• 한국의료질향상학회지
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• 제8권2호
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• pp.186-207
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• 2001

Background : This study presented an analysis of healthcare quality indicators using data mining and a development of decision support system for quality improvement. Method : Specifically, important factors influencing the key quality indicators were identified using a decision tree method for data mining based on 8,405 patients who discharged from a medical center during the period between December 1, 2000 and January 31, 2001. In addition, a decision support system was developed to analyze and monitor trends of these quality indicators using a Visual Basic 6.0. Guidelines and tutorial for quality improvement activities were also included in the system. Result : Among 12 selected quality indicators, decision tree analysis was performed for 3 indicators ; unscheduled readmission due to the same or related condition, unscheduled return to intensive care unit, and inpatient mortality which have a volume bigger than 100 cases during the period. The optimum range of target group in healthcare quality indicators were identified from the gain chart. Important influencing factors for these 3 indicators were: diagnosis, attribute of the disease, and age of the patient in unscheduled returns to ICU group ; and length of stay, diagnosis, and belonging department in inpatient mortality group. Conclusion : We developed a decision support system through analysis of healthcare quality indicators and data mining technique which can be effectively implemented for utilization review and quality management in a healthcare organization. In the future, further number of quality indicators should be developed to effectively support a hospital-wide Continuous Quality Improvement activity. Through these endevours, a decision support system can be developed and the newly developed decision support system should be well integrated with the hospital Order Communication System to support concurrent review, utilization review, quality and risk management.

• 대한한방소아과학회지
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• 제28권3호
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• pp.1-16
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• 2014

Objectives The purpose of this study is to investigate the incidence and clinical features of adverse events associated with herbal medicine, and to analyze their causality and severity. Methods This study was carried out from 159 children and adolescents who took herbal medicine in the Department of Pediatrics, ${\bigcirc}{\bigcirc}$ Korean Medical Hospital from december, 2013 to april, 2014. The data was collected by survey in person or telephone. The World Health Organization (WHO)-Uppsala Monitoring Center (UMC) criteria was used to analyze causality for each adverse events. Results 1. 207 cases were surveyed from 159 children and adolescents who took one or more kinds of herbal medicine. 2. A total of 12 general adverse events (5.8%) were reported from the study. Among these adverse events, 8 cases (3.9%) were associated with herbal medicine. 3. Gastro-intestinal system disorders were most frequently reported (70%) as adverse events, which is followed by psychiatric disorders (15%), skin and appendages disorders (10%), urinary system disorders (5%). 4. The most common clinical symptom was abdominal pain (20%), followed by diarrhea (15%), loose stools (10%), vomiting (10%) and borborygmus (10%). 5. The severity of adverse drug reactions was mostly mild (87.5%), and moderate (12.5%). There was no severe case. Conclusions The adverse events from herbal medicine on children and adolescents were mostly minor, most of them could continue herbal medicines.

• 한국콘텐츠학회논문지
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• 제20권5호
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• pp.500-512
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• 2020

본 연구는 리조트 조직의 저변에 잠재해 있으며 리조트 직원들에 의해 공유되어야 하는 조직문화를 발견하는데 목적이 있다. 최근 힐링에 대한 욕구와 지역사회의 라이프스타일 체험을 강조하는 추세에 주목해 볼 때 이는 리조트가 원래 탄생 시기부터 가지고 있었던 고유의 역할이었다. 그럼에도 불구하고 최근 리조트가 호텔 산업과 경계가 모호해지고 테마파크를 닮은 복합리조트로 변화하는 등 정체성이 흔들리고 있음을 부인할 수 없다. 리조트의 조직문화를 찾아내기 위해 16명의 리조트 전문가들을 대상으로 그레마스 행위소 모형을 기초로 제작된 심층인터뷰를 진행하였는데 3박4일간의 리조트 체험을 통해서 응답내용의 충실성을 유도하였다. 모형이 가지고 있는 6개의 행위소를 리조트를 구성하는 제반 요소와 합치시키고 응답자로 하여금 자유롭게 은유적으로 표현하도록 하였다. 응답자들은 발신자, 수신자, 주체, 객체, 보조자, 반대자를 각각 리조트, 리조트 방문객, 리조트기업, 리조트상품서비스, 리조트지원집단, 리조트방해집단에 대응시킨 결과 순서대로 심신치유, 환자, 치유사, 치유약, 치유도우미, 돌팔이약장수로 은유하였다. 은유한 내용은 모형에 따라 신화(이야기)로 구성하였으며 더 나가 조직문화에 주는 시사점으로 연결하였다. 연구의 이론적 실무적 시사점 및 한계점은 논문 말미에 포함시켰다.

