• Journal of Hospice and Palliative Care
• /
• 제4권1호
• /
• pp.47-56
• /
• 2001

목적 : 영적 간호중재가 호스피스 환자의 불안감소에 미치는 효과를 파악하고 분석함으로써, 호스피스 환자의 안위를 도모하여 전인적이고 개별화된 간호를 제공하는데 도움을 주기 위하여 시도된 비 동등성 대조군 전후시차 유사실험 연구이다. 방법 : 2000년 7월 10일부터 9월 25일 사이에 전주 시내에 소재 하는 1개 종합병원의 호스피스 환자67명을 대상으로 연구참여에 동의한 실험군 37명, 대조군 30명으로 하였다. 일반적 특성, 질병 및 치료적 특성, 상태불안 정도를 측정하였고, 실험군에게 조사당일부터 일주일에 3회를 평균 30분씩 3주 동안 영적 간호중재를 제공하고, 중재 후 상태불안 정도를 측정하였다. 연구도구는 불안정도에 대해서는 Spielberger(1975)의 상태-기질 불안 측정도구를 김정택과 신동균(1978)이 표준화한 도구를 사용하였고, 영적 간호중재는 자신의 치료적 사용, 기도, 성경, 찬송을 사용하였다. 자료분석 방법은 실수, 백분율, 평균, 표준편차 등의 서술통계와 $x^2-test$, t-test, paired t-test로 분석하였다. 결과 : 1) 대상자의 일반적 특성에서, 성별은 남자가 더 많았고, 평균 연령은 실험군이 59.6세, 대조군이 55.9세였다. 동거가족수는 $2{\sim}3$명이 가장 많았다. 2) 실험군과 대조군의 일반적 특성과 질병 및 치료적 특성, 종교적 특성에 대한 비교분석에서는 유의한 차이가 없었다. 3) 질병 및 치료적 특성에서, 암환자(cancer patients)가 대부분을 차지하였다(실험군 92%, 대조군 95%). 4) 실험군은 대조군보다 영적 간호중재 후 상태불안이 유의하게 낮았다(t=-5.987, P=0.000). 5) 실험군의 사전 사후 불안점수 변화량은 유의하게 감소하였다(t=6.237, P=0.000). 결론 : 영적 간호중재를 제공받은 호스피스 환자는 제공받지 않은 호스피스 환자에 비해 상태불안이 낮아짐이 확인되었으며, 영적 간호중재는 호스피스 환자의 불안을 완화시키는데 효과적인 간호중재의 한 방안으로 임상에서 적용할 수 있어야 한다.

• Journal of Hospice and Palliative Care
• /
• 제14권1호
• /
• pp.28-33
• /
• 2011

목적: 임박사건(impending event)에 대한 인지는 보호자와의 보다 효과적인 의사소통을 위해 필요할 뿐 아니라, 임종실로 옮기는 시점을 결정하는데 있어서 매우 중요하다. 이 주제에 대한 지금까지의 연구는 대부분 임종 48시간을 전후한 시점에서 이미 '발생되어 있는' 증상의 나열에 불과하였다. 이에 '변화'의 시점에서 사망까지의 시간을 기준으로 하여 임박사건 간 48시간 이내 임종예측도를 비교하였다. 방법: 인천소재 완화의료병동에서 임종을 맞이한 160명의 환자 중 임종 전 일주일 동안의 의무기록이 있는 80명을 대상으로 하였다. 환자 및 보호자가 호소하는 주관적 증상 9가지와 의료인에 의해 관찰되는 객관적 징후 8가지를 선정하고 각 항목에 대한 '의미 있는 변화'의 기준을 사전에 정하였다. 결과: 증상에서는 수면량의 증가(53.8%), 징후에서는 혈압의 감소(87.5%)가 가장 높은 발생빈도를 보였다. 임종까지의 평균시간은 증상의 경우 안정 시 호흡곤란(46.8시간)이, 징후의 경우 산소포화도의 감소(13.6시간)와 혈압의 감소(36.9시간)가 48시간 이내였다. 48시간 임박사건으로서의 예측도는 증상의 경우, 양성예측도는 안정 시 호흡곤란이 가장 높았고(83%) 음성예측도는 안정 시 호흡곤란과 의식혼탁/섬망의 조합이 가장 높았으며(86%), 징후의 경우 양성 예측도는 모두 95% 이상이었고 음성예측도는 혈압의 감소와 산소포화도 감소의 조합에서 가장 높았다(60%). 증상과 징후의 발생양상은 유의한 차이를 보였다. 결론: 증상에서는 안정 시 호흡곤란과 의식혼탁/섬망이, 징후에서는 산소포화도나 혈압의 감소가 임종임박을 예측하는데 가장 유용한 임상지표로 생각된다.

