• Title/Summary/Keyword: Self-audit

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The Relationship between Insomnia and Somatization According to Types of Work of Firefighters (소방공무원의 직무유형에 따른 불면과 신체화증상과의 관계)

  • Yoon, Heesoo;Ju, Gawon;Lee, Sang Ick;Shin, Chul-Jin;Son, Jung-Woo;Kim, Siekyeong;Park, Hyemi;Lee, Jeong Hwan
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.1
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    • pp.42-52
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    • 2020
  • Objectives : Firefighters are always under stress due to their job environment, and they are likely to become psychologically vulnerable due to continuous exposure to traumatic events, which is a stressful situation that requires emergency standby at all times. The aims of this study were to examine mental health factors for each division of firefighters and to see the relationship between sleep and somatization symptoms among them. Methods : General characteristics and related inspections were conducted through self-reporting questionnaires for 1,264 firefighters working at Chungbuk fire stations. Several mental health factors were investigated by the Insomnia Severity Index, Severity of somatic symptoms, Impact of Event Scale, Perceived Stress Scale, Resilience Scale, Alcohol Dependent Screening Scale, and the Center for Epidemiologic Studies Depression Scale Depression Scale and Mini-International Neuropsychiatric Interview. Results : Among the mental health variables, the relationship between insomnia and somatization varies significantly depending on types of work. It was reported that the first aid team was significantly higher than the fire suppression and rescue team. Post-traumatic stress, depression and drinking also differ significantly depending on types of work. The first aid team reported more posttraumatic stress than the fire suppression team and more depressed mood than the rescue team. The administration part had more alcohol consumption than the fire suppression or first aid team. Resilience was significantly higher in the rescue team than the first aid team. No significant differences between the types of work about stress and suicide risks. Insomnia, stress, and post-traumatic stress were significant predictors of somatization among firefighters. Above all, insomnia was significant mental health variable affecting somatization. Conclusions : Various mental health factors were different according to the types of work in firefighters. The First aid team was more vulnerable to mental health variables such as insomnia and somatization than other divisions. Insomnia is the most important cause of somatization in firefighters, so it is recommended that they be treated for insomnia and to prepare institutional policies.

Adequacy of Medical Manpower and Medical Fee for Newborn Nursery Care (신생아실 의료인력의 적정성 및 신생아관리료의 타당성 분석)

  • Park, Jung-Han;Kim, Soo-Yong;Kam, Sin
    • Journal of Preventive Medicine and Public Health
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    • v.24 no.4 s.36
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    • pp.531-548
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    • 1991
  • To assess the adequacy of medical manpower and medical fee for the newborn nursery care, the author visited 20 out of 24 hospitals with the pediatric training program in Youngnam area between July 29 and August 14, 1991. Total number of newborn, both normal and sick, admission and discharge in 1-30 June 1991 was obtained from the logbook of nursery. Head nurse and staff pediatrician of the nursery were interviewed to get the current staffing for the nursery and their subjective opinion on the adequacy of nursery manpower and the difficulties in recruiting manpower. Average medical fee charged for the maternity and normal newborn nursery care was obtained from the division of self-audit of medical insurance claim of each hospital. Average minimum requirement of nursing care time for one normal newborn per day was 179.5 (${\pm}58.6$) minutes; 202.3(${\pm}50.7$) minutes for the university hospitals and 164.2(${\pm}60.5$) minutes for the general hospitals. The ratio of minimum requirement of nursing care time and available nursing time was 1.42 on the average. Taking the additional requirement of nursing care for the sick newborns into consideration, the ratio was 2.06. The numbers of R. N. and A. N. in the nurserys of study hospitals were 31%, and 17%, respectively, of the nursing manpower for the nursery recommended by the American Academy of Pediatrics. These findings indicate that the nursing manpower in newborn nursery is in severe shortage. Ninety percent of the head nurses and 85% of the staff pediatrician stated that the newborn nursery is short of R.N. and 75% of them said that the nurse's aide is also short. Major reason for not recruiting R.N. was the financial constraint of hospital. For the recruitment of nurse's aide, short supply was the second most important reason next to the financial constraint. However, limit of quarter in T.O. was the mar reason for the national university hospitals. Average total medical fee for the maternity and newborn nursery cares of a normal vaginal delivery who stayed two nights and three days at hospital was 219,430won. Out of the total medical fee, 20,323won(9.3%) was for the newborn nursery care. In case of C-section delivery who stayed six nights and seven days, total medical fee was 732,578won and out of the total fee 76,937won (12.0%) was for the newborn care. Cost for a newborn care per day by cost accounting was 16,141won for the tertiary care hospitals and 14,576won for the all other hopitals. The ratio of cost and the fee schedule of the medical insurance for a newborn care per day was 5.0 for the tertiary care hospitals and 4.9 for the all other hospitals. Considering the current wage level of the medical personnel, capital investment for the hospital facilities and equipments, and the cost for hospital maintenance, it is hard to expect adequate quality care in the newborn nursery under the current medical insurance fee schedule.

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Comparison of health care practice, dietary behavior, and nutrient intakes, considering the alcohol drinking status of industrial workers in the Chungnam area (충남지역 일부 산업체 근로자의 알코올섭취 수준에 따른 건강관리 실천, 식행동 및 영양소 섭취상태 비교)

  • Park, Gun Hee;Rho, Jeong Ok
    • Journal of Nutrition and Health
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    • v.54 no.3
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    • pp.277-291
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    • 2021
  • Purpose: This study was undertaken to identify the alcohol drinking status of industrial workers, their health care practice, and dietary behavior, as well as their nutrient intake. Methods: In July 2019, 220 male subjects working in the Chungnam area were enrolled in the study. Their alcohol drinking status was evaluated by applying the Alcohol Use Disorder Identification-K (AUDIT-K) system. Demographic characteristics, status of health care practice, and dietary behaviors were assessed using a self-administered questionnaire; nutrient intakes were analyzed using 24-hour recalls. Data were analyzed by applying χ2-test, ANOVA, Duncan test, and Pearson's correlation analysis with SPSS v. 25.0. Results: Workers were classified by their alcohol drinking status as 'normal' (84, 38.2%), 'problem drinker' (45, 20.5%), 'alcohol dependence I' (60, 27.3%), and 'alcohol dependence II' (31, 16.0%). The alcohol drinking status showed significant differences with age (p < 0.05), monthly income (p < 0.05), smoking status (p < 0.05), and need for weight control (p < 0.05). Moreover, increased alcohol intake resulted in significantly decreased levels of health care practice and dietary behaviors (p < 0.05, p < 0.01, respectively). The energy intake was highest in the 'alcohol dependence I' group, followed by 'alcohol dependence II', 'problem drinker', and 'normal drinker' (p < 0.05). Intakes of vitamin E, vitamin C, and niacin in the 'alcohol dependence I' group were found to be higher than the other groups (p < 0.05). A negative correlation was obtained between alcohol drinking status, health care practice, and dietary behaviors, whereas a positive correlation was determined between alcohol drinking status, energy and water intakes. Conclusion: Considering these results, we conclude the necessity to consider nutritional and alcoholic education programs for improving the quality of work life of industrial workers, based on their alcohol drinking status.