• 지역사회간호학회지
• /
• 제19권2호
• /
• pp.157-166
• /
• 2008

This study was conducted with whole home care nurses nationwide to provide secondary analyzed data to understand on their usage of medical equipments and their need of them for a month. This study found that treatments given by home care nurses were nelaton catheterization, bladder washing/urethral washing, newborn care, exchange and care for nasogastric tube and suction in that order of frequency. Second, instruments and equipments used for home care were reported to be stethoscope, patient monitor, blood pressure measuring equipment, air flotation mattresses, beds for patients, mattresses, suctioning device sets, enteral feeding equipment and dressing set in that oder of frequency. Moreover, need assessment of medical instruments and equipments showed renal dialysis was most needed and patient monitor, blood pressure measuring equipment, enteral feeding equipment, solution and other supplies for renal dialysis and beds for patient were necessary in that order. In conclusion, the results of this study investigating special treatments and medical instruments and equipments used for home care patients and analyzing patients' need, were expected to be useful for expansion of application of long-term care insurance for the elderly and health insurance as well as for quality control of home care and development of medial instruments and equipments used at home.

• 한국응급구조학회지
• /
• 제13권2호
• /
• pp.17-59
• /
• 2009

Purpose : This study is to provide the basic data for developing the curriculum standardization of emergency medical technology by analyzing the three-year and four-year period curriculum and high-advanced major course to bring up highly qualified paramedics. Method : This study was analyzed, divided in 3 sections, majors, teaching profession subjects and liberal arts of 18 three-year curriculum universities and 7 four-year curriculum universities. Majors were analyzed, departmentalized in the national examination for license, the clinical and on-the-job training(OJT) and other major-related subjects. It is descriptive study, analyzed by dividing high-advanced major course into majors and liberal arts. Result : 1) The average number of subjects established in three-year-course college were 58.1. The completion credit was 130.1 in average. Also, the average number of established subjects at four-year-course were 61.1. The average completion credit was 141. 2) Three-year-course college professors give lecture in theory for 95.4 hours on average, which account for 59.9% of overall lecture, and 63.8 hours for practical training that takes 40.1% of the hours lectures are given. Meanwhile, four-year-course give lecture in theory for 111 hours on average, taking a part of 59.5%, and 76.5 hours for practical training, 40.5%. 3) In regard to liberal arts, at three-year-course college, the average credit was 16 but the proportion that liberal arts charge among the completion credit was 11.6. Meanwhile, at four-year-course universities, the average credit was 28.4 and the percentage that the liberal arts took part in the completion credit was 20.1. 4) Looking over national examination subjects among majors at three-year-course college, basic medicine's average credit was 17.2, introduction to advanced emergency care's average credit was 15.5, Special advanced emergency care's average credit was 28, emergency patient management's average credit was 9.2 and emergency medicine statute's average credit was 3.6. Meanwhile, in case of four-year-course universities, basic medicine's average credit was 14.3, introduction to advanced emergency care's average credit was 12.7, special advanced emergency care's average credit was 31, emergency patient management's average credit was 8.3 and emergency medicine statute's average credit was 2.9. 5) Among national examination subjects, in case of three-year-course, the range of basic medicine credits was 6 to 23, the average credit showed 17.2. The range of introduction to advanced emergency care credits was 9 to 21, the average credit showed 15.5. The range of special advanced emergency care credits was 19 to 36, the average credit showed 28. The range of emergency patient management credits was 5 to 12, the average credit was 9.2. The range of legal medicine credits was 3 to 6, the average was 3.6 credit. In case of four-year-course the range of basic medicine was 12 to 17, the average of the credit was 14.3. The range of introduction to advanced emergency care was 9 to 19, and the average of the credit was 12.7. The range of special advanced emergency care was 18 to 41, and the average of the credit was 31. The range of emergency patient management was 7 to 12, and the average of the credit was 8.3. The range of legal medicine was 3 to 4, and the average of the credit was 2.9. So except special advanced emergency care, all the other subjects had higher score in three-year-course than four-year-course. 6) About the other major-related subjects, the completion credit was 23 on average at three-year-course and 13.5 at four-year-course. 7) The clinical and on-the-job training(OJT), In the case of three-year-course, the average completion credit was 13.5 and 13.5 at four-year-course. 8) The teaching profession subject, In the case of three-year-course, the average credit was 3 and the percentage that the teaching profession subject took part in the completion credit was 2.3% on average. Four-year-course established the subject only at one university. 9) In high-advanced major process, the entire established subjects on average were 12.8 and the average completion credit was 36.3. In liberal arts, the average established subjects were 6.5 and the completion credit was 19.5. The number of majors were 9.5 on average and the credit was 26.5 Conclusion : According to the aforemention results, the curriculum for emergency medical technology needs to be developed and standardized.

