• Journal of Trauma and Injury
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• 제26권3호
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• pp.111-124
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• 2013

Purpose: We should prepare proper medical service for disaster control as South Korea is not free from terrorism and war, as we experienced through the two naval battles of the Yeonpyeong, one in 1999 and the other in 2002, the sinking of Cheonan in 2010, and the attack against the border island of Yeonpyeong in 2010. Moreover, North Korea's increasingly bellicose rhetoric and mounting military threats against the world demand instant action to address the issue. The aim of this article is to describe our experience with three patients with combat-related gunshot and explosive injuries to their extremities and to establish useful methods for the management of patients with combat-related injuries. Methods: Three personnel who had been injured by gunshot or explosion during either the second naval battle of the Yeonpyeong in 2002 or the attack against the border island of Yeonpyeong in 2010 were included in our retrospective analysis. There were one case of gunshot injury and two cases of explosive injuries to the extremities, and the injured regions were the left hand, the right foot, and the right humerus. In one case, the patient had accompanying abdominal injuries, and his vital signs were unstable. He recovered after early initial management and appropriate emergency surgery. Results: All patients underwent emergent surgical debridement and temporary fixation surgery in the same military hospital immediately after their evacuations from the combat area. After that, continuous administration of antibiotics and wound care were performed, and definite reconstructions were carried out in a delayed manner. In the two cases in which flap operations for soft tissue coverage were required, one operation was performed 5 weeks after the injury, and the other operation was performed 7 weeks after the injury. Definite procedures for osteosynthesis were performed at 3 months in all cases. Complete union and adequate functional recovery were achieved in all cases. Conclusion: The patient should be stabilized and any life-threatening injuries must first be evaluated and treated with damage control surgery. Staged treatment and strict adherence to traditional principles for open fractures are recommended for combat-related gunshot and explosive injuries to the extremities.

• 한국방사선학회논문지
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• 제2권4호
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• pp.11-25
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• 2008

유방암이 여성암 발생 1위를 차지함에 따라 선별검사로서 유방촬영율 또한 증가하였다. 유방촬영술은 병변의 유선 조직이나 지방조직 등 주위 조직의 X선 흡수차가 작고 미세 석회화를 묘출해야 되는 어려운 점이 있어 정확한 진단을 위해서는 양질의 영상이 요구되며 이를 위해서는 촬영장비의 성능관리와 화질관리가 필요하다. 이에 본 조사에서는 정도관리가 실제적으로 잘 이루어지고 있는지 알기위하여 광주광역시 소재의 의료기관중 유방암검진기관으로 등록되어 있는 기관 37곳을 대상으로 하여 2008년 7월 1일부터 8월 31일까지 62일 동안 유방촬영장비의 정도관리 실태에 관하여 설문조사하였다. 유방촬영장비의 장치적 특성에 대한 조사결과 사용하는 장비에 대하여 모르고 사용하는 경우가 많았다. 필름과 CR을 이용하는 병원은 각각 19곳(49%)이었고 DR을 이용하는 병원도 1곳 있었다. 또 종합병원의 대부분은 CR을 이용하고 있었으며 의원은 필름을 사용하는 경우가 많았다. 정도관리 방법에 대한 질문 결과 38%만이 매뉴얼대로 점검하고 있었다. 또 조사한 병원 전수가 전문 업체에 정도관리를 맡기고 있었다. 그 이유로는 전담인력, 시간, 거리 등 한계점 때문에 맡긴다는 대답이 65%로 가장 많았으며 기자재가 없어서 맡긴다는 대답이 44%로 그 다음으로 많았다. 이러한 결과는 정도관리가 형식적으로 이루어지고 있음을 반영하며 전문 업체에 의존하므로 점검 항목자체에 수동적이고 무관심한 것으로 사료된다. 따라서 정기적인 교육을 실시하여 정도관리에 관한 인식을 높이고 방사선사의 적극적인 참여를 통하여 올바른 정도관리를 할 수 있도록 하여야 한다. 이러한 노력과 더불어 전담인력이나 기자재 등 문제점을 해결함으로써 정도관리의 발전에 기여할 수 있을 것이다.

