• 제목/요약/키워드: Quality of Medical Care

검색결과 1,546건 처리시간 0.03초

농촌(農村)에 있어서 분만개조요원(分娩介助要員)의 봉사(奉仕)에 의(依)한 모자보건(母子保健)rhk 가족계획(家族計劃)에 관(關) 연구(硏究) (A Study on Maternity Aids Utilization in the Maternal and Child Health and Family Planning)

  • 예민해;이성관
    • Journal of Preventive Medicine and Public Health
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    • 제5권1호
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    • pp.57-95
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    • 1972
  • This study was conducted to assess the effectiveness of service by maternity aids concerning maternal and child health in improving simultaneously infant mortality, contraception and vital registration among expectant mothers in rural Korea, where there is less apportunity for maternal and child health care. It is unrealistic to expect to solve this problem in rural Korea through professional persons considering the situation of medical facilities and the socioeconomic condition of residents. So, we intended to adopt a system of services by maternity aids who were educated formally among indigenous women. After the women were trained in maternal and child health, contraception, and registration for a short period, they were assigned as a maternity aids to each village to help with various activities concerning maternal and child health, for example, registration of pregnant women, home visiting to check for complications, supplying of delivery kits, attendance at delivery, persuasion of contraception, and invitation for registration and so on. Mean-while, four researchers called on the maternity aids to collect materials concerning vital events, maternal child health, contraception and registration, and to give further instruction and supervision as the program proceeded. A. Changes of women's attitude by services of maternity aid. Now, we examined to what extent' such a service system to expectant mothers affected a change in attitude of women residing in the study area as compared to women of the control area. 1) In the birth and death places, there were no changes between last and present infants, in study or control area. 2) In regard to attendants at delivery, there were no changes except for a small percentage of attendance (8%) by maternity aid in study area. But, I expect that more maternity sids could be used as attendants at delivery if they would be trained further and if there was more explanation to the residents about such a service. 3) Considering the rate of utilization of sterilized delivery kit, I am sure that more than 90 percent would be used if the delivery kit were supplied in the proper time. There were significant differences in rates between the study and the control areas. 4) Taking into consideration the utilization rate of the clinic for prenatal care and well baby care, if suck facilities were installed, it would probably be well utilized. 5) In the contraception, the rate of approval was as high as 89 percent in study area as compared to 82 percent in the control area. 6) Considering the rate of pre-and post-partum acceptance on contraception were as much as 70 percent or more, if motivation to use contraception was given to them adequately, the government could reach the goals for family planning as planned. 7) In the vital registration, the rate of birth registration in the study area was some what improved compared to that of the control area, while the rate of death registration was not changed at all. Taking into account the fact that the rate of confirmation of vital events by maternity aids was remarkably high, if the registration system changed to a 'notification' system instead of formal registration ststem, it would be improved significantly compared to present system. B. Effect of the project Thus, with changes in the residents' attitude, was there a reduction in the infant death rate? 1) It is very difficult problem to compare the mortality of infants between last and present infants, because many women don't want to answer accurately about their dead children especially the infants that died within a few days after birth. In this study the data of present death comes from the maternity aides who followed up every pregnancy they had recorded to see what had happened. They seem to have very reliable information on what happened in first few weeks with follow up visitits to check out later changes. From these calculaton, when we compared the rate of infant death between last and present infant, there was remarkable reduction of death rate for present infant compare to that of last children, namely, the former was 30, while the latter 42. The figure is the lowest rate that I have ever heard. As the quality of data we could assess by comparing the causes of death. In the current death rate by communicable disease was much lower compare to the last child especially, tetanus cases and pneumonia. 2) Next, how many respondents used contraception after birth because of frequent contact with the maternity aid. In the registered cases, the respondents showed a tendency to practice contraception at an earlier age and with a small number of children. In a comparison of the rate of contraception between the study and the control area, the rate in the former was significantly higher than that of the latter. What is more, the proportion favoring smaller numbers of children and younger women rose in the study area as compared to the control area. 3) Regarding vital registration, though the rate of registration was gradually improved by efforts of maternity aid, it would be better to change the registration system. 4) In the crude birth rate, the rate in the study area was 22.2 while in the control area was 26.5. Natural increase rate showed 15.4 in the study area, while control area was 19.1. 5) In assessment of the efficiency of the maternity aids judging by the cost-effect viewpoint, the workers in the Medium area seemed to be more efficiency than those of other areas.

