• 제목/요약/키워드: Special hospitals

검색결과 215건 처리시간 0.021초

한 대학병원 응급실에 방문한 환자의 방사선 피폭에 관한 연구 (A Study on Exposure to radiation of the patient who visited an emergency room at a University Hospital)

  • 안병주;이상복;이준행
    • 한국방사선학회논문지
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    • 제1권3호
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    • pp.23-34
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    • 2007
  • 한 대학병원 응급실에 방문한 응급환자들이 방사선에 얼마나 피폭되는지를 알아보고자, 2006년 3월 16일 부터 31일까지 15일 동안 방문환자 200명을 임의 추출하여 방사선 피폭선량을 측정한 결과는 다음과 같다. 1. 연구대상자의 분포는 타병원전원환자 50명(25.0%), 교통사고환자 24명(8.3%), 기타사고환자 50명(25.0%), 일반환자 76명(38.0%)이었다. 2. 환자의 방사선 촬영횟수를 보면 환자 1인당 타병원, 전원환자 6.4회, 교통사고환자 14.5회, 사고환자 2.6회, 일반환자 2.4회로 교통사고환자들이 타환자군에 비해 방사선촬영 건수가 3~4배 많았다. 3. 환자의 방사선촬영종류별 피폭선량을 보면 일반촬영 28.9mGy, CT촬영 84.2 mGy, 특수촬영 1.02mGy로 CT촬영피폭이 일반촬영 비해 10배 정도 많았다. 4. 환자의 평균 방사선 피폭선량을 보면 타병원 전원환자는 24.6mGy, 교통사고환자는 55.2 mGy, 사고환자는 17.1mGy 일반환자는 17.0mGy로 타병원 전원환자와 교통사고환자가 상대적으로 피폭이 많았다. 5. 방사선촬영 부위별로 보면 일반촬영에서는 두부피폭 1.7mGy로 사고환자에서 피폭이 많았고, 흉부 2.0mGy, 복부 1.6mGy는 일반환자에게 많았으며, 척추 3.4mGy, 골반부 1.8mGy, 상지부 0.5mGy, 하지부 0.6mGy는 교통사고 환자에게 피폭이 많았으며, 통계적으로 유의한 차이를 보였다(P<0.001). 6. CT촬영에서는 타병원 및 전원환자가 두부 10.9mGy으로 많았고, 흉부와 복부는 각각 2.9mGy, 3.6mGy로 일반환자에게 많았고, 척추, 골반부 1,9mGy 2.7mGy는 교통사고환자에게 많았다. 특히 복부피폭은 통계적으로 유의한 차이를 보였다.(P<0.05) 결론적으로 한 대학병원 방문한 응급환자 특히 교통사고환자의 방사선 검사시 일반 외래 환자들의 촬영보다는 과다한 검사와 피폭이 노출선량한도가 2배 이상 증가하는 실정이다. 따라서 병원 관리자 및 방사선취급자는 환자 방사선 촬영시 노출을 최소한으로 제한하고, 방사선피폭감소를 위해 병원의 종사자인 방사선사의 기술적인 연구와 및 보조연구자 및 의료인 등 모두가 예방할 수 있는 대책이 필요할 것으로 생각한다.

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퇴원환자의 가정간호 이용의사와 관련 요인 (A Study on the Expressed Desire at Discharge of Patients to Use Home Nursing and Affecting Factors of the Desire)

