• 제목/요약/키워드: Medical service factors

검색결과 1,126건 처리시간 0.031초

119구급대원의 기본소생술 교육 개선 방안 - 자동제세동기 교육을 중심으로 - (Improvement Method for BLS Training for 119Fire-Paramedics - Focused on AED Training -)

  • 이정혁;채진
    • 한국화재소방학회논문지
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    • 제31권3호
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    • pp.127-136
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    • 2017
  • 우리나라는 1994년 "응급의료에 관한 법률"이 제정되면서 응급처치 교육이 본격적으로 시행되는 계기가 마련되었다. 현재 일반인 대상 AED내용이 포함된 응급처치 교육이 이루어지고 있으나 일반인의 AED사용 실적은 매우 미흡한 실정이다. 이에 대한 원인으로 획일화된 BLS교육에 문제점이 있는 것으로 판단하였다. 선행연구를 통해 AED사용 의향을 저해하는 개인적 사회적 요인을 파악하였으며 이를 개선된 BLS교육에 반영하였다. 연구 결과로 대상자 총 481명 중 기존 AED사용 의향이 없던 대상자는 200명(41.6%)이었으며, 개선된 BLS교육 후 43명(8.9%)으로 감소하였다. AED사용 의향을 높이기 위한 구체적 방안으로 교육 후에는 AED위치 교육에 대한 필요성이 가장 높게 나타났으며, 이를 토대로 AED교육 시 정확한 내용의 전달이 무엇보다도 중요하고, 더불어 생활 주변 AED의 위치인식에 대한 교육도 함께 이루어져야 하겠다.

소방공무원 근무환경에 대한 안전보건 의식 연구 (A Study on the Safety and Health Consciousness for the Working Environment of Fire Fighter)

  • 이종호;김요한
    • 한국안전학회지
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    • 제30권1호
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    • pp.137-143
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    • 2015
  • Fire fighter are exposed to the situations which are hard to predict due to continuous and accidental changes which hinder their fire fighting activity. As these threats of safety accident act as fear factors, they are doing insecure fire fighting activities. Therefore, as unclear and abnormal risks of working environment such as the riskiness of expansion of disaster, instability, obstacles of activities, abnormality, urgency, etc. increase, safety accidents are caused. This study analyzes the actual condition of safety and health and awareness of fire fighter who are exposed safety accidents during their fire fighting activities and utilize such result as the basis data to secure safety of fire fighter, keep efficient safety control and prevent accidents. The results of analysis are as follows. As rescue works among all fire-fighting works shows the highest emotional stabilization and the highest post-traumatic stress disorder is shown in fire sergeant level positions, and fire fighters whose working period is 10-15 years, reinforcing safety training to long-term workers is necessary. As the result of survey regarding safety awareness, the highest awareness level was shown in fire sergeant level positions, and fire fighters whose working period is over 20 years, and when it comes to operation of fire fighting equipments, fire-fighting workers and workers having 1-4 years of working period showed high safety awareness. The more serious injury in a fire fighter experienced as the first injury after working as a fire-fighter, the more cause-and-effect relationship was shown between personal physical condition and work, and it is shown as obstacles of fire fighting activities and affects to post-traumatic stress disorder. Moreover, as after-work off duty activities also affect to official disaster, systematic improvement of working environment is required. Occupational medical work compatibility evaluation considering the distinct characteristics of works to secure fire-fighter' health care together with fire-fighting capability is shown to be necessary.

전리방사선 노출과 관리 (Exposure Assessment and Management of Ionizing Radiation)

  • 정은교;김갑배;송세욱
    • 한국산업보건학회지
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    • 제25권1호
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    • pp.27-35
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    • 2015
  • Objectives: To investigate safety and health management, conditions in factories or facilities handling radiation-generating devices and radioactive isotopes were reviewed in terms of regulations of radiation safety control in Korea. Radiation exposure levels generated at those facilities were directly measured and evaluated for establishing an effective safety and health management plan. Methods: Government organizations with laws and systems of radiation safety and health were investigated and compared. There are three laws governing radiation-related employment such as occupational safety and health acts, nuclear safety acts, and medical service acts. We inspected 12 workplaces as research objects:four workplaces that manufacture and assemble semiconductor devices, three non-destructive inspection workplaces that perform inspections on radiation penetration, and five workplaces in textile and tire manufacturing. Monitoring of radiation exposure was performed through two methods. Spatial and surface monitoring using real-time radiation instruments was performed on each site handling radiation generating devices and radioactive isotopes in order to identify radiation leakage. Results: According to the occupational safety and health act, there is no legal obligation to measure ionizing radiation and set dose limits. This can cause confusion in the application of the laws, because the scopes and contents are different from each other. Surface dose rates in radiation generating devices such as implanters, thickness gages and accelerators, which were registered according to nuclear safety acts, using surveymeters, and seven of 36 facilities(19.4%) exceeded the international standards for surface radiation dose of $10{\mu}Sv/hr$. Conclusions: The results showed that occupational health and safety acts require a separate provision for measuring and assessing the radiation exposure of workers performing radiation work. Like noise, ionizing radiation will also periodically be controlled by including it in the object factors of work-environment measurement.

