• 혜화의학회지
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• 제19권2호
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• pp.13-24
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• 2011

The medical profession has the problem of lack of bioethics, due to the expansion of capitalism and mannerism after modernization. Therefore, the need of education of bioethics is increasing, however, the cramming system of education is insufficient for promoting personal morals. So the author studied ancient and present bioethics and searched for the cause of current bioethics absence and the method of overcoming it. Especially, studying the vocational features of oriental medical doctor as profession and the problems of education of bioethics in oriental medical college, the author searched for the directions of educations of bioethics. The conclusions are as follows. The current medical profession have ethical problems because of social moral hazard, evils of capitalism, change of doctor-patient relationship due to expansion of consumerism, limitation of autonomy due to commercialize of hospitals, decrease of knowledge monopolism of professionals, moral indifference and frailty, and a missdeed preference. The education of bioethics needs "Rest's 4 components" but the current education of bioethics in oriental medicine college lacks of time and is composed of the cramming system of education. So it needs various types of education system. Morals are subjective and discretionary personal character. Therefore, informational education is insufficient for enhancing morals and complex education for various personal attainments (various social indirect experience, philosophical speculation, mental serenity) is needed. It has to be done on the basis of educational method by experience not lecture, long term expectation, and basic understanding of bioethics.

• 대한치과의사협회지
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• 제57권11호
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• pp.664-671
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• 2019

As the social interest in medical care has increased and the awareness and autonomy of patients have increased, the importance of communication skills with patients has been increasingly emphasized in providing high quality medical services. In medical education, such education has become an important area in medical school and lifelong medical education, with studies showing that communication skills can be improved through education and training, and that this learned communication skills can be maintained after becoming a doctor. The importance of communication education and research for dental college students is growing as practical examination on communication skills will also be introduced in dental license tests from 2021. Therefore, we aimed to find out the educational goals and educational methods of United States in which these studies are conducted and applied before our country, and compare them with Korean's current educational goals and methods, so that we can explore the desirable direction of education for dental college students in the future.

• KIEAE Journal
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• 제12권6호
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• pp.113-121
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• 2012

A hospital is the most important infra-facility of the places which take care of people's body in social environment. There exist several environmental factors in the ways to heal the human body in hospital ward, but this study tried to look into the improvable pleasant sickroom environment with focus on light environment among the factors. In other words, this study aims at the research on proper daylight inflow into sickroom space as basic data for understanding the link between healing environment and natural lighting. In the simulation analysis through this research, this study completed the initial simulation using Autodesk Revit 2011 with focus on two types of individual multi-bed room units of the two general hospitals located in Gwangju City. This study made a simulation analysis of The two multi-bed rooms looking to the west using the weather data on Gwangju district, which is the strong point of ECOTECT2011. Conclusively, looking into the analysis of the simulation model in time of attaching the length of in & outside light shelf, the angle controlling of light shelf, the daylight factor and DA were found to show the tendency to decrease in the numerical value due to the decrease in sunlight inflow as the simulation model moved more toward the room from the window in comparison with the existing analysis of multi-bed rooms. Particularly, this study was able to read that the daylight factor and DA were more decreasing to improve at the light shelf than the existing bedrooms; conclusively, this study judges that the natural lighting simulation analysis could be helpful in improving the healing environment as basic data.

• 한국병원경영학회지
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• 제3권1호
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• pp.1-33
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• 1998

