• Journal of Preventive Medicine and Public Health
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• 제34권2호
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• pp.141-148
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• 2001

Objective : To investigate the sources, extent and related factors in South Korean doctors. Methods : The study subjects were 934 doctors in Taegu, Kyungpook Province, Korea(540 independent practitioners, 105 employed at hospitals and 289 residents in training). Information concerning job stress was obtained using a 9-item questionnaire. Information regarding related factors such as demographic characteristics(age, sex, marital status), perceptions on the socioeconomic status of doctors and working conditions(work time, on-call days per week) was also obtained by self-administered questionnaire during April and May, 2000. Results : Major sources of job stress included clnical responsibility/judgement factor, patient factor and work loading factor. The job stress score of residents was the highest among three groups. The score was lower in older doctors. The score was low among those who thought doctors' socioeconomic status was not good. The longer the work time, the higher the job stress score was. Multiple regression analysis was conducted to control for the mutual influence of independent variables. In regression analysis, the score of residents was higher than practitioners. Work time and socioeconomic status perception had negative effects on job stress score. Conclusion : The average job stress score of the doctors was high. Age, work type, working conditions and perceptions of socioeconomic status were found to besignificantly related to job stress score. Although the job stress of doctors is somewhat inevitable due to the nature of the doctor's job, control of work time, development of coping tools and other intervention methods are needed to reduce job stress of doctors. Further studies are required to understand the characteristics of iob stress and reduce the job stress of doctors.

• 의학교육논단
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• 제16권2호
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• pp.92-98
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• 2014

Medical education departments or offices are established in response to public expectations relating to health care, societal trends towards increased accountability, educational developments, increased interest in what to teach and how to educate doctors. However, heavy workloads and mixed feelings towards medical education departments or offices by the other members of a medical school can threaten job satisfaction and increase burnout. The authors investigated the prevalence of burnout among medical education specialists and related issues. Individual in-depth interviews with four medical education specialists were conducted to develop a questionnaire. After content analysis of the interview, the authors generated a survey form with 28 items including 6 categories: motivation to choose medical education as a career, job satisfaction, intention to leave their current position in medical education, the frequency and causes of burnout, and demographics. In September 2013, an email survey was administered to 43 faculty including non-tenure staff who were working in the department/office of medical education in 41 medical colleges in Korea. Of 43 medical education specialists, 25 (60%) returned surveys. Forty three-point-three percent of them felt encouraged when their endeavors generated a visible educational improvement in the medical school. A majority (87%) reported feeling burned out. Fifty percent of them experienced the feeling once or twice a year. The extent of burnout tended to be greater in women, those in their forties, those with non-medical doctor degrees, and in non-tenured staff. To reduce and prevent burnout among medical education specialists, the participants suggested that leadership of medical schools and a systematic approach to medical education should be established. A majority of the medical education specialists reported experiencing burnout, although they were satisfied with their jobs. To reduce their burnout and allow them to focus on their own work in medical education, the following factors are needed: perceptual changes of other members of the college about medical education; more systematic institutional strategies; networking among medical education specialists; and personal efforts for professional development.

• Journal of Preventive Medicine and Public Health
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• 제33권2호
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• pp.184-192
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• 2000

Objectives : To inquire the prevalence and the risk factors for myofascial pain syndrome (MPS) on young boys in order to use these results as the fundamental data for the prevention of their MPS. Methods : For 7 days in May 1999, this research was taken on 489 male students ranging from 6th to 12th grade. We randomly selected a class for every group and from these classes we operated physical examinations, self-reported questionnaires and from a rehabilitation doctor, MPS test was taken. Thoracic kyphosis and lumbar lordosis were also taken by using the inclinometer. We defined MPS as a regional pain complaint, palpable taut band that is painful on compression. Results : The shoulder MPS prevalence of the subjects were 29.7 persons/100 persons. The statistics revealed that as grades went up, the percentage significantly increased in the MPS prevalence. As of case-control study, 145 students who were tested postive in all aspects were placed as cases, and 176 students who were perfectly normal as controls on risk factors. As a result of comparing the student groups who were stisfied with their chairs to the student groups were not satisfied, the taller showed a significantly higher odds ratio (p<0.01). By the multiple logistic regression test, we concluded that the MPS disease was prevailed far more in the students in the higher grades (Odds ratio: 1.16, 95% C.I.: 1.03-1.31), and also those who were dissatisfied with their chairs than in the ones who were satisfied (Odds ratio: 1.92, 95% C.I.: 1.17-3.17). Conclusions : Significant correlations showed between the MPS diagnosed group and the students who are dissatisfied with their chairs. As a result, more research and observation has to be made concerning this disease, and the desks and chairs should be adjusted to suit the student's physical standards.

