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문신시술의 비범죄화에 대한 비판적 검토와 대안 (Critical Review and Alternatives to the Decriminalization of Tattooing)

  • 심영주;이상한
    • 의료법학
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    • 제23권1호
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    • pp.149-176
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    • 2022
  • 우리나라 법제는 비의료인에 의한 의료행위를 엄격히 금지하고 있는데, 문신시술의 경우 의료행위로 분류되어 비의료인이 문신시술시 무면허의료행위로 처벌받게 된다. 그런데, 현실적으로 문신시술을 의료인에게 받는 경우가 매우 드물고, 문신시술을 업으로 하고 있는 비의료인들은 직업선택의 자유 침해 등을 주장하며 비의료인에 의한 문신시술의 의료행위성을 부정하고 비범죄화할 것을 요구하고 있다. 그런데 문신시술은 바늘 등을 사용하여 이루어지기 때문에 신체에 대한 침습이 있어 의료인이 행하지 않으면 보건위생상 위해가 발생할 수 있는 행위로 볼 수 있고 감염 예방 등을 위해 엄격한 관리가 필요하다. 그러나 이러한 현실적인 부분과 법제와의 괴리를 고려할 때, 보건의료적 관점에서 안전성을 고려하면서도, 사실상 의료인에 의해 행해지는 문신시술이 많지 않은 현실을 고려하여 비의료인에 의한 문신시술을 제도화하는 방안 등에 대해 전향적으로 생각을 해 볼 필요가 있다. 본고는 이러한 관점에서 문신시술이 의료행위에 해당하는지 법제를 검토하고, 보건의료적 관점에서 문제가 된다면 이를 해결하기 위한 방안을 모색하여 현실을 반영하면서도 안전성을 도모할 수 있는 대안으로 3단계로 나누어 단계화된 접근을 제시하였다.

일반 진료 치과의사와 소아 진료 치과의사의 스트레스 유발 요인과 직무 스트레스 정도에 대한 연구 (Investigation of Stress-Inducing Factors and Occupational Stress Levels in General and Pediatric Dentists)

  • 김승현;이제식
    • 대한소아치과학회지
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    • 제49권4호
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    • pp.481-496
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    • 2022
  • 이번 연구는 소아 환자를 치료할 때 소아 진료 치과의사와 일반 진료 치과의사들에게 스트레스를 유발하는 원인과 직무 스트레스 정도에 대해 알아보고자 하였으며 66명의 소아진료 치과의사와 125명의 일반 진료 치과의사, 총 191명의 연구대상자를 통해 평가하였다. 소아 환자 치료 시 2개의 군 모두 환자의 협조도 부족에 의해 가장 높은 스트레스를 느꼈으며 이외에도 예후의 불확실성과 낮은 수가, 보호자의 협조도 부족 등에 의해 스트레스를 나타내었다. 또한 보호자의 협조도 부족과 예후의 불확실성에 의해 소아 진료 치과의사가 일반 진료 치과의사보다 유의하게 높은 스트레스를 받고 있었다(p < 0.05). 전반적 직무스트레스는 2개의 군 모두 환자, 시간, 직무 환경, 수입 관련 스트레스 순으로 높았으며 소아 진료 치과의사의 스트레스 정도가 더 낮았다. 직업적 번아웃은 '냉소주의'에서 2개의 군 모두 98% 이상이 번아웃을 보였으며 '정서적 소진'은 69% 이상이 번아웃을 보여 그 비율이 매우 높았다. 또한 '성취감 저하'는 번아웃의 비율이 낮았으며 소아 진료 치과의사가 일반 진료 치과의사에 비해 통계적으로 유의하게 높은 성취감을 나타내었다(p < 0.05). 이번 연구를 통해 2개의 군 모두 높은 직무 스트레스를 보였으며 이를 완화하기 위한 노력이 필요하다.