난소과자극증후군의 치료에 관한 한의 임상 연구 고찰 (Review for Clinical Studies of Oriental Medicine on the Treatment of Ovarian Hyperstimulation Syndrome)

  • 구수정;황덕상;이진무;이창훈;장준복
    • 대한한방부인과학회지
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    • 제33권3호
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    • pp.60-79
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    • 2020
  • Objectives: This review plans to assess the efficacy and effectiveness of oriental medicine for the treatment of Ovarian Hyperstimulation Syndrome (OHSS) through literature research and overview. Methods: Database searching was conducted to identify relevant randomized controlled trials (RCTs) on oriental medicine for the treatment of Ovarian Hyperstimulation Syndrome. Studies were searched from Journal of Korean Obstetrics and Gynecology, Korean Medical Database, Korean studies Information Service System, China National Knowledge Infrastructure, Cochrane library, PubMed and EmBase up to 21st May, 2020. Results: Seventeen studies were finally selected. Fifteen studies intervened with oral Chinese herb medicine, two studies intervened with acupuncture and moxibustion. Nine studies concluded that intervention with oriental medicine significantly relieved OHSS symptoms. Three studies reporting ovary diameter, four studies reporting abdominal circumference and other four studies reporting pelvic effusion showed significant reduction compared to control groups. Six studies showed significantly shorter duration for hospitalization in intervention groups. Only one study showed significantly higher pregnancy rate. Factors related with vascular permeability and blood cell coagulation were significantly lowered in intervention groups in general. Conclusions: From seventeen studies, oriental medicine relieved OHSS symptoms and showed treatment effectiveness. Further strictly designed studies and long-term observed studies are needed to establish evidences.

장애인의 사회적 배제 경험에 대한 생애사 연구 -지체와 뇌병변 장애인 중심으로- (A Biographical Study of Social Exclusion Experiences - Focused on the Physical and Cerebral Palsy Disabled -)

  • 신유리
    • 한국사회복지학
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    • 제64권2호
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    • pp.299-323
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    • 2012
  • 본 연구의 목적은 생애사 연구를 통해 장애인의 사회적 배제 경험을 이해하는 데 있다. 이에 지체와 뇌병변 장애인 10명의 사회적 배제 경험을 중심으로 심층 면접하여 그 내용을 분석하였다. 그 결과는 참여 장애인들은 교육, 노동, 사회참여, 정보, 사회서비스, 공간, 건강관리 등의 다차원적인 사회적 배제에 직면해 있는 주변인으로 시민권적 권리가 부재한 삶을 지내왔다. 이러한 배제로 인해 사회적 관계가 단절되고 해체되었으며, 그들의 정체성 또한 규범화된 사회적 관념에 의해 타율적인 방식으로 정형화되어 갔다. 또한 장애와 빈곤이 복합적으로 결합된 참여 장애인들의 삶 가운데 이들 세대의 인식과 가치에 영향을 미친 역사적 경험들이 제시되었다. 한편 사회적으로 배제된 이들의 삶의 의미는 스스로 평가하고 해석하는 원천에 따라 새롭게 구성되는 것으로 나타났다. 이러한 연구결과를 토대로 장애인의 사회적 배제 극복을 위한 정책적 실천적 함의를 제시하였다.

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재가 중증 장애인의 지속적 재활 관리 실태와 재활 서비스 요구 (The Continuum of Rehabilitation Care and the Rehabilitation Services that are Needed by People with Severe Disabilities)

  • 장숙랑;김완호;이규범;김수경;임재영;이선자
    • Journal of Preventive Medicine and Public Health
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    • 제39권3호
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    • pp.263-269
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    • 2006
  • Objectives: As the number of people with disabilities is increasing and their needs for care are varied, the continuum and comprehensiveness of their rehabilitative care are getting more important. This study was performed to understand the utilization of rehabilitation services and requirements of care among the people with severe disabilities in Korea. Methods: We interviewed 578 disabled persons who had severe extremity and cerebral impairment in the urban and rural areas of Korea. The questionnaire included questions on their general characteristics, the type of disability, their physical function (ADL, IADL), their use of rehabilitation services after discharge and their requirements for rehabilitation care Results: Only 12.6% of people with disability in the community continuously used the available medical rehabilitation care. The associated factors for utilization of rehabilitation services were pain and admission for rehabilitative treatment in the acute phase. There was a great need for rehabilitation services in community and this varied according to gender, the socio-economic status, the functional status and the geographic region. The gap between utilization and need for rehabilitation services was largest in the economic support. The gap of primary health care was larger in the rural area than in the urban area. Conclusions: The needs for rehabilitation service were diverse according to the individual functional status, the regional characteristics and other general characteristics of people with disability. Strategies should be considered to eliminate the barriers to obtain rehabilitation services for the people with disability in the community.

