• 호스피스학술지
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• 제5권1호
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• pp.14-25
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• 2005

This study was conducted to examine the present state, types of services, difficulties, education programs, motivation, satisfaction and attitude of hospice volunteers and also to suggest supporting programs for the volunteer. For these purposes, a questionnaire was distributed among the 200 hospice volunteers in ten hospice organizations in Daejeon and Chungcheong province. In this research, 85.5% of the respondents were women and most of them were housewives in their forties and fifties. The majority of hospice volunteers had an education background of more than high school. Christianity (94%) was the dominant religion of volunteers. Among the service area of the hospice, emotional caring, such as listening closely and establishing empathy were the most frequently done by the respondents and the next one was spiritual care. Hospice volunteers who had started with altruistic motivation show more dynamic activities in emotional, spiritual, physical caring and so on, than those with non-altruistic motivation. Most of the respondents expressed that they felt a hospice volunteer was valuable. However they had a hard time to overcome the sorrow coming from sharing empathy with the dying patients. Those who had started with altruistic motivation usually took part in two times per a week and had more positive attitude. Volunteers who had been working more than five years showed better attitude than those who had been working less than three years. The longer the voluntary services, the more positive attitude experienced by volunteers. Hospice volunteers encountered the most considerable difficulty with lack of background knowledge and their actual capability. Insufficiency of time was the next reason for the considerable difficulty of the hospice volunteer. On the other hand, those who served more than twice per week replied that lack of background knowledge and their capability were the least considerable difficulty. Insufficiency of time was the reason of difficulty for male volunteers, as well as for females under thirty and those in their forties and fifties respectively. Generally most of the hospice volunteers (70%) were satisfied with their services and they usually satisfied with physical caring, spiritual caring, hospice's family caring. The less difficulty in voluntary services, more satisfaction for the volunteers in the end. There is a positive correlation between a attitude of the hospice volunteer and frequency of voluntary services while the volunteers' difficulty affect negatively their attitude as well as the frequency of voluntary services. Most of the hospice volunteers want to have more education about basic skills, volunteer's attitude and role, spirituality, the way of attending on the hospice and so on. Most of them considered discussion and sharing different cases as the most effective method. They also wish to had more supporting programs for the hospice volunteers(in the order of their needs) such as regular events, newsletters, personal concern, social meetings among the volunteers, insurance and minimum expenses. Based on the study results, more programs should be run in order to activate the voluntary services regardless of their gender and education background. A continuous practical supporting policy and education programs are required in order to provide special education and training courses considering every field of voluntary services. Expanding the role of the volunteers allows them more opportunities to take part in voluntary services and th activate participation. It is necessary to establish a new hospice system as a part public medical system, which can not only facilitate the voluntary services for a hospice but also enhance professional hospice volunteers. Finally, experts are needed to operate the voluntary services effectively.

• 한국콘텐츠학회논문지
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• 제19권4호
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• pp.41-53
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• 2019

헬스케어의 패러다임이 치료 중심에서 예방 중심으로 변화함에 따라, 질병 예방과 관련된 제품 및 서비스가 국내외로 많이 등장하고 있다. 스마트 헬스케어는 만성질환자 수의 증가, 의료비 부담의 증가 등의 보건의료 문제점의 대안으로 언급되어 기업 및 정부는 산업 확산 움직임을 보여주고 있다. 기업은 웨어러블 기기, 앱 등의 형태로 제품 개발 및 출시를 하고 있고, 정부는 보건소를 중심으로 모바일 헬스케어 사업을 시행하고 있다. 본 연구는 소비자의 스마트 헬스케어 제품 및 서비스 이용에 미치는 요인을 건강정보이해능력(Health Literacy)와 건강관련 개인특성을 중심으로 탐색적 연구를 진행하고, 정책적 시사점을 제공하고자 한다. 전국의 20대 이상 소비자 1,027명을 대상으로 온라인 설문조사를 실시하고 의사결정나무 기법으로 요인을 분석하였다. 연구 결과, 응답자의 대부분(76.9%)은 사용 경험이 없는 것으로 나타났지만 건강정보이해능력 중 '대중매체 정보의 활용'의 어려움 정도에 따라 사용 경험에 차이를 보였다. 그 밖에는 신기술 활용 의향 정도, 주변인의 조언 이해, 건강검진 유무가 관련이 있는 것으로 분석되었다. 스마트 헬스케어를 통한 자가 건강관리가 가능하려면, 건강정보를 대중매체로부터 탐색하고 활용할 수 있는 소비자의 건강정보이해능력이 제고되어야하며 이를 위한 정부와 기업의 노력이 필요하다.

