• Quality Improvement in Health Care
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• v.4 no.1
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• pp.82-103
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• 1997

Background : With increased concerns about variation among physician's practice pattern and their impact on the quality of care, clinical practice guidelines have been developed by many different organizations, with differing aims and incentives. From the same point of view, there is growing interest in the development of clinical practice guidelines in Korea, but with only a few examples. As a result, there is not much exploration on the incentive and barrier to develop guidelines as well as description on the development process. The purposes of this study are to describe the process of the four different clinical practice guidelines in a hospital setting, and to identify incentives and barriers in the development of guidelines. Methods : For this research, a clinical practice guideline development committee and four clinical practice guideline development teams were organized in a university hospital which has more than 1,200 bead. Twenty eight doctors, three nurses, and one technician participated as members of development teams for eight months. Four to six meetings were held, and three to seven departments in the hospital were involved. Results : The topics which developed into clinical practice guidelines were cardiopulmonary resuscitation(CPR), blood transfusion, anticoagulation, and angiography. The main goals set by teams were education(CPR, angiography), risk management(blood transfusion), and to enhance quality of care(anticoagulation). Among four teams, only in the team for anticoagulation guideline medical record review and pilot-testing were performed. Also literature review was not carried out systematically. However, all the guidelines were developed by multidisciplinary be used as standard protocols in the practice. Conclusion : Experience and skill in developing process has to be improved to have a more valid and useful practice guideline. In particular, literature review and problem identification by examining medical record should be emphasized. Also further studies on the clinical outcomes of the guidelines application and changes in physicians' behaviors would be required.

• Journal of Digital Convergence
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• v.13 no.11
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• pp.197-204
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• 2015

This study aims to identify the effects: quality of chest compressions, height and weight of pregnant women cardiac arrest while lying $30^{\circ}$ inclined to the left has on the quality of chest compressions administered by 119 EMT. For the purpose of this study, 62 members of 119 EMTs in M, N, S, Y cities and G cities of J province agreed to join in the test and the test was conducted from June 15 to 16 in 2015. Two mannequins (Resusci Anne$^{(R)}$) were used for the study and the chest compression process was recorded with the use of the Laerdal PC Skill Reporting System$^{(R)}$. As a result, it was discovered that for patients with a $30^{\circ}$ left inclination, who were below 170 cm in height and 65 kg in weight, the proper frequency and depth of compression were unsatisfactory. With this in mind, training programs and instruments that can improve the quality of chest compressions depending on a person's (patient's) height and weight should be developed.

• Korean Journal of Health Education and Promotion
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• v.19 no.3
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• pp.73-85
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• 2002

This study was conducted to examine community residents' knowledge level and related factor on electronic wave in order to provide basic data for development of education and publicity program. 2,000 people, who lived in five big cities and five small and medium cities, were selected ad subjects of this study. The data were collected from May 1, 200 I to August 31, 2001. The results of this study are as follows. According to the average knowledge level of harmful affect of electronic wave on health in general characteristics, female was higher(37.40 ± 5.24 points) than male; ‘forties’ was highest(37.77 ± 5.69 points); ‘married spouse’ was high(36.84 ± 5.59 points); ‘living in small-ta-medium city’ was high(36.84 ± 5.32 points). ‘university graduate’ was highest(37.41 ± 5.32 points) in education level, ‘middle class’ was high(36.61 ± 4.96 points) in economic status, ‘professional technician’ was higher(36.68 ± 6.55 points) than other occupations in occupational type. According to the knowledge level of harmful affect of electronic wave on health in health condition by self-judgment, ‘good health condition’ was highest(36.77 ± 4.99 points). In the case of the knowledge level of those who visited medical institutions for last one year, ‘never visited’ was highest(37.19 ± 5.02 points). In the kind of medical institutions, ‘those who visited general hospital’ was highest(36.58 ± 5.63 points). In the way of knowledge obtainments of electronic wave through education and publicity media, ‘school education’ was highest(37.55 ± 5.19 points). According to the score of awareness level of disease incidence related to electronic wave, allergy and erethism was highest(57.8 points on the basis of 100 points). It appeared in order of leukemia, skin disease or skin cancer, dementia, various cancers, cataract, and brain tumor. The variables which significantly influenced knowledge level of harm of electronic wave were knowledge obtainments of electronic wave, age, economic status, daily TV watching period, sex, period of daily cellular phone use, period of working with computer, and daily VTR watching period. The knowledge of community residents concerning harmful affect of electronic wave on health is needed because people's opportunity of exposing to electronic wave is increasing. Especially, it is the demands of the times to provide information on knowledge of each equipment which generate electronic wave. The government, the product manufacturing companies, related social organizations, and education institutions must make efforts to develop the education program which is needed to make people have right knowledge and attitude.