• 간호행정학회지
• /
• 제6권2호
• /
• pp.259-279
• /
• 2000

This study is a descriptive analytic research measuring nursing service quality, using SERVQUAL model, to make fundamental data and strategies for nursing service improvement. Data were collected by self-reported questionnaire from 202 patients and 142 nurses, from June 7 to 14, 1999. The reliability of instrument were adequate(Cronbach ${\alpha}=.94$). SAS program was utilized for statistical analysis of collected data. The results were as follows; 1. There was a gab between patient's expectation and perception on nursing service(Gap B). Gap D was indicated an affecting factor to decide nursing service quality. Gap C was indicated an indirect affecting factor of nursing service quality. Because it was not statistically significant in total item analysis, but in individual item analysis, 7 items were appeared statistically significant. Gap A was not a gap occurrence factor of nursing service quality. 2. Focuses of nursing service quality improvement strategies were; (1) to direct qualitative improvement of nursing service in order to correspondence patient's nursing service expectation. (2) to make nurse's service activity modified because nurse's practice were not reached patient's expectation level. (3) to need internal, external factor analysis affecting nurse's service activity. 3. Nursing service quality was decided by rather environmental inappropriateness provided nursing service than itself. Therefore, to make nursing service quality improvement, it is required to improve nursing service environment. For this, followings are required; (1) to strengthen nurse's education on lower part of nursing service satisfaction and QI activities. (2) to balance demand and supply of nursing personnel. 3) to fix computerized system for reducing other duties weight except nursing care through analysis of nursing activity. (4) to construct rational cooperating system among related departments. 4. The important parts for nursing service quality improvement were indicated as follows: (1) Gap B: 'prompt reaction', 'examination symptom before patient's complaint', 'hearted nursing service reducing patient's dissatisfaction', 'explanation goals of nursing activities', 'having special Knowledge enough', 'maintenance position comfortably', 'management of patient's physical hygiene'. (2) Gap C: 'maintenance physical safety', 'explanation about hospital rules and facilities'. (3) Gap D: 'tender, safe injection and wound care'. Because above items are mostly improved through nurse's attitude change and quality improvement, it is required to establish nursing standardization and to strengthen nurse's clinical education. As the based on above results, followings are suggested; 1. SERVQUAL model is very useful to make strategies for nursing service quality improvement because it indicates multiple factors affecting hap occurrence. 2. At individual items analysis of Gap C, statistically significant 7 items appeared higher nurse's perception level than patient's perception level on nursing service were trouble perception level on nursing service quality improvement. So. it need further research to analysis about these difference occurring factors. 3. At analysis of Gap D, it is indicated that in nursing service performance process, multiple factors lowing nursing service quality were intruded. So it needs further research to analysis what these factors are and how each factors affect on nursing performance process. 4. nursing service quality measurement is changeable according to sample select time or sampled subject's characteristics. So to develope strategy for nursing service quality improvement is based on the results of periodical analysis.