The purpose of this thesis is to study theoretical access to the methods that have been used for the research of occupational stress, thereby providing management methods of occupational stress of hospital workers. With a stress model of hospital workers set up from the viewpoint of organization management, 929 sets of questionnaires were collected from intern doctors, resident doctors, nurses, nursing aides, pharmacists, medical technicians, workers in patient affairs(reception and medical insurance workers), administrators and clerks from the 8 hospitals in Seoul with more than 500 beds. Upon variance analysis, correlation analysis and regression analysis of the collected questionnaires, this work examined how differences in stress caused by specific occupations and formulated a method of stress management for the hospital workers. The results are as follows. 1) If some duties of the nurses suffering from role-overloaded stress are transferred to the nursing aides dissatisfied with insufficient role, the two grunting groups can be satisfied at the same time. It is also necessary to transfer some jobs of the overloaded workers in patient affairs to the administrators, or the other way around. To reduce stress of conflict and ambiguity of role caused by the obscure division of roles between the workers, the role of each occupation should be delineated and the clear division of roles should be translated into action strictly according to that delineated. 2) Stress of inefficiency of organization from which the student doctors suffer can be relieved by management of participation. If they have access to the process of decision-making in general hospital affairs and consequently their understanding and the autonomy of job performance are promoted, such stress will be reduced. 3) To cope with stress of career development from which nurses, medical technicians, administrators, workers in patient affairs suffer, it is necessary to establish whether they have a chance to revive their careers, whether there are any ways of remotivation for less contributive workers, and whether they encourage each other to develope their careers. If they are given a chance to develope their careers, such stress will be relieved. 4) Pharmacists, suffering from stresses of living and personal relations, have strong cohesive power among themselves and organize a well-integrated team; thereby reducing the stress of personal relations and increasing productivity. 5) For administrators and student doctors confined to lesser social supports and for nurses and workers in patient affairs whose recognition of stress and job satisfaction are affected by social supports, emotional and informational supports for job performance help alleviate an individual's mental, and physical stress. 6) In addition to the above-mentioned stress-management methods, if an organizational coping strategy is provided according to the types of stress from the general viewpoint of the whole group of hospital workers, it would be of great help to managing stress. For example, the redesign of jobs, the management of objective, the improvement of working environment, the formation of an autonomous working group and various working plans can be set up for those who suffer from stress related to inappropriate role, while career counseling and development of career process can be provided for those dissatisfied with career development. Participation in the process of decision-making and the restructuring of the organization are needed for those who suffer from stress of malfunctioning organization, whereas creation of a supportive organizational atmosphere is desired for those who feel stressed due to personal relations. As well, such organizational coping strategies. as the increase of welfare facilities, seminars and educational programs and provision of health-promotion facilities can be provided.

• Journal of Hospice and Palliative Care
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• 제18권3호
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• pp.179-187
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• 2015

환자가 죽음에 임박했을 때 환자, 보호자, 의사 사이에서 심폐소생술에 대한 논의는 피할 수 없는 주제이다. 환자가 회복 불가능한 말기의 암환자인 경우에는 환자의 품위 있는 죽음을 고려하여 심폐소생술을 시행하지 않음(Do-not-resuscitate, DNR)을 결정하게 된다. 그러나 DNR에 대한 선택은 환자와 보호자의 심폐소생술과 DNR의 의미 및 그 결과에 대한 이해를 바탕으로 한다. DNR에 대하여 환자, 보호자, 의료진이 상담을 할 때는 환자의 질환이 더 이상 치료가 불가능하며, 심폐소생술이 환자의 생명을 연장시키는 것이 아니라 죽음의 과정을 연장시키는 것이며, 심폐소생술 이후에 삶의 질이 급격히 나빠질 수 있는 상황이라는 합의가 필요하다. 충분한 이해는 환자 또는 보호자가 품위 있는 죽음을 위한 DNR을 선택하도록 한다. 국내에서는 DNR 자체 보다는 이미 생명유지장치를 가지고 있는 환자에서의 생명유지장치의 제거에 대한 법적인 문제가 2차례 발생하면서 사회적으로 품위 있는 죽음에 대한 일반 대중의 관심이 이전보다 증가하였다. 환자와 의료진을 대상으로 한 설문에서는 DNR에 대한 인식과 의지가 80년대에 비해 2000년대 초반에 이르러 상당히 증가하였으나, 실제 의료 현장에서는 DNR의 결정에 있어 환자가 직접 관여를 하는 경우는 많지 않았고 DNR 작성 시점과 사망 시점과의 시간 간격이 1주 이내로 환자가 관여를 하거나 임종시기의 의료를 결정하기에는 너무 짧은 문제가 있었다. 이러한 문제는 조기 완화의료의 확산을 통하여 개선이 가능할 것으로 생각된다. 일부에서는 DNR이라는 용어보다는 자연적인 죽음을 허용함(Allow-Natural-Death)이라는 용어로 바꾸어서 설명하는 것이 이해를 돕고 선택의 갈등을 줄인다는 보고를 하여 DNR 논의와 결정에 있어서 적절한 시기 이외에도 환자와 보호자에게 많은 어려움이 있다는 것을 보여 주고 있다. DNR은 말기암환자에서 품위 있는 죽음을 위해 고려해야 하는 사항이며, 임상에서 DNR이 잘 시행되도록 임상적, 제도적 노력이 필요하다.