고령자 고용정책의 대응전략에 대한 비판과 시민권(citizenship)의 원리를 통한 대한 모색 (A critical study on the strategies of the employment policies for older people)

  • 이가옥;이지영
    • 한국노년학
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    • 제25권2호
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    • pp.171-193
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    • 2005
  • 시대적 변화의 흐름 속에서 고용자 고용을 위한 어떤 가능성을 찾아낼 수 있는가에 대해서 면밀한 검토를 해 볼 필요가 있지만, 현 고령자 고용정책은, 거세어지는 외부의 압력에 의해서 빠른 변화만을 요구받으면서, 노동만을 강조하고 있다. 이러한 흐름 속에서 현재 우리나라에서 새롭게 논의되고 있는 고령자 일자리 전략은 크게 두 가지이다. 하나는 일자리 연장 방식이며, 다른 하나는 사회적 일자리 방식이다. 일자리 연장의 방식의 경우, 유연적 삶이 노년기의 이상적 사회로 간주되면서 안정화의 필요성이 간과되는 양상을 보이고 있다. 사회적 일자리의 경우, 사회통합의 의미는 배제된 채 잔여적 복지의 일환으로 협소하게 해석되어 적용되고 있다. 이러한 고령자 고용정책의 한계는 연령차별주의와 경제우선주의가 맞물려서 이루어지고 있으며, 이 두 가지 논리에 의해서 고령자의 삶의 질은 간과되고 있다. 따라서 본 고에서는 시대변화에 따른 현 고령자고용정책의 비판을 통해, 고령자의 삶의 질 향상을 위해 강조되어야 할 것은 무엇인지를 살펴보고, 이에 따른 새로운 방향을 제시해 보고자한다. 연령 차별적 논리와 경제우선주의를 극복하고, 사회통합을 지향하는 새로운 이념적 틀로, 본 고에서는 시민권(citizenship)의 원리를 제시하였다. 노동생활의 지속성을 유지하기 위해서는 기본적으로 생존권과 건강권이, 그리고 질적인 향상을 위해서는 평생학습권의 보장이 전제되어야 할 것이다. 시민권에 대한 논의는 기존의 경제논리에 묶여 있던 고령자 고용정책에서 새로운 차원으로 전환되어야 함을 역설하고 그 정당성을 확보해 주는 데 의의가 있다.

4차 산업혁명시대 대학무용학과 커리큘럼의 방향모색 (Seeking for a Curriculum of Dance Department in the University in the Age of the 4th Industrial Revolution)

  • 백현순;유지영
    • 한국엔터테인먼트산업학회논문지
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    • 제13권3호
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    • pp.193-202
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    • 2019
  • 4차 산업시대에 대학무용학과의 커리큘럼은 무엇을 변화시켜야 하는가에 초점을 둔 연구이다. 이는 무용학과의 교육과정이 미래 직업 창출과 무관하지 않음으로 4차 산업과 연관 지어 무용전공자의 미래 직업을 전망해 본다면 지금 대학 무용학과 커리큘럼으로는 미래 직업을 창출하기 힘들다는 생각에 따른 것이다. 따라서 서울에 소재하고 있는 5개 대학의 무용학과 커리큘럼을 비교 분석해 보았으며 그 후 4차 산업혁명시대에 적응하고 새로운 기술의 개념이 포함된 무용교육을 하려면 무엇을 어떻게 배워야 할 것인가 하는 무용학과 커리큘럼에 대해 5개의 교과목을 제시하였다. 첫째, 무용과 통합교육이다. 이는 창의성과 과학교육을 통합한 교육으로 STEAM(Science-Technology-Engineering-Art-Methematics)이라는 대 주제를 중심으로 아이디어와 창의성을 향상시키고 나아가 예술적 감수성 등을 키울 수 있는 교과이다. 둘째, 빅데이터 분석 및 빅데이터로 미래를 전망해 보는 교과로 이는 무용의 전반적인 것에 대한 대중들의 의견이나 평가, 감정 등을 분석함으로써 무용공연이나 무용전공자의 진로방향, 직업창출 등에서 유용하게 활용할 수 있는 학문이다. 셋째, 영상교육으로 영상은 현 시대의 대표적 표현매체로 오늘날 대부분의 예술표현영역을 영상이 차지함을 볼 때 영상을 통한 무용은 기존의 무용작품을 새로운 형태의 작품으로 창조적으로 변형시킬 수 있으며 학문적으로나 공연예술로서 무용의 영역을 넓힐 수 있다. 넷째, VR과 AR은 스마트 미디어시대의 중요한 기술로 미래 무용학이 공연이든 교육이든 산업이든 간에 시대의 흐름에 맞춰 디지털식 방법을 갖춰야 한다면 VR이나 AR에 대한 학습을 할 필요가 있다. 다섯째, 4차 산업혁명과 무용예술교과는 4차 산업혁명시대의 변화를 미리 예견하고 무용교과의 변화, 발전 모색 등을 교육하는 교과로 필요하다.

