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문화간호를 위한 한국인의 민간 돌봄에 대한 연구 : 출생을 중심으로 (Study on Folk Caring in Korea for Cultural Nursing)

  • 고성희;조명옥;최영희;강신표
    • 대한간호학회지
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    • 제20권3호
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    • pp.430-458
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    • 1990
  • Care is a central concept of nursing. Nursing would not exist without caring. Care and quality of life are closely related. Human behavior is a manifestation of culture. We can say that caring and nursing care are expression of culture. The nurse must understand the relationship of culture with care for ensure quality nursing care. But knowledge of cultural factors in nursing is not well developed. Time and in - depth study are needed to find meaningful relationships between culture and care. Nurses recognized the importance of culturally appropriate nursing There are two care systems in culturally based nursing. The folk care system and the professional nursing care system. The folk care system existed long before the professional nursing care system was introduced into this culture. If the discrepancy between these two care systems is great, the client may receive inappropriate nursing care. Culture and subcaltures are diverse and dynamic in nature. Nurses need to know the caring behaviors, patterns, and their meaning in their own culture. In Korea we have taken some first step to study cultural nursing phenomena. It is not our intent necessarily to return to the past and develop a nationalistic of nursing, but to identify the core of traditional caring and relate that to professional nursing care. Our Assumptions are as follows : 1) Care is essential for human growth, well being and survial. 2) 7here are diverse and universal forma, expressions, patterns, and processes of human care that exist transcul - turally. 3) The behaviors and functions of caring differ according to the social structure of each culture. 4) Cultures have folk and professional care values, beliefs, and practices. To promote the quality of nursing care we must understand the folk care value, beliefs, and practices. We undertook this study to understand caring in our traditional culture. The Goals of this study were as follows : 1) To identify patterns in caring behavior, 2) To identify the structural components of caring, and 3) To understand the meaning and some principles of caring. We faised several questions in this study. Who is the care-giver? Who is the care-receipient? Was the woman the major care -giver at any time? What are the patterns in caring behavior? What art the priciples underlying the caring process? We used an interdisciplinary team approach, composed of representatives from nursing and anthropology, to contribute in -depth understanding of caring through a socicaltural perspeetive. A Field study was conducted in Ro-Bong, a small agricultural kinship village. The subjects were nine women and one man aged be or more years of age. Data were collected from january 15 to 21, 1990 through opem-ended in-depth interviews and observations. The interview focused on caring behaviors sorrounding birth, aging, death and child rearing. We analysed these data for meaning, pattern and priciples of caring. In this report we describe caring behaviors surrounding childbirth. The care-givers were primarily mothers- in -low, other women in the family older than the mother - to- be, older neighbor woman, husbands, and mothers of the mother-to- be. The care receivers were the mother-to-be the baby, and the immediate family as a component of kinship. Emerging caring behavior included praying, helping proscribing, giving moral advice(Deug - Dam), showing concern, instructing, protecting, making preparations, showing consideration, touching, trusting, encouraging, giving emotional comfort, being with, worrying about, being patient, preventing problems, showing by an example, looking after bringing up, taking care of postnatal health, streng thening the health condition, entering into another's feelings(empathizing), and sharing food, joy and sorrow The emerging caring component were affection, touching, nurtuing, teaching, praying, comforting, encouraging, sharing. empathizing, self - discipline, protecting, preparing, helping and compassion. Emerging principles of. caring were solidarity, heir- archzeal relationships, sex - role distinction. Caring during birth expresses the valve of life and reflects the valued traditional beliefs that human birth is given by god and a unique unifying family event reaching back to include the ancestors and foreward to later generations. In addition, We found positive and rational foundations for traditionl caring behaviors surrounding birth, these should not be stigmatized as inational or superstitious. The nurse appropriately adopts the rational and positive nature of traditional caring behaviors to promote the quality of nursing care.

