• 기록학연구
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• 제29호
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• pp.79-127
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• 2011

이 글은 한국 사회에 내재된 무수히 많은 대항기억들 중 '민간인학살사건'이라는 대항기억을 역사화 하기 위하여 구술이라는 방법론적 매개체에 대한 이론적 방법론적 논의를 시작해보기 위함이다. 즉 구술 자료의 수집에 앞서 '구술'이라는 행위의 근본적 바탕이 되는 '기억'에 대한 논의를 중심으로 지배기억과 대항기억의 발생과정, 대항기억으로써의 구술이 가지는 의미, 소외된 기억들의 역사화 필요성을 이론화한 후 구술사연구방법론, 구술기록의 질적연구방법론에 대한 논의를 통해 신뢰성이 높은 구술기록의 생산을 모색해보고자 하는 것이다. 이러한 기초를 바탕으로 구술이라는 특정 방법론에 대한 정확한 숙지 아래에서 어떤 질 좋은 기록물이 생산되는지를 알아볼 수 있는 한 사례로써 민간인 학살사건의 연구대상으로 선정된 경상북도 영덕군 창수면에 대한 구술기록화 과정이 진행되었다.

• 한국콘텐츠학회논문지
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• 제21권10호
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• pp.630-644
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• 2021

본 연구는 인공호흡기 관련 폐렴 예방을 위한 근거기반 간호실무지침을 개발하고자 수행되었다. 한국보건의료연구원의 하이브리드 방법에 따라 근거기반 간호실무지침을 개발하고 유효성을 검증한 방법론적 연구이다. 주제와 핵심 질문은 문헌 검토와 전문가 인터뷰를 통해 도출하였고, 핵심 질문과 관련된 권고안은 체계적 검색과 선정에 의한 기존 가이드라인을 분석하여 수렴하였으며, 미해결 핵심 질문과 관련된 권고안은 체계적고찰과 메타 분석을 통해 새로 개발하였다. 개발된 권고안은 RAND에 의한 유효성 검증과 간호실무지침 초안은 AGREE II에 의한 방법론적 질평가를 수행하였다. 9개 범주의 44개 권고안으로 구성된 최종 간호실무지침의 임상타당성은 중환자실 간호사 122명을 대상으로 평가하였다. 최종 개발된 인공호흡기 관련 폐렴 예방을 위한 근거기반 간호실무지침은 방법론적 타당성과 내용타당도가 검증되었고 우리 간호실무 환경에 적합하여 중환자 간호실무의 질적 향상에 기여할 수 있을 것으로 기대된다.

• 보건행정학회지
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• 제18권3호
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• pp.1-17
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• 2008

The measurement and management of patient satisfaction has become one of the key issues in the last two decades. Hospitals must thoroughly understand the needs of their customers and design products and health services that meet and exceed their expectations. The importance-performance analysis(IPA) is a widely used analytical technique that yields strategies for managing customer satisfaction in a variety of applications. IP A is a two-dimensional grid based on customer-perceived importance of quality attributes and attribute performance. Depending on the interplay of these two dimensions, four strategies can be derived. The aim of this study is to develop the management strategies for improving patient satisfaction in university hospitals using the I-P analysis. The attributes on inpatient service quality in 4 university hospitals was investigated using the Martilla and James(l977)' s a mean adjusted I-P grid where the axes of the grid cross at the average rating point of all items. The patient satisfaction questionnaires were completed by 600 hospital inpatients. The main statistical methods are path analysis and IPA with SPSS 12.0 and AMOS 4.0 statistical softwares. The two attributes, physician and medical service, administrative staff kindness attributes position in first quadrant(Keep Up the Good domain). The nurse and nursing service attributes position in second quadrant(Possible Overkill domain). The two attributes, convenience of check-in service, facilities and physical environment position in third quadrant(Low Priority domain). Finally the quality of inpatient service(food etc.) attributes position in fourth quadrant(Concentrate Here domain). These findings show various implications on the development of strategies in university hospitals in the future. It was determined that quality of inpatient service(food etc.) need to concentrate more on investments. These investments include a taste, price, proper provision of food service and quick response of pain management. A low priority was given to investment in streamlining the check-in process of inpatient and hospital facilities and physical environment in the long run.