• 한국엔터테인먼트산업학회논문지
• /
• 제14권7호
• /
• pp.529-538
• /
• 2020

본 연구는 국내 실정에 맞고 임상에 적용 가능한 한국형 일상생활활동훈련치료 콘텐츠를 개발하고자 하였다. 콘텐츠 개발을 위해 전문가 13명을 대상으로 델파이 연구를 시행하였다. 1차 델파이 조사에서는 선행연구를 기반으로 일상생활활동훈련 133개 항목을 도출한 후 전문가 집단에 의뢰해, 도출해 낸 항목이 실제 국내 임상적용에 적합한가에 대해 답하도록 하였다. 2차 델파이 조사에서는 1차 조사 결과를 토대로 내용타당도 지수가 낮은 항목은 제외하였고, 기타 의견 중 콘텐츠로 도출할 수 있는 항목을 추가하여 118개로 항목을 재구성하였다. 3차 델파이 조사에서는 2차 델파이 조사 항목을 그대로 제시하면서, 자신의 2차 응답과 다른 전문가 패널의 2차 평균 점수를 동시에 제시하여 자신의 의견을 수정할 수 있는 기회를 제공하였고, 추가로 적합도와 중요도를 함께 평가하도록 하였다. 본 연구에서 자료는 평균과 표준 편차, 사분위수 범위, 내용타당도 지수, 수렴도, 합의도를 구하는 것으로 분석하였다. 연구 결과 3차 델파이에서 CVR 0.54 이상이 105개 항목, 수렴도 0.50 이하가 111개 항목, 합의도 0.75 이상이 70개 항목으로 나타나 최종적으로 총 69개의 항목이 선정되고, 49개의 항목이 삭제되었다. 성적 활동, 타인 돌보기, 반려동물 돌보기, 아이양육은 사회문화적으로 적용하기 힘들고, 운전 및 지역사회 이동은 치료실 내에서 수행할 수 없으며, 집안관리 및 유지는 성별에 따라 역할이 다를 수 있고, 종교적·영적 활동과 표현은 개인적인 것이므로 등과 같은 이유로 중요도 혹은 적합도가 낮은 항목으로 나타났다. 본 연구에서 개발한 한국형 일상생활활동훈련의 콘텐츠는 앞으로 임상이나 지역사회에서 일상생활활 동훈련의 지표로 유용하게 활용이 가능할 것이다.

