• 제목/요약/키워드: RAM Objective

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요양·재활병원 환자의 사회적 입원과 지역사회 복귀 어려움에 대한 작업치료사의 관점: 현상학적 연구 (Phenomenological Qualitative Research of Social Admission in Rehab hospitals: Occupational Therapists' Perspectives)

  • 김정헌;황나경;김종성;송영진;최민경;김형선;한가람
    • 재활치료과학
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    • 제9권3호
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    • pp.103-120
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    • 2020
  • 목적 : 본 연구는 재활·요양병원 환자의 사회적 입원이 증가하고 있는 현상에 대해 작업치료사의 관점에서 분석하고자 하였다. 연구방법 : 작업치료사들의 관점을 확인하기 위하여 재활 서비스 평가 도구 RSAT를 기반으로 주관식 설문지를 구성하였고, 2019년 8월 전국 3년차 이상의 작업치료들에게 설문지를 배포 및 수거하였다. 설문지의 응답자료를 van Kaam의 현상학적 연구 방법을 통해 분석하였고, 유효 세부서술에 대해 Word cloud로 다빈도 단어를 분석하였다. 결과 : 배포한 설문지는 수도권, 충청권, 경상권에서 46명의 작업치료사들로부터 응답을 받았다. 설문지의 응답자료는 2개의 범주(categories)와 4개의 주제(theme), 13개의 하위주제(subtheme)로 분석되었다. 2개 범주는 '병원의 체계'와 '작업치료 임상의 내·외부적 요인'으로 나타났으며 '병원의 체계'에 따른 주제는 '다학제 팀 접근의 어려움'과 '퇴원계획 체계의 미흡'으로 나타났다. '작업치료 임상의 내·외부적 요인'에 따른 주제로는 '작업치료사의 어려움'과 '작업치료 실시의 어려움'으로 분석되었다. 결론 : 작업치료사들은 재활·요양병원 환자들의 지역사회 복귀가 어려운 가장 큰 원인이 합리적이지 못한 작업치료 관련 요양급여체계에 있다고 지적하였다. 퇴원 및 지역사회 적응을 위한 작업치료 서비스 체계의 미흡함 역시 환자들로 하여금 퇴원하지 못하고 결국 다시 병원으로의 입원을 하게 만드는 주요 원인의 하나로 인식하고 있었다. 향후 작업치료 처방 및 의료 급여 체계를 환자의 재활 목적에 맞도록 다면화할 필요가 있음을 제언한다.

반회후두신경 손상을 동반하지 않은 갑상선 절제술 환자에서 수술 초기의 음성 및 연하 기능의 변화에 대한 분석 (Analysis of Voice and Swallowing Symptoms after Thyroidectomy in Patients without Recurrent Laryngeal Nerve Injury in Early Postoperative Period)

  • 김희진;금보람;김근희;전승식;김혜진;김성균;홍석진;홍석민;김용복;박일석
    • 대한후두음성언어의학회지
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    • 제27권2호
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    • pp.108-113
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    • 2016
  • Background and Objectives : After thyroidectomy, many patients experience problems report such things as reduced voice range and vocal fatigue, swallowing problems without superior and recurrent laryngeal nerve injury. The purpose of this study was to evaluate voice and swallowing problems before and after thyroid surgery without laryngeal nerve injury. Materials and Methods : Ninety-three patients who underwent thyroidectomy without laryngeal nerve injury and completed the follow-up evaluations were studied between June 2013 and December 2015. Each evaluation was performed preoperatively, as well as 1 week, 1 month postoperatively. Analysis was performed including voice handicap index (VHI), dysphagia handicap index (DHI), and acoustic voice analysis. Results : Patients show significant variation of parameters in the fundamental frequency (F), maximal phonation time (MPT), shimmer, jitter and soft phonation index (SPI) early after operation, and most of them showed recovery of parameters after 1month of operation. Perceptive complaint of voice and swallowing also showed significant decreased after operation (p<0.005). After 1month of operation, MPT, highest frequency and frequency ranges still showed significant decreased parameters. Comparing acoustic and perceptive parameters of total thyroidectomy and lobectomy, there was no significant changes between them except highest frequency (p=0.042). Conclusion : The results from both subjective and objective evaluations show voice and swallowing disturbance after thyroidectomy even in the absence of laryngeal nerve and provide patients information about the recovery process after surgery. Highest frequency parameter showed most significant changes after operation.

