• 제목/요약/키워드: Outpatient clinics

검색결과 179건 처리시간 0.023초

소아의 열에 대한 부모의 반응과 이해 및 처치 (Parental response, recognition and management about fever in children)

  • 김유진;허재균
    • Pediatric Infection and Vaccine
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    • 제14권1호
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    • pp.55-61
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    • 2007
  • 목 적 : 열은 소아에서 매우 흔한 증상 중 하나이지만 부모들은 열 자체를 위험한 질환으로 인식하는 경우가 많다. 열에 대해 올바로 아는 것은 부모의 불필요한 염려를 덜고 환아의 질환과 진단 및 치료 과정을 이해하는데 도움을 줄 것이다. 이에 저자들은 소아의 열에 대한 부모들의 인식을 조사하고 과거와 비교하여 변화가 있는지 알아보고자 하였다. 방 법 : 2006년 5월부터 7월까지 3개월 동안 가톨릭대학교 성바오로병원 소아과 외래를 방문한 소아의 보호자들에게 열에 대한 지식, 태도, 대처 방법을 묻는 19문항의 설문조사를 실시하였다. 결 과 : 136명이 답하였으며 10년 전에 비하여 열에 대한 정보, 태도, 대처 방법 등에서 크게 개선된 점이 없었다. 열에 대한 기본 지식인 열의 기준과 측정 방법에 대해서 잘못 알고 있는 보호자가 많았고, 열성경련과 뇌손상의 가능성에 대한 염려는 여전히 지속되고 있었다. 열은 항상 해롭고 위험한 것이라고 생각하고 있었으며, 따라서 치료가 필요하지 않은 체온에서도 실제보다 심각한 결과를 걱정하며 해열제를 투여하고 병원에 방문하고 있음을 보여주었다. 결 론 : 보호자들은 열이 이로운 점을 가진 생리 반응중의 하나라는 사실을 인식하지 못하고 실제보다 심각한 결과를 예상하며 따라서 불필요한 우려와 치료를 택하게 된다. 이런 잘못된 인식은 시간의 경과에도 불구하고 큰 변화가 없었으며 따라서 소아과 의사들의 역할이 중요하다고 할 수 있다. 부모들에게 해열제를 사용하도록 할 때는 열이 해롭지 않으며 해열제의 목적은 열로 인한 아이의 불편감을 덜어주는 것임을 반복하여 알려주고, 더 나아가서는 소아과 의사들이 좀 더 체계적인 정보 및 교육 프로그램을 제공한다면 열에 대한 올바른 인식 형성에 도움이 되리라고 생각된다.

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동영상 운동교육이 견관절 환자의 관절가동범위, 통증 및 삶의 질에 미치는 효과 (The Effects of Video Exercise Education on Range of Motion, Pain and Quality of Life for Shoulder-joint Patients)

  • 임세미;염영란;이정화
    • 융합정보논문지
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    • 제10권9호
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    • pp.43-52
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    • 2020
  • 본 연구의 목적은 견관절 환자를 대상으로 동영상 교육을 개발하고 관절가동범위, 통증 및 삶의 질에 미치는 효과를 평가하기 위함이다. 본 연구는 2020년 1월부터 6월까지 G시 소재 대학병원의 정형외과 외래에 내원한 견관절 환자 중 실험군 30명, 대조군 26명을 대상으로 하였다. 자료분석은 SPSS를 이용하여 두 그룹의 일반적 특성 및 종속변수에 대한 사전 동질성 검정은 𝑥2-test, t-test로 분석하였다. 연구결과, 대상자의 사전 사후 점수 변화는 관절가동범위의 내회전 정도와 통증점수에서 유의한 차이가 있는 것으로 나타났으며, 관절가동범위의 굴곡, 외전 정도와 삶의 질에서는 유의한 차이가 없는 것으로 나타났다. 본 연구에서 동영상 교육의 임상 적용은 외래 뿐만 아니라 병동에서도 간호사의 환자교육에 소비되는 시간을 절약할 수 있어 간호 실무를 개선하는 방안으로 제시될 수 있다.

