• 제목/요약/키워드: Shapiro

검색결과 168건 처리시간 0.025초

소뇌성 운동실조증 성인의 균형 유지를 위한 신체활동 지도 경험 사례 연구 (Case Study on Physical Activity Guidance Experience to Maintain Balance in Adults with Cerebellar Ataxia)

  • 김정현
    • 산업융합연구
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    • 제22권3호
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    • pp.51-65
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    • 2024
  • 본 연구는 소뇌성 운동실조증인 사람을 대상으로 반복적인 기본운동 기술 기반 신체활동을 통하여 균형 및 보행 기능의 긍정적인 변화와 지도자의 지도 과정에서의 어려움을 이해하는 것이다. 이를 위해 5명의 소뇌성 운동실조증 성인을 연구대상자로 선정하였고, 이들을 지도한 3명의 지도자가 연구참여자로 참여하였다. 양적 자료 수집을 위하여 연구참여자들의 16주 동안 신체활동 수업 사전 및 사후 평가를 통하여 평균과 표준편차를 살펴보았다. SAS 9.1 통계 프로그램의 샤피로-윌크 검정법으로 수집한 자료의 평균과 표준편차를 산출하였다(p<.05). 질적자료수집 방법으로 Spradley(1980)가 제안한 발전식 연구단계(DSR)의 문화기술적 방법을 채택하였고, Mertens(1990)의 분석법에 따라 수집한 자료를 귀납적으로 분석하였다. 이를 통하여 31개의 개념, 10개의 하위 범주, 4개의 범주를 발견하였다. 그 결과 연구참여자들이 겪는 어려움으로는 지도환경의 미흡, 수요자들의 불만, 지도의 어려움 그리고 동료 비협조 등으로 나타났다. 이러한 연구 결과를 바탕으로 소뇌성 운동실조증 성인들의 균형 유지뿐만 아니라 그들의 신체활동 지도를 위하여 공공기관뿐만 아니라 바우처를 사용할 수 있는 사설신체활동 기관에도 제도적·법적·정책적 지원이 이루어져야 하는 것으로 나타났다.

중증 손상 기전의 안정된 환자에서 중증도 예측 인자들에 대한 다변량 분석 (Multivariate Analysis of Predictive Factors for the Severity in Stable Patients with Severe Injury Mechanism)

  • 이재영;이창재;이형주;정태녕;김의중;최성욱;김옥준;조윤경
    • Journal of Trauma and Injury
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    • 제25권2호
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    • pp.49-56
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    • 2012
  • Purpose: For determining the prognosis of critically injured patients, transporting patients to medical facilities capable of providing proper assessment and management, running rapid assessment and making rapid decisions, and providing aggressive resuscitation is vital. Considering the high mortality and morbidity rates in critically injured patients, various studies have been conducted in efforts to reduce those rates. However, studies related to diagnostic factors for predicting severity in critically injured patients are still lacking. Furthermore, patients showing stable vital signs and alert mental status, who are injured via a severe trauma mechanism, may be at a risk of not receiving rapid assessment and management. Thus, this study investigates diagnostic factors, including physical examination and laboratory results, that may help predict severity in trauma patients injured via a severe trauma mechanism, but showing stable vital signs. Methods: From March 2010 to December 2011, all trauma patients who fit into a diagnostic category that activated a major trauma team in CHA Bundang Medical Center were analyzed retrospectively. The retrospective analysis was based on prospective medical records completed at the time of arrival in the emergency department and on sequential laboratory test results. PASW statistics 18(SPSS Inc., Chicago, IL, USA) was used for the statistical analysis. Patients with relatively stable vital signs and alert mental status were selected based on a revised trauma score of more than 7 points. The final diagnosis of major trauma was made based on an injury severity score of greater than 16 points. Diagnostic variables include systolic blood pressure and respiratory rate, glasgow coma scale, initial result from focused abdominal sonography for trauma, and laboratory results from blood tests and urine analyses. To confirm the true significance of the measured values, we applied the Kolmogorov-Smirnov one sample test and the Shapiro-Wilk test. When significance was confirmed, the Student's t-test was used for comparison; when significance was not confirmed, the Mann-Whitney u-test was used. The results of focused abdominal sonography for trauma (FAST) and factors of urine analysis were analyzed using the Chi-square test or Fisher's exact test. Variables with statistical significance were selected as prognostics factors, and they were analyzed using a multivariate logistics regression model. Results: A total of 269 patients activated the major trauma team. Excluding 91 patients who scored a revised trauma score of less than 7 points, 178 patients were subdivided by injury severity score to determine the final major trauma patients. Twenty-one(21) patients from 106 major trauma patients and 9 patients from 72 minor trauma patients were also excluded due to missing medical records or untested blood and urine analysis. The investigated variables with p-values less than 0.05 include the glasgow coma scale, respiratory rate, white blood cell count (WBC), serum AST and ALT, serum creatinine, blood in spot urine, and protein in spot urine. These variables could, thus, be prognostic factors in major trauma patients. A multivariate logistics regression analysis on those 8 variables showed the respiratory rate (p=0.034), WBC (p=0.005) and blood in spot urine (p=0.041) to be independent prognostic factors for predicting the clinical course of major trauma patients. Conclusion: In trauma patients injured via a severe trauma mechanism, but showing stable vital signs and alert mental status, the respiratory rate, WBC count and blood in the urine can be used as predictable factors for severity. Using those laboratory results, rapid assessment of major trauma patients may shorten the time to diagnosis and the time for management.

