• 한국병원경영학회지
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• 제14권1호
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• pp.123-144
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• 2009

Recently, a long strike by hospital labor union emerged as a serious social issue. During the Worldcup Games in June, 2002, labor strikes broke up at 'C', 'K' and other hospitals, and in 2007, 'Y' hospital suffered much from a strike. Such series of extreme labor disputes have awakened people of importance of a more stable labor-management relationship for the medical institutions responsible for people's health than any other business organization. The purpose of this study was to examine the labor-management disputes at 'Y' hospital in 2007 and 'C' and 'K' hospitals in 2002. The results of this study can be summarized as follows; First, requests of the labor union such as pay raise, reemployment of the irregular workers as regular employees and participation of the labor union in personnel affairs are the long-held or core issues suffered by the medical institutions. Such issues are not independent from each other but complicated with each other surrounding the pay raise. Accordingly, it is not easy to determine the genuine bone of issue for labor-management disputes. Second, the model type of disputes between labor and management at medical institutions may be strike. However, it is conceived that the type of disputes would be subject to change as the essential medical service area system began to be operated since 2008. Third, the common characteristic of the labor strike among the 3 sample hospitals was occupation of the hospital lobby for a sit-in strike to maximize the negative effects of strike. Article 42 (Prohibition of Violence) of Labor Union and Labor Relation Coordination Act prohibits occupation of production or other important business facilities. In addition, since Ministry of Labor interprets that the hospital lobby belongs to the important business facilities enumerated by Article 42 of the above act, occupation of the hospital lobby for a sit-in strike may be too controversial to be admitted as a fair act of labor dispute when its legitimacy should be judged. Fourth, the counter-measures taken by the hospitals against the strike were observance of the principle 'no labor no pay,' closure, legal action, accusation, claim for recovery of damage, provisional seizure, disciplinary punishment, etc., but the principle of 'no labor, no pay' was not applied in a fair manner by 'C' and 'K' hospitals. However, 'Y' hospital applied this principle thoroughly to the strike; the hospital conduced to correction of the wrong labor-management relationship by refusing inclusion in the labor collective agreement of a provision about payment of wage during the period of strike or labor union's request to that effect during a strike. In addition, 'Y' hospital took an effective measure to end the strike earlier by notifying the labor union of cancellation of the collective agreement and banning the unionists from entering the hospital.

• Perspectives in Nursing Science
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• 제13권2호
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• pp.88-95
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• 2016

Purpose: Gestational weight gain and prepregnancy body weight are important factors of childbirth outcomes, which further cause obesity, metabolic diseases, or psychological problems later in women's lives. Changes in diet, westernized lifestyle, traditional postpartum care, and childbirth at older age are thought to be threats to proper weight management in Korean women of reproductive age. Public health and antenatal care need to focus on the proper body weight management of women by carefully planning pregnancy to postpartum periods. Purpose: This study explored the body weight changes from pregnancy to postpartum and the related characteristics in women within 12 months after childbirth. Methods: A cross-sectional, retrospective study was conducted with 102 Korean women within 12 months after childbirth. Data were collected using an online survey system, and a structured questionnaire available for electronic self-administration was modified to include demographics, obstetrical history, and body weight at 6 time points. The International Physical Activity Questionnaire and Eating Habit Measurement instruments were also used in data collection. A professional survey agency recruited the participants, and data were automatically saved and then analyzed. Results: The average age of the participants was 33.8 years, 48% were housewives and were well-educated. Seventy-two percent of the participants were primiparas and 82% had breastfed their babies. The body mass index (BMI) ranged from 17.3 to 27.8, indicating that 21.5% of the participants were overweight or obese. The mean gestational weight gain was 11.8 kg, and weight loss was apparent during the first 3 months postpartum. The mean decline in weight was 3.4 kg at one year after childbirth. Women wanted to lose 5.6 kg (range: 3~20 kg), however 44% of them reported that they had not engaged in any weight control efforts. Further, 72% of them reported having engaged in a low level of physical activity. Body weight was not associated with women's characteristics, physical activity score, and diet. Conclusion: Women's awareness of gestational weight gain, lifestyle modification, and the risk of prolonged weight retention should be promoted through the antenatal and women's healthcare systems. As pregnancy and childbirth are critical events that affect women's health, integrative education to ensure healthy transition to life after delivery is required.