• 식품과학과 산업
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• 제55권2호
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• pp.154-165
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• 2022

인간이 최소 8,500년 이상 이용하고 섭취를 해온 누에는 화학물질과 공해에 매우 민감하다. 뽕나무 밭이나 누에를 키우는 잠실 근처의 농작물 재배용 밭이나 과수원에서 병해충 방제를 위해 살포한 농약이 비산 되면, 매우 적은 양의 농약이 누에의 먹이가 되는 뽕나무 잎을 오염시키거나, 잠실로 침투해도 누에 유충은 섭식을 더 이상 하지 않아서 성장을 멈추고 죽는 특징이 있다(양잠보급과, 2022). 그리고, 누에 유충은 가축 배설물에서 나는 냄새와 차량통행에서 나오는 공해 물질과 먼지에도 매우 민감하므로(양잠보급과, 2022), 정상적으로 성장한 누에는 천연식품으로 간주할 수 있다. 누에제품들에 대한 성분분석결과를 보면 5령3일 동결건조 누에 분말(권해용 등, 2019)과 홍잠 분말(Ji 등, 2016, 2017, 2019)에서는 중금속이 전혀 검출되지 않는다. 그러므로, 누에를 이용하여 제조된 제품들의 안전성은 다른 곤충식품이나 육류에 비하여 매우 높다. 하지만, 누에는 오로지 뽕 나뭇잎 만을 섭취하고, 5령 동안 전 생애 섭취하는 뽕 나뭇잎의 80% 이상을 섭취하기 때문에 단 기간 고강도의 노동이 필요하므로, 제품의 단가가 높은 단점을 가지고 있다. 이러한 문제점을 해결하기 위해서는 누에 사육에 자동화 시스템을 도입해서, 노동력 투입을 줄이면서 품질이 일정한 제품을 생산할 수 있어야 한다. 현재 선진국들은 의생명과학의 발전과 개인 위생의 증진으로 기대수명이 빠르게 늘어나고 있다. 대한민국을 포함한 많은 여러 선진국은 2030년에 기대수명이 90세를 초과할 것이라고 예측되고 있다(Kontis 등, 2017). 하지만, 65세 이상의 노인은 하나 이상의 만성질환으로 고통을 받고 있어서 기대수명(또는 기대여명)과 질병없이 건강하게 살아가는 건강수명과는 9년 내외의 차이가 나고 있다(Garmany 등, 2021). 2021년 현재 노인인구의 비율은 16.5%이지만(통계청, 2021), 노인이 사용하는 건강보험 진료비 비율은 2020년에 이미 총 진료비에서 43.4%에 도달하였다(건강보험심사평가원, 2021). 그러므로, 향후 개인과 국가의 의료비용을 절감하기 위해서는 건강수명을 늘려야 한다. 누에의 산물들은 다양한 건강증진 효과가 있고(표1과 2), 인류가 이미 8500년 이상 섭취를 하여온 대부분의 사람들에게는 부작용이 없는 식품이다. 그리고 누에 산물 중 홍잠의 경우는 동물 모델의 건강수명을 증진시켜 줌이 알려져 있으므로(Choi 등, 2017b; Mai 등, 2022; Nguyen 등, 2016; Park 등, 2022), 향후 홍잠을 이용한 새로운 제품을 개발하고 판매하여 대중화되면, 국민들의 건강수명이 증대됨으로서 의료비용의 감소를 가져오고 개인의 행복이 증진될 것이다.

