• 호스피스학술지
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• 제1권1호
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• pp.46-69
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• 2001

Hospice Care is the best way to care for terminally ill patients and their family members. However most of them can not receive the appropriate hospice service because the Korean health delivery system is mainly be focussed on acutly ill patients. This study was carried out to clarify the situation of hospice in Korea and to develop a hospice care delivery system model which is appropriate in the Korean context. The theoretical framework of this study that hospice care delivery system is composed of hospice resources with personnel, facilities, etc., government and non-government hospice organization, hospice finances, hospice management and hospice delivery, was taken from the Health Delivery System of WHO(1984). Data was obtained through data analysis of litreature, interview, questionairs, visiting and Delphi Technique, from October 1998 to April 1999 involving 56 hospices, 1 hospice research center, 3 non-government hospice organizations, 20 experts who have had hospice experience for more than 3 years(mean is 9 years and 5 months) and officials or members of 3 non-government hospice organizations. There are 61 hospices in Korea. Even though hospice personnel have tried to study and to provide qualified hospice serices, there is nor any formal hospice linkage or network in Korea. This is the result of this survey made to clarify the situation of Korean hospice. Results of the study by Delphi Technique were as follows: 1.Hospice Resources: Key hospice personnel were found to be hospice coordinator, doctor, nurse, clergy, social worker, volunteers. Necessary qualifications for all personnel was that they conditions were resulted as have good health, receive hospice education and have communication skills. Education for hospice personnel is divided into (i)basic training and (ii)special education, e.g. palliative medicine course for hospice specialist or palliative care course in master degree for hospice nurse specialist. Hospice facilities could be developed by adding a living room, a space for family members, a prayer room, a church, an interview room, a kitchen, a dining room, a bath facility, a hall for music, art or work therapy, volunteers' room, garden, etc. to hospital facilities. 2.Hospice Organization: Whilst there are three non-government hospice organizations active at present, in the near future an hospice officer in the Health&Welfare Ministry plus a government Hospice body are necessary. However a non-government council to further integrate hospice development is also strongly recommended. 3.Hospice Finances: A New insurance standards, I.e. the charge for hospice care services, public information and tax reduction for donations were found suggested as methods to rise the hospice budget. 4.Hospice Management: Two divisions of hospice management/care were considered to be necessary in future. The role of the hospice officer in the Health & Welfare Ministry would be quality control of hospice teams and facilities involved/associated with hospice insurance standards. New non-government integrating councils role supporting the development of hospice care, not insurance covered. 5.Hospice delivery: Linkage&networking between hospice facilities and first, second, third level medical institutions are needed in order to provide varied and continous hospice care. Hospice Acts need to be established within the limits of medical law with regards to standards for professional staff members, educational programs, etc. The results of this study could be utilizes towards the development to two hospice care delivery system models, A and B. Model A is based on the hospital, especially the hospice unit, because in this setting is more easily available the new medical insurance for hospice care. Therefore a hospice team is organized in the hospital and may operate in the hospice unit and in the home hospice care service. After Model A is set up and operating, Model B will be the next stage, in which medical insurance cover will be extended to home hospice care service. This model(B) is also based on the hospital, but the focus of the hospital hospice unit will be moved to home hospice care which is connected by local physicians, national public health centers, community parties as like churches or volunteer groups. Model B will contribute to the care of terminally ill patients and their family members and also assist hospital administrators in cost-effectiveness.

• 대한간호학회지
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• 제36권4호
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• pp.637-644
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• 2006

Purpose. The purpose of this study was to construct a measurement instrument for climacteric symptoms among Korean and Japanese women. Methods. From Dec. $1^{st}$ of 2003 to March $30^{th}$ of 2004, in-depth interviews were made with 26 women (15 in Jinju, Korea and 11 in Nagasaki, Japan) aged from 45 to 59 years who had not taken hormone replacement therapy to relieve the climacteric symptoms. A draft questionnaire with 45 items was constructed on the basis of the interview data and literature review. Three obstetricians, three PhDs in nursing science, and a chief nurse who was exclusively in charge of the climacteric management, examined the draft questionnaire to evaluate content validity. After deletions 39 items remained for a preliminary questionnaire. A survey was conducted by using a convenient sampling method in Jinju of Korea and Nagasaki of Japan during the period from April $1^{st}$, 2004 to July $10^{th}$, 2005. Results. Factor analysis identified 4 factors, which were 'mental and psychological symptoms', 'physical symptoms', 'loss of autonomic nervous system symptoms', 'sexual symptoms'. These four factors explained 46.9% of total variance. Conclusions. The results demonstrated that climacteric symptom scale was multidimensional, and the reliability and validity of the scale was supported.