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간호진단 프로토콜(Protocol)의 임상적용 효과에 관한 연구 (The Effects of Clinical Application of a Nursing Diagnosis Protocol)

  • 이향련;조미영;조결자;김윤희;김귀분;김광주;문희자;박신애;강현숙
    • 대한간호학회지
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    • 제19권1호
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    • pp.40-62
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    • 1989
  • This study was conducted to measure the effects of clinical application of a Nursing Diagnosis Protocol. The dependent variables were the degree of patient's satisfaction and the degree of nurse's satisfaction with the nursing activity. Analysis of the effect of the use of the nursing diagnosis protocol was based on the nursing record. The subjects for this study were 61 nurses(experimental group 31, control group 30) and 155 patients (experimental group 55, control group 100) on four internal medicine wards in K University Hospital in Seoul. Data collection was done from August to October 12,1988. The results obtained in this study can be summarized as follows, 1, Effect of the clinical application of the nursing diagnosis protocol. 1) The first hypothesis ; “nurses who use the nursing diagnosis protocol will have higher degrees of satisfaction than those who use traditional methods” was rejected (t=.54, df=58, p=.59). 2) The second hypothesis ; “patients nursed by nurses using the nursing diagnosis protocol will have higher degrees of satisfaction than those nursed with traditional methods” was supported(t=1.93, df=154, p=.05). 3) The third hypothisis : Major hypothesis ; “the nursing records of the experimental group, who used the nursing diagnosis protocol, will be more detailed than those of the control group” was supported (t=6.40, df=79.90, p=.000). (1) The first subhypothesis ; “The recorded data collection of the experimental group will be more detailed than that of the control group” was rejected (t=1.79, df=118, p=.07). (2) The second subhypothesis ; “The recorded patient's problem statement of the experimental group will be more detailed than that of the control group”, was supported. (3) The third subhypothesis ; “The nursing record of the experimental group will be more convenient for implementation than that of the control group” was supported. 2. Factors related to the nurse's degree of satisfaction with protocol. 1) No general characteristics(age, religion, education level, duty career, present duty career) were related to the nurse's degree of satisfaction. 2) Variables related to the nurse's degree of satisfaction were “satisfaction as a nurse” and “consider nursing as lifelong job” (t=-2.6, df=13.22, p=.02, t=2.41, df=23.85, p=.02). 3. Factors related to the patient's degree of satisfaction. 1) General characteristics related to the patient's degree of satisfaction with nurses using the protocol were age, educational level, and being married.(F=5.17, df=3/153, p=.00, t= -2.39, df=154, p=,01, f=5.91, df=2/153, p=.00) 2) The variables previous hospitalization, duration of hospitalization, the hospital unit presence of a relative, medical insurance, or medical diagnosis were not related to the patient's degree of satisfaction. 1. The experimental group's nursing record was more detailed than the control group's record with regard to the physical and psychological state of the patients. As noted above, the experimental group nurses, who use a nursing diagnosis had protocol were less satisfied than the control group who used traditional methods of the recording, but experimental group patients had a higher degree of satisfaction than the control group patients. The nursing records of experimental group, using the nursing, diagnosis protocol was more detailed than that of the control group. If the nursing diagnosis protocol is used in clinical nursing practice, the quality of nursing care may be improved.