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경직형 양하지 마비 아동과 일반아동의 감각처리 능력 비교 (A Comparison of the Sensory Processing of Children With and Without Spastic Diplegia)

  • 김보람;신지은;김경미
    • 대한감각통합치료학회지
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    • 제13권2호
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    • pp.21-29
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    • 2015
  • 목적 : 뇌성마비아동 중 양하지마비 아동과 일반아동을 대상으로 감각처리 능력을 비교하고자 하였다. 또한 아동을 학령전기와 학령기로 나누어 연령에 따른 감각처리 특성을 알아보고자 하였다. 연구방법 : 경직형 양하지마비 아동과 일반아동의 감각처리 능력을 알아보기 위해 단축형 감각프로파일(Short Sensory Profile: SSP)을 사용하였다. 연구대상은 뇌성마비 중 양하지마비 유형으로 진단받은 만 3~10세 아동과 일반아동을 대상으로 보호자가 직접 설문지 작성을 하도록 하였다. 2013년 11월부터 2014년 2월까지 설문지 배부 및 수거가 이루어 졌으며 경직형 양하지마비 아동 40명, 일반아동 40명의 자료가 분석에 사용되었다. 연구 분석은 집단별 비교를 위해 독립표본 t-test, 연령별 비교를 위해 Mann Whitney U-test를 사용하였다. 연구결과 : 단축형 감각프로파일 총점과 모든 영역에서 경직형 양하지마비 아동이 일반아동보다 점수가 낮게 나타났으며 촉각 민감성과 맛/냄새 민감성을 제외한 5가지 영역과 감각처리 총점에서 두 그룹 간 유의미한 차이가 있는 것으로 나타났다. 학령전기 아동은 총점과 움직임 민감성, 과소반응/특정자극 찾기, 청각 여과하기, 활력이 부족하고 허약함, 시각/청각 민감성에서 일반아동과 유의미한 차이를 보였으며 학령기 아동은 움직임 민감성, 활력이 부족하고 허약함, 시각/청각 민감성에서 유의미한 차이를 보였다. 결론 : 본 연구 결과는 경직형 양하지마비 아동의 감각처리 평가 시 기초자료로 사용될 수 있으리라 생각된다. 앞으로 뇌성마비의 다른 유형을 대상으로 하는 감각처리 능력에 대한 연구가 이루어져야 할 것이다.

Dental Practitioners Self Reported Performance of Tobacco Cessation Counseling Interventions: A Cross Sectional Study

  • Parakh, Abhinav;Megalamanegowdru, Jayachandra;Agrawal, Rohit;Hathiwala, Siddhi;Chandrakar, Mayank;Tiwari, Ram;Veeranna, Thippeswamy
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권10호
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    • pp.6141-6145
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    • 2013
  • Background: The objective of the study was to determine the knowledge, attitude and behaviors of the practicing dentists regarding tobacco cessation counseling (TCC) in Chhattisgarh state and also the barriers that prevent them from doing so. Materials and Methods: The study was conducted among dental practitioners of Raipur district, Chhattisgarh state (India). The sampling frame was registration with the State Dental Council and practicing in Raipur district. A questionnaire was personally administered and the practitioners were given explanations regarding how to complete it. Only descriptive statistics were calculated (SPSS version 16 for Windows). Results: Based on the responding dentists' self reports, 76% were not confident in TCC, 48% did not assume TCC to be their responsibility, 17% considered that it might have a negative impact on their clinical practice, whereas 24% considered it might take away precious time from their practice, 25% considered TCC by dentists to be effective to a considerable extent and 80% considered TCC activities are not effective due to lack of formal training, 69% considered dental clinics as an appropriate place for TCC but 82% thought there must be separate TCC centre and 100% of the dentists wanted TCC training to be a part of practice and that it should be included in dental curriculum. Some 95% of them were of the view that tobacco products should be banned in India and 86% responded that health professionals must refrain from tobacco habits so to act as role models for society. Conclusions: Dental professionals must expand their armamentarium to include TCC strategies in their clinical practice. The dental institutions should include TCC in the curriculum and the dental professionals at the primary and the community health care level should also be trained in TCC to treat tobacco dependence.

