• 정신신체의학
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• 제10권1호
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• pp.27-36
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• 2002

연구목적: 뇌졸중은 개인의 삶의 질에 부정적인 영향을 미치는 만성 질환이다. 그러나 뇌졸중에 대한 대부분의 연구 및 치료, 그리고 재활은 주로 신체적 측면에 집중되었고, 정선과적 측면과 삶의 질에 대한 고려는 많은 부분이 무시되어 왔다. 따라서 본 연구에서는 신체적 영역, 심리적 영역, 사회적 관계 영역, 그리고 환경 영역을 평가하는 WHO 삶의 질 척도를 사용해 뇌졸중 환자들의 삶의 질을 정상인과 비교하고 뇌졸중 환자의 여러 임상 양상과 삶의 질과의 관련성을 알아보고자 한다. 방법: 98명의 급성기 뇌졸중 환자들과 24명의 정상인을 대상으로 세계보건기구 삶의 질 간편형 척도를 사용하여 각 영역과 총점의 평균을 비교하였다. 그리고 뇌졸중 환자군에서 나이, 성별, 교육수준, 우울 및 불안 증상의 정도, 신체적 장애의 정도 등과 삶의 질과의 상관성을 분석하였다. 또한 이들 요인이 삶의 질에 미치는 영향을 다중회귀분석으로 평가하였다. 결과: 뇌졸중 환자군에서 정상군에 비해 전체 삶의 질 및 각 하위 영역 모두 낮은 삶의 질 수준을 보였다 우울 및 불안 증상, 사회적 지지체계의 정도는 전체 삶의 질 및 대부분의 하위 영역과 유의한 상관성을 보였다. 또한 뇌졸중 환자들 중 남자의 경우 여자에 비해 높은 삶의 칠 수준을 보였다. 그러나 Barthel's index로 평가한 신체적 장애의 정도는 삶의 질 수준과 유의한 상관성이 없었다. 다중회귀분석 결과 우울 및 불안 증상의 정도, 사회적 지지체계의 정도, 그리고 성별이 뇌졸중 환자의 삶의 질에 영향을 미치는 요인으로 추출 되었다. 결론: 뇌졸중 환자의 삶의 질은 정상군에 비해 저하되어 있었다. 또한 우울 및 불안 증상의 정도, 사회적 지지 체계의 정도, 그리고 성별이 뇌졸중 환자의 삶의 질에 영향을 미치는 요인이었다.

• 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.

• 성인간호학회지
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• 제26권4호
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• pp.466-478
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• 2014

Purpose: The purpose of the study was to explore and describe the experience of breast cancer self-help group activities in Korea. Methods: The data were collected via individual in-depth interviews with 8 women with breast cancer, who participated in self-help groups during 2012~2013. All interviews were audio-taped and transcribed, and they were analyzed using a phenomenological method. Results: Six theme clusters were identified. "Breakthrough toward survival" describes how the participants identified self-help groups and got involved in the activities. "Genuine comfort obtained by 'misery loves company' deals with the emotional relief and catharsis. "New life fully recharged" demonstrates the changed belief system and the joy for life and living. "Rebirth in family" deals with how family dynamics has been changed. "Societal change by raising collective consciousness" illustrates many activities to improve their rights and advocate employment issues. "Obstacles to the group harmony" illustrates the major difficulties including interpersonal conflicts the participants encountered during their participation. Conclusion: The results of the study showed that participating in self-help groups was mostly beneficial for women with breast cancer. Therefore, oncology professionals need to encourage them to participate in self-help groups and also need to provide professional support to self-help groups for their harmonious interpersonal relationships.

• 대한간호학회지
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• 제46권4호
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• pp.523-533
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• 2016

Purpose: This study was done to examine physical, psycho-social, and individual factors influencing musculoskeletal symptoms among Korean military trainees. Methods: Using a correlation study design, military trainees who had completed almost of all the basic combat training (BCT) days were recruited from two military training units selected by convenience sampling. Data from 415 participants were analyzed. Results: Prevalence of musculoskeletal symptoms was 29.6% defined as a participant having pain or discomfort in one or more body parts during training hours for more than seven consecutive days. Back/pelvic (10.8%), knees (10.1%), shoulders (7.7%), feet/toes (5.6%), ankles (4.8%) were prone to musculoskeletal symptoms. Musculoskeletal symptoms appeared to be related to physical exertion during BCT, stress during BCT, social support from fellow trainees, or previous musculoskeletal injuries. In the logistic regression model, physical exertion during BCT (OR=2.27, 95% CI: 1.42~3.65), stress during BCT (OR=1.79, 95% CI: 1.15~2.78), and previous musculoskeletal injuries (OR=1.58, 95% CI: 1.01~2.47) were the significant factors affecting prevalence of musculoskeletal symptoms. Conclusion: Findings indicate that physical exertion and psycho-social stress should be managed to prevent musculoskeletal symptoms in military trainees with more attention being given to trainees having a history of musculoskeletal injuries.

