• 대한예방한의학회지
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• 제22권2호
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• pp.13-24
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• 2018

Objectives : According to the data from the 2016 Yearbook of Traditional Korean Medicine, 10 out of 12 medical schools of Korean medicine are offering medical ethics. Medical ethics has become essential in Korean medicine education, but there has been no agreement on the content of education yet, so initial discussions are necessary with respect to the content and methods of education. Methods : In this study, basic data were collected by searching papers, reports, books, and media articles on medical ethics related to Korean medicine education, and by studying the website of medical schools of Korean medicine nationwide. Based on the collected data, the status of medical ethics lectures were determined and compared with the current state of medical ethics lectures by western medical schools. The contents suitable for medical ethics education at medical schools of Korean medicine were discussed. Results : The topics of the medical ethics include: the basic concepts of medical ethics, the ethics of birth, the ethics associated with genetics, the ethics associated with death, and the ethics regarding doctor-patient interaction, the ethics of medical research, medical rationing ethics, ethics between medical staffs, medical law and ethics, philosophical base of medical ethics, ethics of doctor as professional, and moral personality formation of doctor. The contents of medical ethics in traditional Korean medicine reflected views on the human body and life based on "Huangdi's Internal Classic"and medical ethics from the viewpoints of Buddhism and Confucianism. Conclusions : Medical schools of Korean medicine are medical training institutions, and medical ethics education is essential to become a Korean medicine doctor as professional worker, medical practitioner, and biomedical researcher. There is no fundamental difference in the basic principles of medical ethics in both western and Korean medicine, and there are differences in contents depending on the clinical practice. The contents of medical ethics on clinical practice should be modified for Korean medicine doctors, and traditional Korean medicine ethics would be set up upon that. In the national licensing examination, medical ethics needs to be added as one part so that all the ethical problems related to the clinical situation can be solved.

• 한국의료질향상학회지
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• 제3권1호
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• pp.104-124
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• 1996

Background : In these days, the health care organizations have concerned about customer-centered care in order to empower the competitiveness on the health care markets. The departments working for quality management of the hospitals have used health care quality indicators in terms of medical areas as well as service areas of the hospitals. However, there were insufficient efforts to develop the credible measurement to seek the customers' needs, their expectations and their satisfaction levels related to health care services because various kinds of challenges were in the process of scale development to measure customers' satisfaction in health care. The purpose of this study was to develop the satisfaction scale to health care services in a Korea health care organization and to test its tool with validity and reliability. Method : The concept of this tool was acceptability that one of the components of health care quality defined by Donabedian. Acceptability has the five dimensions of concept: Accessibility; Patient-Practitioner Relations; Amenities; Patient Preferences as to the effects of care; and Patient Preferences as to the costs of care. The Satisfaction Tool to Health Care Services was reviewed by expert panel with five researchers, including hospital managers and a professor related to quality management of the hospitals. As a result, the content validity index was .84 in the outpatient satisfaction tool. The inpatient satisfaction tool had .87 of the content validity index. The Satisfaction Tools to Health Care Services finally consisted of 44 items for outpatients/their families and of 60 items for inpatients/their families. Study subjects of the construct validity test were 479 outpatients/their families and 561 inpatients/their families who visited or admitted at a University hospital from July 1, 1996 through August 10, 1996. The data were examined by Factor Analysis with SPSS. Result : The items of Satisfaction tools for outpatients/their families were categorized by eleven factors with eigenvalue greater than 1.0 accounting for 64.2 percent of the variation in item scores. Also, the items of inpatient tool had eleven factors with eigenvalue greater than 1.0 accounting for 60.3 percent of the variation in item scores. The reliability of overall scale were .95 and .96 for the outpatients/their families satisfaction scores and inpatient/their families satisfaction scores. The internal consistency reliability with eleven factors was ranged from .30 to .94 for inpatients/their families. The Satisfaction Tool with eleven factors for inpatients/their families had internal consistency reliability ranged from .53 to .89. Conclusion : The Satisfaction Tools to Health Care Services focused on outpatients/their families and inpatients/their families developed in this study had a high reliability and the strong evidence of content validity and construct validity based on quality concept. Therefore, this tool would be utilized as a credible quality indicator of health care services to assess the quality problems and to monitor the quality improvement activities in Korean Health Care Organizations.