• 한국병원경영학회지
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• 제17권1호
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• pp.1-22
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• 2012

This study tires to examine affects that job and socio-psychological stresses of female office workers influence job satisfaction, organization commitment, and leaving intentions. A complete data are collected by conducting a survey with 240 female office workers from 9 medical institutions regarded as almost general hospital in Seoul. It is analyzed that the relation between socio-psychological stress and job satisfaction, organization commitment, and leaving intentions by using t-test; analysis of variance; correlation analysis; principal component analysis; linear structural equation modeling; etc. The results of this study are summarized as following. First, as it was comprehended by specific characteristics of subjects that the female office workers' level of job and socio-psychological stress, job satisfaction, organizational commitment, and leaving intention, there were statistically significant distinctions from their age, marital status, presence of children, position in the organization, type of employment, and monthly average income. Second, this study regarded relationship between the female office workers' level of job and socio-psychological stresses, job satisfaction, organizational commitment, and leaving intention. Job and socio-psychological stresses were negatively correlated with job satisfaction and organizational commitment, but the stresses were positive with leaving intention. Third, after evaluating effect that 8 features related to the job stress could influence job stress, the most effective valuables were in order to unfairness in organizational structure, workplace culture, inadequate compensation, and relationship conflict. Fourth, when looking at the overall effects of the job and sociopsychological stresses on job satisfaction, organizational commitment, and leaving intention, work autonomy was the most influencing factor of work stress levels. The level of the job stress seemed to be a prevalent impact on the leaving intention and it showed the most negative relationship that path coefficient from leaving intention to organizational commitment and also from organizational commitment to job satisfaction. Based on these findings, it can be defined that the job and socio-psychological stresses strongly influence job satisfaction, organizational commitment, and leaving intention.

• 대한지역사회영양학회지
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• 제14권6호
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• pp.767-776
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• 2009

This study evaluated the effect of nutritional improvement of 0~5 year children of financially poor families after nutrition supplement of children and nutrition education in parents/guardians. The subject selected among applicants for low-income family financing of the government included 198 children (0~12 months:92, 1~5 years:106), and the average ages were 5.3 months and 2.4 years respectively. Food that includes each nutrient factor was provided to the subject for six months. Nutrition education was performed in two ways, through class and private education, once a month for both. Nutritional improvement was evaluated by body measurement and anemia prevalence rate. As to the survey on breast-feeding, complete breast-feeding accounted for 58.7%, weaning food 27.3%, and combined feeding 14.1% respectively, which shows that breast-feeding accounted for the largest percentage. The education program improved knowledge and attitude of the parents/guardians, which brings in positive effects on growth of children as well. The nutrition knowledge score was improved after nutrition education in 0~12 month children $(8.5\pm1.75\;to\;8.9\pm1.69)$ and 1~5 year children $(7.3\pm1.39\;to\;7.8\pm1.30)$. The nutrition attitude score was significantly improved in 0~12month children $(52.0\pm6.99$ to $53.5\pm5.21$, p < 0.001) and 1~5year children ($45.1\pm7.30$ to $49.0\pm5.96$, p < 0.001). In evaluation on nutritional improvement based on body measurements, it turned out that the wasting was reduced as for children in consideration of the height and weight according to the subject's age. The concentration of hemoglobin after the nutrient treatment for six months was significantly improved, and the anemia prevalence rate as well was reduced from 40.6% to 13.5%, which indicates the significant improvement. Based on the findings above, it turned out that providing quality food to children and nutrition education to the parents/guardians poorly fed in low-income families improved knowledge and attitude of the guardians and prevents anemia and improves growth, which brings in positive effects on growth of children. In the results regarding attitude and knowledge on nutrient/dietary life; however, the improvement level was relatively low when the extent before the education was too small, which indicates the need to revise and complement the contents and methods. In addition, as shown in the result of body measurement, long-term and consistent investigation is necessary since it is difficult to judge the effect on growth only based on short-term nutrient supplement.

• 한국산학기술학회논문지
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• 제11권7호
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• pp.2497-2507
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• 2010