• 전자공학회논문지SC
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• 제49권1호
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• pp.39-46
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• 2012

IT 및 통신 기술의 발달로 의료시스템 분양에 적용하여 원격진료 서비스를 제공하게 되었다. 원격진료 서비스는 인력 및 장비가 부족한 보건소, 학교, 도서지역 등에서 원격진료 서비스를 이용하여 2, 3차 의료기관의 의료진과 원격 자문과 진단 서비스를 통하여 양질의 서비스를 받을 수 있다. 원격진료를 이용하는 환자와 의료진은 다양한 통신망을 사용하여 원격진료 서비스를 이용 할 수 있지만, 통신망에 따라 대역폭의 차이와 공인 IP, 사설 IP의 특성으로 인하여 원격진료 서비스를 원활히 이용하는데 어려움이 있다. 따라서 본 논문에서는 다양한 네트워크 환경에서도 원격진료 서비스를 원활하게 이용 할 수 있고, 의료진과 환자 사이의 연결 리스트를 관리하여 효율적으로 원격진료 서비스를 제공할 수 있도록 다중접속 제어서버를 구현하였다. 다중접속 제어서버는 환자와 의료진의 리스트관리, 네트워크 타입, 사용자 장치타입을 이용하여 최적의 정책을 결정하여('Flowing'과 'Bypassing') 서비스하고, 사용자(의료진과 환자)의 연결 정보를 모니터링 할 수 있는 시스템을 구현하였다.

• Journal of Preventive Medicine and Public Health
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• 제35권4호
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• pp.351-358
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• 2002

Objective : To evaluate the relationship between physical activity and the risk of hip fracture in the elderly Korean people. Methods : The study population was a Physical Activity Subcohort (n=8,908) extracted from the Korean Elderly Pharmacoepidemiological Cohort (KEPEC). Physical activity information was obtained from a mailed questionnaire surveys. The outcome data was collected from claims data gathered between Jan. 1993 and Dec. 1998. A hospital survey relating to potential cases was conducted to confirm the final diagnoses. The abstracted data was reviewed by a medical doctor before the final diagnoses were confirmed. A mailing questionnaire survey was performed to obtain information on potentially confounding variables, including alcohol intake, smoking habits, weight, height and postmenopausal duration. There were 79 confirmed cases hospitalized due to hip fractures between Jan. 1993 and Dec. 1998. Relative risk of physical activity scores on the hip fracture, and their 95% confidence intervals, were estimated by a Cox's proportional hazard model using SAS for Windows ver.6.12. Results : Compared to the reference group, the adjusted relative risk of hip fracture associated with the most physical active category: after controlling for age, weight and alcohol intake in the males, and for weight, alcohol intake and postmenopausal duration in the females, were 1.04 (95% CI=0.35-3.06) and 0.f4 (95% CI=0.26-0.77), respectively. Conclusions : Physical activity may protect elderly women from hip fracture.