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농촌마을 생태체험 공간으로 활용하기 위한 연못형습지 평가지표 개발 (The Development of Evaluation Indicator for Eco-experience in Rural Village)

  • 이상영;김미희;강방훈;손진관
    • 농촌지도와개발
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    • 제21권4호
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    • pp.1125-1147
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    • 2014
  • 본 연구는 생태체험 프로그램의 질적 향상을 위해 농업인 등 일반인이 사용가능한 연못형습지의 건강성 평가지표를 개발하였다. 평가지표 개발은 선행 방법을 농촌마을 10개 연못형습지에 적용한 평가체계 문제점 도출, 도출된 결과를 바탕으로 습지 및 생태체험 전문가를 대상으로 한 델파이조사 2회, 평가항목 수정 및 중요도 산출 과정으로 이루어졌다. 선행 평가체계 적용 결과 문제점은 (1) 가치판단과 보전계획 결과와 평가항목 간 평가 점수가 동일하게 나타나 전체적으로 세분화되어 있지 못한 점과 (2) 평가자의 주관적 기준에 따라 평가 결과가 달라질 수 있다는 것이다. 이러한 문제점을 전문가에게 제시하여 평가항목 및 기준의 적절성을 수정 보완하였으며, 최종적으로 수정된 평가항목과 평가기준의 중요도를 산출하여 생태체험 공간으로서 연못형습지의 건강성을 평가하기 위한 지표를 개발하였다. 평가항목은 (1)산림과의 연결성, (2)습지 및 수체와 연결성, (3)현존식생종류, (4)주변 토지이용, (5)식생의 혼재도, (6)식생 및 횡단구조, (7)습지 규모, (8)유출 구조의 중요도 순서로 총 8개 항목이다. 이와 함께 연못형습지를 체험 장소로 활용 시 접근성, 시각적 개방성, 폐기물의 흔적에 대한 별도 고려사항 및 개선사항을 추가로 제시하였다. 본 결과는 방치되어 있는 농촌지역의 습지를 체험공간으로 활용하고 더불어 전통지식이 내재한 생물다양성을 위한 공간으로 보전하고 관리하는데 기여할 수 있을 것으로 판단한다.

일부 도시지역 주민의 약물 장기복용에 관한 사회의학적 연구 (A Study on the Long-Term Use of Drugs Among Some Urban Residents)

  • 유호상;송동빈;염용태;차철환
    • 농촌의학ㆍ지역보건
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    • 제12권1호
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    • pp.102-110
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    • 1987
  • One of the familiar medical facility that most people reach easily in Korea is the drug store. In Korea, it is possible to purchase all kinds of common drugs without physician's prescriptions, which caused some problems. In other words, such treatment without professional supervision has led to medical, social and economical problems. In view of the above, this study is aimed at revealing the actual status of long-term use of drugs in some urban residents. Long-term use of drugs is operationally defined as using certain drugs at least once a week for more than 3 months. This survey took the residents of Guro 6-Dong where was one of the target areas for Community Health Development Project managed by Korea University as a target population. A sample of 1,517 residents was selected by the multistage sampling method. The interview was conducted on September 21st and 22nd in 1985. The object of this study was to compare the result with that of the rural area which was obtained by the same method, tools and research team, prior to this study in 1984. The results were as follows; 1) The age-standardization of the study showed that 97 per 1,000 urban residents were actually on long-term drug use. The prevalance of long-term use is high in accordance with aging and low with education level. 2) Out of 1,000 urban samples the most popular item involved in the long-term drug use was antipyretic-analgesic-antiinflammatory drug (26), and next in order was vitamin (23), antibiotics (13), digestives (10) and antacids (7). In the rural samples as for compare, that was antipyretic-analgesic-antiinflammatory drug (100), antacids (36), digestives (23), adrenocortical hormones (12) etc. 3) With antipyrctic-analgesic-antiinflammatory drugs, 50% of the urban samples were taking for more than a year, whereas such were 82.7% of the rural samples. Using such a high percentage of antipyretic-analgesic-antiinflamatory drugs in the rural residents is probably due to the high prevalence rate of musculo-skeletal diseases. 4) The urban long-term drug users of antipyretic-analgesic-antiinflammatory drugs were influenced mostly by the mass media (43.6%), next in order was pharmacist (35.9%) and physician (10.3%). Comparing with the result from the rural areas the role of mass media was much more influencial in the urban areas. 60% of them consulted with pharmacists, 14.3% with physicians and 25.7% had no history of consultation in the urban samples. 5) Considering the incidence of knowing the possible side-effects of each drug, 28.2% of the urban residents had no recognition about side-effects prior to use antipyretic-analgesic-antiinflammatory drugs. In the rural residents, 29.67o had no knowledge about the side-effects before using the drug. 6) For the solution of the above problems, it is necessary to limit the advertisement of some drugs by the parmaceutical company. And therapeutic drugs which may bring on side effects in case of long-term use should not be sold at drug stores without physician's prescription.

