• Journal of Hospice and Palliative Care
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• 제1권1호
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• pp.56-64
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• 1998

목적 : 본 연구는 서울대학교병원의 말기암환자와 가족을 위한 집단상담 프로그램을 소개하고, 현황 및 문제점을 파악하고자 하였다. 방법 : 1996년 한 해동안 상담에 참석한 말기암환자 및 가족들의 상담기록지를 중심으로 연구자들이 상담한 내용을 분석하였다. 결과 : 참석자 312명은 가족(84%)이 환자(16%)의 4배 이상 참석했고, 대부분 1회만 참석하고 있음을 보여주었다. 참석한 환자 또는 가족이 돌보는 환자의 현황은 나이별로 60대, 50대, 40대가 많았고, 암의 종류는 폐암, 위암, 간암 순으로 많았다. 가족의 특성은 261명으로 배우자, 자녀, 며느리, 형제자매, 부모순으로 많았다. 프로그램에 오게된 경로는 의사의 권유(69%), 병원 포스터(26%), 기타 순이었다. 이것은 의사가 환자와 가족을 집단에 참여시키는데 중요한 역할을 담당하고 있음을 보여준다. 질문은 우선적으로 의료적인 정보에 대한 욕구가 많았다. 이것은 환자나 가족이 의료진으로부터 정보를 제대로 전달받지 못하고 있음을 보여준다. 또한 가족은 환자를 돌보는데 있어서 정보의 제공만으로 해결될 수 없는 여러가지 실제적인 어려움을 주고 있었다. 그 결과 계속적인 24시간 전화상담 서비스 호스피스 시설 가정간호 서비스의 확대, 3차 의료기관과 1,2차 의료기관과의 의뢰 체계 등을 필요로하고 있었다. 따라서 병원에서 제공될 수 있는 프로그램과 지역사회에서 제공될 수 있는 자원, 호스피스 시설과의 연계가 필요하며 이를 관리해줄 수 있는 환자 관리 전담 인력이 필요하다. 결론 : 본 프로그램은 1회(single-session)적인 성격이 강하지만 환자와 가족이 궁금해하는 점들을 만족시켜주므로서 암에 대한 인식이 증가하고 대처능력이 향상되고 있음을 볼 수 있다. 이것은 이 프로그램이 위기에 처한 말기암환자와 가족을 지지하는 프로그램으로서 활용가치가 높다고 볼 수 있다. 추후 연구는 프로그램의 효용성에 대한 평가가 검토되어야 할 것이며, 다른 병원에서도 각 병원의 특성과 참석자들의 특성을 고려하여 보다 발전된 프로그램이 나오기를 바란다.

• 한국비블리아학회지
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• 제26권4호
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• pp.283-304
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• 2015

본 연구는 정부 및 공공기관의 보건 관련 웹 사이트들의 웹 접근성을 한국형 지침에 따라 평가하여 장애인이나 노령자들과 같은 정보이용 소외집단들이 겪을 수 있는 문제점들을 파악하고자 하였다. 본 연구에서는 총 27개의 보건 관련 웹 사이트의 접근성을 자동평가 및 전문가 평가를 수행하여 측정하였다. 두 단계의 평가를 실시한 결과를 종합해 볼 때, 국립병원이나 국립재활원 등과 같은 의료기관들은 웹 접근성 오류가 거의 없는 것으로 나타났으며, 그 외에도 건강보험심사평가원, 보건복지부, 보건사업진흥원, 식품의약품안전처, 그리고, 한국의료분쟁 조정중재원 등은 웹 접근성 준수율이 매우 높았다. 그러나 전문가 평가를 실시한 결과, 자동평가에서는 오류가 없는 것으로 나타났던 적절한 대체텍스트의 제공이 매우 미흡한 것으로 나타났으며, 텍스트 콘텐츠의 명도 대비가 표준에 미치지 않아 전맹자나 저시력자들의 웹 접근성을 지원하기 힘든 것으로 평가되었다. 그 외에도 기본언어표시와 마크업 오류 등 정확한 정보의 전달을 어렵게 하는 문제들이 나타났고, 반복영역 건너뛰기, 콘텐츠 선형화, 그리고 키보드 사용보장을 준수하지 않는 문제들이 발견되어 시각장애뿐 아니라 인지장애 내지 운동장애가 있는 이용자에게는 웹 접근성을 심각하게 방해하는 요소가 될 수 있는 것으로 파악되었다. 본 연구는 국내 연구로서는 처음으로 정부 및 공공기관의 보건관련 웹 사이트들의 접근성을 한국형 지침에 따라 평가했다. 또한, 이러한 웹 사이트들을 대상으로 자동 평가로 측정하기 어려운 웹 접근성의 정도와 상세한 내용 분석을 포괄하는 전문가 평가를 수행했다는 점에서 웹 접근성 연구 분야에 기여했다고 볼 수 있다.