• 대한한의학회지
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• 제44권3호
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• pp.59-73
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• 2023

Objectives: The role of physician-scientists who bridge the gap between basic science and clinical medicine is crucial in advancing medical innovation. This study aims to examine the educational and research environment and career satisfaction of graduate students in Korean Medicine among those who are Korean medicine doctor (KMD). Methods: This study analyzed the results of a survey consisting of respondents' composition, job status, graduate education and job satisfaction, economic conditions, career determinants, and obstacles to the career path of KMD-scientists from 65 participants including both full-time and part-time graduate students. Results: The results revealed significant differences between full-time and part-time graduate students in terms of weekly hours spent and job priorities, motivation for entering graduate school, career preferences, and desired career paths. The study highlights the need for tailored support for full-time and part-time graduate students and the importance of economic assistance in fostering KM scientists. Economic difficulties were identified as a major obstacle for full-time graduate students pursuing research careers. Tuition fees were found to be a significant burden for all graduate students. Furthermore, it emphasizes the importance of enhancing the research capabilities of part-time graduate students and improving the quality of education to foster KMD-scientists. Conclusion: This research provides essential insights for Korean Medicine colleges and graduate schools to develop targeted improvement plans and effectively train KMD-scientist.

• 한국학교보건학회지
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• 제9권1호
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• pp.55-67
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• 1996

This research has incorporated a postal survey from the principals, nurse-charging teachers and nurse-teachers of the fiftyfive elementary, middle and high school in Yang-pyeong county area where its supplementary rate of nurse-teachers is less than adequate. It is to analyse the current status of the school health service in the area and to come out with a plan to improve the school health program through the participations of the health related experts of the local community. The survey was done in the two months of period of April to May of 1994. The result of the survey follows. The student population in the Yang-pyeong county area is 13,998 and the school employee population is 904 which counts for about 19.2% of the whole population of the area. However, the supplementary rate of nurse-teachers is only 10.8% (4 in 55 schools) which is very low in terms of relativity. School health committee only exist in 17% of the whole number of schools in the area and 50 of school health committee answered that their activity do not meet the adequate level. Only 54. 3% of the whole school numbers has included the school health finance in their financial plans and the amount set for the school health finance is about 500,000 wons (100,000-1,600,000 wons). 64.9% of the schools in the Yang-pyeong county area have the permanent nursing room established in the school. But, often than the equipment for a simple physical examinations, their supply of the health related equipments are less than adequate. Particitations of school doctor in the school health service is at only 67.6% which pretty much include only the physical examinations. Nurse-charging teachers consider their utmost important role is to teach health education but, they answered that they spent most of their times and efforts on physical examinations & immunizations. The average number of students visition to the nursing room is 2.5 persons and complains for basic discomfort as headache, concussion, stomachache and indigestion problems and usual pills used are the analgesics and digestives. Physical examination is done in the most schools every year but, 51.4% of nurse-charging teachers answered the physical examination does not really help. About the emergency treatment ability, 75.7% reports that both manpower & equipment are short. The school food services are present in only 8 schools (21.6%) but, 89.2% of nurse-charging teachers answer that there is a definite need of the food service. The survey says that the utmost important environmental health and safety factors are the traffic accidents followed by improper heat system, lighting, the stools and desks that do not consider the student physical status The overall evaluation of school health program reports that there are adequate physical examination, immunization, environmental hygiene, and management of safety but, on the other hand, health education, health councelling & management of nursing room are not managed properly. The principals of the survey pool report shortage of public agency support, lack of understanding of school health, shortage of nursing equipments and school health finance as the barrier factors of school health. The nurse-charging teachers report on the same questions as their less than qualitifying expertise, extraload of work upon the nursing affairs, shortage of nursing equipments & school health finance. The head masters & nurse-charging teachers answered that they are desperate for the meetings of nurse-charging teachers, construction of school health councelling system & training education in order to improve school health and if these are available, they will actively participate in them. After the careful analysis of the survey result, it is apparent that through the relations of the manpowers, establishment of community-oriented school health is definitely in need in rural area where there is low supplementary rate of nurse-teachers and poor school health environment.

