• 한국직업건강간호학회지
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• 제18권2호
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• pp.141-152
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• 2009

Purpose: The purpose of this research was to describe the decision making of nurses in a VIP ward. Method: The methodology of collecting and analyzing the data was based on the grounded theory of Strauss and Corbin (1998). The data were collected through an in-depth interview, which were audio-taped and transcribed. The data were collected from 10 nurses from July to November 2007. Results: The core category on VIP ward nurses' decision making was named as "adjusting with flexibility and deepened insight". The causal condition was established by 'the patients who wanted to be treated specially'. The contextual conditions included 'caring patients from various departments', 'differences depending on the nurses' clinical experience', and 'client-centered atmosphere in the VIP ward'. The intervening conditions included 'problem solving styles of nurses', 'attitudes of patients and family members', 'nurse-doctor relationships', and 'accessibility to information'. It was confirmed that nurses changed their action-interaction strategies depending on the intervening conditions, thus resulted in the nurses' role conflict and the need to expand their consciousness. Conclusion: The result of this study indicates that nurse's decision making depends on their experiences and the nature of social context in which nursing occurs.

• 기본간호학회지
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• 제2권1호
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• pp.87-101
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• 1995

This study was conducted with the subject of showing the importance of early rehabilitation and exercise therapy in patients who have stroke, of confirming the adavntage of ward exercise conducted by nurse, which had been conducted mainly by physical therapist only in physical thrapy room and of developing the exercise program as the independent rehabilitation nursing intervention. A total of 62 patients were selected as object from April, 5th, to May, 17th, 1995, who had been hospitalized in K medical center, and the half of them were assigned to Experimental group in ramdom assignment using a coin. It was ADL check list tool developed by Kang and Ward Exercise Program developed by the researcher that were used as a treatment. Ward Exercise Program was conducted by the reseacher and the physical therapist measured ADL score before and after Ward Exercise Program. The data were analyzed using ANOVA, pearson correlation, Chi-Square test and the effect of Ward Exercise Program was analyzed by t-tast. The result of this study is as follows. 1. The experimental group showed eminent improvement of ADL compared with the counter group with statistical significance. In eating(t=6.10, df=60, p=.000), personal hygiene performing(t=4.86, df=60, p=.000), wearing(t=5.86, df=60, p=.000), elimination(t=7.89, df=60, p=.000), mobility on the bed(t=13.36, df=60, p=.000), moving(t=9.11, df=60, p=.000), walking(t=7.45, df=60, p=.000) 2. There was no qualitative difference between experimental group and control group with the significance of $p{\le}.05$. 3. There was no relation between the general condition and the difference of ADL, while there was significant relation between the starting point of exercise and the difference of pre-exercise and post exercise ADL. As a result, it should be emphasized that the early rehabilitation and exercise therapy are important in patients who have stroke, and that it is necessary to extend the exercise therapy to the ward. Therefore, this Ward Exercise Program could be recommended as a independent clinical exercise nursing intervention in rehabilitation nursing of patients who have stroke.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제18권2호
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• pp.77-84
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• 2012

This study is to understand the architectural types and characteristics of the medical facilities during ancient period. The study is based on the research of the medical and architectural history. The medical or healthcare facilities are influenced by their social, cultural and conceptual idea, especially how they think about 'disease', 'cure' and the 'medicine'. As the results of the examination of this study can be summarized as followings. Firstly, Ancient medical facilities are classified into four types according to the ideas of 'disease' and 'cure' ; 1) God oriented facility 2) health welfare facility 3) treatment oriented facility 4) practice & educational facility. Secondly, there are three typical types of the spatial characteristics what modern hospitals have ; 1) nursing ward 2) treatment ward 3) hostel or hospice. And they are all assembled around the courtyard in common. Thirdly, their architectures are not 'designed' but 'derived' plan by reasonable other building types, and transformed by medical function. Fourthly, a consideration of the surrounding circumstances is the most important point to make the medical health facilities during ancient period.