• 대한장애인치과학회지
• /
• 제7권1호
• /
• pp.25-28
• /
• 2011

자폐증을 진단 받은 16세 남환이 하악 좌측 부위의 낭종 및 매복치를 주소로 내원하였다. 해당낭종은 함치성 낭종으 로 최종 진단 되었으며 일일 입원 및 전신 마취 하에 낭종의 적출 및 매복치의 발거와 자가 이식을 시행 후 치근단 형성 술 진행하였다. 2년 6개월 경과 관찰한 현재 주소 증상은 사라지고 재발 성향은 없으나, 치근단 염증 소견 및 발거 부 위 공간 소실 등의 합병증이 관찰된다. 저자는 본 증례를 통 해 다음과 같은 지견을 얻었다. 1. 함치성 낭종의 치료는 일반적으로 골 결손이 적고 매복치의 자발적 맹출을 유도할 수 있는 조대술이 추천된다. 2. 매복치의 자발적 맹출 가능성은 매복 깊이, 치축 각도, 환자의 나이, 치근 성숙도 등을 주의 깊게 고려하여 판단해야 한다. 3. 본 증례의 경우 매복치의 자발적 맹출 가능성이 낮으며 자폐증으로 인한 구강위생 불량, 저조한 협조도 등 을 고려하여 적출술을 시행하였다. 4. 치료 계획 설정 시 일반적 요인뿐만 아니라 환자의 의과 적, 전신적 병력에 따른 특별한 요구도 고려해야 한다.

• 대한간호학회지
• /
• 제11권1호
• /
• pp.45-63
• /
• 1981

This study was done to determine the relationship between the anxiety levels of hospitalized psychiatric patients and various influencing variables. The purpose of this study was to determine factors that may help hospitalized psychiatric patients to experience lower levels of anxiety in relation to changing situations and provide the basic data for a dynamic approach which is important in the field of modern psychiatric nursing that understands and analyses the meaning of patients behavior. The anxiety may produce stress, which is a common experience among all human beings. Patients may merely feel uncomfortable in the state of mild anxiety, however, the severe state could be an obstacle to treatment and recovery from disease. The anxiety of the psychiatric patient is a factor which greatly influencing the patient's behavior, so his disorderd behavior is an expression of defence or pathologically fixed behavior. According the psychiatric patient's anxiety at the time of admission is the concern of the health team. The nurse's special concern has to do with understanding and supporting the patient and meeting his individual needs by frequent close contact during the entire hospitalization period, compared to other teamembers the nurse's responsibility in this regard is greated. So this study emphasizes the necessity of creating conditions these, but above all the psychiatric nurse should create a therapeutic environment by not only regarding the patient's behavior or symptoms but understanding the meaning of them. The subjects of this study were 57 psychiatric patients selected from the K neuropsychiatric hospital located in Kunsan city. Data were collected twice from the same patients within a 24 hour period after admission and 10 days after admission. (September 18th to November 8th, 1980). The data collected method was through direct interview, and the interview time was 20 minutes for each patient. Data analysis included Item Analysis & Internal Consistency Reliability Tests, Percentages, t-test, analysis of variance and stepwise multiple regression analysis. The findings of this study were as follows. A. Test of Hypothesis a. Hypothesis 1 :“The anxiety level of psychiatric patients within 24 hours after admission will be higher than those of the same patients 10 days after admission,”was accepted. (t = 3. 15 ; p < 0.005) b. Hypothesi 2:“The more the number of admissions the higher the level of anxiety related to two categories”, was accepted. (affective anxiety: F = 5.50, p < 0.005, Somatic anxiety: F = 9.12, p <.