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농촌 일차 보건사업에 있어서 마을건강원 업무량 및 업적에 관한 연구 (A Study on Performance and Achievement of Village Health Workers in Rural Primary Health Care Program)

  • 허달영;이명숙;염용태;김순덕
    • 농촌의학ㆍ지역보건
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    • 제12권1호
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    • pp.36-53
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    • 1987
  • It is utmostly important to establish the efficient fitable way of peoples' active participation in primary health care especially in the areas where the public or governmental service input for the basic health care is insufficient like as in rural areas of Korea. In light of above reason, this study focused mainly on the evaluation of roles and activities of village health workers (VHWs) who were selected from grass- root level of village people in order to derive further motivation for active participation. This is believed to be a sort of feedback mechanisms. Actually, the authors collected the activity reports of VHWs who had been devoting themselves in the primary health care services of Jeomdong Area, of Yeoju Gun one of Korea University Community Health Action Programmes and survey record on the VHWs activity from correspondent people. 1 hose data were analyzed through computer programmed package. The activities performed by VHWs were limited to the performance in 1985 for conveniance. The summarized results were as follows; 1) General characteristics of VHWs. Among a total of 28 VHWs in the area, about 39.3g of them have been replaced up to the date since the implementation in 1983, because of moving out, occupational employment and of others. The age of majority (75.0%) lied between the range of 30-50, and educational background of 67.9% belonged to category of primary school graduation, about 50% of them experienced to be or were also entiled "chief of women club" of corresponding villages. 2) Work-load of VHWs. Each VHW was assigned for tasks of health care for average 55 households of 248 persons. They shared approximately 6 days a month for the activity in average and it covered 17 cases of basic health care in a month. A half of the VHWs performed home visits irregularly without solidified schedule. 3) Work performance analysis. Informations collected through VHWs were compared with data from official vital registration at local administration center "Myon Office" in 1985. VHWs collected 100.8 of new born, 116.2 of death, 58.3 of move in and 74.8 of move out in comparison with 100.0 of official registration each. Pregnant women of 79.8% of mothers among the total pregnancy of 94 which were confirmed as normally delivered or aborted cases by all means afterwards had been detected by VHWs as being pregnant and all of them received some of antenatal cares by VHWs. All(100%) of delivered women were detected by VHWs through home visits and they were cared postnatally. Whereas, according to the records of birth registration, the places of delivery were clinic in 33.7%, and mother's home in 66.3%, VHWs reported them to be clinic in 48.9%, midwifery in 20.2%. It was cleared that most of misinformation was caused by uncautious filling of birth registration at notification. Among the total of 717 eligible women under age 44 years, family planning status of 92.6% was reported by VHWs confirming practice of control to be 70.8% of reported fertile women. 4) Attitude of VHW on the roles and functions. Although 92.0% of VHWs expressed VHWs to be worthwhile, only 52.0% of them had dignity and satisfaction in their activity and 44.0% of them had passive attitude of working saying they followed direction regardlessly. Concerning difficulties in performance as a VHW, 60.7% of them pointed out lacking of medical and health related knowledge by themselves. Still, 64.0% of them thought visiting unfamilier house to be awful and 40.0% complained forms of activity to be difficult and hard. It was also revealed that 56.6% confessed lack of interest on community health service itself. Most of VHWs needed more educational training especially on clinical fields such as cares of gynecological diseases, hypertension, diabetes, and other chronic diseaes of the aged. Regular on-the-job basic trainings were said to be needed twice a year.

