• 한국의료질향상학회지
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• 제9권2호
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• pp.210-228
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• 2002

Background: The purpose of this research was to examine the fall incidence rate and its related factors of fall in inpatients. Methods: The data were collected from the 138 fall incident reports in one tertiary hospital in Seoul from April 1st 1999 to September 30th 2001. The Fall Incident Report Form was originally developed based on that of Massachusetts General Hospital revised in 1995. And this was modified for this survey by the collaborating work of QI team including researcher and department of nursing service of this particular hospital. The contents of Fall Incident Form were general characteristics of patient. factors related to fall. types and places of fall. circumstances, nursing interventions. and outcome. Results: 1) The incidence rate of fall was 0.08% of total discharged patients and 0.081 per 1000 patient-day. This incidence rate is much lower than that of several hospitals in USA. This finding might result from the different incidence report system of each hospital. 2) The characteristics of fall-prone patient were found as follows. They were mostly over 60 years old, in alert mental status, ambulatory with some assistance, and dependent on ambulatory device. The types of diseases related high incidence rate were cerebrovascular disease(3.2), hypertension(1.6), cardiovascular disease(1.4), diabetes(1.3) and liver disease(0.6). 3) The majority of fall events usually occurred m bed. bedside(walking or standing) and bathroom in patient room. Usually they were up on their own when they fell. And there were more falls of elderly occurred during night time than day or evening. 4) 63.8% of fall events resulted in physical injuries such as fracture and usually the patients had diagnostic procedures and some treatment(ex. suture) which caused additional cost to the patients and their families. 5) The found risk factors of fall were drugs(antihypertensive drug, diuretics) and environmental factors like too high bed height, long distance of bedside table and lamp switch, and slippery tile of bathroom floor. Conclusion: Considering these results, every medical and nursing staff should be aware of the risk factors of patients in hospital, and should intervene more actively the preventive managements, specially for the elderly patients during night. Therefore, it is recommended that the development of Fall Prevention Programs based on these results.

• KSII Transactions on Internet and Information Systems (TIIS)
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• 제13권4호
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• pp.2060-2077
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• 2019

Recently, mobile healthcare services have attracted significant attention because of the emerging development and supply of diverse wearable devices. Smartwatches and health bands are the most common type of mobile-based wearable devices and their market size is increasing considerably. However, simple value comparisons based on accumulated data have revealed certain problems, such as the standardized nature of health management and the lack of personalized health management service models. The convergence of information technology (IT) and biotechnology (BT) has shifted the medical paradigm from continuous health management and disease prevention to the development of a system that can be used to provide ground-based medical services regardless of the user's location. Moreover, the IT-BT convergence has necessitated the development of lifestyle improvement models and services that utilize big data analysis and machine learning to provide mobile healthcare-based personal health management and disease prevention information. Users' health data, which are specific as they change over time, are collected by different means according to the users' lifestyle and surrounding circumstances. In this paper, we propose a prediction model of user physical activity that uses data characteristics-based long short-term memory (DC-LSTM) recurrent neural networks (RNNs). To provide personalized services, the characteristics and surrounding circumstances of data collectable from mobile host devices were considered in the selection of variables for the model. The data characteristics considered were ease of collection, which represents whether or not variables are collectable, and frequency of occurrence, which represents whether or not changes made to input values constitute significant variables in terms of activity. The variables selected for providing personalized services were activity, weather, temperature, mean daily temperature, humidity, UV, fine dust, asthma and lung disease probability index, skin disease probability index, cadence, travel distance, mean heart rate, and sleep hours. The selected variables were classified according to the data characteristics. To predict activity, an LSTM RNN was built that uses the classified variables as input data and learns the dynamic characteristics of time series data. LSTM RNNs resolve the vanishing gradient problem that occurs in existing RNNs. They are classified into three different types according to data characteristics and constructed through connections among the LSTMs. The constructed neural network learns training data and predicts user activity. To evaluate the proposed model, the root mean square error (RMSE) was used in the performance evaluation of the user physical activity prediction method for which an autoregressive integrated moving average (ARIMA) model, a convolutional neural network (CNN), and an RNN were used. The results show that the proposed DC-LSTM RNN method yields an excellent mean RMSE value of 0.616. The proposed method is used for predicting significant activity considering the surrounding circumstances and user status utilizing the existing standardized activity prediction services. It can also be used to predict user physical activity and provide personalized healthcare based on the data collectable from mobile host devices.

• 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.