• 대한간호학회지
• /
• 제3권1호
• /
• pp.13-40
• /
• 1972

Much has teed changed in the field of hospital administration in the It wake of the rapid development of sciences, techniques ana systematic hospital management. However, we still have a long way to go in organization, in the quality of hospital employees and hospital equipment and facilities, and in financial support in order to achieve proper hospital management. The above factors greatly effect the ability of hospitals to fulfill their obligation in patient care and nursing services. The purpose of this study is to determine the optimal methods of standardization and quality nursing so as to improve present nursing services through investigations and analyses of various problems concerning nursing administration. This study has been undertaken during the six month period from October 1971 to March 1972. The 41 comprehensive hospitals have been selected iron amongst the 139 in the whole country. These have been categorized according-to the specific purposes of their establishment, such as 7 university hospitals, 18 national or public hospitals, 12 religious hospitals and 4 enterprise ones. The following conclusions have been acquired thus far from information obtained through interviews with nursing directors who are in charge of the nursing administration in each hospital, and further investigations concerning the purposes of establishment, the organization, personnel arrangements, working conditions, practices of service, and budgets of the nursing service department. 1. The nursing administration along with its activities in this country has been uncritical1y adopted from that of the developed countries. It is necessary for us to re-establish a new medical and nursing system which is adequate for our social environments through continuous study and research. 2. The survey shows that the 7 university hospitals were chiefly concerned with education, medical care and research; the 18 national or public hospitals with medical care, public health and charity work; the 2 religious hospitals with medical care, charity and missionary works; and the 4 enterprise hospitals with public health, medical care and charity works. In general, the main purposes of the hospitals were those of charity organizations in the pursuit of medical care, education and public benefits. 3. The survey shows that in general hospital facilities rate 64 per cent and medical care 60 per-cent against a 100 per cent optimum basis in accordance with the medical treatment law and approved criteria for training hospitals. In these respects, university hospitals have achieved the highest standards, followed by religious ones, enterprise ones, and national or public ones in that order. 4. The ages of nursing directors range from 30 to 50. The level of education achieved by most of the directors is that of graduation from a nursing technical high school and a three year nursing junior college; a very few have graduated from college or have taken graduate courses. 5. As for the career tenure of nurses in the hospitals: one-third of the nurses, or 38 per cent, have worked less than one year; those in the category of one year to two represent 24 pet cent. This means that a total of 62 per cent of the career nurses have been practicing their profession for less than two years. Career nurses with over 5 years experience number only 16 per cent: therefore the efficiency of nursing services has been rated very low. 6. As for the standard of education of the nurses: 62 per cent of them have taken a three year course of nursing in junior colleges, and 22 per cent in nursing technical high schools. College graduate nurses come up to only 15 per cent; and those with graduate course only 0.4 per cent. This indicates that most of the nurses are front nursing technical high schools and three year nursing junior colleges. Accordingly, it is advisable that nursing services be divided according to their functions, such as professional, technical nurses and nurse's aides. 7. The survey also shows that the purpose of nursing service administration in the hospitals has been regulated in writing in 74 per cent of the hospitals and not regulated in writing in 26 per cent of the hospitals. The general purposes of nursing are as follows: patient care, assistance in medical care and education. The main purpose of these nursing services is to establish proper operational and personnel management which focus on in-service education. 8. The nursing service departments belong to the medical departments in almost 60 per cent of the hospitals. Even though the nursing service department is formally separated, about 24 per cent of the hospitals regard it as a functional unit in the medical department. Only 5 per cent of the hospitals keep the department as a separate one. To the contrary, approximately 12 per cent of the hospitals have not established a nursing service department at all but surbodinate it to the other department. In this respect, it is required that a new hospital organization be made to acknowledge the independent function of the nursing department. In 76 per cent of the hospitals they have advisory committees under the nursing department, such as a dormitory self·regulating committee, an in-service education committee and a nursing procedure and policy committee. 9. Personnel arrangement and working conditions of nurses 1) The ratio of nurses to patients is as follows: In university hospitals, 1 to 2.9 for hospitalized patients and 1 to 4.0 for out-patients; in religious hospitals, 1 to 2.3 for hospitalized patients and 1 to 5.4 for out-patients. Grouped together this indicates that one nurse covers 2.2 hospitalized patients and 4.3 out-patients on a daily basis. The current medical treatment law stipulates that one nurse should care for 2.5 hospitalized patients or 30.0 out-patients. Therefore the statistics indicate that nursing services are being peformed with an insufficient number of nurses to cover out-patients. The current law concerns the minimum number of nurses and disregards the required number of nurses for operation rooms, recovery rooms, delivery rooms, new-born baby rooms, central supply rooms and emergency rooms. Accordingly, tile medical treatment law has been requested to be amended. 2) The ratio of doctors to nurses: In university hospitals, the ratio is 1 to 1.1; in national of public hospitals, 1 to 0.8; in religious hospitals 1 to 0.5; and in private hospitals 1 to 0.7. The average ratio is 1 to 0.8; generally the ideal ratio is 3 to 1. Since the number of doctors working in hospitals has been recently increasing, the nursing services have consequently teen overloaded, sacrificing the services to the patients. 3) The ratio of nurses to clerical staff is 1 to 0.4. However, the ideal ratio is 5 to 1, that is, 1 to 0.2. This means that clerical personnel far outnumber the nursing staff. 4) The ratio of nurses to nurse's-aides; The average 2.5 to 1 indicates that most of the nursing service are delegated to nurse's-aides owing to the shortage of registered nurses. This is the main cause of the deterioration in the quality of nursing services. It is a real problem in the guest for better nursing services that certain hospitals employ a disproportionate number of nurse's-aides in order to meet financial requirements. 5) As for the working conditions, most of hospitals employ a three-shift day with 8 hours of duty each. However, certain hospitals still use two shifts a day. 6) As for the working environment, most of the hospitals lack welfare and hygienic facilities. 7) The salary basis is the highest in the private university hospitals, with enterprise hospitals next and religious hospitals and national or public ones lowest. 8) Method of employment is made through paper screening, and further that the appointment of nurses is conditional upon the favorable opinion of the nursing directors. 9) The unemployment ratio for one year in 1971 averaged 29 per cent. The reasons for unemployment indicate that the highest is because of marriage up to 40 per cent, and next is because of overseas employment. This high unemployment ratio further causes the deterioration of efficiency in nursing services and supplementary activities. The hospital authorities concerned should take this matter into a jeep consideration in order to reduce unemployment. 10) The importance of in-service education is well recognized and established. 1% has been noted that on the-job nurses. training has been most active, with nursing directors taking charge of the orientation programs of newly employed nurses. However, it is most necessary that a comprehensive study be made of instructors, contents and methods of education with a separate section for in-service education. 10. Nursing services'activities 1) Division of services and job descriptions are urgently required. 81 per rent of the hospitals keep written regulations of services in accordance with nursing service manuals. 19 per cent of the hospitals do not keep written regulations. Most of hospitals delegate to the nursing directors or certain supervisors the power of stipulating service regulations. In 21 per cent of the total hospitals they have policy committees, standardization committees and advisory committees to proceed with the stipulation of regulations. 2) Approximately 81 per cent of the hospitals have service channels in which directors, supervisors, head nurses and staff nurses perform their appropriate services according to the service plans and make up the service reports. In approximately 19 per cent of the hospitals the staff perform their nursing services without utilizing the above channels. 3) In the performance of nursing services, a ward manual is considered the most important one to be utilized in about 32 percent of hospitals. 25 per cent of hospitals indicate they use a kardex; 17 per cent use ward-rounding, and others take advantage of work sheets or coordination with other departments through conferences. 4) In about 78 per cent of hospitals they have records which indicate the status of personnel, and in 22 per cent they have not. 5) It has been advised that morale among nurses may be increased, ensuring more efficient services, by their being able to exchange opinions and views with each other. 6) The satisfactory performance of nursing services rely on the following factors to the degree indicated: approximately 32 per cent to the systematic nursing activities and services; 27 per cent to the head nurses ability for nursing diagnosis; 22 per cent to an effective supervisory system; 16 per cent to the hospital facilities and proper supply, and 3 per cent to effective in·service education. This means that nurses, supervisors, head nurses and directors play the most important roles in the performance of nursing services. 11. About 87 per cent of the hospitals do not have separate budgets for their nursing departments, and only 13 per cent of the hospitals have separate budgets. It is recommended that the planning and execution of the nursing administration be delegated to the pertinent administrators in order to bring about improved proved performances and activities in nursing services.

