• Safety and Health at Work
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• 제9권4호
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• pp.416-420
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• 2018

Background: Urinary 1-hydroxypyrene (1-OHP) has been widely used as a biomarker of polycyclic aromatic hydrocarbons (PAHs) in occupationally exposed workers. The objective of this study is to investigate the concentration of urinary 1-OHP among charcoal workers as subjects and non-charcoal workers as controls. Methods: Early morning urine samples were collected from 68 persons (25 charcoal workers in Igbo-Ora, 20 charcoal workers in Alabata, and 23 non-charcoal workers) who volunteered to participate in this study. 1-OHP determination in urine samples was carried out using high performance liquid chromatography after hydrolysis. Descriptive and inferential statistics were used for data analysis at p < 0.05. Results: The mean urinary 1-OHP concentration (${\mu}mol/mol$ creatinine) among charcoal workers at Igbo-Ora and Alabata and non-charcoal workers were $2.22{\pm}1.27$, $1.32{\pm}0.65$, and $0.32{\pm}0.26$ (p < 0.01). There existed a relationship between respondent type and 1-OHP concentration. Charcoal workers were 3.14 times more at risk of having 1-OHP concentrations that exceed the American Conference of Governmental Industrial Hygienists guideline of $0.49{\mu}mol/mol$ creatinine than non-charcoal workers (relative risk = 3.14, 95% confidence interval: 1.7-5.8, p < 0.01). Conclusion: Charcoal workers are exposed to PAHs during charcoal production and are at risk of experiencing deleterious effects of PAH exposure. Routine air quality assessment should be carried out in communities where charcoal production takes place. Assessment of urinary 1-OHP concentration and use of personal protective equipment should also be encouraged among charcoal workers.

• Journal of Preventive Medicine and Public Health
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• 제55권6호
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• pp.539-548
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• 2022

Objectives: The purpose of this study was to assess the organizational effectiveness of the introduction of a healthcare information system (electronic medical records and databases) in healthcare in Kazakhstan. Methods: The authors used a combination of 2 methods: expert assessment and strengths, weaknesses, opportunities, and threats (SWOT) analysis. SWOT analysis is a necessary element of research, constituting a mandatory preliminary stage both when drawing up strategic plans and for taking corrective measures in the future. The expert survey was conducted using 2 questionnaires. Results: The study involved 40 experts drawn from specialists in primary healthcare in Aktobe: 15 representatives of administrative and managerial personnel (chief doctors and their deputies, heads of medical statistics offices, organizational and methodological offices, and internal audit services) and 25 general practitioners. Conclusions: The following functional indicators of the medical and organizational effectiveness of the introduction of information systems in polyclinics were highlighted: first, improvement of administrative control, followed in descending order by registration and movement of medical documentation, statistical reporting and process results, and the cost of employees' working time. There has been no reduction in financial costs, namely in terms of the costs of copying, delivery of information in paper form, technical equipment, and paper.

• 한국건축시공학회지
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• 제21권6호
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• pp.629-640
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• 2021

2018년 국토교통부 통계에 따르면 재건축 연한이 도래한 주거용 건축물은 2018년 기준 약 37%에 달한다, 해체물량의 증가는 해체산업의 성장과 함께 환경 및 안전사고 등 많은 부작용을 일으키고 있다. 이에 본 연구는 해체공법 선정에 있어 안전성, 경제성, 환경성 등을 종합적으로 고려하여 현장 적용에 가장 적합한 공법 의사결정 방법을 제시하고, 특히 해체공사의 안전성을 고려하여 현장 공법 적용 시 위험요인에 대한 사전평가를 통해 공법선정뿐만 아니라 선정 공법의 현장 적용성을 평가한다. 이를 위해 본 연구는 QFD 기반의 TOPSIS 해체공법선정과 FMEA 위험성평가 통합모델을 제안한다.