• 한국학교보건학회지
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• 제12권1호
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• pp.85-95
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• 1999

The objectives of this study are to explain the performance patterns of health education and related factors in elementary middle, and high schools in Korea. The survey data were collected by questionnaires from June to September in 1998. the number of subjects were 294 school nurses. The SAS-pc program was used for statistical analyses such as percent distribution, a $x^2-test$, a Spearman correlation est., and logistic regression analysis. The major results were as follows: 1. The performance rates of health education by elementary, middle and high schools was higher than before. But the education time was not as sufficient as desired. 2. Planning and practice for health education in elementary and middle schools were high. The preparation of the instruction for health education in elementary school was especially strong. 3. The need survey for health education was low '-' 32~46%. The performance rates of health education increased yearly in elementary school. 4. The reference data were insufficient for health education; In other words, it was difficult for a systematic education. 5. Usually lecture and other methods were used. 10-15% used only the lecture method. 6. The content of heath education was life style in the lower levels of elementary school, Drinking, smoking, drug use etc. were concentrated on in middle and high school. 7. The education evaluation and application was activated in elementary school, otherwise, was low in high school. 8. School nurses and school performance in health education were influenced significatly by planning of health education and the instruction of heath education in elementary school. In the case of planning, the budget was a significant variable; in the case of instruction, the number of school classs was significant. In conclusion, these findings suggest that a developed health education curriculum be performed gearly in order to create a systematic school health education. Also, it is necessary to activate an evaluation to system measure behavioral changes. It is expected that the improvement of school health education be accomplished through the systematic support of schools by government in the physical, economi, and psychological areas.

• 대한가정학회지
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• 제27권3호
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• pp.13-28
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• 1989

With the purpose of identifying clothing for persons with special needs one of new directions in Clothing and Textiles, this pater comparatively analyzed current curriculum and research trends related to this field between Korea and America. Questionaire was distributed to 25 Korean colleges with Clothing and Textiles department and 4 American colleges known for special clothing study. Questions regarded the name of course, level (grade), number of credit houre, prerequisits and supporting courses, subjects of lecture and projects, way of managing lecture and projects, evaluation system, other special characteristics. Resources for analyzing research trends are Thesis and Dissertations in Clothing and Textiles, Research Journal of Clothing & Textiles/Home Economics Association, College Professors' research reports collection, of both Korea and America. Years of publications are 1972∼1986 (America), 1978∼1988 (Korea). Findings are as follows; 1. Clothing for special needs can be classified into various groups; Clothing for physically handicapped, mentally retarded, elderly, unusual-sized, pregnant/nursing mothers, institutionalized, protective clothing, uniform/career apparel. 2. Management of coursework related to special clothing has several common characteristics specially in America; Building-up coursework, problem-solving orientation, cooperative team-preject, interdisciplinary approach, client-versus-designer preference, community involvement. In Korea, a few school only has special clothing coursework and its scope of study was very limited. 3. Majority of research reports done with the subjects of special clothing had made for physically handicapped people and the elderly. Protective clothing and uniform have recently been paid much interests. 4. Researchers had mainly concerned on Design and Construction Aspects and nextly on social-psychological aspects. However, in America, selection and care aspects and marketing aspects of special clothing have been very procuctive issues recently. 5. Study on clothing for special needs has several opportunities to be stressed and improvements to be strengthened. Opportunities included active participation to the welfare of community society, strong publicity of accurate professional image, share with business and industry, interdisciplinary approach and new job market. Improvements were discussed in terms of strengthening supporting courses/prerequistes, intensifying interdisciplinary cooperation, provoking strong community involvement and securing financial support and research funds.

• 산업경영시스템학회지
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• 제41권3호
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• pp.108-114
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• 2018

One of the most performed action in daily life is standing up from sitting position. As the population of the world is aging at the high rates, people may face problems with reduced muscle strength as well as psychological changes. This can lead elderly people having difficulties with standing up from chair. Now, with the aging trend worldwide, products are being developed that can support the lives of the elderly. This study examines the distribution of hip pressure in relation to the seating positions of the standing assistance seats under development to prevent standing up accidents in older adults. The currently developing standing assistant chair designed to tilt to a maximum angle of 25 degrees. At over $25^{\circ}$, design considers that older people are at risk of thrown back out of that force and that the forces exerted on their arms and legs can be a significant burden to older people. By considering danger of higher than $25^{\circ}$ for older people which is experimented in the basis of static capturing approach in previous papers, it is experimented people with age group of 20~60 on $0^{\circ}$ to $25^{\circ}$ tilting angle on the basis of dynamic capturing method in order to pick convenient angle of inclination. Moreover, tried to find the optimum angle by comparing the hip pressure distribution when seated at the edge of the seat and at the center of the seat with the pressure distribution sensor.