• 한국응급구조학회지
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• 제9권2호
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• pp.111-128
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• 2005

Background: Cardiac arrest is one of the most critical diseases which can likely lead to severe cerebral disability or brain death when the cases can not recover their circulation within 10 minutes. Saving out-of-hospital cardiac arrest cases is a recent concern in Korea. Resuscitation has become an important multidisciplinary branch of medicine, demanding a spectrum of skills and attracting a plethora of specialities and organizations. The best survival can be achieved if all the following links have been optimized : rapid access, and early CPR, defibrillation and ACLS, Since the "Utstein Style" was advocated in 1991, many reports about out-of-hospital cardiac arrest have been published based on this guideline. These differences prevent valid inter-hospital and international comparisons. However, it is not known how effective resuscitation has become to the patients. In other words, there are no guidelines for reviewing, reporting, and conducting research on resuscitation in Korea. This dissertation aims to provide the basic data for a unified reporting guideline of resuscitation in Korea and evaluating the out-of-hospital factors associated with survival discharge of out-of-hospital cardiac arrest. Methods: As for this study, uses the collected data about Out-of-hospital cardiac arrests at 4 area, from January, 2005 to April. 2005. With a retrospective study, 174 cases were analyzed. The data was recorded based on the Out-of-Hospital Utstein Style. Results: Resuscitation was performed on 174 out-of-hospital cardiac arrest cases at the 4 area 14 patients(8.1%) recovered their spontaneous circulation. Overall, the ROSC of the out-of-hospital cardiac arrest patients was 8.1%, which was poorer than that of western countries. Gender distribution was 50 females(28.7%) and 124 males(71.3%), approximately twice as many males as females. ROSC of witnessed arrests was found out to be 97.7%. The ratio of the witnessed arrest groups showed higher results than that of unwitnessed arrest groups in the above-examined cases. Cardiac etiology consisted of cardiac(33.5%), non-cardiac(45.7%), trauma(20.1%), and unknown(6.0%). Cardiac was the best performance. Initial rhythm showed Ventricular Tachycardia/pulseless Ventricular Fibrillation in 8 patients(6.0%), asystole in 100(75.2%) and unknown in 25(18.8%). The results of the Ventricular Tachycardia/pulseless Ventricular Fibrillation showed higher results than the others cases, The proportion of the cardiogenic cause was 33.5%, which was only half of western countries. Ventricular Tachycardia/pulseless Ventricular Fibrillation is relatively rare. These differences were due to the prevalent pattern of Out-of-hospital cardiac arrest as well as prematurity of the EMSS. Bystander CPR was practiced on 13 patients(7.52%). ROSC was shown in 46.2% cases. CPR by EMT was carried out on 167 cases(96.5%). ACLS by EMf was rare. From collapse, 4 cases(2.6%) arrived to ED within 6 minutes. 13 (8.6%) within 10 minutes, and 49(32.5%) over 31 minutes. The sooner the patients arrived, the greater the ratio of ROSC and discharged alive became, and the same with collapse time to ROSC. As the results of the logistic regression analysis, ROSC was found out to be highly influenced by the time of ED arrival from collapse and Ventricular Tachycardia/pulseless Ventricular Fibrillation. Therefore, the ratio of ROSC depends on not any single factor but various intervention factors. Conclusion: This dissertation presents the following suggestions and directions of the study hereafter. First, the first step for a chain of survival should be taken to activate EMSS early with a phone as soon as cardiac arrests are witnessed. Second, it is keenly needed that emergency medical technicians should be increased through emergency education for living. Third, it is necessary to establish the emergency transportation system. Fourth, most of the Koreans have little understanding of EMT and the present operation systems have many problems, which should be fundamentally changed. Fifth, it is required to have an active medical control over Out-of-hospital CPR, And proper psychological supports should be given not only to patients themselves and their family but also individuals who are engaged in emergency situation. Finally, through studies hereafter on nationwide, comprehensive, and standard forms, it is needed to examine into the biological figures of human body, causes and trends of cardiac arrests, and then, to enhance the survival rate of Out-of-hospital cardiac arrests. Korean guidelines for Cardiopulmonary resuscitation need to be made.