• 기본간호학회지
• /
• 제3권2호
• /
• pp.213-233
• /
• 1996

This study was made on 274 apoplectics patients who received the rehabilitation therapy and tests on physical, psychological and social adaptations as outpatients in 23 general hospitals in the Seoul and Kyungi area. The basic data on degree of improvement of apoplectic patients studied from rehabilitation therapy. Data was collected over a period of 63 days, from February 21st till April, 23, 1996. The assigned physical therapist conducted direct interviews with patients after he answered the distributed questionnaires for each individual patient. The colleted data was processed by the $SPCC/C^+$ method. The results of the tests conducted to meascne the the degree of ADL dependency, depression and social activity corresponding to the physical, psychological, and social adaptation. The details are ; 1) The test to meascne the degree of ADL dependency, corresponding to the study of physical adaptation of CVA patients, indicated a mean score of 2.57(ideal score is 1.0) with a standard deviation of ${\pm}0.75$. The worst score was 3.95 while the best score was a perfect 1.0, representing a severe range of dependency. The distribution was centered with a median of 2.65 and a mode of 2.68. 2) The test to meascne the degree of depression which corresponds to the level of psychological adaptation yielded a mean of 2.99 which is higher than the normal limit of 2.45. The standard deviation was ${\pm}0.52$ and the worst score and the best score were 4.35 and Respectirdy. The distribution was centered with a median of 3.00 and a mode of 3.00. 3) The test to meascne the degree of social activities for the level of social adaptation indicated a very low mean score of 26.52 (perfect score is 144), with the standard deviation of ${\pm}16.23$. Some patients scored as high as 100, but others scored as low as 3. The distribution of social activities at a very low level was shifted to the left with a median of 24.00 and a mode of 20.00. 4) Factors influencing the level of physical, psychological and social adaptation are as follows : Factors significantly influencing the level of physical adaptation measured by ADL dependency are age, personal guardian, payer of medical expenses, and paralysis of the right arm, right leg and facial paralysis. Factors significantly influencing the level of psychological adaptation measured by the degree of depression, are age, marital status, education, medical history of individual and family, speech impediment, and facial paralysis. Factors significantly influencing the level of social adaptation measured by the degree of social activity are age, marital status, education, employment status, and the burden of medical expense. 5) The Corelationship is significant(9.00), between ADL dependeing as degree of physical adaptation and depreseion as degree of psychologial adaptation. ADL dependency is proportional to depression. But social activity is inversely protional to ADL dependeny and depression. In conclusion, the increased care for physical function of the patients is not the only necessary means to better facilitate the appropriate adaptation of CVA patients. The introduction of a solid rehabilitation program for psychological and social adaptation will also play the integral part of the treatment of CVA patients.