본 연구의 목적은 일 지역 여성의 결혼 전 건강검진에 대한 인지, 의도, 이행정도를 파악하고, 미혼여성의 검진의도 및 기혼여성의 검진이행을 예측하는 요인을 규명하기 위한 연구로 총 257명의 연구대상자를 대상으로 하였다. 자료는 결혼 전 건강검진에 대한 인지(인식, 태도, 주관적 규범, 행동통제인식), 의도, 이행정도를 묻는 질문지를 이용하여 조사하였고, 분석은 SPSSWIN 12.0 프로그램을 활용하여 평균, 표준편차, $x^2$-test, t-test, 다중회귀분석(multiple Logistic regression)을 이용하였다. 결혼 전 건강검진을 수행한 정도를 살펴본 결과 28.4%의 기혼여성이 수행한 것으로 나타났고, 35%의 미혼여성과 71.6%의 기혼 여성이 결혼전 건강검진에 대해 들어본 적이 있는 것으로 나타났다. 결혼 전 건강검진에 대한 태도는 미혼과 기혼여성에게서 각각 23.04점, 22.55점(t=1.39, p=.16), 주관적 규범은 각각 14.49점과 14.46점 (t=.13, p=.90)으로 미혼여성이 기혼여성에 비해 긍정적이었으나 통계적으로 유의한 차이가 없었다. 하지만, 행동통제인식에서는 미혼여성이 15.46점, 기혼여성이 16.79점(t=5.32, p<.001)로 두 군간 유의한 차이가 있었다. 미혼여성의 검진의도에 영향을 미치는 요인은 검진의 필요성(OR=14.186, t=.001)이었고, 기혼여성의 검진 이행에 영향을 미치는 요인은 검진에 대해 들은 경험(OR=7.765, p=.012)과 행동통제인식(OR=1.423, p=.025)이었다. 이 결과는 여성의 결혼 전 건강검진의 의도 및 실천을 증진시키기 위해서는 검진의 필요성에 대한 인지강화, 행동통제인식의 강화가 필요하며 이를 위한 프로그램의 개발이 지역사회를 중심으로 이루어져야 함을 제시해준다.

• 대한의용생체공학회:의공학회지
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• 제40권5호
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• pp.215-221
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• 2019

The respiratory medical device is a medical device that delivers optimal oxygen or a certain amount of humidification to a patient by delivering artificial respiration to a patient through a machine when the patient has lost the ability to breathe spontaneously. These include respirators for use in chronic obstructive pulmonary disease and anesthesia or emergency situations, and positive airway pressure devices for treating sleep apnea, and as the population of COPD (chronic obstructive pulmonary disease) and elderly people worldwide surge, the market for the respiratory medical devices it is getting bigger. As the demand for both airway pressure devices, there is a problem that the ventilator standard is applied because the reference standard has not been established. Therefore, the boundaries between the items are blurred due to the purpose, intended use, and method of use overlapping similar items in a respiratory medical device. In addition, for both airway pressure devices, there is a problem that the ventilator standard is applied because the reference standard has not been established. Therefore, in this study, we propose clear classification criteria for the respiratory medical devices according to the purpose, intended use, and method of use and provide safety and performance evaluation guidelines for those items to help quality control of the medical devices. And to contribute to the rapid regulating and improvement of public health. This study investigated the safety and performance test methods through the principles of the respiratory medical device, national and international standards, domestic and international licensing status, and related literature surveys. The results of this study are derived from the safety and performance test items in the individual ventilator(ISO 80601-2-72), the International Standard for positive airway pressure device (ISO 80601-2-70), The safety and performance of humidifiers (ISO 80601-2-74) and the safety evaluation items related to home healthcare environment (IEC 60601-1-11), In addition, after reviewing the guidelines drawn up through expert consultation bodies including manufacturers and importers, certified test inspection institutions, academia, etc., the final guidelines were established through revision and supplementation. Therefore, in this study, we propose guidelines for evaluating the safety and performance of the respiratory medical device in accordance with growing technology development.

• Tuberculosis and Respiratory Diseases
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• 제84권4호
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• pp.317-325
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• 2021

Background: Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) are significant public health issues in the world, but the epidemiological data pertaining to HAP/VAP is limited in Korea. The objective of this study was to investigate the characteristics, management, and clinical outcomes of HAP/VAP in Korea. Methods: This study is a multicenter retrospective cohort study. In total, 206,372 adult patients, who were hospitalized at one of the 13 participating tertiary hospitals in Korea, were screened for eligibility during the six-month study period. Among them, we included patients who were diagnosed with HAP/VAP based on the Infectious Diseases Society of America (IDSA)/American Thoracic Society (ATS) definition for HAP/VAP. Results: Using the IDSA/ATS diagnostic criteria, 526 patients were identified as HAP/VAP patients. Among them, 27.9% were diagnosed at the intensive care unit (ICU). The cohort of patients had a median age of 71.0 (range from 62.0 to 79.0) years. Most of the patients had a high risk of aspiration (63.3%). The pathogen involved was identified in 211 patients (40.1%). Furthermore, multidrug resistant (MDR) pathogens were isolated in 138 patients; the most common MDR pathogen was Acinetobacter baumannii. During hospitalization, 107 patients with HAP (28.2%) had to be admitted to the ICU for additional care. The hospital mortality rate was 28.1% in the cohort of this study. Among the 378 patients who survived, 54.2% were discharged and sent back home, while 45.8% were transferred to other hospitals or facilities. Conclusion: This study found that the prevalence of HAP/VAP in adult hospitalized patients in Korea was 2.54/1,000 patients. In tertiary hospitals in Korea, patients with HAP/VAP were elderly and had a risk of aspiration, so they were often referred to step-down centers.