• Journal of Hospice and Palliative Care
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• 제9권1호
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• pp.30-34
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• 2006

목적: 본 연구는 말기 질환자 및 가족들의 삶의 질 증진 차원에서 호스피스 사이버 상담을 위한 인력 훈련 및 홍보 시행을 통하여 호스피스 사이버 상담 프로그램을 운영하여 보고자 한다. 방법: 본 연구는 호스피스 사이버 상담 제공을 위한 상담 인력 훈련, 홍보 전략 구축, 운영 및 효과 평가의 절차로 진행하였다. 결과: 2004년 10월부터 2005년 7월까지 약 9개월 동안 사이버 호스피스 홈페이지를 방문하여 회원가입을 한 대상자는 총 72명으로 20대가 17명(23.6%), 30대가 12명(16.7%), 40대가 17명(23.6%), 50대 이상이 13명(18%)를 차지하였다. 진단명 별로는 암과 관련된 질환이 90%를 차지하였으며, 상담 내용과 상담신청자와의 관계는 가족이 90%를 차지하였으며, 10%만 본인이었다. 회원 중 30명이 온라인 상담을 이용하였으며 상담 건수는 35건이었다. 상담 건수 및 상담 이용 회원수는 적었으나, 상담 이용 후 지속적인 상담원과의 연계 및 사이트 활용의 경향을 보였다. 결론: 말기 질환자 및 가족들의 삶의 질 증진, 호스피스 사업 활성화의 기초 활동으로써 호스피스에 대한사이버 상담 프로그램을 실질적으로 운영하였다. 호스피스 사이버 상담의 활성화를 위해 대중 매체 및 언론을 통한 호스피스 사업에 대한 기본적인 홍보들이 지속적으로 이루어져야 하며, 의료진을 대상으로 한 호스피스에 대한 교육도 계속되어야 할 필요가 있다.

• Journal of Preventive Medicine and Public Health
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• 제35권1호
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• pp.13-23
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• 2002

Objectives : To investigate the therapeutic compliance and its related factors in lung cancer patients. Methods : The subjects of this study comprised 277 patients first diagnosed with lung cancer at Kyungpook National University Hospital between Jan 1999 and Sept 1999. Of these, 141(50.9%) participated in the study by properly replying to structured questionnaires. The data was analyzed using a simplified Health Decision Model. This model includes categories of variables covering therapeutic compliance, health beliefs, patient preferences, knowledge and experience, social interaction, sociodemographic and clinical characteristics. Results : The therapeutic compliance rate of the 141 study subjects was 78.0%. An analysis of health beliefs and patient preferences revealed health concern (p<0.05), dependency on medicine (p<0.05), perceived susceptibility and severity (p<0.05) as well as preferred treatment (p<0.01) as factors related to therapeutic compliance. Factors from the sociodemographic characteristics and clinical factors that were related to therapeutic compliance were age (p<0.01), monthly income (p<0.05), histological type (p<0.05) and clinical stage (p<0.05) of cancer. Conclusions : In order to improve therapeutic compliance in lung cancer patients it is necessary to educate the aged, low-income patients, or patients who have small cell lung cancer or lune cancer of an advanced stage for which surgery is not indicated. Additionally, it is essential for medical personnel to have a deep concern about patients who have poor lifestyles, a low dependency on medicine, or a high perceived susceptibility and severity. Practically, early diagnosis of lung cancer and thoughtful considerations of low-income patients are important. By means of population-based education in a community, we may promote attention to health and enhance the early diagnosis of lung cancer.

• 한국보건간호학회지
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• 제2권2호
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• pp.62-80
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• 1988

The main purpose of this study was to find out the actual status of safety and heal th education activities in the manufacturing industries through survey of 136 plants in Seoul City and Gyunggi- Province Area which employ nurses being charged in the safety and health care services to the employees. A questionaire was mailed to the employees on the Mar. 2, 1987. Total 634 responds from 87 industries were collected by Apr. 20, 1987. Among the total, 618 responds from 80 industries were included in the analysis. The major findings obtainded from this study are summarized as follows; 1. Safety and health education activities in each industry: 1) The $67.6\%$ of safety directors surveyed were performing the education to the employees. And in case of medical directors, it was $18.8\%$ of them. 2) Periodically, annual safety' and health education programs were being drawn up in the $65.0\%$ of the industries (52 companies). And the $60.6\%$ of the planners were safety directors of safety staffs in charge. 3) It was only $27.5\%$ of the companies surveyed in which the safety and health education were performed more than an hour every month. In the $22.5\%$ of the companies, neither safety programs nor health education activities were performed. 4) In the $47.5\%$ of them, safety and health educations were performed in cooperation with related agencies such as health center. 2. The rate of employees participated in safety and health educations; 1) The received rates by subjects of the educations when labors were newly employed to their companies were as follows; education regarding danger and profer handling method of machinery and appliances: $64.2\%$, education regarding noxiousness and handling method of raw materials: $42.2\%$, etc. 2) The $63.6\%$ of the labors received educations on safety and health when they changed their work places. 3) The $74.8\%$ of the labors received specific safety and health educations. 4) The general safety and health educations were received by the $47.2\%$ of management and clerical personnel and $50.0\%$ of labors pre and post physical examination. 3. The main reasons of inactive performance of the educations were as follows; lack of knowledge and inexperience of the occupational safety and health staffs, lack of cooperations between themselves and low need of workers for safety and health education, etc. 4. The preferable subjects of educations for workers; (1) pre and post education of physical examination, (2) education regarding the prevention of accidents. (3) general health care, sex education and family planning, etc. As a result of this study, we can conclude that the safety and health education work in industries as the subject of this study is on the incipient stage. Appropriate measures are to be taken for the activation of safety and health education work such as; continuous public relations, financial and technical supports of the government, training of professional/occupational safety and health staffs, efforts of workers to receive the education and collaborations of the employers.

