• 제목/요약/키워드: Oriental Medicine Hospital

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산재환자의 진료비 본인부담 발생 및 크기와 이에 영향을 미치는 요인 (Incidence and magnitude of out-of-pocket payment and factors influencing them in Industrial Accident Compensation Insurance)

  • 박보현;이태진;임화영
    • 보건행정학회지
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    • 제20권1호
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    • pp.103-124
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    • 2010
  • 산재보험의 목표는 업무상 재해 및 질병으로 인한 수입상실에 대한 실질적 보상이 이루어지도록 하는 데 있으나 실제 산재환자들이 요양급여를 제공받는 과정에서 환자본인부담을 지불해오고 있었다. 그럼에도 불구하고 이제까지 산재환자의 본인부담에 대해서는 주의를 기울이지 못하였다. 따라서 본 연구에서는 산재환자 본인부담 발생률 및 본인부담률에 어떤 요인이 영향을 미치는지 파악하고자 하였다. 본 연구는 2009년 5월 퇴원 또는 외래방문 환자 중 의료기관 종별과 지역의 도시화정도를 고려하여 추출된 총 204개(양방 187개 치과, 한방 17개) 의료기관을 대상으로 조사하였다. 회수율이 57.8%(양방 57.2%, 치과, 한방 64.7%)로 총 24,826건(입원 2,457건, 외래 22,369건)이 분석에 이용되었다. 분석결과 본인부담의 발생률은 9.9%였고 본인부담률은 전체건 중에서는 3.5%, 본인부담 발생건 중에서는 8.3%로 나타났다. 본인부담률은 의료기관 종별로 차이를 보였다(산재의료원 : 전체건 0.5%, 본인부담 발생건 2.5%, 종합병원 : 전체건 4.4%, 본인부담 발생건 9.5%, 한방 : 전체건 24.4%, 본인부담 발생건 25.2%). 다수준 분석결과 본인부담의 발생은 주로 종합병원급 이상의 규모가 큰 의료기관과 서울 등 대도시에 소재한 의료기관에서 주도되는 경향을 보였고, 환자의 입원일수가 증가함에 따라 본인부담의 발생이 증가하는 것으로 나타났다. 종합병원급 의료기관에서 발생한 본인부담은 주로 입원료와 선택진료료의 비중이 큰 것으로 나타났다. 따라서 대도시에 소재한 규모가 큰 의료 기관을 우선으로 하여 본인부담 발생률 및 본인부담률을 줄이기 위한 대책이 마련되어야 한다.

노인의 성별 만성동통 호소의 차이에 대한 조사연구 (Difference of Pain Description According to Gender in the Elderly)

  • 김명애;박경민;김효정
    • 대한간호학회지
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    • 제28권2호
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    • pp.369-379
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    • 1998
  • Despite acknowledgment that pain is likely to be a major problem for many older adults, it is difficult to estimate the frequency of pain problems for this population. The main purpose of this study was to identify the various characteristics of chronic pain in the elderly by gender. It examines by gender, pain frequency, pain intensity, number of chronic pain sites, localization of pain, impact on activities, methods of pain management, and effects of chronic pain management. The subjects were 189 elderly people(65 years and older) living in an urban area. They were surveyed at their homes. They were surveyed by interview using a closed-ended questionnaire. The survey was done from Nov. 6th. to Dec. 6th. 1997. Descriptive statistics were used to determine all of the reported pain variables. Chi-square tests were used to determine crude differences between pain intensity and gender. T-test was used to determine differences in number of pain sites between men and women. The findings are as follows ; Of the 189 subjects, 83.6% reported experiencing pain, and men reported a lower prevalence (69.5%) than women(89.2%). Women had significantly more severe pain than did men(p=.001). Lower back pain(20.2%) and leg pain(20.2%) were the most prevalent, followed by knee pain(17.4%), arm pain(13.3%), neck and shoulder pain(11.6%), and headache(9.9%). Women experienced more multiple localizations of pain(p=.0001), the greatest impact was on movement (83.5%) , followed by usual activities(60.8%), sleep(49.4%), visiting(29.1%), and hobbies and recreations(50.0%). No differences were observed between men and women in the proportion of subjects reporting a negative impact on each of these activities. The methods of pain management were hospital visit(70.9%), drug store medication(46.7%), oriental medicine clinic(32.9%), endurance(13.3%), self-management(6.3%). Drug therapy was the most effective pain management strategy(94%), followed by physical therapy(63%) and accupuncture.byssocausis(55%). The conclusion : Pain is a symptom of great clinical importance that is often associated with disability, loss of independence, and reduced quality of life. In this study chronic pain symptoms were common but unevenly distributed in men and women. The results further advance understanding of the experience and impact of pain by gender. Future studies should incorporate questions that gather systemic and more detailed information on the characteristics of pain, especially by gender and by age.