• 한국노년학
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• 제38권3호
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• pp.501-519
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• 2018

본 연구의 목적은 초기 치매환자 가족 돌봄제공자의 공유 의사결정에 대한 인식을 탐색하는 데 있다. 이를 위해 서울시 3개 치매지원센터에 등록된 초기 치매환자를 돌보는 가족 돌봄제공자 12명(여성 8명, 평균연령=$71.4{\pm}10.4$세)을 대상으로 반 구조화된 개별 심층면담을 이용하여 수집된 자료에 대해 질적 내용분석을 시행하였다. 본 연구를 내용 분석한 결과 6개 범주, 17개의 하위 범주가 도출되었는데 구체적인 연구결과는 다음과 같다. 초기 치매환자 가족 돌봄제공자의 공유 의사결정에 관한 인식은 치매환자와의 의사소통 촉진 수단과 치매환자의 자율성 보장 수단, 치료 촉진 기회, 가족 돌봄제공자의 부담감 증가 원인, 치매환자와의 관계 악화 원인, 우선순위 변화에 따른 선택 사항의 여섯 가지 범주로 나타났다. 또한, 공유 의사결정의 상황과 시기 및 공유 의사결정에 대한 인식이 가족 돌봄제공자의 경험을 통해 만들어졌다는 점을 알 수 있었다. 따라서 치매 관련 교육 시 간접경험을 통해 공유 의사결정을 선택 사항으로 생각하는 가족 돌봄제공자들에게 공유 의사결정을 경험할 수 있는 기회 등을 제공하는 것이 공유 의사결정에 대한 인식 제고에 도움이 될 수 있을 것으로 사료된다. 이상 결과에 근거하여 초기 치매환자의 자기결정권 존중과 가족 돌봄제공자들의 부담감을 감소시키기 위해 공유 의사결정을 성공적으로 할 수 있는 실제적이고 총체적인 교육 프로그램의 개발 및 평가 연구를 제언한다.

• 농촌의학ㆍ지역보건
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• 제19권2호
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• pp.141-158
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• 1994