• 의료법학
• /
• 제10권2호
• /
• pp.309-341
• /
• 2009

According to a case of Supreme Court's Sentence No. 2009DA17417 (May 21, 2009), the Supreme Court judges that 'the right to life is the ultimate one of basic human rights stipulated in the Constitution, so it is required to very limitedly and conservatively determine whether to discontinue any medical practice on which patient's life depends directly.' In addition, the Supreme Court admits that 'only if a patient who comes to a fatal phase before death due to attack of any irreversible disease may execute his or her right of self-determination based on human respect and values and human right to pursue happiness, it is permissible to discontinue life-sustaining treatment for him or her, unless there is any special circumstance.' Furthermore, the Supreme Court finds that 'if a patient who is attacked by any irreversible disease informs medical personnel of his or her intention to agree on the refusal or discontinuance of life-sustaining treatment in advance of his or her potential irreversible loss of consciousness, it is justifiable that he or she already executes the right of self-determination according to prior medical instructions, unless there is any special circumstance where it is reasonably concluded that his or her physician is changed after prior medical instructions for him or her.' The Supreme Court also finds that 'if a patient remains at irreversible loss of consciousness without any prior medical instruction, he or she cannot express his or her intentions at all, so it is rational and complying with social norms to admit possibility of estimating his or her own intentions on withdrawal of life-sustaining treatment, provided that such a withdrawal of life-sustaining treatment meets his or her interests in view of his or her usual sense of values or beliefs and it is reasonably concluded that he or she could likely choose to discontinue life-sustaining treatment, even if he or she were given any chance to execute his or her right of self-determination.' This judgment is very significant in a sense that it suggests the reasonable orientation of solutions for issues posed concerning withdrawal of meaningless life-sustaining medical efforts. The issues concerning removal of medical instruments for meaningless life-sustaining treatment and discontinuance of such treatment in regard to medical treatment for terminal cases don't seem to be so much big deal when a patient has clear consciousness enough to express his or her intentions, but it counts that there is any issue regarding a patient who comes to irreversible loss of consciousness and cannot express his or her intentions. Therefore, it is required to develop an institutional instrument that allows relevant authority to estimate the scope of physician's medical duties for terminal patients as well as a patient's intentions to withdraw any meaningless treatment during his or her terminal phase involving loss of consciousness. However, Korean judicial authority has yet to clarify detailed cases where it is permissible to discontinue any life-sustaining treatment for a patient in accordance with his or her right of self-determination. In this context, it is inevitable and challenging to make better legislation to improve relevant systems concerning withdrawal of life-sustaining treatment. The State must assure the human basic rights for its citizens and needs to prepare a system to assure such basic rights through legislative efforts. In this sense, simply entrusting physician, patient or his or her family with any critical issue like the withdrawal of meaningless life-sustaining treatment, even without any reasonable standard established for such entrustment, means the neglect of official duties by the State. Nevertheless, this issue is not a matter that can be resolved simply by legislative efforts. In order for our society to accept judicial system for withdrawal of life-sustaining treatment, it is important to form a social consensus about this issue and also make proactive discussions on it from a variety of standpoints.

• 한국정보통신학회논문지
• /
• 제6권4호
• /
• pp.610-615
• /
• 2002

한의학에서는 맥은 심장을 포함한 오장육부 전신의 상태를 파악하는 매개체로서 혈관의 탄력성과 혈액의 흐름 상태를 나타내고 있으며, 의사는 환자의 진단과 맥파의 진찰에 의해서 얻어지는 정보를 가지고 주관적으로 건강 상태를 판단한다. 따라서 오진을 막기 위해서 의사의 판단은 객관적인 기록물의 증거에 의해서 결심하는 것이 필요하다. 본 논문은 건강상태 판단의 기초 자료를 검출하는 맥파 해석의 3차원 시각화하는 방식과 시뮬레이션을 통해서 맥파의 특성 파라메터를 검출하는 것을 제시한다.

• 디지털융복합연구
• /
• 제16권11호
• /
• pp.521-533
• /
• 2018

본 연구의 목적은 조현병을 가진 사람의 삶의 경험에 내재되어 있는 의미와 본질이 무엇인지를 이해하는 것이었다. 이를 위하여 현상학적 연구방법으로 접근하였으며, 연구참여자들은 조현병으로 진단을 받은 지 5년이 경과하고 20세 이상인 성인 10명이었다. 연구결과, 4개의 본질주제인 '내 인생의 나락, 정신질환', '어쩔 수 없는 받아들임과 내려놓음', '어둠속에서도 나를 일으킴', '평범한 일상 살아가기'를 발견하였다. 조현병은 연구참여자들을 상처와 고통 속의 삶으로 내던지는 특별한 굴레였지만 그럼에도 불구하고 이들의 일상은 자신의 감정과 욕구를 바탕으로 유지되고 있었다. 본 연구를 통해 조현병을 가진 사람은 병리적 결과물인 '환자'가 아니라 한 명의 '인간'이라는 관점에서 이해하고 접근해야 한다는 의미를 확인하였다.

