• 한국의료질향상학회지
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• 제4권1호
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• pp.50-63
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• 1997

Background : A pressure sore was defined as any skin lesion caused by unrelieved pressure and resulting in damage to underlying tissue. The health care institutions in the United States were reported the incident rate of pressure sores ranging from 6 to 14 %. Intensive Care Unit needed highest quality of care has been found over 40% incidence rate of pressure sore. Also, Annual expenditures for the care of pressure sores in patients in the United States have been estimated to be $7.5 billion; furthermore, 50 percent more nursing time is required to care for patients with pressure sore in comparison to the time needed to implement preventive measures against pressure sore formation. However, In Korea, there were little reliable reports, or researches, about incidence rates of pressure sore in health care institution including intensive care unit and about the integrated approach like CQI action team for risk assessment, prevention and treatment of pressure ulcers. Therefore, this study was to develop pressure sore risk assessment tool and the protocol for prevention of pressure sore formation through CQI action team activities, to monitor incident rate of pressure sore and the length of sore formation for patients at high risk, and to approximately estimate nursing time for sore dressing during research period as the effect of CQI action team. Method : CQI action team in intensive care unit, launched since early 1996, reviewed the literature for the standardized risk assessment tool, developed the pressure sore assessment tool based on the Braden Scale, tested its validity, compared on statistics including incidence rate of pressure sore for patients at high risk. Throughout these activities, CQI action team was developed the protocol, called as St. Marys hospital Intensive Care Unit Pressure Sore Protocol, shifted the emphasis from wound treatment to wound prevention. After applied the protocol to patients at high risk, the incident rate and the period of prevention against pressure development were tested with those for patients who received care before implementation of protocol by Chi-square and Kaplan-Meier Method of Survival Analysis. Result : The CQI action team found that these was significant difference of in incidence rate of pressure sores between patients at high risk (control group) who received care before implementation of protocol and those (experimental group) who received it after implementation of protocol (p<.05). 25% possibility of pressure sore formation was shown for the patients with 6th hospital day in ICU in control group. In experimental group, the patients with 10th hospital day had 10% possibility of pressure sore. Therefore, there was significant difference(p<.05) in survival rate between two groups. Also, nursing time for dressing on pressure sore in experimental group was decreased as much as 50% of it in control group. Conclusion : The collaborative team effort led to reduced incidence, increased the length of prevention against pressure sore, and declined nursing care times for sore dressing. However, there have had several suggestions for future study. The preventive care system for pressure sore should be applied to patients at moderate, or low risk throughout continuous CQI team activities based on Bed Sore Indicator Fact Sheet. Hospital-wide supports, such as incentives, would be offered to participants for keeping strong commitment to CQI team. Also, Quality Information System monitoring incidents and estimating cost of poor quality, like workload (full time equivalence) or financial loss, regularly in a hospital has to be developed first for supporting CQI team activities as well as empowering hospital-wide QI implementation. Being several limitations, this study would be one of the report cards for the CQI team activities in intensive care unit of an acute hospital and a trial of quality improvement of health care in Korea.

• 한방안이비인후피부과학회지
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• 제34권1호
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• pp.29-43
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• 2021

Objectives : The purpose of this study is to investigate the using trends of UAS7 over the last 5 years to analyze patients using UAS7 in a single Korean medicine hospital and to understand and suggest the actual status of application in clinical research. Methods : PubMed, RISS and OASIS were used to search clinical research papers related to chronic urticaria in the last 5 years. The adherence of UAS7 was assessed based on medical records in a single Korean medical hospital for 4 weeks. Results : Total 536 articles were selected, and 401(74.8%) articles used the assessment tool. UAS7 has been most commonly used assessment tool to evaluate the severity of chronic urticaria and DLQI has been most commonly used to evaluate the quality of life. The usage rate of UAS7 increased from 50% in 2016 to 85% in 2020. There were a total of 10 articles in traditional medicine research, of which 9 assessment tools were used and 4 articles used UAS7. To analyze adherence of UAS7, a total of 15 patients were selected. 6 patients (40%) did not record any value, and only 2 patients(13%) showed more than 80% adherence. Conclusions : UAS7 is most commonly used assessment tool in clinical research currently. However, since patient record adherence tends to be poor, it is needed to find ways increasing the UAS7 record adherence.

