• 대한임상검사과학회지
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• 제49권4호
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• pp.366-373
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• 2017

소변검사는 다른 검사에 비해 쉽고 간편하면서도 환자에게 부담이 없는 검사로 신장 및 요로계 질환의 진단, 치료 및 예후 결정에 중요한 정보를 제공한다. 요 침전물은 일반적으로 원심분리된 소변을 검사자가 현미경을 통한 검경에 의해 이루어진다. 대한임상검사정도관리협회에서 제안한 가이드라인과 실제로 의료기관에서 시행되고 있는 내용이 다르고 임상병리학을 전공하는 학생들이 사용하고 있는 서적에 제시된 내용도 서로 차이가 있었다. 따라서 요 침전물 표본제작에 따른 차이가 검사결과에 영향을 주는지 확인하기 위하여. 요시험지봉검사에서 잠혈반응과 백혈구 에스터라아제 검사 결과 양성으로 확인된 검체를 무작위로 선별하여 현미경적 검사를 시행하였다. 요 침전물 표본제작 차이는 요 농축 배수에 영향을 주어 cell grade나 시야 당 평균 세포 수 결과에 영향을 미쳤다. 침전물의 농도를 결정짓는 첫 번째 요소는 원심력이다. 그러나 많은 의료기관에서 원심분리기 반경을 고려하지 않는 채 1,500 rpm을 사용하고 있었으며 이는 400 G라는 정확한 원심력을 얻을 수 없었다. 결과적으로 요 농축에 있어 차이가 발생하여 결과에도 영향을 미쳤다. 두 번째 요소는 요 침사물의 양이다. 제거하고 남은 요의 상청액의 양은 요 침사물의 농축 계수에 영향을 주어 다른 결과를 초래하였다. 뿐만 아니라 피펫을 사용하여 제시된 정확한 용량을 취하지 않고 대략적으로 한 방울을 떨어뜨린 후 경검했을 때도 결과에 영향을 주었다. 따라서 일관성 있고 보다 정확한 검사결과를 위해 반드시 표본제작 과정이 표준화가 되어야 할 것이다.

• Journal of Preventive Medicine and Public Health
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• 제40권5호
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• pp.388-396
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• 2007

Objectives: The purpose of this study was to examine the relationship between the differences in employment status and self assessed health in Korea. Methods: We analyzed 4 year follow-up data generated by the Korean Labor and Income Panel Study(KLIPS), which was conducted on 1,207 men and 582 women who had undergone a change in employment status. The study subjects were placed into 1 of the following 4 groups based on their employment history; Non-precarious workers, Precarious to non-precarious workers, Non-precarious to precarious workers and Precarious workers. Logistic regression was then used to examine the relationship between the changes in employment status and self assessed health. Results: When males were considered, self assessed health was better among the precarious to non-precarious workers (OR 1.58, 95% CI=1.57-1.60) and the precarious workers (OR 1.29, 95% CI=1.28-1.30) than in the non-precarious workers, after adjusting for age, socioeconomic status (education level, occupational class, marital status, average equivalent household income and average number of hours worked per week), health behavior (smoking, drinking and exercise) and medical service access (regular medical examination, have chronic disease or hospitalized within 1 year). When female workers were considered, the precarious to non-precarious workers (OR 1.89, 95% CI=1.86-1.92), non-precarious to precarious workers(OR 1.24, 95% CI=1.23-1.26) and precarious workers (OR 1.27, 95% CI=1.25-1.28) all reported poorer health than the non-precarious workers after adjusting for the aforementioned factors. Conclusions: This study showed that changes in employment status were associated with differences in self assessed health among men and women. Specifically, the results of this study showed that a corresponding positive outcome based on self assessed health was greater for employees that changed from precarious to non-precarious jobs and for male employees with precarious jobs., whereas female employees with non-precarious jobs had higher self assessed health. However, additional longitudinal studies on the health effects of employment status should be conducted.