• 지역사회간호학회지
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• 제9권2호
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• pp.324-335
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• 1998

This study describes the extent of recognition of problems to the aged in a future society, the recognition and necessity of day care facilities, and the service contents and patterns preferred as a method of mediation for nursing the aged and increasing their quality of life. It also tries to certify the relations between those subjects. The result of the study is as follows: 1. Concerning problems of the aged of social significance the aged of the next generation consider the difficulties in nursing the aged to be the most important at 63.6%. 2. Concerning the nursing of parents, 49.4% of those answered 'children should take care of their parents and live together', while 46.7% answered that 'it is enough for children to provide an economic support, not necessarily living together. 3. Concerning information of day care facilities, 66.9% answered that they have no information. 4. Concerning the use of day care facilities, 54.6% answered that 'they would under certain circumstances', and 21.0% that 'they had better use them in the future'. 5. Concerning the feelings of the aged using day care facilities, 46.6% say 'they do not look poor', and 33.4% said that 'they look a little poor'. 6. Concerning the reasons for using day care facilities, 56.1% answered' because children do not proride care', and 48.5% answered 'because their economic ability is not sufficient'. 7. Concerning the programs potentially needed, food supply, medical services and physical therapy were ranked in that order. 8. Concerning social facilities necessary for the aged, centers that specialize in dementia, free day care facilities, home care services, and fee - based day care centers were ranked in that order. 9. Concerning institutions providing day care, welfare centers for the aged, those centers auxiliary to hospitals, asylums, and individuals were ranked in that order. 10. Concerning the responsibity running day care facilities, social workers, doctors/nursing assistants, nurses, and entrusted visitors were ranked in that order. Based on the results of this study, the study proposes that the study of applied cases of therapy in day care facilities for the aged continue.

• 한국항행학회논문지
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• 제6권1호
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• pp.37-43
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• 2002

본 논문은 IEEE 802.11a에서 사용되는 ISM (Industry, Science, Medical) 밴드인 5GHz 대역에서의 무선 LAN(W-LAN)에 대한 시스템의 성능평가와 분석을 하였다. W-LAN은 현재까지 개발, 적용되고 있는 2.4 GHz대의 제품이 주류를 이루고 있으나, 이는 전송 속도가 11 Mbps로 고속의 전송이 요구되는 시스템에는 부적합하다. 이를 해결하기 위해 5 GHz 대역에서 54 Mbps까지 전송 속도를 지원하는 차세대 W-LAN을 구현하여, 강의실이나 구내 일정한 지역에서의 통신은 물론 차량과 같은 고속으로 이동시에도 데이터가 끊어짐이 없이 지속적인 서비스가 되도록 무선 접속장치(AP: Access Point)와 무선 단말 장치 (NIC: Network Interface Card) 간의 다중 경로 페이딩 채널을 모델링하였다. 또한 간섭성을 감소시키기 위해 컨벌루셔널 부호의 사용과 데이터 통신에서 필요로 하는 신뢰성있는 BER을 얻기 위해 단일 텝 LMS (Least Mean Square) 등화기를 적용하였고, 인접 심볼 또는 채널간 간섭을 제거하는 시뮬레이션으로 차세대 LAN 시스템의 성능을 평가 및 분석 하였다.