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간호학과와 사회복지학과 학생의 치매에 대한 지식과 태도 (Nursing Students and Social Welfare Students' Knowledge and Attitudes toward Dementia)

  • 김숙희;안옥희;박다혜
    • 한국융합학회논문지
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    • 제6권3호
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    • pp.111-117
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    • 2015
  • 본 연구는 간호학과와 사회복지학과 학생을 대상으로 치매에 대한 지식과 태도를 파악하여 교육프로그램 개발의 기초자료를 제공하기 위한 서술적 조사연구이다. 연구 대상자는 J도 4년제 대학교에 재학 중인 간호학과와 사회복지학과 학생 451명을 대상으로 하였다. 자료수집기간은 2012년 10월 1일부터 10월 20일까지였으며, 수집된 자료는 SPSS 20.0 프로그램을 이용하여 분석하였다. 대상자들은 치매에 대한 지식수준이 비교적 높은 수준이었으며, 간호학과 학생들의 치매에 대한 지식수준이($16.42{\pm}1.77$점, 범위 0~20점) 사회복지학과 학생들($16.02{\pm}2.30$점, 범위 0~20점)보다 약간 높았다(p=.015). 두 학과 모두 치매에 대한 태도가 비교적 긍정적이었고(간호학과 $40.48{\pm}4.29$점, 사회복지학과 $40.54{\pm}4.62$점, 범위 10~50점). 치매에 대한 지식과 관심도가 높을수록 긍정적인 태도를 나타냈다. 이상의 결과를 토대로, 치매에 대한 지식과 태도를 향상시키기 위한 다양한 교육프로그램 개발과 연구 진행이 이루어져야 할 것이다.

편마비 환자가 지각한 가족지지와 불안과의 관계 연구 (A Study on Perceived Family Support and Anxiety in Hemiplegic Patients)

  • 이명해;강현숙
    • 대한간호학회지
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    • 제21권1호
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    • pp.50-62
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    • 1991
  • The purposes of this study were to identify causal factors of Anxiety and to analyze correlation between perceived family support and anxiety in hemiplegic patients. The subjects of this study were 88 hospitalized hemiplegic patients at Kyung - Hee Oriental medicine Hospital. Data were collected by using interview with questionaire from Jan. 15 to Mar, 31, 1990. The measurement tools used by this researcher were Kang's family support scale, Spielberger's trait anxiety scale and the other anxiety scale which was developed by this researcher, approved it's reliability and validity. For the purposes of the study, the collected data were analyzed by frequency, t-test, ANOVA and the hypothesis was tested by pearson correlation, partial correlation. The results of the study were as follow. 1) The analysis of causal factor of anxiety higher anxiety these three cases ; \circled1 1st causal factor was the delayed recovery of paralyzed upper limbs(2.42$\pm$1.27). \circled2 End causal factor was the dysfunction of physical ability(2.30$\pm$1.29). \circled3 3rd causal factor was difficulty for walking(2.30$\pm$0.83) and the anxiety level(2.02$\pm$0.83) of physical factor was the highest level than any other factors. 2) The hypothesis that the more perceived family support level is the less anxiety level of patient was supported(r=-.29, p=.003). 3) The analysis of the general characteristics exerting influences on anxiety level patients ; (sex, age, marrital status, religious, education level, occupation, economic status, experience of hospitalization, care giver, the period of hospitalizatiot side of paralysis). In this analysis, any factor has not a statistical significance.(p>.05). 4) The analysis of the relationship about effective factors of family support level by the general characteristics of patient (sex, age, marrital status, religious, education level, occupation, economic status, experience of hospitalization, care giver, the period of hospitalization, side of paralysis). In this analysis, there was significant difference on perceived family support between married and bereaved patients(t=-2.68, p= .009) As a result of this study, anxiety level of physical factor was higher than any other factors (psychological factor, social factor) and the delayed recovery of paralyzed upper limbs is the largest causal factor of anxiety of physical factor. Meanwhile, the relationship between the degree of family support and the level of anxiety was negatively correlated but the degree of relationship was low. Therefore, one can infer from this study that sufficient information about recovery of physical problems and family support were effective in preventing and reducing anxiety in hemiplegic patient.