• Journal of Acupuncture Research
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• 제27권1호
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• pp.109-116
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• 2010

Objectives : Since The Journal of Korean Acupuncture and Moxibustion Society(JKAMS) started publishing in 1984, randomised controlled trials(RCTs) and non-randomised clinical studies(NRSs) consistently have increased in quality and quantity. There has been no study on quality assessment of NRSs. Thus, this study evaluted non-randomised comparative clinical trials in the JKAMS to assess the quantity and quality. Methods : Upon extracting NRSs for assessing the intervention effects from all the articles published in the JKAMS from 1984 to 2009, assessments were made on methodological index for non-randomised studies(MINORS). Also, the analysis were made upon the proportion of non-randomised comparative clinical trials within original articles. The mean scores by research methods and years, and total scores and mean scores of yearly research methods were analyzed. Results : A total of 44 trials on non-randomised comparative clinical trials were selected. In 1980s, 4.3% of the total selected original articles, in 1990s, 4.1%, and in 2000s 14.2% were NRSs. According to the research designs, the mean scores of MINORS were Case-control study 18.3, Controlled before and after 18.5, Quasi randomised trial 18.5, and non randomised trial 17.9(out of 24), respectively. Cross-sectional study was the most frequently used(41.9%). Conclusion : Although NRSs consistently increased in quantity, the assessed mean scores were low and most articles used Cross-sectional study. Thus, there should be studied using appropriate research methods in the future.

• 중환자간호학회지
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• 제14권3호
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• pp.113-127
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• 2021

Purpose : This systematic review was conducted to identify which dyadic intervention could be implemented for heart failure patient-family caregiver dyads to improve patient and/or their family caregivers outcomes. Method : Eleven databases were searched from their inception to July, 2021. This review considered any randomized controlled trials that evaluated the effectiveness of intervention including heart failure patient-family caregiver dyads. Two reviewers independently evaluated the methodological quality using the Cochrane Collaboration's tool for assessing risk of bias and extracted details of the included studies. The studies included in this review were not suitable for meta-analysis and therefore the results were presented as a narrative summary. Results : Six studies including 900 dyads were included and mainly primary family caregiver of patients was spouse. Majority of dyadic intervention were focused on psychoeducational intervention excepting one study on mobile health intervention. All studies included in this review focused on patients' outcomes compared to family caregivers' outcomes and dyadic outcomes. Individual interventions improved quality of life among heart failure patients and their family caregivers in two articles. The overall quality of selected articles was low. Conclusions : This study provides moderate support for the use of a dyadic intervention to improve quality of life among heart failure patients and their family caregivers. More rigorous high-quality studies investigating interventions to meet the needs of patient and family caregivers in heart failure care are needed.

• 대한간호학회지
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• 제44권6호
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• pp.595-607
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• 2014

Purpose: The Braden Scale is one of the most intensively studied risk assessment scales used in identifying the risk of developing pressure sore. However, not all studies show that the predictive validity of this scale is sufficient. The purpose of this study was to evaluate the Braden Scale for predicting pressure ulcer development. Methods: Articles published 1946 and 2013 from periodicals indexed in Ovid Medline, Embase, CINAHL, KoreaMed, NDSL and other databases were selected, using the following keywords: 'pressure ulcer'. The QUADAS-II was applied to assess the internal validity of the diagnostic studies. Selected studies were analyzed using meta-analysis with MetaDisc 1.4. Results: Thirty-eight diagnostic studies with high methodological quality, involving 17,934 patients, were included. Results of the meta-analysis showed that the pooled sensitivity and specificity of the Braden Scale were 0.74 (95% CI: 0.72-0.76), 0.75 (95% CI: 0.74-0.76) respectively. However the predictive validity of the Braden Scale has limitation because there was high heterogeneity between studies. Conclusion: The Braden Scale's predictive validity of risk for pressure ulcer is interpreted as at a moderate level. However there is a limitation to the interpretation of the results, because of high heterogeneity among the studies.