Living Arrangements Affect Nutritional Status of the Elderly

  • Kim, Cho-Il;Lee, Haeng-Shin
    • Journal of Community Nutrition
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    • 제3권2호
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    • pp.103-109
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    • 2001
  • With a continuous and steep increase in life expectancies, Korean society is expected to enter the aged society by year 2020. And as the number of elderly increases, the burden of medical and health care expenses for them becomes greater in every developed society. Hence, the preventive approach for chronic degenerative diseases remains to be the best solution for the above-mentioned problem and warranting optimal nutrition would be one of the most important approaches. We performed a nutrition survey on 585 older adults of 50 years of age and older, residing in 3 metropolitan areas including Daejun, Daeku and Kwangju. Anthropometry, including body composition analysis based on the bioelectrical impedance analysis using InBody 3.0 and dietary intake survey by semi-quantitative flood frequency questionnaires, were used in collecting data. As one of the most important factors affecting the health and nutritional status of the elderly, we focused on living arrangements. Analyses were performed on the data from 550 subjects only, after excluding statistical outliers. Three hundred and sixty-eight of them(66.9%) were female and the number of elderly(65 years of age and older) was 485. According to the statistical analyses, the female elderly were more vulnerable to malnutrition than the male elderly. And the older they befame, the less adequate they were in nutrient intake. In addition to this, the elderly living alone showed the poorest patterns of nutrient intake and anthropometry. Although the exact effect of living alone could differ among different sex-age groups, the fact that the elderly living alone is vulnerable to malnutrition would remain concrete. This raises the utmost necessity of nutrition intervention to be devised and directed to the targeted population, namely the living-alone elderly from the government level. The intervention may include nutrition education, nutrition counseling and support In forms of meal service by networking the efforts of central as well as local governments to ensure the good health of the Korean elderly.

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급성심근경색증 환자의 진료 질 평가를 위한 병원별 사망률 예측 모형 개발 (Development of a Model for Comparing Risk-adjusted Mortality Rates of Acute Myocardial Infarction Patients)

  • 박형근;안형식
    • 한국의료질향상학회지
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    • 제10권2호
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    • pp.216-231
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    • 2003
  • Objectives: To develop a model that predicts a death probability of acute myocardial infarction(AMI) patient, and to evaluate a performance of hospital services using the developed model. Methods: Medical records of 861 AMI patients in 7 general hospitals during 1996 and 1997 were reviewed by two trained nurses. Variables studied were risk factors which were measured in terms of severity measures. A risk model was developed by using the logistic regression, and its performance was evaluated using cross-validation and bootstrap techniques. The statistical prediction capability of the model was assessed by using c-statistic, $R^2$ as well as Hosmer-Lemeshow statistic. The model performance was also evaluated using severity-adjusted mortalities of hospitals. Results: Variables included in the model building are age, sex, ejection fraction, systolic BP, congestive heart failure at admission, cardiac arrest, EKG ischemia, arrhythmia, left anterior descending artery occlusion, verbal response within 48 hours after admission, acute neurological change within 48 hours after admission, and 3 interaction terms. The c statistics and $R^2$ were 0.887 and 0.2676. The Hosmer-Lemeshow statistic was 6.3355 (p-value=0.6067). Among 7 hospitals evaluated by the model, two hospitals showed significantly higher mortality rates, while other two hospitals had significantly lower mortality rates, than the average mortality rate of all hospitals. The remaining hospitals did not show any significant difference. Conclusion: The comparison of the qualities of hospital service using risk-adjusted mortality rates indicated significant difference among them. We therefore conclude that risk-adjusted mortality rate of AMI patients can be used as an indicator for evaluating hospital performance in Korea.

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일 종합병원 간호사의 지각된 간호조직특성과 직무만족 (Nursing Organizational Characteristics and Job Satisfaction of Nurses in a general hospital)

  • 박성애;이은주;김정희
    • 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.

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Risk Factors for Poorer Breast Cancer Outcomes in Residents of Remote Areas of Australia

  • Roder, David;Zorbas, Helen;Kollias, James;Pyke, Chris;Walters, David;Campbell, Ian;Taylor, Corey;Webster, Fleur
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권1호
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    • pp.547-552
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    • 2013
  • To investigate patient, cancer and treatment characteristics in females with breast cancer from more remote areas of Australia, to better understand reasons for their poorer outcomes, bi-variable and multivariable analyses were undertaken using the National Breast Cancer Audit database of the Society of Breast Surgeons of Australia and New Zealand. Results indicated that patients from more remote areas were more likely to be of lower socio-economic status and be treated in earlier diagnostic epochs and at inner regional and remote rather than major city centres. They were also more likely to be treated by low case load surgeons, although this finding was only of marginal statistical significance in multivariable analysis (p=0.074). Patients from more remote areas were less likely than those from major cities to be treated by breast conserving surgery, as opposed to mastectomy, and less likely to have adjuvant radiotherapy when having breast conserving surgery. They had a higher rate of adjuvant chemotherapy. Further monitoring will be important to determine whether breast conserving surgery and adjuvant radiotherapy utilization increase in rural patients following the introduction of regional cancer centres recently funded to improve service access in these areas.