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비대칭적 입식자세에서 상지 조립 작업 시 체간 및 둔부 근육의 좌우 근활성도 비교 (Comparison Between Right and Left Muscle Activities of Hip and Trunk During Manual Task in Asymmetric Weight-Bearing Posture)

  • 정지윤;전혜선;이충휘;이정원
    • 대한인간공학회지
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    • 제29권3호
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    • pp.279-286
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    • 2010
  • The purpose of this study was to compare the electromyographic(EMG) activities of trunk and hip muscles between right and left sides while subjects performed prolonged manual task in asymmetric and symmetric weight-bearing posture. Fifteen healthy male college students were recruited for this study. The subjects were asked to perform bimanual upper extremity task for 6 minutes in two different standing postures. In the symmetric weight-bearing posture, the subjects were standing with evenly distributed body weights to both legs. In the asymmetric weight-bearing posture, the subjects distributed about 90% of their body weight onto their preferred(supporting) leg and 10% of their body weight onto the opposite leg while they were standing. EMG activities of the right and left internal oblique, erector spinae, gluteus maximus, and gluteus medius were measured and normalized as % MVIC. Then the EMG data were statistically analyzed using paired t-tests. The EMG activities of all measured muscles were not significantly different between the right and left side in the symmetrical weight-bearing posture(p>0.05). However, the EMG of the supporting side internal oblique was significantly lower than the opposite side(p<0.05), and the EMG of the erector spinae, gluteus maximus, and gluteus medius were significantly greater on the supporting side(p<0.05). The results of this study support that unbalanced use of right and left muscle possibly causes the changes in muscle length which results in asymmetry of trunk and hip muscles. Furthermore, the uneven weight support onto right and left legs will cause a distortion of viscoelastic ligaments around hip and sacroiliac joints in the long run. Further studies to determine the effect of various manual tasks on the trunk and hip muscles as well as the effect of asymmetrical weight-bearing standing posture on hip and back muscle fatigue may be required.

중년여성 골다공증과 체질량지수와의 관계 분석 (Relationship Analysis of Osteoporosis and Body Mass Index(BMI) in the Middle-Aged Women)

  • 임종덕;정재은;박철우;동경래;김호성;김순근
    • 한국방사선학회논문지
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    • 제5권6호
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    • pp.363-367
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    • 2011
  • 일반적으로 중년여성의 골다공증은 저체중에서 발생률이 높은 것으로 보고되었으나 비만인 경우에도 발생할 수 있다. 따라서 본 연구의 목적은 골밀도 검사에서 골다공증으로 진단받은 중년여성 120명을 대상으로 골다공증과 체질량지수의 상관관계를 비교하고자 하였다. 체질량지수가 18.5 미만을 저체중, 18.5 ~ 22.9를 정상, 23.0 ~ 24.9를 과체중, 25.0 ~ 29.9를 비만, 30.0 이상인 경우를 고도비만으로 하였다. 연구 결과 대상자의 체질량지수 분포는 저체중이 2명(1.7%), 정상이 18명(15.0%), 과체중이 19명(15.8%), 비만이 75명(62.5%), 고도비만이 6명(5.0%) 이었다. 또한 체질량지수와 골다공증의 상관관계는 체질량지수가 정상인 경우 18명 중 13명(72.2%)이 골다공증이었으며 과체중의 경우 19명 중 14명(73.7%), 비만의 경우 75명 중 63명(84%), 고도비만의 경우 6명 중 5명(83.3%)로 나타나 체질량지수가 비만인 경우에서 골다공증 발생률이 높았다. 결론적으로 중년여성의 골다공증은 체질량지수가 비만일수록 골다공증 환자가 많다는 것을 알 수 있었으며 대부분 골감소증보다는 골다공증이 높게 나타남을 알 수 있었다.