건강증진행위의 영향요인 분석 -위암환자중심 - (Predicting Health-Promoting Behaviors in Patients with Stomach Cancer)

  • 오복자
    • 대한간호학회지
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    • 제25권4호
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    • pp.681-695
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    • 1995
  • It has been noted that a genetic alteration of cells influenced by unhealthy lifestyle In addition to a series of other carcinogens increases various neoplasmic diseases. Therefore the importance of lifestyle that minimizes such impact on health should be emphasized. Since stomach cancer, the most common neoplasmic disease in Korea, is re-lated to the Korean lifestyle and as there's a possibility of its recurrence, people with stomach cancer need to lead a healthy lifestyle. The purpose of this study is to provide a basis for nursing intervention strategies to promote health promoting behaviors that are constructive to a healthy lifestyle. A multivariate model was constructed based on the fender's health promotion model and Booker's health belief model by including influential factors such as hope. The sample was composed of 164 patients with stomach cancer who visited outpatient clinics of a university hospital in Seoul. The following instruments were used in the study after some adaptation : Wallston and others' multidimensional health locus of control scale Laffrey's health conception scale, Lawston and others' health self- rating scale, Walker and others' health promotion lifestyle profile and Rogenberg's self esteem scale. In addition Moon's health belief scale was used with some modification. For self efficacy, the present author constructed a self-efficacy scale based on previous research. The above mentioned instruments were tested in a pilot study with 24 patients with stomach cancer. The reliabilities of instruments were tested with Cronbach's alpha(0.574∼0.949). Data were analyzed using a SAS program (or Pearson correlation coefficients, descriptive correlational statistics and stepwise multiple regression. The results are as follows : 1. The scores on the health promoting behavior scale ranged from 55 to 145 with a mean of 107.91 (S. D : 16.50). The mean scores(range 1-4) on the different dimensions were nutrition 3.14, exercise 2.48, stress management 2.69, health responsibility 2.65, interpersonal relationship 2.878E self actualization 2.85. 2. There were significant correlations among all the predictive variables & the health promoting behavior (r=.20-.55, p〈.01) 3. Stepwise multiple regression analysis showed that : 1) Hope was the main predictor and accounted for 29.8% of the total variance. 2) Self efficacy, perceived barriers & self esteem accounted for an additional 14.6% of the total variance. 3) Hope, self efficacy, perceived barriers & self esteem altogether accounted for 44.3% of the total variance. In conclusion, hope, self efficacy, perceived barriers & self esteem were identified as important variables that contributed to promote health promoting behavior.

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화학소독제 처리 후 가타파차 콘의 멸균 효과 및 표면 성상의 변화 평가 (Assessment of decontamination of gutta-percha cone and the change of surface texture after rapid chemical disinfection)

  • 방난심;정일영;유윤정;금기연
    • Restorative Dentistry and Endodontics
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    • 제31권2호
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    • pp.133-139
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    • 2006
  • 본 연구의 목적은 첫째 임상에서 진료실에 노출된 가타파차 콘 표면의 오염 균종을 중합효소연쇄반응법 (polymerase chain reaction, PCR)을 이용해 동정하고, 둘째 이들 세균으로 오염시킨 가타파차 콘에 대해 2종의 소독제의 rapid sterilization 효과를 비교하였다. 또한 이들 소독제에 5분간 처리된 가타파차 콘 표면 성상의 변화를 주사전자현미경으로 관찰하였다. 진료실에 수 개월간 노출된 가타파차 콘 100개를 수거하여 배양지에 넣어 배양 후 universial primer를 사용한 PCR assay 를 통해 오염 균종을 동정하였다. 실험실 상에서 이 균종을 다시 배양하여 소독된 가타파차 콘에 접종하고 1주일간 배양한 후 2종의 소독제(5% NaOCl, 2% Chlorhexidine)에 1, 3, 5, 10 분간 담근 후 각 소독제의 종류와 적용시간에 따른 멸균 효과를 turbidity test 와 subculture 를 이용하여 평가하였다. 또한 각 소독제에 5분간 처리된 가타파차 콘 표면 성상의 변화를 주사전자현미경으로 관찰하였다. 중합효소연쇄반응법의 분석결과 17개의 가타 파차 콘이 오염된 것으로 나타났고 대부분이 Staphylococcus 계통이었으며, 2종의 소독제 모두 이들 균종에 대해 1분내에 멸균 효과를 나타냈다. 주사전자현미경상 NaOCl로 소독된 가타파차 콘 표면에는 cuboidal crystal 의 침전물이 전반적으로 관찰되었다. 본 연구 결과 2종의 소독제 모두 근관충전 전 가타파차 콘의 rapid sterilization 을 위해 유용하였으나 클로헥시딘으로 처리된 가타파차 콘이 크리스탈 침전물이 없는 좀더 깨끗한 표면을 갖는 것으로 나타났다.

