• 보건행정학회지
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• 제33권4호
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• pp.389-399
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• 2023

Background: The purpose of this study is to analyze the factors affecting the unmet healthcare needs of older people with chronic diseases in Korea and provide a basic research report to strengthen their access to medical care. Methods: In the 2020 older people survey data, 8,182 older people aged 65 or older who were diagnosed with one or more chronic diseases were the final subjects of the study. According to Andersen's behavioral model used in unmet healthcare needs, independent variables were composed of predisposing factors, possible factors, and necessary factors, and whether or not unmet healthcare needs was set as dependent variable. Results: Of the older people with chronic diseases, 1.6% experienced unmet healthcare needs, of which 55.9% experienced unmet healthcare needs for reasons related to economic burden, 31.6% physical constraints, and 12.5% time constraints. As a result of the analysis, older people with chronic diseases were more likely to experience unmet healthcare needs if they were relatively low in age, low in education level, no spouse, low in household income, poor subjective health, complex chronic diseases, and functional restrictions. However, by major reasons for experiencing unmet healthcare needs, living in rural areas were more likely to experience unmet healthcare needs due to physical constraints, and those who participated in economic activities and who had were more likely to experience unmet healthcare needs due to time burden. These results were not derived when only unmet healthcare needs was set as the dependent variable. Conclusion: This study emphasizes the need for an approach by cause of unmet medical occurrence by suggesting that there are differences in influencing factors by reason for experiencing unmet healthcare needs.

• Childhood Kidney Diseases
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• 제1권2호
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• pp.117-122
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• 1997

목적 : 지속적 외래 복막투석(CAPD)직후 발생하는 비감염성 호산구성 복막염(eosinophilic peritonitis, EP)의 임상경과 및 검사소견을 분석하고 가능한 원인인자를 확인하고자 하였다. 방법 : 1994년 1월 1일부터 1996년 12월 31일까지 3년간 서울대학교 어린이병원 소아과에서 만성신부전으로 CAPD를 시행한 34명의 환아들을 대상으로 EP의 발생여부에 따른 임상소견, 검사소견, 임상경과 등의 차이에 대하여 후향적 고찰을 하였다. 결과 : 34명의 전체 환아들중 EP가 병발한 예는 7명 (21%) 이었다. EP 발생유무에 따른 연령, 성별, 원인질환 간의 유의한 차이는 없었다. EP는 5례(71%)에서 CAPD 카테타 삽입후 4일 이내에 발생하였고 주증상은 전례에서 투석액의 혼탁이었으며 발열, 복통, 배액장애 등의 소견은 동반되지 않았고 각종 세균에 대한 투석액의 배양검사는 전례에서 음성이었다. 투석액의 혼탁은 항생제 투여 유무와 무관하게 저절로 좋아지는 경과를 보였다. CAPD 시술전의 말초혈액 호산구 증가와 EP의 발생과는 유의한 상관관계가 있었고 (P=0.002), CAPD 시술 전에 혈액투석을 받은 경우에도 혈액투석용 카테터 삽입 후의 말초혈액 호산구 증가와 EP의 발생과는 유의한 상관관계가 있었다 (P=0.016). CAPD 시술 후의 말초혈액 호산구 증가와 EP와는 유의한 상관관계가 없었다. 한편 투석액중 호산구의 정확한 계수를 위하여는 투석액의 cytospin검사가 필요하였다. 결론 : CAPD를 시작한 만성신부전 환아에서 CAPD 카테터 삽입전에 이미 말초혈액 호산구 증가가 있을 경우 초기에 EP의 발생 가능성이 있음을 염두에 두고, 다른 임상증상없이 투석액의 혼탁만 있는 경우 투석액의 cytospin 검사를 시행하여 조기에 EP를 진단함으로써 불필요한 항생제의 투여를 방지할 수 있다.