정부는 보건진료원으로 하여금 지역주민들에게 보다 더 의욕적으로 양질의 보건의료서비스를 제공하도록 하기 위하여 1992년 4월 1일부터 보건진료원을 별정직 공무원으로 정규직화 하였다. 본 연구는 보건진료원의 정규직화가 보건진료원의 업무활동과 보건진료소의 관리운영체계에 미친 영향을 분석하기 위해 경상남도와 경상북도의 보건진료소 중 집락추출법과 단순확률추출법으로 50개소를 뽑아 보건진료원을 대상으로 직접 면담조사하고 제반기록 및 보고서에서 필요한 자료를 발췌하였다. 조사기간은 1992년 1월 1일에서 3월 31일까지(정규직화 이전)와 1993년 1월 1일에서 3월 31일까지(정규직화 이후)였다. 보건진료원들의 96%가 정규직화를 원했는데 그 이유는 신분보장과 보수가 좋아지리라는 것이었다. 정규직화 후 보건진료원직을 자랑스럽게 생각한다는 사람이 24%에서 46%로 증가하였다. 신분보장에 대해서는 항상 불안하다는 사람이 30%에서 10%로 감소하였다. 정규직화 후 월평균 급여액은 802,600원에서 1,076,000원으로 34% 증가했으며 90%가 만족한다고 했다. 업무 내용별 자율성 인지정도는 업무계획, 업무수행, 진료소관리(재정)운영, 업무평가 영역에 대한 자율성 인지도가 정규직화 후에 증가되었다. 보건진료원의 활동내용 중 지역사회 자원파악, 지도작성상태, 지역사회조직 활용정도, 인구구조 파악정도와 가정건강기록부 작성은 정규직화 후에 특별한 변화는 없었다. 또한 집단보건교육, 개인보건교육, 학교보건교육의 실시도 정규직화 후에 변화가 없었다. 그러나 가정방문 실시현황은 1인당 월평균 13.6%회에서 정규직화 후에는 27.5%회로 늘었다. 모성보건 및 가족계획 사업 그리고 예방접종도 정규직화 후에 타기관에 의뢰하는 것이 더 늘었다. 통상질병관리 가운데 성인병관리는 3개월 동안 1개 진료소당 평균 고혈압환자는 12.7%명에서 11.6명으로, 암환자는 1.5명에서 1.2명으로, 당뇨병환자가 4.3명에서 3.4명으로 줄었다. 각종 기록부 비치상황은 장비대장, 약품관리 대장, 환자진료기록부는 100% 비치되었으나 기타 기록부는 그렇지 않았고 정규직화 후에도 변화는 없었다. 보건진료소가 보건소로부터 지원을 받는 내용은 약품 14.0%에서 30%로, 소모품 22.0%에서 52.0%로, 건물유지 및 보수가 54.0%에서 68% 로, 보건교육 자료가 34.0%에서 44.0%로 증가하였고, 장비는 58.0%에서 54.0%로 감소했다. 보건진료소의 월평균 수입은 진료수입이 약 22,000원 증가했고, 국비 또는 지방비 보조금이 4,800원에서 38,508%원으로 증가했으나 회비 및 기부금은 줄어 총수입은 약 50,000원 증가했다. 지출총액은 큰 변동이 없었다. 보건소로부터 3개월 동안 받은 지도감독 중 지시공문을 받은 진료소가 20%에서 38%로 늘었고, 방문지도는 79%에서 62%, 회의소집은 88%에서 74%로 감소하였다. 전화지도는 보건진료소당 평균 1.8회에서 2.1회로 늘었다(p<0.01). 면보건요원과의 협력관계가 있다고 한 보건진료원은 42%에서 36%로 감소하였다. 보건소장과의 관계가 좋다는 보건진료원이 46%에서 24%로 감소하였고, 보건행정계장과 관계가 좋다는 사림이 56%에서 36%로 감소하였다(p<0.05). 보건진료소 운영협의회 회장과의 관계가 좋다는 사람은 62%에서 38%로 감소되었고 보건진료소 운영협의회가 보건진료소에 별로 도움이 안된다와 전혀 도움이 되지 않는다는 사람이 정규직화 전과 후에 각각 92.0%, 82.0%였다. 운영협의회가 필요 없다는 사람은 정규직화 전에 4%에서 16%로 증가되었다(p<0.05). 보건진료원제도 발전을 위해 제안된 사항은 보건교육중심의 활동, 보건진료소운영의 자율성 보장 보건소에 경험이 풍부한 보건진료원을 두어 지도감독하게 할 것과 사용하는 약품의 종류를 늘려 줄 것 등이었다. 이상의 결과로 보하 정규직화 후 보건진료원의 역할, 기능 등의 업무활동의 변화는 거의 없었으나 신분보장과 봉급에 대한 만족도는 향상이 되었고 또한 자율성도 증가하였다. 보건소의 지원은 약간 늘었으며, 지도감독체제에서 지시 공문의 증가로 사무보고 업무가 많아지고, 근무 확인을 위한 전화감독은 늘었으나 업무치진을 위한 행정직 지도 또한 기술적 지도는 거의 없었다.