• Clinical and Experimental Reproductive Medicine
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• 제25권3호
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• pp.245-249
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• 1998

White blood cells (WBCs) are present in most human ejaculates, but abnormally high concentration of seminal leukocytes may reflect an underlying pathological condition. The World Health Organization (WHO) has defined leukocytospermia as status of more than $10^6$ WBC/mL of semen. The purpose of this study was firstly, to compare the outcomes between conventional IVF and ICSI in leukocytospermia, and secondly, to investigate whether ICSI may be an alternative treatment for patients with leukocytospermia. Total 121 cycles of conventional IVF and ICSI candidates underwent IVF cycles at PL Infertility Clinic. Semen Parameters including concentration, motility, morphology of spermatozoa and concentration of leukocytes were assessed from the raw ejaculates. There was no difference in sperm concentration, motility and morphology. The rates of fertilization and good embryo development from ICSI were significantly higher than those from conventional IVF in leukocytospermia (63.9% & 48.6%, respectively for ICSI group and 33.4% & 24.1%, respectively for IVF group, p<0.001). The pregnancy rate after ICSI was also higher than that from conventional IVF (34.3% vs 21.6%, p<0.05). These results indicate that the presence of seminal leukocytes ($>1\times10^6$ WBC/mL of semen) is adversely related with fertilization, embryo development and pregnancy rate. Therefore the measurement of seminal leukocytes in routine semen analysis appears to be of prognostic value with regard to male fertilizing potential. In conclusion, it is suggested that ICSI is an alternative choice of treatment for patients with leukocytospermia.

• Asian Pacific Journal of Cancer Prevention
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• 제15권22호
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• pp.9753-9757
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• 2014

Purpose: To study the quality of life and to identify associated factors among breast cancer patients undergoing treatment in national cancer centers in Nepal. Materials and Methods: One hundred breast cancer patients were selected and interviewed using a structured questionnaire. European Organization of Research and Treatment of Cancer EORTC-QLQ-C30 and EORTC-QLQ-BR23 were used to assess quality of life and modified Medical Outcome Study -Social Support survey(mMOS-SS) was used to assess social support. Only multi-item scales of EORTC C30 and BR23 were analyzed for relationships. Independent sample T-tests and ANOVA were applied to analyze differences in mean scores. Results: The score of global health status/quality of life (GHS/GQoL) was marginally above average (mean=52.8). The worst performed scales in C-30 were emotional and social function while best performed scales were physical and role function. In BR-23, most of the patients fell into the problematic group regarding sexual function and enjoyment. Almost 90% had financial difficulties. Symptom scales did not demonstrate many problems. Older individuals, patients with stage I breast cancer and thosewith good social support were found to have good GHS/GQoL. Of all the influencing factors, social support was established to have strong statistical associations with most of the functional scales: GHS/GQoL (0.003), emotional function (<0.001), cognitive function (0.020), social function (<0.001) and body image function (0.011). Body image was significantly associated with most of the influencing factors: monthly family income (0.003), type of treatment (<0.001), type of surgery (<0.001), stage of cancer (0.017) and social support (0.011). Conclusions: Strategies to improve social support of the patients undergoing treatment should be given priority and financial difficulties faced by breast cancer patients should be well addressed from a policy making level by initiating health financing system.