• 한국응급구조학회지
• /
• 제13권1호
• /
• pp.19-33
• /
• 2009

Purpose : To check the legal relation between rescue team and patient as well as legal responsibility for patient's damage intentionally or erroneously caused by rescue member, a public official, in the performance of relevant job ; to prevent legal dispute over rescue team and to present program for fair settlement of dispute and equitable and feasible burden of damage. Method : First, the legal principle of Civil Law, Criminal Law and Administrative Law related to the theme of this research will be investigated around research by literature. Second, the case of dispute related to rescue team will be introduced. Result: 1. If 119 rescue members as a public official intentionally or erroneously cause damage to patient in the performance of job, they shall bear civil, criminal and administrative responsibility. They shall bear civil responsibility for indemnity for damage due to default or tort. The typical criminal responsibility includes accidental homicide arising out of duty, preparing falsified official document, dereliction of duty, etc. In the administrative side, the state is responsible for indemnity for peculiar status of the rescue member, public official. 2. Though raising civil petition or legal dispute over unsatisfactory rescue service may be reasonable to guarantee the right of nation, such action may cause stress to rescue member as well as may lead to mental shrinking and defensive attitude only to take the basic first aid treatment which has low possibility of mistake instead of active first aid treatment so as to avoid legal responsibility. 3. The program that may prevent legal dispute over 119 rescue team includes expansion of manpower specialized in first aid treatment, enhancement of education on legal environment, development and application of standard job guideline, formation of mutual trust with patient, detailed explanation, preparing and keeping minute record, improvement of the rescue members' ability of first aid treatment and development of medical instruction mode. Conclusion : The best policy is to prevent legal dispute. If it is impossible to basically exclude the possibility of dispute, however, we need to make effort to minimize the occurrence, settle fairly and divide damage equitably and feasibly. To improve the preventible death rate of our first aid system to the level of advanced country, 119 rescue team which is in charge of the stage before hospital needs to positively enforce special first aid by improving the qualitative level of rescue service and to strive to prevent legal dispute that may occur in the process.

• 한국병원경영학회지
• /
• 제6권3호
• /
• pp.148-166
• /
• 2001

The purpose of this study is to classify elderly patient in long-term care facilities using RUG(Resource Utilization Group)-III. It is designed by measuring patient medical characteristics and medical staff time. Elderly patients are classified into 7 categories by clinical(medical and behavioral) hierarchical typology of patients. Through the tertiary split, all 44 groups are formulated. This classification is explained by each patient resource(staff time) utilization level which is called CMI(Case-Mix Index). Major findings are as follows; 1. The objects in this study were classified into 35 groups out of 44 groups. The most frequent category is clinical complex category(CCC; 38.9%). And extensive service category(ESC; 18.8%), reduced physical function category(RPC; 13.1%), special rehabilitation category(SRC; 12.8%), and impaired cognitive category(ICC; 0.00%) are followed. 2. The mean of total CMI was $1.02{\pm}0.36$, ranging from 0.68 to 1.44(1 vs 2.12). The mean of CMI of SRC is only 1.17 which should be the highest. The means of ESC and see are equally 1.20. The means of CMI of CCI, ICC, BPC, and RPC were 0.90, 0.75, 0.83 and 0.96, respectively. 3. The validity of this classification was tested. Trend-test using Regression Analysis was done in the secondary split level. SCC, CCC, ICC, and RPC which covered 68.4% of this research objects showed linear trend of CMI in interim classification. This results were statistically significant. 4. In clinical hierarchy, the trend were showed linearity. But the multiple comparison of categories using Scheffe-test showed that SRC, ESC and see had same level of CMI means and CCC and ICC, too. This results were statistically significant. Classifying elderly patients with RUG-III, the results showed partly linear trend in clinical hierarchy and in interim classification in conclusion. But, in clinical hierarchy, it was failed to show the consistent order of CMI. It can be explained by two reasons. One is that this research subjects were overlapped in each clinical hierarchy group. And the other is that the some of the characteristics for clinical hierarchy is not appropriate for them. For the further study, it needs to have proper sample size and to modify RUG-III to K-RUG to consider our.. medical environment.