산부의 삼음교(SP-6).합곡(LI-4)지압이 분만통증과 분만소요시간에 미치는 효과 (Effects on Labor Pain and Length of Delivery Time for Primipara Women treated by San-Yin-Jian(SP-6) Acupressure and Hob-Gog(LI-4) Acupressure)

  • 김영란;장순복;이미경;맹웅재
    • 여성건강간호학회지
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    • 제8권2호
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    • pp.244-256
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    • 2002
  • The purpose of this study was to examine the effects on labor pain and duration of delivery time for primipara women treated by San-Yin-Jiao(SP-6) and Hob-Gog(LI-4) acupressure. The design of this study was a nonequivalent control group non-synchronizedpost test only design. It was done to identify the effects of SP-6 acupressure or LI-4 acupressure on labor pain in primipara women. The benefits of using SP-6 acupressure or LI-4 acupressure were evaluated by comparing three groups, a SP-6 acupressure group, a LI-4 acupressure group and a control group, not treated with acupressure. The participants included 192 primiparas who underwent vaginal delivery, 72 primiparas in the control group, 71 in the SP-6 acupressure group and 49 in the LI-4 acupressure group. Data were collected using a structured questionnaire consisting of general characteristics, a subjective labor pain scale (Johnson, 1974), and measurement of duration of delivery time. The results of this study are summarized as follows : 1. Differences in the acupressure effect for SP-6 and LI-4 were analyzed using Scheffe's test which showed that differences in the control group vs the SP-6 group and the control group vs the LI-4 group were statistically significant (t=21.767, p<0.05; t=23.923, p<0.05), but the SP-6 group vs the LI-4 group showed no significant differences. 2. The duration of delivery time in the group which had SP-6 acupressure or LI-4 acupressure was shorter (400.77${\pm}$153.34; 379.10${\pm}$127.60) than in the control group (528.68${\pm}$239.08). Differences in the effects of acupressure with SP-6 and LI-4 were also analyzed by Scheffe's test. Control group vs SP-6 group and Control group vs LI-4 group were significantly different(t=127.91, p<0.05; t=149.58, p<0.05), but the SP-6 group vs the LI-4 group did not show any statistically significant difference (t=21.67). This study has shown that SP-6 and LI-4 acupressure were both effective in relation to labor pain and duration of delivery time for primiparas. But it is necessary to replicate the study with a larger number of participants to generalize of the results.

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뇌졸중 환자의 체질별 건강통제위 성격별 자가간호에 대한 교육의 효과 (The Effects of Education According to Constitution & Character of Patients Who have Stroke)

  • 강현숙;이정민;최은선;전은영
    • 기본간호학회지
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    • 제2권1호
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    • pp.7-18
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    • 1995
  • This study was designed to explore the effectiveness of education to improve self-care of stroke patients with three types of charactor health locus of control and constitution. A total of 56 patients were selected by convenience sampling at one oriental hospital. The teaching of self-care was conducted by the researcher. The self-care performance was measured for 10 days. The data were analyzed using t-test, ANOVA and Scheffe method as post hoc test. The results of this study are as follows : 1. The self-care performance by patients' characteristics : Age and education had impact on the self-care performance. The level of self-care performance of young and high educated patients was high, gender, religion, occupation, monthly income, and the paralyzed side, however, didn't have influence on the self-care performance. 2. The self-care performance of patients with three types of constitution : There was no statistical significance on the self-care performance of patients group by constitution. However, average score of self-care performance of patients with So-Um was high. 3. The self-care performance of patients with three types of health locus of control : There was no statistical significance on self-care performance of patient group by health locus of control. 4. The correlation between the constitution and the health locus of control : There was no statistical significance on the introverted and chance health locus of control of patients with three types of constitution. However, there was a statistically significant relationship between the powerful others health locus of control and So-Yang. Even though there was no statistically significant self-care performance of patients with So-Um, there was a clinical significance on the high score of self-care performance of patients with So-Um as compared with the self-care performance of the patients. The health locus of control didn't have influence on the self-care performance of patients. There was a statistically significant relationship between the powerful others health locus of control and So-Yang. Therefore, this study suggest the need to develop the nursing intervention to improve the self-care of stroke patients with the powerful others health locus of control and So-Yang, Furthermore, the longitudinal research is needed to determine the effectiveness of training to imp