• 한국의료질향상학회지
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• 제19권2호
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• pp.14-34
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• 2013

Objectives: The purpose of this study is to provide comprehensive information of qualification systems of developed countries needed to establish our national system for QI(Quality improvement) specialists. Methods: All articles related to any applicable domestic or foreign countries' laws, operational status, and detailed programs for professional qualification system of QI were reviewed. Result: In the United States, a non-profit organization, Healthcare Quality Certification Commission (HQCC) has set the policies, procedures and standards in the field of health care quality. And qualification system of CPHQ (certified professional in healthcare quality) has been operated in order to authenticate the qualifications in the field of quality management. IBQH(international Board for quality in healthcare), a qualification system of experts in the United Kingdom, was designed to assist the qualification of professionals to improve the quality of healthcare. In addition, Health Research Center of Feinberg School of Medicine in Northwestern University has been operating Master's and doctoral degree programs in the field of the quality of care and patient safety and IHI (institute for healthcare improvement) open school was operating a professional training course related to the quality of care and patient safety. Conclusion: Quantity and complexity of information of the quality of care and patient safety have been increased. For reform of the health care system, a special training course of the expertise and leadership are needed. So far, there is no national professional certification courses in our nation. Therefore essential job skill should be acquired individually. For systematic and effective quality improvement activities, the educational and certification system with professional development model are needed.

• 한국산학기술학회논문지
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• 제14권10호
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• pp.4935-4942
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• 2013

이 연구는 우리나라 종합병원에 근무하는 직원들의 의사소통에 대한 만족도와 조직유효성 인식과의 관계를 실증적으로 조사하기 위한 것이다. 이와 같은 연구의 목적을 달성하기 위해 4개의 연구가설을 설정하였으며, 가설검증을 위해 전국 10개 병원에 근무하는 의사, 진료지원직, 행정직 직원 473명에 대한 설문조사를 2013년 1월 3일부터 2월 8일까지 실시했다. 단계적 회귀분석 결과, 병원 직원들의 의사소통에 대한 만족도는 조직유효성에 정(+)의 영향을 미치는 것으로 나타났다. 또한 의사소통 만족도와 직종 간의 상호작용 효과는 조직유효성 중 안정성보다는 성장성에 더 크게 영향을 미치는 것으로 나타났다. 직종별 의사소통 만족도조사에서는 진료지원직종이 5점 만점에 3.11점으로 가장 낮아 문제점으로 지적되었다. 병원이 조직의 통합을 원한다면 직종 간 의사소통 만족도를 높이기 위한 세부적인 전략 개발이 필요하다고 하겠다.

• 한국물환경학회지
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• 제28권2호
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• pp.313-319
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• 2012

Various nanomaterials may flow into the aquatic ecosystem via production, use, and treatment processes. Especially, gold nanoparticles (AuNPs) were categorized as manufactured nanomaterials presented by the Organization for Economic Cooperation and Development Working Party on Manufactured Nanomaterials (OECD WPMN) in 2010. AuNPs have been used in medical area, however, they were reported to induce cytotoxicity and oxidative DNA damage, as well as down-regulation of the DNA repair gene in mice and human cell lines. In this study, the aquatic toxicity data of AuNPs and gold ions were collected, with the specific test methods analyzed with respect to the form and size of AuNPs, test species, exposure duration, and endpoints. Currently, aquatic toxicity data of AuNPs and gold ions have been presented in 14 studies including 4 fish, 6 crustacean, 2 green algae, and 2 macrophytes studies, as well as a further 8 studies including 4 fish, 4 crustacean, 1 platyhelminthes, and 1 green algae, respectively. The AuNPs were 0.8-100 nm in size, as gold nanoparticles, gold nanorod, glycodendrimer-coated gold nanoparticles, and amine-coated gold nanoparticles. The tested endpoints were the individual toxicities, such as mortality, malformation, reproduction inhibition, growth inhibition and genetic toxicity such as oxidative stress, gene expression, and reactive oxygen species formation. The accumulation of AuNPs was also confirmed in the various receptor organs. These results are expected to be useful in understanding the aquatic toxicity of AuNPs and gold ions, as well as being applicable to future toxicity studies on AuNPs.

