• 산업융합연구
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• 제20권1호
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• pp.77-86
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• 2022

본 연구는 전문 의료인인 의사와 간호사간 의사소통 인식 정도와 의사소통에 대한 세부 영역과 만족도를 파악하기 위한 서술적 조사 연구이다. 자료수집은 C시의 종합병원 의사, 간호사 372명을 대상으로 2021년 3월부터 5월까지 수집하였다. 수집된 자료는 SPSS/WIN 20.0 프로그램을 이용하여 기술통계, 평균과 표준편차, t-검정, ANOVA, Scheffe test, 상관관계 분석을 이용하여 분석하였다. 연구 결과, 의사와 간호사 간 의사소통 인식의 차이가 있었으며, 의사가 인식한 의사소통과 간호사가 인식한 의사소통 세부영역 중 개방성(t=9.91), 직종 간 상호이해(t=5.25), 만족도(t=8.13)에서 통계적으로 유의한 차이를 보였다. 의사소통 세부영역에서 간호사와 의사 그룹 모두 의사소통 세부영역과 만족도는 양의 상관관계가 있었다. 간호사는 개방성(r=.72, p<.001), 직종 간 상호이해(r=.71, p<.001)가 의사소통 만족도와 높은 양의 상관관계가 있었고, 의사는 직종 간 상호이해(r=.79, p<.001), 적시성(r=.73, p<.001)이 의사소통 만족도와 높은 양의 상관관계가 있는 것으로 나타났다. 따라서 환자안전을 보장하고 양질의 의료를 제공할 수 있도록 간호사, 의사 직종 간 상호이해, 개방성 등 취약부분을 효과적으로 개선할 수 있는 의사소통 프로그램 개발이 필요하다.

• 한국응용과학기술학회지
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• 제38권6호
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• pp.1393-1404
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• 2021

본 연구는 장기요양 기관 종사자들의 감염관리에 대한 인지도와 수행도 현황조사를 통해 감염관리 실태를 파악하여 장기요양 기관의 종사자를 위한 효율적인 감염관리 및 교육 프로그램 개선을 위해 수행되었다. 연구 대상자는 C 지역의 장기요양 기관 35곳의 종사자 134명이며 2021년 7월 12일부터 7월 30일까지 구조화된 설문지를 사용하여 자료를 수집하였으며 SPSS 22.0 program을 이용하여 자료 분석하였다. 연구 결과 대상자의 감염관리 인지도에 영향을 미치는 요인은 종사자의 직종(F=3.181, p=.032), 감염관리 교육 경험(F=6.372, p=.013) 이었으며 감염관리 수행도 또한 종사자의 직종(F=3.972, p=.010), 감염관리 교육 경험(F=4.403, p=.038)이 영향을 크게 미쳤다. 대상자의 감염관리 인지도와 수행도는 양의 상관관계가 있었다(r=.919, p<.001). 본 연구의 결과를 종합해 볼 때, 코로나-19 팬데믹 상황에서 장기요양기관의 환자 안전을 위해서는 종사자가 감염관리 중요성을 인지하는 것뿐만 아니라 직접 감염관리 행위를 수행하는 것이 매우 중요하다. 이를 위해서는 기관의 규모에 상관없이 직종별, 교육 주제별 체계적이고 지속적인 교육과정 마련과 감염관리체계의 질적 향상을 위한 평가 시스템의 법적 강화가 필요할 것으로 생각한다.

• The Korean Journal of Pain
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• 제35권4호
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• pp.475-487
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• 2022

Background: Use of opioids for chronic intractable pain is increasing globally, and their proper use can improve patients' quality of life. In contrast, opioid use disorders, such as abuse or addiction, caused by prescribing opioids, are a worldwide issue. This study aimed to understand current opioid prescribing patterns and pain physicians' experiences with opioid use in South Korea. Methods: Pain physicians in 42 university hospitals in South Korea were asked to complete anonymous questionnaires regarding opioid prescriptions. Results: A total of 69 surveys were completed. Most pain physicians started prescribing opioids at a pain score of 7/10 and aimed to reduce pain by 50%. Most physicians (73.1%) actively explained the prescribed medications and possible side effects, and 61.2% of physicians preferred the prescription interval of 4 weeks. Immediate-release opioids were the most popular treatment for breakthrough pain (92.6%). The most common side effect encountered by physicians was constipation (43.3%), followed by nausea/vomiting (34.3%). Of the physicians, 56.5% replied that addiction and misuse prevalences were less than 5%. However, the most concerning side effect was addiction (33.0%). Conclusions: The survey results showed that the prescribing patterns of pain physicians generally followed Korean guidelines. Physicians were most interested in the safety and effectiveness of opioid prescriptions. They were most concerned about respiratory depression and abuse or addiction. A significant number of physicians agreed that the NHIS regulations needed improvement for patient convenience and safe and effective treatment, though there were pros and cons of the NHIS restrictions on prescription conditions.