비콘을 활용한 위치기반 지역축제 모바일 애플리케이션과 데이터 분석 시스템 개발 (Developments of Local Festival Mobile Application and Data Analysis System Applying Beacon)

  • 김송이;김원표;정철
    • 한국과학예술포럼
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    • 제31권
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    • pp.21-32
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    • 2017
  • 지역축제는 문화를 형성하는 소통의 장으로 국내 관광 사업의 수요를 증가시키고, 지역의 이미지 창출, 전통 문화의 보존, 관광객 유입, 일자리 창출, 지역문화의 콘텐츠 개발, 지역특산품 판매 촉진 등 지역경제에 많은 파급효과와 지역경제 활성화에 중요한 가치를 지니고 있다. 무선통신 기술인 사물인터넷(IoT, Internet of Thing) 요소기술은 점차적으로 발전하고 있고, 특히 사물인터넷 서비스 중 하나인 비콘은 국내·외에서 다양한 서비스 형태로 활용되고 있다. 그러나 이러한 사물인터넷 서비스, 디지털 및 모바일 기술의 확산에도 불구하고, 수 없이 많은 지역축제에 대한 정보를 개인이 하나하나 찾기란 쉽지 않고, 기존에 개발된 축제 관련 애플리케이션은 단순 정보전달 수준에 국한되어 있거나 일회성인 축제 정보제공, 축제장 내의 정보제공 방식, 개발 축제마다 별도의 애플리케이션 형태제공, 단발성 사용 등의 문제점을 안고 있다. 이러한 배경 하에 본 연구는 비콘을 활용한 위치기반 지역축제 모바일 애플리케이션과 데이터 분석 시스템 개발하여 축제 방문객에게 맞춤형 정보를 제공하는데 그 목적이 있다. 본 연구의 기술개발을 통해 '축제장 혼잡도 알고리즘', '방문객 통계분석 알고리즘', '맞춤형 정보 알고리즘'의 총 3개의 알고리즘 및 데이터분석 시스템을 개발했고, 개발된 애플리케이션과 데이터 분석 시스템을 통해 실제 축제장에서 베타테스트를 실시했다. 그 결과, 방문객 행태 DB 구축, 지역축제 방문객에게 Hot place 기능, 대기시간 기능, 맞춤형 정보제공의 서비스와 기능을 제공할 수 있었다. 또한, 출시 3개월 간 1만 3천 건 이상의 다운로드 실적 달성, 구글플레이스토어에 '축제' 관련 애플리케이션 중 노출 1위를 달성하는 등 지역 관광 축제 플랫폼으로서의 시장성과 우수성을 인정받았다. 본 연구는 다음과 같은 순서로 기술한다. 2장에서는 본 연구의 기술개발과 관련된 지역축제, 사물인터넷, 비콘 서비스, 축제 관련 애플리케이션의 선행연구를 살펴보고, 3장에서는 지역축제 모바일 애플리케이션 설계와 데이터 분석 시스템의 구현환경을 상세히 기술한다. 4장에서는 본 연구에서 개발한 모바일 애플리케이션과 데이터 분석 시스템이 제대로 적용되지는 실험하기 위해 베타테스를 실시하여 제품의 성능평가를 기술하고, 마지막으로 5장에서는 결론과 향후 연구과제에 대해 기술한다.