• 성인간호학회지
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• 제20권4호
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• pp.573-587
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• 2008

Purpose: The purpose of this study was to identify the factors affecting sleeping patterns among hospitalized elderly. Methods: A descriptive correlational study was conducted. Participants were 121 hospitalized elderly in a hospital located in a county. A structured questionnaire was used for data collection. Collected data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson's correlation, and stepwise multiple regression. Results: Almost a half of hospitalized elderly in this study suffer from sleep disturbances. As results of univariate analyses, physical symptoms, anxiety, depression, and environmental factors disturbed sleep among hospitalized elderly. However, the result of stepwise multiple regression analysis identified that anxiety and environmental factors were significant predictors of sleeping patterns for hospitalized elderly and these two factors accounted 32.5% of variance of sleeping patterns among hospitalized elderly. Conclusion: Sleep assessment should be conducted on admission to identify sleep difficulties and thereby to improve quality of nursing care. Nurses and other health care personnels should make efforts to decrease anxiety and to eliminate environmental barriers of sleep among hospitalized elderly. Educational programs for nursing staff that offer information about sleep and sleep promoting interventions for the elderly patients are critical. Moreover, sleep promotion intervention program should be developed, applied and evaluated.

• 성인간호학회지
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• 제17권2호
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• pp.310-319
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• 2005

Purpose: The purpose of the study is to investigate the degree of fatigue and its related factors in patients with breast cancer. Method: The subjects of this study consisted of 62 breast cancer patients receiving chemotherapy. The Revised Piper Fatigue Scale, Disruption of Usual Activity Scale, Linear Analogue Self Assessment Scale and Self-Care Diary Scale were employed to measure fatigue, disruption of usual activity, mood state and physical symptom respectively. Collected data were analyzed using SPSS-PC to obtain summary statistics for the descriptive analysis, Pearson Correlation, and Stepwise Multiple Regression. Result: The results are as follows. 1. The mean score of the degree of fatigue was 4.82 points indicating moderate level. 2. The mean score of the degree of disruption of usual activity, mood state and physical symptom were 2.66, 5.00, and 4.69 points. 3. Fatigue of the subjects was significantly correlated with disruption of usual activity(r=.517, p<.01), mood state(r=.420, p<.01) and physical symptom(r=.463, p<.01). 4. With the result of stepwise multiple regression, disruption of usual activity, mood state and physical symptom being the three variables which could explain fatigue by 39.1%. The results of this study suggest that comprehensive intervention strategy for fatigue should be developed to maintain quality of life during and following chemotherapy considering these factors.

• 임상간호연구
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• 제14권1호
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• pp.99-111
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• 2008

Purpose: This study was done to provide basic data for developing an in-service education program to improve nurses' quality. First, frequency of nursing activities and competency levels of emergency nurses according to their career ladders were compared through job analysis and then practical education programs were presented on based of the results. Method: Data were collected from 335 nurses working in emergency rooms in 31 tertiary hospitals. Data collection was done from September to November 2005 using the job analysis questionnaire. Results: There were 41 nursing activities that showed differences in frequency and 78 activities that showed differences in perceived competency level. Irrespective of emergency nurses' careers, activities that show high frequency but low competency were sputum liquefying therapy, assessment of cranial nerve function, identification of diagnostic radiology, and communication with various departments. In-service education content according to nurse's career ladders was presented by adding high frequency nursing activities and activities with low competency level even though having high frequency. Conclusion: There is a need to develop and provide in-service education programs, which consider nurses' difference in frequency and competency level for their career ladders.

• 웰빙융합연구
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• 제4권2호
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• pp.26-34
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• 2021

Purpose: The ultimate purpose of this study is to analyze this survey to understand the overall contents of college career guidance and psychological counseling, and to utilize it to improve the quality of learning and provide career guidance. Research design, data and methodology: The research period and survey subject are approximately one month from 2020.12.01(Tue) to 2021.01.03(Sun). Convenience sampling was conducted using a structured questionnaire composed of a 5-point Likert scale and 5 open-ended questions. As the analysis method, descriptive statistics such as reliability analysis and frequency analysis of Cronbach's α coefficient of internal consistency were mainly used. Data Analysis Statistical program was analyzed using SPSS 25 version. Results: The item with the highest score is that the counseling and counseling-related non-specialized programs offered by the Student Counseling Center are helpful for school life (3.56 points). Conversely, the lowest question is that seminars accompanied by priests are helpful for study (3.38 points). Conclusions: The average score of 5 questions in the career guidance and psychological counseling areas is 3.38 out of 5.

