• 제목/요약/키워드: Patient-focused Care

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일개 공공병원 금연클리닉 이용 흡연 환자의 금연 성공 및 유지 요인 : 일반적 특성과 금연관련 특성 중심으로 (Related Factors of Smoking Cessation Success and Maintenance of Patients using Smoking Cessation Clinic at a Public Hospital : focused on patient demographics and smoking related factors)

  • 황은정
    • 한국산학기술학회논문지
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    • 제20권3호
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    • pp.535-543
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    • 2019
  • 본 연구의 목적은 일개 공공병원의 금연클리닉 프로그램에 참여한 흡연 환자(입원 및 외래 포함)를 대상으로 일반적 특성과 흡연관련 특성 측면에서 프로그램 시작 6주 후, 12주 후 금연성공 및 유지 요인을 확인하는 것이다. 본 연구에서 활용된 자료는 2014년 공공보건의료프로그램 중 금연프로그램을 통해 수집된 2차 자료를 활용하였다. 금연 프로그램은 6주 동안 중재가 진행되며, 12주째 금연 유지 상태를 점검한다. 자료분석방법은 카이제곱 검정, t-test, 로지스틱 회귀분석법을 활용하였다. 연구대상자는 총 90명이며, 남자는 85명(94.45%), 여자는 5명(5.55%)으로 대부분 남자였다. 금연프로그램 종료시점인 참여 6주째 금연성공군과 금연실패군간에 가족유형(${\chi}^2=4.496$, p=0.037), 최종 교육정도(${\chi}^2=12.253$, p=0.002), 프로그램 참여 전 하루 흡연량 (t=-2.906, p=0.005), 프로그램 참여 전 니코틴의존도(t=-3.081, p=0.003)간에 유의한 차이를 보였다. 금연 프로그램 참여 6주 후 금연성공 요인으로는 종교유무(OR=3.719, 95% CI=1.076-12.859)와 프로그램 참여 전 니코틴의존도(OR=0.713, 95% CI=0.520-0.976)가 유의한 것으로 나타났다. 금연프로그램 참여 12주 후 금연 유지 요인으로는 가족유형(OR=0.017, 95% CI=0.001-0.507)과 금연의지(OR=2.062, 95% CI=1.059-4.015)가 유의한 것으로 나타났다. 금연이 성공하고 지속적으로 유지되기 위해서는 대상자의 특성별 프로그램 개발이 요구되며 이와 관련한 지속적인 연구 및 지원이 필요할 것이다.

중환자실 간호사들의 손 소독제에 따른 소독효과 및 MRSA 분리 (The Effect of Disinfection and the MRSA Isolation from Hand Disinfectant in ICU Nurses)

  • 박선남;류경화;정정임;박옥순
    • 기본간호학회지
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    • 제13권3호
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    • pp.359-367
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    • 2006
  • Purpose: This study was a within subject repeated pretest-posttest design done to compare the effect of disinfection and the degree of MRSA(Methicillin- resistant staphylococcus aureus) isolation from hand disinfectant in ICU nurses. Method: Out of the total internal medicine/surgery ICU nurses at a university hospital in Seoul, 29 female nurses who were participating in direct patient care were participants in this study. After collection of samples, Staphylococcus aureus and MRSA were isolated from the palms, nails and nasal cavities of the nurses according to disinfectants (soap and beta-scrub). Results: The effect of disinfection was greater in the beta-scrub group than in the soap group, and the effect of disinfection on palms was higher in the beta-scrub group than in the soap group. As for the degree of MRSA isolation, there was more isolation in palms in the soap group than in the beta-scrub group but there was no difference in the degree of MRSA isolation from the hand disinfectant in nails and nasal cavities. Conclusion: Beta-scrub showed a superior prolonged effect against transient bacteria compared with soap. Further, to reduce MRSA infection, we recommend interventions focused on these aspects.