광주지역 제조업 근로자의 근무형태가 식습관에 미치는 영향 (Effect of working patterns on eating habits in manufacturing workers of Gwangju area)

  • 임지숙;허영란;정은;이재준
    • Journal of Nutrition and Health
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    • 제49권6호
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    • pp.495-505
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    • 2016
  • 본 연구는 산업체에 근무하는 직장인의 근무형태별 특성을 살펴보고 그에 따라 식습관에는 어떠한 상관관계가 있는지 알아보고자 광주광역시 광산구에 소재한 K 제조 공장에 재직 중인 근로자를 대상으로 식습관과 직무스트레스에 관한 설문조사를 실시하고, 이를 토대로 하여 근무형태에 따른 식습관 특성을 살펴보았다. 연구대상자의 나이는 40~49세 및 50세 이상이 가장 많았으며 근무기간은 근무형태와 상관없이 대부분 10년 이상의 경력에 하루 평균 8~10시간을 근무하였다. 단순분석에서 통계적으로 유의한 차이를 보인 연령, 근무기간, 평균근무시간, 교육수준, 가족월 평균수입, 주관적 건강인식, 중등도 신체활동여부, 음주량, 흡연량, 수면시간, 이상지질혈증 처음진단시기를 보정하여 조사대상자들의 식습관, 카페인 섭취량, 직무스트레스 정도를 분석한 결과 평소의 식사량에 대해 비교대근무 근로자가 $1.4{\pm}0.9$, 교대근무 근로자가 $1.1{\pm}0.5$로 나타나 유의한 차이를 보였고 (p < 0.001), 균형 잡힌 식사 정도는 비교대근무 근로자가 $1.5{\pm}0.6$, 교대근무 근로자 $1.3{\pm}0.4$로 유의한 차이가 나타났다 (p = 0.005). '채소 섭취'는 비교대근무 근로자가 $1.9{\pm}0.7$, 교대 근무 근로자 $1.7{\pm}0.5$로 유의한 차이를 보였고 (p = 0.024), '해조류 섭취' 역시 비교대근무 근로자자 $1.7{\pm}0.6$, 교대근무 근로자 $1.5{\pm}0.4$로 교대근무자에 비하여 유의하게 높았다 (p = 0.049). 반면 '1일 3끼의 식사 중 거르는 일이 있습니까'는 비교대근무에서 $2.1{\pm}0.8$ 교대근무에서 $2.5{\pm}0.5$로 식습관 조사 항목 중 유일하게 교대근무 근로자에서 유의하게 높았다 (p = 0.001). 또한 근무형태별 식습관 점수 합계는 비교대근무 $16.1{\pm}0.6$, 교대근무 $14.0{\pm}0.3$으로 비교대근무 근로자가 유의하게 높았다 (p = 0.035). 직무요구도에서 받는 직무스트레스 정도는 비교대근무에서 $46.2{\pm}2.6$, 교대근무에서 $34.0{\pm}1.4$로 비교대근무에서 유의하게 높게 나타났으며 (p = 0.001), 직무 자율성 결여는 교대 근무 근로자가 $50.7{\pm}1.0$, 비교대근무 근로자가 $44.2{\pm}1.0$으로 교대근무 근로자가 유의하게 높았다 (p < 0.001). 조직적 관리체계에 대한 직무 스트레스는 교대근무 $57.0{\pm}1.2$, 비교대근무 $50.9{\pm}2.0$로 교대근무 근로자에서 유의하게 높았다 (p = 0.036). 연구대상자들의 직무스트레스 정도에 따른 제요인 분석은 스트레스 정도의 총합으로부터 정도에 따라 백분위수로 구분하여 분석하였다. 직무스트레스를 가장 적게 받는 근무형태는 교대근무 근로자로 28.1%를 나타냈고, 직무스트레스를 가장 많이 받는 근무형태는 교대근무 근로자에 비해 비교대근무 근로자가 39.7%로 나타나 유의하게 높았다 (p < 0.001). 이상의 결과를 종합하여 보면 교대근무 근로자는 중등도 신체활동과 음주량 및 흡연자가 비교대근무 근로자에 비해 높았으며, 식습관도 좋지 않았다. 사무직을 포함하는 비교대근무 근로자는 교대근무 근로자들에 비해 신체활동이 적고, 직무스트레스를 더 많이 받으며, 식습관은 다소 높게 나타났으나, 전반적인 식습관 평가 점수는 비교대근무 근로자와 차이가 없는 것으로 나타났다. 이러한 결과에도 불구하고 본 연구의 제한점 및 제언은 다음과 같다. 설문조사가 재직근로자의 일부에 국한되었고, 대상자들의 설문결과 근무형태와 무관하게 전반적으로 이상지질혈증 유병률이 높게 나타났으며, 사무직과 생산직 근로자를 포함한 비교대 근로자가 생산직 교대 근무자들에 비해 식행동이 바람직하지 못하고, 직무스트레스를 더 많이 받는 것으로 나타났으나, 본 연구가 단면연구로서 서로의 인과관계를 유추하기에는 한계가 있었다. 따라서 후속연구로는 사무직과 생산직에 근무하는 비교대 근로자 간에, 혹은 생산직에만 근무하는 비교대 근로자와 교대근로자 간의 식습관과 직무스트레스 차이를 비교하는 세분화된 연구가 필요할 것이다.