보건소의 환경, 조직구조와 조직유효성과의 관계 (A Study on Relationships Between Environment, Organizational Structure, and Organizational Effectiveness of Public Health Centers in Korea)

  • 윤순녕
    • 지역사회간호학회지
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    • 제6권1호
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    • pp.5-33
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    • 1995
  • The objective of the study are two-fold: one is to explore the relationship between environment, organizational structure, and organizational effectiveness of public health centers in Korea, and the other is to examine the validity of contingency theory for improving the organizational structure of public health care agencies, with special emphasis on public health nursing administration. Accordingly, the conceptual model of the study consisted of three different concepts: environment, organizational structure, and organizational effectiveness, which were built up from the contingency theory. Data were collected during the period from 1st of May through 30th of June, 1990. From the total of 249 health centers in the country, one hundred and five centers were sampled non proportionally, according to the geopolitical distribution. Out of 105, 73 health centers responded to mailed questionnaire. The health centers were the unit of the study, and a various statistical analysis techniques were used: Reliability analysis(Cronbach's Alpha) for 4 measurement tools; Shapiro-Wilk statistic for normality test of measured scores of 6 variables: ANOVA, Pearson Correlaion analysis, regressional analysis, and canonical correlation analysis for the test of the relationships and differences between the variables. The results were. as follows : 1. No significant differences between forma lization, decision-making authority and environmental complexity were found(F=1.383, P=.24 ; F=.801, P=.37). 2. Negative relationships between formalization and decision-making authority for both urban and rural health centers were found(r=-.470, P=.002 ; r=-.348, P=.46). 3. No significant relationship between formalization and job satisfaction for both urban and rural health centers were found (r=-.242, P=.132, r=-.060, P=.739). 4. Significant positive relationship between decision - making authority and job satisfaction were found in urban health centers (r=.504, P=.0009), but no such relationship was observed in rural health centers. Regression coefficient between them was statistically significant($\beta=1.535$, P=.0002), and accuracy of regression line was accepted (W=.975, P= .420). 5. No significant relationships among formalization and family planning services, maternal health services, and tuberculosis control services for both urban and rural health centers were found. 6. Among decision-making authority and family planning services, maternal health services, and tuberculosis control services, significant positive relationship was found between de cision-making authority and family planning services(r=.286, P=.73). 7. A significant difference was found in maternal health services by the type of health centers (F=5.13, P=.026) but no difference was found in tuberculosis control services by the type of health centers, formalization, and decision-making authority. 8. A significant positive relationships were found between family planning services and maternal health services and tuberculosis control services, and between maternal health services and tuberculosis control services (r=-.499, P=.001 ; r=.457, P=.004 ; r=.495, P=.002) in case of urban health centers. In case of rural health centers, relationships between family planning services and tuberculosis control services, and between maternal health services and tuberculosis control services were statistically significant (r=.534, P=.002 ; r=.389, P=.027). No significant relationship was found between family planning and maternal health services. 9. A significant positive canonical correlation was found between the group of independent variables consisted of formalization and de cision-making authority and the group of dependent variables consisted of family planning services, maternal health services and tuberculosis control services(Rc=.455, P=.02). In case of urban health centers, no significant canonical correlation was found between them, but significant canoncial correlation was found in rural health centers(Rc=.578, P=.069), 10. Relationships between job satisfaction and health care productivity was not found significant. Through these results, the assumed relationship between environment and organizational structure was not supported in health centers. Therefore, the relationship between the organizational effectiveness and the congruence between environment and organizational structure that contingency theory proposes to exist was not able to be tested. However decision-making authority was found as an important variable of organizational structure affecting family planning services and job satisfaction in urban health centers. Thus it was suggested that decentralized decision making among health professionals would be a valuable strategy for improvement of organizational effectiveness in public health centers. It is also recommended that further studies to test contingency theory would use variability and uncertainty to define environment of public health centers instead of complexity.

