important factors contributing to a good image formation of the hospital were 'this is a clean hospital', 'This is a hospital with kind people' and 'this hospital is equipped with good medical facilities'. 4. The factors for making a good image concerning the nursing service were professional knowledge, good nursing skills and kindness. After grasping the marketing conditions of the hospital aided by the above-mentioned research results, the researchers concludes that it is necessary to develop an institutionalized service strategy to increase the satisfaction the patients feel about the hospital facilities and kindness of the staff and as a result, to differentiate it from other medical institutions.

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중환자실 환자의 입원시 불안정도와 영향요인 (The Level of Anxiety and Relating Factors of ICU Patients)

  • 한경신;박영임
    • 한국간호교육학회지
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    • 제8권1호
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    • pp.155-166
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    • 2002
  • This study was performed to figure out the level of anxiety and relating factors of ICU patients as the hospitalization in ICU grows more recently. Data collection was conducted from July 1st to August 31st, 2001. The subjects of this study were consisted of 101 ICU patients who were selected according to the criteria in S hospital, C city. The instruments of the research were consisted of 14 questions of general characteristics, 20 items of STAI, VAS, 24 questions for the anxiety relating factors. And data were analyzed by t-test, ANOVA, and pearson correlation for group difference and correlation with SPSS Win 10.0 program. The followings were the results of the study: 1. In the anxiety level, mean score on STAI was 53.7(item mean $2.69{\pm}.83$), and mean score on VAS was 5.23. It means that the anxiety level of ICU patients was moderate. 2. Among the relating factors of anxiety, the most highest scores were 'by seeing other patient's emergency situation' and 'by seeing other patient's death' figured 3.85 and 3.79 each. And the lowest marks were 'by the unkind behavior of doctors and nurses'(2.13) and 'nurses' or doctors' indifferent actions'(2.21). And the anxiety according to the environmental factor was the highest (3.17) and the anxiety regarding to the human relationship was the lowest (2.53). 3. In the anxiety level STAI according to the general characteristics, the patients who didn't have to take care of their family showed more anxiety than who had to take care of their family(t=-2.38, p=.02). And the variables that shows a significant difference on VAS was sex and women's anxiety was higher than men's level (t=-2.56, p=.01). 4. When the physical anxiety level was compared, the patients who had to take care of their family showed more anxiety than the people who didn't have to take care of their family(t=-1.95, p=.05). In the level of anxiety relating the human relationship, the patients who had religion showed more anxiety than patients who didn't(t=2.43 p=.02). And the married patients(t=2.43, p=.01) and more educated people(F=3.77, p=.01) showed more anxiety. Even though environmental anxiety was the highest factor, it was not significant with general characteristics. 5. The anxiety and relating factors showed positive significant relationship, and physical anxiety factor showed the strongest relation with STAI(r=.21, p<.01). And VAS level showed stronger relation with every factor of the anxiety than STAI. When the VAS level became higher, the anxiety relating to physical factor(r=.72, p<.01), human relationship(r=.63, P<.01), and environment became higher. According to the above result, the environmental anxiety was the highest level than other factors in ICU patient and thus the environmental nursing intervention becomes very important in ICU. Also nurses in ICU have to support the patients who showed higher level of anxiety in this study and try to develop the nursing intervention to relieve the anxiety of patients. And it is recommended that VAS is convenient and practical instrument for measuring the anxiety level in ICU patients.

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관상동맥중재술을 받은 지역사회 거주 노인의 건강행위 이행에 영향 미치는 심리사회적 요인 분석 (Analysis of Psychosocial Factors Affecting Health Behavior Adherence among Community-dwelling Older Adults undergoing Percutaneous Coronary Intervention)