양호겸직교사의 학교보건간호 업무활동에 관한 조사연구 (A Study of School Health Nursing Activity Performed Teachers Holding Additonal school Health)

  • 정찬규;정연강
    • 한국학교보건학회지
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    • 제2권1호
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    • pp.108-130
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    • 1989
  • The purpose of this study is to provide the basic data for the development of school health nursing activities by surveying realities of school health nursing activities in schools lacking in a school nurse performed by teachers holding additional school health. The subjects for the study was selected from teachers holding additional school health who participated in the annual training course for teachers holding additional school health in 1988 organized by Province Education Council. 105 teachers holding additonal school health from Kyung-gi Province, 85 from Chung-buk province, 50 from Chun-buk Province, answered the questionaire. The results can be epitomized as follows. 1. General characteristics of Teachers Holding Additional School Health. The majority of the subjects are female (94.3%) and 64.1% of the subjects are in their twenties, 79.5% of them graduated from four-year teacher's college, 54.5% of them are unmarried, 74.5% has less than one-year experience as a teacher holding additional school health. 2. General characteristics of schools 92.4% of schools are national, of public schools, and 91.9% are located in country, elementary schools are 64%, junior high schools are 35.4%. The annual school nursing budget is unknow to 89.2% of them. The school nursing organization is non- existent to 85.6%. 82.4% of the school nursing clinics occupy their place solely, or jointly. 3. Status of School Health Nursing Activities In the questionaire, School Health Nursing Activities arc divided into Health Program planning and Evaluation (4 items), Clinic Management (4 items), Health Education (4 items), Management of School Environment 98 items), Operating of School Health Organization (1 item) and Health Care Service (25 items). The answers to each item measured by the Likert-type scale reveals that in the activities of techcrs holding additional school health the practice rate in Management of School Environment is 55%, 47% in Health Education, 45% in Health Program Planning and Evaluation, 32% in Health Care Service, 27% in Operating of School Health Organization, and 27% in Clinic Management. 4. The Relation between Influencing variables and School Health Nursing Activities. The results are as follows. (1) Health Program Planning and Evaluation: religion, marital status ($P<0.05^{**}$) (2) Clinic Management: age, school health organization ($P<0.05^{**}$) (3) Health Education: age ($P<0.01^*$), religion ($P<0.05^{**}$), business except for school nursing ($P<0.05^{**}$), form of operation ($P<0.05^{**}$), the number of clinic client a month ($P<0.05^{**}$). (4) Management of School Health Environment: age, marital status, business except for school nursing ($P<0.05^{**}$), presence of the annual school health nursing budget ($P<0.01^*$), school health organization ($P<0.05^{**}$). (5) Operating of School Health Organization: There is a statistical significance in Education, Interest in School Nursing ($P<0.05^{**}$). 5. The Regional Relationship of School Health Nursing Activity. There is a statistically significal difference in Health Education ($P<0.05^{**}$) and Health Care Service ($P<0.01^*$) of elementary school located in Kyung-gi, Chung-buk, Chun-buk Province. There is a statistically significant difference Health Program Planning and Evaluation of junior high Schools located in Kyung-gi, Chung-buk, Province ($P<0.05^{**}$). 6. The Correlation in School Health Nursing Activities. The analysis of the correlation in the 6 fields of school Health Nursng Activities shows that there is a statistically significant difference between Clinic Management and health Education, Clinic Management and Operating of School Health Organization, and between management of School Environment and operating of School Health Organization ($P<0.05^{**}$). The conclusions are as follows The 40.5 percent of schools should arrange nurse teachers by regulation 38, relative to the application of the Law of Education. But, in reality, teachers who have nothing to do with nursing, hold school health as an additional job. And it is very difficult to expect the qualititive health management of school faculty and students. In the 85.6 percent of schools, there is no organization for school health. And also, persons in charge of pracitcal affairs perform the school health activity without any knowledge about annual school health nursing budget. In the school health nursing activity of teacheres holding additional school health, operating of school, health organization and clinic management are the most difficult to get the cooperation from the persons relate to school and communities. There are a lot of problems in performing the school health nursing activity without any disposition of school health teachers, therefore, it is necessary to supplement school health teachers who had a professional training in order to make efficient the school health nursing management for children who are about to attend a school.