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보건소 금연사업의 현황과 문제점 분석을 통한 개선방안 (The Current Status and Problems of Tobacco Control Programs of Public Health Centers in Korea)

  • 박순우;이주열
    • 농촌의학ㆍ지역보건
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    • 제34권1호
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    • pp.87-100
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    • 2009
  • 보건소의 금연사업은 정부의 정책이 지역사회에서 대주민 사업을 통해 직접 수행된다는 측면에서 매우 중요하며 따라서 보건소 금연사업을 지속적으로 모니터링하고 발전하도록 할 필요가 있다. 본 연구는 보건소 금연사업 담당자들을 대상으로 한 설문조사를 통해 우리나라 보건소 금연사업의 현황 및 문제점 파악을 하여 이를 근거로 보건소 금연사업의 개선 및 발전방안을 제시하고자 하였다. 2006년 11월에 전국의 보건소 금연사업 담당자를 대상으로 교육 참석자 및 우편 혹은 이메일을 통해 자기기입식 설문조사를 실시하였다. 246개 보건소 중에서 213명이 응답하였고 그 중 응답내용이 부실한 1건을 제외한 212건을 대상으로 분석하였다. 조사 결과 금연사업 담당자들의 업무 경력에서 86.7%가 금연사업 종사 기간이 3년 미만이었고 90% 정도가 87.3%가 다른 업무를 겸하고 있었다. 금연사업의 내용으로서 포스터나 리플렛을 이용한 홍보와 중고등학생 대상 흡연예방 교육을 거의 모든 보건소에서 실시하였으며, 실제적인 사업의 우선순위는 지역사회 진단이 아닌 현실적인 이유에 의해 결정하는 경우가 많았다. 사업수행을 위한 자원에서 예산이 부족하다고 한 경우는 1.9%에 지나지 않았으며 44.7%가 인력이 부족하다고 하였다. 사업에 필요한 지식과 기술의 습득은 스스로 터득하거나 전임자의 도움에 의존하는 경우가 많았다. 금연사업을 위한 부서간 업무 조율이 잘 된다는 경우가 39.5%에 지나지 않았으며, 금연사업 지원을 위한 중앙정부의 기능에 대해서는 대체적으로 만족하는 경향이었다. 보건소 금연사업 발전을 위해 가장 필요한 것으로서 인력의 역량강화가 65.6%로서 가장 많았다. 본 연구 결과 보건소 금연사업의 발전을 위해서 향후 보건소 금연사업의 발전을 위해서는 과학적 근거를 바탕으로 하고 지역사회 여건에 적합한 금연사업의 기획 및 수행이 필요하며 이를 위해 보건소 인력의 역량과 전문성 강화를 위한 교육 훈련 과정의 지속적 개발이 필요하다. 또한 사업대상자의 참여 유도 방안 개발, 지역사회의 인적 자원 활용 강화, 부서간 업무 연계의 강화방안 마련 등이 필요한 것으로 나타났다.

정확도 높은 검색 엔진을 위한 문서 수집 방법 (A Document Collection Method for More Accurate Search Engine)

  • 하은용;권희용;황호영
    • 정보처리학회논문지A
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    • 제10A권5호
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    • pp.469-478
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    • 2003
  • 인터넷상의 정보 검색 엔진들은 웹 로봇을 이용해서 인터넷에 연결되어 있는 수 많은 웹 서버들을 주기적 또는 비주기적으로 방무나여 자체적인 인텍싱 방법에 따라 자료를 추출하고 분류해서 검색 엔진의 기초가 되는 데이터 베이스를 구축하고 변겨아는 작업을 계속하고 있다. 이런 일련의 작업은 인터넷 상에 분산되어 있는 막대한 정보를 쉽고 정확하게 찾을 수 있는 게이트 사이트로서의 역할을 담당하기 위한 전략적인 목적으로 진행되고 있다. 수천만 이상의 웹 사이트들을 상대로 하는 정보 수집은 검색 엔진 사이트 중심으로 기존 데이터의 수정과 삭제 등과 같은 데이터 베이스 유지 관리와 신규 사이트들에 대한 자료 수집 작업이 이루어지고 있다. 이러한 작업은 웹 서버에 대한 사전 지식 없이 정보 추출을 위해 웹 로봇을 실행하므로 인터넷 상에 수많은 요구가 전송되고 이는 인터넷 트래픽을 증가 시키는 원인이 되고 있다. 따라서 웹 서버가 사전에 자신이 공개할 문서에 대한 변경 정보를 웹 로봇에게 통보하고 웹 로봇은 이 정보를 이용해서 웹 서버의 해당 문서에 대한 정보 수집 작업을 한다면 불필요한 인터넷 트래픽을 감소시킬 수 있을 뿐만 아니라 검색 엔진의 정보의 신뢰도도 높아지고 웹 서버의 해당 문서에 대한 정보수집 작업을 한다면 불필요한 인터넷 트래픽을 감소 시킬 수 있을 뿐만 아니라 검색 엔진의 정보의 신뢰도도 높아지고 웹 서버의 시스템 부하와 검색 엔진의 시스템 부하를 줄일 수 있는 효과를 가질 수 있을 것이다. 본 논문에서는 웹 서버상의 웹 문서 파일의 변동 사항을 자동으로 검사하고 변동 사항들을 종합 정리해서 변경 문서에 대한 정보를 통보 받기 원하는 등록된 각 웹 로봇에게 전송하는 검사 통보 시스템을 설계 구현하였다. 웹 로봇을 운영하는 검색 엔진에서는 통보된 요약 정보를 이용해서 웹 서버로부터 해당 문서를 전송 받아 필요로 하는 인덱스 정보를 추출해서 데이터베이스를 구축하는 효율적인 웹 로봇을 설계 구현하였다.