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의료용 Cyclotron의 방사선안전관리 행위 예측모형 (A Prediction Model for the Radiation Safety Management Behavior of Medical Cyclotrons)

  • 정지혜;한은옥;김쌍태
    • Journal of Radiation Protection and Research
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    • 제33권2호
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    • pp.77-86
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    • 2008
  • 방사성동위원소(RadioIsotope) 생산시설인 Cyclotron의 방사선안전관리는 방사선작업종사자뿐만 아니라 일반 이용자들의 방사선에 의한 건강장해를 예방하기 위해 중요한 부분이므로 방사선안전관리 행위에 영향을 미치는 예측모형을 도출하여 방사선안전관리 행위수준을 높이는데 필요한 근거자료를 제공하고자 하였다. 문헌고찰, 현장관찰, 전문가 포커스 토의를 통하여 도출되고 내용타당도가 확보된 설문지를 사용하여 국내 Cyclotron이 설치된 24개 허가기관의 방사선안전관리자를 대상으로 2008년 1월 2일부터 30일간 조사하여 다음과 같은 결과를 도출하였다. 방사선안전관리에 관한 경로는 1단계 생산준비, 2단계 RI생산, 3단계 합성, 4단계 분배, 5단계 품질관리, 6단계 운반용기 포장, 7단계 운반 단계로 지정하였다. 방사선피폭의 우려가 가장 높다고 생각하는 단계는 분배 15명(62.5%), 시설 설치부터 운영까지 가장 힘든 업무는 인허가 관련'과 설치시설 및 생산장비확보'가 각 9명(37.5%), 방사선피폭 관련 문제가 발생한 단계는 '합성과 분배'각 4번(30.8%)으로 높게 나타났다. 방사선안전관리 행위수준은 4점 만점을 기준으로 최소 2.42점, 최고 4.00점, 평균 $3.46{\pm}0.47$점으로 나타났다. 방사선안전관리 행위와 직업에 대한 복지후생(r=0.529)이 유의수준 5%에서 통계적으로 유의한 상관관계가 있는 것으로 나타났다. 방사선안전관리 행위에 영향을 미치는 변수를 기준으로 예측모델을 도출한 결과 일반적 특성, 기관 특성, 자기효능감은 통계적으로 유의한 경로를 나타내지 않았고 직업특성 중 복지후생이 방사선안전관리 행위에 영향을 미치는 것으로 나타났다. 따라서 방사선안전관리 행위수준을 높이기 위해 직업적 특성 중 복지후생 수준을 향상시킬 수 있는 전략이 필요하다고 본다. 본 연구는 최근 설치가 급격히 증가하는 Cyclotron의 방사선안전관리에 대한 국내 전수조사로 최초 수행하여 기초자료를 제공하는데 의미가 있다고 본다.

노령출산에 관한 연구 (A Study on Childbrith in Late Maternal Age)

