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의료기관의 외국인 대상 환자식 운영 현황 및 내실화 방안 분석 (Analysis of Operational Characteristics and Substantiality Plan of Inpatient Diets for Foreigners in Hospitals)

  • 김형미;김은미;김혜진;백희준;박미선;이금주;이해영
    • 대한영양사협회학술지
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    • 제22권2호
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    • pp.118-130
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    • 2016
  • The objectives of this study were to analyze the operational characteristics and to explore the substantiality plan of inpatient diets for foreigners in hospitals. Questionnaires were mail-delivered to 128 hospitals, and a total of 62 questionnaires were usable with a response rate of 48.4 percent. Statistical data analysis was completed using SPSS Win 11.0 for descriptive analysis, independent t-test, and ${\chi}^2$ test. Results can be summarized as follows. The average number of inpatient meals for foreigners in the last 6 months were 405 and 53 for general therapeutic diets and special therapeutic diets, respectively. The rates of hospitals with an exclusive department and exclusive staff for foreign inpatients were 48.4% and 53.2%, respectively. Major nationalities of foreign inpatients were China (37.5%) and Russia (31.3%), and their major medical departments were internal medicine (43.9%) and surgery (39.0%). The number of hospitals that provided inpatient diet only for foreigners was 42 (72.4%) and influencing factors were number of permitted beds (P<0.05), an exclusive department (P<0.001), and exclusive staff (P<0.01). The main type of menu was USA European style (61.1%), and the price of inpatient meals for foreigners was mostly \10,000~\25,000 (62.0%). As 75.9% of hospitals did not possess dietary slip manuals for foreigners, the case of preparing inpatient meals for foreigners in the form of a general therapeutic diet partially-modified according to disease was the majority (55.4%). Dietitians felt the need for nutrition management guidelines and dietary slip manuals (47.3%) as a substantiality plan of inpatient diets for foreigners. There is a need for exclusive foodservice standards for foreign inpatients in the changing medical environment.

여대생의 아침 결식 여부에 따른 식행동 및 식이 섭취 상태와 DQI-I를 기준으로 한 식사의 질 평가 (Evaluation of Dietary Behavior, Nutrient and Food Intake Status, and Dietary Quality Based on Diet Quality Index-International (DQI-I) in Female University Students)

  • 배윤정;김은영;연지영;조혜경;이지선;김명희;김미현
    • 동아시아식생활학회지
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    • 제20권4호
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    • pp.491-501
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    • 2010
  • The purpose of this study was to evaluate the dietary behavior, nutrient and food intake status and dietary quality based on nutrient and food group intake and Diet Quality Index-International (DQI-I) according to breakfast eating status in female university students. The survey was conducted using questionnaires and 3-day dietary records for 181 female university students residing in Seoul, Gyunggi, and Gangwon. The subjects were divided into two groups by frequency of breakfast eating: skipping breakfast (frequency of eating breakfast under 4 times/week, n=69) and eating breakfast (frequency of eating breakfast over five times/week, n=112). The skipping-breakfast group was significantly lower in its frequency of having lunch than that of the eating-breakfast group. There was no significant difference of energy intake between the two groups; however, the intake of carbohydrate, fiber, folate, vitamin C, vitamin E, Ca and Fe in the skipping-breakfast group was significantly lower than those in the eating-breakfast group. There was no significant difference in Korean's Dietary Diversity Score (KDDS) between the skipping-breakfast group ($4.65{\pm}0.56$) and eating-breakfast group ($4.73{\pm}0.50$). The average DQI-I of the skippingbreakfast group ($56.96{\pm}9.04$) was significantly lower than that of the eating-breakfast group ($61.32{\pm}7.99$). In conclusion, female university students with a high frequency of skipping breakfast may have a lower diet quality and DQI-I score. Therefore, in support of proper dietary management, it is necessary to promote and support breakfast eating.