• Journal of agriculture & life science
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• v.43 no.2
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• pp.39-46
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• 2009

Ten animal hospitals in Seoul were selected, and of which 41,305 practice in total for recent 1 year were analyzed based on international classification of disease(ICD) of WHO. Of the entire practice, prophylaxis cases accounted for 42.2%. Of the 9,376 cases of internal diseases, digestive system diseases accounted for 4,957 cases(52.9%), respiratory system diseases 1,776 cases(18.9%), circulatory system diseases 1,239 cases(13.2%), and neoplasms diseases 413 cases(4.4%), respectively. In the estate investment expenses, to be specific, rental guarantee deposit accounted for about 50% of the entire estate cost, foregift(48%), and monthly rent(2%). Dividing the income of animal hospitals into medical service, articles selling, and pet-dog beauty, medical service accounted for 71.6% of the entire sales, selling of articles 16.7%, and pet-dog beauty 11.6%. Publicity work for the animal hospital was done mostly through web sites on internet(47%), then through local advertising papers(23.5%), and through bulletins and telemarketing(11.8%). Manpower of the animal hospitals in this study was mostly composed of veterinarians(45.5%) up to about half of the entire staffs, while there was no veterinary technician who had specialized education in that area.

• Journal of Korean Clinical Health Science
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• v.9 no.2
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• pp.1502-1510
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• 2021

Purpose. To investigate on the awareness of consumers on the expertise of optometrists. Methods. Data were collected and analyzed through an online questionnaire targeting 63 consumers (42 consumers over the age of 10 who wore glasses, and 21 students in the Department of Optometry). Result. As a consideration when choosing an optometrist, consumers considered the variety of products (15 persons(23.8%)), expertise such as optometry and fitting, kindness and credibility (11 persons(17.5%)). Students in the Department of Optometry of each selected expertise such as optometry and fitting, kindness and credibility (5 persons(7.9%)) and the results were high. In addition, about the main tasks of optometrists, 20 consumers (31.7%) and 9 students (14.3%)(SD 14.5±5.5) answered that they were medical technicians specializing in vision health. And the service satisfaction of the optometrist (5 point scale) was evaluated as 3.77 points for the consumers and 3.76 points for students(SD 3.77±0.01), and the reliability (5 point scale) for the consumers was 3.42 points and students 3.53 points (SD 3.48±0.06). In terms of expertise (5 point scale), the consumers scored 3.47 points and current students 3.58 points (SD 3.53±0.06). Conclusion. As a result of the study on consumer awareness of the expertise of optometrists, there was no significant difference in the perceptions of the reliability, service, and expertise of optometrists in the opinion of the consumers and students of the Department of Optometry. In terms of reliability and expertise, students in the Department of Optometry were evaluated somewhat higher than the consumers. Therefore, in order for consumers to be able to trust the expertise of optometrists in the future, it is necessary to take pride in being a medical technician specializing in vision health, and to actively promote and make efforts to inform consumers that optometrists are experts recognized by the state.

• Journal of agricultural medicine and community health
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• v.25 no.2
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• pp.427-440
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• 2000

A comparative study was made about health resources, medical care service statistics and public health service statistics by health subcenters at Jangdong and Jangpyung townships, Jangheung County, Chollanamdo before and after the unification of two health subcenter to improve their function. 1. While two general physicians, one dentist, 4 nurse aids arid one oral hygienist were working at two health subcenters with simple facility with examination room and public health office in 1997 prior to the unification, in 1999 after the unification of two health subcenters 14 staff including a specialist physician, a general physician, a dentist, a herb hygienist, a radiology technician and a physical therapist were working in the new health subcenters equipped with appropriate facilities in two storey building. 2. In 1997 before the unification the yearly total income of two health subcenters was 78,815 thousand won(about 14,000 won per capita) and the amount was 140,376 thousand won(about 25,000 won per capita) in 1999 after the unification. And the income was used for operation of health subcenters excluding personnel expense. 3. While 90.5% of visitors to the health subcenters came for general medical care, and 91.6% came for the revisit before the unification, after the unification 71.2% came for general medical care, 10.8% for dental care, 16.5% for oriental physician's care, 29.7% for the first visit and 70.3% for revisit. Most common problem cared for was musculoskeletal disorder like arthralgia. Average treatment cost per person per month was 9,363 won before the unification and 8,309 won after the unification. 4. Through the comparison of execution rate of public health services before and after the unification. the practice rate of most health service among target population including visiting service for chronic illness, maternal and child health service and immunization service increased after the unification. The practice rate of tuberculosis control service, hypertension control and diabetes management was a little decreased. In conclusion, continuous effort to satisfy all persons in two townships and evaluation are necessary to coincide with the spirit of unification of two health subcenters.