병원약국 실무실습 교육 제공 의도에 대한 영향요인 (The Factors Related to the Intention of Hospital Pharmacists for taking the Role of a Preceptor)

  • 한주리;남지나;방준석;조은
    • 한국임상약학회지
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    • 제25권4호
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    • pp.238-245
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    • 2015
  • Background: Pharmacy schools newly adopted a 6-year program strengthening clinical knowledge since 2011 in Korea. The clinical training under the guidance of preceptors at hospital sites is a requisite for pharmacy students during the last year of undergraduate course. It has been rarely studied on the hospital pharmacists' perspective regarding being a preceptor or teaching pharmacy students. Objectives: This study aimed to examine the hospital pharmacists' intention toward student training and to identify the relevant factors among the individual pharmacists' characteristics and working environment within the theoretical frame of the Theory of Planned Behavior (TPB). Method: A mail-survey was conducted for pharmacists working in tertiary hospitals in Seoul and Incheon. The survey questionnaire consisting of 131 questions with a 5-likert scale was developed for investigating pharmacists' attitude, subjective norm, perceived behavioral control and the intention to teach pharmacy students as well as other demographic variables. To estimate the construct validity of components, factor analysis was conducted and Cronbach's alpha was calculated to estimate the reliability of the observed variables. Statistical analyses of one-way variance analysis and multiple regression analysis were performed using SPSS 18.0. Results: The survey response rate was 53% (116/210) and the three constructs of attitude (r = .519), subjective norm (r = .233) and perceived control (r = .392) have appropriate correlations with the intention, proving the appropriateness of using the TPB model. Pharmacists working in inpatient (mean = 3.45) and outpatient clinics (mean = 3.34) generally showed positive intention for teaching. The attitude (${\beta}=.432$, p < 0.01) and perceived control (${\beta}=.270$, p < .01) constructs were significant predictors of the intention. Both age (r = 0.246, p = 0.017) and length of career (r = 0.310, p = 0.002) were positively related with the perceived control. Conclusion: Hospital pharmacists showed generally positive intention to provide student training in spite of the concern on their limited perceived behavioral control. Future research to find the actual barriers pharmacists faced in educating students need to be conducted.

Denver II 발달검사를 이용한 한국과 미국의 아동 발달 비교 연구 (Denver II Developmental Screening Test: A Cross Cultural Comparison)

  • 신희선;한경자;오가실;오진주;하미나
    • 지역사회간호학회지
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    • 제13권1호
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    • pp.89-97
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    • 2002
  • Purpose: The purpose of this study is to explore the validity of the application of the Denver II developmental screening test to Korean children. This screening test. which was developed and standardized in United States. was designed to screen for developmental delay in Korea. and to compare the levels of development of Korean children with the development of children from the U.S. Method: Quota sampling. NP To facilitate field sampling. the age range used from 0 to 6 years old. was split into 10 different age groups. Sample size was estimated according to residence. 1.054 children were recruited from Seoul's metropolitan. urban and rural areas. NP To fill the quota established. the Recruitment and testing of children was done at public health centers, pediatric outpatient clinics of general hospitals and a child care center. The 25, 50, 75 and 90 percentiles were identified by using logistic regression analysis and were calculated as norms. The items in which the ages of both 50 and 90 percent passing differed more than 20 percent by the calculation was identified for comparison. NP Result: There were significant differences found in 45 items between Korean children and the children from the City of Denver as it relates to age differences. 90% of the sample passed items among 125 items from 4 sectors, e.g., personal- social. fine motor adaptive, language, and gross motor sectors. Korean children were found to be advanced in 9 items, whereas there were significant differences found in 38 items in our comparison of the two countries for age differences when 50% of sample pass items. Korean children were found to be advanced in 16 items. NP Conclusion: The result showed that there was a discrepancy in the developmental norms. It could be explained by the differences in the developmental environment. including child rearing patterns and ethnicity. Therefore, a restandardization of the Denver Screening Test is necessary as it relates to its application on Korean children. This restandardization is necessary in order to avoid both under and over-referrals of children with developmental abnormality. The modification of items in the language sector is especially suggested.