• 간호행정학회지
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• 제3권1호
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• pp.51-64
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• 1997

The purpose of the study was to introduce an integrated approach of new Casuistry and specified principlism in resolving ethical problems and studying nursing ethics. In studying clinical ethics and nursing ethics, there is no systematic research method. While nurses often experience ethical dilemmas in practice, much of previous research on nursing ethics has focused merely on describing the existing problems. In addition, ethists presented theoretical analysis and critics rather than providing the specific problems solving strategies. There is a need in clinical situations for an integrated method which can provide the objective description for existing problem situations as well as specific problem solving methods. We inherit two distinct ways of discussing ethical issues. One of these frames these issues in terms of principles, rules, and other general ideas; the other focuses on the specific features of particular kinds of moral cases. In the first way general ethical rules relate to specific moral cases in a theoretical manner, with universal rules serving as "axioms" from which particular moral judgments are deduced as theorems. In the seconds, this relation is frankly practical. with general moral rules serving as "maxims", which can be fully understood only in terms of the paradigmatic cases that define their meaning and force. Theoretical arguments are structured in ways that free them from any dependence on the circumstances of their presentation and ensure them a validity of a kind that is not affected by the practical context of use. In formal arguments particular conclusions are deduced from("entailed by") the initial axioms or universal principles that are the apex of the argument. So the truth or certainty that attaches to those axioms flows downward to the specific instances to be "proved". In the language of formal logic, the axioms are major premises, the facts that specify the present instance are minor premises, and the conclusion to be "proved" is deduced (follows necessarily) from the initial presises. Practical arguments, by contrast, involve a wider range of factors than formal deductions and are read with an eye to their occasion of use. Instead of aiming at strict entailments, they draw on the outcomes of previous experience, carrying over the procedures used to resolve earlier problems and reapply them in new problmatic situations. Practical arguments depend for their power on how closely the present circumstances resemble those of the earlier precedent cases for which this particular type of argument was originally devised. So. in practical arguments, the truths and certitudes established in the precedent cases pass sideways, so as to provide "resolutions" of later problems. In the language of rational analysis, the facts of the present case define the gounds on which any resolution must be based; the general considerations that carried wight in similar situations provide warrants that help settle future cases. So the resolution of any problem holds good presumptively; its strengh depends on the similarities between the present case and the prededents; and its soundness can be challenged (or rebutted) in situations that are recognized ans exceptional. Jonsen & Toulmin (1988), and Jonsen (1991) introduce New Casuistry as a practical method. The oxford English Dictionary defines casuistry quite accurately as "that part of ethics which resolves cases of conscience, applying the general rules of religion and morality to particular instances in which circumstances alter cases or in which there appears to be a conflict of duties." They modified the casuistry of the medieval ages to use in clinical situations which is characterized by "the typology of cases and the analogy as an inference method". A case is the unit of analysis. The structure of case was made with interaction of situation and moral rules. The situation is what surrounds or stands around. The moral rule is the essence of case. The analogy can be objective because "the grounds, the warrants, the theoretical backing, the modal qualifiers" are identified in the cases. The specified principlism was the method that Degrazia (1992) integrated the principlism and the specification introduced by Richardson (1990). In this method, the principle is specified by adding information about limitations of the scope and restricting the range of the principle. This should be substantive qualifications. The integrated method is an combination of the New Casuistry and the specified principlism. For example, the study was "Ethical problems experienced by nurses in the care of terminally ill patients"(Um, 1994). A semi-structured in-depth interview was conducted for fifteen nurses who mainly took care of terminally ill patients. The first stage, twenty one cases were identified as relevant to the topic, and then were classified to four types of problems. For instance, one of these types was the patient's refusal of care. The second stage, the ethical problems in the case were defined, and then the case was analyzed. This was to analyze the reasons, the ethical values, and the related ethical principles in the cases. Then the interpretation was synthetically done by integration of the result of analysis and the situation. The third stage was the ordering phase of the cases, which was done according to the result of the interpretation and the common principles in the cases. The first two stages describe the methodology of new casuistry, and the final stage was for the methodology of the specified principlism. The common principles were the principle of autonomy and the principle of caring. The principle of autonomy was specified; when competent patients refused care, nurse should discontinue the care to respect for the patients' decision. The principle of caring was also specified; when the competent patients refused care, nurses should continue to provide the care in spite of the patients' refusal to preserve their life. These specification may lead the opposite behavior, which emphasizes the importance of nurse's will and intentions to make their decision in the clinical situations.