• 한국임상약학회지
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• 제32권3호
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• pp.215-225
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• 2022

Background: Patients with hematologic cancers have a risk of drug-related problems (DRPs) from medications associated with chemotherapy and supportive care. Although the role of oncology pharmacists has been widely documented in the literature, few studies have reported its impact on cost reduction. This study aimed to describe the activities of oncology pharmacists with respect to hematologic diseases and evaluate the associated cost avoidance. Methods: From January to July 2021, patients admitted to the department of hemato-oncology at Seoul National University, Bundang Hospital were studied. The activities of oncology pharmacists were reported by DRP type following the Pharmaceutical Care Network version 9.1 guidelines, and the acceptance rate was calculated. The avoided cost was estimated based on the cost of the pharmacy intervention, pharmacist manpower, and prescriptions associated with the intervention. Results: Pharmacists intervened in 584 prescriptions from 208 patients during the study period. The most prevalent DRP was "adverse drug event (possibly) occurring" (32.4%), followed by "effect of drug treatment not optimal" (28.6%). "Drug selection" (42.5%) and "dose selection" (30.3%) were the most common causes of DRPs. The acceptance rate of the interventions was 97.1%. The total avoidance cost was KRW 149,468,321; the net profit of the avoidance cost, excluding labor costs, was KRW 121,051,690; and the estimated cost saving was KRW 37,223,748. Conclusion: Oncology pharmacists identified and resolved various types of DRPs from prescriptions for patients with hematologic disease, by reviewing the prescriptions. Their clinical service contributed to enhanced patient safety and the avoidance of associated costs.

• 한방비만학회지
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• 제22권2호
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• pp.125-135
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• 2022

Objectives: A restrospective chart review were conducted to investigate the overall weight loss effect of the integrated Korean medicine treatment on obese patients (body mass index [BMI] ≥25 kg/m²) in Korean medicine clinic and analyze the difference in the effect according to lifestyle behaviors. Methods: The medical records of 43 obese patients were retrospectively analyzed including body weight, BMI, waist circumference, hip circumference, and body composition who received integrated Korean medicine treatment for 4 weeks at 24 Korean medicine clinics in Daejeon metropolitan city. All outcome measures were evaluated again 8 weeks after the end of treatment at week 12 for follow-up. EuroQol-5D (EQ-5D), the Korean version of the obesity-related quality of life scale (KOQOL) and patient's satisfaction were also evaluated. The analysis was divided according to the treatment period and observation period, and subgroup analysis was performed according to drinking and exercise habits. Results: Body weight, body fat, waist circumference, hip circumference, body fat were significantly reduced at week 4 and week 12. Theses weight reduction effects were significantly greater within treatment period (0 to 4 week) than observation period (4 to 12 week). Especially in the non-exercise group, the changes in body fat mass and body fat percent showed a significant difference between the treatment period and the observation period. KOQOL were also significantly improved at 12 week, but not in EQ-5D. No severe adverse events were observed. Conclusions: The integrated Korean medicine treatment could be effective to treat obesity including weight loss. It is necessary to prevent additional weight regain through regular exercise even after Korean medicine treatment.

• 대한임상검사과학회지
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• 제55권3호
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• pp.143-150
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• 2023