• 대한치과기공학회지
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• 제34권3호
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• pp.303-314
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• 2012

Purpose: This study aimed to find overseas workplace and improve global competence through the preference survey on overseas employment by dental technology students. Methods: The survey sample consisted of 250 randomly selected dental technology students. Survey was conducted from March 1 to May 1 in 2012. Total of 245(98.0%) replies and analyzed 236 questionnaires excluding 9 incomplete questionnaires. The questionnaires used in this study consisted of 7 items for general information, overseas employment characteristics of 10 items, 7 items for overseas employment activation plane and job competency development of 7 items. Collected data were analyzed using SPSS(Statistical Package for Social Sciences) Win 19.0 statistics program. Results: Regarding general characteristics of the subjects, there were 131 third graders(55.5%), 63 first graders(26.7%) and 42 second graders(17.8%) among 130 males(55.1%) and 106 females(44.9%). 221(93.6%) of the subjects had no experience in language training. Students who had clinical training for 1-5 months were 123(52.1%), and 24(10.2%) students had more than six months. 89(37.7%) of the subjects had no clinical training. 155(65.7%) of the subjects hope to work with korean owner, and 81(34.3%) chose foreign owner. Favored working countries were Australia(41.5%), the United States(29.2%), Canada(18.2%) and other(11.0%). The field of dental ceramic was indicated to be the highest proportion of 104(44.1%). Period of training were 3 hours(40.3%) and 6 hours(35.2%). The most important training were language-centered education(54.2%), Job-oriented education(24.2%), local culture education(16.1%), other(3.0%) and Leadership Training(2.5%). The subjects chose overseas worker(44.9%), working-level practitioner (28.8%), successfully employed dental technology graduate(19.5%a) and professor(3.4%) as an instructor. The subjects get education and training information from professor(40.3%), other(28.0%), senior(14.4%), job site(8.9%) and acquaintance(8.5%). A credit exchange(2.46 points), a joint degree program(2.46 points), and a foreign professor(2.33 points) were needed to activate the overseas employment. A kind of dental prosthesis(3.58 points), carving tooth morphology(3.38 points), and majors of dental technology(3.30 points) were indicated to develop job competency for overseas employment. Age, year, clinical training experience and company owner were statistically meaningful data among the general characteristics affecting job competency development. Conclusion: The college needs to offer variety programs such as foreign language-centered education and a local job competency development program to graduates to be connected with international workplace and employment.

• 한국노년학
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• 제38권1호
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• pp.169-185
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• 2018

당뇨병 노인환자의 자기관리 교육은 대상자의 건강행위를 변화시켜야 하는 목표를 성취해야하므로 노인의 자기관리 역량 강화에 중점을 두고, 노인 대상자의 특성과 개별적인 상황 및 조건을 반영해야 한다. 그러나 이러한 노인 특화 프로그램은 매우 제한적이고, 대상자 중심의 효과가 평가된 경우도 드물다. 이에 본 연구는 노인복지관을 이용하는 지역사회 거주 당뇨병 노인 맞춤형 당뇨자기관리 프로그램을 실행연구 방법으로 적용하고, 그 효과를 평가하기 위해 시행되었다. 본 연구는 실행연구방법의 계획, 실행, 평가, 성찰단계를 각 회기마다 시행하여 이전 회기의 결과가 다음회기의 중재계획의 변화에 근거가 되는 체계적인 순환과정을 3회기에 걸쳐 순차적으로 적용하였다. 일개의 지역사회 복지관에서 15개월에 걸쳐 12주의 소규모 노인 당뇨병 교육 프로그램을 제공한 후 양적, 질적 자료를 모두 사용하여 참여대상자 측면의 평가가 충분히 포함되도록 하였다. 총 46명중 43명(93.48%)이 프로그램을 이수하였다. 양적인 프로그램의 효과결과에서는 당화혈색소(p<.001), 공복혈당(p<.001), 신체질량지수(p=.016), 허리둘레(p=.001), 수축기혈압(p=.036), 당뇨병 자기관리 행위(p<.001), 노인 건강행위지식(p=.008)이 통계적으로 유의하게 향상되었다. 질적 평가 자료에서는 본 프로그램은 개별적인 맞춤 관리로 느껴지며 이를 통해 역량 강화하게 되었고, 상호작용을 통한 능동적인 참여를 통해 자신의 자기관리 이행에 자신감과 실천의 즐거움을 느꼈다고 하였다. 본 연구는 실행연구방법을 적용하여 지역사회 노인을 대상으로 당뇨병 교육 프로그램을 적용한 결과로 대상자의 신체적 지표와 행위지표, 유용성 등의 양적인 효과뿐만 아니라 대상자 측면에서의 주관적인 효과성을 확인 한 것은 효율성과 실현 가능성을 살펴보는 의미 있는 시도였다. 따라서 이러한 실행연구 방법을 통한 프로그램의 적용과정과 평가는 현장 실무자에게 대상자의 요구 중심의 맞춤형 중재 프로그램 시행의 가이드가 될 것이다.