Comparison of Biomechanical Characteristics of Rowing Performance between Elite and Non-Elite Scull Rowers: A Pilot Study

  • Kim, Jin-Sun;Cho, Hanyeop;Han, Bo-Ram;Yoon, So-Ya;Park, Seonhyung;Cho, Hyunseung;Lee, Joohyeon;Lee, Hae-Dong
    • 한국운동역학회지
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    • 제26권1호
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    • pp.21-30
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    • 2016
  • Objective: This study aimed to examine the characteristics of joint kinematics and synchronicity of rowing motion between elite and non-elite rowers. Methods: Two elite and two non-elite rowers performed rowing strokes (3 trials, 20 strokes in each trial) at three different stroke rates (20, 30, 40 stroke/min) on two stationary rowing ergometers. The rowing motions of the rowers were captured using a 3-dimensional motion analysis system (8-infrared camera VICON system, Oxford, UK). The range of motion (RoM) of the knee, hip, and elbow joints on the sagittal plane, the lead time ($T_{Lead}$) and the drive time $T_{Drive}$) for each joint, and the elapsed time for the knee joint to maintain a fully extended position ($T_{Knee}$) during the stroke were analyzed and compared between elite and non-elite rowers. Synchronicity of the rowing motion within and between groups was examined using coefficients of variation (CV) of the $T_{Drive}$ for each joint. Results: Regardless of the stroke rate, the RoM of all joints were greater for the elite than for non-elite rowers, except for the RoMs of the knee joint at 30 stroke/min and the elbow joint at 40 stroke/min (p < .05). Although the $T_{Lead}$ at all stroke rates were the same between the groups, the $T_{Drive}$ for each joint was shorter for the elite than for the non-elite rowers. During the drive phase, elite rowers kept the fully extended knee joint angle longer than the non-elite rowers (p < .05). The CV values of the TDrive within each group were smaller for the elite compared with non-elite rowers, except for the CV values of the hip at all stroke/min and elbow at 40 stroke/min. Conclusion: The elite, compared with non-elite, rowers seem to be able to perform more powerful and efficient rowing strokes with large RoM and a short $T_{Drive}$ with the same $T_{Lead}$.

의사들의 유헬스케어 서비스에 대한 인식과 사용의도 (Doctors' Perception and Intention of the U-healthcare Service)

  • 이윤경;박지윤;노미정;왕보람;최인영
    • 한국콘텐츠학회논문지
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    • 제12권2호
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    • pp.349-357
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    • 2012
  • 유헬스케어 서비스는 오랫동안 만성질환 관리에 대한 효과적인 대안으로 부각되고 있으나 아직까지 활성화되지 못하고 있다. 본 연구는 유헬스케어 서비스 도입에 있어 중요 의사결정자인 의사들의 유헬스케어 서비스에 대한 인식과 사용의도에 영향을 주는 요인에 대해 고찰해 보고자 한다. 이를 위해 유헬스케어 서비스 제공자인 의사들을 대상으로 설문조사를 실시하여 유헬스케어 서비스 사용의도에 따른 집단별 특성을 비교하고, 사용의도에 영향을 주는 요인을 고찰하기 위해 로지스틱 회귀분석을 실시하였다. 분석 결과 의사들의 유헬스케어 서비스 사용경험은 16.0%로 낮으나 사용의도는 70.1%로 높게 나타났다. 또한 유헬스케어 서비스 적용은 만성질환과 예방분야가 적절하다고 응답하였으며, 적용이 적합한 질환은 당뇨병과 고혈압등의 순으로 나타났다. 의사 특성에 따른 사용의도의 차이에 관한 로지스틱 분석 결과 유헬스케어 서비스 사용의도는 대학병원에 비해 비대학병원 의사들의 사용의도가 3.7배 높았다. 본 연구는 유헬스케어 서비스에 대한 의사들의 인식 그리고 사용의도에 대한 집단 간 차이를 파악함으로써 유헬스케어 서비스의 활성화와 효과적인 비즈니스 모델 개발에 기여할 것이다.