• 디지털융복합연구
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• 제14권8호
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• pp.319-329
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• 2016

본 연구의 목적은 간호사들이 인지하는 직무교육 참여동기와 요구도를 파악하고, 또 직무교육 참여동기에 미치는 영향요인을 알아보기 위함이다. 본 연구는 경기도 소재 일 종합병원 간호사 345명을 대상으로 임의 표출하여 설문조사 하였다. 자료수집 기간은 2015년 10월5일부터 18일까지였다. 연구자료는 SPSS 21.0 Program을 이용하여 t-test와 ANOVA, Bonferroni 사후검정, Multiple regression으로 분석하였다. 본 연구결과 직무교육 참여동기는 '전문역량 향상과 개발'이 높게, 개인이익과 직업 안정성이 낮게 나타났다. 직무교육 요구도는 전문간호 영역은 병원감염관리와 심폐소생술이 가장 높았고, 호스피스와 재활간호가 가장 낮았다. 직무교육 참여동기는 연령, 결혼유무, 교육수준, 임상경력에 따라 유의한 차이가 있었고, 전문간호영역의 직무교육 요구도와 질병치료에 필요한 의학적 지식에 대한 직무교육 요구도로 부터 영향을 받는 것으로 나타났다. 따라서 직무교육의 효과성을 높이기 위해서는 전문간호 영역과 질병치료에 필요한 의학적 지식을 주제로 한 교육프로그램을 계획하고, 참여동기를 증가시킬 수 있도록 개인별 특성과 함께 임상단계를 고려한 체계적인 전략이 필요하며, 병원 차원의 교육공가 지원 등 직무교육관련 다양한 복지가 확대되어야 할 것으로 보인다.

• 한국산학기술학회논문지
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• 제20권8호
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• pp.313-320
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• 2019

본 연구는 중소병원들의 전문성역량을 강화하기 위한 방안을 모색하고 전문병원 운영전략 수립에 유용한 정보를 제시하고자 전문병원에 대한 기대수준과 전문병원 전문성역량 인식을 비교분석 하였다. 연구대상은 20세 이상 일반인과 임상 총 경력 3년 이상 병원종사자를 대상으로 하였으며, 연구도구는 선행연구와 보건복지부의 전문병원 지정요건을 고려한 전문병원의 전문성 요소 중요도와 전문성을 하위한 하위요인의 필요성으로 구성한 설문지로, 2018년 7월부터 8월까지 2개월간 자료를 수집하여 일반인 400명과 병원종사자 317명을 대상으로 분석하였다. 연구기간은 2018년 7월부터 2019년 5월까지였으며, 분석방법은 연구도구의 타당도와 신뢰도 검정을 실시한 후, t-test와 회귀분석을 사용하였다. 연구결과, 전문병원에 대한 기대수준은 일반인과 병원종사자 간에 차이가 없었으나, 전문병원에 대한 주관적인 기대수준에 영향을 미치는 전문성 요소는 일반인과 병원종사자 간에 다르게 생각하고 있다는 것을 알 수 있었다. 그리고 일반인과 병원종사자의 전문병원에 대한 기대수준에 영향을 미치는 전문성 요소는 의사에 대한 신뢰감이었으나 의사에 대한 신뢰감에 영향을 미치는 전문성 하위요인이 일반인은 해당분야의 탁월한 기술력, 병원종사자는 의사와 진료의 전문성과 해당 분야의 노하우로 일반인과 병원종사자가 서로 달랐다. 결론적으로 전문병원이 발전적인 전문성역량을 강화하기 위해서는 병원종사자들의 인식과 일반인들의 인식 간의 차이를 줄이는 노력이 필요할 것으로 사료된다.

• 대한임상검사과학회지
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• 제53권2호
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• pp.174-187
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• 2021

세포병리사는 인체를 구성하고 있는 세포의 상태를 분석하여 암을 포함한 다양한 질병을 진단하는 1차 선별자로서 역할을 수행하고 있으나, 세포병리사의 고용 형태, 업무량 등이 제대로 파악되고 있지 않다. 이에 본 연구는 세포병리사의 효율적인 직무수행의 범위, 의료기관의 종별에 따른 세포병리사의 업무량 분석 결과를 토대로 병리과질관리 인증평가항목의 기준 설정에 기초자료를 제공하고자 하였다. 연구방법은 전국 의료기관에 근무하는 세포병리사 자격증 소지자를 연구대상으로 설문조사를 실시하였다. 총 245명의 세포병리사가 설문에 응답하였으며 그 중 1차 선별검사 업무를 수행하고 있는 인원은 178명(72.7%)으로 조사되었다. 각 기관별 1일 기준, 세포병리사 1인의 평균 1차 선별검사 건수는 대학병원그룹이 75.4장(16.8장/시간), 병원그룹이 72.4장(18.6장/시간) 그리고 76명이 응답한 전문수탁 기관은 231장(32.6장/시간)으로 조사되었다. 이에 본 연구결과를 기초로 세포 선별검사 업무에 대한 기준지침을 수립하여 대한세포병리학회 등과 협의체를 구축하고, 현안 사항에 대한 해결방법을 모색하여 국민건강 보건 향상에 기여해야 할 것이다.