• 한국인터넷방송통신학회논문지
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• 제17권2호
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• pp.141-146
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• 2017

최근 지속적으로 발생하고 있는 메르스와 같은 신종 감염병은 초기발견, 격리, 위기대응 등 많은 대응책을 필요로하고 있으며 아울러 일반인의 문병과 간호 간병 통합서비스 시행 등 병원의 문화가 바뀌는 추세이다. 그러나 병원에서 근무하는 의료인의 자격조건, 규정 등이 까다로와지면서 해외에서는 린넨, 폐기물, 수액 이동 등 로봇으로 가능한 부분은 대체하는 추세이다. 본 연구에서는 병원 내에서 발생하는 각종 물품의 배송 업무를 수행할 수 있는 IoT 기반의 병원 물류 로봇으로 다양한 종류의 물건을 원하는 위치까지 안전하게 이동 할 수 있는 기술에 대하여 연구하였다. 병원 내 로봇의 이동은 사람 또는 사물간 충돌을 발생 시킬 수 있기 때문에 충돌을 최소화 해야 한다. 충돌을 최소화하기 위해서는 로봇의 이동 경로에 사물의 유무를 판단하고 사물이 있다면 이동하는 것인지 아닌지를 인지해야 한다. 그래서 얼굴/전신정보 검출과 3D Vision 영상분할 기술을 이용하여 장애물의 상황 정보를 생성하였다. 생성 된 정보를 활용하여 로봇 이동 범위 내 사물과 사람을 고려한 맵을 생성하여 로봇이 안전하고 효율적으로 운행 될 수 있도록 하였다.

• 지역사회간호학회지
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• 제15권4호
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• pp.551-565
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• 2004

Purpose: The purpose of this study is to develop a day care center model focused on public health institutions for the elderly residing in their homes. Method: Research design for this study was a mult-level research, which consisted of a related literature review, an Internet search for knowledge of the current situation at home and abroad, on-site interviews, questionnaires collected from a sample of residents in a rural area, and a key-informants approach. Results: 1) The subjects of service - Generalized service should be provided to the elderly, 65 years and older, regardless of their assets. 2) The contents of service - Providing pre-health oriented and post-social welfare service that can integrate and satisfy a wide variety of public health and welfare needs of the elderly would strengthen the health care service of a day care center for the elderly. 3) Delivery system - Basic-level local self-governments should become a central operating body, and establishing a properly adjusted delivery system to a rural area after considering the efficiency and the access of vulnerable rural areas is needed based on modification of 'a Special Law for Agricultural and Fishery Areas' (rural public health center>rural health sub-center ${\rightarrow}$ unified health sub-center ${\rightarrow}$ public health hospital (public health center) ${\rightarrow}$ public welfare office). 4) Facility - Public health facilities such as public health centers and sub-centers should be located in areas that can easily access the facilities. 5) Funding - For day care center for the elderly in local self-government, the central government should modify a relevant implementation of subsidy in and provide some facilities and service regardless of the degree of self reliance of local self-government. 6) Human resources - It is needed to guarantee the period of workers of a day care center for the elderly, at least 3 to 5 years, with considering their specialty on aged care and avoiding circulation based positions. Furthermore, appropriate specially trained personnel such as medical workers and social workers should be placed to take care of both health service and welfare through strengthening of 'rules of law of elderly welfare,' Conclusion: future research is needed to test the model through a demonstration study using a model which may be developed in the future and to standardize the appraisal criteria of people hoping to enter a day care center for the elderly.