• 치위생과학회지
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• 제5권4호
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• pp.211-220
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• 2005

서울, 경기, 인천 지역을 중심으로 치과코디네이터가 근무하는 치과병 의원 선정하여 현직 치과코디네이터들을 대상으로 치과코디네이터의 업무수행 정도와 인식도를 조사하여, 보다 효율적인 인력활용 방안을 마련하는 기초를 제공하고자 2005년 5월 1일부터 8월 8일까지 설문지를 통하여 자료를 수집한 후 회수된 108부를 분석한 결과는 다음과 같다. 1. 응답한 치과코디네이터들의 치과근무기간은 5년 이상이 43.5%, 2년 미만이 19.5%, 3년 이상 5년 미만이 19.4%의 순으로 나타났고, 치과코디네이터로서의 업무기간은 2년 미만이 39.8%, 2년 이상 3년 미만과 5년 이상이 각 19.4%의 순으로 나타났다. 그리고 현재 불리워지는 명칭으로는 실장(팀장)이 38%, 코디네이터가 30.6%이었으며, 치과코디네이터로 담당하는 세부 업무로는 리셉션이 30.6%로 가장 높았고, 소속된 부서는 진료지원팀이 57.4%로 가장 높게 나타났다. 2. 교육관련 사항으로는 치과코디네이터가 되기 위해 가장 많이 교육을 받은 기관으로는 45.4%가 사설기관이고, 응답자의 73.1%가 공인된 치과코디네이터 자격시험이 필요하다고 응답하였다. 또한 자격인정을 위한 적절한 공인기관으로는 중앙부처라고 응답한 율이 43.5%로 가장 높았고, 응답자의 70.8%는 이수한 업무교육 내용이 직무수행에 적합했다고 응답하였다. 치과코디네이터 업무능력 향상을 위한 지속교육 필요 여부는 96.3%가 "예"라고 응답하였고, 그 이유는 능력향상을 위해서가 63.9%, 체계적인 교육을 위해서가 22.2였다. 교육비 부담은 근무기관에서 총 교육비의 일정액 보조가 29.6%, 전액 자비 부담이 25.9%였다. 치과코디네이터 교육과정 중 필수 이수항목에서는 의료서비스 마케팅이 66.7%, 치과코디네이터 이론과 실무가 65.7%, 치과의료기초 57.4%의 순이었고, 보완을 희망하는 교육항목은 치과의료서비스 마케팅이 46.3%, 건강보험실무가 35.2%였다. 3. 치과코디네이터로서 현재 수행하는 업무는 고객관리 분야에서는 예약관리가 88.9%, 자기관리 분야에서는 서비스기본매너 갖추기가 87.9%, 원무관리 분야에서는 수납이 81.3%로 높게 나타났다. 4. 치과코디네이터의 수행업무에 대한 인식으로는 '현재 수행하고 있는 직종에 자부심을 가지고 있다($3.99{\pm}0.76$)', '치과코디네이터 업무는 경영 기여도가 높다고 생각한다($3.92{\pm}0.70$)', '내가 수행하는 업무는 전체 치과병 의원 업무에서 차지하는 비중이 크다($3.91{\pm}0.84$)', '나는 직원들과 직급에 관계없이 잘 지낸다($3.86{\pm}0.74$)', '업무를 통하여 환자의 구강건강 증진에 많은 도움이 되고 있다고 생각한다($3.76{\pm}0.75$)', '내 직업은 미래 전망이 밝다($3.74{\pm}0.86$)' 순으로 높게 나타났다. 5. 치과코디네이터의 연령별로 인식을 살펴보면 대체적으로 모든 항목에서 연령이 높을수록 업무에 대한 인식도가 높은 것으로 나타났고, '내가 수행하는 업무는 전체 치과병 의원업무 차지하는 비중이 크다'(P < 0.001), '수행하는 업무에 대하여 경영자의 인정과 신뢰를 받는다'(P < 0.01), '현재 수행하고 있는 직종에 자부심을 가지고 있다', '내 직업에 대한 사회적 인지도가 높다', '스텝들은 치과코디네이터들이 하는 일에 대해 이해하고 인정한다', '치과의사들은 치과코디네이터들이 하는 일에 대해 이해하고 인정한다', '현재 불리워지는 직명에 만족한다', '내 직업은 나이의 제한을 받지 않는다고 생각한다', '치과 코디네이터 업무는 경영 기여도가 높다고 생각한다'(P < 0.05)의 항목에서는 연령별로 통계적 유의성이 유의한 차이를 보였다. 6. 치과코디네이터의 직종별로 업무에 대한 인식을 살펴보면 대부분의 항목에서 치과위생사, 간호조무사, 기타 순으로 업무에 대한 만족도가 높은 것으로 나타났다. 그리고 '업무를 수행함에 있어서 업무관련 결정을 내가 하고 있다'(P < 0.001), ' 내가 수행하는 업무는 전체 병원업무에서 차지하는 비중이 크다', '내 업무는 나의 능력을 향상시켜 준다', '업무를 통하여 환자의 구강건강건강 증진에 많은 도움이 되고 있다고 생각한다', '현재 받고 있는 보수에 만족한다', '스텝들은 치과코디네이터들이 하는 일에 대해 이해하고 인정한다'(P < 0.01), '내 직업에 대한 사회적 인지도가 높다', '업무 수행시 스텝과의 갈등이 없다', '치과병 의원에서는 치과코디네이터의 능력향상을 위한 자기개발 기회를 주고 있다'(P < 0.05)의 항목에서 통계적으로 유의한 차이를 보였다.