  • 전혜원;장희경
    • 문화기술의 융합
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    • 제6권4호
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    • pp.231-244
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    • 2020
  • 본 연구는 관상동맥중재술을 받은 지역사회 거주 노인의 건강행위 이행에 영향을 미치는 심리사회적 요인을 분석하기 위해 수행된 서술적 조사연구이다. 경상남도 J시 G대학교병원에서 관상동맥중재술을 받고 외래를 내원한 환자 126명을 대상으로 2018년 7월 15일부터 10월 2일까지 구조화된 설문지를 사용하여 자료수집 후 SPSS/WIN 21.0으로 통계 분석하였다. 분석결과 대상자 특성에 따른 건강행위 이행은 배우자 유무, 교육수준, 주관적 건강상태, 주관적 삶 만족도에 따라 차이가 있었으며, 의료인 지지, 회복탄력성에서는 정적 상관관계가 있었고, 지각된 스트레스, 지각된 스트레스의 하위영역인 가족관계, 불안과 위축, 빈곤과 재정, 우울과는 부적 상관관계가 있었다. 다중회귀분석 결과 회복탄력성, 지각된 스트레스의 하위영역인 빈곤과 재정, 교육수준, 주관적 삶 만족도가 관상동맥중재술을 받은 노인의 건강행위 이행을 27.9% 설명하는 것으로 나타났다. 이러한 결과를 기반으로 관상동맥중재술을 받은 지역사회 거주 노인의 건강행위 이행을 향상시키기 위한 간호중재 프로그램 개발과 적용이 필요하다.

입원한 암환자의 암피로, 수면의 질 및 환경적 수면장애가 안위에 미치는 영향 (The Influence of Cancer Fatigue, Quality of Sleep, and Environmental Sleep Disturbance on Comfort in Hospitalized Cancer Patients)

  • 김희진;장희경
    • 문화기술의 융합
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    • 제6권4호
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    • pp.643-653
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    • 2020
  • 본 연구는 입원한 암환자가 인식하는 암피로, 수면의 질, 환경적 수면장애 및 안위 간의 관계를 파악하기 위한 서술적 상관관계 연구이다. 대상자는 J시에 위치한 대학병원 암센터에 입원한 성인 암환자 113명을 대상으로 설문조사를 실시하였다. 연구기간은 2019년 9월 17일부터 2019년 11월 5일까지 진행하였으며, 자료 분석은 SPSS/WIN 21.0 프로그램을 이용하여 통계 처리하였으며, independent t-test, one-way ANOVA, Scheffé test, Pearson's correlation coefficient, and stepwise multiple regression으로 분석하였다. 본 연구결과 대상자의 안위는 대상자의 교육수준, 암유형, 방사선 치료유무, 평소운동 유무에 따라 유의한 차이가 있는 것으로 나타났다. 또한 안위는 암피로(r=-.609, p<.001), 수면의 질(r=-.478, p<.001), 환경적 수면장애(r=-.297, p=.001)와 부적 상관관계가 있었으며, 입원한 암환자의 안위에 유의한 영향을 미치는 변인은 암피로(β=-.42, p<.001), 주관적 수면의 질(β=-.30, p=.001), 암유형(β=-.18, p<.015)으로 설명력은 46.1%였다(F=27.24, p<.001). 이러한 결과를 바탕으로 입원한 암환자의 안위 향상을 위해 의료진들의 다학제적 협력을 통해 암피로를 감소시키고, 수면의 질 향상을 통한 안위 증진 프로그램을 개발하는 것이 필요하다.

외국인 건강보험가입자의 의료서비스 이용 현황 분석 (A Study on the Healthcare Utilization Pattern of Foreign Nationals with National Health Insurance in South Korea)

  • 박형아;진기남;구준혁
    • 한국콘텐츠학회논문지
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    • 제21권3호
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    • pp.314-323
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    • 2021
  • 이 연구의 목적은 국내거주 건강보험 가입 외국인의 국적 및 자격유형별 의료이용현황을 분석하는 것이다. 2018년 건강보험 가입 외국인 중 보험료 결측인원을 제외한 1,058,886명을 분석대상으로 선정하였다. 분석결과, 의료를 한 번이라도 이용한 사람은 822,267명으로, 의료이용률은 약 78%임을 확인할 수 있었다. 이용 인원 수가 많은 국가는 중국, 베트남, 미국 순이었다. 1인당 총 진료비는 입원과 외래에 관계없이 미국이 가장 높았다. 자격유형별로는 지역가입자의 1인당 진료건수, 외래진료비, 입원진료비가 가장 높았으며, 1인당 입원 일수는 직장피부양자가 가장 높았다. 마지막으로 중국인과 지역가입자는 다른 그룹에 비해 납부한 보험료 대비 많은 혜택을 누리고 있음을 확인할 수 있었다. 이 연구는 외국인 건강보험 당연적용제도 시행 이전 자료를 사용함으로 인해 현재 상황을 정확히 보여주고 있지 못하지만, 추후 변화에 대한 비교분석을 위한 기초자료를 만들었다는 점에 그 의의가 있다.