• Tuberculosis and Respiratory Diseases
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• 제48권6호
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• pp.837-852
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• 2000

연구배경 : 이 연구는 우리나라 각 기초자치단체에서 발행하는 "통계연보" 등을 활용하여 결핵관리사업의 성과를 결핵예방사업, 환자발견 및 지속관리사업, 그리고 결핵 치료사업 측면에서 소규모 지역간 사계열분석 모형에 의해 연도별 인구천명당 결핵등록률 및 결핵 치료순응도 등의 성과지표로 산출하여 비교분석하고 이에 영향을 미치는 요인을 규명하고자 하였다. 방법 : 전국 234개 시 군 구 기초자치단체별로 발간된 "통계연보"나 광역자치단체별 "통계연보"를 원주시청 행정자료실, 강원도청 행정자료실, 통계청 민원실 등을 방문, 1980년도부터 2000년도까지 순차적으로 열람하여 결핵관리사업등 관련 정보를 지난 1년여동안 추적 조사하였다. 결핵관리사업의 성과지표인 연도별 결핵유병률 등을 산정, 이를 종속변수로 하여 다중 희귀모형을 구축하여 Micro TSP와 SAS 패키지를 이용하여 확률론적안 시계열분석을 하였다. 결과 : 1998년까지의 지역별 현황을 비교하면, 인구지표 중 인구이동률을 제외한 나머지 변수들의 경우 모두 구지역, 시지역, 군지역의 순으로 유의하게 감소하였다. 사회 경제학적 지표로는 인구천명당 자동차 등록대수, 지방세, 담배소비세 모두 시 군 구지역간에 유의한 차이를 보였다. 또한 보건의료지표는 시 군 구지역간 인구천명당 의사수 및 병상수 모두 통계적으로 유의하게 지역 규모의 크기에 따라 감소하였다. 지역별 관련 결핵지표의 시계열 분포의 변화를 비교하면, BCG접종률의 경우 1980년부터 1984년까지 약간의 증가 추세를 보이다가 그 이후 1993년도까지는 일정한 평형 수준 (plateau state) 을 유지한 이후 다시 감소추세를 보였다. 1985년 이전에는 시지역이, 1985년 이후에는 군지역의 접종률이 타지역에 비해 유의하게 높았다. 폐결핵양성자수 시점유병률, 폐결핵 음성자수 시점유병률 및 결핵사망률의 분포를 보면, 세가지 결핵지표 모두 1981년 이후 지속적으로 감소하는 영향을 보여주되, 군지역이 가장 높았고 시간이 경과할수록 시 군 구지역간 차이도 점차 줄어들었다. 이는 지역 특성상 민간의료기관의 분포가 적은 군 지역에서의 결핵등록 및 관리사업이 상대적으로 시 구(광역도시)지역보다 보건소 중심으로 용이하게 운영되어지고 있음을 시사한다. 결핵 치료순응도의 경우 기간유병률이나 사망률과는 반대로 1982년 이후 점차 증가하는 추세였다. 결론 : 이 연구결과는 현재 보건소 중심으로 관리되어 매년 집계, 보고, 발간되는 시 군 구 기초자치단체별 "통계연보"의 결핵보건사업 결과정보에 대한 이용의 실증연구에 해당된다. 따라서 지난 제7차까지 시행해 오던 전국결핵실태조사 대신에 향후 시행될 결핵정보 감시체계 운영등의 기초자료로서 가능성을 제공해주고 있다. 결국 이를 바탕으로 결핵관리사업과 관련 지역 특성에 맞는 지역보건의료계획 수립의 기초자료 및 정부의 국가결핵보건사업 기획의 근거를 제공함으로써 결핵관리 대책 수립시 우선순위 결정과 예산배분, 기대효과 산정에 필수적인 정보로 활용되기를 기대한다.