• Structural Monitoring and Maintenance
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• 제2권1호
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• pp.19-34
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• 2015

One of the main causes of a limited use of nondestructive evaluation (NDE) technologies in bridge deck assessment is the speed of data collection and analysis. The paper describes development and implementation of the RABIT (Robotics Assisted Bridge Inspection Tool) for data collection using multiple NDE technologies. The system is designed to characterize three most common deterioration types in concrete bridge decks: rebar corrosion, delamination, and concrete degradation. It implements four NDE technologies: electrical resistivity (ER), impact echo (IE), ground-penetrating radar (GPR), and ultrasonic surface waves (USW) method. The technologies are used in a complementary way to enhance the interpretation. In addition, the system utilizes advanced vision to complement traditional visual inspection. Finally, the RABIT collects data at a significantly higher speed than it is done using traditional NDE equipment. The robotic system is complemented by an advanced data interpretation. The associated platform for the enhanced interpretation of condition assessment in concrete bridge decks utilizes data integration, fusion, and deterioration and defect visualization. This paper concentrates on the validation and field implementation of two NDE technologies. The first one is IE used in the delamination detection and characterization, while the second one is the USW method used in the assessment of concrete quality. The validation of performance of the two methods was conducted on a 9 m long and 3.6 m wide fabricated bridge structure with numerous artificial defects embedded in the deck.

• 공학교육연구
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• 제12권2호
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• pp.63-70
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• 2009

본 논문에서는 현재 대학 현장에서 적용하고 있는 학습성과 평가체계를 분석하여, 이를 개선한 평가체계의 모형을 국제성함양 학습성과를 예로 들어 제시하였다. 제시된 학습성과 평가체계는 PC별로 수행수준을 제시하고, 수행수준에 근거한 달성목표를 프로그램 차원에서 설정하여, 학생이 졸업 시점에서 학습성과 달성 여부를 용이하게 입증하는 체계를 갖추고 있다. 이렇게 평가체계를 구축함으로서 PC별로 CQI를 운영할 수 있어 교육현장에서의 업무를 감소할 수 있을 것이다. 또한 이러한 평가체계 수립에서 고려해야할 중요한 측면은 평가체계를 논리적이고 객관적으로 구성해야 한다는 사실을 논의하였다. 본 논문에서 제시한 학습성과 평가체계 모형은 대학 현장에서 학생의 학습성과 달성을 입증할 수 있는 용이한 모형이 될 것이라 판단된다.

• 한국환경과학회지
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• 제9권6호
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• pp.443-447
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• 2000

Chonan and Asan city have been a focal point due to rapid development as the first station for Express Railroad and key cities West Coast Development Region. Gokgyo stream adjacent to the cities plays an important role as a drainage channel for an agriculture and a discharger of urban storm water. Waster quality of the stream has been deteriorating caused by pollution sources such as a untreated wastewater discharge and runoff from the watershed. In the study, we conducted 4 surveys in April, May, July, and September to understand the current state of water quality for the stream and to make it possibe to predict future water-quality variation for future development. The system runs on a personal computer under the windows enviroment and provides extensive graphic user interface(GUI) for user-friendly assessment. Using the pull-down menus provided by the GUI panel, the user is able to operate the system by pointing and clicking the icon to identify the state of water-quality at locations concerned. Furthermore, we developed an integrated watershed management system. The constructed system could be a useful tool as a decesion maker for pollution source control strategy.