• 간호행정학회지
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• 제6권3호
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• pp.333-345
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• 2000

The health care environment becomes more competitive every day. It has fallen to nurse managers - from vice presidents of patient care to nurse managers and their assistants - to recruit and develop a workforce that successfully meets the needs of both patients and the organization. This means employees who demonstrate advanced critical thinking skills, creative problem solving, and sound decision making skills combined with clinical skills and patient advocacy. The environment which nurse managers create and the way they relate to their workforce, are pivotal to organizational viability. Especially leadership of first -line nurse managers contributes to the success of their organizations. First-line nurse managers are deserved to be one of the most administrative supervisors through the middle stratum in a hospital organization as being a manager in the field service if assessed from the overall aspects of hospital, as being an interim managers in the nursing department as well as being a supreme supervisor in a unit in terms of an organizational structure in the hospital. Similarly, as a compete leader, the first-line nurse managers have not only a professional which is qualified to perform a role of appropriate coordination with medical staff and key personnel but also hold an important key position a being responsible for performing his or her given role. The first-line nurse manager is expected to manage human and fiscal resources in ways not required before. While an identified need for well-prepared first-line nurse manager continues to plague the profession, first-line nurse managers often have difficulty providing the leadership required. The need leadership training to function effectively in their positions. But we hardly find a useful leadership training program for first-line nurse managers, therefore the purpose of this study was to developed the leadership training program for them. The steps of leadership program development were below: 1st step, 2 studies were done before develop a leadership program. One was done to ask to first-line nurse managers what they want to learn through leadership training, the other one was to ask the staff nurses what their opinions are for their first-line nurse managers leadership. 2nd step was searching other leadership programs contents. The results of this study were below: The total amount of hours is 24. Leadership training program contents are : Future of nursing profession (210min), understanding basic factor's of leadership and leadership theories(310 min), self understanding as first- line nurse managers(320 min), basic principle and practice of interpersonal relationship(210 min), assertiveness training, conflict management (180min), and group study(210min). This is challenging time to be a leader, especially in nursing. As nurse managers look toward the new millennium, it seems as through the same struggles are ahead that are behind. So nurse managers need to embrace change with a positive attitude. They need to demonstrate risk taking and support it in their staffs. All these things are possible that after they participate the leadership training program.

• 여성건강간호학회지
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• 제5권1호
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• pp.133-145
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• 1999

The purposesof the study are to analyze the community nursing center in U.S.A and to develop the model of nursing care system based on nurse-midwifery clinic in community for women's health in Korea. 1. In America nursing center is defined as nurse-anchored system of primary care delivery or neighborhood health center. Nursing centers are identified the following four types: (1) community outreach centers, which are similar to traditional public health clinics: (2) institutional-based centers following the mission of a large institution, such as a hospital or university: (3) wellness/health promotion centers, which offer screening, education, counseling, triage, and health maintenance services: and (4) independent practice. Nursing centers are a concept of services provided by nurses in practice arrangements in a community. Nursing centers offer a variety of services, ranging from primary care provided by advanced practice nurses with medical acute management and nursing care to the more traditional education, health promotion, screening wellness and coordination services. Some services, such as the care provided by advanced practice nurses are reimbursed under various insurance plan in some instances and states, where as others, such as preventive and educational services, are not. Thus, lack of reimbursement has threatened the survival of some centers. Licensing of nursing centers varies by state and program and accreditation of nursing centers is also limited. 52% of centers are affiliated with another facility and 48% are freestanding centers. The number of registered nurse at the nursing centers ranges from just one to 115, with a mean of eight RNs peragency and a median of three. Nursing centers avail ability varies: 14% are open 24 hours, 27% have variable short hours, 23% are open 6-7 days per week, and 36% are open Monday- Friday. As the result of my visiting three health centers in Seattle and San Francisco, the women's primary care nurse practitioners focus on a systematic and comprehensive assessment of the health status of women and diagnosis and management of common physical and psychosocial health concerns of women in ambulatory settings. Therapeutic nursing strategies are directed toward self-care, risk reoduction, health surveillance, stress reduction, healthy nutrition, social support, healthy coping, psychological well-being, and pharmacological therapy. They function as primary care providers for the well ness and illness care of women from adolescence through the older adult years and pregnant families. 2. In Korea a nurse-midwife practices independently for pregnant women's health including childbearing family at her own clinic in community. Her services are reimbursed under national health insurance but they are not paid on a fee-for-service schedule covering items. Analyzing the nursing centers in America, I suggest that nurse-midwifery clinics offer primary care for women and home care for chronic ill patients. The health law and health insurance policy should be reovised in order to expand nurse-midwife's and home care nurse's roles at nurse-midwifery clinic.