• The Korean Journal of Emergency Medical Services
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• v.6 no.1
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• pp.141-152
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• 2002

The purpose of this study is to provide the basic materials for searching the way of improvement to heighten the emergency medical welfare level by one step further. To achieve this purpose, the subjects of this study were selected 452 college students in Gwangju, using a random sampling method. The statistical analysis methods utilized for analyzing the collected data are frequency analysis, $x^2$ test. The conclusions obtained from these analyses are as following ; 1. In question about necessary optimum number of persons for rescue first aid activity, health and non-health major college students responded by 39.2%, 45.3% respectively that rescue team 15 people, first aid team 3 people is most suitable. But there was no significant difference in major department(p<0.05). 2. In question about security of the public health doctor and the emergency medical technician, all health and non-health major college students are recognizing necessity urgently, but there was no significant difference in major department(p<0.05). 3. In question about 119 rescue first aid team member applying for an examination qualification grant to the department of EMT's graduate, all health and non-health major college students were highest by 52.9%, 52.4% respectively in "necessity" item. But there was no significant difference in major department(p<0.05). 4. Because rescue first aid equipment level appears higher than 41.7% in non-health major college student's case by 54.2% in health major college student's case, health major college students are recognizing that equipment level should be supplemented more but there was no significant difference in major department(p<0.05). 5. In question about equipment supplement, all health and non-health major college students appeared highest by 64.8%, 69.3% in accident type different special equipment. But there was no significant difference in major department(p<0.05). 6. In question about rescue ambulance car size, we could know being thinking that health and non-health major college student each 61.2%, 56.5% is small and narrow that large size of the rescue ambulance amount need. But there was no significant difference in major department(p<0.05). 7. In question about patient's state is worsened, because rescue first aid equipment is inferior, health major college student responded sometimes 55.1%, many 29.5%. very many by 11.5%, while non-health major college student responded 65.8%, 23.1%, 4.0% respectively. There was significant difference in major department(p<0.05). 8. In question about emergency patient must utilize for 119 rescue ambulance car, all health and non-health major college students appeared highest by 38.8%, 41.3% in "not so" item. In question about rescue first aid team's first-aid treatment ability improves more, all health and non-health major college students appeared highest by 58.1% and 58.7% respectively in "improve" item. In question about "119 rescue ambulance car must go more rapidly than now", all health and non-health major college students are recognizing that should be quicker by 58.1%, 60.9% respectively. When called to 119 all health and non-health major college students responded highest by 55.5%, 53.3% respectively that we must receive first-aid treatment direction from a doctor. In question about "119 rescue ambulance car must be made the pay system", all health and non-health major college students responded 74%, 80% respectively in "not so" item. There was significant difference in major department(p<0.05). In conclusions, In oder to provide superior rescue first aid service to people, a public health doctor should be placed in the situation room inside the fire station so that the doctor could instruct the proper emergency treatment suitable for each situation to the rescue first aid team. Also, national education about a first-aid treatment that do to all people is necessarily necessary in emergency delivery system and this should be spread extensively through school education and broadcasting medium and education should be gone side by side, and see that will can save emergency patients' life which is more when these education consists continuously fixed period for public institution of policeman, fire officer etc. specially. And for reinforcement of patient transfer system, public organization must procure special ambulance car so that emergency patient receive first aid treatment while transfer.