  • 한예영
    • 한국보건간호학회지
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    • 제8권2호
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    • pp.101-113
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    • 1994
  • Maternity means all the women who are capable to conceive. In the aspect of health and medical care. however. it means the women who are now in pregnancy or have already given birth to a baby or are in a period of being recoverd from physiological changes occurred by pregnancy. According to the rapidly changing social structure. both the Quality and Quantity of the capacity of childbirth experienced by women are changing. Our society. having established a great economical growth by virtue of the highly developing and growing industrialization and urbanization. stimulates the women's advance into society and thereby increasing the number of employed women. When the women's participation in society is increased. their age of marriage is also affected. Which means there are a decrease of the capacity of childbirth in terms of quantity and a trend for women to have less children and to deliver a baby in their old age in terms of quality. On the contrary. since the number of multipara who want to have a baby in their old age is increasing. as a counter functional effect to the political project of decrease of a birth rate. concern has been focussed on childbirth in old age in the present study. And also such kind of the childbirth may be danger to the health of both mother and baby. Therefore the present study intended to provide some basic data of health education in the part of the health management of both mother and baby in the general hospital. based on understanding the realities of childbirth in. old age and things related to them. To achieve such a purpose of the present study. an analytical study by means of SPSS. was done using the data of 269 clinical records on both the newborn .babies and their mothers who had been supported by public general hospitals located in Seoul for 3 years from Jan. 1. 1991 to Dec. 31. 1993. Some significant results from the analytic study are as follows: 1. It appeared that the average age of normal. natural delivery was 33.8 years old and the average age of delivery through the cesarean operation was 35.4 years old. 2. It appeared that danger factors to childbirth women were types of the delivery and placental extrusion and danger factors to newborn babies are not so outstanding. 3. It appeared that the variables of the childbirth capacity which showed a significant difference according to each age group of women were the number of pregnancy. number of still birth, and number of existing children. That is. the age group of 'more than 35 years' had more frequency of experience In all 3 variables than the age group of 'less than 35 years'. 4. It appeared that the variables of the childbrith capacity which showed a significant difference a according to the sex of a newborn baby were number of pregnancy, number of still birth, and number of existing children. That is, the age group of 'more than 35 years' had more frequency of experience in all 3 variables than the age group of 'less than 35 years'. 5. It appeared that the health index of newborn babies which showed a significant difference was only 5 minute APGAR. That is, the health index 9.46 in the age group of 'more than 35 years' was less than an index of 9.72 in the age group of 'less than 35 years'. 6. Since a counter correlation of -0.10, as Pearson Correlation Coefficient, was showed between the age of childbirth mothers and the weight of newborn babies, it indicated that the higher age of childbirth woman, the lesser the weight of newborn baby. 7. It appeared that the number of women who had confirmed the sex of their baby before their delivery were 45 women, $67.2\%$ of total 67 women who had delivered a baby. and the expected sex by women in childbed was male with $73.1\%$ of total childbirth women expecting male birth and with their expression of feeling of female delivery. very regretful' by $39.3\%$ of total childbirth women. The results as shown above may indicate that instead of the possibility of danger to both the mother delivering a baby in old age and the baby delivered, the expectation of getting a son motivates childbirth in old age. As a conclusion, in a dimension of general hospital as well as national reform. it is required that a program of health education for childbirth in late maternal age have to be developed in the part of the health management of both mother and baby in the near future.

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소아 치과환자에 대한 진정법의 체계적 분석 방법 고찰 (A Review of the Systemic Analysis Method on Dental Sedation for Children)

  • 안소연;이제우;김승오;김종빈
    • 대한소아치과학회지
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    • 제42권4호
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    • pp.331-339
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    • 2015
  • 소아치과에서 협조가 되지 않는 어린이의 치과치료 시 사용하는 진정법은 환자안전을 최우선으로 고려하여야 하며, 의료사고예방을 위한 evidence-based 진료가 필요하다. 근거중심의학의 부상에 따라 치의학계에도 근거중심치의학(Evidence-Based Dentistry)에 대한 관심이 점차 증가하고 있으나 한국의 진정법에 대한 근거중심의 체계적인 연구는 거의 이루어지지 않고 있다. 이 연구의 목적은 체계적인 문헌고찰법을 이용하여 지금까지 국내에 보고된 소아치과진정(요)법을 검토하고, 향후 국내의 근거중심 소아치과 진정법의 발전 방향을 모색하는 것이다. 본 연구는 "한국보건의료연구원의 체계적인 문헌고찰 지침"을 참고하여 국내 5개 데이터베이스 1) Core 검색 데이터베이스- KM base, KISS 2) 학술정보 및 포털 -국회도서관, DBpia, RISS를 검색하였다. "치과진정법" 및 "치과진정요법"으로 검색어를 제안한 총 470편의 논문 중 문헌선택과정의 흐름도를 따라 중복제거 하고 남은 31개의 논문 중 원문이 제공되는 문헌을 모두 취합한 총 20개 문헌을 분석대상으로 삼았다. 이번 체계적 문헌고찰은 한국 소아치과 영역에서 지난 25년간 시행된 치과진정법에 관한 일관된 근거(evidence)를 확인하기 위하여 GRADE 과정에 정의된 객관적인 기준에 기초하여 진행된 결과, 전체적인 근거는 보통(moderate)의 질로 평가되었다. 그러나, 특히 약물의 추가 투여 부분에 대해서는 매우 낮은(very low)의 질로 평가되었다. 그러므로 향후 안전한 약물의 사용 부분에 대해 보다 체계적으로 잘 고안된 임상 실험이 필요하다.