• 한국산학기술학회논문지
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• 제19권2호
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• pp.530-547
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• 2018

본 연구는 사회 경제적 여건의 변화에 따라 급변하는 의료환경 속에서 중소병의원의 개원 및 운영과 관련하여 고객입장에서 입지환경의 중요성에 주목하고 입지 및 교통, 입주건물의 매력도와 고객만족도 간의 관련성을 분석한 실증연구이다. 내원환자 350여명에 대해 2017년 7월부터 8월까지 약 40일간 설문조사를 수행하고 회수된 343부중 결측치 8부를 제외한 335부에 대해 SPSS와 AMOS 통계패키지를 활용하여 분석하였다. 주요 연구결과는 다음과 같다. 첫째, 건물매력도가 고객만족도에 유의적인 정(+)의 영향을 미칠 것이라는 가설은 채택되었다. 둘째, 교통인프라가 고객만족도에 유의적인 정(+)의 영향을 미칠 것이라는 가설은 기각되었다. 셋째, 건물매력도가 입지시장성에 유의적인 정(+)의 영향을 미칠 것이라는 가설은 채택되었다. 넷째, 교통인프라가 입지시장성에 유의적인 정(+)의 영향을 미칠 것이라는 가설은 채택되었다. 다섯째, 입지시장성이 고객만족도에 유의적인 정(+)의 영향을 미칠 것이라는 가설은 채택되었다. 여섯째, 건물매력도와 고객만족도 간의 관계를 입지시장성이 매개할 것이라는 가설은 부분매개역할이 있음이 확인되어 채택되었다. 일곱째, 교통인프라와 고객만족도 간의 관계를 입지시장성이 매개할 것이라는 가설은 완전매개역할이 있음이 확인되어 채택되었다. 본 연구는 서울지역의 중소병의원만을 대상으로 하고 있어서 지방 중소병의원의 입지 및 교통인프라, 건물매력도에 대한 환자들의 인식까지 아우르지 못하고 있다. 또한 병의원의 매출, 순이익 등 재무적 경영성과에 대한 객관적 자료 대신 고객만족도라는 환자들의 인식만을 분석대상으로 하고 있다는 한계를 가지고 있다. 본 연구의 결과는 향후 의료서비스 시설의 입지선정을 위한 기초를 제공하는데 응용할 수 있을 것이다.

• 한국의료질향상학회지
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• 제8권1호
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• pp.44-55
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• 2001

Background : This study aimed at identifying the effect of the standardized protocol on lowering the incidence of the ventilator associated pneumonia(VAP). Methods : The standard protocol focusing on decreasing VAP was made and applied at 5 ICUs (Medical ICU, surgical ICU, Respiratory ICU, Neonatal ICU, Pediatric ICU) in a university affiliated tertiary hospital, from April 1, 2000 to Oct 31, 2000. The protocol involved 3 parts : hand washing, the suctioning method and ventilator circuit management. All the nursing personnel received intensive education which was consisted of lecture, video film and demonstration. 176 nurses reported the performance of handwashing pre and post intervention. And randomly selected 15 nurses were observed by charge nurse and the handwashing practice was analyzed pre and post intervention. The incidence of VAP was compared with the former year incidence. Results : The self reported frequency of hand washing increased. In the direct observation of handwashing, the frequency, time, thoroughness of hand washing during 8 hours day duty was found to be improved. The frequency was increased from 1.1 time to 4.1 times; the time was improved from 1.7 seconds to 5.7 seconds and the thoroughness of the washing practice was from 0.2 times to 3.0 times respectively (p<0.001). The incidence of VAP decreased from at a rate of 15.63 number of case per 1,000 ventilator-day (April 1~August 31, 1999) to 7.23 number of case per 1,000 ventilator-days(April 1~Oct 31, 2000)(P<0.001). Conclusion : We developed the protocols which included hand washing, the suctioning method, and ventilator circuit management. Through the implementation of the protocol, the performance of hand washing improved and the VAP incidence rate in ICU was decreased.