• Journal of Hospice and Palliative Care
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• 제17권4호
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• pp.248-258
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• 2014

목적: 본 연구는 호스피스병동 입원 환자의 간호요구도와 간호만족도를 확인하여 궁극적으로는 호스피스 서비스의 질을 향상시키기 위한 기초자료를 제시하기 위해 실시되었다. 방법: 연구대상자는 S시에 소재한 2개 호스피스병동에 입원한 말기암환자 80명이다. 수집된 자료는 IBM SPSS 20.0을 이용하여서 기술통계, t-검정, ANOVA 및 Pearson correlation coefficient 등을 실시하였다. 결과: 호스피스병동 입원 환자의 간호요구도는 $3.58{\pm}0.31$점, 간호만족도는 $3.25{\pm}0.20$으로 간호요구도에 비해 간호만족도는 낮은 수준이었다. 대상자의 일반적 특성중 교육상태, 직업, 종교 및 기능 상태에 따라 호스피스 간호요구도에 유의한 차이가 있었으며, 성별과 치료비 부담자와 기능 상태에 따라 호스피스 간호만족도에 유의한 차이가 있었다. 대상자의 간호요구도와 간호만족도는 양의 상관관계가 나타났다. 결론: 호스피스병동 입원 환자의 간호만족도는 간호요구도에 비해 낮은 수준으로 호스피스 서비스를 받는 환자의 서비스의 질을 높이기 위해서는 신체적, 심리/사회적, 영적 및 교육/의뢰 영역별로 구체적인 간호중재 방안이 마련되어야 한다.

• 한국산학기술학회논문지
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• 제21권9호
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• pp.134-143
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• 2020

본 연구의 목적은 국내 요양병원에 입원한 감염병 환자의 실태를 파악하기 위함이다. 본 연구는 국내 요양병원에 입원한 감염병 환자의 실태를 조사하기 위한 서술적 조사연구이다. 798개의 요양병원을 대상으로 14개 감염병에 대해 2016년 1월 1일부터 2017년 12월 31일까지 2년 동안 지속적으로 운영된 요양병원에 입원한 감염병 환자수, 내원일수, 총 진료비 현황을 조사하였다. 2016년에 비해 2017년에 감염병 환자수, 내원일수, 총 진료비는 증가하였고, 요양병원에 많은 감염병은 클로스트리듐디피실리에 의한 장결장염, 인플루엔자, 옴이었다. 또한 연도별로 감염병이 발생한 요양병원 수를 확인한 결과, 인플루엔자, 클로스트리듐디피실리에 의한 장결장염, 카바페넴계내성 감염증이 발생한 병원이 2016년에 비해 2017년 증가하였다. 병상수에 따른 환자수는 150병상 이상 300병상 미만인 군이 가장 많았다. 따라서 요양병원에 많이 발생하는 클로스트리듐디피실리에 의한 장결장염, 인플루엔자, 옴에 대한 관리방안이 집중적으로 이루어져야 하며, 해당 질병에 대한 감염관리방법과 교육 등 가이드라인을 제공하는 것이 도움이 될 것이다. 또한 300병상 미만 요양병원에서의 감염관리를 위해 요양병원에 적용 가능한 감염감시기준을 마련하고, 감염관련시설 및 인력 확충을 지원하는 등 감염관리 시스템 구축이 필요하다.