퇴원손상심층자료를 이용한 환자안전지표의 적용 (Application of Patient Safety Indicators using Korean National Hospital Discharge In-depth Injury Survey)

  • 김유미
    • 한국산학기술학회논문지
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    • 제14권5호
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    • pp.2293-2303
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    • 2013
  • 목적: 본 연구의 목적은 국내 환자안전지표 산출 가능성을 확인하는 것이다. 조사방법: 환자안전지표의 정의는 OECD에서 AHRQ에 근거하여 작성한 보건기술문서 19의 기준을 이용하였고, 이에 따라 2004-2008년 퇴원손상심층조사 875,622건에서 환자안전지표(PSIs)를 산출하였다. 로지스틱 회귀분석을 이용하여 환자안전지표별 비율의 변이요인을 확인하였다. 분석결과: 2004-2008년간 약 80만 건의 퇴원 중에서 8개의 환자안전지표에 해당하는 위해사건은 3,084건이었다. 욕창(PSI3, 4.88), 시술 중 이물질 체내 잔류(PSI5, 0.05), 수술 후 패혈증(PSI13, 1.32), 출생손상-신생아(PSI17, 7.92), 산과적 외상-도구를 이용한 질식 분만(PSI18, 32.81)의 퇴원 1,000건당 비율은 모두 OECD 환자안전지표 비율의 최소-최대 범위 내에 포함되었다. 그러나 내과적 치료에 의한 감염(PSI7, 0.22), 수술 후 폐색전증 또는 심부정맥혈전증(PSI12, 0.90), 우발적 천공 또는 열상(PSI15, 0.71)의 퇴원 1,000건당 비율은 OECD 환자안전지표 최소값에 못 미쳤다. PSI 18을 제외한 7개의 지표값 모두 부진단명의 개수와 유의한 상관관계가 있는 것으로 나타났다. 또한 환자안전지표 비율은 환자특성을 보정했을 때, 병상규모 및 병원소재지 등 병원특성에 따른 유의한 차이를 보였다. 결론: 본 연구는 국가적인 행정자료를 이용하여 위해사고를 스크리닝 하는 환자안전지표를 산출한 최초의 실증적 연구이다. 본 연구의 결과는 자료의 질, 임상 관련 변수 등의 결과에 영향을 미치는 요소가 여전히 있지만, 환자안전에 대한 국가적인 통계를 추계하는 기초자료를 제공하였다는데 의의가 있다. 향후 본 연구결과를 바탕으로 위해사건으로 인한 사망 규모 산출 등의 결과연구가 필요하다.

서울지역 국민학교(國民學校) 양호교사의 학교간호업무(學校看護業務) 수행정도(遂行程度)에 관(關)한 연구(硏究) (A Study on status of school health and analysis of factors affecting school nursing activities in the secondary school in Seoul)