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일 대학병원 간호사의 다약제 내성균 감염관리지침에 대한 지식과 수행정도 (Hospital Nurses' Knowledge and Compliance on Multidrug-resistant Organism Infection Control Guideline)

  • 강지연;조진완;김유정;김동희;이지영;박혜경;정성희;이은남
    • 대한간호학회지
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    • 제39권2호
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    • pp.186-197
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    • 2009
  • Purpose: This study was done to investigate nurses' knowledge of, and compliance with the multidrug-resistant organism (MDRO) infection control guidelines. Methods: A survey questionnaire was developed based on the institutional and national guidelines and was administered to a convenience sample of 306 nurses in a university hospital. Results: The mean score for knowledge was 33.87 (percentage of correct answers: 82.61%). The percentages of correct answers for basic concepts, route of transmission, hand washing/protective devices and environment management were 74.27%, 94.29%, 92.90% and 75.54% respectively. The mean compliance score was 4.15 (range: 1-5). The compliance scores for education, communication, contact precaution, disinfection, surveillance culture, and hand washing were 3.29, 4.05, 4.20, 4.50, 4.40 and 4.48 respectively. Nurses indicated "lack of time (30.06%)", "lack of means (10.78%)" and "lack of knowledge (9.48%)" as reasons for noncompliance. Conclusion: While most educational programs have focused on hand washing or use of protective devices to prevent transmission of MDRO in acute care settings, hospital nurses' knowledge of the basic concepts of MDRO and environmental management has remained insufficient. Nurses are relatively non-compliant to the guidelines in the areas of education (staff, patient, family) and communication. Comprehensive educational programs are needed to decrease hospital infection rates and to improve the health of patients.

선택진료제도 개편에 대한 중요도-성취도 분석(IPA) - 서울시내 상급종합병원 의료종사자 인식을 중심으로 - (An Importance-Performance Analysis of the Healthcare Reform on a Doctor-Designation System - Focused on the Perception of Medical Providers' at Tertiary Hospital in Seoul -)

  • 박혜진;김효정;김영훈
    • 한국병원경영학회지
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    • 제23권1호
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    • pp.28-40
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    • 2018
  • Purpose: The purpose is to understand the perception of medical providers at tertiary hospitals in Seoul on the importance-performance of the reform on a doctor-designation system, and to provide the policy suggestion of the perception on such a system. Methodology: To achieve the purpose, this study utilized structured survey tools to conduct a questionnaire survey of nursing, administrative and medical technology professionals at six tertiary hospitals in Seoul. An importance-performance analysis was utilized for an analysis that showed the perception of the reform on a doctor-designation system. Findings: First, it was identified that those medical providers had the highest perception of the importance about the performance of the reform on a doctor-designation system. Second, according to the result of action grid of an importance-performance analysis (IPA), it can be identified that in the 2nd stage of 'Concentrate here' included are the items as to design and effect of medical care quality and subsidies & patient infection and safety and control fees, effect of income security of the method for compensating for loss established by the government and offering sufficient information on general medical services and doctor-designation medical services. In the 1st stage of 'Keep up the Good Work', and the 2nd stage of 'Concentrate here' included is the item as to the performance of patients of the reform on a doctor designation system. Practical Implications: There could be identified the effect of the reform bill on the perception of medical providers. It is expected that a better environment would be provided for patients to use a hospital and for medical providers to offer medical services, if the goverment makes efforts to improve methods for compensating for loss and continuous monitoring of the performance of patients.

치과용 임플란트 보철물적용환자의 만족요인 (A Study on Satisfaction Factors with Dental Implant Patients)

  • 이성욱;김지환
    • 대한치과기공학회지
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    • 제28권1호
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    • pp.67-81
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    • 2006
  • This research has been attempt to examine closely factors that high cost and value to overall satisfaction state for dental implant prosthesis, re-utilization intention, inducement intention of the general hospital dental service user and provide basis data necessary to establish competitive general hospital dentistry management strategy. Collected data using own recording way questionnaire from April 17, 2004 to May 15, 2004 choosing 142 people that agree on this research and question of 361 people that dental implant prosthetic treatment finished from March 1, 1999 to March 1, 2004 for this. Major analyzation consequences are as follows : First, general satisfaction, re-utilization intention, inducement intention for implant prosthesis that highly correlation variables are kindness, explanation, medical treatment level and appreciation of the aesthetic. Second, correlation is high relatively between re-utilization intention, inducement intention in the 3 variables such as general satisfaction re-utilization intention, inducement intention. Third, the result of multiple regression analysis showed that most significant effective factors are satisfaction with explanation of dental implant prosthesis between the 3 dependant variables such as general satisfaction, re-utilization intention, inducement intention. In looking into these consequence, how to improve that raise satisfaction about dental implant prosthetic treatment and to establish patient focused care service system for dental implant prosthesis, it is consider that explain enough about implant prosthesis and raise quality of medical examination and treatment level, including satisfied with fabrication of good esthetic dental implant prosthesis.