• Tuberculosis and Respiratory Diseases
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• v.42 no.1
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• pp.84-92
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• 1995

Background: Nasal applied continuous positive airway pressure(CPAP) is a highly effective method of treatment for obstructive sleep apnea syndrome. More than a decade of accumulated experience with this treatment modality confirmed that it is unquestionably the medical treatment of choice for patients with obstructive sleep apnea syndrome. However it takes long time to reach optimal CPAP pressure. To save the time to reach optimal pressure, it is necessary to clarify the time to reach optimal pressure for treatment of obstructive sleep apnea syndrome. Method: CPAP pressure is titrated during an overnight study according to a standardized protocol. Just before the presleep bio-calibration procedures, the technician applies the nasal mask and switches on the clinical CPAP unit. Initial positive for pressure is typically 3.0 centimeters of water pressure. After sleep onset, the technician gradually increases the pressure until sleep-disordered breathing events disappear or become minimal. The pressure must maintain maximal airway patency during both NREM and REM sleep to be considered effective. Before recommending a final pressure setting, sleep recording and oximetry data are reviewed by an American Board of Sleep Medicine certified Sleep Specialist and a Registrered Polysomnographic Technologist. Results: We examined the time required to reach optimal pressure during routine CPAP titration in 127 consecutively evaluated individuals diagnosed with sleep-disordered breathing. Results indicate that 33% of patients required more than four hours to attain satisfactory titration. This indicates that a four-hour session is marginally enough time, at best, to determine a proper CPAP pressure setting. Moreover, 60 of 127 patients required further adjustment after optimal pressure was reached. These additional pressure trials were needed to confirm that higher pressures were not superior for eliminating sleep-disordered breathing events. Conclusions: The data presented underscore the logistical difficulty of titrating CPAP during split-night studies without modifying the titration procedure. Futhermore, the time needed to reach optimal pressure makes it improbable that proper CPAP titration can be performed during a 2-3 hour nap study.

• The Korean Journal of Emergency Medical Services
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• v.8 no.1
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• pp.87-104
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• 2004

This study selected the fifth and sixth graders of elementary school in Jeollanamdo who can express their opinions of safety consciousness and understand the items of questionnaire as the population. It selected 10 elementary schools under the supervision of Jeonnam Board of Education and sampled 700 students randomly from 2-3 classes in the 5th and the 6th grade. One preliminary survey was conducted to revise and complement the contents and forms of questionnaire with 70 students of a school from Apr. 1 to 6, 2004 and this study was conducted from Apr. 10 to 30, 2004. Data of this study were collected by explaining the purport of study to subjects after obtaining approval of principal and teacher of the school and distributing questionnaires. Total 700 questionnaires were distributed and 681 were collected (97%) and 602 were used for final analysis except 79 lacking responses. The results of this study are as follows. According to demographical characteristics of subjects, 'male' students were 302(50.%) and 'female' students were 300(49.8%) by sex and 'the 5th graders' were 285(47.3%) and 'the 6th graders' were 317(52.7%) in grade distribution. Residents at 'apartment house' were 406(67.4%) in residence type, 'going to school by foot' was 477 students(79.2%), 'high school graduates' were 297(49.3%) in fathers' education, 'high school graduates' were 366 (60.8%) in mothers' education, 'professional and office workers' were 231(38.4%) in fathers' job, 'full-time workers' were 283(47.0%) in mothers' job, and the number of siblings was one except myself in 343 students(57.0%). Respondents on the level of class showing 'good' were 340(56.5%) and those on the degree of adaptation to school life showing 'active' were 349(58.0%). On the characteristics related to safety education, 360(59.8%) responded it was 'very necessary', on the frequency of safety education at school for last one year, 339(56.3%) responded they had 'once or twice', on the frequency of safety education by parents, 279(46.3%) responded they 'often' had it, on the level of safety practice by parents, 347(57.6%) responded they practiced it 'frequently', on the source of knowledge of safety, 223(37.0%) responded they got it from 'parents, siblings and relatives', on the degree of recognizing the need of safety education textbooks, 295(38.5%) responded 'it was needed', on the recognition of necessity of teacher for safety education, 271(45.0%) answered it was very necessary', and on the recognition of qualification of teacher for safety education, 370(61.5%) answered it was 'paramedic'. The mean score of safety consciousness of subjects was 2.72 (SD. 21) of full score 3, having high score over mean score. According to each area, the area showing the highest safety consciousness was safety of fire(2.83), followed by home safety(2.76) and first-aid treatment(2.76), traffic safety(2.71), play and leisure safety(2.66) and school safety(2.56). Items showing statistical differences in the degree of safety consciousness according to demographical characteristics were sex(t=-3.11, p=.002), education(t=2.33, p=.021) and number of siblings(F=3.729, p=.011). In the difference of safety consciousness between both sexes, 'female' students(2.75) showed higher safety consciousness than 'male' students (2.69), and the former also showed higher safety consciousness than the latter in all six areas of school safety, play and leisure safety, traffic safety, fire safety, home safety and first-aid treatment, and there were statistical differences in the areas of play and leisure safety, traffic safety, fire safety and first-aid treatment. According to the differences of safety consciousness by grade, 'the fifth graders'(2.74) showed higher safety consciousness than 'the sixth graders'(2.70) and the former also showed higher safety consciousness than the latter in all six areas of school safety, play and leisure safety, traffic safety, fire safety, home safety and first-aid treatment, and there were statistical differences in the areas of fire safety and home safety. In the safety consciousness by the number of siblings, 'single son or daughter' (2.78) was highest and their safety consciousness was also highest in all six areas of school safety, play and leisure safety, traffic safety, fire safety, home safety and first-aid treatment, and there were statistical differences in the areas of school safety, fire safety and home safety, There were statistically remarkable differences in degree of adaptation to school life (F=15.349, p=.000) and perceived schooling level(F=9.552, p=.000). According to the degree of safety consciousness related to characteristics of safety education, there were statistical differences at the degree of recognizing the need of safety education(F=9.797, p=.000), degree of safety education at school(F=2.595, p=.006), degree of safety education by parents(F=12.709, p=.000), degree of practicing safety by parents(F=17.579, p=.000), source of knowledge of safety education (F=2,715, p=.044), necessity of safety education textbooks(F=3.972, p=.008), need of safety teacher(F=4.137, p=.006) and qualification standard of safety teacher(F=3.016, p=.029).