  • 김은희
    • 한국학교보건학회지
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    • 제1권2호
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    • pp.50-65
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    • 1988
  • This study was conducted in order to grasp the condition of about the school nurse's service and to offer the basic materials of improving the school health service. The objects were comprised of 98 volunteered school nurses who take service in the elementary school. The material of this study was the questionaire suited to the purpose of this research which has been made through studying references and this questionaire has been corrected and revised three times. All the questionaire written by school-nurses. The results are as follows; 1. General features of the objects of study Average age was 35.9 and average career was 9.2 years. Except working as school-nurse, the past career was that average clinical-field was 3.4 years and health service was 4 months. Their educational level was as high as 72.4% of the objects were graduated from above 3 years college and 89.8% were married. 76.5% have religions and 94.8% were working at with national and public schools. 99.0% were doing only nursing service. 2. The conditions of the school health resources. The ratio of school-nurse to students was one to 2630. School-nurse to classes, one to 49.3, and school-nurse to teachers, one to 54. For total amount of a year budget of school health, from three hundred thousands to fifty nine hundred thousands won was most common. Expenses for purchasing medicine were used most. 58.2% of school-nurses hasn't known a year budget. There was an organization for school health in 74.2% of schools. 42.9% of nursing rooms were in the center of school and 88.8% were on first floor. Nursing room were used alone without being used by another purpose and the room size of 71.6% was below 10 pyong. 3. The conditions of school health service Average users of nursing room were 413 a month. The most of them had digestive trouble. Sending letters to home was 15.9 times a year. The most contents of letters was about health education. Object spent much time managing nursing room. 4. The degree of school health service When 2 points was given to "perform" and 1 point was to "not perform" the total average was 1.75, health education 1.89, environmental management 1.86, plan of project and evaluation 1.83, management of nursing room 1.82, health management 1.78, run of school health organization 1.32. 5. Correlation between the school health services and variables (1) The part of project plan and evaluation of school health service has relationship to existence or none-existence of school health organization (P<0.01), past health service career (P<0.05), number of classes (P<0.01), number of students (P<0.01), sending letters to home about health education (P<0.01) and number of users (P<0.05). (2) The part of nursing room management has relationship to ages (P<0.05) past clinical career (P<0.05), number of classes (P<0.05), number of students (P<0.05) and sending letters to home about health education (P<0.01). (3) The part of health education has relationship to existence or none-existence of school health organization (P<0.05), past clinical career (P<0.05), the ratio of health management to school nurse's all work (P<0.05) and the ratio of health education to school nurse's all work (P<0.01). (4) The part of environmental management to ages (P<0.01), career as a school-nurse (P<0.01), salary step(P<0.01), sending letters to home about health education (P<0.01), sending all letters to home (P<0.001), the ratio of health management to school nurse's all work (P<0.05), the ratio of health education to school nurse's all work (P<0.05) and area of school-nurse's room to be used. (5) The part of school health organization management to number of classes (P<0.05). (6) The part of health management to number of classes (P<0.05), sending letters to home about health education (P<0.001), sending all of letters to home (P<0.01) and the ratio of health management to school nurse's all work (P<0.05). (7) The part of school health service to ages (P<0.05), past clinical career (P<0.05), past health career (P<0.01), number of classes (P<0.05), number of student (P<0.05), sending letters to home about health education (P<0.05), sending all letters to home (P<0.05), the ratio of health management to school nurse's all work (P<0.05), the ratio of health education to school nurse's all work (P<0.01) and area of school - nurse's room to be used (P<0.05). ## Suggestion for further studies are as follows. 1. School-nurse should exert herself to advance a quality to take care of school population's health. 2. It is necessary that systematic support required to keep school population's health. 3. Home, school and community should make efforts cooperatively and the proper roles of students, teachers, health team members and parents must be achieved.