• 한국사회정책
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• 제24권1호
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• pp.239-275
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• 2017

본 연구는 사회복지 실천현장에 나타난 신자유주의적 성과주의 요구에 대해 사회복지사들이 '무엇'을 '어떻게' 경험하는가를 탐구함으로써 이들 경험의 본질적 주제를 드러내고자 하였다. 자료수집을 위해 사회복지사 18명에 대한 심층면접을 실시하고, 수집된 자료를 Colaizzi(1978)가 제안한 현상학적 방법으로 분석했다. 분석결과 총 4개의 본질적 주제로 통합되었다. 연구참여자들은 효과성과 효율성에 기반 한 의미 있는 성과 아닌 '실속 없는 형식적 성과' 만들기에 매몰되어 있었다. 이러한 상황에서 클라이언트는 실적의 도구가 되고, 현장과의 접촉점이 상실되며, 서비스의 질적 저하와 기관 간 연계가 약화되는 '본연의 실천 가치에 역행하는 실천의 재조직화'로 나타난다. 또한, 성과주의가 의도했던 책임성의 구현은 외부에서 의해 부여된 성과기준에 매몰되어 성과가 불명확한 도전은 포기하게 되는 '재량권 없는 경직된 책임성'만 남게 되었다. 실속 없는 형식적 성과 만들기에 몰두하는 동안 사회복지 실천현장의 가치와 특수성을 담아내지 못하고 실천가의 자부심을 상실하는 '사회복지 정체성 침식'을 경험하였다. 이러한 결과는 성과주의의 본래 목적이 전치된 성과주의의 역설과 실패로 귀결된다. 연구결과를 바탕으로 논의와 정책 방향을 제시 하였다.

• 농촌의학ㆍ지역보건
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• 제20권2호
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• pp.157-168
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• 1995