• 대한간호학회지
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• 제44권4호
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• pp.446-457
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• 2014

Purpose: This study was done to evaluate the effects of psychosocial interventions on cortisol and immune response in adult patients with cancer. Methods: MEDLINE via PubMed, Cochrane Library CENTRAL, EMBASE, CINAHL and domestic electronic databases were searched. Twenty controlled trials (11 randomized and 9 non-randomized trials) met the inclusion criteria with a total of 862 participants. Methodological quality was assessed using the Cochrane's Risk of Bias for randomized studies and the Risk of Bias Assessment tool for non randomized studies. Data were analyzed using the RevMan 5.2.11 program of Cochrane library. Results: Overall, study quality was moderate to high. The weighted average effect size across studies was -0.32 (95% CI [-0.56, -0.07], p=.010, $I^2 $=45%) for cortisol concentration, -0.62 (95%CI [-0.96,-0.29], p<.001, $I^2 $=0%) for T lymphocyte (CD3) and -0.45 (95%CI [-0.74, -0.16], p=.003, $I^2 $=0%) for Th lymphocyte (CD4) numbers. Psychosocial interventions were not effective for Tc lymphocyte (CD4), NK cell, monocyte, and cytokine response. Conclusion: Although these results provide only small evidence of successful immune modulation, they support the conclusion that psychosocial interventions can assist cancer patients in reducing emotional distress and improving immune response.

• 대한간호학회지
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• 제43권5호
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• pp.658-668
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• 2013

Purpose: The purpose of this study was to investigate the effects of psychosocial interventions on pain in cancer patients. Methods: Eight studies published between 1980 and 2012 in Korean and ten studies published between 2002 and 2012 in English met the inclusion criteria with a total of 1539 participants. Methodological quality assessed by Cochrane's Risk of Bias for randomized studies and Risk of Bias Assessment tool for non randomized studies. The data were analyzed by the RevMan 5.2 program of Cochrane library. Results: Overall, study quality was moderate to high. Effect sizes were heterogeneous and subgroup analysis was done. Cognitive behavioral therapy (CBT) were effective for pain (ES= -0.35; 95% CI= -0.56, -0.13). Pain education studies measured with NRS and VAS were effective for pain (ES= -0.77; 95% CI= -1.01, -0.52). Publication bias was not detected. Conclusion: This study support the use of psychosocial interventions administered to cancer patients for their pain management. However, more well-designed studies are needed.

• Journal of Preventive Medicine and Public Health
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• 제41권2호
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• pp.74-79
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• 2008

Since the positive listing system for prescription drug reimbursement has been introduced in Korea, the number of pharmacoeconomic evaluation studies has increased. However it is not clear if the quality of pharmacoeconomic evaluation study has improved. Due to the lack of randomized clinical studies in Korean health care setting, Korean economic evaluation studies have typically integrated the local cost data and foreign clinical data. Therefore methodological issues can be raised in regard to data coherence and consistency. But the quality of data was not questiened and the potential bias has not been investigated yet. Even though changes in policy have encouraged the undertaking of pharmacoeconomic evaluations, there is few public-side funding for validation study of cost-effectiveness models and data. Several companies perform economic evaluation studies to be submitted on behalf of their own products, but do not want the study results to be disclosed to the academic community or public. To improve the present conduct of pharmacoeconomic evaluations in Korea, various funding sources need to be developed, and, like other multidisciplinary areas, the experts in different fields of study should collaborate to ensure the validity and credibility of pharmacoeconomic evaluations.

• 대한한방내과학회지
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• 제41권4호
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• pp.644-657
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• 2020

Objectives: The aim of this study was to systematically evaluate the clinical therapeutic effects and safety of the Zeo lyung tang (ZLT) on primary glomerulonephritis (PGN). Methods: The MEDLINE, EMBASE, PubMed, CENTRAL, CNKI, RISS, NDSL, KISS, and OASIS databases were searched for randomized controlled trials (RCTs) testing the effects of ZLT on PGN. The Cochrane collaboration bias risk assessment scale was used to evaluate the methodological quality of the included studies. RevMan 5.3 software was used for data analysis. Results: Ten RCTs involving 781 patients were included in the review. Compared with conventional Western medicine (WM) therapy alone, a combination treatment of ZLT and WM improved the total effective rate (RR=1.24; 95%CI [1.16, 1.33]; p<0.00001), reduce the blood urea nitrogen (BUN; MD=-1.05; 95%CI [-1.32, -0.78]; p<0.00001) and the 24-hour urinary protein (MD=-0.38; 95%CI [-0.46, -0.29]; p<0.00001). Conclusions: The combination of ZLT with WM has therapeutic effects on PGN, and it has advantages over WM treatment alone in reducing BUN and 24-hour urinary protein. However, due to the low quality of the included studies and the small sample sizes, additional research is needed in this area.