• Journal of Hospice and Palliative Care
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• 제19권3호
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• pp.240-248
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• 2016

목적: 호스피스완화의료의 목적은 환자와 가족의 고통을 줄이고 삶과 죽음의 질을 향상시키는데 있다. 편안한 임종을 맞이하는 것은 죽음의 질을 향상시키는데 역할을 한다. 이를 위해 환자와 보호자는 남은 삶 동안 임종을 준비할 수 있도록 임종과정 중 발생하는 다양한 문제와 요구에 대한 이해가 필요하다. 따라서 호스피스 환자와 가족을 위한 매뉴얼화된 임종교육 시청각 자료를 개발하고자 한다. 방법: 시청각 자료 개발을 위해서는 문헌고찰을 토대로 접근하기 쉬운 파워포인트 유인물로 초기 교육자료 개발하였고 다섯 차례에 걸친 전문의의 자문과 수정 및 보완, 평가 과정을 거쳐 완성하였다. 결과: 호스피스 환자와 가족들을 대상으로 한 시청각 교육자료는 3차시 5단계로 분류하였으며 교육 소요시간은 총 26분 34초이다. 최종 교육프로그램은 시청각 교육실 협력 하에 촬영하였으며 시청각 자료를 완성하였다. 결론: 본 연구는 완화의료병동의 구축과 전문성 증대를 위해 개발된 매뉴얼화 된 임종교육 시청각 자료로써 큰 의의가 있으며, 호스피스 환자와 가족뿐 아니라 호스피스 영역 전문 종사자들이 호스피스 환자와 가족을 대상으로 효율적인 임종교육 자료로 적극 활용되길 기대한다.

• Journal of Breast Cancer
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• 제21권4호
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• pp.371-381
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• 2018

Purpose: Immune suppression is common in patients with advanced breast cancer but the mechanisms underlying this phenomenon have not been sufficiently studied. In this study, we aimed to identify B7 family members that were able to predict the immune status of patients, and which may serve as potential targets for the treatment of breast cancer. We also aimed to identify microRNAs that may regulate the expression of B7 family members. Methods: The Cancer Genome Atlas data from 1,092 patients with breast cancer, including gene expression, microRNA expression and survival data, were used for statistical and survival analyses. Polymerase chain reaction and Western blot were used to measure messenger RNA and protein expression, respectively. Luciferase assay was used to investigate direct microRNA target. Results: Bioinformatic analysis predicted that microRNA (miR)-93, miR-195, miR-497, and miR-340 are potential regulators of the immune evasion of breast cancer cells, and that they exert this function by targeting CD274, PDCD1LG2, and NCR3LG1. We chose CD274 for further investigations. We found that miR-195, miR-497, and CD274 expression levels were inversely correlated in MDA-MB-231 cells, and miR-195 and miR-497 expressions mimic inhibited CD274 expression in vitro. Mechanistic investigations demonstrated that miR-195 and miR-497 directly target CD274 3' untranslated region. Conclusion: Our data indicated that the level of B7 family members can predict the prognosis of breast cancer patients, and miR-195/miR-497 regulate CD274 expression in triple negative breast cancer. This regulation may further influence tumor progression and the immune tolerance mechanism in breast cancer and may be able to predict the effect of immunotherapy on patients.

• International Journal of Oral Biology
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• 제38권1호
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• pp.1-4
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• 2013

Staphylococcus species are one of prevalent pathogens found in hospitals. Microbes that are a primary cause of nosocomial infection were isolated from a dental and medical environment it may assist the reader to explain what this is and how it differs from the 'dental health care providers and ward health care providers'. To investigate the distribution of staphylococcus species in this environment, we used vitek II to measure drug sensitivity, and further performed biochemical testing. The isolation rate of staphylococcus species from the dental and medical environment was 100% but from dental health care providers and ward health care providers were 44.4% and 33.3%, respectively. In the analyses, staphylococcus species showed resistance to diffusion of cefoxitin and oxacillin discs. These staphylococci may be sufficiently positive for the mecA gene. Our results suggest that staphylococci might be an important cause of nosocomial infection in the dental clinic.

• Journal of Preventive Medicine and Public Health
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• 제53권3호
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• pp.205-210
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• 2020

Objectives: Aging is assumed to be accompanied by greater health care expenditures. The objective of this retrospective, bottom-up micro-costing study was to identify and analyze the variables related to increased health care costs for the elderly from the provider's perspective. Methods: The analysis included all elderly inpatients who were admitted in 2017 to a hospital in Tehran, Iran. In total, 1288 patients were included. The Mann-Whitney and Kruskal-Wallis tests were used. Results: Slightly more than half (51.1%) of patients were males, and 81.9% had a partial recovery. The 60-64 age group had the highest costs. Cancer and joint/orthopedic diseases accounted for the highest proportion of costs, while joint/orthopedic diseases had the highest total costs. The surgery ward had the highest overall cost among the hospital departments, while the intensive care unit had the highest mean cost. No statistically significant relationships were found between inpatient costs and sex or age group, while significant associations (p<0.05) were observed between inpatient costs and the type of ward, length of stay, type of disease, and final status. Regarding final status, costs for patients who died were 3.9 times higher than costs for patients who experienced a partial recovery. Conclusions: Sex and age group did not affect hospital costs. Instead, the most important factors associated with costs were type of disease (especially chronic diseases, such as joint and orthopedic conditions), length of stay, final status, and type of ward. Surgical services and medicine were the most important cost items.