• 지역사회간호학회지
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• 제5권1호
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• pp.64-80
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• 1994

The purpose of this study was to identify factors affecting family caregiver burden, and to identify the relationship between family caregiver burden and family function /self-care of psychiatric out-patient. These data were collected by questionnaire from September 20 to October 8, 1993. The subjects were 285 family caregiver of psychiatric out-patients. The instruments used in this study were Caregiver Burden Inventory(CBI) by Novak(1989), self-care performing by Yu(1992), and Family APGAR by Smilkstein(1979). The data were analyzed by cronbach's $\alpha$, mean, standard deviation, percentage, t-test, ANOVA, Pearson's correlation coefficient, and Stepwise Multiple Regression with SPSS /pc+ program. The result of this study were as follows ; 1. The means of family caregiver Burden revealed total 2.00, Time-Dependence Burden 78, developmental Burden 2.22, physical Burden 1.90, social Burden 1.43, emotional Burden 2.18, financial Burden 1.51. family caregiver burden score showed moderate level. time-dependence burden showed the highest score and social burden showed the lowest score. 2. The means of family function revealed total 5.67. 7 through high-21.4% (61), low through 3-38.6%(110). family function score showed moderate level. 3. The means of patient's self-care performance revealed total 137.71. self-care performance showed moderate level. 4. A ststistically significant correlation between family caregiver burden and patient's demographic variables, age (F=3.83, p<.01), marrital status(F=3.50, p<.01), job(F=3.17, p<.01), diagnosis(F=4.46, p<.01), income (F=4.46, p<.01). No significant differences between family caregiver burden and prevalent period, religion, sex (p>.05). S. A ststistically significant correlation between family caregiver burden and family's demographic variables, age (F=7.34, p<.01), sex(t=-2.63, p<.01), education level(F=7.61, p<.01), income (F=8.13, p<.01), relation with patient (F=6.92, p<.01), job(F=2.03, p<.05), medical service (F=3.89, p<.05), presence of chronically ill without patient(t=-2.01, p<.05) 6. Family function was the highest factor predicting family caregiver burden(R=.4168, $R^2=.1737$), low education level of family, patient's self-care, family income accounted for 36% in family caregiver burden.

• 한국산학기술학회논문지
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• 제11권11호
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• pp.4360-4366
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• 2010

본 연구에서는 고등학교 단거리 선수의 심폐능력, 기초체력, 신체조성, 그리고 각 부위별 근력이 24주간 운동을 통하여 어떠한 변화가 있는지 규명하였다. D 고등학교에 재학중이며 운동경력이 최소 4년이상된 남자 단거리 선수 8명을 연구대상자로 선정하였다. 운동 전 후 연구대상자들의 심폐능력, 신체조성, 근력 그리고 기초체력을 측정하여 자료처리 하였다. 본 연구결과, 체지방률, 체지방량, 제지방량, 그리고 체수분량 모두 훈련 후 통계적으로 유의한 증가가 있었다(p<0.05). $VO_2$max와 aerobic threshold는 운동전보다 향상되었으며 통계적으로 매우 유의한 변화가 나타났다 (p<0.05). 근력 및 기초체력 또한 통계적으로 유의한 상승 변화을 보였다 (p<0.05.) 본 연구결과 24주간의 훈련 프로그램은 남자 고등학교 단거리 선수들의 총체적 체력 향상을 도모하였다. 단거리 훈련 프로그램 작성 시 전통적인 방법으로 훈련을 계획하고 실천하기 보다는 경기력 향상 및 부상 예방을 위하여 훈련 전 종합적인 신체검사 및 체력 검사를 전문가와 같이 실시 및 평가하여 이를 토대로 개인의 체력에 맞게 훈련 프로그램을 계획 실천할 필요가 있을 것이다.

• 농촌계획
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• 제25권1호
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• pp.113-125
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• 2019

The purpose of this study is to provide the demand information about services (S/W) and infrastructure (H/W) for rural welfare and culture. The survey was conducted on the overall satisfaction level, the condition change, the importance-satisfaction level of each field and the top priority items for administrative agencies and rural residents. In the overall satisfaction level, administrative agencies responded more than 'normal' to all fields, but the overall satisfaction level was lower than 'normal' in the fields excluding the healthcare field in the case of rural residents. In terms of condition changes compared to the past five years, both administrative institutions and local residents evaluated the improvement. IPA analysis was conducted to identify the priority ranking of each field and it was found that emergency medical facilities in the healthcare field, infant day care facilities in the social welfare field, movie theaters in the culture field, lifelong education institutions and academy facilities in the education field and private sports facilities in the leisure and sports field were most needed, respectively. The results of this study are expected to be helpful in increasing the efficiency and presenting the improvement direction about the development policy of the rural culture and welfare.