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수평내전에 의해 악화되는 견관절 후방 통증 환자에서 초음파하 극하근 주사요법의 효과 (The Effectiveness of Ultrasonography-guided Injection at Infraspinatus of Shoulder in Patients with Posterior Shoulder Pain Induced Horizontal Adduction Test)

  • 박치형;문영래;이현준
    • 대한정형외과 초음파학회지
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    • 제8권1호
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    • pp.1-5
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    • 2015
  • 목적: 본 연구는 수평 내전 검사로 인해 견관절 후방부 동통의 악화를 보이는 환자에 대해서 초음파 유도 하에 스테로이드를 이용한 극하근 주사 치료 후 그 유용성에 대하여 평가하고자 하였다. 대상 및 방법: 2013년 5월부터 2014년 5월까지 견관절 후방부 통증을 주소로 내원한 환자 중 수평 내전 검사 시 동통의 악화를 보이는 21명을 대상으로 하였다. 외래에서 초음파 유도하에 극하근에 스테로이드 주사 치료를 시행하였으며 시술 전, 시술 후 3개월, 6개월로 나누어 VAS 통증 점수, UCLA 점수를 평가하였다. 결과: 스테로이드를 이용한 극하근 주사 치료 3개월 경과 시 환자들의 VAS 점수, UCLA 점수에서 임상적으로 유의하게 향상되었다(p<0.05). 시술 후 3개월과 6개월을 비교하면 VAS 점수와 UCLA 점수는 유의한 차이는 없었다(p>0.05). 6개월 추시 후 증상의 호전이 있는 완쾌 및 호전은 14예(67%)이었고, 호전이 없는 비호전 및 악화는 7예(33%)이었다. 결론: 초음파 유도 하에 스테로이드를 이용한 극하근 주사요법은 견관절 후방 통증이 있으며 수평 내전 시 통증이 악화되는 증상이 있는 환자들에게 유용한 시술이라고 생각된다.

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관절경하 회전근개 봉합술을 시행한 환자에 대한 초음파 유도하 상견갑 신경차단술의 효과 (The Effectiveness of Ultrasonography-guided Suprascapular Nerve Block in Patients treated with Arthroscopic Rotator Cuff Repair)

  • 문영래;강정훈;김현학
    • 대한정형외과 초음파학회지
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    • 제7권2호
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    • pp.84-88
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    • 2014
  • 목적: 본 연구는 회전근 개 파열에 대하여 관절경하 봉합술을 시행받은 환자 군에 대하여 수술 후 시행한 혈소판 농축 혈장을 이용한 상견갑 신경 차단술의 효과에 대하여 알아보고자 하였다. 대상 및 방법: 2013년 3월부터 2014년 3월 사이 본원에서 회전근 개 파열 진단 하에 수술적 치료를 시행한 환자 50명을 대상으로 하였다. 수술 후 6주 경과하여 외래 내원시 초음파 유도 하에 혈소판 농축 혈장을 이용한 상견갑 신경 차단술을 시행하였으며 수술 전, 술 후 6주, 그리고 술 후 3개월 추시를 통하여 환자의 통증에 대한 visual analog score(VAS), 관절 운동 범위(ROM), Constant Shoulder Score (CSS)를 평가하였다. 결과: 상견갑 신경 차단술을 시행한 후 환자들의 VAS, 관절 운동 범위, CSS이 시술전과 비교하여 임상적으로 유의하게 향상되었다. 결론: 초음파 유도 하 혈소판 농축 혈장을 이용한 상견갑 신경 차단술은 어깨 주변 통증에 대한 치료 효과뿐 아니라 술 후 남아 있는 견관절 통증이나 운동 범위 제한 등에도 효과적인 치료법으로 생각된다.