  • 이지현;이영은;이명화;손수경
    • 재활간호학회지
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    • 제2권2호
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    • pp.257-270
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    • 1999
  • The purpose of this study is to investigate factors related to the intent of using home nursing of chronic disease patients who got out of a university hospital. For the purpose, the study selected 153 patients who were hospitalized and left K university hospital with diagnoses of cancer, hypertension, diabetes and cerebral vascular accident and ordered to be discharged and performed interviews with them and surveys on their medical records to obtain the following results. For this study a direct-interview survey and medical record review was conducted from June 28 to Aug. 30, 1998. The frequency and mean values were computed to find the characteristics of the study subjects, and $X^2$-test, t-test, factor analysis and multiple logistic regession analysis were applied for the analysis of the data. The following results were obtained. 1) When characteristics of the subjects were examined, men and women occupied for 58.8% and 41.2%, respectively. The subjects were 41.3 years old in aver age and had the monthly aver age earning of 0.99 million won or below, which was the most out of the total subjects at 34.6%. Among the total, 87.6% resided in cities and 12.4 in counties. The most left the hospital with diagnosis of cancer at 51.6%, followed by hyper tension at 24.2%, diabetes at 13.7% and cerebral vascular accident at 7.2%. 2) 93.5% of the selected patients had the intent of using home nursing and 6.5%, didn't. Among those patients having the intent, 85.6% had the intent of paying for home nursing and 14.4%, didn't. The subjects expected that the nursing would be paid 9,143 won in aver age and 47.7% of them preferred national authorities as the main servers. 86.3% of the subjects thought that home nursing business had the main advantage of making it possible to learn nursing methods at home and thereby contributing to improving the ability of patients and their facilities to solve health problems. 3) Relations between the intent of use and characteristics of the subjects such as demography-related social, home environment, disease and physical function characteristics did not show statistically significant differences among one another. Compared to those who had no intent of using home nursing, the group having the intent had more cases of male patients, the age of 39 or below, residence in cities, 5 family member s or more, no existence of home nursing servers, leaving the hospital from a non-hospitalized building, disease development for five months or below, hospitalization for ten days or more, non-hospitalization with in the recent one month, two times or over of hospitalization, leaving the hospital with no demand of special treatment, operation underwent, poor results of treatment, leaving the hospital with demand of rehabilitation services, physical disablement and high evaluation point of daily life. 4) Among those patients having the intent of using home nursing, 47.6% demanded technical nursing and 55.9%, supportive nursing. As technical nursing,' inject into a blood vessel ' and 'treat pustule and teach basic prevention methods occupied for 57.4%, respectively, topping the list. Among demands of supportive nursing, 'observe patients 'status and refer them to hospitals or community resources as available, if necessary' was the most with percent age point of 59.5. Regarding the intent of paying for home nursing, 39.2% of those patients wishing to use the nursing responded paying for technical services and 20.2, supportive services. In detail, 70.0% wanted to pay for a service stated as 'inject into a blood vessel', highest among the former services and 30.7%, a service referred to as 'teaching exercises needed to make the body of patients move', highest among the latter. When this was analyzed in terms of a relation between the need(the need for home nursing) and the demand(the intent of paying for home nursing), The rate of the need to the demand was found two or three times higher in technical nursing(0.82) than in supportive nursing(0.35). In aspects of tech ical nursing, muscle injection(1.26, the 1st rank) was highest in the rate while among aspects of supportive nursing, a service referred to as 'teach exercises needed for making patients move their bodies normally'(0.58, the 1st rank). 5) factors I(satisfaction with hospital services), II(recognition of disease state), III(economy) and IV(period of disease) occupied for 34.4, 13.8, 11.9 and 9.2 percents, respectively among factors related to the intent by the subjects of using home nursing, totaled 59.3%. In conclusion, most of chronic disease patients have the intent of using hospital-based home nursing and satisfaction with hospital services is a factor affecting the intent most. Thus a post-management system is needed to continue providing health management to those patients after they leave the hospital. Further, supportive services should be provided in order that those who are satisfied with hospital services return to their community and live their in dependent lives. Based on these results, the researcher would make the following recommendation. 1) Because home nursing becomes more and more needed due to a sharp increase in chronic disease patients and elderly people, related rules and regulations should be made and implemented. 2) Hospital nurses specializing in home nursing should be cultivated.