2019년 12월에 발생한 COVID-19는 세계적으로 대유행하였고, 이로 인해 폐기능검사실의 안전한 감염관리가 절실히 요구되었다. 그러나 국내 유관 기관에서 제공하는 지침과 규제는 이 심각한 공중보건 위기에 대응하기에는 부족한 실정이었다. 이에 본 연구에서는 2021년 10월 1일부터 2021년 11월 2일까지 국내 2차 이상 의료기관 51개를 대상으로 감염관리 기본규정, 일회용품 사용, 환기 시설, 공간 분리, 출입문의 형태 등에 대해 조사하였다. 그 결과, 공기 주의, 비말 주의, 접촉 주의를 위한 인식과 보호용구착용은 상당 부분 적절히 이루어지고 있었으나, 1인 검사 후 환경소독을 항상 시행하는 기관이 39.22%로 낮은 수준으로 조사되었다. 또한, 일회용품 사용(81.05%), 환기 시설(45.75%), 검사 전용 공간(80.39%), 사무 공간 분리(15.69%), 자동문 설치(19.61%)의 경우 조사 항목에 따라 큰 차이가 있는 것으로 나타났다. 본 연구는 국내 폐기능검사실의 감염관리의 일반적 사항과 시설의 실태조사를 통해 폐기능검사실의 감염관리의 중요성을 재고하고, 국내 의료기관의 감염병 위기 대응을 위한 후속 연구에 기초 정보를 제공함으로써, 폐기능검사실의 감염관리 표준 지침서 개발 및 개선에 기여할 것으로 판단된다.

• 한국의료질향상학회지
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• 제28권2호
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• pp.30-38
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• 2022

Purpose: The Health Insurance Review and Assessment Service (HIRA) in South Korea initiated a quality assessment (QA) program for blood transfusion healthcare services in 2020 to ensure patient safety and appropriate blood use. This study examines the quality of blood transfusion services since the first national QA program for blood transfusion services in Korea. Methods: We analyzed HIRA claims and QA investigation data based on inpatient medical records from all tertiary, general, and primary hospitals between October 2020 and March 2021. The target population was patients aged 18 years and older who received either total knee arthroplasty or red blood cell transfusion. The QA indicators for transfusion healthcare service consisted of four quality indicators and four monitoring indicators. Results: We analyzed the results of QA indicators for transfusion service from the medical records of 189,668 patients from 1,171hospitals and expressed indicators as proportions. The average results for evaluation indicators were as follows: transfusion checklist presence, 64.8%; irregular antibody tests, 61.8%; transfusions in which the hemoglobin levels before transfusion met the transfusion guidelines for patients undergoing total knee arthroplasty, 20.6%, and transfusions in patients undergoing total knee arthroplasty, 59.3%. The average results for monitoring indicators were as follows: transfusion management implementation in medical institutions, 56.9%; preoperative anemia management in anemia patients undergoing total knee arthroplasty, 43.9%; one-unit transfusions, 82.5%; and the transfusion index. Conclusion: The quality of blood transfusion healthcare varied and the assessment revealed that there is scope for improvement. Hospitals require more effective blood transfusion management and this can be facilitated by providing feedback on the QA results about blood transfusion healthcare services to medical institutions, and by disclosing the results to the public.

• 대한임상검사과학회지
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• 제54권1호
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• pp.61-67
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• 2022

INM은 수술의 안정성을 더해주고 고위험군의 수술을 안전하게 진행할 수 있게 도움을 주고 있다. INM검사가 적용이 되는 모든 수술에서의 수술 과정과 신경학적 결손이 발생할 수 있는 과정에서 집중적으로 검사를 진행해 보다 신속하게 수술자에게 알리지 않으면 손상이 되었을 때 그에 대한 대처가 늦어서 환자에게 돌이킬 수 없는 심각한 후유증을 가져다 줄 수 있다. 대동맥류 및 대동맥 박리로 발생되는 대동맥 치환술은 개흉 및 개복술이 진행되며 심장의 혈류를 차단하는 매우 위험한 수술이다. 대동맥에서 분지되어 척수에 혈류를 공급하는 혈관들을 교체할 때 척수로 가는 혈류가 감소해 척수 허혈이 올 수 있다. 대동맥 수술에서의 INM은 겸자시에 유발전위를 이용하여 빠르게 척수 허혈이 시작되는 시점을 찾아내고 수술자에게 보고해 척수 허혈을 방지하며 심각한 합병증을 막는 중요한 역할을 수행한다. 이에 수술의 과정과 TceMEP, SSEPs의 검사 방법 및 검사 시점, 검사 기준에 대하여 작성을 하여 INM을 시행하는 검사자들에게 도움이 되고자 본문을 작성하였다. 본문으로 인해 대동맥수술에서 INM의 필요성, 대동맥 수술에서의 흐름을 파악하고 정확하고 신속한 검사를 통한 보고로 원활한 검사가 진행되길 바라는 바이다.