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Changes of Plasma Tumor Necrosis Factor α and C-Reactive Protein Levels in Patients with Hypertension Accompanied by Impaired Glucose Tolerance and their Clinical Significance

  • Xiao, Qiang;Wang, Lan-Ping;Ran, Zhang-Shen;Zhang, Xin-Huan
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권8호
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    • pp.3389-3393
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    • 2015
  • Background: Chronic inflammation could affect the occurrence and development of malignant tumors. To explore the levels of tumor necrosis factor ${\alpha}$ (TNF-${\alpha}$) and C-reactive protein (CRP) in patients accompanied by impaired glucose tolerance (IGT) and their clinical significance. Materials and Methods: A total of 210 patients hospitalized in Affiliated Hospital of Taishan Medical University from Jun., 2013 to Dec., 2014 were selected, in which 92 cases were accompanied by IGT. Meanwhile, 80 randomly-selected healthy people by physical examination were as the control. The levels of routine biochemical indexes, plasma TNF-${\alpha}$ and CRP in all subjects were measured. Results: Both systolic and diastolic pressures in hypertension group and hypertension plus IGT group were significantly higher than in control group (p<0.01), but there was no statistical significance between these two groups (p>0.05). The levels of fasting plasma glucose (FPG) and blood glucose 2 h after taking glucose in hypertension plus IGT group were markedly higher than other groups (p<0.01). Homeostasis model assessment-insulin resistance (HOMA-IR), TNF-${\alpha}$ and CRP contents were on the progressive increase in control, hypertension and hypertension plus IGT groups, but significant differences were presented among each group (P<0.01). Hypertension accompanied by IGT had a significantly-positive association with CRP, TNF-${\alpha}$, FPG and blood glucose 2h after taking glucose. Conclusions: The levels of plasma TNF-${\alpha}$ and CPR in patients with hypertension accompanied by IGT increase significantly, indicating that inflammatory reaction in these patient increases, thus suggesting that these patients should be focused regarding cancer prevention.

적취(積聚)를 위주로 한 종양(腫瘍)의 치법(治法)에 관한 소고(小考) (Brief review of cancer treatment focused on JIJU(積聚))

  • 박재현;문구
    • 대한암한의학회지
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    • 제13권1호
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    • pp.1-11
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    • 2008
  • Objectives: To grasp the traditional stream of cancer treatment inherited from the previous doctors. Methods: The author's research has been performed cancer treatment based on JIJU(積聚) taking the original text as a reference. Results & Conclusion: The general three outlines and five detailed rules of cancer treatment have been obtained as follows. The first outline of cancer treatment is that reinforced vital function makes cancer reduce naturally. the second is that Harmless cancer can coexist in human beings and aging with them. and the third is that Elimination and reinforcing therapies should be executed in appropriate era and those therapies should utilize appropriate methods. The first detailed rule of cancer treatment is when using reinforcing therapy, it must applicate mildly and when using elimination therapy, it must applicate calmly. The second detailed rule is that the methods of cancer treatment are different from each cancer stage. The concentration should be made on reinforcing therapy at early stage while reinforcing and elimination therapies must be conducted together at middle stage. At terminal stage reinforcing therapy is the sole method to be taken. The third detailed rule is that the basis property of cancer drug is warm nature and extremely biased property should be avoided and when complication arises (eg. inflamatory disease, cancer fever, etc), cold or cool nature can be applied. The fourth detailed rule is that Cancer drug must have the effect eliminating the blood stasis, phlegm and excessive fluid, all together. The fifth detailed rule is that Physicians have to control patient's stress or stress related symptom and teach patients about right way of taking care of themselves and patients should take hygienic rules with their free will by themselves (eg diet, exercise, stress, etc)

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119 구급 신고 분석: 대화 시간 및 내용을 중심으로 (An Analysis of 119 Emergency Calls: Focused on Conversation Time and Contents)