반자연적인 조건에서 두 계통 바퀴(Blattella germanica)의 휴식처 체제 시간 및 방문빈도에 대한 시간적 유형 (Temporal Pattern of Within-harborage Time and Visiting Frequency in Two Strains of the german Cockroach, Blatella germanica, in Semi-natural Conditions)

  • 전태수;박영석
    • 한국응용곤충학회지
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    • 제36권4호
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    • pp.299-310
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    • 1997
  • 돌연변이체인 or (orange body) 계통과 KNIH (Korea National Institute of Health) 계통의 바퀴(Blattella germanica (L.) (Orthoptera: Blattellidae)를 반자연적인 조건하에서 비디오와 컴퓨터 자료처리를 통하여 연속적으로 관찰하였다. 휴식처에 머무르거나, 먹고, 물 마시며, 다른 개체들과 교신하는 행동을 관찰 할 수 있는 사각형의 관찰상자 내에서 수컷 성충을 개체별로 4~5일 동안 연속적으로 관찰하였는데, 본 논문에서는 휴식처에 머무르는 시간과 방문 빈도를 분석하였다. 개체들 간의 변이가 상대적으로 컸지만 시험개체들은 휴식처에 전체 관찰시간의 47 -61%를 평균적으로 머무르는 것으로 나타났다. 판찰 개체가 휴식처에서 머무르는 시간은 모계에 따른 유의한 차이가 있었으나, 계통 사이에는 뚜렷하게 구분이 되지 않았다. 명암기의 차이는 두 계통 모두 관찰되었는데 휴식처에 머무르는 시간은 암기보다 명기에서 더 길었다. 휴식처 주변의 국소적 활동성을 나타내주는 방문빈도는 KNIH 계통보다 or 계통에서 상대적으로 높게 나타났는데, 모계와 계통간에 유의한 차이가 있었다. 방문빈도의 명암기 차이는 or 계통에서는 유의하게 나타났지만 KNIH 계통에서는 없었다. 개체들 간의 변이가 있었으나 동일한 모계 내에서 휴식처에 머무르는 시간이나 방문빈도가 유사하게 관찰되는 개체들이 있었다.

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주의력결핍 과잉행동장애 한국형 치료 권고안 개정안(II) - 진단 및 평가 - (The Revised Korean Practice Parameter for the Treatment of Attention-Deficit Hyperactivity Disorder (II) - Diagnosis and Assessment -)

  • 이문수;박수빈;김경미;김현진;박상원;김윤신;이영식;권용실;신동원
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제28권2호
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    • pp.58-69
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    • 2017
  • Attention-deficit hyperactivity disorder (ADHD) is a highly prevalent, impairing, and comorbid disorder that persists into adulthood. ADHD should be diagnosed in the same manner as other common adult mental health disorders. The three most important components in the comprehensive evaluation of patients with ADHD are the clinical interview, medical examination, and completion and scoring of behavior rating scales. The diagnostic evaluation of ADHD should include questions about the symptoms, family history, prior evaluation and treatment of ADHD, as well as other problems including alcohol and drug use. Screening interviews or rating scales, as well as interviews, should be used. When it is feasible, clinicians may wish to supplement these components of the evaluation with the objective assessments of the ADHD symptoms, such as through psychological tests. These tests are not essential to reaching a diagnosis, however, or to treatment planning, but may yield further information about the presence and severity of cognitive impairments that could be associated with some cases of ADHD. As comorbidity is the rule rather than the exception, clinicians should carefully screen for comorbid disorders as part of a comprehensive assessment of ADHD. To receive a diagnosis of ADHD, the person must be experiencing significant distress or impairment in his or her daily functioning, and must not meet the criteria for other mental disorders which might better account for the observed symptoms, such as mental retardation, autism or other pervasive developmental disorders, mood disorders and anxiety disorders. This report aims to suggest practice guidelines for the assessment and diagnosis of children, adolescents and adults with ADHD in Korea.