• 한국산학기술학회논문지
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• 제19권9호
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• pp.374-383
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• 2018

본 논문은 영구적 장루보유자와 일시적 장루보유자의 미충족 요구와 삶의 질을 비교하고, 어떤 미충족 요구가 있는지 분석하여 향후 장루보유자의 특성에 맞는 자가 관리 프로그램 개발에 필요한 기초자료를 제공하고자 시도되었다. 연구대상은 직장 결장암이나 다른 진행성 암에 대한 치료적 혹은 고식적 목적으로 장루 형성술을 시행한 장루보유자 128명으로써, 일시적 장루보유자 64명, 영구적 장루보유자 64명으로 구성되었다. 자료수집 기간은 2018년 2월 1일부터 4월 5일까지였으며, 수집된 자료는 IBM SPSS 21.0 program을 이용하여 카이제곱과 독립 t-검정으로 분석하였다. 설문조사는 암환자 미충족 요구사정도구인 Comprehensive Needs Assessment Tool in Cancer(CNAT)를 수정 보완하였고, 장루보유자 삶의 질 측정도구는 The City of Hope Quality of Life(COH-QOL) ostomy Questionnaire를 이용하여 자가 보고 하도록 하였다. 연구결과 일시적 장루보유자의 미충족 요구가 영구적 장루보유자의 미충족 요구도보다 유의하게 더 높았다(t=-2.284, P=.024). 일시적 장루보유자의 미충족 요구가 더 많은 영역은 정보 및 교육 영역(t=-2.747, p=.007), 심리적 문제(t=-2.578, p=.011), 의료진 영역(t=-2.599, p=.010)이었다. 또한 일시적 장루보유자의 삶의 질은 영구적 장루보유자의 삶의 질보다 더 낮은 편이었으나, 통계적으로 유의한 차이는 없었다(t=-1.364, P=.0175). 본 연구결과를 바탕으로 일시적 장루보유자들에게 적절한 정보와 심리적 지지를 제공하고 일시적 장루보유자를 위한 퇴원 후 자가 관리 프로그램을 개발할 필요가 있겠다.

• 임상간호연구
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• 제19권1호
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• pp.57-68
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• 2013

Purpose: In assessing patients' neurological status following a stroke it is very important to have a valid tool for early detection of neurological deterioration. NIHSS is considered the best tool to reflect neurological status in patients with ischemic stroke. An education program on use of NIHSS was planned for nurses caring for these patients and the effects of the program were evaluated. Methods: The NIHSS education program (NEP) which includes online and video lectures, and practical education was provided to the nurses from April to July, 2010. To examine the effect of NEP, nursing records of patients with ischemic stroke who were admitted to a stroke center were analyzed. Two groups, a historical control group (n=100) and the study group (n=115) were included. Results: Nursing records for neurologic symptoms for each patient increased (41.0% versus 100.0%, p<.001), and especially, visual disturbance, facial palsy. limb paralysis and ataxia, language disturbance, dysarthria, and neglect symptoms significantly increased (all p<.001). Nurse notification to the doctor of patients with neurological changes increased (21.0% versus 39.1%, p=.004), and nurses' neurological deterioration detection rates also increased (37.5% versus 84.6%, p=.009). Conclusion: NEP improved the quality of nursing records for neurological assessment and the detection rate of neurological deterioration.

• Journal of Hospice and Palliative Care
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• 제6권2호
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• pp.152-163
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• 2003

Pupose : The Korean cancer pain assessment tool (K-CPAT) was developed in 2003 is consisted of questions concerning the pain location, quality of pain, present pain intensity, symptoms associated with pain, and psychosocial/spiritual pain assessments. This study was done to evaluate the reliability and validity of K-CPAT. Methods : A Stratified, proportional-quota, clustered, systematic sampling has been employed. Study population (903 cancer patients) was 1% of the target population (90,252 cancer patients). A total of 314 (34.8%) questionnaires have been collected. Results : Average pain score (5 Likert scale) by cancer type and at-present average pain score (VAS, $0{\sim}10$) were correlated (r=0.56, P<0.0001), and showed a moderate agreement (kappa=0.364). Mean score of satisfaction was 3.8 ($1{\sim}5$). The average time of completion of the questionnaire was 8.9 minutes. Conclusions: The K-CAPT is a reliable and valid instrument for the assessment of Cancer Pain for Korean.