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다중 클래스 데이터셋의 메타특징이 판별 알고리즘의 성능에 미치는 영향 연구 (The Effect of Meta-Features of Multiclass Datasets on the Performance of Classification Algorithms)

  • 김정훈;김민용;권오병
    • 지능정보연구
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    • 제26권1호
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    • pp.23-45
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    • 2020
  • 기업의 경쟁력 확보를 위해 판별 알고리즘을 활용한 의사결정 역량제고가 필요하다. 하지만 대부분 특정 문제영역에는 적합한 판별 알고리즘이 어떤 것인지에 대한 지식은 많지 않아 대부분 시행착오 형식으로 최적 알고리즘을 탐색한다. 즉, 데이터셋의 특성에 따라 어떠한 분류알고리즘을 채택하는 것이 적합한지를 판단하는 것은 전문성과 노력이 소요되는 과업이었다. 이는 메타특징(Meta-Feature)으로 불리는 데이터셋의 특성과 판별 알고리즘 성능과의 연관성에 대한 연구가 아직 충분히 이루어지지 않았기 때문이며, 더구나 다중 클래스(Multi-Class)의 특성을 반영하는 메타특징에 대한 연구 또한 거의 이루어진 바 없다. 이에 본 연구의 목적은 다중 클래스 데이터셋의 메타특징이 판별 알고리즘의 성능에 유의한 영향을 미치는지에 대한 실증 분석을 하는 것이다. 이를 위해 본 연구에서는 다중 클래스 데이터셋의 메타특징을 데이터셋의 구조와 데이터셋의 복잡도라는 두 요인으로 분류하고, 그 안에서 총 7가지 대표 메타특징을 선택하였다. 또한, 본 연구에서는 기존 연구에서 사용하던 IR(Imbalanced Ratio) 대신 시장집중도 측정 지표인 허핀달-허쉬만 지수(Herfindahl-Hirschman Index, HHI)를 메타특징에 포함하였으며, 역ReLU 실루엣 점수(Reverse ReLU Silhouette Score)도 새롭게 제안하였다. UCI Machine Learning Repository에서 제공하는 복수의 벤치마크 데이터셋으로 다양한 변환 데이터셋을 생성한 후에 대표적인 여러 판별 알고리즘에 적용하여 성능 비교 및 가설 검증을 수행하였다. 그 결과 대부분의 메타특징과 판별 성능 사이의 유의한 관련성이 확인되었으며, 일부 예외적인 부분에 대한 고찰을 하였다. 본 연구의 실험 결과는 향후 메타특징에 따른 분류알고리즘 추천 시스템에 활용할 것이다.

경찰서 유치장 시설 및 운영에 관한 유치인의 인식연구 (A Study of Detainees' Perceptions of the Detention Facilities of the Police Station and their Operation)

  • 정우열;박동균;김도균
    • 시큐리티연구
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    • 제13호
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    • pp.423-449
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    • 2007
  • 본 연구는 경찰서 유치장에 구금되어 있는 유치인들의 인식분석을 통하여 유치장의 시설 및 운영 실태를 분석하고, 그에 대한 정책적 시사점을 제시하는데 목적이 있다. 한국 경찰서 유치장 시설에 대한 유치인 인식조사 결과에 따른 정책적 제언은 첫째, 유치장 구조는 인권친화적인 일자형으로 배치하고, 여성${\cdot}$남성${\cdot}$장애인${\cdot}$소년범등의 피의자를 차별하여 유치할 수 있는 유치장 시설을 확충해야 한다. 둘째, 유치실 외부에 목욕장과 세면장 시설을 유치인들이 항상 이용할 수 있도록 하여야 한다. 셋째, 비상구가 설치되어 있지 않은 경우 빠른 시일 내에 비상구를 설비해야 하며, 수용된 유치인수와 내부면적을 고려하여 소화기를 충분히 비치해야 할 것이다. 넷째, 외부의 공기를 유치장 내부로 순환할 수 있도록 적절한 수의 창문을 확보하여야 할 것이며, 인공조명에만 의존하기 보다는 자연채광을 활보하는 실질적인 조치가 필요하다. 다섯째, 유치장 내 냉${\cdot}$난방 시설은 유치인의 수와 규모에 합당한 시설을 구비하여야 할 것이다. 또한, 경찰서 유치장 운영에 대한 유치인 인식조사 결과에 따른 정책적 제언은 첫째, 유치장 운영의 문제는 낙후된 유치장 시설과 함께 다루어져야 할 것이며, 빠른 시일 내에 예산확보 등과 같은 조치를 해야 한다. 둘째, 낡고 오랜 된 책들은 폐기하고, 독서 흥미를 유발 할 수 있는 잡지 등을 구비하는 것이 요구되며, 유치된 피의자 중에는 생계가 곤란한 점 등을 충분히 고려하여 기본적인 생필품 등은 지급하는 것이 바람직하다. 셋째, 영치물품의 관리는 모든 경찰서 유치장에서 동일한 제목의 서류와 양식으로 관리 되어져야 하며, 여성유치보호관 인력을 확충하여 여성 유치인들에 대한 신체검사 및 송치 등의 업무를 전담하게 하여야 한다. 또한, 장애인을 위해 구비된 목발이나 휠체어, 이동식 좌변기 등과 같은 장애인관련 시설물들을 잘 관리하고 보관할 필요가 있다.