슬관절 전치환술 후 한방병원에 입원한 환자 20명에 대한 후향적 분석 (Effects of Korean Medicine on 20 Post-TKR Inpatients: A Retrospective Observational Study)

  • 임지성;김지은;정영진;강도영;박은상;김종규;송용선
    • 동의생리병리학회지
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    • 제36권4호
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    • pp.138-142
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    • 2022
  • This study aimed to evaluate the effectiveness of Korean rehabilitation treatement for patients with post-TKR. The medical records of inpatients undergoing Korean rehabilitation treatment after TKR from 2016.01.01. to 2021.12.31. during the admission, were analyzed retrospectively. The effect of treatment was evaluated by using a numeric rating scale(NRS) and range of motion(ROM) of knee. Statistical analysis was done using the IBM SPSS statistics 26 program. If the period of hospitalization was within 7 days or change of NRS and ROM was not recorded properly, the case was excluded. All inpatients received acupuncture treatment, Electro-acupuncture. Soyeom pharmaco-acupuncture were used at a high rate. Blood letting cupping therapy, dry cupping therapy, Interferential Current Therapy(ICT) continuous passive motion(CPM), cryotherapy were used at a high rate. A significant improvement was noted when comparing the NRS and knee ROM results at the time of admission and discharge. Korean medical rehabilitation can be effectively used for patients who have undergone TKR, to relieve pain and enable returning to daily activities. It is expected to be helpful in future studies of post-TKR in Korean Medicine. Also It can be used for medical treatment of post-TKR in Korean Medicine Hospital and clinic. However, further research with a high level of evidence is necessary to support this finding.

심장판막수술 환자의 비계획적 재입원 영향요인: 전자의무기록분석 (Factor affecting Unplanned Readmissions after Cardiac Valve Surgery: Analysis of Electric Medical Record)

  • 이정선;신용순
    • 한국콘텐츠학회논문지
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    • 제22권2호
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    • pp.794-802
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    • 2022
  • 본 연구의 목적은 심장판막 수술 받은 환자를 대상으로 전자의무기록 검토를 통해 퇴원 후 30일 내 비계획적 재입원군의 특성과, 재입원 영향요인을 규명하고자 하는 후향적 조사연구이다. 대상자는 S시에 위치한 상급종합병원에서 2018년 1월부터 2019년 8월까지 심장판막수술을 받고 포함기준에 맞는 퇴원환자 423명이었다. 비계획적 재입원 대상자는 총 48명(11.3%)이었고, 그 원인은 심방세동 13건 (27.1%)과 수술부위 통증이 13건(27.1%)으로 가장 많았고, 와파린의 치료농도가 안 맞는 경우 10건 (20.8%), 전신 위약감 7건 (14.6%). 저혈압 5건 (10.4%). 심낭삼출 4건 (8.3%), 수술상처 감염 3건 (6.3%), 출혈 3건 (6.3%), 고열 3건 (6.3%), 뇌경색 1건(2.1%)이었다. 재입원에 영향을 미치는 변수는 암의 병력 (OR=2.60, 95% CI 1.13-6.03, p=.025), 퇴원 후 거주지는 병원이 아닌 집으로 간 경우 (OR=2.91, 95% CI 1.33-6.36, p=.008), 판막수술종류로서 승모판막성형술이 대동맥판막 치환술보다 재입원률이 높았다(OR=1.21, 95% CI 1.21-4.98, p=.012). 비계획적 재입원 감소를 위해 환자와 돌봄 제공자에게 퇴원 전 만성질환병력관리와 재입원의 위험 요인을 미리 사정하고 병원 방문할 수 있도록 하는 개별화된 교육프로그램이 필요하다.