• 한국조리학회지
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• 제20권3호
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• pp.186-200
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• 2014

외식기업 종사자를 대상으로 멘토링 역할이 감정표현 및 자아존중감에 미치는 영향 관계을 알아보기 위하여 설문지를 이용하여 조사하였다. 수집한 통계처리 및 분석방법은 SPSS 18.0와 AMOS을 이용하여 빈도분석, 탐색적, 확인적 요인분석, 상관관계분석, 구조방정식 모형을 실시한 결과 첫째, 멘토와 멘티 간의 공감대와 협조관계가 형성되어 개인적인 조언, 상담, 지원 등 심리적인 스트레스의 해소 방안으로 멘토링 역할이 조직의 목표에 중요한 것으로 나타났다. 둘째, 멘토링 역할은 조직성과 및 팀웍을 형성하는데 심리적 영향력이 멘토의 역할에 따라 조직적응 능력에 긍정적인 것으로 나타났다. 셋째, 팀내에서 조직의 갈등은 구성원의 의사소통이나 상호작용 속에서 감정표현은 자아존중감에 영향이 있는 것으로 나타났다. 외식 업무 특성상 인적자원 의존도가 높은 산업으로서 조직에서 발생할 수 있는 심리적인 스트레스로 인한 직원들 간의 갈등 관계를 해소할 수 있는 멘토와 멘티 간의 긴밀한 공감대와 협조 관계가 형성되어 조직의 목표를 달성하고 높은 수준의 서비스를 제공할 수 있는 것을 알 수 있다.

• Safety and Health at Work
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• 제10권3호
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• pp.362-369
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• 2019

Background: Chronic nonspecific symptoms attributed to indoor nonindustrial work environments are common and may cause disability, but the medical nature of this disability is unclear. The aim was to medically characterize the disability manifested by chronic, recurrent symptoms and restrictions to work participation attributed to low-level indoor pollutants at workplace and whether the condition shares features with idiopathic environmental intolerance. Methods: We investigated 12 patients with indoor aire-related work disability. The examinations included somatic, psychological, and psychiatric evaluations as well as investigations of the autonomic nervous system, cortisol measurements, lung function, and allergy tests. We evaluated well-being, health, disability, insomnia, pain, anxiety, depression, and burnout via questionnaires. Results: The mean symptom history was 10.5 years; for disabling symptoms, 2.7 years. Eleven patients reported reactions triggered mainly by indoor molds, one by fragrances only. Ten reported sensitivity to odorous chemicals, and three, electric devices. Nearly all had co-occurrent somatic and psychiatric diagnoses and signs of pain, insomnia, burnout, and/or elevated sympathetic responses. Avoiding certain environments had led to restrictions in several life areas. On self-assessment scales, disability showed higher severity and anxiety showed lower severity than in physician assessments. Conclusion: No medical cause was found to explain the disability. Findings support that the condition is a form of idiopathic environmental intolerance and belongs to functional somatic syndromes. Instead of endless avoidance, rehabilitation approaches of functional somatic syndromes are applicable.

• Journal of Hospice and Palliative Care
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• 제24권2호
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• pp.130-134
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• 2021

In the era of coronavirus disease 2019 (COVID-19), social distancing and strict visitation policies at hospitals have made it difficult for medical staff to provide high-quality end-of-life (EOL) care to dying patients and their families. There are various issues related to EOL care, including psychological problems of patients and their families, difficulties in EOL decision-making, the complicated grief of the bereaved family, moral distress, and exhaustion of medical staff. In relation to these issues, we aimed to discuss practical considerations in providing high-quality EOL care in the COVID-19 pandemic. First, medical staff should discuss advance care planning as early as possible and use the parallel planning strategy. Second, medical staff should play a role in facilitating patient-family communication. Third, medical staff should actively and proactively evaluate and alleviate dying patients' symptoms using non-verbal communication. Lastly, medical staff should provide care for family members of the dying patient, who may be particularly vulnerable to post-bereavement problems in the COVID-19 era. Establishing a system of screening high-risk individuals for complicated grief and connecting them to bereavement support services might be considered. Despite the challenging and limited environment, providing EOL care is essential for patients to die with dignity in peace and for the remaining family to return to life after the loved one's death. Efforts considering the practical issues faced by all medical staff and healthcare institutions caring for dying patients should be made.