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일부 만성 정신질환자의 구강건강 상태 (Oral Health Status of Some Patients with Chronic Mental Illness in Korea)

  • 서혜연;전현선;박수경;박기창;정원균;문소정
    • 치위생과학회지
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    • 제13권4호
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    • pp.493-500
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    • 2013
  • 본 연구는 최근에 크게 증가하고 있는 정신질환자의 구강건강 문제에 주목하여 그 실태를 파악하고자 시행하였다. 강원도 소재의 정신보건센터 한 곳의 주간 프로그램 참여대상자(23명)와 정신병원 한 곳의 입원 대상자(69명) 전체 92명을 편의집락추출하여 구강건강상태와 치주건강상태, 구강위생상태를 사정하였으며 수집된 자료를 비교 분석한 결과 다음과 같은 결론을 얻었다. 1. 상실치아(MT)는 병원 대상자(6.42)가 센터 대상자(1.83)보다 더 높았으나, 충전치아(FT)는 센터 대상자(4.78)가 병원 대상자(2.52)보다 높았다(p<0.05). DMFT index는 정신질환자(12.80)가 전국표본(6.22)에 비해 더 높았고, 연령이 높을수록, 학력이 낮을수록, 의료급여 대상자의 구강건강 상태가 더 나빴다(p<0.05). 2. 구강위생상태는 PHP index 3.41로 자가구강건강관리가 잘 이루어지지 않는 편이였다(p<0.05). 3. 치주건강 상태는 병원 대상자(81.7%)가 센터 대상자(47.6%)에 비해 치주요양필요자율이 더 높았으며, 특히 40대와 60대, 학력이 낮을수록, 가족이 없을수록 더 나빴다(p<0.05). 치주요양불필요자율(CPITN0)은 병원 대상자(18.3%)가 전국표본(27.4%)에 비해 낮았으며, 치주조기병치료필요자율(CPITN3)은 병원 대상자(13.3%)가 전국표본(5.7%)보다 더 높았다. 4. 정신질환자의 구강건강상태를 개선하기 위하여 치과위생사는 정신질환자의 구강건강 상태 증진을 위한 노력을 해야 하며, 이에 앞서 해당 집단 안에서 연령과 학력, 결혼유무, 가족 형태, 경제적인 상태 등을 선행조사할 필요가 있다. 또한 정신질환 종류와 심도별 인지능력을 고려하여 교육매체와 교육 프로그램을 구분하여 고안해야 한다. 한편 치과계에서는 정신질환자의 구강건강상태를 개선하기 위한 정책적인 방안을 마련하는 데에 점진적인 노력을 기울여야 하며, 주기적인 구강건강관리실태를 파악할 필요가 있다. 5. 본 연구는 접근이 어려운 정신질환자를 대상자로 선정하여 전반적인 구강건강상태를 측정하였다는 점에 그 의의가 있으나, 표본을 단일모집단으로 선정하였다는 점에 한계가 있다.