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대학종합병원 수간호사의 업무분석과 모형연구 (Analysis of the Work of the Head Nurse and a Work Model for the Head Nurse in University Hospitals in Korea)

  • 김인숙
    • 대한간호학회지
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    • 제19권2호
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    • pp.212-222
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    • 1989
  • When the head nurse who is pivotal in the nursing service administration of the hospital performs efficiently as a first-line manager, the effectiveness of the nursing unit, which includes the quality of nursing care, the jab satisfaction of staff members, and the cohesiveness of staff members is increased. With this point of view in mind, the researcher carried out a study to determine the actual work (the content of the work, the work process, the role of the head nurse, the activity media, and the purpose of the work) of the head nurse in a university hospital in Korea. In addition, this study was also carried out for the purpose of preparing an ideal model for the work of the head nurse. The research subjects were 39 head nurses. This included all the head nurses in two university hospitals except those who were working in outpatient care, operating rooms, central supply, nursing administration, in-service education and emergency care. Data were collected from September 24th to October 21th, 1987 and April 4th to 12th, 1988. A work activity record on which the head nurse recorded directly in a chronological narrative form, was used as the research instrument. The 234 work activity records, 39 head nurse's continuous recording over 6 days(from Monday to Saturday) were collected and analysed. The results were as follows ; 1. With regard to the work content for the total daily work of the head nurse, 45.2% of the activities were managerial activities but 58.1% of the head nurse' s time was spent in direct patient care. 2. With regard to the work process of the head nurse, specifically the location, the size and membership of groups contacted, the results were as follows : 1) Of the total daily work activities 92.4% were carried out in the nursing unit and this occupied 84.5% of total daily work time. Direct patient care was generally performed on the nursing unit and managerial work was performed in other areas. 2) Of the total daily work activities, 73% was with one or more persons and 51.2% of total daily work time was spent in groups. 3) A total of 51 persons, working in different capacities were contacted. These included 21 persons giving patient care, 19 persons working in nursing unit management, and 7 persons working in human resource management. 3. With regard to the head nurse's role in work activity, 53.3% of total daily work activities involved the informational role, 26.9%, the interpersonal role and 19.9%, the decisional role. With regard to time, 57.7% was spent in the informational role, 23.9%, in the interpersonal role and 18.3%, in the decisional role. When the head nurse performed managerial work, she gave nearly equal emphasis to all three roles when she gave direct patient care the informational role was increased. 4. With regard to the activity media, the number of unscheduled activities accounted for 27.1% of the activities, scheduled activities, 24.3%, desk work activity, 22.1%, rounds, 12.5% and telephone calls, made or received, 14.0%. In daily total work time managerial work related to desk work and scheduled activities were high, ranging from 29.8% to 29.9% but for direct patient care time, scheduled activities and unscheduled activities were high, ranging from 23.6% to 35.3%. 5. With regard to the purpose of the work performed, 54.4% of the total daily work was concerned with the team and 41.4% was concerned with the agency. The managerial work was concerned mainly with the team and the direct patient care was concerned mainly with the patient. When the frequency of an activity and time were compared no significant difference was found between the days for which the work was recorded for any of the variables : the work content, the work process, the work role, the activity media and purpose of the work. On the basis of this study the following are proposed as an ideal model for head nurse work in Korea : The managerial work should be increased to 70%. The decisional role activities should be increased to 40%. Twenty percent of the work activity should be allocated to agency, community and profession. It is believed that this model for the head nurse's work can contribute to guidelines for job description development. Finally, educational programs, organizational and structural devices, and administrative support are needed for the proper function of the head nurse in this proposed model.