대학교 재학생에서 Fatigue Severity Scale의 신뢰도 및 타당도 연구 (Reliability and Validity of the Fatigue Severity Scale among University Student in South Korea)

  • 이정현;정현석;임수미;조한별;마지영;고은;임주연;이선혜;배수진;이유진;류인균;정도언
    • 생물정신의학
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    • 제20권1호
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    • pp.6-11
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    • 2013
  • Objectives There are only a limited number of studies on instruments assessing fatigue in university students, although fatigue exerts negative influences on their health and academic performances and fatigue-related complaints are more frequently reported in young adults than middle-aged adults. The aim of this study was to validate the 9-item Fatigue Severity Scale (FSS) among university students including both undergraduate and graduate students in South Korea. Methods A total of 176 university students completed a battery of self-report questionnaires, including the FSS, the Brief Fatigue Inventory (BFI), the Beck Depression Inventory-II (BDI-II), the Beck Anxiety Inventory (BAI), the Medical Outcomes Study Short Form 36 version 2 (MOS-SF36v2), and the Inclusion of Community in the Self Scale (ICS). The data were collected from February of 2012 to June of 2012. The reliability, convergent validity, divergent validity, and exploratory factor analyses were conducted to assess psychometric properties of the FSS. Results The mean FSS score was 3.20 (standard deviation = 1.43). The FSS demonstrated an excellent internal consistency (Cronbach's ${\alpha}$ = 0.93) and item-total correlations ranged from 0.56 to 0.90. Correlations of the FSS with the BFI (r = 0.71, p < 0.01), BDI-II (r = 0.54, p < 0.01), BAI (r = 0.46, p < 0.01), MOS-SF36v2 physical component summary (r = -0.28, p < 0.01), MOS-SF36v2 mental component summary (r = -0.55, p < 0.01), and ICS (Spearman's rho = -0.07, p = 0.33) showed acceptable convergent and divergent validity. Exploratory factor analysis defined one underlying factor (eigenvalue = 5.67) that explained 93.50% of the total variance. Conclusions To the best of our knowledge, this is the first study to investigate reliability and validity of the FSS in university students. The FSS exhibits good psychometric properties for evaluation of fatigue among university students in South Korea. Since the FSS is easy to administer, score, and interpret, it could be a useful tool in research and practice for assessing fatigue among university students.