• 한국콘텐츠학회논문지
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• 제19권7호
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• pp.489-505
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• 2019

본 연구는 한국의 직장인들에게 익숙해지고 있는 '직장 내 괴롭힘'에 대한 근본적인 원인인 상사의 비인격적인 행동에 대한 연구이다. 이를 위해, 선행연구를 통해 상사의 특성 3가지를 개인적 상황(권위주의성향), 조직적 상황(직무불안정성), 개인 및 조직적 상황(자기방어양가성)으로 구분하였다. 그리고 비인격적 감독을 매개로 부하의 조직몰입에 미치는 영향을 분석하였다. 이를위해 국내 대기업에 근무하는 남녀 종사자를 대상으로 팀장과 팀원을 위한 설문지를 각각 구성하여 설문조사를 실시하였다. 주요연구 내용에 대한 결과는 다음과 같다. 첫째, 상사의 비인격적 감독과 관련한 선행요인 3가지(권위주의, 직무불안전성, 자기방어 양가성)가 상사의 비인격적 감독에 모두 정(+)의 영향을 미치는 것으로 나타났다. 둘째, 상사의 비인격적 감독이 조직몰입에 미치는 영향에 관한 가설 2에서, 상사의 비인격적 감독이 부하의 조직몰입에 부(-)의 영향을 미치는 것으로 나타났다. 셋째, 비인격적 감독의 매개효과의 관한 가설 3 검증 결과 선행요인 3가지가 비인격적 감독을 부분매개하여 조직몰입에 부(-)의 영향을 미치는 것으로 나타났다.

• 재활복지
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• 제21권1호
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• pp.47-70
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• 2017

본 연구의 목적은 역학적 요인(우울), 행위적 요인(일상생활 수행능력), 소인요인(자기효능감), 강화요인(가족지지, 전문가 지지), 촉진요인(자원이용가능성, 접근성)이 농촌지역 재가 장애인의 삶의 질에 미치는 영향요인을 파악하기 위한 것이다. 연구의 개념적 기틀은 Green과 Kreuter의 PRECEDE 모형을 기반으로 하였다. ${\bigcirc}$군 보건소에서 실시한 지역사회중심 재활사업 기초조사 결과 자료를 근거로, 기초조사에 참여한 190명중 186명이 최종분석에 포함되었다. 선택된 요인들과 삶의 질 간의 직 간접 경로를 파악하기 위하여 AMOS 19.0을 이용하여 자료를 분석하였다. 모형 검증 결과 농촌지역 재가 장애인의 삶의 질은 85.5%의 설명력을 가지며, 역학적 요인(우울)과 강화요인(가족지지, 전문가지지)에 의해 직접적 영향을 받은 반면, 행위적 요인(일상생활수행능력), 소인요인(자기효능감), 촉진요인(자원이용가능성, 접근성)을 통하여 간접적 영향을 미치는 것으로 나타났다. 본 연구 결과는 농촌지역 재가 장애인의 삶의 질 증진을 위한 재활사업 계획 시 우울을 감소시키거나 가족이나 건강전문가로부터의 지지를 강화해야 할 필요성을 조명하였다. 뿐만 아니라 자기효능감 향상을 위한 전략을 세우고 지역의 보건기관과 전문 의료기관과의 연계를 확대하는 것도 농촌지역 재가 장애인을 위한 지역사회 중심 재활서비스에 유용할 수 있음을 제안하였다.

• 한국임상수의학회지
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• 제16권2호
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• pp.439-442
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• 1999

An animal health monitoring system in Gyeongnam area (near-Chinju) was studied to evaluate the environmental risk factors, physical examinations and 4 disease entities(abomasal displacement, traumatic reticulopericarditis ＆ -peritonitis, milk fever and lameness) in 40(34 in second year)dairy herds (total 1253 dairy cattle). In feeding environments, we examined housing system, forage percentage in ration, stall types, playground, cleanness of stall. In housing system, most of herds (60%) have tie-stall types and 36 herds are open-type housing. The forage ratio of ration was less than 50% in most of herds (67%). 39 herds had their own playgrounds and the frequency of playground cleanness was irregular, Physical examinations included the T(temperature), P (pulse), R (respiration), abnormalities of superficial lymph nodes, claw examination and total CBC with blood from tail veins. T, P, R are within normal limits (T : 38.1$\pm$0.6$^{\circ}C$, P : 84.6$\pm$12.9/min., R : 24.0$\pm$7.6/min. ,respectively), the swelling of lymph nodes were shown in 13 cattle and overall claw trimming was required in 3 herds. In blood examination, 23 cattle showed leuko-cytosis and 7 cattle showed low RBC and hemoglobin level, the other cattle were within normal limits (WBC : 8.90$\pm$2.06 10$^3$/ul., RBC : 6.36$\pm$1.02 10$^{6}$ ul, Hb : 9.83$\pm$ 1.20 g/dl PCV : 27.43$\pm$5.67 %, respectively). In 4 disease entities, we found some metallic foreign bodies in men of 13 cattle, which had predisposing factors of traumatic reticulopericarditis and reticuloperitonitis, 13 abomasal displacement, 51 milk fever and lameness in 39 cattle.