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A Study on the Prediction Model of the Elderly Depression

  • SEO, Beom-Seok;SUH, Eung-Kyo;KIM, Tae-Hyeong
    • 산경연구논집
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    • 제11권7호
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    • pp.29-40
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    • 2020
  • Purpose: In modern society, many urban problems are occurring, such as aging, hollowing out old city centers and polarization within cities. In this study, we intend to apply big data and machine learning methodologies to predict depression symptoms in the elderly population early on, thus contributing to solving the problem of elderly depression. Research design, data and methodology: Machine learning techniques used random forest and analyzed the correlation between CES-D10 and other variables, which are widely used worldwide, to estimate important variables. Dependent variables were set up as two variables that distinguish normal/depression from moderate/severe depression, and a total of 106 independent variables were included, including subjective health conditions, cognitive abilities, and daily life quality surveys, as well as the objective characteristics of the elderly as well as the subjective health, health, employment, household background, income, consumption, assets, subjective expectations, and quality of life surveys. Results: Studies have shown that satisfaction with residential areas and quality of life and cognitive ability scores have important effects in classifying elderly depression, satisfaction with living quality and economic conditions, and number of outpatient care in living areas and clinics have been important variables. In addition, the results of a random forest performance evaluation, the accuracy of classification model that classify whether elderly depression or not was 86.3%, the sensitivity 79.5%, and the specificity 93.3%. And the accuracy of classification model the degree of elderly depression was 86.1%, sensitivity 93.9% and specificity 74.7%. Conclusions: In this study, the important variables of the estimated predictive model were identified using the random forest technique and the study was conducted with a focus on the predictive performance itself. Although there are limitations in research, such as the lack of clear criteria for the classification of depression levels and the failure to reflect variables other than KLoSA data, it is expected that if additional variables are secured in the future and high-performance predictive models are estimated and utilized through various machine learning techniques, it will be able to consider ways to improve the quality of life of senior citizens through early detection of depression and thus help them make public policy decisions.

암환아 가족의 가치관, 강인성과 적응과의 관계 (Relationships of Family Value, Vamily Hardiness and Hamily Adaptation in Family who has a Child with Cancer)

  • 박인숙
    • Child Health Nursing Research
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    • 제7권2호
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    • pp.179-190
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    • 2001
  • The purposes of the study were to develop an instrument for family value and to identify the relationships of family value, family hardiness, and family adaptation by appling the family value scale to family with cancer children. The study was conducted in three phases. 1) A survey was conducted from July 20 to August 20, 1999 and 18 items of general family value scale was modified from the data of 153 fathers and 164 mothers. 2) In-depth interviews were made with 29 parents of cancer children from April 20, 1998 to May 20, 1999 to develop family value scale with cancer children, and 12 statements were developed. 3) The final survey was conducted from July 18, 2000 to August 30, 2000 and the data from 309 parents of children who are diagnosed as cancer, 18 or less years of age, and treated either hospitalized or at the outpatient clinics were analyzed to identify the relationships of the concepts. The data analysis utilized SAS 6.12 and LISREL 8 for descriptive statistics, correlation, and Regression for path analysis. The study findings are as follows. The psychometric testing of general family value scale was Cronbach's alpha = 0.78. The reliability of the family value scale with cancer children showed the reliability as Cronbach's alpha = 0.73. Demographic characteristics showing significant correlations were cancer children's age, period of illness, period after completing treatment, mother's age, mother's education level, monthly income, payment type, confidence with health professional, and severity of children's illness. The correlation coefficients among major variables showed that family stressor was positively related with family strains(r=0.33, p<.001), and negatively related with family hardiness(r=-0.21, p<.001). Family strains was negatively related with family hardiness(r= -0.41, p<.001) and family adaptation(r=-0.46, p<.001). Correlations of family hardiness was positive with family value with cancer children(r=-0.31, p<.001), and negative with general family value(r=-0.16, p<.01). Family hardiness was positively related with family adaptation(r=0.35, p<.001). The causal relationship between study variables showed that family strains predicts general family value(γ=0.12, t=2.02), family value with cancer children predicts family hardiness(γ=0.31, t=6.30), family strains predicts family hardiness(γ=-0.40, t=-7.70), family value with cancer children predicts family adaptation(γ=-0.23, t=-4.11), and family hardiness predicts family adaptation(γ=0.43, t=7.78).

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