• 한국산학기술학회논문지
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• 제19권5호
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• pp.459-469
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• 2018

본 연구는 전국적으로 확대 시행하고 있는 간호 간병통합서비스병동 간호사와 일반병동 간호사의 직무만족, 직무스트레스, 직무소진 및 이직의도를 조사하고 비교하여 간호 간병통합서비스 병동의 효율적인 간호인력 관리를 위한 기초자료를 제공하기 위한 비교조사 연구이다. 대상자는 G광역시 소재 간호 간병통합서비스를 시행하고 있는 6개 병원에서 간호 간병통합서비스병동 간호사와 일반병동 간호사 181명으로, 자료수집은 구조화된 설문지를 이용하여 2017년 5월 16부터 6월 30일까지 실시하였고, t-test, one-way ANOVA, Pearson 상관관계를 이용하여 분석하였다. 연구결과, 간호 간병통합서비스병동 간호사와 일반병동 간호사의 직무만족, 직무스트레스, 직무소진 및 이직의도에서 집단 간의 차이는 없는 것으로 나타났으나, 간호 간병통합서비스병동 간호사가 직무만족 점수는 더 높았고, 직무스트레스, 직무소진 및 이직의도 점수는 더 낮았다. 또한 간호 간병통합서비스병동 간호사는 직무스트레스(r=.39, p=<.001)와 직무소진(r=.43, p=<.001)이 높을수록 이직의도가 높게 나타났고, 직무만족(r=-.66, p=<.001)이 높을수록 이직의도가 낮게 나타났다. 간호 간병통합서비스병동 간호사는 일반병동 간호사에 비해 직무 관련해서 더 긍정적으로 생각하고 있었다. 따라서 본 연구결과는 간호 간병통합서비스병동의 효율적인 간호인력 관리를 위한 기초자료로 활용될 수 있을 것이다.

• 정신신체의학
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• 제1권1호
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• pp.14-24
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• 1993

The author discussed present problems and future prospects of psychosomatic medicine in clinical, educational, research, and social aspects. In general, psychosomatic field. particularly. consultation-liaison(C-L) psychiatry in Korea seems to remain on early developmental phase. However, positive change in the general publics' and societal view of psychiatry, specialization of medicine and development of medical technology, implementation of delivery system in medical care could contribute to development of this field. In future, clinically, liaison activity will be more activated. and this field will be developed as main subspecialty of psychiatry. In addition. C-L psychiatry will be subspecialized. and prevention and humanization of medical care could be more emphasized. In education. the main place of education for medical students and psychiatric residents will be changed from closed ward to general ward in which consultation-liaison activity can be performed. In research. consultation liaison model suitable for Koreans will be developed and studies on disease mechanism will be more promoted. In social aspects, this field could influence the general publics' view of psychiatry and change the whole areas of medicine and society toward integration. In order to achieve these goals, medical insurance system and cost relevant to C-L activity should be essentially improved.

• 간호행정학회지
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• 제21권4호
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• pp.341-353
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• 2015

Purpose: The purpose of this study was to identify nurse's role through job analysis of nursing duties for nurses working on East Asia traditional medicine wards. Methods: Major steps in the study included a literature review, description of job activities of nurses on oriental medicine wards, comparative description of the literature, expert tests of validity of derived duties and tasks, and investigation of importance, difficulty and frequency of duties on job list. Results: The job of nurses on oriental medicine wards was classified into 12 duties, 59 tasks, and 295 task elements. The 12 duties were nursing assessment, nursing diagnosis, nursing planning, nursing implementation, nursing evaluation, supplies management, management of human resources, management of environment, management of documents, formation of cooperative relationships, self-development, and nursing activity in oriental medicine. 'Formation of cooperative relationships' was the duty ranked highest for importance (4.34), 'self-development' was ranked highest for difficulty (3.47), and 'Formation of cooperative relationships' was ranked highest for frequency (4.21). Conclusion: Basic education for nurses on an oriental medicine unit is necessary for the performance of oriental nursing to be considered as a specialized field. This study contributes to human resource management in the oriental medical hospital.