• 공업화학
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• 제33권5호
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• pp.545-550
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• 2022

급격한 고령화 사회로의 진입과 서구화된 식습관에 의해 협심증, 심근경색증, 고혈압 등에 의한 심장질환자의 수가 5년간 10만명 이상 증가했다. 심장질환은 지난 8년간 꾸준히 국내 사망원인 2위를 기록 중이며, 이로 인해 연간 소모되는 의료비는 6조원에 달한다. 증가한 환자와 함께 다양한 치료법이 제시되고 있는 가운데, 현재 보편화 된 관상동맥중재시술 중 스텐트 삽입술의 단점인 재협착이나 장기간 이중항혈소판제 복용으로 인한 출혈의 위험 증가 등의 문제점을 보완하기 위해 약물코팅풍선카테터가 개발되어 점차 상용화되고 있는데, 국내에선 2010년 'SeQuent Please^Ⓡ (비브라운코리아)'라는 제품이 처음 출시되면서 약물코팅풍선카테터를 사용한 시술이 시작되었고, 이후 2012년 보험급여가 적용되면서 그 사용량이 본격적으로 늘어났다. 약물코팅풍선치료는 국내뿐만 아니라 전 세계적으로 사용이 증가하고 있는데, 특히 일본을 포함한 아시아태평양 지역에서 그 사용량이 급격히 증가하고 있다. 현재까지 국산 제품의 수요가 증가하고 있는 상황이며 향후, 동물시험 및 임상시험에서의 성능이 입증된다면 위험성이 높은 스텐트 삽입술에 비해 효과적인 시술이 될 것이라 예상한다.

• Journal of Korean Neurosurgical Society
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• 제65권5호
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• pp.741-750
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• 2022

Objective : In March 2020, World Health Organization declared a global pandemic caused by a novel coronavirus (SARS-CoV-2). The disease caused by this virus is called COVID-19. Due to its high contagiousness, many changes have occurred in overall areas of our daily life including hospital use by patients. The aim of this study was to investigate the impact of COVID-19 on volume of spine surgery in South Korea using the National Health Insurance database and compare it with the volume of a homologous period before the pandemic. Methods : Data of related to spine surgery from January 2019 to April 2021 were obtained from the National Health Insurance and Health Insurance Review and Assessment Service database. Primary outcomes were total number of patients, rate of patients per 100000 population, and total number of procedures. The number of patients by hospital size was also analyzed. Results : COVID-19 outbreaks occurred in South Korea in March, August, and December of 2020. Compared to the previous year, the total number of patients who underwent spinal surgery showed a decrease for 2-3 months after the first and second outbreaks. However, it showed an increasing trend after the third outbreak. The same pattern was observed in terms of the ratio of the number of patients per 100000 population. Between 2019 and 2021, the mean number of spine surgeries per month tended to increase. Mean annual medical expenses increased over the years (p=0.001). When the number of spine surgeries was analyzed by hospital size, proportion of tertiary general hospital in 2021 increased compared to those in 2019 and 2020 (vs. 2019, p=0.012; vs. 2020, p=0.016). The proportion of general hospital was significantly decreased in 2020 compared to that in 2019 (p=0.037). Conclusion : After the COVID-19 outbreak, patients tended to postpone spinal surgery temporarily. The number of spinal surgeries decreased for 2-3 months after the first and second outbreaks. However, as the ability to respond to the COVID-19 pandemic at the hospital and society-wide level gradually increased, the number of spine surgeries did not decrease after the third outbreak in December 2020. In addition, the annual number of spine surgeries continued to increase. However, it should be noted that patients tend to be increasingly concentrated in tertiary hospitals for spinal surgery.