• 간호행정학회지
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• 제6권3호
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• pp.347-356
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• 2000

The purpose of this study was to identify the relationship between the nursing organizational characteristics and job satisfaction. Subjects were 362 nurses at a general hospital in Seoul. Data were collected from November 1, 1999 to November 31, 1999 with the structured questionnaires and analyzed by $SPSS-PC^+$ 8.0 for descriptive statistics, ANOVA, Pearson correlation, and stepwise multiple regression. The results were as follows; 1. The average score of the nursing organizational characteristics was 3.7. The score of head nurse's leadership was highest and supervisor's was lowest. The average score of the job satisfaction was 3.1 and was similar to the results of other studies. 2. Being regarded to the nursing organizational characteristics and job satisfaction by general demographic variables, The head nurse's leadership, the supervisor's leadership and interaction, and the overall nursing organizational characteristics showed significant differences by year of career, position status, and service-department(p<.1, p<.05). The job satisfaction showed significant difference by position status(p<.01). 3. There were correlations between the nursing organizational characteristics and job satisfaction(r=0.358-0.815). 4. The most important variable in the job satisfaction was 'organizational climate' and it was explained 32.0% out of the total variance of job satisfaction and 'all of nursing organizational characteristic factors' explained 47.5%. According to the results of this study, the suggestions were as follow: 1. To improve nurses' job satisfaction, the strategy for the development of the cooperative nursing organizational climate and for the strengthening of 'the nursing manager's leadership and interaction' in the nursing department are necessary. It should to be considered the differences in the nursing organizational characteristics and job satisfaction by nursing manager and staff nurses. 2. Further study needed to analysis the organizational climate for the management of the nursing organization. Also it is necessary for further investigation regarding to the relationship between the nursing organizational characteristics and job satisfaction of pre and post-organizational change.

• 부모자녀건강학회지
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• 제3권2호
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• pp.81-93
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• 2000

The role of the neonatal nurse specialist has been well established over the past decade and now reform in 21st century. Neonatal nurse specialists responsibilities in caring for critically and long-term chronically ill infants and their families are very important. Neonatal nurse specialists have a two fold responsibility in caring for these infants. First, through acquiring advanced practice education in complex neonatal care and diagnostic skills, neonatal nurse specialists meet the physiologic needs of the infant. Second, neonatal nurse specialists provide a more holistic approach to their care through evaluating the family in treatment plans and involving the family in discharge planning for the infant. In some institutions, neonatal nurse specialists are directly involved in institutional and/or home follow-up care and case management also. It is the neonatal nurse specialists responsibility to function collaboratively with the multidisciplinary team in managing critically or chronically ill infants from admission to discharge. The role of the neonatal nurse specialist case manager can be described as one that focuses on individualized care of the infant, while providing continuity of care to both the infant and family. The neonatal nurse specialist's role will vary depending on the neonatal intensive care unit(NICU). Therefore, the multidisciplinary collaborative approach to long-term management of infants in the NICU is extremely important to provide successful transition to home or to long-term rehabilitative care facilities because care for the chronically ill infant is complex and multifaceted. I suggest the role of neonatal nurse specialist in 21st century are as follows. 1. Diagnostic/patient assessment 2. Management of patient health/illness 3. Administering/monitoring therapeutic interventions and regimens 4. Monitoring/ensuring quality of health care practices 5. Organization and work role 6. Helping role 7. Teaching/coaching role 8. Management of rapidly changing situations 9. Consulting role The advanced practice nursing model of care delivered by neonatal nurse specialist's in the NICU incorporates medical and nursing role functions and emphasizes holism, caring, and a health perspective for critically and chronically ill neonates and their families.