Morphological defects of sperm and their association with motility, fertility, and hatchability in four Korean native chicken breeds

  • Feyisa, Shiferaw Garoma;Park, Young Hyun;Kim, Young Min;Lee, Bo Ram;Jung, Kyung Min;Choi, Seong Bok;Cho, Chang Yeon;Han, Jae Yong
    • Asian-Australasian Journal of Animal Sciences
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    • 제31권8호
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    • pp.1160-1168
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    • 2018
  • Objective: This study was conducted to compare morphological defects, viability, motility (MOT), fertility (F), and hatchability (H) in four Korean native chicken breeds (KNCBs), and to evaluate whether defective segments of spermatozoa are associated with MOT, F, and H. Methods: Four KNCBs, including Korean Ogye (KO), Hwangbong (HB), Hyunin Black (HH), and Hoengseong Yakdak (HY) were used. White Leghorn (WL) was used as a control. Nine cocks from each breed were randomly assigned into three groups. Semen was collected by abdominal massage method. Eosin-nigrosin staining method was used to identify live-dead spermatozoa. Different segments and specific morphological defects of spermatozoa were identified using 4', 6-diamidino-2-phenylidole and MitoTracker Red CMXRos. F and H rates were evaluated following artificial insemination (AI). Results: KO had the highest MOT rate compared to HY. Viable normal sperm rates of KO and HH were high and comparable with WL. HY spermatozoa had the highest viable abnormal sperm (VAS) or morphological defect rate followed by HB. Likewise, HB spermatozoa had the highest dead sperm (dead) rate compared to KO, HY, and WL. Bent, coiled, detached, broken, and knotted were common identified specific morphological defects for all breeds. Most morphological defects were at the head and tail in all breeds. VAS showed strong negative correlation with MOT (r = -0.697) and F (r = -0.609). Similarly, defective tail was negatively correlated with MOT (r = -0.587), F (r = -0.797), and H (r = -0.448). The F and H rates of KO and WL were comparable. Conclusion: These data indicate that most identified specific morphological defects are at the head and tail. VAS and defective tail were associated with poor motility, F, and H. KNCBs showed more morphological defects than WL. Finally, these results will facilitate successful AI and semen cryopreservation.

Flux, Solder 및 Grease 세정용 CFC 대체 비수계 세정제 배합 연구 (Formulation of Alternative Non-Aqueous Cleaning Agents to Chlorofluorocarbon Compounds for Cleaning Flux, Solder and Grease)

  • 정용우;이호열;이명진;송아람;배재흠
    • 청정기술
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    • 제12권4호
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    • pp.250-258
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    • 2006
  • CFC-113과 1,1,1-trichloroethane 등과 같은 CFC 화합물은 화학적 안정성 및 열역학적 특성 등이 우수하고, 불연성이며, 부식성이 없는 화합물로 오랜 시간 동안 전 산업에 걸쳐 널리 사용 되어 왔다. 하지만, 1989년 지구 환경의 보호를 위해 이들의 생산과 사용을 규제하는 국제협약인 '오존층 파괴물질에 관한 몬트리올 의정서'가 체결되어 대체 세정제가 요구되고 있다. 본 연구에서는 세정 시스템을 변화시키지 않고 세정력이 우수하면서 환경 친화적이며 인체 유해도가 낮으며 부식성 물질을 발생 시키지 않는 비수계 세정제를 개발하고자 하였다. 이를 위하여 글리콜 에테르계의 용매와 파라핀계 탄화수소 물질을 일정 비율로 혼합, 배합하면서 실록산을 첨가하여 비수계 세정제를 배합 제조하였다. 그리고 이들 세정제의 물성과 세정성을 평가하여 대체 세정제로서의 가능성을 평가하였다. 배합세정제의 물성측정 결과 밀도와 표면장력이 낮아 오염물에 대한 침투력이 우수할 것으로 예상되었고 인화점과 증기압 측정값으로 세정제의 안전성을 평가할 수 있었다. 플럭스, 솔더 및 그리스에 대한 세정성능 측정결과 높은 세정성능을 보여주었고 피세정물의 표면에 잔류물이 생성되지 않았다. 결과적으로, 규제물질과 동등한 세정능력을 지니며 침투력이 우수하고 인체 유해도가 낮은 세정제를 개발할 수 있었다.