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인공호흡기 사용 신생아의 폐쇄형과 개방형 기관흡인에 관한 연구 (A Comparative Study on Closed vs. Open Endotracheal Suctioning on the Newborn Infants Treated with Ventilator)

  • 박정원;박영애
    • 아동간호학회:학술대회논문집
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    • 아동간호학회 1997년도 정기총회 및 학술대회
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    • pp.61-74
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    • 1997
  • Endotracheal suctioning is a routine procedure used for clearing secretions from the airway of the intubated infant. This procedure is not without complications. Endotracheal suctioning has been associated with decreases in $PaO_2$, decreases in systemic venous oxygenation, alterations in mean arterial Pressure, disturbances in cardiac rhythm and development of nosocomial pneumonia. So several endotracheal suctioning techniques have been developed to prevent these blown complications. Another method of Endotracheal suctioning eliminates the risk associated with disconnecting the infant from the ventilatior to perform the suctioning procedure. Studies examining closed endotracheal suctioning methods reported that the closed method results in less arterial oxygen saturation, and less systemic venous oxygen desaturation. However those studies have focused on adult patients, and there have been no published studies for newborn infants. The specific purpose of this study is to investigate the two methods and to make a comparison in terms of (1)variations in $SaO_2$, heart rate, and respiration rate appeared before and after the endotracheal suctioning; (2)difference in occurrence of nosocomial infection; (3)difference in recovery time to arrive at pre-suction baseline after suctioning and in nursing time taken for the suctioning. The present study is based on the data obtained from two groups of newborn infants : one group comprises 8 infants with closed suctioning (a total of 304 suctions) among 17 infants treated with ventilator and the other group 9 infants with open method (a total of 629 suctions). The data were analyzed using the SPSS statistical program package. As the distribution test on dependent variables with the Skewnesser Shapiro Wilk test showed an asymmetric distribution, the Wilcoxon Matched-pairs Singled- Ranks test was used for the test of variations in $SaO_2$, heart rate, and respiration rate appeared before and after the endotracheal suctioning. The difference in $SaO_2$ recovery time and nursing time was analyzed with the Mann-Whitney U-Test. The difference in physiologic consequences and occurrence of nosocomial infection between the two groups was analyzed with the Fisher's Exact Test. The results of the study are summarized as follows. For the hypothesis 1 (There would be a difference in $SaO_2$, heart rate, and respiration rate before and after suctioning between the two suctioning methods), the difference in $SaO_2$ turns out to be statistically significant (P=0.015), but heart rate and respiration rate do not procedure a notable difference (P=0.630). The hypothesis 2 (There would be a difference in rates at which a complication arises after suctioning between the two groups) does not prove to be statistically valid (P=0.246). For the hypothesis 3(There would be a difference in $SaO_2$ recovery time and nursing time between the two groups), the average $SaO_2$ recovery time after suctioning turned out to have somewhat significant difference (P=0.064), however the difference in nursing time taken for the suctioning was not statistically significant (P=0.610). The analyses indicate that the closed endotracheal suctioning is more efficient as compared with the open method, in maintaining pre-suction baseline $SaO_2$ and a rapid recovery of newborn infants. Based on these results we suggust to apply the closed method to newborn infants in the ventilation treatment. We also suggest to extend the investigation to include the comparison of suction cost taking into account the case in which a complication arises after endotracheal suctioning between the two groups.