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전립선 비대증에 대한 Houttuynia cordata Thunberg 에탄올 추출물의 최적용량 결정 (Determination of Optimal Dosage of Ethanol Extract of Houttuynia cordata Thunberg Against Benign Prostatic Hyperplasia)

  • 이진영;김형회;강재선
    • 생명과학회지
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    • 제31권7호
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    • pp.631-640
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    • 2021
  • Houttuynia cordata Thunberg는 전통의학에서 다양한 약리학적 작용에 대해 연구되어 왔다. 본 연구에서, 거세 및 테스토스테론 프로피오네이트(TP) 주입에 의해 유도된 양성 전립선 비대증(BPH) 모델에 대한 Houttuynia cordata 에탄올 추출물(HCE)의 영향을 조사했다. 총 30마리의 쥐를 6개의 그룹으로 나누었다. 한 그룹은 정상 대조군으로 사용되었고 다른 그룹은 거세 후 14일 동안 복강내 TP를 주입하여 BPH를 유도하였다. 양성 대조군은 BPH 모델에 매일 피나스테라이드(5 mg/kg)를 투여했다. 피나스테라이드 대신 HCE (0.5, 1, 2mg/kg)를 투여한 군은 실험 군으로서 대조군과 비교하였다. 체중 100 g 기준으로 전립선 무게에 대한 통계적 유의성은 없었다. ELISA 검사로 5-α 환원효소 및 디하이드록시 테스토스테론(DHT) 농도를 측정하였으며, 모든 실험군에서 유의미한 감소가 있었다. 5-α 환원효소의 경우 HCE (0.5 mg/kg) 군이 가장 낮았고, DHT는 HCE (2 mg/kg) 군에서 가장 낮은 수치를 보였다. 전립선에 대한 조직병리학적 관찰에서 대조군과 HCE (2 mg/kg) 투여 군은 정상 세포 형태를 보였고 세포팽창이 없었다. 그러나 음성 대조군과 HCE (1 mg/kg) 군에서는 세포가 부풀어 오르고 세포 사이의 간격이 좁아졌다. 특히 HCE (0.5 mg/kg) 군에서는 일부 세포가 터지는 현상이 나타났다. 따라서 2 mg/kg 이상의 HCE를 투여하는 것이 BPH의 보호 효과에 적합할 것이다.

노인 당뇨환자의 시각-운동 통합능력 평가 (Evaluation of Visual-Motor Integration in Elderly Patient with Diabetes Mellitus)

  • 윤효순;김미애;김미한;서순림;김홍
    • 한국노년학
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    • 제31권3호
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    • pp.641-652
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    • 2011
  • 본 연구는 VMI-3R 측정도구를 이용하여 노인 당뇨환자의 시각-운동 통합능력을 측정함으로써 당뇨병이 노인의 시각-운동 통합능력을 저하시키는지 규명하고 또한 이 도구의 노인 적용 시 개선방향에 대한 기초자료를 제시해 보고자 실시하였다. 연구방법은 사회생활을 하고 있는 노인 30명은 대조군, 근골격계 질환으로 입원했으나 당뇨가 없는 노인 30명은 비당뇨군, 그리고 당뇨로 진단받은 노인 30명은 당뇨군으로 구분하여 시각-운동 통합 측정도구(VMI-3R)를 사용하여 자료를 수집하였다. 집단 간 차이가 있는지를 검정하기 위하여 일원분산분석, Duncan 사후검정을 실시하였다. 또한 각 집단 간 각 문항별 정답 비율과 오답 비율은 백분율로 산출하였다. 연구결과 노인 당뇨 환자의 시각-운동통합 능력은 대조군과 비당뇨군과 비교할 때 유의하게 낮았다. 이러한 결과는 당뇨환자의 인지기능 감소가 시각-운동 통합능력의 감소와 관련이 있음을 말해준다. VMI-3R 문항별 정답과 오답에 대한 수와 비율에 관한 연구결과는 집단 간 큰 차이가 없는 것으로 나타나 차후 VMI-3R의 문항별 변별력을 높이기 위한 연구가 필요한 것으로 생각된다.