• 임상간호연구
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• 제29권2호
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• pp.198-209
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• 2023

Purpose: The purpose of this study was to develop a Korean Adult Patients Delirium Screening Tool (K-APDS) for those admitted to general wards, and to verify its reliability and validity. Methods: For the development of the tool, 12 items were derived through the results of literature review and focus group interviews with general ward nurses, and the content validity was confirmed by experts. To verify the reliability and validity of the developed tool, 317 adult patients who were admitted to general wards of three tertiary general hospitals from October to November 2022 were evaluated by the attending nurse and data were collected. Results: After factor analysis for construct validity verification, two factors were extracted, which explained 60.1% of the total variance. After the validation of the control group, the difference in the delirium incidence scores calculated using the K-APDS between the delirium group and non-delirium group was very significant (Z=-10.82, p<.001). To verify the criterion validity, K-APDS, Delirium Observation Screening, and Pearson's correlation coefficient were checked and found to be .94 (p<.001). The predictive validity test reported that the sensitivity was 91.1%, specificity was 82.4%, positive predictive value was 52.6%, and negative predictive value was 97.8%. The reliability of K-APDS was found to be high with Cronbach's ⍺=.91. Conclusion: K-APDS can screen for delirium with 2 or more points, excellent validity and reliability have been verified. Therefore, this tool could be applied immediately in the clinical field, and will contribute to the early detection of delirium, enabling rapid interventions.

• 한국노년학
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• 제30권3호
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• pp.855-869
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• 2010

본 연구는 노인장기요양보험 도입이후 장기요양시설과 요양병원의 효율적 연계방안을 모색하기 위한 기초조사 연구이다. 본 연구는 문헌고찰을 기반으로 국민건강보험공단 노인장기요양운영센터를 이용 장기요양시설 192곳과 요양병원 168곳 시설관계자(시설장, 병원장 및 이용자 등)에게 운영현황과 효율적 연계방안에 대해 면접조사를 실시 분석하였다. 자료분석은 기술통계, χ²검증 등을 SPSS 13.0으로 분석하였다. 연구결과 운영현황에서는 요양시설과 요양병원 모두 본인부담의 차이가 미미하나 식대에 대한 편차가 크게 나타났다. 경영수지적자에 대해서는 양 기관 모두 수가보전에 문제점을 지적하고 있으며, 교통과 환경요인이 입지조건을 좌우하는 것으로 파악되었다. 둘째 이용행태면에서는 양 기관 모두 비용할인 경험이 높은 것으로 나타났고, 면회를 오지 않는 경우가 많은 것으로 파악되었다. 반면, 요양시설이 사망 시까지 있는 경우가 요양병원에 비해 더 높게 나타나고 있다. 셋째, 기관의 서비스제공문제점으로는 일률적인 서비스제공, 가족의 지지나 방문 부족 등을 들 수 있다. 끝으로 양 기관의 효율적 연계방안으로는 수가현실화, 간병비 지급, 복합시설 허용, 판정기준 강화, 주치의, 요양병원의 장기요양보험 관리 방안 등을 제시하였다.

• 유통과학연구
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• 제15권1호
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• pp.105-114
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• 2017

Purpose - Recently, domestic pharmaceutical market is growing steadily, but top-tier companies are concentrating on sales growth. In this market, SMEs, which account for more than 80% of the entire market, suffer from the problem of lower margins and increasing inventory costs. According to the government's policy changes related to pharmaceuticals, it is pointed out that the management of existing customers and the control of salespeople are important issues for pharmaceutical companies. This study investigates the effect of the control system on the salesperson in domestic pharmaceutical distribution channel on customer-oriented selling behaviors and sales performance. Research design, data, and methodology - To verify the proposed research model and test hypotheses, the authors selected 244 MR(medical representatives)'s responses which have currently relationship with doctors or pharmacists. This study carefully investigated the reliability, content validity, convergent validity, and discriminant validity of the proposed model. Results - The authors find out the following results: capacity control, activity control, and self control have positive effects on customer-oriented selling behaviors and customer-oriented selling behaviors have a positive effect on sales performance. In addition, we present alternative model to check the direct effect between the control systems and the sales performance, but control system factors except self control have no direct influence. Conclusions - First of all, competency control and activity control increases the customer-oriented selling behavior of the salesperson. This means that the salesperson's sales skill, negotiation skill, customer access skill, presentation ability, monitoring, direction and evaluation are important and it is also important to control activities to check the number of visits to customers, report preparation, and customer service etiquette. Second, the fact that self-control of salesperson affects the customer-oriented selling behavior suggests that self-control is not controlled by external factors but rather establishes short/long-term goals. Therefore, it is important for sales organization to create an environment in which members can induce persistent incentives for self-control. Finally, output control did not affect customer-oriented sales behavior, which is less likely to form confidence or motivation to MRs when output control is perceived as a means of monitoring, supervising, or controlling rather than providing information to salespeople.