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결장루형성술 환자 간호를 위한 일 연구

  • 모경빈
    • 대한간호학회지
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    • 제1권1호
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    • pp.27-43
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    • 1970
  • This study is designed to find out proper nursing activities for the needs of the colostomy patients, i.e., mental and psychological as well as physical needs for rapid recovery, and to help them build up the follow-up care for proper social adjustment. The study is based on 268 cases out of 381 colostomy patient's records kept in Ewha Womans University Hospital, Yonsei Medical Center, and National Medical Center in between the period from Jan. 1953 to Jan. 1970. The items of study are mainly on etiology, sex, age, duration of hospitalization, mortality rate, seasonal frequency, time from the onset of illness to the admission of the hospital, signs and symptoms. 1. Frequency of onset by etiology: Neoplastic disease 112 cases (42%), Inflammatory disease 33 cases (12%), Congenital malformation 30 cases (11%), Intussusception 25 cases (9.3%), Trauma 24 cases (9%), Volvulus 17 cases (6.3%), and Crohn's disease 6 cases (2.2%). 2. By sex: male 167 cases (62.9%), and female 101 cases (37.1%). So the ratio of portion of male and female 2:1. 3. By age: under 1·year·old 27 cases (10.1%) highest, 41-50 yrs 54 cases (20.2%), 51-60 yrs 42 cases (15.5%), above 71 yrs 5 cases (1.9%). 4. Duration of hospitalization: the shortest is 2-days and the longest is 470 days. 1-20-days 52%, 40-60 days 14%. 5. Mortality rate: Under the 10-days-admission 19.5%, and the beyond 30-days-admission 3.9%. 6. Seasonal frequency: Higher in summer (32% ). 7. Signs and symptoms: abdominal pain (56%), abdominal distention (54%), vomiting (40%), bloody mucoid diarrhea (38%) , pain of anal region (18%), abdominal tenderness, anorexia, indigestion, constipation, disuria, tenesmus, high fever and chilling sensation, bile tingled vomiting. Nursing activities for the patient's physical needs are as follows: Skin care for colostomy region, Prevention of colostomy constriction and depression, Removal of an offensive odor, The use of colostomy bag-selection for, and demonstration of the use of inexpensive colostomy irrigation equipment, Personal hygiene, general skin care, care of hair, finger nails and toe-nails, Oral hygiene, sleep and rest, aquate, Daily activities, etc. Measures for regulation of bowl movement. Keeping the instruction of taking food, Preparing the meal and help for anorexia, Constipation and it's solution, Prevention of diarrhea, helping the removal of mucous, and stretch constricted steam as needed. Nursing activities for pt's socio-psychological needs are as follows; Help the patient to make decision for the operation, Remove pt's anxiety toward operation and anesthesia, To meet the pt's spiritual needs at his death bed, Help to establish family and friends cooperation, Help to reduce anxiety at the time of admission and it's solution, Help to meet religious need, Help to remove pt's anxiety for loosing his job and family maintenance, Follow-up studies for 7 cases have been done to implement the present thesis. The items of the personal interviews with the patients are as follows: Acceptability for artificial anus, The most anxious thing they had in mind at the time of discharge, The most anxious thing they hat·e in mind at present, Their friends and family's attitudes toward the patient after operation, Relations with other colostomy patients, Emotional damage from the operation, Physical problem of enema, irrigation, Control of diet, Skin care, Control of offensive odor, Patient's suggestions to nurses during hospital stay and after discharge. In conclusion, the follow-up care for colostomy patients shares equal weight or perhaps more than the post-operative care. The follow-up care should include the spiritual care for moral support of the patient, to drag him out of isolation and estrangement, and make him fully participate in social activities. It is suggested that the following measures would help to rehabilitate the colostomy patients (1) mutual acquaintance with other colostomy patients if possible form a sort of club for the colostomy patient to exchange their experiences in care (2) through the team work of doctor, nurse and rehabilitation specialists, to have a sort of concerted effort for betterment of the patient.