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정보시스템 아웃소싱에서 심리적 계약 커미트먼트의 중요성에 대한 연구 (An Empirical Study on the Importance of Psychological Contract Commitment in Information Systems Outsourcing)

  • 김형진;이상훈;이호근
    • Asia pacific journal of information systems
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    • 제17권2호
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    • pp.49-81
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    • 2007
  • Research in the IS (Information Systems) outsourcing has focused on the importance of legal contracts and partnerships between vendors and clients. Without detailed legal contracts, there is no guarantee that an outsourcing vendor would not indulge in self-serving behavior. In addition, partnerships can supplement legal contracts in managing the relationship between clients and vendors legal contracts by itself cannot deal with all the complexity and ambiguity involved with IS outsourcing relationships. In this paper, we introduce a psychological contract (between client and vendor) as an important variable for IS outsourcing success. A psychological contract refers to individual's mental beliefs about his or her mutual obligations in a contractual relationship (Rousseau, 1995). A psychological contract emerges when one party believes that a promise of future returns has been made, a contribution has been given, and thus, an obligation has been created to provide future benefits (Rousseau, 1989). An employmentpsychological contract, which is a widespread concept in psychology, refers to employer and employee expectations of the employment relationship, i.e. mutual obligations, values, expectations and aspirations that operate over and above the formal contract of employment (Smithson and Lewis, 2003). Similar to the psychological contract between an employer and employee, IS outsourcing involves a contract and a set of mutual obligations between client and vendor (Ho et al., 2003). Given the lack of prior research on psychological contracts in the IS outsourcing context, we extend such studies and give insights through investigating the role of psychological contracts between client and vendor. Psychological contract theory offers highly relevant and sound theoretical lens for studying IS outsourcing management because of its six distinctive principles: (1) it focuses on mutual (rather than one-sided) obligations between contractual parties, (2) it's more comprehensive than the concept of legal contract, (3) it's an individual-level construct, (4) it changes over time, (5) it affects organizational behaviors, and (6) it's susceptible to organizational factors (Koh et al., 2004; Rousseau, 1996; Coyle-Shapiro, 2000). The aim of this paper is to put the concept, psychological contract commitment (PCC), under the spotlight, by finding out its mediating effects between legal contracts/partnerships and IS outsourcing success. Our interest is in the psychological contract commitment (PCC) or commitment to psychological contracts, which is the extent to which a partner consistently and deeply concerns with what the counter-party believes as obligations during the IS project. The basic premise for the hypothesized relationship between PCC and success is that for outsourcing success, client and vendor should continually commit to mutual obligations in which both parties believe, rather than to only explicit obligations. The psychological contract commitment playsa pivotal role in evaluating a counter-party because it reflects what one party really expects from the other. If one party consistently shows high commitment to psychological contracts, the other party would evaluate it positively. This will increase positive reciprocation efforts of the other party, thus leading to successful outsourcing outcomes (McNeeley and Meglino, 1994). We have used matched sample data for this research. We have collected three responses from each set of a client and a vendor firm: a project manager of the client firm, a project member from the vendor firm with whom the project manager cooperated, and an end-user of the client company who actually used the outsourced information systems. Special caution was given to the data collection process to avoid any bias in responses. We first sent three types of questionnaires (A, Band C) to each project manager of the client firm, asking him/her to answer the first type of questionnaires (A).

사일리지용 옥수수의 건물수량에 영향을 미치는 기후요인 탐색 (Detecting the Climate Factors related to Dry Matter Yield of Whole Crop Maize)