• 무역상무연구
• /
• 제19권
• /
• pp.224-242
• /
• 2003

The author believes that the main task of study in international trade usage and practice is the management of transactional risks involved in international sale of goods. They are foreign exchange risks, transportation risks, credit risk, risk of miscommunication, etc. In most cases, these risks are more serious and enormous than those involved in domestic sales. Historically, the merchant adventurers organized the voyage abroad, secured trade finance, and went around the ocean with their own or consigned cargo until around the $mid-19^{th}$ century. They did business faceto-face at the trade fair or the open port where they maintained the local offices, so-called "Trading House"(商館). Thererfore, the transactional risks might have been one-sided either with the seller or the buyer. The bottomry seemed a typical arrangement for risk sharing among the interested parties to the adventure. In this way, such organizational arrangements coped with or bore the transactional risks. With the advent of ocean liner services and wireless communication across the national border in the $19^{th}$ century, the business of merchant adventurers developed toward the clear division of labor; sales by mercantile agents, and ocean transportation by the steam ship companies. The international banking helped the process to be accelerated. Then, bills of lading backed up by the statute made it possible to conduct documentary sales with a foreign partner in different country. Thus, FOB terms including ocean freight and CIF terms emerged gradually as standard trade terms in which transactional risks were allocated through negotiation between the seller and the buyer located in different countries. Both of them did not have to go abroad with their cargo. Instead, documentation in compliance with the terms of the contract(plus an L/C in some cases) must by 'strictly' fulfilled. In other words, the set of contractual documents must be tendered in advance of the arrival of the goods at port of discharge. Trust or reliance is placed on such contractual paper documents. However, the container transport services introduced as international intermodal transport since the late 1960s frequently caused the earlier arrival of the goods at the destination before the presentation of the set of paper documents, which may take 5 to 10% of the amount of transaction. In addition, the size of the container vessel required the speedy transport documentation before sailing from the port of loading. In these circumstances, computerized processing of transport related documents became essential for inexpensive transaction cost and uninterrupted distribution of the goods. Such computerization does not stop at the phase of transportation but extends to cover the whole process of international trade, transforming the documentary sales into less-paper trade and further into paperless trade, i.e., EDI or E-Commerce. Now we face the other side of the coin, which is data security and paperless transfer of legal rights and obligations. Unfortunately, these issues are not effectively covered by a set of contracts only. Obviously, EDI or E-Commerce is based on the common business process and harmonized system of various data codes as well as the standard message formats. This essential feature of E-Commerce needs effective coordination of different divisions of business and tight control over credit arrangements in addition to the standard contract of sales. In a few word, information does not alway invite "trust". Credit flows from people, or close organizational tie-ups. It is our common understanding that, without well-orchestrated organizational arrangements made by leading companies, E-Commerce does not work well for paperless trade. With such arrangements well in place, participating E-business members do not need to seriously care for credit risk. Finally, it is also clear that E-International Commerce must be linked up with a set of government EDIs such as NACCS, Port EDI, JETRAS, etc, in Japan. Therefore, there is still a long way before us to go for E-Commerce in practice, not on the top of information manager's desk.

