• 한국컴퓨터정보학회논문지
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• 제17권12호
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• pp.1-10
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• 2012

본 논문에서는 모바일 헬스케어 시스템에 적합한 환자모니터링 시스템을 제안한다. 모바일 헬스케어 시스템은 스마트폰과 같은 모바일 장치를 사용하기 때문에 휴대가 간편한 소형 컴퓨팅 장치로 구성되어 있으며, 기존 컴퓨터에서 수행하던 작업을 수행할 수있다. 환자의 생체정보를 이동통신망환경에서 의료진과 환자 및 환자 가족의 스마트폰으로 실시간으로 전달할 수 있도록 TinyOS 기반의 의료용 메시지 구조를 설계하였으며 NesC를 사용하여 HBE-Ubi-ZigbeX에 포팅 하였다. 의료진과 환자 및 환자 가족이 스마트폰을 통하여 실시간으로 확인 할 수 있도록 안드로이드 기반의 환자 정보 모니터링 애플리케이션을 구현하여 일상생활에서 사용되고 있는 스마트폰에서 동작을 확인함으로써 생체정보의 원활한 송수신을 확인하였다.

• 한국의료질향상학회지
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• 제25권1호
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• pp.2-10
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• 2019

Purpose: The purpose of this study was to share program and/or resource on patient safety education for patients and families conducted overseas agency. This study will help the patient safety officer establish and implement an educational plan for patients and families. Methods: We searched the Internet for patient safety related organizations. We chose an institution that provided education for patients and families. Results: Most of the program and/or resource was about patient and family involvement; Taking Care of Myself, My Questions for This Visit, Patient Prep Card, 20 Tips to Help Prevent Medical Errors, Ask Me 3(R), Health and Safety Passport, My Medication log etc. Conclusions: It is necessary to distribute educational materials for patients and families in the country through the results of this study. For patient safety, education and publicity are needed so that developed educational materials can be actively used.

• 한국의료질향상학회지
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• 제27권1호
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• pp.26-42
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• 2021

Purpose: This study aimed to explore frontline nurses' experience of patient-centered care and understand the factors affecting its implementation in hospitals. Methods: Four focus group interviews were conducted with 30 nurses in two university hospitals. The following theoretical framework of patient-centered care was used: 1) Respect for patients' values, preferences, and expressed needs, 2) Care coordination and integration, 3) Information, communication, and education, 4) Physical comfort, 5) Emotional support and alleviation of fear and anxiety, 6) Involvement of family and friends, 7) Care transition and continuity, and 8) System issues. We performed a directed content analysis. Results: The most frequent patient-centered nursing practices of the hospital nurses were "promoting physical comfort" in inpatient settings and "providing information and communicating" in outpatient settings. The factors influencing patient-centered nursing included the health professionals' mindfulness, work overload and staff shortage, and unreasonable social demands and regulations. Conclusion: A more comprehensive patient-centered nursing practice should be implemented by improving "care transition and continuity," "family/caregiver involvement," and "system building." Health professionals' mindfulness is significant, and organizational supports addressing work overload and staff shortage are needed alongside change in social awareness.

• 의료법학
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• 제9권2호
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• pp.77-107
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• 2008

In Republic of Chaina (Taiwan), Natural Death Act named "Anning Huauhe Yiliao Tiaoli" which means palliative and hospice care act was enacted in year of 2000. And enforced in the same year. Many scholars say that Taiwan's Act took Many U.S.A.'s acts such as 'Federal Patient Self-Determination Act 1990', 'California Natural Death Act 1976' and 'Washington Natural Death Act 1979' for a model. Taiwan's Act adopts a few outstanding systems - 'advance declarations' including 'living will' and 'durable power of attorney for health care', 'family-determination system' for a patient who is in a persistent unconscious state. This paper disusses this Act. 'The content is as follow: 1. A background of legislation. 2. The purpose of legislation. 3. The concept of terms. 4. Patient's self-determination. 5. Subrogated determination by family. 6. Keeping documents. 7. Punitive provision. 8. The relationship with euthanasia. 9. Controversial issues.