• The Korean Journal of Emergency Medical Services
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• v.12 no.3
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• pp.87-98
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• 2008

Purpose : This study was designed to figure out the necessity of continuing basic CPR education for the higher grade students of elementary school. The assessment contents were knowledge, practice ability, precision level of CPR skills and continuation of the educational efficiency. Methods : Twenty two students of 4th and 5th grade of elementary school in K city in Chungcheongnam-do were recruited for this study. The study method was a control group of non-synchronized design. A preliminary study was done on October 27 in 2006. The main study was performed from February 14 to May 11 in 2007. The researcher adopted the method of Kyung-hui, Kang (1998) such as awareness, attitude and knowledge in control group, emergency medical technician test protocol, Anne/SkillReporter$^{(R)}$ in case of the basic CPR knowledge. Four times of measures were done in shortly after practicing CPR, 4 weeks after the education, 8 weeks after the education, and 12 weeks after the education. By using SPSS/PC+ (version 12.0), the researcher analyzed the collected data based on frequency, percentage, repeated measurement, ANOVA (analysis of variance), and sidak (multiple comparison - sidak). Results : 1) The confidence of people in the control group in terms of practicing CPR showed a statistically meaningful difference (t = 10.230, p = .000) before/after CPR education. Therefore, hypothesis No.1-1 was accepted. 2) The educational necessity of people in the control group showed no statistically meaningful difference (t = -1.695, p = 0.105) before/after CPR education. Therefore, hypothesis No.1-2 was rejected. 3) The knowledge points of people in the control group showed a statistically meaningful difference (t = -7.731, p = .000) before/after CPR education. Therefore, hypothesis No.2 was accepted. 4) The confidence of people in the control group in terms of practicing CRP showed no meaningful difference (F = 2.789, p = 0.072) as time passed. Therefore, hypothesis No.3 was rejected. 5) The knowledge of people in the control group showed a meaningful difference (F = 9.090, p = .000) as time passed. Therefore, hypothesis No.4 was accepted. 6) The capability of people in the control group in terms of practicing CPR showed a statistically meaningful difference (F = 42.795, p = .000) as time passed. Therefore, hypothesis No.5 was accepted. 7) The precision level of CPR skill of people in the control group showed a statistically meaningful difference (F = 25.198, p = .000) as time passed. Therefore, hypothesis No.6-1 was accepted. 8) The precision level of chest compression skill of people in the control group showed a statistically meaningful difference (F = 5.188, p = .003). Therefore, hypothesis No.6-2 was accepted. Conclusion : In a nutshell, CPR education for the 4th and 5th graders of elementary schools had an influence on their confidence in practicing CPR and on their knowledge. This study showed that as time passed. the educational effect declined in terms of knowledge point, capability of practicing CPR, and the precision level of CRP skill. The results of the study could be postulated into the fact that re-education within 8 weeks after the first education was essential to retaining the educational effect. Therefore, we need to vitalize the CPR education for elementary school students repeatedly on a regular basis in order to continue the educational effect after they were grown-ups and to make them play their roles as a first aider.