• 복식
• /
• 제10권
• /
• pp.63-80
• /
• 1986

The Old Testament cotains mention of the history of creation and clothing in ancient Hebrew. This study dealt with Hebrew dress customs especially aimed at the manners of their hair styles, headgears, footwear and personal ornaments. References are Korean Revised Version, English King James Version and Revised Standard Version. There is little mention of hair styles and headgears in the Old Testament. Some sort of turban was worn by priests, and soldiers protected themselves with helmets, but most Israelitish men went bareheaded except on special occasions and often wear simple headbands. It was more common for women to use headwear of some type-turbans, scarves, and veils concealing the face. The veil was the distinctive female wearing apparel. All females, with the exception of maidservants and women in a low condition of life, wore a veil. It was the custom for women to wear a veil entirely covering their head in the public. Through most of the Old Testament periods long and thick hair was admired on men and women alike. The Hebrews were proud to have thick and abundant long hair, and they gave much attention to the care of their hair. The caring of hair was deeply related to their rituals. Nazirites never took a razor to their hair during his vow-days, but instead let it grow long, as an offering to God. Men would not cut their beards, but allow them to grow long. The Israelites' standard footwear was a pair of simple leather sandals. This was one of the items of clothing not highly prized. In a colloquial saying of the time, a pair of shoes signified something of small value, and to be barefoot except in times of mourning or on holy place, was a sign either of extreme poverty or humiliation, as in the case of war prisoners. Because precious stones were not mined in the Palestine-Syria region, Hebrews imported them from foreign country. They were consumer-to a large degree limited by their very modest standard of living-but not producers. Hebrews liked the precious stones and were motivated to acquire and wear jewels. Besides their use for adornment and as gifts, the precious or semiprecious stones were regarded by Jews of property. The Hebrews were not innovators in the field of decorative arts. The prohibition of the Law against making any "graven image" precluded the development of painting, sculpture, and other forms of representational art. Jewish men did not indulge in extravagances of dress, and there was little ornamentation among them. Men wore a signet ring on their right hand or sometimes suspended by a cord or chain around the neck. The necklaces, when worn by a male, also bore any symbol of his authority. Bracelets were extremely popular with both men and women, men usually preferring to wear them on their upper arms. The girdle was a very useful part of a man's clothing. It was used as a waist belt, or used to fasten a man's sword to his body, or served as a pouch in which to keep money and other things. Men often carried a cane or staff, which would be ornamented at the top. Among the women there was more apt to be ornamentation than among the men. Hebrew women liked to deck themselves with jewels, and ornamentation of the bride were specially luxurious and numerous. They wore rings on their fingers or On toes, ankle rings, earrings, nosering, necklace, bracelets. Their shapes were of cresent, waterdrops, scarab, insect, animal or plant. Sometimes those were used as amulets. They were made of ceramics, gold, silver, bronze, iron, and various precious stones which were mostly imported from Egypt and Sinai peninsular. Hebrews were given many religious regulations by Moses Law on their hair, headgears, sandals and ornamentation. Their clothing were deeply related with their customs especially with their religions and rituals. Hebrew religion was of monotheism and of revealed religion. Their religious leaders, the prophets who was inspired by God might need such many religious regulations to lead the idol oriented people to God through them.

• 치위생과학회지
• /
• 제18권6호
• /
• pp.357-366
• /
• 2018

본 연구는 치과위생사 직무를 다양한 각도에서 분석하고 검토하여 향후 치과 팀 내 치과진료업무를 효율적으로 분담하고 직무에 따른 교육 과정을 개발하는 데 기초 자료로 활용하기 위하여, 의료법에서 의료행위를 판단하는 기준에 따라 치과위생사 직무의 타당도를 평가하고자 하였다. 본 연구는 2017년 11월 10일부터 20일까지 강릉원주대학교 치과대학의 12명 교수를 대상으로 치과위생사 직무의 타당성을 평가하기 위해 자기기입 설문조사를 실시하였다. 치과위생사 직무가 질병예방과 치료, 환자요양지도, 보건 위생상 위해 발생 여부의 의료행위 판단기준에 해당하는지에 대한 전문가 일치율을 산출하였고, 각 행위를 의료행위 타당성 평가기준에 따라 점수화하여 level 1~4로 최종 분류하였다. 본 연구 결과에 따르면, 응답자의 50% 이상이 치위생 관리에 포함하는 치은출혈, 치주낭, 임상적 부착수준 측정 및 기록과 전문가 치면세균막 관리, 스케일링, 칫솔질 및 구강 관리용품 처방, 교육을 포함한 대상자별 구강보건교육과 치료 후 주의사항에 대한 상담이 세 가지의 의료행위 판단기준에 모두 해당된다고 응답하였다. 치과위생사가 치과임상에서 수행하는 행위는 의료행위 판단 기준에 따라 크게 4가지 범주로 분류하였고, 범주의 수준이 높을수록 수행난이도가 높고, 전문지식과 기술이 요구되는 직무로 판단할 수 있다. 치은출혈, 임상적 부착수준, 치주낭 측정 및 기록과 치면 연마, 전문가 치면세균막 관리, 스케일링, 치근활택술, 국소적 항균제 적용의 항목은 최종 점수 4.3으로 수행난이도와 전문성이 요구되는 Level 4 그룹으로 분류되었다. 우리나라 치과진료현장에서 환자의 안전과 건강권을 보장하면서 효율적으로 진료를 분담하기 위해서는 수행 행위에 따라 필요한 지식의 수준과 적절한 교육, 자격 기준 등에 대한 표준화된 지침이 개발되어 활용될 필요가 있다.