• 방사성폐기물학회지
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• 제4권1호
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• pp.65-75
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• 2006

방사성폐기물 처분 연구 사업이 법률적인 인허가 뿐만이 아니라 일반 국민의 동의를 얻기 위해서는 처분 사업의 안전성에 대한 신뢰성 획득이 중요하며 이를 위해 투명하게 공개될 수 있는 종합 성능 평가 (TSPA, Total System Performance Assessment)의 수행 이 필요하다. 본 연구에서는 처분 성능 평가의 투명성 증진을 위한 방안의 하나로 처분 종합 성능 평가 전 과정에 대해 품질 보증 원칙을 도입하여 평가 관련 전체 업무에 관한 신뢰성 향상을 꾀하고자 하였다. 이를 위해 처분 종합 성능 평가 수행의 다섯 단계인 (1) 기획, (2) 연구 수행 , (3) 문서화, (4) 내부 검토, (5) 독자적인 외부 검토 과정에 T2R3의 품질 보증 원칙을 적용한 인터넷 기반의 Cyber R&D Platform이 개발되었다. 인터넷을 기반으로 하는 본 시스템의 개발을 통해 안전성 평가 관련 모든 참여자들은 평가 전 과정에서 투명성이 유지된 데이터들에 쉽게 접근하여 이를 이용할 수 있다 Cyber R&D Platform은 안전성 평가를 위한 시나리오 개발 관련 데이터인 FEP 목록과 관련 시나리오 정보, 관련 시나리오 도출 과정 및 평가 체계 등을 체계적으로 구축한 FEAS (FEp to Assessment through Scenario development)프로그램과 안전성 평가에 필요한 입력 데이터들을 분류, 저장해 놓은 PAID (Performance Assessment Input Data) 프로그램, 그리고 이러한 자료들을 품질 보증 원칙과 절차에 의한 승인 과정을 통해 입력, 저장할 수 있는 품질 보증 시스템으로 구성되어 있으며 이를 통합 운영함으로써 도출된 데이터들의 신뢰성을 높이고자 하였다. 향후 연구에서는 Cyber R&D Platform과 평가 software와의 통합 운영으로 웹 기반 시스템에 대한 한 번의 접속만으로 안전성 평가 관련 모든 정보를 확인, 이용할 수 있도록 할 것이다.

• 한방재활의학과학회지
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• 제33권1호
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• pp.13-29
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• 2023

Objectives To evaluate the evidence supporting the effectiveness of acupuncture for facet joint syndrome. Methods We conducted search across 9 electronic databases (PubMed, EMBASE, Cochrane CENTRAL (CENTRAL), KoreaMed, Kmbase, Koreanstudies Information Service System (KISS), ScienceOn, China National Knowledge Infrastructure (CNKI), and Wanfang) to find clinical trials that used acupuncture as treatment for facet joint syndrome. The methodological quality of randomized controlled clinical trials (RCTs) were assessed using the Cochrane Risk of Bias (RoB) tool, while non-randomized controlled clinical trials (nRCTs) were assessed using the Cochrane Risk of Bias Assessment tool for Non-randomized Study (RoBANS) tool. Results Nine RCTs and one nRCT met our inclusion criteria. Fire needle was more effective than medial branch block in terms of visual analogue scale (VAS) after 1 month (p=0.02). Also, Fire needle was more effective than Ibuprofen in terms of VAS and oswestry disability index (ODI) (p<0.05). However, in the rest of the study results, the intervention group did not show a statistically significant difference than the control group. Conclusions Although our review found encouraging but limited evidence of acupuncture for facet joint syndrome, most of the studies included in the analysis were evaluated as methodologically high risk of bias. From now on further well-designed RCTs should be encouraged.