• 보건행정학회지
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• 제34권1호
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• pp.68-77
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• 2024

연구배경: 우울은 저하된 기분이 비교적 경미한 수준인 일상 우울과 병적 상태인 임상적 우울로 구분할 수 있다. 우울 경험은 치료순응도 저하, 신체증상 등을 경험하게 하여 의료이용을 높일 수 있으나 우울 중 임상적 우울 집단은 질환에 대한 사회적 편견을 경험하여 의료이용이 제한될 수 있다. 의료이용은 개인 나아가 사회 문제의 원인이 되어 중요하다는 측면에서 본 연구는 임상적 우울 집단, 일상 우울, 비우울 집단의 의료이용을 비교하여 살펴보고자 한다. 방법: 일반화 성향점수(generalized propensity score) 기반 처치역확률가중기법(inverse probability of treatment weighting)을 이용하여 비우울, 일상 우울, 임상적 우울 집단 간 공변량의 불균형을 최소화하고 우울과 의료이용, 총진료비의 관계를 각각 음이항 회귀분석과 로그변환한 선형회귀분석을 통해 확인하였다. 결과: 우울은 여성, 소득이 낮은 집단, 교육수준이 낮거나 배우자가 없거나 건강보험에 가입되지 않았거나 경제활동을 하지 않은 집단에서 높았으며, 우울중 임상적 우울은 경제활동을 하지 않거나 민간의료보험에 미가입된 집단, 질환의 보유개수가 많은 집단에서 비중이 높았다. 의료이용 횟수는 우울 집단(일상 우울 집단 및 임상적 우울 집단)이 비우울 집단보다 유의하게 높았으며, 임상적 우울 집단이 일상 우울 집단보다 유의하게 높았다. 총진료비는 우울 집단이 비우울 집단보다 높았으나, 임상적 우울 집단과 일상 우울 집단 간에는 유의한 차이가 없었다. 결론: 의료이용은 비우울 집단보다 우울 집단(임상적 우울 집단 과 일상 우울 집단)에서 높았으며, 임상적 우울 집단보다 일상 우울 집단에서 높았다.

• 한국조경학회지
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• 제52권4호
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• pp.104-119
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• 2024

만성질환으로 인한 진료비 부담과 사회적 자본의 손실은 전 세계적으로 문제가 되고 있으며, 만성질환의 예방과 관리를 위해 다양한 분야에서의 종합적이고 포괄적인 대책이 요구되고 있다. 만성질환 환자 건강 문제의 근본적인 원인 해결과 기존의 치료법을 지원하는 방법으로 사회적 처방이 효과적인 것으로 나타났는데 특히, 사회적 처방을 기반으로 자연과 녹지의 치유 효과를 활용한 녹색처방이 해외 여러 국가들에서 도입되고 있다. 녹색처방은 보건의료인이 환자에게 만성질환의 예방 및 관리의 목적으로 공원녹지에서의 활동이나 자연환경 체험을 권고하는 것을 말한다. 본 연구에서는 국가 체계 아래에서 녹색처방을 도입하여 운영 중인 영국과 미국 사례의 정책체계를 중심으로 녹색처방의 도입배경, 관련정책, 운영방식을 비교 분석하였다. 이를 바탕으로 국내에 녹색처방을 도입하기 위한 실효적인 계획을 수립할 수 있도록 시사점을 네 가지로 제안하였다. 첫째, 녹색처방의 정책 수립에 앞서 녹색처방에 대한 관심과 연구가 바탕이 되어야 한다. 둘째, 국가 보건의료체계에 맞는 실행계획 수립이 요구되며 정책상 계획이 뒷받침되어야 한다. 셋째, 장기적이고 점진적인 관점에서의 녹색처방 도입이 요구된다. 넷째, 녹색처방 제도 도입과 실행에 있어 전방위적 협력이 필요하다. 본 연구는 향후 국내 녹색처방 도입에 앞서 논의가 이루어지기 위한 기초자료로 활용될 수 있을 것이다.

• 기본간호학회지
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• 제3권2호
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• pp.213-233
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• 1996