• 대한간호학회지
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• 제16권2호
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• pp.63-69
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• 1986

The main purpose of this study was to find out variables relevant to self-care activities of physically disabled person. The subjects of this analysis were 1277 person which is between 15~64 years, the data came from the 1985 National Interview Survey on Disabled Person in Korea. For this analysis, Breakdown, Oneway and Discriminant Analysis were used. The finding of the analysis can be summarized as follows: First, the mean of self care activities was 2.57 (SD: 0.69, range: 1-3). The relevance for the self-care activities by several variables is as follows. 1. The relevance for the self-care activities by socioeconomic status is significant at age, education level, occupation of household members variables. Especially, in the case of high age, low education level, the self-care activities are shown low score. 2. The relevance by impairment characteristics is shown high significance at all input variables. When disabled person have double impairment. paralysis, late occurance age, and is due to diseases the self-care activities score is lowered. 3. The relevance by health care services variables. is not shown significant at all input variables. Second, the relevance for social activities by sev-eral variables was conducted by discriminant analysis. The relative importance of social activities discriminant function is 0.344 of eigenvalue. The-canonical correlation between the social activities discriminant function and 9 dummy variables is 0.51, total variance of dummy variables for social activities is shown 26 persent. The self-care activities variable represents the highest contribution of its associated variable to the function (canonical coefficient: -.56). The occurance age, the occupation of household members, the education level variables are shown comparatively high contribution to the function. To sum up, this analysis suggests that the self-care activities variable is the highest contributed to the social activities. In relation to self-care concept, this finding will be useful in rehabilitation nursing care.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제30권3호
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• pp.121-126
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• 2019

Objectives: Awareness of attention-deficit/hyperactivity disorder (ADHD) in adults has significantly increased; however, clinical data specific to the Korean population are insufficient. Clinical experience of ADHD may differ based on whether psychiatrists have received pediatric psychiatry-specific training. In order to prepare a practice parameter for adult ADHD patients in Korea, we examined questionnaire data to observe how pediatric psychiatry training could affect clinical practice for adults with ADHD. Methods: A questionnaire about the diagnosis and treatment process was distributed to both general psychiatrists (GPsy) and child and adolescent psychiatrists (CAP) at the summer and winter workshop meetings of Korean Academy of Child and Adolescent Psychiatry. Results: In total, 142 psychiatrists participated in the survey (86 GPsy, 56 CAP). GPsy and CAP preferred pharmacotherapy (GPsy 82.40%, CAP 64.30%) as the primary treatment option and answered that the clinical psychiatric interview is the most necessary step in diagnostic assessment (GPsy 22.16%, CAP 19.00%). The GPsy responded with an optimal and average treatment duration that was shorter than that reported by CAP. Conclusion: Identification of the initial presenting symptom as the correct diagnosis and the optimal duration of pharmacotherapy differed between GPsy and CAP in practice, whereas concepts in diagnosis and treatment of ADHD in adults were similar for both groups. These results suggest the urgent need for the Continuing Medical Education program for psychiatrists treating adults with ADHD.

• 대한안전경영과학회지
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• 제26권1호
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• pp.75-89
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• 2024

The objective of this study was to conduct research and analysis using Group Focus Interview to survey the between construction site workers and managers implementing for the Severe Accident Punishment Act. Focused on measures to improve safety management effectiveness for the effectiveness of establishing a safety management system. A plan to improve the efficient safety management system was presented to 50 construction industrial managers and workers. In order to ensure the industrial accident prevention policies appropriately, it is necessary to be aware of safety obligations for workers as well as business operators. In addition, despite the existence of a commentary on the Serious Accident Punishment Act, confusion in the field still persists, so in the event of a major accidents, the obligation to take safety and health education is strengthened, and effective case education is proposed by teaching actual accident cases suitable for actual working sites. It is necessary to make all training mandatory, and it is necessary to reconsider awareness through writing a daily safety log, awareness of risk factors, etc., and writing down risk information. Above all, at the construction ordering stage, it is necessary to keep the construction safety, request corrections and supplements for problems issues that arise, and consult between the orderer and the construction company about the problems issues. Rather than having only the construction company correct or supplement the safety management plan, the contents should be shared with supervisors and workers to establish a more practical solution. Results of this study will contribute to improving the effectiveness of the serious accident and construction safety management system.