심방세동 환자에서 Warfarin 반응성에 이뇨제가 미치는 영향 (Effects of Diuretics on Warfarin Responses in Patients with Atrial Fibrillation)

  • 박희주;나현오;곽혜선
    • 한국임상약학회지
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    • 제23권2호
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    • pp.151-157
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    • 2013
  • Purpose: Warfarin is the most widely used anticoagulant drug for preventing cardiovascular diseases after ischemic stroke and thromboembolism related to atrial fibrillation, artificial heart valves, deep vein thrombosis, and pulmonary embolism. Warfarin is commonly used in combination with other drugs such as diuretics in order to treat the comorbidity. Although several warfarin-diuretics interactions have been reported, the results are conflicting. Therefore, the initial aim of this study was to identify the effects of diuretics on the warfarin response in patients with atrial fibrillation. Methods: One hundred forty six patients with atrial fibrillation who were on anticoagulation therapy with warfarin and maintained INR levels of 2-3 for three consecutive times were followed up, retrospectively. Stable warfarin doses and INR per stable warfarin dose were compared according to age, gender, comorbidity, and concurrent medication. The stable warfarin dose was defined as the maintenance dose of warfarin of the measured patient whose INR was within the target INR range more than 3 times consecutively. Results: The differences of stable warfarin doses in patients with ($3.22{\pm}1.21$ mg/day) and without ($3.58{\pm}1.14$ mg/day) diuretics were marginally significant (P=0.069). On the other hand, stable warfarin doses were $2.97{\pm}1.10$ mg/day in patients with thiazide (n=36) and $3.58{\pm}1.14$ mg/day in patients without diuretics (n=82), which was statistically significant (p=0.009). INR values per stable warfarin dose in patients with diuretics and thiazide were $0.84{\pm}0.31$ and $0.90{\pm}0.34$, respectively, which were statistically different from those without diuretics ($0.72{\pm}0.21$, P=0.010 and P=0.006, respectively). Age, gender, and concurrent use of thiazide diuretics were found to have significant influence on the warfarin response from multivariate analysis. Conclusion: Our study showed that the concurrent use of thiazide diuretics could increase the response of warfarin in patient with atrial fibrillation. Therefore, clinicians should be aware that warfarin dose needs to be adjusted when it is used with thiazide diuretics concomitantly.

Comparison of treatment effects between the modified C-palatal plate and cervical pull headgear for total arch distalization in adults

  • Park, Chong Ook;Sa'aed, Noor Laith;Bayome, Mohamed;Park, Jae Hyun;Kook, Yoon-Ah;Park, Young-Seok;Han, Seong Ho
    • 대한치과교정학회지
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    • 제47권6호
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    • pp.375-383
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    • 2017
  • Objective: The purpose of this study was to evaluate the dental and skeletal effects of the modified C-palatal plate (MCPP) for total arch distalization in adult patients with Class II malocclusion and compare the findings with those of cervical pull headgear. Methods: The study sample consisted of the lateral cephalograms of 44 adult patients with Class II Division 1 malocclusion, including 22 who received treatment with MCPP (age, $24.7{\pm}7.7years$) and 22 who received treatment with cervical pull headgear (age, $23.0{\pm}7.7years$). Pre- (T1) and post-treatment (T2) cephalograms were analyzed for 24 linear and angular measurements. Multivariate analysis of variance was performed to evaluate the changes after treatment in each group and differences in treatment effects between the two groups. Results: The mean amount of distalization at the crown and root levels of the maxillary first molar and the amount of distal tipping was 4.2 mm, 3.5 mm, and $3.9^{\circ}$ in the MCPP group, and 2.3 mm, 0.6 mm, and $8.6^{\circ}$ in the headgear group, respectively. In addition, intrusion by 2.5 mm was observed in the MCPP group. In both groups, the distal movement of the upper lip and the increase in the nasolabial angle were statistically significant (p < 0.001). However, none of the skeletal and soft tissue variables exhibited significant differences between the two groups. Conclusions: The results of this study suggest that MCPP is an effective treatment modality for total arch distalization in adults.