• 핵의학기술
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• 제27권1호
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• pp.47-54
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• 2023

Purpose PET-CT imaging require an appropriate quality assurance system to achieve high efficiency and reliability. Quality control is essential for improving the quality of care and patient safety. Currently, there are performance evaluation methods of UN2-1994 and UN2-2001 proposed by NEMA and IEC for PET-CT image evaluation. In this study, we compare phantom images with the same experiments before and after PET-CT 3D normalization and well counter correction and evaluate the usefulness of quality control. Materials and methods Discovery 690 (General Electric Healthcare, USA) PET-CT equiptment was used to perform 3D normalization and well counter correction as recommended by GE Healthcare. Based on the recovery coefficients for the six spheres of the NEMA IEC Body Phantom recommended by the EARL. 20kBq/㎖ of ¹⁸F was injected into the sphere of the phantom and 2kBq/㎖ of ¹⁸F was injected into the body of phantom. PET-CT scan was performed with a radioacitivity ratio of 10:1. Images were reconstructed by appliying TOF+PSF+TOF, OSEM+PSF, OSEM and Gaussian filter 4.0, 4.5, 5.0, 5.5, 6.0, 6,5 mm with matrix size 128×128, slice thickness 3.75 mm, iteration 2, subset 16 conditions. The PET image was attenuation corrected using the CT images and analyzed using software program AW 4.7 (General Electric Healthcare, USA). The ROI was set to fit 6 spheres in the CT image, RC (Recovery Coefficient) was measured after fusion of PET and CT. Statistical analysis was performed wilcoxon signed rank test using R. Results Overall, after the quality control items were performed, the recovery coefficient of the phantom image increased and measured. Recovery coefficient according to the image reconstruction increased in the order TOF+PSF, TOF, OSEM+PSF, before and after quality control, RCmax increased by OSEM 0.13, OSEM+PSF 0.16, TOF 0.16, TOF+PSF 0.15 and RCmean increased by OSEM 0.09, OSEM+PSF 0.09, TOF 0.106, TOF+PSF 0.10. Both groups showed a statistically significant difference in Wilcoxon signed rank test results (P value<0.001). Conclusion PET-CT system require quality assurance to achieve high efficiency and reliability. Standardized intervals and procedures should be followed for quality control. We hope that this study will be a good opportunity to think about the importance of quality control in PET-CT

• 대한한방부인과학회지
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• 제36권4호
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• pp.78-95
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• 2023

Objectives: This study aims to analyze the results of the 2022 Gyeonggi-do Oriental Medicine Fertility Treatment Support Project, review the outcomes and satisfaction of Oriental Medicine fertility support initiatives, and propose progressive fertility treatment support strategies by comparing them with the results of the past three years. Methods: Total of 242 women and 205 spouses participated in the Korean Medicine fertility treatment support project, which encompassed herbal medicine, acupuncture, and counseling treatments over a 3-month period, followed by a 3-month post-treatment follow-up. Data pertaining to patients' general, demographic, and fertility-related characteristics were collected before treatment initiation. During treatment, information regarding the treatments administered by Korean medical doctors was recorded, along with post-treatment outcomes and satisfaction levels. Safety assessments included pre- and post-treatment blood tests and monitoring for adverse events. Results: Among the 242 female subjects, 209 successfully completed the treatment program. Of these, 35 (16.7%) achieved pregnancy, with 30 (15%) attaining pregnancy through herbal monotherapy. Out of the 35 pregnancies, 17 were maintained, while 10 resulted in miscarriage. Notably, 83.8% of patients expressed satisfaction with the treatment outcomes. An analysis spanning three years revealed a continuous increase in the average age of patients, surpassing 38 years in 2022, a critical point in fertility decline age. Additionally, there was a notable rise in the prevalence of patients with a history of gynecological issues, advanced spouse age, and semen abnormalities, which is assumed to have contributed to the decrease in the pregnancy success rate. Conclusions: This study compares the clinical results of the 2022 Gyeonggi-do Korean Medicine Fertility Treatment Support Project with those of the past three years. Based on these findings, recommendations are made to enhance the project, including stricter age criteria for patient selection, enhanced specialized treatment tools for medical doctors, and combining Korean Medicine treatment and medical assisted reproductive technologies, all aimed at increasing pregnancy success rates. These results provide a foundation for the development of fertility support projects and related policies.