  • 장경호;강경희
    • 한국화재소방학회논문지
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    • 제32권4호
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    • pp.103-109
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    • 2018
  • 119 종합상황실의 상황 요원은 화재, 구조, 구급 등의 위기 상황을 처음으로 인지하고 대응 체계를 가동시켜야 하는 중요한 역할을 수행하고 있다. 특히 119 구급 신고와 관련하여 상황 요원의 신속하고 정확한 수보 활동은 환자의 생명은 물론 예후를 결정할 수 있다. 이에 본 연구에서는 2014년 4월 8일부터 12월 31일의 ${\bigcirc}{\bigcirc}$시 신고 접수, 출동, 구급활동 자료를 이용해 상황 요원과 신고자의 대화 회전 수와 대화 시간, 그리고 대화 구조 및 순서의 시간 등을 접수 경로와 중증도에 따라 분석하였다. 상황 요원과 신고자의 대화 분석은 향후 상황관리단계에 따른 조치 사항 또는 행동 매뉴얼의 개발이나 개선에 활용할 수 있을 것으로 기대된다.

병원서비스품질, 고객만족, 재이용 의도간의 영향 관계 (Relation with Hospital Quality of Service, Customer Satisfaction, Reuse)

  • 최승일;김동일
    • 한국콘텐츠학회논문지
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    • 제10권6호
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    • pp.344-351
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    • 2010
  • 최근 병원은 의료에 대한 수요가 점차 증가하면서 신설과 확장을 통해 다양한 경쟁상황에 직면하고 있는 실정이다. 이러한 현실에서 병원서비스에 대한 품질 유지는 곧 병원의 생존과 발전을 위해, 병원 본래의 기능뿐만 아니라 경쟁력을 확보하기 위한 핵심 요인으로 평가되고 있다. 따라서 본 연구는 병원의 서비스 품질에 초점을 두고 서비스 내용을 중심으로 고객과의 접촉으로 나타나는 결과들을 종합 평가하였다. 본 연구에서 투입된 변수 즉, 병원서비스 품질과 고객만족, 재이용의도 등의 관계정도는 병원의 전략적 병원경영의 기초가 될 수 있기 때문이다. 본 연구결과 병원서비스 품질과 고객 만족, 재이용의도간의 영향 관계에서 병원서비스 품질은 고객 만족, 재이용의도에 매우 유의한 것으로 나타났다. 향후 이러한 결과는 고객중심적 병원경영에 지침을 제공할 수 있으며, 더 나아가 경쟁력 강화에 응용될 수 있을 것으로 기대된다.

뇌혈관질환 사망자 의료이용 변이의 분석 (A Study on the Variation in Meical Service Utilization of The Dead by Cerebrovascular Diseases Patients in Korea)

  • 홍월란;정두채
    • 한국병원경영학회지
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    • 제14권1호
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    • pp.36-61
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    • 2009
  • This study focused on finding the variation of medical service utilization, paths of medical service utilization and medical payments of the patients died by cerebrovascular diseases. For this study, data of the one-year episodes of the health insurance subscribers died in 2004 were selected. The frequency of medical visits, the lengths of stays, the days of outpatient visits, the total period of medical services and the total medical payments were compared by the characteristics of the suppliers and utilizers. This study is useful in reviewing the equity of medical service utilization because it analyzed variance in utilization by episodes. In oder to collect accurate data of the patients died by cerebrovascular diseases in 2004 the 2004 reimbursement data of all medical institutions were matched to the data of funeral fee payment by the National Health Insurance Corporation from January 2004 to May 2005. The major results of the study are as follows. The variation of medical service utilization of cerebrovascular diseases was influenced by supplier factors suppliers, such as types and locations of medical institutions and user factors such as sex and age. It was suspected that the reimbursement by fee-for-service contributed to the variation quite a lot, but we could not compare the variation between the different reimbursement systems in Korea. On the basis of analyzing results this study suggests that the factors of suppliers and utilizers should be reviewed to reduce the under use and over use expressed by variations of medical service. The processes of care, effective communication and management system should be investigated for the equity of medical service utilization and also. alternative medical services would be recommended to reduce the high medical payment. Additionally to find other causes of variation further in depth study controling the severity of diseases, socio-economic status of the users and the system factors is required.

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