This study was made on 274 apoplectics patients who received the rehabilitation therapy and tests on physical, psychological and social adaptations as outpatients in 23 general hospitals in the Seoul and Kyungi area. The basic data on degree of improvement of apoplectic patients studied from rehabilitation therapy. Data was collected over a period of 63 days, from February 21st till April, 23, 1996. The assigned physical therapist conducted direct interviews with patients after he answered the distributed questionnaires for each individual patient. The colleted data was processed by the $SPCC/C^+$ method. The results of the tests conducted to meascne the the degree of ADL dependency, depression and social activity corresponding to the physical, psychological, and social adaptation. The details are ; 1) The test to meascne the degree of ADL dependency, corresponding to the study of physical adaptation of CVA patients, indicated a mean score of 2.57(ideal score is 1.0) with a standard deviation of ${\pm}0.75$. The worst score was 3.95 while the best score was a perfect 1.0, representing a severe range of dependency. The distribution was centered with a median of 2.65 and a mode of 2.68. 2) The test to meascne the degree of depression which corresponds to the level of psychological adaptation yielded a mean of 2.99 which is higher than the normal limit of 2.45. The standard deviation was ${\pm}0.52$ and the worst score and the best score were 4.35 and Respectirdy. The distribution was centered with a median of 3.00 and a mode of 3.00. 3) The test to meascne the degree of social activities for the level of social adaptation indicated a very low mean score of 26.52 (perfect score is 144), with the standard deviation of ${\pm}16.23$. Some patients scored as high as 100, but others scored as low as 3. The distribution of social activities at a very low level was shifted to the left with a median of 24.00 and a mode of 20.00. 4) Factors influencing the level of physical, psychological and social adaptation are as follows : Factors significantly influencing the level of physical adaptation measured by ADL dependency are age, personal guardian, payer of medical expenses, and paralysis of the right arm, right leg and facial paralysis. Factors significantly influencing the level of psychological adaptation measured by the degree of depression, are age, marital status, education, medical history of individual and family, speech impediment, and facial paralysis. Factors significantly influencing the level of social adaptation measured by the degree of social activity are age, marital status, education, employment status, and the burden of medical expense. 5) The Corelationship is significant(9.00), between ADL dependeing as degree of physical adaptation and depreseion as degree of psychologial adaptation. ADL dependency is proportional to depression. But social activity is inversely protional to ADL dependeny and depression. In conclusion, the increased care for physical function of the patients is not the only necessary means to better facilitate the appropriate adaptation of CVA patients. The introduction of a solid rehabilitation program for psychological and social adaptation will also play the integral part of the treatment of CVA patients.

• 대한간호학회지
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• 제11권2호
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• pp.33-54
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• 1981

The purposes of this study were to determine the relevant nursing needs of patients following discharge; to identify the degree of their nursing needs; to identify types and status of discharge order and information given to patients; and to determine their specific nursing needs according to their diagnosis. In addition, opinions toward home care services provided by hospitals or by public health nurses and appointment plans with their physicians were also asked in order to determine the necessity of follow-up care for the patient after discharge. Nine hundred and eighty eight subjects were collected among patients being discharged from one national university hospital and four city hospitals. Data were collected from June,1979 to December,1979 using questionnaires and interviews. On the bases of these data the following findings were observed; 1) Almost 40 percents of total subjects discharged from the hospital with some or great degree of nursing needs in general. The most problematic nursing needs were needs for comfort which include needs for releaving pain, for sound sleep and rest, because these needs can only be met by professional help. More than 50% of total subjects have this problem. 2) Needs for mental health, general metabolism, general hygiene and activities and safety were observed in more than 20 percent of subjects. 3) Discharge orders on diet and oral medication were recorded in patients' charts in 70% of all cases. However, more than fifty percents of patients have not been told these information from doctors or nurses. Even though some of them might have had appointment plans with their physicians, they would not keep the appointments unless they completely understood the necessity of the follow-up care. If they have not had any appointment or would not visit the out-patient clinic, there is no method of caring them and prerenting funther discomfort or complications. Even in injection, ski care, dressing and bath, only one thirds of the subjects having recorded discharge orders understood what they need after discharge. The rest of cases have not known what to do for their further care. 4) More than 80 percents and 70 percents of total subjects agreed to a system of home care services provided by hospitals or public health nurses respectively. That is, regardless of sources of medical expenses, most of patients wanted to be taken care of at home following discharge. 5) While more than half of the patients having benefit of medical insurance or paying fully by themselves had appointment plans with their physicians, only one thirds of the patients fully or partially paid by government had appointment plans with their physicians. These results ex-plain that the appointment plan is directly associated with their economic power. This indicates that the home care services are more needed to the people with lower economical status. 6) Those who have been in the hospital more than 24 days wanted !o have home care services more than those who had less hospital days. They also had more appointment plans than other groups. 7) More than 70 percents of the subjects who had been in a university hospital and approximately 30 percents of the subjects in the city hospitals had appointment plans with their physicians. 8) Those who had the cerebrovascular disease, cancer or hypertension demanded more nursing needs such as needs for comfort, for general metabolism and for mental health. 9) Factors which were associated with the degree of patients' nursing needs were age, duration of hospitalization, opinion toward home care services given by public health nurses, hospital appointments and types of hospital. That is, the older they were and the longer the periods of hospitalization were, the higher were their nursing needs. The more they had nursing needs, the more they wanted to have nursing services and had appointment plans. It can be concluded that there is a great demand for a positive and systematic home care services to the people who have been discharged from hospitals following critical care. This program is definitely demanded for the low income groups of people with less education with the financial assistance of the government or other funding agencies.