• 한국응급구조학회지
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• 제15권1호
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• pp.47-63
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• 2011

Purpose : This research is to examine the work and job satisfaction of paramedics in the emergency room of university hospitals. This research is done to provide basic data needed for establishing work realms of paramedics in hospitals and to enhance their degree of satisfaction. Methods : Research questionnaire survey was conducted on 141 paramedics working in the emergency room of 32 university hospitals from August 24, 2010 to September 30, 2010 through direct visits and telephone interviews or email to explain the purpose of this research and assurance of confidentiality of responses on the questionnaires. As the tool for the degree of job satisfaction, 'The Index of Work Satisfaction' developed by Slavitt, et al(1978) and revised and supplemented by Soon-shim Kim and Hye-ran Kwon(2002) was used. The collected data were analyzed by evaluating frequency, percentage, mean, standard deviation, t-test and ANOVA, Cronbach's $\alpha$ by using SPSS WIN 18.0 program. Results : 1. Investigating the work and role of paramedics in the emergency room of university hospitals, electrocardiogram(EKG) was found to be highest with $\alpha$ was widely used with the rate of patient evaluation and test area. In the medical treatment for patients area, cardiopulmonary resuscitation(CPR) with 95%(134 persons) and ventilation assistance through ambu bagging(BVM) with 95%(134 persons) were found to be high. $\alpha$ were performed. In the role within the hospital and other areas, a member of CPR team in the hospital accounted for 78%(110 persons). 2. In the measurements of the job satisfaction of paramedics working at university hospitals, the total mean score was 2.91. The mean score in each question area indicated: section on job 3.48, autonomy 3.05, interaction 3.01, organizational demand 2.85, working conditions 2.67, salaries 2.40. This result obviously demonstrates the work of paramedics itself was most satisfied but the salaries were most dissatisfied. 3. In the measurements of the job satisfaction of paramedics working at university hospitals, job satisfaction based on the general characteristics showed significant difference in age (F=6.547, p=.002), gender (F=4.436, p=.000) marital status (F=-3.270, p= .001), religion (F=2.041, p= .043), motive for application (F=3.603, p= .015), and salary (F=6.658, p= .000). 대학병원 응급실 내 1급 응급구조사의 업무와 직무만족도 The Journal of the Korean Society of Emergency Medical Technology Vol. 15 (1) 63 4. In the measurements of the job satisfaction of paramedics working at university hospitals, job satisfaction based on the working environmental characteristics showed significant difference in total number of paramedics (F=3.779, p= .012), form of employment (F=5.601, p= .001), existence or non-existence of intention to change jobs (F=-4.037, p= .000). Conclusion : The work of paramedics in the emergency room of university hospitals consists of lots of treatment processes after specialized diagnosis and performance of professionally subdivided works. However, current legislation does not reflect such circumstances to which paramedics are exposed; thus, it should be considered for further revision and modification. The degree of job satisfaction of paramedics in the emergency room of university hospitals was high but low in salaries and working conditions were the weak points. The measures to enhance their degree of job satisfaction should be taken though improvement of labor conditions such as consideration of the rate of increase in salaries, compensation for overtime work, providing rest areas, improvement of current employment system, and conversion of temporary employees into regular employees.