• 산경연구논집
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• 제9권6호
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• pp.77-85
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• 2018

Purpose - The purpose of this study is to subdivide trade transaction-centered structure in a logistics/distribution industry system to apply blockchain, to establish and resolve with which types of technology, and to provide policy direction of government institution and technology to apply blockchain in this kind of industry. Research design, data, and methodology - This study was conducted with previous researches centered on cases applied in various industry sectors on the basis of blockchain technology. Results - General fields of blockchain application include digital contents distribution, IoT platform, e-Commerce, real-estate transaction, decentralized app. development(storage), certification service, smart contract, P2P network infrastructure, publication/storage of public documents, smart voting, money exchange, payment/settlement, banking security platform, actual asset storage, stock transaction and crowd funding. Blockchain is being applied in various fields home and abroad and its application cases can be explained in the banking industry, public sector, e-Commerce, medical industry, distribution and supply chain management, copyright protection. As examined in the blockchain application cases, it is expected to establish blockchain that can secure safety through distributed ledger in trade transaction because blockchain is established and applied in various sectors of industries home and abroad. Parties concerned of trade transaction can secure visibility even in interrupted specific section when they provide it as a base for distributed ledger application in trade and establish trade transaction model by applying blockchain. In case of interrupted specific section by using distributed ledger, blockchain model of trade transaction needs to be formed to make it possible for parties concerned involved in trade transaction to secure visibility and real-time tracking. Additionally, management should be possible from the time of contract until payment, freight transfer to buyers through land, air and maritime transportation. Conclusions - In order to boost blockchain-based logistics/distribution industry, the government, institutionally, needs to back up adding legal plan of shipping, logistics and distribution, reviewing standardization of electronic switching system and coming up with blockchain-based industrial road maps. In addition, the government, technologically, has to support R&D for integration with other high technology, standardization of distribution industry's blockchain technology and manpower training to expand technology development.

• 한국재난정보학회 논문집
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• 제1권1호
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• pp.3-26
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• 2005

In recent years, there is growing concern about the potential use of biological agents in war or acts of terrorism accompanied an increased realization that rapid preparedness and response are needed to prevent or treat the human damage that can be caused by these agents. The threat is indeed serious, and the potential for devastating numbers of casualties is high. The use of agents as weapons, even on a small scale, has the potential for huge social and economic disruption and massive diversion of regional and national resources to combat the threat, to treat primary disease, and to clean up environmental contamination. Biological weapons are one of weapons of mass destruction (or mass casualty weapons, to be precise. since they do not damage non-living entities) that are based on bacteria, viruses, rickettsia, fungi or toxins produced by these organisms. Biological weapons are known to be easy and cheap to produce and can be used to selectively target humans, animals, or plants. Theses agents can cause large numbers of casualties with minimal logistical requirements (in wide area). The spread of disease cannot be controlled until there is awareness of the signs of infection followed by identification of agents; and if the organism is easily spread from person to person, as in the case of smallpox, the number of casualties could run into the tens of thousands. Biological weapons could be used covertly, there can be a lot of different deployment scenarios. A lot of different agents could be used in biological weapons. And, there are a lot of different techniques to manufacture biological weapons. Terrorist acts that make use of Biological Agents differ in a number of ways from those involving chemicals. The distinction between terrorist and military use of Biological Weapon is increasingly problematic. The stealthy qualities of biological weapons further complicate the distinction between terrorism and war. In reality, all biological attacks are likely to require an integrated response involving both military and civilian communities. The basic considerations when public health agencies establish national defence plan against bioterrorism must be 1) arraying various laws and regulations to meet the realistic needs, 2)education for public health personnels and support of concerned academic society, 3)information collection and cooperative project with other countries, 4)Detection and surveillance(Early detection is essential for ensuring a prompt response to biological or chemical attack, including the provision of prophylactic medicines, chemical antidotes, or vaccines) and 5) Response(A comprehensive public health response to a biological or chemical terrorist event involves epidemiologic investigation, medical treatment and prophylaxis for affacted persons, and the initiation of disease prevention or environmental decontamination measures). The purpose of this paper is providing basic material of preparedness and response for biological terrorism in modern society.