This study was carried out, through analyzing the annual reports(year of 1973-1993) on health status of Su Dong-Myun, and specific survey data of 332 households(Su Dong-Myun 209, Byul Nae-Myun 123), located in Nam Yang Ju-Si, Kyung Gi-Do, from July 20 to July 31, 1995, to find out more effective means for primary medical care in a rural area. The results were as fellows : 1. Number of population in Su Dong-Myun was 5,419 in 1973, 4,591(the lowest) in 1987 and 5,707 in 1995. In the composition rate of population, "0-14" of age group showed markedly decreasing tendency from 43.1% in 1975, to 19.1% in 1995, however "65 and over" markedly in creasing tendency form 5.3% in 1975 to 9.8% in 1995. 2. Annual utilization rate per 1,000 inhabitants in Su Dong-Myun showed markedly increasing tendency from 1973 to 1977 such as 343 in 1973, 540 in 1975, 900 in 1977. However, since 1979, the rate showed rapidly decreasing tendency, such as 846 in 1979, 519 in 1985, 190 in 1991 and 1993. 3. The morbid household rate per year was 53.6% of respondents and the rate per 15 days was 48.2%. In disease classification rate of morbid household per year, Arthralgia & Neuralgia was the highest rate(33.9%) and gastro-intestinal disorder(19.3%), Cough(11,9%), Hypertension(7.8%), Accident(3.2%) in next order. 4. In the utilizing facilities for Primary Medical Care, Medical facilities was showed the highest rate(58.1% of respondents) and Pharmacy and Drug Shp(33.1%), Tradition Method(4.0%) in next order. In the Medical facilities, General private clinic was showed the highest rate(34.3%) and specific private Clinic(22.3%), Hospital(19.0%), Health (Sub)center(16.3%), Nurse practitioner (3.3%), Oriental hospital and clinic(2.7%) in next order. 5. Experience rate, utilizing health subcenter was 51.8% of the respondents, and it was 55.0% in Su Dong-Myun and 46.3% in Byul Nae-Myun. In utilization times of health subcenter, times-rate showed next orders such as 1-2 times/6months(31.6%), 1-2 times/year (22.1%), 1-2 times/months(19.2%), 1-2 times/3months(15.6%). 6. In objectives, visiting Health Subcenter, Medical Care was the highest rate(59.8% of the respondents) and health control(23.3%) was in next order. In Medical Care, Primary Care by general physician was higher rate(51.1%) almost all. In the Health control, Immunization too was high rate(18.0%) in health control activities. 7. The reasons rate, utilizing health subcenter showed next order, such as distance to Medical facilities(33.0% of the respondents), Medical Cost(28.1%), Simple process of consultation (10.8%), Effectiveness of cure(7.6%), Function of primary medical care(7.0%) and Attitude of physician(6.5%). 8. In the affecting factors to utilization of primary medical facilities, medical needs was showed the highest rate(29.5% of the respondents) and medical cost(15.4%), distance to medical facilities(14.2%), traffic vehicle(14.2%) and farm work(6.9%) in next order. 9. In the priority between 'daily farm work,' and 'primary medical care', only 46.4% of respondents answered that primary health care is more important than the daily farm work The 22.6% of respondents answered 'daily farm work', and the 12.3% answered 'the equal of the both'. 10. In the criterion of medical facilities choice, medical knowledge and technical quality was showed the highest rate(56.3%), distance or time to medical facilities(10.9%), sincerity and kindness of physician(9.4%), medical cost(8.7%) and traffic vehicle(6.5%) in next order 11. In the advise for improvement of health subcenter function, the 36.1% of respondents answered that 'enforcement of medical personnel and equipment' was required, and then 'improved medical technology'(25.5%), 'good attitude of physician'(14.9%), 'improved medical system'(13.3%), 'enforced drug'(6.7%) in next order. 12. The study on affecting factors to utilization of primary medical facilities was very difficult subject to systematize the analyzed results, due to a prejudice of protocol planner, surveyer and respondent, and variety and overlapping of subject matter.

• 대한교통학회:학술대회논문집
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• 대한교통학회 1995년도 제27회 학술발표회
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• pp.3-32
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• 1995

The Highway Capacity Manual specifies procedures for evaluating intersection performance in terms of delay per vehicle. What is lacking in the current methodology is a comparable quantitative procedure for ass~ssing the safety-based level of service provided to motorists. The objective of the research described herein was to develop a computational procedure for evaluating the safety-based level of service of signalized intersections based on the relative hazard of alternative intersection designs and signal timing plans. Conflict opportunity models were developed for those crossing, diverging, and stopping maneuvers which are associated with left-turn and rear-end accidents. Safety¬based level-of-service criteria were then developed based on the distribution of conflict opportunities computed from the developed models. A case study evaluation of the level of service analysis methodology revealed that the developed safety-based criteria were not as sensitive to changes in prevailing traffic, roadway, and signal timing conditions as the traditional delay-based measure. However, the methodology did permit a quantitative assessment of the trade-off between delay reduction and safety improvement. The Highway Capacity Manual (HCM) specifies procedures for evaluating intersection performance in terms of a wide variety of prevailing conditions such as traffic composition, intersection geometry, traffic volumes, and signal timing (1). At the present time, however, performance is only measured in terms of delay per vehicle. This is a parameter which is widely accepted as a meaningful and useful indicator of the efficiency with which an intersection is serving traffic needs. What is lacking in the current methodology is a comparable quantitative procedure for assessing the safety-based level of service provided to motorists. For example, it is well¬known that the change from permissive to protected left-turn phasing can reduce left-turn accident frequency. However, the HCM only permits a quantitative assessment of the impact of this alternative phasing arrangement on vehicle delay. It is left to the engineer or planner to subjectively judge the level of safety benefits, and to evaluate the trade-off between the efficiency and safety consequences of the alternative phasing plans. Numerous examples of other geometric design and signal timing improvements could also be given. At present, the principal methods available to the practitioner for evaluating the relative safety at signalized intersections are: a) the application of engineering judgement, b) accident analyses, and c) traffic conflicts analysis. Reliance on engineering judgement has obvious limitations, especially when placed in the context of the elaborate HCM procedures for calculating delay. Accident analyses generally require some type of before-after comparison, either for the case study intersection or for a large set of similar intersections. In e.ither situation, there are problems associated with compensating for regression-to-the-mean phenomena (2), as well as obtaining an adequate sample size. Research has also pointed to potential bias caused by the way in which exposure to accidents is measured (3, 4). Because of the problems associated with traditional accident analyses, some have promoted the use of tqe traffic conflicts technique (5). However, this procedure also has shortcomings in that it.requires extensive field data collection and trained observers to identify the different types of conflicts occurring in the field. The objective of the research described herein was to develop a computational procedure for evaluating the safety-based level of service of signalized intersections that would be compatible and consistent with that presently found in the HCM for evaluating efficiency-based level of service as measured by delay per vehicle (6). The intent was not to develop a new set of accident prediction models, but to design a methodology to quantitatively predict the relative hazard of alternative intersection designs and signal timing plans.