• 한국직업건강간호학회지
• /
• 제13권1호
• /
• pp.5-18
• /
• 2004

This study aims to investigate the use state of the health service computerization system in the occupational nursing field and the occupational nursers' satisfaction level, and provide basic data to promote the development of the health service computerization system for the nursing field. For this study, a questionnaire was provided to 118 occupational nurses who belong to Busan and Gyeongnam branches of KAOHN(Korean Association of Occupational Health Nurses) for 2 months (from Dec. 1, 2002 to Jan. 31, 2003). A tool of Choi Yong-Heui(2000) was used to investigate the satisfaction level of using the health service computerization system. The collected materials were analyzed in real number and percentage, average and standard deviation, t-test and ANOVA by using the SPSS WIN 10.0 program. This study is summarized as follows: 1. The average age was $31.99{\pm}5.58$ old in this study. The married were 54.2%. Participants who graduated from a junior college was 76.9%. The average service period was $4.48{\pm}4.68$ years. In service types, 79.7% of participants served in a health care center. The average service period was $3.22{\pm}2.89$ years. The service place which had 1000 workers or more was 35.6%. 2. Only 20.3% of participants in this study had a computer use education. 3. The field who participants used mostly was communication/internet, $3.29{\pm}.85$ hours in average. 4. 97.1% of occupational fields had computers and peripheral devices: 71.4% in pentium computer, 42.8% in the hard disk capacity of 20-29GB, 60.0% in 15 inch monitors, 86.2% in printers, 18.1% in digital cameras, 12.4% in LAN, and 9.5% in scanners. 80.1% of the occupational fields which were objects of study could use communication. 5. The occupational fields which did not introduced the health service computerization system were 62.8%. The main cause was attributable to entrepreneurs' insufficient recognition 66.6%. 51.5% of the entrepreneurs did not have an introduction plan. 37.2% of participating companies had the health service computerization system. 56.4% of them introduced it since the year 2000. 81.6% of the introduction motivation aimed to the efficiency of health service. The most issue upon introduction was insufficient understanding of a person in charge - 25.6%. The in-house development of the system covered 56.4%. 61.5% of the participants accepted their demands from the first stage of development. The direct effect of computerization showed the increase of 25.9% in the quickness and continuity of service treatment, and 25.9% in the serviceability of statistical treatment. 6. 22.0% of the participants had a computerization system use education. 69.2% of them had a in-house education. An educational method by nurses who used the computerization system was 76.9%. 92.3% of the education was helpful for practical duties. 7. An analysis of the computer use by health service fields showed that the medicine management in a health management field was 15.9%. the work environment measuring management in a work environment filed was 32.9%. the employment. general and special examination management in a heal th management field was 61.1 %. the various reports management in an administrative field was 64%. the health education data preparation management in an educational field was 58.0%. and the medicine and expendables management in an equipment management field was 51.6%. An analysis of the computerization system use showed that the various statistical data manage in a health management field was 13.0%. the work environment measuring management in a health management field was 34.8%. the personal disease management in a health management field was 51.9%. the heal education data preparation management in an educational field was 54.5%. and the equipment management of health care centers in an equipment management field was 52.6%. 8. 31.6% of the participants wanted that health service computerization system would include the generals of health services. 42.4% of the participants thought that first of all. the aggressive interest and investment of employers were required to build the health service computerization system. 9. The participants' satisfaction level on the computerization system use was $3.51{\pm}.57$ points. An analysis by each factor showed $3.62{\pm}.68$ points in a service change factor. $3.15{\pm}.63$ points in a computer program use factor, and $3.45{\pm}.71$ points in a continuous computerization use factor. 10. An analysis of the computerization system use by general characteristics of participants showed that the married (p = .022) had the satisfaction level higher than the unmarried. 11. The satisfaction level of the computerization system use by participants' computer use ability tended to be higher in proportion to the increase of computer use abilities in spreadsheet (F=2.606. p=.048). presentation (F=3.62. p=.012) and communication/internet(F=2.885. p=.0321. Based on the study results mentioned above. I will suggest as follows : The nationwide enlargement and repetition study is required for occupational nurses who serve in occupational nursing fields. The computerization system in a health service field is inferior comparing with other fields. The computerization system standard by business types and characteristics should be prepared through employers's aggressive participation and national support. Therefore various statistical data which occurs in occupational fields will be managed systematically and efficiently. A regular and systematic computer education plan for occupational nurses in charge of health services in the filed is urgently required to efficiently manage and improve the health of on-site workers.