• Journal of Dental Anesthesia and Pain Medicine
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• 제21권3호
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• pp.227-236
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• 2021

Background: Emergencies in outpatient clinics are rare. However, potentially catastrophic events can be challenging to manage due to a variety of factors, including limited equipment and staff. The purpose of this quality improvement project was to improve the staff knowledge and familiarity with critical performance elements for emergencies encountered in the setting of a periodontics clinic. Methods: Emergency cognitive aids tailored to the clinic's resources were created for anaphylaxis, airway obstruction, and sublingual hemorrhage. The project pre-post-test repeated measures design evaluated the effectiveness of cognitive aids using a combination of hands-on simulation, written knowledge assessments, and self-efficacy surveys. Training sessions and simulations were provided to the clinic's existing care teams made up of a periodontist and two dental assistants with an anesthetist who was present for simulations involving sedation. Due to the small sample size (N = 14) and non-normal distribution, all metrics were evaluated using non-parametric statistics. Results: Significant improvements were found in knowledge assessment (-2.310, P = 0.021) and self-efficacy (-2.486, P = 0.013) scores when retention after a training session before and after the introduction of cognitive aid was compared. The mean simulation scores and times improved steadily or reached maximum scores during the project progression. Conclusion: Training sessions before and after cognitive aid introduction were effective in improving knowledge, self-efficacy, and simulation performance. Future projects should focus on validating the process for creating contextualized cognitive aids and evaluating the effectiveness of these cognitive aids in larger samples.

• 보건행정학회지
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• 제26권4호
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• pp.359-372
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• 2016

Background: The purpose of this study was to develop risk-adjustment models for acute stroke mortality that were based on data from Health Insurance Review and Assessment Service (HIRA) dataset and to evaluate the validity of these models for comparing hospital performance. Methods: We identified prognostic factors of acute stroke mortality through literature review. On the basis of the avaliable data, the following factors was included in risk adjustment models: age, sex, stroke subtype, stroke severity, and comorbid conditions. Survey data in 2014 was used for development and 2012 dataset was analysed for validation. Prediction models of acute stroke mortality by stroke type were developed using logistic regression. Model performance was evaluated using C-statistics, $R^2$ values, and Hosmer-Lemeshow goodness-of-fit statistics. Results: We excluded some of the clinical factors such as mental status, vital sign, and lab finding from risk adjustment model because there is no avaliable data. The ischemic stroke model with age, sex, and stroke severity (categorical) showed good performance (C-statistic=0.881, Hosmer-Lemeshow test p=0.371). The hemorrhagic stroke model with age, sex, stroke subtype, and stroke severity (categorical) also showed good performance (C-statistic=0.867, Hosmer-Lemeshow test p=0.850). Conclusion: Among risk adjustment models we recommend the model including age, sex, stroke severity, and stroke subtype for HIRA assessment. However, this model may be inappropriate for comparing hospital performance due to several methodological weaknesses such as lack of clinical information, variations across hospitals in the coding of comorbidities, inability to discriminate between comorbidity and complication, missing of stroke severity, and small case number of hospitals. Therefore, further studies are needed to enhance the validity of the risk adjustment model of acute stroke mortality.

• 디지털융복합연구
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• 제11권10호
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• pp.609-618
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• 2013

본 연구는 당뇨병 환자의 의료이용 현황과 삶의 질에 영향을 미치는 요인을 살펴보는 데 목적이 있다. 2009년 한국의료패널조사 자료를 이용하였으며, 삶의 질 조사에 응한 만 50세 이상 응답자 6,146건을 대상자로 하였다. 분석대상자의 의료이용 현황을 파악하기 위하여 기술통계를 실시하였으며, 당뇨 환자의 삶의 질에 영향을 미치는 요인을 파악하기 위해 다중 회귀분석을 실시하였다. 연구 결과, 당뇨 환자의 건강관련 삶의 질은 성, 연령, 교육수준, 보험유형, 가구소득, 당뇨질환 외래진료비, 기타질환 외래이용 건수 등과 유의하게 관련이 있었다. 여성, 연령이 높을수록, 교육수준이 낮을수록, 의료급여 환자인 경우, 가구소득이 낮을수록, 당뇨질환 외래 진료비가 높을수록, 기타질환 외래 이용 건수가 많을수록 삶의 질이 유의하게 낮은 것으로 나타났다. 따라서 당뇨 환자들의 삶의 질 향상을 위한 보다 적극적인 사회적 프로그램을 도입하고, 문제의 원인과 대상에 맞는 구체적인 접근방안을 모색하는 노력이 필요할 것이다. 이러한 결과들은 향후 보건의료정책 수립에 기초 자료로 의미 있게 활용되어질 수 있으리라 여겨진다.