• 대한예방한의학회지
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• 제2권1호
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• pp.87-111
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• 1998

For the newly approach of policy with the old aged era at hand, the result which examines the 1,200 students attending professional colleges and upward in three small-to-medium sized cities, for two months, from October 1, 1996 to November 30, in order to know the change of consciousness of the growing modern young intellectual age group is as follows. 1. The objects of survey consist of 72.1% of women, 40.4% of 20 to 21 age, 49.1% of atheists, and people from big cities and fishing and agrarian village occupy equally 40.2%. Concerning the long-termed residents, 49% of them dwell in big cities. In case of the parents' age is more than 55, 31.5% in fathers, and 10.9% in mothers. 2. The types of housing in which they desire to reside in their getting older are : 72.8% of them hope to live in individual houses, 16.6% in apartments or villas, and 3.4% in social welfare facilities. Out of respondents, compared with other groups, man rather than woman, those who are 20 to 21 age group and from fishing and agrarian villages and have over 7 family members and live with their parents have a higher preference for independent houses. 3. The districts in which they hope to live when they are old are : 41.6% of them, with the highest percent, hope to live in farming villages, the older they are, the more they hope to live in agricultural district, and women of 21 years and upward hope to live in big cities. On the other hand, the preferable degree for social welfare facilities is higher each in people who are 24 years and upward, buddhists, self-boarding students, and the more poorly they are off, the higher the percent is. 4. The types of preferable welfare facilities for the elderly are : 58.2% of them think silver towns desirable, 28.4% think the charged (or free) elderly welfare facilities. Compared with other groups, the percentage which prefer silver towns is higher in women, people from big cities, residents of main family, long-termed city residents, people with higher income, people having grandparents alive, and people who had experience of taking lectures on hygienics or social welfare. 5. 50.3% of the respondents insist that provision of living expenses against old age should be insured by social security system, and 42.8% by the elderly themselves. The percentage of the former shows higher in people of 21 years and upward, women, residents of fishing and agrarian villages, christians, people in more needy circumstances and people who have experience of using a medical institution. 6. Compared with other nations, 54.5% of the respondents have an opinion that elderly welfare and welfare work in Korea stays in insufficient level and most of them are women, people from farming village, residents of head family, people having younger parents and people being worse health condition, and they have a more positive attitude about the elderly welfare work. 7. 92.3% of the respondents answered that a national budget for the elderly welfare is scarce, and the percentage is higher in people who are older, residents of big cities, people in lower living condition and people in worse health condition. 8. 35.2% of the respondents answered that the proper cost of their old age must be over 220mi11ion. The more a family's total income is, the higher the percentage is. 9. The factors which have an effect on the preference of silver towns are sex(p<0.01, the type of the present residence(p<0.05), and a family's total income(p<0.05). 10. From the survey result of the above, we comes to the conclusion that, for the sake of welfare of the increasing elderly population, government authorities and parties concerned must exert their utmost for the elderly welfare by increasing a budget of it and establishing a number of facilities of the elderly welfare and silver towns located in fresh and comfortable villages. In addition, they have to set up a course of hygienics in all the colleges and instruct the contexts on hygienic welfare as well.