• 한국간호교육학회지
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• 제12권1호
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• pp.95-103
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• 2006

Purpose: This is to find out the correlation between a families burden on a cerebrovascular accident patient and the demand for nursing home. Method: The data was established by using structured questionnaires for 102 nursing families of cerebrovascular accident patient at three university hospitals. Result: 1) The total burden was showed to be at 3.21, which was some what higher than average. Total average of demand for nursing home was at 3.30, which was higher than average. 2) This showed static correlations between the economic, social, physical dependent and psychological burden, and demand for nursing home. The result represents that the higher burden showed a significantly positive correlation to the higher demand for nursing home. Conclusion: If a systemic support of nursing home is prepared the differentiated nursing home matched perfectly on each burden, the burden on a family of the patient can be decreased effectively.

• 대한간호학회지
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• 제42권2호
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• pp.280-290
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• 2012

Purpose: This study done to identify the experiences of families caring for patients with terminal cancer. The question was, "What is the caregiving experience of a family who has a member with terminal cancer?" Methods: Grounded Theory was applied and in-depth interviews were done with 11 family members. Interviews were recorded with the interviewees' consent and were transcribed and analyzed. Participants' relationships to patients were 6 spouses, 4 daughters, and 1 mother. The ages of the participants were between 32 and 62, with an average of 47.5. Results: The study showed "enduring with bonds" as the main category and the main factor affecting this category was the "patients' diagnosis of terminal cancer." The caregiving experience was divided into four stages: shock, confusion, struggle, and acceptance. Mediating factors were relationship with the patient, intimacy with the patient, social support, communication, and trust. Conclusively, participants underwent internal maturity, and changes occurred in family and social and personal life. Conclusion: The families took care of the patients with responsibility and love. The study results should help with the understanding of a family with a member with terminal cancer and should be used to develop nursing, mediating, and consulting programs for these caregivers.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 2001년도 제53차 추계 학술대회 연제집
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• pp.155-156
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• 2001

• Journal of Hospice and Palliative Care
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• 제5권2호
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• pp.94-100
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• 2002

목적 : 말기 암 환자가 삶의 마지막 시간 동안 정서적, 사회적으로 안정을 취할 수 있는 곳은 대형화된 3차 의료기관이 아니라, 거주지에서 가까운 1, 2차 의료기관이나 호스피스 기관, 혹은 가정일 것이다. 그러나 현재 우리 나라는 말기 암 환자들을 3차 의료기관에서 1, 2차 의료기관, 호스피스 시설 등으로 연계(referral)하여 주는 시스템이 매우 미약한 상태이다. 본 연구는 현재 연계 상황의 문제점을 파악하여 이에 대한 개선점을 제시해 보고자 한다. 방법 : 2001년 4월부터 2002년 3월까지 서울대학교 병원으로부터 각 기관으로 연계된 말기 암 환자 76명의 보호자와 이 환자들을 연계 받은 35개의 의료기관을 대상으로 하여 설문 조사를 실시하였다. 환자의 보호자에게는 직접 전화를 하여 조사하였고, 의료기관에 대해서는 우편으로 설문지를 발송하였다. 결과 : 환자 보호자를 대상으로 한 47부의 설문지 분석 결과는 다음과 같다. 연계를 결정하는 데 있어서 의료진의 권유가 44%로 가장 큰 영향을 미쳤으며, 32%가 환자의 편의, 24%가 가족의 편의를 주로 고려하여 결정하였다. 연계 결정 과정에서는 가족의 생활권, 연계 기관의 인지도, 환자가 마지막으로 지내고 싶어하는 곳, 가족의 경제 상황, 장례 장소가 순서대로 영향을 많이 미치는 것으로 나타났다. 연계 과정에서는 47명 중 38명이 어려움을 겪었다고 응답했으며, 이들은 원하지 않는 퇴원의 종용을 가장 큰 어려움으로 꼽았다. 이 외에도 연계 기관에 대한 정보 부족, 환자의 고통에 대한 염려, 환자 및 가족의 거부 등으로 인해서도 어려움을 겪은 것으로 나타났다. 이와 같이 연계 과정에서는 어려움을 표현하였지만, 실제로 연계된 기관에서는 47명 중 35명이 완화 의료에 대해 대체로 만족스러웠다고 응답하였다. 그 이유로 환자가 안정과 평안함을 찾았고, 가족들도 편안하였으며 경제적 부담이 감소하였다는 점을 꼽았다. 그러나 15명은 연계 전후에 별 차이가 없다고 응답하였다. 연계된 기관을 대상으로 한 24부의 설문지 분석 결과는 다음과 같다. 24명의 응답자 중 1명을 제외한 23명이 완화 의료 연계 시스템에 대해 찬성하였고, 좀더 활발한 연계가 이루어질 수 있는 제도적 뒷받침의 필요성을 절실히 표현하였다. 의뢰된 환자를 돌보는 데 있어서 경험하는 어려움으로는 가장 큰 것으로 환자에 대한 정보 부족을 꼽았고, 그 외에도 환자의 경제적인 어려움이나 완화 의료 연계 기관에 대한 이해 부족, 통증 조절의 어려움 등을 호소하였다. 대부분(96%)의 기관 종사자들은 환자들이 연계된 이후의 보살핌에 만족하고 있다고 생각하는 것으로 나타났다. 결론 : 3차 기관으로부터 1, 2차 의료기관 및 호스피스로 말기 암 환자들이 연계되는 과정에서 환자, 보호자 뿐만 아니라 연계 기관도 많은 어려움을 겪고 있다. 향후 완화 의료의 연계 시스템 개발과 제도적 뒷받침이 절실히 필요하다.