• 대한간호학회지
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• 제25권3호
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• pp.472-484
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• 1995

The purpose of this study was to develop a home health care model in the public health system and to test the effectiveness of the model. Seven com-munity health practitioners in Yon- Cheon county. Kyunggi province, carried out home health care service for this research. The subjects of the home health care were a total of 111 community residents with chronic health problems and risk-prone infants and children; 29 persons with hypertension, 18 persons with diabetes, 12 persons with neurologic problems, 12 elderly, and 40 infants and children. During the period of study, from December, 1993 to March, 1995, a demonstrative home health care model was developed in the Yon-Cheon County community health centers with the cooperation of the Yon-Cheon Medical Center and Yon-Cheon Public Health Center for the first six months. A home care practice manual and recording system for home visits were also co-developed by the researchers and community health practitioners. Four workshops and monthly conferences were held for this purpose. Actual home care practice took place for two months, and on-going evaluation and replanning accompanied this process. The result of the evaluation of home care service were as follows. 1) For persons with hypertension, diabetes, neurologic problems, there was significant improvement in knowledge of disease and care, but no significant difference was seen in health behavior or symptoms after home care service. 2) No significant difference was seen in level of self esteem or depression after reminiscence therapy among 12 elderly subjects. 3) There were significant differences in satis-faction toward child rearing and parental sup-port, but no significant difference In education needs for parental role after home care service among parents of infants and children. 4) There was significant improvement in the quality of life among the subjects after the home care service. 5) Subjects responded that they were highly satisfied with the home care service given by the community health practitioners. Although, the actual implementation period was very short, and not all of the evaluation outcomes showed significant improvement, the home health care model of community health practitioners was, in general, positively evaluated. Through this re-search, the possibility of community health practitioners working as active home care personnel in the public health care system is supported. Further research with an expanded area and subjects for a longer period is recommended. Cost effectiveness research is also needed.

• 한국산학기술학회논문지
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• 제12권4호
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• pp.1696-1702
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• 2011

본 연구는 생활습관 개선을 통하여 질병의 사전 예방과 조기진단을 목적으로 발의한 건강관리서비스법안에 관한 방사선사와 치위생사의 의식을 분석하여 향후 건강관리서비스법안의 세부 내용 및 제공 요원의 선정에 기초 자료를 제시하고자 하였다. 조사대상은 방사선사와 치위생사 총 359명을 대상으로 2010년 7월부터 9월까지 3개월간 조사하였다. 분석 결과, 건강관리서비스법안이나 세부 내용에 관하여 인지도는 30%% 미만이었고, 필요하다는 의견은 78.0%로 높게 나타났다. 항목의 추가는 방사선사는 현행 유지를, 치위생사는 82.3%가 추가를 희망하여 대조를 보였으며, 추가 항목으로는 치과 질환을 선호하였다. 서비스 제공요원에 방사선사와 치위생사 등이 보건(의료)관련 교육을 이수하였으므로 포함되어야 한다는 의견이 높았으며, 건강관리서비스에 참여 의향은 평균 8.1점으로 높게 나타났다. 이상과 같이 건강관리서비스법은 필요하지만, 주요 내용과 서비스 제공요원 등에 관한 다양한 의견수렴을 바탕으로 보다 체계적인 연구가 요구된다. 특히 정규 대학(교)에서 보건(의료)에 관한 교육을 이수하고 임상에서 지속적으로 이수하고 있는 일정 경력 이상의 보건직(방사선사, 치위생사 등) 인력의 포함은 필연적이라고 사료된다.

• 한국방사선학회논문지
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• 제10권3호
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• pp.145-152
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• 2016

방사선치료중인 암 환자를 대상으로 하여 환자의 일차 환경에 속하는 가족지지와 의료인 지지로 구성된 사회적 지지와 삶의 질과의 관련성을 알아보고자 본 연구를 실시하였으며, 연구대상자는 서울특별시에 소재한 일개 대학병원 방사선종양학과에서 방사선치료중인 암 환자들 중 2012년 1월 25일부터 2012년 4월 30일까지 조사가 가능하였던 199명을 대상으로 하였다. 수집된 자료 분석은 SPSS/WIN 18.0 통계 프로그램을 이용하여 t-test, 분산분석, 상관관계분석 및 다중회귀분석을 이용하여 사회적 지지를 비롯한 독립변수와 종속변수인 삶의 질과의 관련성을 알아보았다. 결론적으로 방사선 치료중인 암 환자가 지각하는 가족지지가 높을수록 삶의 질도 높게 나타나 유의한 관련이 있음을 알 수 있었다. 따라서 방사선치료중인 암 환자들의 삶의 질을 향상시키기 위해서 가족지지 및 사회적지지 등을 강화시킬 수 있는 중재 전략의 개발이 필요할 것으로 생각되며, 더 나아가 향후 삶의 질을 영역별로 세분화하여 다양한 측면을 분석할 추가적인 연구가 필요하다고 생각된다.