• 제3의학
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• 제2권1호
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• pp.55-84
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• 1997

Inferential structure and reality problem is a serious issue to O.M.(oriental medicine). The study will analyze this issue through a philosophical and historical comparative study of W.M.M(Western modern medicine) and O.M. First, I presuppose some basic ideas. The first is the division of the 'the philosophy of medicine' and 'the medicine itself'. Second, there is a 'visibility' that discriminate between 'the abstractive concept' and 'the concrete object' in diagnostic terminology. The third is the separation of disease, the entity and disease, the phenomenon. Finally, the distinction between the cause of disease and the nature of disease. Through these basic concepts, this study will analyze O.M's diagnostic methodology, 'Pattern identification of the S.A.S(sign and symptom)'. The results are follows: 1. O.M's views disease as a phenomenon. So, the S.A.S, which is visible, is the disease itself. Tough the analysis and inference of the S.A.S, 證(zheng) the essence is derived. 2. 證(zheng) can be considered as 'the abstractive concept' reflecting the essence of a disease. 3. 證(zheng) is not arrived through causal sequence reasoning but rather by analogical reasoning. 4. 證(zheng) is 'the non-random correlative combination of S.A.S', pattern. These patterns secure the abstractive deduction in reality. that is, The causality, the positivism, the view of disease as entity, and anatomical knowledge are the traits peculiar to W.M.M. But, these properties can not be applied universally to every medical systems. Also, these properties do not indicate the superiority or inferiority of any medical system. 5. 證(zheng) summarizes the patients condition simultaneously with the S.A.S. However, 證(zheng) doesn't necessarily indicate the knowledge about the actual internal organ. That is, Early in O.M.'s history, the diagnostic terminologies including 證(zheng) were analogical reflections of a naive knowledge of internal organs and external environmental factors. Later, the naive knowledge in 證(zheng) changed int new nature, an abstractive concept. The confusion of the concept of disease, the indiscriminate acceptance of Western anatomical knowledge, and the O.M.'s theoretical evolution et are the challenge facing modern O.M. To find solutions, this study looks at the sequence of the birth of W.M.M. and then compares it's system with the O.M. system. The confusion of the concept of disease, the indiscriminate acceptance of Western anatomical knowledge, and the O.M.'s theoretical evolution et are the challenge facing modern O.M. To find solutions, this study looks at the sequence of the birth of W.M.M. and then compares it's system with the O.M. system. It is recommended that O.M. diagnostics should pay close attention to the ambiguity of the diagnostic methodology in order to further development. At present time, the concept and the system peculiar to O.M. can not be explained by common language. but O.M.'s practitioner can not persist in this manner an: longer. Along with the internal development of O.M., the adjustment of O.M.'s diagnostic terminology needs to be adopted.