• Child Health Nursing Research
• /
• 제5권1호
• /
• pp.70-83
• /
• 1999

The birth of a premature infant is distressing for its parents. The parents of a premature infant experience stress according to the infant's physical appearance and behavior, the environment of the neonatal intensive care unit (NICU) , and the alteration in the parental role. Especially, a mother of a premature infant feels distressed even after the discharge of the infant : therefore, she has difficulties in maternal role performance. The main purpose of this study is to identify the effects of the planned infant care information program in order to lower the stress level for mothers of premature infants caused by the birth and hospitalization in NICU of premature infants, to reduce the maternal role strain, and to promote the maternal role performance after the infants' discharge. This study employed two methods of research at the same time : quasi -experimental non-equivalent pre and post test to compare : non-equivalent post test to compare. The total number of subjects was 19 who were assigned to the research program : 12 mothers of premature infants at the NICU at the Ch university hospital and 7 at the NICU at the Y general hospital located in Chounju city. The data were collected for 79 days from August 18 to November 5, 1998. The questionnaire method was applied for the data collection, and the measures used in this study were Parental Stressor Scale : NICU(Miles, 1993), the Maternal Role Strain Measures ( Hobbs, 1968 ; Steffensmeier, 1982) , and Self Confidence Scale (Pharis, 1978). Research procedure is as follows : after preliminary examination, the experimental subjects, the mothers of premature infants at the Nl CU at Ch university hospital were provided with slide films and information developed by the researcher based on existing documents and data. It took two 60-minute sessions a week for two weeks, and the mothers' stress level was measured using the same instrument twice one week and two week after the infants' hospitalization. The stress level of the contrast subjects, the mothers at Y general hospital was measured during the same period. The experimental subjects were provided with booklets on matters that require attention after the infants' discharge and on developmental project, and they were educated to play the maternal role in person for 2-3 hours a week : breast-feeding, burping a baby, and changing diapers. One week after the infants' discharge, the maternal role strain and the maternal role performance were examined in two groups of the subjects. The analysis of collected data was done using descriptive statistics including real numbers, percentages, averages, and standard deviations. Mann-Whitney test ; x² test ; Repeated Measures Analysis of Variance ; ANCOVA Spearman's rho correlation coefficients. The results on this study were as follows. (1) The examination of the same quality showed that there were no differences in the general and obstetrical characters between the two groups. However, in terms of the characters of premature infants. just right after their birth, the infants at the contrast group weighed more than those at the experimental group(U=16.5, p=.02), and the former was in mother's womb longer than the latter(U=15.5, p=.02). (2) The stress level of the mothers provided with the plannned nursing intervention program became lower as time passed compared to the others'(F=16.61, p=.00) Even when the influence of weight at birth and the length of gestation was removed among the premature infants' characters, the mothers' stress levels made a statistical difference 2 weeks after the infants' hospitalization depending on treatment (F=8.00, p=.01) (3) The maternal role strain of the mothers provided with the planned nursing intervention program was lower than the others'(U=2.0, p=.00). Even when the influence of weight at birth and the length of gestation was removed among the premature infants' characters, the maternal role strain levels made a statistical difference 2 weeks after the infants' hospitalization, depending on treatment(F=14.72, p=.00). (4) The maternal role performance level of the mothers provided with the planned nursing program was higher than the others'(U=.0, p=.00). Even when the influence of weight at birth and the length of gestation was removed among the premature infants' characters, the mothers' stress levels made a statistical difference 2 weeks after the infants' hospitalization, depending on treatment(F=8.00, p=.01). (5) The correlation between a mother's stress level 2 weeks after her infant's hospitalization, the maternal role strain and the maternal role performance were compared : the stress and the maternal role strain were statistically irrelevant to each other(r=.33, p=.12) : the stress was found to be in inverse proportion to the maternal role performance(r=-.53, p=.02). The maternal role strain was in inverse proportion to the maternal role performance as well(r=-.50, p=.00). In conclusion, for the mothers provided with the planned nursing intervention program, their stress level was getting lower as time passed during the infants' hospitalization, their maternal role strain reduced when they took care of their infants after their discharge, and their maternal role performance level was high compared to the other mothers. Besides, the lower the stress level of mothers of premature infants was during the infants' hospitalization, the higher the maternal role performance after their discharge was. The lower maternal role strain was, the higher the maternal role performance was as well. These results of the study suggested that the nursing intervention program for the mothers of premature infants developed by the researcher would be effectively applied to nursing practice, and it would be a foundation for the development of this kind of program.