• Journal of Preventive Medicine and Public Health
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• 제20권2호
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• pp.312-321
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• 1987

뇌성마비아의 조기 발견에 관련된 모자인자를 조사하기 위하여 1987년 2월부터 1987년 4월까지 대구 장애자 복지관, 대구대학교 부설재활원, 성바오로 어린이집, 그리고 부산 뇌성마비아복지회에 통원 또는 입원치료를 받고 있는 어린이 110명중 1980년 1월 1일 이후 출생자 74명 전원의 어머니를 대상으로 면담조사 하였다. 아버지의 학력과 이상 발견시기와는 아무런 상관관계가 없었으나 어머니의 학력이 대학졸업이상 일때가 고졸이하에 비해 어린이의 이상을 일찍 발견했고, 또 아버지의 직업이 전문직 또는 관리직일 때가 그 이외의 직업에 비해, 그리고 아버지의 월수입이 610,000원이상 일때가 600,000원 이하보다 더 일찍 발견하는 경향이었다. 첫째아이가 둘째아이 보다 그리고 부모의 나이가 34세 이하인 경우가 35세 이상인 경우에 비해 좀더 일찍 이상을 발견하는 경향을 보였다. 남아에서 여아에 비해 더 일찍 이상이 발견되었고 육아상담을 정기적으로 받은 어린이에서 정기적으로 받지 않은 어린이보다 더 일찍 이상이 발견되었는데 5% 유의수준에는 약간 못미쳤다. 연구대상아를 임신했을 때 산전관리를 7회이상 받았던 경우가 6회이하 받았던 경우에 비해 통계적으로 유의하게 일찍 어린이의 이상이 발견되었다. 처음으로 이상을 발견한 사람은 부모가 85.1%, 육아 상담을 정기적으로 받은 여부와는 관계없이 의사가 발견한 것은 2.7%였고 부모가 어린이의 이상을 발견하고 의사의 진단을 받았을때 36.5%에서 뇌성마비 진단을 받았고 나머지는관찰, 정상등으로 진단이 확실하지 않았다. 부모가 어린이의 이상을 발견하고 $2{\sim}3$개월 뒤에 의사의 진단을 받았고 진단후 전문적 치료를 시작할 때까지 방치했거나 물리치료, 한약, 침술 등을 받았다. 뇌성마비아의 조기 발견을 위해 의학교육과 임상수련과정에서 어린이의 발달을 평가하는 방법의 교육과 수련이 강화되어야 할 것이며 진단을 위한 전문인력의 양성이 필요한 것으로 생각된다. 또 부모들의 뇌성마비를 비롯한 각종 장애의 진단과 치료에 대한 인식을 높이기 위한 계몽교육이 필요하다.

• 한국보건간호학회지
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• 제3권2호
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• pp.5-46
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• 1989