• Asian Pacific Journal of Cancer Prevention
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• 제16권17호
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• pp.7603-7606
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• 2015

Background: The chemotherapeutic agent oxaliplatin can cause acute and chronic forms of peripheral neuropathy. The aim of this study was to evaluate the incidence of chronic neuropathy and its risk factors in colorectal cancer (CRC) patients treated with FOLFOX or XELOX regimens in the Oncology Ward of Hazrate-Rasoul Hospital in Tehran. Materials and Methods: A total of 130 patients with CRC were entered into our study, aged over 18 years, without history of receiving other neurotoxic agents or other predisposing factors such as diabetes or neurologic diseases and kidney and liver dysfunction. For the FOLFOX regimen, patients received oxaliplatin, 85mg/m2, every 2 weeks for 12 courses and with the XELOX regimen, oxaliplatin was $130mg/m^2$, every 3 weeks for 8 courses. Based on Common Toxicity Criteria (CTC or NCI-CTC v.3), the patients were divided into 5 groups (grades) based on the severity of their symptoms. Results: Fifty-seven patients (43.8%) were male and 73(56.2%) female. Some 19 patients (14.7%) had BMI<20, 97(74.6%) were between 20-25 and 14 (10.8%) ${\geq}25$. In 105 patients (80.7%) neuropathy was found. There was significant correlation between BMI, hypomagnesaemia and especially, severity of anemia in patients with neuropathy compared to those without. Conclusions: Oxaliplatin regimens can induce chronic neuropathy in CRC patients, with anemia, high BMI and hypomagnesaemia as risk factors that can predispose to this kind of neurotoxicity.

• Journal of Korean Neurosurgical Society
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• 제56권1호
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• pp.34-41
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• 2014

Objective : The purpose of this study was to describe the clinical characteristics, treatment outcomes, and prognostic factors in patients with brain abscesses treated in a single institute during a recent 10-year period. Methods : Fifty-one patients with brain abscesses who underwent navigation-assisted abscess aspiration with antibiotic treatment were included in this study. Variable parameters were collected from the patients' medical records and radiological data. A comparison was made between patients with favorable [Glasgow Outcome Scale (GOS) ${\geq}4$] and unfavorable (GOS <4) outcomes at discharge. Additionally, we investigated the factors influencing the duration of antibiotic administration. Results : The study included 41 male and 10 female patients with a mean age of 53 years. At admission, 42 patients (82%) showed either clear or mildly disturbed consciousness (GCS ${\geq}13$) and 24 patients (47%) had predisposing factors. The offending microorganisms were identified in 25 patients (49%), and Streptococcus species were the most commonly isolated bacteria (27%). The mean duration of antibiotic administration was 42 days. At discharge, 41 patients had a favorable outcome and 10 had an unfavorable outcome including 8 deaths. The decreased level of consciousness (GCS <13) on admission was likely associated with an unfavorable outcome (p=0.052), and initial hyperglycemia (${\geq}140mg/dL$) was an independent risk factor for prolonged antibiotic therapy (p=0.032). Conclusion : We found that the level of consciousness at admission was associated with treatment outcomes in patients with brain abscesses. Furthermore, initial hyperglycemia was closely related to the long-term use of antibiotic agents.