• 치위생과학회지
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• 제12권3호
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• pp.197-207
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• 2012

본 연구는 노인들의 구강건강상태와 관리실태가 자가건강평가수준(SRH)에 얼마나 영향을 미치는 지를 파악하기 위하여 부산광역시에 거주하는 65세노인 479명을 대상으로 구강검진과 1:1면접을 통한 설문조사를 실시하였다. 분석결과는 다음과 같다. 1. 성별에서는 남자가 일반적 건강상태(p=0.033), 1년 전과 비교한 건강상태(p=0.029), 연령에서는 일반적 건강상태(p=0.004), 1년 전과 비교한 건강상태(p=0.011), 자가주택을 소유하고 있는 경우 일반적 건강상태(p<0.001), 1년 전과 비교한 건강상태(p<0.001), 신체적 건강상태(p<0.001), 정신적 건강상태(p<0.001)가 높았다. 2. 구강건강과 관련해서는 상실치아의 개수가 많을수록 일반적 건강상태(p=0.015), 치주염을 가지고 있는 경우 일반적 건강상태(p=0.020), 정신적 건강상태(p=0.032), 틀니가 상하모두 필요한 경우 일반적 건강상태(p=0.040)가 자가건강평가수준이 낮았다. 3. 건전치율이 65% 이상인 경우 일반적 건강상태(p=0.003), 1년 전과 비교한 건강상태(p=0.013), 신체적 건강상태(p=0.013), 기능치율이 89%이상인 경우 일반적 건강상태(p=0.012), 신체적 건강상태(p=0.004), 정신적 건강상태(p=0.017)에서 자가건강평가 수준이 높았다. 4. 전신질환의 수가 많을수록 자가건강평가수준이 낮았고, 구강증후증상의 수가 많을수록, 기능치율이 낮을수록 자가건강수준이 낮았다. 결과적으로, 전신질환의 수와 구강증후증상의 수는 부(-)의 영향, 기능치율은 정(+)의 영향을 미치는 것을 알 수 있다. 결론적으로 노인들에게 있어 자가건강평가수준을 향상하기 위해서는 노인들의 건전치율과 기능치율을 높이기 위한 다양한 구강보건사업들이 체계적으로 이루어져야 하리라 사료된다.

• 치위생과학회지
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• 제12권4호
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• pp.359-367
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• 2012

우리나라 성인의 우식예방 관심도와 지식에 따른 본인의 우식예방 실천행위와 자녀의 우식예방 실천행위에 대해 조사하였다. 이 연구는 한국갤럽에 설문조사를 의뢰하였으며 전국 만 19세 이상의 성인 남녀를 비례 할당으로 표본 추출을 하여 전화면접조사를 실시한 후 총 1,014명(남자 502명, 여자 512명)의 자료를 수합하여 분석한 결과는 다음과 같았다. 1. 연구대상자의 성별에 따른 우식예방 관심도는 남성에 비해 여성, 연령에서 40~49세군이 높게 나타났다. 교육 수준은 대졸 이상인 경우, 주부인 경우, 자녀가 있는 경우, 지역크기가 읍면지역에 비해 대도시, 중소도시 거주자가 우식예방 인식도가 유의하게 높게 나타났다(p<.001). 2. 우식예방 지식수준이 높을수록 구강보건교육 여부 및 우식예방 실천행위인 정기적인 치과방문, 스케일링 여부, 잇솔질 빈도, 보조구강위생용품 사용이 높게 나타났다. 3. 자녀의 우식예방 관심도는 남성에 비해 여성, 교육수준과 소득수준이 높을수록, 주부인 경우 높게 나타났다. 자녀가 학령기 시기인 경우 부모의 우식예방 지식수준이 높게 나타났다. 우식예방 지식수준이 높을수록 자녀의 정기적인 구강건강 검진, 불소도포, 치면열구전색과 같은 실천행위는 유의하게 높게 나타났다(p<.001). 4. 부모의 우식예방 지식수준이 높을수록 본인의 우식예방 실천행위와 자녀의 우식예방 실천행위가 증가하는 것으로 나타났다(p<.001). 이상의 결론을 통해 우식예방 관심도와 지식수준은 우식예방 실천행위에 영향을 미치며, 본인의 우식예방 지식과 실천행위는 자녀의 구강건강에 영향을 미치는 것을 알 수 있었다. 따라서 우식예방을 통한 구강건강을 증진시키기 위해서는 경제적, 보건학적 관점에서 체계적인 지역 사회 기반의 구강건강 교육을 강화해야 되며, 부모를 위한 구강보건교육 프로그램을 개발하여 자녀들이 건강한 치아를 보존할 수 있도록 노력해야 될 것이다.