• Journal of Hospice and Palliative Care
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• 제8권1호
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• pp.57-64
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• 2005

Cyclooxygenase-2 (COX-2) selective inhibitors were specifically developed to reduce the risks of gastrointestinal bleeding associated with other NSAID drugs. However, the APPROVe (Adenomatous Polyp Prevention on VIOXX) trials revealed that rofecoxib sometimes exerts prothrombotic effects. Meanwhile, cancer patients, who also carry a risk of thrombosis due to a variety of mechanisms, are often treated with COX-2 selective inhibitors, due to their relative gastrointestinal safety. This report concerns the case of a 46-year old woman with advanced cervical cancer, who had been treated with opioids and a COX-2 selective inhibitor (celecoxib) for 2 months, for the relief of pain associated with her cancer. The patient was admitted due to swelling of the left leg, which was also accompanied by pain. A computerized tomography scan revealed deep vein thrombosis occurring in multiple veins of both legs. After the administration of low-molecular weight heparin and oral warfarin, the patient's symptoms were relieved initially. However, her prothrombin time was found to be prolonged, necessitating the discontinuation of anticoagulation therapy. The patient's dyspnea worsened, ultimately resulting in her death. In conclusion, the administration of cox-2 selective inhibitors should be carefully considered in patients with a number of different risk factors, and assessed on a case-by-case basis.

• 대한간호학회지
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• 제30권3호
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• pp.595-605
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• 2000

The purpose of this study was to describe the perceived burden of the stroke patient's caregiver and related factors to analyze relationships between perceived burden and social supports. A convenient sample of 225 caregivers who take care for a stroke patient at home participated in this study. Caregiver's perceived burden was measured by the objective and subjective burden scale developed by Montgomery (1985). Related factors of burden were studied in terms of the patient's instrumental activties of daily living, cognitive function, caregiver's demographic variables and caregiver's illness intrusiveness. The results were as follows: (1) The mean of objective burden score was 4.5, and subjective burden score was 3.1. These scores show that caregivers perceive moderate level of burden. (2) Caregivers' objective burden was significantly related to caregivers's illness intrusiveness (r=.62), patient's IADL (r=-.33), and patient's cognitive function (r=-.15). The subjective burden was related to the caregiver's illness intrusiveness (r=.29), the patient's IADL (r=.24), and the caregiver's age(r=.23). (3) The percentage of stroke caregivers who perceived physical support was 49.1%. The percentage of those who perceived emotional support was 61.0%, and those who perceived financial support totaled 37.6%. (4) Caregivers who received any type of social supports perceived lower subjective burden, and caregivers who received physical or psychological support perceived lower objective burden. These results emphasized the necessity of a rehabilitation programs for stroke patients and support program for family caregivers.