  • 팽경룬;김문주;김영주;조무환;자릴 가세미 네자드;이배훈;지도현;김지융;오승민;김병완;김경대;소민정;박형수;성경일
    • 한국농림기상학회지
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    • 제17권3호
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    • pp.261-269
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    • 2015
  • 본 연구는 탐색적 자료분석을 이용하여 사일리지용 옥수수(whole crop maize, WCM) 연도별 건물수량 변동의 유의성과 이와 관련 있는 기후요인의 유의성을 확인 하는데 목적이 있다. WCM의 원자료는 30년간의 농협중앙회 수입적응시험 심의결과(7개도 124품종 1,027점)였으며, 이 중 미비하거나 중복된 자료는 삭제 또는 수정하여 최종적으로 7개 도에서 124품종 993점을 이용하였다. WCM의 상대숙도와 출사일수를 기준으로 분류하면 조생종(25품종 200점), 중생종(40품종 409점), 만생종(27품종 234점)및 기타(32품종 150점)였다. 기상자료를 이용하여 기후요인을 측정하기 위한 6개의 기상변수를 생성하였다. 건물수량 및 기후요인을 탐색하기 위해서 기술통계량 및 정규성검정을 실시하였으며, 통계분석은 SPSS 21.0을 이용하였다. 연도별 평균 건물수량을 상위와 하위집단으로 분류하여 비교한 결과 상위와 하위집단 간에는 건물수량의 유의적 차이가 있었다(p<0.05). 두 집단간 차이의 원인을 구명하기 위하여 기후관련 요인들을 분석한 결과 파종수확적산생육온도일수(파종~수확 생육온도일수의 합), 파종수확일조시간(파종일부터 수확일까지의 일조시간의 합) 및 파종수확강수량(파종일부터 수확일까지 일강수량의 합)에서 집단간 유의적 차이가 나타났다(p<0.05). 반면 파종수확강수일수(파종에서 수확까지 강수일수)는 건물수량에 영향을 미치지 않았다(p>0.05). 이상의 결과에서 여러 기상변수 중 파종에서 수확까지의 적산온도, 일조시간 및 강수량이 WCM의 건물수량과 연관이 있는 것으로 나타났다. 그러나 세 변수 간의 기여도($R^2$)는 비교할 수가 없어 추후 회귀분석을 이용하여 WCM의 건물수량에 미치는 각 변수의 기여도 및 건물수량 예측모형을 구축할 필요가 있다.

다용도 프라이머가 레진 시멘트와 수복재의 전단 결합 강도에 미치는 영향 (Effect of universal primer on shear bond strength between resin cement and restorative materials)

  • 김나홍;심준성;문홍석;이근우
    • 대한치과보철학회지
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    • 제50권2호
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    • pp.112-118
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    • 2012
  • 연구 목적: 이 연구의 목적은 실란과 인산 모노머를 혼합한 프라이머인 Monobond plus (Ivoclar Vivadent, Schaan, Liechtenstein)를 사용했을 때 레진 시멘트와 수복물 간의 전단 결합 강도가 귀금속, 비귀금속, 글라스 세라믹과 지르코니아 네 가지 재료 모두에서 기존의 프라이머를 사용했을 때의 결합 강도와 비교하여 유의한지 평가하는 것이다. 연구 재료 및 방법: 디스크 모양(${\phi}\;9mm{\times}3mm$)의 귀금속(Argedent Euro) 시편 16개, 비귀금속(T-4) 시편 20개, 지르코니아(Cercon) 시편 20개, 글라스 세라믹(IPS e.max press) 시편 20개를 제작한 후 아크릴릭 레진(${\phi}\;15mm{\times}15mm$)에 포매하였다. 귀금속 시편에 airborne-particle abrasion을 시행하고 대조군으로 사용한 8개 시편에는 귀금속용 프라이머(Metal primer II)를, 나머지 8개 시편에는 Monobond plus를 도포하였다. 비귀금속 시편과 지르코니아 시편은 airborne-particle abrasion 후 각각 두 그룹으로 나누어 대조군 10개 시편에는 비귀금속 및 지르코니아용 프라이머(Alloy primer)를, 나머지 10개에는 Monobond plus를 도포하였다. 글라스 세라믹 시편은 4% 불산으로 부식한 후, 대조군 10개 시편에는 실란(Monobond-S)을, 나머지 10개에는 Monobond plus를 적용했다. 표면 처리된 시편 위에 디스크 형태(${\phi}\;5mm{\times}2mm$)로 레진 시멘트(Multilink N)를 위치시키고 중합하였다. 제작된 모든 시편을 열순환($5^{\circ}C$$55^{\circ}C$, 1분씩 2060회)시킨 후 전단 결합 강도를 측정하였다. 전단 결합 강도의 유의차를 살펴보기 위해 Shapiro-Wilk test를 이용하여 모집단의 분포에 대한 검정을 하고 그 결과에 따라 Two sample $t$-test 또는 Mann-Whitney U test를 실시하였다(${\alpha}$=.05). 파절된 시편을 확대경으로 관찰하여 그 양상을 분류하였다. 결과: 귀금속과 글라스 세라믹 군에서는 두 프라이머간의 전단 결합 강도에 유의한 차이가 존재하지 않았으나($P$>.05) 비귀금속 군과 지르코니아 군에서는 기존 프라이머(Alloy primer)를 사용했을 때 레진 시멘트와 수복물간의 전단 결합 강도가 Monobond plus를 사용한 군보다 통계적으로 유의하게 높았다(비귀금속 군$P$=.004, 지르코니아 군$P$=.001). 결론: 실란과 인산 모노머를 혼합한 다용도 프라이머는 귀금속과 글라스 세라믹 군에서는 기존의 프라이머를 대신하여 사용할 수 있을 것이다. 그러나 비귀금속과 지르코니아 세라믹에서는 10-MDP 프라이머에 비해 접착 강도가 낮아 기존 프라이머를 대신하여 적용하기 위해서는 좀 더 연구가 필요할 것이다.