• 대한방사선기술학회지:방사선기술과학
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• 제44권4호
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• pp.399-407
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• 2021

This study discussed the validity and necessity of compulsory recording of radiographic examination performed by radiological technologist on patients in medical institutions related to radiation exposure. Also, this study provided reasonable evidence of radiographic examination related medical records can contribute to the improvement of public health. Based on overseas cases of implementing a radiographic examination record system, the essential items to be included in medical record are the exposure date, exposure time, exposure method, exposure conditions that is tube voltage, tube current. Name and license number of the radiological technologist who performed the examination should be include in medical record. It is expected that the medical record of the total amount of radiation exposure per year would be in giving the maximum benefit with the minimum exposure to the medical radiation examination of the patient. In addition, interventional radiography medical record should also include exposure time, type and dose of the contrast medium.

• 재활복지
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• 제17권4호
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• pp.401-420
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• 2013

본 연구는 신경인지재활치료가 뇌졸중 환자의 상지기능 회복과 일상생활동작 수행능력에 미치는 효과를 알아보고 장기적인 치료를 위한 기초자료를 제시하고자 한다. 연구대상은 뇌졸중으로 인한 편마비 환자 총 30명을 대상으로 신경인지재활치료군과 전통적인 작업치료군을 각각 15명씩 무작위로 선정하였으며, 실험은 1회 30분, 주 5회, 4주 동안 적용하였다. 대상자의 실험 전과 후의 기능회복 정도는 뇌졸중 상지기능검사(Manual Function Test; MFT)와 Fugl-Meyer Assessment Scale(FMA), 한국판 수정바델지수(Korean-Modified Bathel Index; K-MBI) 점수를 활용하였다. 연구 결과 신경인지재활치료군이 상지기능검사에서 MFT와 FMA 측정값이 유의하게 증가하였으며(p<.05), 두 군 간의 차이를 비교한 결과 상지기능이 통계학적으로 유의한 차이를 보였다. 일상생활동작 검사에서는 신경인지재활치료군에서만 K-MBI 값이 유의하게 향상되었다(p <.05). 연구결과를 통하여 신경인지재활치료가 뇌졸중 환자의 상지 기능과 일상생활동작 수행능력향상에 효과적임을 알 수 있었다.

• 재활치료과학
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• 제8권1호
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• pp.63-71
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• 2019

목적: 본 연구는 뇌졸중 환자를 돌보는 중 고령층 여성 간병인의 신체통증 영향 요인을 탐색하고 하였다. 연구방법: 본 연구는 대구 및 경북 지역에 위치한 병원 5곳에서 뇌졸중 환자 75명과 이들을 간병하는 중 고령층 여성 간병인 75명을 대상으로 수행하였다. 측정은 뇌졸중환자의 일반적 특성, 인지기능, 상지기능, 일상생활능력을 평가하였고, 간병인은 일반적 특성과 신체통증이 평가되었다. 신체통증 영향 요인을 알아보기 위하여 위계적 다중회귀분석(stepwise multiple regression analysis)을 이용하였고 상관관계를 확인하기 위하여 피어슨 상관분석(Pearson correlation analysis)을 이용하였다. 결과: 중 고령층 여성 간병인의 신체통증 영향 요인은 현재 자신이 돌보고 있는 뇌졸중 환자의 일상생활능력(${\beta}=-.489$, p<.001)과 간병경력(${\beta}=-.309$, p=.003)으로 나타났다($R^2=.276$). 상관분석결과, 뇌졸중 환자의 일상생활능력, 상지기능, 인지기능은 유의한 연관성을 나타냈다(r=.434~.751, p<.001). 결론: 본 연구의 결과는 중 고령층 여성 간병인의 신체통증 감소를 위해 현재 자신이 돌보는 뇌졸중 환자의 기능수준과 간병경력이 중요한 변수임을 증명한다.