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응급의료센터 내원환자 진료시 소요시간과 관련된 요인 (Factors Related to Waiting and Staying Time for Patient Care in Emergency Care Center)

  • 한남숙;박재용;이삼범;도병수;김석범
    • 한국의료질향상학회지
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    • 제7권2호
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    • pp.138-155
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    • 2000
  • 3차 의료기관 응급의료센터의 총 진료소요시간을 단축하여 업무의 효율성을 높이고 환자적체를 해소하는 방안을 마련하기 위하여 l997년 4월 1개월 동안 대구광역시 소재 영남대학교병원 응급의료센터 내원환자 1,742명을 대상으로 환자의 특성, 응급진료와 관련된 내용 및 응급진료시간, 그리고 상호관련성을 분석하였다. 평균 초진소요시간은 83.3분이었고, 남자 83.1분, 여자 84.9분여였으며, 평균 총 진료소요시간은 전체 698분이었고, 남자 718.0분 여자 670.5분이었다. 총 진료소요시간은 고령일수록 증가하였으며 의료보호환자에서 초진 및 퇴실시간이 가장 많이 소요되었고 산재환자는 가장 적게 소요되었다. 전원시 소견서를 구비하지 않은 경우에 초진소요시간어이 많았으며, 총 진료소요시간은 외래어에서 전과된 경우, 타병원으로부터 전원된 경우, 전원시 소견서를 구비한 경우와 OCS를 부분적으로 사용한 경우에 많았다. 약물중독환자, 심폐소생술을 시행한 환자, 내과환자 수혈을 받은 환자 및 복합진료 여부가 3개과 이상이었던 환자에서 총 진료소요시간이 많았으며 당직인턴수가 4명이었던 경우가 총 진료소요 시간이 5명이었던 경우에 비해 더 많이 걸렸다. 입원한 경우, 입원명령후 공실이 없었던 경우에서 역시 총 진료소요시간이 증가하였으며 총 진료소요시간과 유의한 상관관계를 갖는 연속변수로는 환자의 연령, 방사선검사수 및 일반검사수였다. 초진소요시간에 대한 중회귀분석결과, 응급의학과 환자, 응급환자, 내원시 심폐소생술 시행환자유무, 내원시 기관내삽관 여부 등이 유의한 독립변수였다. 총 진료소요시간에 대한 중회귀분석결과, 공실유무, 일반검사수, 최종진료과, 타병원 전원유무, 방사선검사수, 퇴원약 유무, 입원실 종류, 입원유무, 담당전공의 연차, 내원원인, 내원시 심폐소생술 시행환자 유무, 수술여부, 병원직원 지인유무 및 특수검사수가 유의한 독립변수였다. 이상의 결과로 보아 응급의료센터내의 환자적체현상을 해결하기 위한 방안으로는 응급환자와 비응급환자를 분류하는 제도적 장치가 필요하며, 필수적인 경우에 한해 일반검사 및 방사선검사를 실시하도록 하며, 병동내의 과별 지정병상을 유동적으로 운영하여 응급의료센터 환자가 우선적으로 입원될 수 있도록 각과의 협조가 필요할 것으로 사료된다.

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조선시대(朝鮮時代) 전기(前期)의 의료제도(醫療制度)에 대한 연구(硏究) (A study of the Medical System in the Early Chosun-Dynasty)