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서울시(市) 대기오염(大氣汚染)이 시민보건(市民保健)에 미치는 영향(影響)에 관(關)한 조사연구(調査硏究) (Epidemiological Study of Air Pollution and Its Effects on Health of Urban Population)

  • 정규철
    • Journal of Preventive Medicine and Public Health
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    • 제2권1호
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    • pp.5-22
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    • 1969
  • The urban population of our country is rapidly increasing due to many factors of social structure, and sociologists are predicting that the increase rate of the urban population will be over 50% in 1980's. Above all, the population of the capital city of Seoul, is at present more than four millions. Such centring of people in cities, together with the improvement of the standards of living, caused rapid increase in the amount of fuel consumption, and this consumption of fuels became one of the primary sources of the air pollution in cities. Moreover, the heavy traffic, construction of many tall buildings, and the increasing number of new factories due to the industrial development-all these are contributing to make the matter of air pollution worse and worse in the Metropolitan, whose geographical location is quite unfavorable considered from the view point of air pollution. Most homes in Seoul use briquet as fuel, while oils are used in tall buildings. The CO, $SO_2$, and smoke that come from burning of these fuels are a great threat to the health of the urban population. With the purpose of examining the influence of air pollution upon the public health, written inquiries were made upon respiratory diseases, and the carboxyhemoglobin saturation in the blood was measured to determine whether the air pollution may affect the health of the urban population. Method of Health Examination (1) Investigation of Respiratory Diseases Patients' records were examined to figure out the monthly ambulance rate of respiratory patients to the total number of patients treated. On the other hand, by using the questionnaire form approved by the Medical Research Council's Committee on Research into Chronic Bronchitis, investigators interviewed the examinees and inquired into the respiratory symptoms. (2) Measuring of Carboxyhemoglobin Saturation From the ear lobe of the examinees, with the use of the melangeur for the white blood cell counting, blood was taken, and after diluting it ten times with 0.1% $Na{2}CO_{3}$, again diulting it 20 times with 0.5% $Na_{2}\;CO_{3}$, its absorbancy was measured. The following results are obtained from the investigation. (1) It was found out that 7.7% of the total patients under treatment were suffering from upper respiratory infection, acute or chronic bronchitis, bronchial asthma, pulmonary emphysema and bronchiectasis. Of them all, patients with upper respiratory infection numbered the greatest with 4.8% and patients with acute or chronic bronchitis the next with 2.1%, and their monthly ambulance rate was high from December to February during the winter, and from April to May and from September to October during the changeable seasons. (2) The daily ambulance rate of respiratory patients, it was revealed, had a close connection with the concentration of $SO_2$ and CO in the air. (3) It was found out that men were more subject to respiratory disease than women, and both men and women were more liable to the diseases with the advancing of age. (4) People living at Choong-ku with the heavy traffic and in the industrial zones of Yeungdungpo had high frequency of respiratory symptoms. (5) Considered from the view point of occupations, high frequency was found among those without job, with jobs unknown, merchants and intdustrial workers, whose social status was rather low and traffic policemen who were always exposed to the exhaust gas of cars. As for women, the frequency was detected in the order of those from high to low, housewives who were exposed to briquet gas, women with jobs unknown, women without jobs, whose social status was low. (6) Ex-smokers rather than smokers, of both sexes, had higher frequency. As for men, heavy smokers had high frequency, while in women light smokers had rather high frequency which was presumed to be due to their average old age. (7) Men's average of carboxyhemoglobin saturation was 9.48%, while women's was 11.3%, higher than men's. (p<0.05). Age meant no difference in the case of men, but as for women, the saturation was remarkably high between the ages from 20 to 60. (8) No regional difference was detected in the carboxyhemoglobin saturation. (9) The carboxyhemoglobin saturation was found, in the case of men, in the order of office workers, traffic policemen, students, the unemployed, merchants and industrial workers, drivers; and as for women, the order was housewives, office workers, merchants and industrial workers. (10) No significant correlation was found between the carboxyhemoglobin saturation and the concentration of CO detected in kitchens, or between the carhoxyhemoglobin saturation and the passing of time after exposure to briquet gas. No difference of carboxyhemoglobin saturation was detected between smokers and non-smokers, and the degrees of smoking; only, significant negative correlation was found between the passing of time after smoking and the carboxyhemoglobin saturation. It is ture that air pollution causes or aggravates the respiratory diseases, increases the carboxyhemoglobin saturation in the blood, but what seems to be more hazardous to the health is the air polluted by the briquet gas in the kitchens and on-dol rooms rather than the atmospheric air pollution.

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