• 농촌의학ㆍ지역보건
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• 제17권1호
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• pp.34-45
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• 1992

In this county, the gap between the urban 'haves' and the rural 'have-nots' continues to be an increasing problem. WHO and UNICEF see primary health care(PHC) as the key to achieving an acceptable level of health throughout the world as a community development. PHC is essential health care made accessible to individuals and families in the community by means acceptable to them. It is the first level of contact of individual, the family, and community with the national health system. It includes at least education on health system. It includes at least education on health problems, promotion of food supply, MCH including family planning, immunization against infectious diseases, control of endemic diseases, treatment of common diseases and injuries, promotion of mental health, and provision of essential drugs. However, of the aboves, education concerning of mental health problems and the methods to identify, prevent, and control them is the principal step of establishment. In Korea, the category of PHC worker includes the physician as public doctor and nurse as primary health care practitioner and community health leader as village health worker. PHC workers of the aboves will thus function best if they are appropriately trained to respond to the health needs of the community. However in this country, since the national PHC service project launched in 1980, the government has not developed and performed appropriate and enough education and training activities. In light of above reasons, several categories of health education activities had been planned and performed being aimed at above specific target groups and the main focus was on the village health workers for about one year from July 1991 to July 1992 in Yeoju Kun of Kyonki Province. At the end of the period, evaluation of education input was carried out to measure the improvement of healthful life of people in terms of awareness, attitude, and practice. At the end of the period, evaluation of education input was carried out to measure the improvement of healthful life of people in terms of awareness, attitude, and practice. The totals of 80 village health workers, 13 public health practitioners and 9 public docters took in the course of health education for a few hours at every month and the evaluation works of educational effect were taken. The results the study were as follows. 1) Number of persons who realized the maxim "health care of the people is a duty of the government" increased after the education course, On the other hand, the rate of satisfaction on the effort of government for health promotion of the people decreased. 2) Public doctors and primary health care practitioners(nurses) liked and enjoyed the education schedule as a meeting of peer group. It provided chances of communication with staffs of Korea University Hospital. It was said that lectures covered great deal of knowledge and technic they urgently needed in the field. 3) After finishing the education course, more of village health workers(VHW) thought they adapted themselves to their roles and functions showing increased number of home visit and contact with primary health care practitioners by month. 4) In case of patient refer, VHW preferred primary health care practitioners to public doctors. 5) Capability of VHWs in most of their functions increased dramatically after when the education course finished except tuberculosis control.

• 지능정보연구
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• 제23권4호
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• pp.169-196
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• 2017

제4차 산업혁명의 도래로 IT(information technology)를 활용한 다양한 융합기술에 대한 관심이 높아지고 있으며, 이에 따른 고품질의 IT관련 교육서비스 제공의 필요성 및 중요성 또한 점차 증대되고 있다. 한편, 일반적인 교육서비스 품질 및 만족도에 관한 연구는 그 동안 다양한 맥락에서 활발히 진행된 바 있으나, IT교육 참가자를 대상으로 한 IT교육 서비스품질의 역할을 살펴본 연구는 상대적으로 부족한 것으로 파악된다. 이에 본 연구에서는 SERVPERF 모형 및 관련 선행연구를 바탕으로 IT교육 맥락에서 IT교육 서비스품질의 다섯 가지 차원(유형성, 신뢰성, 반응성, 확신성 및 공감성)을 도출하고, 이러한 세부 IT교육 서비스품질 요인이 학습자의 교육만족도, 나아가 현업적용의도 및 추천의도에 미치는 영향을 검증하였다. 또한, 이러한 영향이 학습자 직위(실무자 집단/관리자 집단) 및 참여동기(자발적 참여집단/비자발적 참여집단)에 따라 어떻게 달라지는지에 대한 추가분석도 실시하였다. 서울 소재 'M'교육기관 203명의 IT교육 참가자 대상 설문을 활용한 구조방정식모형 분석 결과, IT교육 서비스품질의 다섯 가지 차원 가운데 유형성, 신뢰성 및 확신성이 교육만족도에 유의한 영향을 주는 것으로 나타났으며, 이러한 교육만족도는 현업적용의도와 추천의도에도 유의한 영향을 주는 것으로 조사되었다. 또한, IT교육 서비스품질이 교육만족도에 미치는 영향 관계에서 학습자 직위 및 참여동기가 유의한 조절효과를 가진다는 사실을 확인하였다. 본 연구는 SERVPERF 모형을 활용하여 IT교육 맥락에서 IT교육 서비스품질의 영향력을 실증한 최초의 연구라는 점에서 학술적 의의가 있다. 본 연구결과가 IT교육 서비스 제공기관의 교육만족도 제고 및 효율적인 서비스 운영을 위한 실질적인 지침을 제공해 줄 수 있을 것으로 기대한다.