• 생물정신의학
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• 제20권2호
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• pp.45-53
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• 2013

Objectives Non-major depression with fewer symptoms than required for a Diagnostic and Statistical Manual of Mental Disorders-4th edition diagnosis of major depressive disorder (MDD) has consistently been found to be associated with functional impairment. In this study, we aim to estimate the cognitive impairment and the quality of life in elderly patients with subsyndromal depression (SSD) compared with non-depressive elderly (NDE). Methods The Korean version of Mini International Neuropsychiatric Interview was administered to 194 outpatients with depression and 108 normal controls. SSD is defined as having five or more current depressive symptoms with core depressive symptoms (depressive mood or loss of interest or pleasure) during more than half a day and more than seven days over two weeks. Depression was evaluated by the Korean form of Geriatric Depression Scale of a 15-item short version. Global cognition was assessed by Mini-Mental State Examination in the Korean version of CERAD assessment packet (MMSE-KC). Subjective cognitive impairment was assessed by the Subjective Memory Complaint Questionnaire. Quality of life was evaluated by the Korean Version of Short-Form 36-Item Health Survey. Results The mean score of the MMSE-KC in the SSD group was lower than that in the NDE group with adjustment for age, gender, and education [F = 4.270, p = 0.04, analysis of covariance (ANCOVA)]. If we defined those having Z-score of MMSE-KC < -1.5 as a high risk group of cognitive impairment, the odds ratio for the high risk group of cognitive impairment was 1.86 [95% confidence intervals (CI) 1.04-3.34] in SSD and 7.57 (95% CI 3.50-16.40) in MDD compared to NDE. The scores of physical component summary (F = 9.274, p = 0.003, ANCOVA) and mental component summary (F = 53.166, p < 0.001, ANCOVA) in the SSD group were lower than those in the NDE group with adjustment for age, gender, and education. Conclusions The subjects with SSD, as well as those with MDD, showed impairment of global cognition and also experienced low quality of life in both physical and mental aspects, compared to the NDE group.

• 생물정신의학
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• 제21권3호
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• pp.107-113
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• 2014

Objectives Restless legs syndrome (RLS) is a sleep disorder characterized by uncomfortable and unpleasant sensations in the legs and an urge to move the legs, usually at night. The aim of this study is to investigate the incidence of RLS in patients with late life depression and its influence on various clinical outcomes such as severity of depression, sleep quality, cognitive function, and quality of life and accordingly, to elucidate the clinical significance of RLS in patients with late life depression (LLD). Methods This study enlisted 170 depressive patients aged 65 years or older from an outpatient clinic. Structured diagnostic interviews were performed using the Korean version of the Mini-International Neuropsychiatric Interview. All patients completed the questionnaires, including the International RLS Severity Scale, the Korean version of Short-Form 36-Item Health Survey (SF-36), and the Pittsburgh Sleep Quality Index (PSQI). The severity of depression was evaluated by the Korean form of the Geriatric Depression Scale (KGDS) and the level of global cognition was assessed by the Mini-Mental State Examination in the Korean version of The Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (MMSE-KC). Results The incidence of RLS was 17.6% in LLD patients. RLS was more prevalent among the subjects with major depressive disorder (MDD) than those with minor depressive disorder or subsyndromal depressive disorder. The RLS group showed higher score in the KGDS than the Non-RLS group but the difference did not reach the statistical significance (p = 0.095, Student t-test). The mean PSQI score was significantly higher in the RLS group than in the Non-RLS group (p = 0.001, Student t-test). The MMSE-KC score was also lower in the RLS group than in Non-RLS group (p = 0.009, analysis of covariance). But, there was no difference in the score of SF-36 between the RLS group and the Non-RLS group. Conclusions RLS is common in LLD patients, especially in the patients with MDD and is associated with poor sleep quality and cognitive dysfunction, indicating that RLS is clinically significant in patients with LLD. Therefore, RLS should be considered as an important clinical issue in the management of LLD.

• 한국산학기술학회논문지
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• 제10권11호
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• pp.3434-3443
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• 2009

본 연구는 3차병원에서 퇴원하는 환자의 상처관리에 대한 지식과 염려사항을 파악하기 위해 112명의 피부상처를 지니고 퇴원을 앞둔 112명 환자에게 구조화된 설문지로 면담을 통해 조사하였다. 상처의 유형은 외과적 절개(52.7%), 삽관상처(26.8%), 욕창(9.8%), 당뇨발과 동맥궤양(5.4%) 등이었다. 상처관리에 관한 지식은 52.0%의 정답률을 보였고, 상처관리에 대한 염려(범위1-7)는 2.79였고, 상처관리에 대한 지식과 염려는 상관관계가 유의하지 않았다. 퇴원후 상처관리에 관한 염려에 영향을 미치는 요인으로 유의한 변수는 상처관리에 대한 두려움, 상처통증, 입원기간, 및 주관적 건강인식으로 나타났다. 상처를 지니고 퇴원하는 환자들의 상처관리에 대한 지식은 부정확한 것이 많으며 다양한 염려사항들을 가지고 있으므로 퇴원계획시 이에 대한 구체적인 교육이 필요할 것이다.