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응급구조학과 대학생들의 안락사에 대한 생명의료윤리 의식 연구 (A Study on the Biomedical Ethics Consciousness for Euthanasia of the Paramedic Students)

  • 최보람
    • 한국응급구조학회지
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    • 제14권2호
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    • pp.41-55
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    • 2010
  • Objective : This study is designed to present the direction and the necessity of education on the biomedical ethics the establish desirable ethical view of paramedic students by understanding on the consciousness of students of department of emergency medical technology on biomedical ethics on euthanasia. Method : Data were collected from on 335 students of department of emergency medical technology in 4-year-college located in districts of Chungcheong-do, from March 4 to April 22, 2010. The questionnaire consisted of total 29 items, i.e., 11 items of general characteristics, 11 items of characteristics related to biomedical ethics and 7 items of consciousness on euthanasia. Result : In general characteristics, the first grade showed the most dense distribution of 37.3%, the second grade was 20.0%, the third grade was 20.9% and the fourth grade was 21.8%. In the consciousness of biomedical ethics on euthanasia, the third and the fourth grades showed a higher ratio(${\chi}^2$ = 136.327, p= .000), in comparison with the first and the second grades, the higher year they were, the higher degree of consciousness they had. The consciousness on each item of euthanasia showed significant differences in grade (F = 8.203, p= .000), experience of clinical practice or none (t = 3.731, p= .000), experience of biomedical ethics education or none (t = 1.997, p = .047) and degree of consciousness on DNR (F = 8.240, p = .000) regarding 'CPR shall not be required in any cases if a patient wants DNR', in experience of biomedical ethics education or none (t = 2.452, p= .015) and degree of consciousness on DNR (F = 2.725, p = .044) regarding if a patient refuses all treatments, the patient's opinion shall be respected', and in degree of consciousness on DNR (F = 2.858, p = . 037) regarding 'after determination of DNR, if the family wants a positive treatment, it shall follow the family's request'. Conclusion : It seemed that the differences in consciousness according to grade and experience of clinical practice were influenced by experiences to treat patients in personally. Moreover, it showed that the higher grade they are, the more experience of education they have, the experiences of education had influences on the consciousness. Development of educational programs is required in order to supply accurate knowledge on biomedical ethics for euthanasia to lower-grade students the to let them establish ethical views properly, and in order to correct wrong knowledge and to establish ethical views while supplying knowledge on biomedical ethics for euthanasia to higher-grade students.

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Clinical image quality evaluation for panoramic radiography in Korean dental clinics

  • Choi, Bo-Ram;Choi, Da-Hye;Huh, Kyung-Hoe;Yi, Won-Jin;Heo, Min-Suk;Choi, Soon-Chul;Bae, Kwang-Hak;Lee, Sam-Sun
    • Imaging Science in Dentistry
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    • 제42권3호
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    • pp.183-190
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    • 2012
  • Purpose: The purpose of this study was to investigate the level of clinical image quality of panoramic radiographs and to analyze the parameters that influence the overall image quality. Materials and Methods: Korean dental clinics were asked to provide three randomly selected panoramic radiographs. An oral and maxillofacial radiology specialist evaluated those images using our self-developed Clinical Image Quality Evaluation Chart. Three evaluators classified the overall image quality of the panoramic radiographs and evaluated the causes of imaging errors. Results: A total of 297 panoramic radiographs were collected from 99 dental hospitals and clinics. The mean of the scores according to the Clinical Image Quality Evaluation Chart was 79.9. In the classification of the overall image quality, 17 images were deemed 'optimal for obtaining diagnostic information,' 153 were 'adequate for diagnosis,' 109 were 'poor but diagnosable,' and nine were 'unrecognizable and too poor for diagnosis'. The results of the analysis of the causes of the errors in all the images are as follows: 139 errors in the positioning, 135 in the processing, 50 from the radiographic unit, and 13 due to anatomic abnormality. Conclusion: Panoramic radiographs taken at local dental clinics generally have a normal or higher-level image quality. Principal factors affecting image quality were positioning of the patient and image density, sharpness, and contrast. Therefore, when images are taken, the patient position should be adjusted with great care. Also, standardizing objective criteria of image density, sharpness, and contrast is required to evaluate image quality effectively.