The current medical payment Insurance Rates in Korea stipulate charges for medical treatment by the doctor, pharmaceutist, medical technician and maternity nurse. But unfortunately didn't specify those charges for nursing done by the professional nurse. Only basic nursing fee is accounted insufficiently in current medical insurance fee schedule. therefore, Being face with covering entire people by medical insurance by 1991, It seems that the problems pertaining to operating the hospital and medical insurance system would be incessantly expanded in that no mention is made of medical charges rendered by major medical producer service in the current system, For that reason, this study made an attempt to clarify the importance the professional nursing puts of the current medical payment. The purpose of this study was to accounting nursing fee which diveded into the current medical fee schedule. (Method) 1. Data collection; Importance and difficulties in nursing activities was conducted in 'S' National University Hospital. Total nursing activities were selected 72 items which included direct care and indirect care. This study was conducted to evaluating the degree of importance and difficulties according to nursing activities through questionnaire to 204 RN. and so relative difficulties (acuity) were computered because the nursing cost level of each nursing service was differently established by the equivalent coefficient according to degree of relative difficulty and time required. 2. Calculation of cost according to nursing activities; After 47 nursing activities were selected in General surgery nursing units, calculation of nursing cost was as follows Cost of Nursing activity = (relative difficulty X Average hourly wage and benefits of nurse) + material cost of nursing -t- Average nursing administration cost So, Calculated cost by nursing activities was compared to current non-insured and insurance rate. 3. Calculation of nursing cost by K - DRG ; Total of 578 patients who were hospitalized in General Surgery units from January to March 1988 ware classified by K - DRG After estimation of total nursing cost based on the K-DRG, verified the appropriateness of basic nursing fee in medical insurance rate (Results) 1. Analysis of degree of importance and difficulties were 4.16 and 3.67 based on 5 point scale. This score were judged that it is worthy specifying the nursing fee 2. The nursing cost of 47 nursing service items in general surgery patients showed that the average cost of nursing activity was \1374.5 and The lowest cost was \217 of 'oral administration nursing' item, The highest cost was \11,025 of 'saline enematill clear' item 3. The result of comparison between the calculated cost by nursing activities against the current non-insured and insurance rate showed that 13 items(27.7%) involved to payment of insurance rate, 9 items(19.1%) involved to non-insured rate, remainder 25 items (53.2%) were not charged anywhere of total 47 nursing activities 4. When calculated cost by nursing activities was 100. current insurance rate was 62.3, non-insured rate was 176.6. Therefore this showed that most of non-insured rate were higher than calculated nursing cost. The insurance rate, however, were lower than it. Reim-bursement was imputed to non-insured patients. So the current rate system became estrainged from cost system. When Remainder 25 items of nursing activities compared' to \1390 of daily basic nursing fee per patient belonged to payment as a insurance fee schedule, basic nursing fee schedule was 1-2% of calculated cost of nursing activities. Therefore it showed that nursing fee was not counted adequately in it. 5. Nursing cost by K-DRG estimated in chart review based on counting number of nursing activities and length of stay The result showed that average amount of total nursing cost was \183828.1 Comparison of nursing cost calculated by K- DRG and basic nursing fee schedule showed that only 12.3% of nursing cost was charged (Conclusion) From the above research result, It is fact that nursing prime cost should be estimated more accurately and included adequately in current medical payment system. The payment system of nursing activities should be introduced not only nursing activities of drug administration and injection fee belonged to insurance fee schedule but also most nursing activities belonged not to mekical fee schedule. Even if introducing payment system of nursing activities, It should be estimated scientific method of Accounting nursing cost So nurses could offer nursing care of good quality, thereby they could make a great contribution not merely to the convalescence of the patient but to the promotion of the people's health.

• 가정간호학회지
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• 제5권
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• pp.20-31
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• 1998

The purpose of this study was to develop the framework of community-based home care nursing delivery system, and to examine the validity of it. For these, home care nursing study team of College of Nursing, Seoul National University has studied home care nursing system since September, 1996, and has operated home care center since August, 1997. This study has been supported by the Korean Sience Foundation. We organized Committee of rules, and Clinical specialist consultant group for more efficient running of the home care center. In nursing station, research assistant controlled general work, and 5 home care nurses were hired for home visiting. We developed the Standards for operations, that included criteria for clients, central supply system of nursing materials, central management of nursing care cost, advertisement, patient referral system, and so forth. In our center, 108 patients enrolled, and neurologic disorders including cerebrovascular accident, and cancer were the most prevailing diseases. We tried to overcome the limitations of hopital -based home care, and to provide more accessible, efficient, safe, and stable home care nursing. Therefore, we were referred clients from patients and families, public health care center, industries, as well as from hospitals. Meanwhile, we developed home care recording system and assessment-intervention algorithm for various diseases for quality control and standardization. Also, we did continuing education, and tried to detect problems and to find solutions by regular meeting between the committee of rules and home care nurses. As the results of this study, several limitations of operation were found. First, it was difficult to manage and communicate with the doctor in the emergency situation, Second, we spent too much time for trasnsportation, because only five nurses covered all areas of Seoul and nearby cities. Third, preparation for special care of home care nurses were lacked. Forth, criteria for termination of care and frequency of home visit were ambiguous. Fifth, some difficulties were found in retrospective payment system. And finally, interconnection with home care machinery company were needed. Strategies for solving these problems were suggested.