정맥주입요법 간호실무지침 수용개작 (Adaptation of Intravenous Infusion Nursing Practice Guideline)

  • 구미옥;조용애;조명숙;은영;정재심;정인숙;이영근;김미경;김은현;김지혜;이선희;김현림;윤희숙
    • 임상간호연구
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    • 제19권1호
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    • pp.128-142
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    • 2013
  • Purpose: This study was conducted to adapt the previously developed intravenous infusion guidelines with good quality for development of the evidence-based intravenous infusion nursing practice guideline in Korea. Methods: Guideline adaptation process was conducted according to guideline adaptation manual version 2.0 developed by NECA (Kim, Kim et al., 2011) which consisted of three main phases, 9 modules including a total of 24 steps. Results: Adapted intravenous infusion nursing practice guideline was consisted of 19 domains and 180 recommendations. The domains and number of recommendations in each domain were: general guide, 4; assessment, 1; vascular access device selection, 4;site selection, 14;site preparation, 5;site care, 29; maintaining patency, 11; blood sampling via vascular access, 4; vascular access device exchange and removal, 9; add-on device selection, 27; infusion related complications, 63; education, 7; and documentation and report, 2. There were 11.9% of A, 28.4% of B, 58.7% of C in grade of recommendations. Conclusion: Adapted intravenous infusion nursing practice guideline is expected to contribute providing an evidence based practice guides for intravenous infusion. The guideline is recommended to be disseminated to nurses nationwide to improve the efficiency of intravenous infusion practice.

노인의 에너지 섭취 부족과 관련된 사회환경요인 분석 (Socio-economic status is associated with the risk of inadequate energy intake among Korean elderly)

  • 소은진;정효지
    • Journal of Nutrition and Health
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    • 제48권4호
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    • pp.371-379
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    • 2015
  • 본 연구는 우리나라 노인세대가 겪는 사회환경요인이 에너지 섭취 부족에 어떠한 영향을 주는지 알아보고자 제5기 1차년도 (2010) 국민건강영양조사 자료를 바탕으로 분석을 실시하였으며, 결과를 요약하면 다음과 같다. 1) 남녀 모두 연령이 70세 이상이고, 경제활동을 하지 않는 경우, 활동제한이 있는 경우 에너지 섭취 부족 비율이 높은 것으로 나타났다. 그 밖에 남자는 배우자는 없이 가족과 동거하는 경우, 학력, 그리고 가구소득, 여자는 자살생각 여부가 에너지 섭취량에 영향을 주는 것으로 분석되었다. 2) 에너지 필요 추정량의 75% 미만으로 섭취하는 노인의 비율은 남자는 23.7% (196명), 여자는 31.1% (324명)으로 나타났으며 에너지 섭취량이 75% 미만인 그룹의 경우 탄수화물 섭취 비율이 유의적으로 높은 것으로 분석되었다. 3) 에너지 섭취가 부족한 그룹의 경우 남녀 모두 돼지고기와 소고기가 10위 안에 포함되지 않았고 배추김치와 된장이 20위 안의 주요 급원식품에 들었다. 4) 최종적으로 남녀 모두 학력 (남자: OR = 1.480, 여자: OR = 1.614)과 경제활동 여부 (남자: OR = 1.751, 여자: OR = 1.464)가 에너지 섭취 부족에 영향을 주는 요인으로 분석되었으며, 이 외에도 남자는 70세 이상의 고령 (OR = 1.475), 여자는 배우자 없이 가족과 동거하는 경우 에너지 섭취 부족일 확률이 1.496배로 나타났다. 이상의 연구 결과 노인의 에너지 섭취량은 노화로 인한 신체적 생리적 변화 외에도 노인이 속한 사회환경, 사회구조적 변화에 민감하게 반응한다는 것을 확인할 수 있었다. 효과적인 노년기 영양관련 정책 수립을 위해서는 사회환경의 변화에 따른 영양취약계층을 선별하는 것이 무엇보다 중요하므로, 본 연구에서 확인한 노인의 에너지 섭취 부족과 관련된 요인들은 노년기 영양정책을 계획하는 데 있어 기초자료로 활용될 수 있을 것으로 사료된다.