초기 창업기업 창업지원정책의 효과성 분석: 창업업종 및 창업성장단계 조절효과 (Effectiveness Analysis of Startup Support Policy of Early Start-ups: Moderating Effect of the Industry and Growth Stage of the Start-ups)

  • 정경희
    • 벤처창업연구
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    • 제15권1호
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    • pp.59-70
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    • 2020
  • 본 연구는 초기 창업기업 성과에 영향을 미치는 요인으로 창업지원정책을 실증적으로 규명하고, 현재의 창업지원정책에 대한 효과성을 측정하여, 이를 토대로 향후 정책적 방향을 제시하기 위한 것이다. 이를 위해 창업지원정책이 초기 창업기업의 성과에 미치는 영향에 대해 분석하고, 창업기업의 특성으로 창업업종 및 창업성장단계에 따라 어떠한 차이점이 있는지 확인하였다. 연구대상은 초기창업패키지 사업에 선정된 최근 3년간 창업기업 297개의 실제 테이터를 수집하여, 변수 간 영향력은 다중회귀분석, 조절효과는 위계적 회귀분석을 실시하였다. 연구결과를 요약하면 다음과 같다. 첫째, 창업지원정책과 창업성과의 영향 관계 확인 결과, 매출은 창업자금, 창업멘토링, 창업인프라(공간) 모두 유의한 영향을 보였으며, 반면 창업교육은 매출증가에 유의한 영향을 미치지 못하였다. 고용은 창업멘토링만이 유의한 영향 관계임을 확인하였다. 둘째, 창업업종과 창업성장단계의 조절효과 확인 결과, 창업업종은 통계적으로 유의한 영향력을 미치지 못하였으나, 상호작용 효과는 창업교육에서 유의하게 나타났다. 구체적으로 업종별 매출 관계는 지식서비스는 창업교육이 매출향상에 도움을 주며, 제조는 창업멘토링과 창업인프라(공간) 지원 여부와 관계없이 모두 매출향상에 효과적인 것으로 나타났다. 창업성장단계별 매출 관계는 통계적으로 유의한 영향력을 확인하였다. 예비단계는 통계적으로 유의하지 않으며, 창업단계는 창업멘토링 지원, 성장단계는 창업자금 지원이 효과적인 것으로 확인되었다. 반면 고용은 창업성장단계에 따라 유의한 영향력을 미치지 못하였다. 본 연구는 초기 창업기업 대상 창업지원정책의 효과성을 분석하여, 창업기업 특성에 따른 차별적 정책지원의 필요성을 확인하고, 향후 정책적 방향에 대한 시사점을 제시하였다.

한국인에서의 페닐케톤뇨증의 유전자변이에 대한 고찰 (The Study of DNA Mutations of Phenylketonuria in Koreans)

  • 유수정;홍용희;이용화;정성철;기창석;이동환
    • Journal of Genetic Medicine
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    • 제5권1호
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    • pp.26-33
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    • 2008
  • 목 적 : 페닐케톤뇨증은 상염색체 열성으로 유전되는 아미노산 대사질환으로 PAH와 조효소인 $BH_4$의 활성이 저하되어 발생한다. 본 연구에서는 PAH 유전자 돌연변이와 임상양상과의 연관성을 조사하였고 PAH DNA 변이의 국가간의 차이를 분석하였다. 방 법 : 페닐케톤뇨증 환자와 환자 가족의 동의하에 DNA를 말초혈액의 백혈구에서 분리하여 PAH 유전자를 PCR을 통해 증폭하여 유전자 서열을 분석하였고 PAH 돌연변이가 하나의 대립유전자에서만 발견이 되거나 없는 경우는 분석된 서열을 MLPA를 시행하여 분석을 하였다. 결 과 : 유전자 검사를 시행한 102명의 대립유전자 204개 중 199개의 돌연변이가 발견되어 97%의 검출률을 보였다. 발견된 돌연변이는 총 44가지의 유전자형으로 9개는 novel missense mutation이었고 1개는 novel splice site mutation이었다. 가장 많은 대립 유전자형은 R243Q와 $IVS4^{-1}$G>A로 각각 13.1%와 11.6%를 나타내었다. 전형적 페닐케톤뇨증에서는 R243Q와 $IVS4^{-1}$G>A가 각각 14.2%를 차지하였고 $BH_4$ 반응형 페닐케톤뇨증의 경우에는 R241C가 33.3%, 양성 고페닐알라닌혈증이 R241C가 40%에서 나타났다. $BH_4$ 반응형 페닐케톤뇨증의 경우에는 약물 치료만으로 조절이 되는 환자에서 T278I와 V388M mutation이 발견되었고 약물 치료만으로 조절이 되지 않고 식사요법을 병행해야하는 환자들에서만 K95del과 A447P의 돌연변이가 나타났다. 그리고 2004년 이전에는 동양인에게서 A259T 대립유전자 돌연변이가 발견되지 않은 것으로 보고되었으나 본 연구에서는 10.1%에서 발견되었다. 결 론 : 페닐케톤뇨증과 관련된 새로운 유전자 변이들이 발견되고 있으며 $BH_4$에 반응하는 유전자 변이들의 유전자형들이 확인되면서 PAH 유전자 분석은 페닐케톤뇨증 환자에서 진단, 유전상담, 식사 요법과 치료 계획 수립에 기여할 것이다.