  • 한대희;강효신
    • 대한한의학원전학회지
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    • 제9권
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    • pp.555-652
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    • 1996
  • Up to the present the scholastic achievements in the history of the medical system have been rather scare despite its importance in the Korean History. Hence, this dissertation attempts to examine the significance of the institute in the Korean History, covering the period from the ancient times through the early Chosun-Dynasty. In the ancient times, the medical practice relied primarily upon human instincts and experiences at the same time, shaman's incantations were widely believed to cure diseases, the workings of evil spirits supposedly. For the period from the Old Chosun through Samhan(巫堂), Chinese refugees brought a long medical knowledge and skills of the continent. New Chinese medicine, traditional practices and incantations were generally used at this time. Medicine and the medical system were arranged by the period of the Three Countries(三國時代). No definite record concerning Koguryo remains now. As for Paekje, however, history shows that they set up the system under the Chinese influence, assigning medical posts such as Euibaksa(medical doctor), Chaeyaksa(pharmacist), and Jukeumsa(medicine man) within Yakbu(department of medicine). Scientifically advanced, they sent experts to Japan, giving a tremendous influence on the development of the science on ancient Japan. After the unification of the three countries, Shilla had their own system after the model of Dang(唐). This system of the Unified Shilla was continued down to Koryo and became the backbone of the future ones. In the ancient time religion and medicine were closely related. The curative function of the shaman was absolute. Buddhism played a notable part in medical practice, too, producing numerous medical monks. The medical system of Koryo followed the model of Dang with some borrowings from Song(宋). Sangyakkuk(尙藥局) was to deal exclusively with the diseases of the monarch whereas Taeeuigam(太醫監) was the central office to handle the national medical administration and the qualification test and education for doctors. In addition, Dongsodaebiwon(東西大悲院), Jewibo(濟危寶), and Hyeminkuk(惠民局) were public hospitals for the people, and a few aristocrats practiced medicine privately. In 987, the 6th year of Songjong(成宗), local medical operations were installed for curing the sick and educating medical students. Later Hyonjong(顯宗), established Yakjom(clinics, 藥店) throughout the country and officials were sent there to see patients. Foreign experts, mainly from Song, were invited frequently to deliver their advanced technology, and contributed to the great progress of the science in Korea. Medical officials were equipped with better land and salary than others, enjoying appropriate social respect. Koryo exchanged doctors, medicine and books mainly with Song, but also had substantial interrelations with Yuan(元), Ming(明), Kitan(契丹), Yojin(女眞), and Japan. Among them, however, Song was most influential to the development of medicine in Koryo. During Koryo Dynasty Buddhism, the national religion at the time, exercised bigger effect on medicine than in any other period. By conducting national ceremonies and public rituals to cure diseases, Taoism also affected the way people regarded illness. Curative shamanism was still in practice as well. These religious practices, however, were now engaged only when medication was already in use or when medicine could not held not help any more. The advanced medical system of Koryo were handed down to Chosun and served the basis for further progress. Hence, then played well the role to connect the ancient medicine and the modern one. The early Chosun followed and systemized the scientific and technical achievement in medicine during the Koryo Dynasty, and furthermore, founded the basis of the future developments. Especially the 70 years approximately from the reign of Sejong(世宗) to that of Songjong(成宗) withnessed a termendous progress in the field with the reestablishment of the medical system. The functions of the three medical institute Naeeuiwon(內醫院), Joneuigam(典醫監), Hyeminkuk(惠民局) were expanded. The second, particualy, not only systemized all the medical practices of the whole nation, but also grew and distributed domestic medicaments which had been continually developed since the late Koryo period. In addition, Hyeminso(惠民局, Hwarinwon(活人院)) and Jesaenwon(濟生院)(later merged to the first) played certain parts in the curing illness. Despite the active medical education in the capital and the country, the results were not substantial, for the aristocracy avoided the profession due to the social prejudice against technicians including medical docotors. During the early Chosun-Dynasty, the science was divided into Chimgueui (acupuncturist), Naryogeui(specialist in scrofula) and Chijongeui (specialist in boil). For the textbooks, those for the qualification exam were used, including several written by the natives. With the introduction on Neoconfucianism(性理學) which reinforced sexual segregation, female doctors appeared for the female patients who refused to be seen by male doctors. This system first appeared in 1406, the sixth year of Taejong(太宗), but finally set up during the reign of Sejong. As slaves to the offices, the lowest class, female doctors drew no respect. However, this is still significant in the aspect of women's participation in society. They were precedents of midwives. Medical officials were selected through the civil exam and a special test. Those who passed exams were given temporary jobs and took permanent posts later. At that time the test score, the work experience and the performance record of the prospective doctor were all taken into consideration, for it was a specialized office. Most doctors were given posts that changed every six months, and therefore had fewer chances for a goverment office than the aristocracy. At the beginning the social status of those in medicine was not that low, but with the prejudice gradully rising among the aristocracy, it became generally agreed to belong to the upper-middle technician class. Dealing with life, however, they received social respect and courtesy from the public. Sometimes they collected wealth with their skills. They kept improving techniques and finally came to take an important share in modernization process during the late Chosun-Dynasty.