만성통증과 사회적지지가 노인의 우울과 자살의도에 미치는 영향 (Effects of Chronic Pain and Social support on Depression and Suicide in the Elderly)

  • 이주연;문영숙
    • 디지털융복합연구
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    • 제13권10호
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    • pp.445-458
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    • 2015
  • 본 연구는 65세 이상의 노인을 대상으로 만성통증과 사회적지지가 노인의 우울과 자살의도에 미치는 영향을 파악하고자 연구되었다. 연구대상은 복지관을 이용하는 만성통증이 있는 노인을 대상으로 자료수집기간은 2014년 4월 20일부터 5월 20일까지 시행하였고, 최종 178부를 자료를 분석하였다. 수집된 자료는 SPSS를 이용하여 실수와 백분율, 평균과 표준편차, t-test, ANOA, 상관관계, 다중회귀분석을 하였다. 연구분석 결과 만성통증은 우울과 자살의도에 유의한 정적 상관관계가 나타났으며 사회적지지는 우울과 자살의도에 유의한 부적 상관관계가 나타났다. 또한, 만성통증은 자살의도에 영향을 미치며 사회적지지는 우울에 영향 미치는 가장 강력한 변수로 확인되었다. 노인의 우울과 자살의도에 있어서 만성통증이 높을수록 우울과 자살의도는 높아지고 사회적지지가 낮을수록 우울과 자살의도가 높아지는 결과를 나타냈다. 따라서 노인의 우울과 자살을 예방하기 위해 가족과 사회적 관심과 사회적지지 서비스 개발이 필요하며만성통증을 경감시켜 줄 수 있는 다양한 프로그램 개발과 중재가 필요하다.

Treatment outcomes of curative radiotherapy in patients with vulvar cancer: results of the retrospective KROG 1203 study

  • Kim, Youngkyong;Kim, Joo-Young;Kim, Ja Young;Lee, Nam Kwon;Kim, Jin Hee;Kim, Yong Bae;Kim, Young Seok;Kim, Juree;Kim, Yeon-Sil;Yang, Dae Sik;Kim, Yeon-Joo
    • Radiation Oncology Journal
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    • 제33권3호
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    • pp.198-206
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    • 2015
  • Purpose: We evaluated the prognostic factors and clinical outcomes of 56 patients with vulvar cancer treated with curative radiotherapy (RT) or concurrent chemoradiotherapy. Materials and Methods: Overall survival (OS) and disease-free survival (DFS) were assessed retrospectively. Prognostic factors evaluated included age, International Federation of Gynecology and Obstetrics (FIGO) stage, TNM classification, tumor size, treatment modality, RT duration, and RT field. The association between the tumor human papillomavirus (HPV) status and survival was analyzed in 35 patients. Results: During the median follow-up of 2.8 years (range, 0.3 to 18.9 years), 21 patients (37.5%) experienced treatment failure. Fifteen patients (27%) had local failure: nine (16%) local failure only, three (5%) locoregional failure, two (4%) local and distant failure, and one (2%) locoregional and distant failure. Of 56 patients, seven (13%) had persistent disease at the first follow-up at 2 months and all but one died within a year after completing RT. The 5-year OS and DFS were 51.6% and 44.0%, respectively. In multivariate analysis, clinical size ${\geq}3$ cm predicted a poor prognostic factor for DFS (p = 0.040) and age (${\geq}70years$) was poor prognostic for DFS (p = 0.032) and OS (p = 0.048). Patients with HPV-positive tumors tended to have better 5-year OS and DFS, but the differences were not significant statistically. Conclusion: Clinical size ${\geq}3$ cm was a significant prognostic factor for DFS. However, age was the most important prognostic factor for DFS and OS in patients treated with curative RT. Further studies are needed to determine which treatment should be considered for old age ${\geq}70years$.