머신러닝 기반 기업부도위험 예측모델 검증 및 정책적 제언: 스태킹 앙상블 모델을 통한 개선을 중심으로 (Machine learning-based corporate default risk prediction model verification and policy recommendation: Focusing on improvement through stacking ensemble model)

  • 엄하늘;김재성;최상옥
    • 지능정보연구
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    • 제26권2호
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    • pp.105-129
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    • 2020
  • 본 연구는 부도위험 예측을 위해 K-IFRS가 본격적으로 적용된 2012년부터 2018년까지의 기업데이터를 이용한다. 부도위험의 학습을 위해, 기존의 대부분 선행연구들이 부도발생 여부를 기준으로 사용했던 것과 다르게, 본 연구에서는 머튼 모형을 토대로 각 기업의 시가총액과 주가 변동성을 이용하여 부도위험을 산정했으며, 이를 통해 기존 방법론의 한계로 지적되어오던 부도사건 희소성에 따른 데이터 불균형 문제와 정상기업 내에서 존재하는 부도위험 차이 반영 문제를 해소할 수 있도록 하였다. 또한, 시장의 평가가 반영된 시가총액 및 주가 변동성을 기반으로 부도위험을 도출하되, 부도위험과 매칭될 입력데이터로는 비상장 기업에서 활용될 수 있는 기업 정보만을 활용하여 학습을 수행함으로써, 포스트 팬데믹 시대에서 주가 정보가 존재하지 않는 비상장 기업에게도 시장의 판단을 모사하여 부도위험을 적절하게 도출할 수 있도록 하였다. 기업의 부도위험 정보가 시장에서 매우 광범위하게 활용되고 있고, 부도위험 차이에 대한 민감도가 높다는 점에서 부도위험 산출 시 안정적이고 신뢰성 높은 평가방법론이 요구된다. 최근 머신러닝을 활용하여 기업의 부도위험을 예측하는 연구가 활발하게 이루어지고 있으나, 대부분 단일 모델을 기반으로 예측을 수행한다는 점에서 필연적인 모델 편향 문제가 존재하고, 이는 실무에서 활용하기 어려운 요인으로 작용하고 있다. 이에, 본 연구에서는 다양한 머신러닝 모델을 서브모델로 하는 스태킹 앙상블 기법을 활용하여 개별 모델이 갖는 편향을 경감시킬 수 있도록 하였다. 이를 통해 부도위험과 다양한 기업정보들 간의 복잡한 비선형적 관계들을 포착할 수 있으며, 산출에 소요되는 시간이 적다는 머신러닝 기반 부도위험 예측모델의 장점을 극대화할 수 있다. 본 연구가 기존 머신러닝 기반 모델의 한계를 극복 및 개선함으로써 실무에서의 활용도를 높일 수 있는 자료로 활용되기를 바라며, 머신러닝 기반 부도위험 예측 모형의 도입 기준 정립 및 정책적 활용에도 기여할 수 있기를 희망한다.