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초등학교 아동의 개인위생에 대한 조사 (A Study on Personal hygiene of Primary School Students)

  • 김재삼;남철현;강희양
    • 한국학교보건학회지
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    • 제9권1호
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    • pp.109-123
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    • 1996
  • The study was designed to gain necessary basic data, in order to grasp the actual condition on personal hygiene of primary school students and to help school health education and child health education data development of parents of students, the survery was carried out through this reporter's interview for mothers who have primary school pupil in KyungBug area during the period of a month from 14 the April to 30 the April 1994. The results of this study can be summarized as follows. 1. As for general characteristics, the percent of answer mothers with 30~34 years 44.9%, and the percent of answer mothers with 35~39 years was 37.6%, 14.6% of answer mother was 40 years and over. The most house types was apartment house, that is 64.8% and independence house was 18.9%, 13.7% of answer mothers was multivalent house residents. As for level of school career, the percent of high school was 64.2% and the percent of university was 20.5%, 10.1% of answer mothers was finishment of middle school. As for religion a lack of religion was 38.4% and a Buddhist was 36.8%, a christian was 13.4%, 10.4% of answer mothers was a catholic. As for jobs, the percent of office was 33.9%, specialist and expert skiller was 17.3%, self-management was 16.0%, fishing and agrarian villiages was 11.6%, public service personnel and shool personnel was 9.1%. As for the number of sons and daughters, the percent of two was 70.5%, the percent of one was 16.0%, and the percent of male students was 54.1%. As for level of economic life middle level was 59.9%. 2. The percentage of washing hand after school hours was 66.8% and not washing hand after school hours was 33.2%. In washing hand after school hours family of independence house, mothers that have schoolcareer of university, female students, three and over of sons and daughters was high individually (p<0.05). 3. As for paring one's nails, once a ten days was 52.9% once a five days was 22.5% once a fifteen days was 19.0%, once a twenty and over was 5.6%. 4. 54.7% of primary school students of answer mother's take a bath once a few days and 31.6% take a bath once a week, 10.1% take a bath once a tendays. 5. The percentage of changing of underwear once a day was 60.9%, once a few days was 37.1%, once a week was 2.0%, as for changing of underwear, sons and daughters that has mothers with 29 years and downward, one number of sons and daughters, females students was high individually (p<0.01). 6. The percentage of haircut once a 20~30 days was 59.9%, once a 31~40 days was 17.9%, once a 40 days and over was 16.6%. As for the percentage of haircut once a 20~30 days apartment house residents, male students was high (p<0.01). 7. The percentage of experience in taking nutrition was 79.8% and the percentage of experience in taking restorative was 72.3%. As for taking nutrition, apartment house residents, one number of sons and daughters, male students was high individually (p<0.01). As for taking restorative apartment house residents, on number of sons and daughters, male students was high individually (p<0.05). 8. The percentage of habit of unbalanced diet was 44.0%, sons and daughters that have mother with 40 years and over apartment house residents, male students, one number of sons and daughters was high indivdually (p<0.05). 9. As for hygiene condition of sons and daughters, the percentage of good state of health was 65.2%, middle state of health was 3.5% bad state of health was 11.4%. In good state of health sons and daughters that have mothers with 29 years and downward, multivalent house residents, three numbers of sons and daughters, female students, high birth was high individually. 10. As for fattness of sons and daughters, existence was 18.2%. No existence was 81.8%. in existence sons and daughters who have mothers with 40 years and downward, independence house resident, special job and expert skill job, three and over number of sons and daughters, female students, low birth was high individually. 11. As for use aspect of medical facilities of sons and daughters, hospital doctors was 53.1%, drugstore was 42.3%, chinese medicine hospitals or health organization was 4.6%. In usage of drugstore, sons and daughters of mothers with 29 years, 40 years and over was 55.6%, 61.4% individully, inusage of hospital doctors 30~34 years, 34~39 tears was 64.5%, 49.1% individully (p<0.01), apartment house residents, one or two numbers of sons and daughters, male students was high individually. In the percentage of using drugstore, school career of middle school and downward, in occupation, three and over numbers of sons and daughters, low birth was high individually (p<0.05). According to the results mentioned above. An actual condition and a related matters on personal hygiene of primary school students must be used as the basis data of a health education program and a health data of a health education program and a health data related, a teaching materials development and must be helped to the health life education of parents of students and childs.

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