• Journal of Trauma and Injury
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• 제20권2호
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• pp.96-100
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• 2007

Purpose: Trauma is the 5th most common leading cause of death in Korea, but there has been no appropriate management system for patients until now. We analyzed the main causes of death in trauma patients by comparing the characteristics of those patients with the characteristics of patients who survived. We feel this analysis should have a positive effect on the development of an appropriate trauma management system in Korea. Methods: We retrospectively reviewed trauma patients who had been admitted to the Department of General Surgery from February 2002 to February 2007. We compared several expected risk factors between the mortality and the survival group. Data on the transportation, arrival time at the emergency center, amount of transfusion, initial shock index, cause of death, and initial physical condition according to RTS (Revised trauma score), ISS (Injury severity score) and TRISS (Trauma and Injury Severity Score) were collected. Patients with ISS lower than 12 were excluded. Results: Three hundred sixty-six(366) patients with multiple injuries were included. There were 40 patients in the mortality group and 326 patients in the survival group. The mean arrival time (minutes) to emergency center was longer in the mortality group (137.6 vs 93.6 p 0.04). The total amount of transfusion (ml) was larger in the mortality group (7139 vs 2470 p 0.01). The initial shock index was higher in the mortality group (1.45 vs 1.17 p<0.01). The RTS, ISS, and TRISS were not statistically different between the groups. In the multivariate analysis, mean arrival time and initial shock index were important factors for survival. Conclusion: If the mortality rate of trauma patients is to be reduced, the arrival time at the emergency center should be minimized. Improvement of the emergency medical transfer service system is very important for achieving that.

• 보건행정학회지
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• 제10권1호
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• pp.111-125
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• 2000

To compare the differences in the recognition on hospital utilization and satisfaction, 368 hospital employees and 485 patients were selected in four hospitals in Seoul and Kyung-gi do. The survey was done using a constructed form of checklist from Apr. 30 to May 10, 1999. And the results are as follows: l. Gaining knowledge of hospitals available among hospital employees differed from that of patients. When finding out about sources of information concerning hospitals, direct visit to the hospital was recognized to be the main factor for the hospital employees in contrast to the patients' recognition which were mass media, personal involvement of job related workplace and recommendations from other hospitals. There was no difference between university and general hospitals. 2. The factors that concern which hospital to choose there was a difference between hospital employees and patients. Hospital employees recommended their own hospital solely based on the reason that it was their work place. On the other hand, the patients made a choice based on the type of medical staff, transportation available and whether it was a university hospital or not. There was no difference between university and general hospitals. 3. The recognition of employees concerning hospital image of a hospital between hospital employees and patients was different. In university hospitals, the employees recognized the name value of university hospital and cooperation as most important, whereas the patients thought convenience, kindness were the main factors. Patients considered general hospitals to be more convenient. There was some difference between university and general hospitals. For university hospitals employees' recognition was higher and for the general hospital patients' recognition is higher on hospital image. 4. The recognition of employees was different from that of patients' on hospital satisfaction. The patients' satisfaction was higher than that of employees'. There was no difference between university and general hospitals. Based on the above findings, the employees' recognition on hospital utilization and satisfaction was different from that of the patients, but there was no difference between university and general hospitals. In both groups choice of hospital was associated with satisfaction. Results showing difference between employees' and patients' recognition can be applied to implement customer-oriented attitude and be used as a baseline data for internal-external marketing planning of hospital management. The study may be limited in that the results cannot be generalized due to its small sample size and not being able to reflect demographic variables and life style. Further studies to investigate the difference of hospital utilization and hospital satisfaction will be necessary to define demographic characteristics and recognition of employees which influences patients' hospital satisfaction.