• 한국치위생학회지
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• 제11권5호
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• pp.603-613
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• 2011

Objectives : This study is to investigate factors that predispose the oral health education patterns of teachers at preschool institutions such as kindergartens and day nurseries, for which a comparison was made among the patterns, whereto the PRECEDE model was applied. Methods : A survey was conducted by two visits, a preliminary survey and a main survey, and teachers at the foregoing institutions personally filled in the questionnaire. Results : 1. With relation to epidemiological and social diagnosis, the largest number of respondents (53.7%) agreed on the need for oral health education, but at the same time, the largest number of respondents (40.3%) was unsatisfactory with oral health education given by them. 2. With relation to behavioral diagnosis, there were many cases where respondents taught their students to brush their teeth after meals and snacks. Oral health education was focused on safety and injuries. There was no significant intergroup difference (p>0.05). 3. Predisposing factors (a subcategory of educational diagnosis) showed the following results: As for the frequency of oral health education, most respondents at both institutions answered preferred once every six month (p>0.05). In the case of oral health checkup, 75.4% of respondents at kindergartens preferred once a year. 72.2% of respondents at day nurseries preferred the same frequency. They showed a statistically significant difference (p<0.05). In enabling factors, it was found that most respondents at both institutions collected information and teaching materials from mass media and public health centers respectively. In enabling factors, insufficient teaching materials, media and knowledge were found to be obstacles to oral health education. Conclusions : Oral healthcare providers' cooperation is required to diversify away from tooth brushing-centered education and to enrich oral health education. In addition, continuous supplements are required to make teachers at preschool institutions acquire expert knowledge and give oral health education with confidence. Moreover, it needs to train them for various education programs as well as to support them with educational media. Lastly, family members' cooperation is required to develop oral health education programs.

• 보건행정학회지
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• 제10권3호
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• pp.1-18
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• 2000

This study was conducted to find medical care utilization pattern and to examine the affecting factors on medical facilities utilization using Andersen's medical care service behavioral model. Three hundreds and five public officials with detected disease through the health examination in 1998 were surveyed using self-administered questionnaire. And 230 data were available and analyzed. The results of this study were summarized as follows: Among variables of predisposing factors, knowledge for disease, confidence about periodic health examination program in health insurance, and the attitude toward medical utilization in the usual showed significant relations with the medical utilization. Other variables were not related with the medical utilization. Variables of enabling factors did not show significant relations with the medical utilization. Recognition of family members for detected disease had significant relations with the medical utilization. Among variables of need factors, absence caused by detected disease was significantly related with the medical utilization. The number of non-occupational diseases detected, but untreated people were 75(32.6%) of total subjects, mainly because detected diseases seemed insignificant to them. With multiple logistic regression analysis, the significant variables having an effect on the medical facilities utilization were 'knowledge for disease', 'attitude toward medical utilization in the usual', 'recognition of family members for detected disease' and 'experience of absence caused by detected disease'. On considerations of above findings, counselling for detected disease and its treatment, health education for individuals and program for family support promotion are needed for health management of public officials with diseases detected in health examination.

• 보건행정학회지
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• 제30권1호
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• pp.72-81
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• 2020

Background: The out-of-pocket maximum is one of the distinctive healthcare systems which sets a ceiling on co-payment in order to reduce the burden of households from the unpredictable medical expenditure. However, this leads to an increase in the demand for healthcare services especially in long-term care hospitals (LTCHs) in Korea. Methods: This study analyzed the influence factor of medical service overuse of 165,592 inpatients in LTCHs which out-of-pocket maximum is applied, by utilizing data from the National Health Insurance Service (2016). Based on Anderson Model, the medical service overuse, as a dependent variable, was defined as long-stay admission more than 180 days at the LTCHs. Independent variable was comprised of predisposing factors (gender, age), enabling factors (income level, types of out-of-pocket maximum) and need factors (illness level, patient use of tertiary hospital). Results: The most powerful factor of medical service overuse in LTCHs was availability of pre-payment for the out-of-maximum (odds ratio [OR], 191.66; p<0.001). This tendency was found in high income level status (p<0.001). Furthermore, mild inpatients (OR, 1.50; p<0.001) which had no experience with the tertiary hospitals (OR, 2.06; p<0.001) were more relevant to the medical service overuse in LTCHs, compared to the severe inpatients. Conclusion: It is suggested that a separate standard of out-of pocket maximum with regards to LTCHs is required to secure the beneficial functions of long-term hospitals and prevent unnecessary financial leakage to achieve sustainable and financially sound National Health Insurance.