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원격의료서비스 수용요인의 구조적 관계 실증연구 (Structural Relationships Among Factors to Adoption of Telehealth Service)

  • 김성수;류시원
    • Asia pacific journal of information systems
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    • 제21권3호
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    • pp.71-96
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    • 2011
  • Within the traditional medical delivery system, patients residing in medically vulnerable areas, those with body movement difficulties, and nursing facility residents have had limited access to good healthcare services. However, Information and Communication Technology (ICT) provides us with a convenient and useful means of overcoming distance and time constraints. ICT is integrated with biomedical science and technology in a way that offers a new high-quality medical service. As a result, rapid technological advancement is expected to play a pivotal role bringing about innovation in a wide range of medical service areas, such as medical management, testing, diagnosis, and treatment; offering new and improved healthcare services; and effecting dramatic changes in current medical services. The increase in aging population and chronic diseases has caused an increase in medical expenses. In response to the increasing demand for efficient healthcare services, a telehealth service based on ICT is being emphasized on a global level. Telehealth services have been implemented especially in pilot projects and system development and technological research. With the service about to be implemented in earnest, it is necessary to study its overall acceptance by consumers, which is expected to contribute to the development and activation of a variety of services. In this sense, the study aims at positively examining the structural relationship among the acceptance factors for telehealth services based on the Technology Acceptance Model (TAM). Data were collected by showing audiovisual material on telehealth services to online panels and requesting them to respond to a structured questionnaire sheet, which is known as the information acceleration method. Among the 1,165 adult respondents, 608 valid samples were finally chosen, while the remaining were excluded because of incomplete answers or allotted time overrun. In order to test the reliability and validity of the assessment scale items, we carried out reliability and factor analyses, and in order to explore the causal relation among potential variables, we conducted a structural equation modeling analysis using AMOS 7.0 and SPSS 17.0. The research outcomes are as follows. First, service quality, innovativeness of medical technology, and social influence were shown to affect perceived ease of use and perceived usefulness of the telehealth service, which was statistically significant, and the two factors had a positive impact on willingness to accept the telehealth service. In addition, social influence had a direct, significant effect on intention to use, which is paralleled by the TAM used in previous research on technology acceptance. This shows that the research model proposed in the study effectively explains the acceptance of the telehealth service. Second, the research model reveals that information privacy concerns had a insignificant impact on perceived ease of use of the telehealth service. From this, it can be gathered that the concerns over information protection and security are reduced further due to advancements in information technology compared to the initial period in the information technology industry, and thus the improvement in quality of medical services appeared to ensure that information privacy concerns did not act as a prohibiting factor in the acceptance of the telehealth service. Thus, if other factors have an enormous impact on ease of use and usefulness, concerns over these results in the initial period of technology acceptance may become irrelevant. However, it is clear that users' information privacy concerns, as other studies have revealed, is a major factor affecting technology acceptance. Thus, caution must be exercised while interpreting the result, and further study is required on the issue. Numerous information technologies with outstanding performance and innovativeness often attract few consumers. A revised bill for those urgently in need of telehealth services is about to be approved in the national assembly. As telemedicine is implemented between doctors and patients, a wide range of systems that will improve the quality of healthcare services will be designed. In this sense, the study on the consumer acceptance of telehealth services is meaningful and offers strong academic evidence. Based on the implications, it can be expected to contribute to the activation of telehealth services. Further study is needed to assess the acceptance factors for telehealth services, such as motivation to remain healthy, health care involvement, knowledge on health, and control of health-related behavior, in order to develop unique services according to the categorization of customers based on health factors. In addition, further study may focus on various theoretical cognitive behavior models other than the TAM, such as the health belief model.