• 대한감각통합치료학회지
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• 제19권2호
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• pp.46-59
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• 2021

목적 : 아동작업치료사의 부모상담에 관한 경험을 현상학적으로 탐색하여 추후 부모상담 기술 향상을 위한 프로그램 마련의 근거로 활용하고자 하였다. 연구방법 : 연구 방법은 Colaizzi의 현상학적 연구 방법을 적용하였다. 임상경력 8년 이상으로 사설센터에서 근무하는 아동작업치료사 6명을 대상으로 전화 인터뷰를 실시하였다. 인터뷰 내용은 연구참여자의 동의하에 녹음하였으며, 추가적인 내용 확인은 이메일로 받았다. 녹음된 내용은 전사 뒤 분석하여, 아동작업치료사의 부모상담 경험의 의미와 본질을 기술하였다. 결과 : 면담 내용을 분석한 결과 2개의 범주화, 4개 주제모음, 21개의 주제가 도출되었다. 2개의 범주화에는 부모상담의 중요성과 부모상담에 영향을 미치는 요소가 있었고, 4개의 주제모음에는 부모상담의 의미, 부모-아동-치료사 간의 상호성, 치료사의 노력, 필요한 역량이 있었다. 결론 : 본 연구의 결과는 초임 아동작업치료사에 의미있는 자료로 활용될 수 있으며 앞으로 아동작업치료사의 부모상담 기술 향상을 위한 교육 프로그램이나 자료 개발의 기초자료로 활용될 수 있을 것이다.

• 한국병원경영학회지
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• 제26권1호
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• pp.42-54
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• 2021

The purpose of this study is to analyze that ICT-based primary health care affects clinical changes of participants in the primary care chronic disease management pilot project using ICT medical care. Customized health information data, provided by National Health Insurance Service, was used for the analysis. The study targeted a total of 676 people that participated in primary care chronic disease management pilot project using ICT medical care from 2017 to 2018. Hierarchical regression was used to test three model. First, there were many subjects who used face-to-face consultation and non-face-to-face consultation(messaging), but less than half of patients using non-face-to-face consultation(telephone). Second, after participating in the pilot project, the fasting blood sugar level decreased. Third, the clinical condition of the subjects appeared to be an important factor in controlling blood sugar levels. Finally, patients using the non-face-to-face consultation(messaging) had reduced blood sugar levels after participating in the project. This results imply that non-face-to-face consultation is effective in reducing fasting blood sugar level with hospital intervention, and there are effects of the primary care chronic disease management project using ICT.

• 임상간호연구
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• 제14권3호
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• pp.99-115
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• 2008

Purpose: The purpose for this study was to identify the present state of Clinical Nurses with Expanded Role (CNERs) and provide basic data to refine the roles of CNERs. In this study, CNREs refers to nurses who perform techniques traditionally done by doctors and use titles such as clinical nursing specialist, educator with consultation, research assistant, coordinator, physician assistant and special examiner. Method: This study was conducted from September 1 to November 12, 2007. Data from 684 nurses from 38 hospitals who responded to the questionnaire were analyzed with descriptive statistics using the SPSS 14.0 program. Results: The mean percentage of time spent was, for direct practice, 41.1%, for education and counseling, 22.8%, for consultation and coordination, 10.4%, for research, 6.8%, for administration, 8.9% and for other activities, 10.0%. The most frequently implemented CNERs, activities included consultation and education for patients and their families, counseling by telephone, history taking, physical examination, reading examination results, psychosocial assessment, managing treatment, input of prescriptions, and writing up patient records, Although not frequently performed, nurses in some fields carried out invasive procedures and prescribed medication and laboratory tests. Conclusion: Although the number of hospital CNERs are rapidly increasing, there is still confusion about the title and framework as well as standards. Furthermore, because some nurses are prescribing medication and laboratory tests as well as performing techniques not traditionally done by nurses, there is an absolute need for a legalized system and systematic education system for the safety of patients who are being cared by all CNERs.

• 간호행정학회지
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• 제5권2호
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• pp.355-368
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• 1999

This study was a quasi-experimental study to investigate the effect of a telephone follow-up on the self-care and the satisfaction on nursing care in G-I surgical patients. The subjects of the study were 38 patients, 19 in experimental group and 19 in control group, who discharged after gastrointestinal surgery at a university hospital in Taegu between August 11. 1998 and October 16, 1998. The telephone follow-up program for the experiment was developed by the researcher, which contained consultation, support and encouragement for self-care after discharge. Number of the instruments used for measurement of the outcome variables were 5, self-care after discharge, satisfaction(1)${\sim}$(2) on Nursing care. intention to visit the hospital again. intention to recommend the hospital to others. The results of this study were as follows ; 1. The first hypothesis, "The subjects of experimental group will show a higher level of self-care than the subjects of control group" was rejected (F=.48. p=.4937). 2. The Second hypothesis. "The subjects of experimental group will show a higher level of satisfaction than the subjects of control group" was accepted partly as follows. 1) The hypothesis 2-1, "The subjects of experimental group will show a higher level of satisfaction(1) than the subjects of control group" was accepted(F=4.04. p=.0496). 2) The hypothesis 2-2. "The subjects of experimental group will show a higher level of satisfaction(2) than the subjects of control group" was accepted(F=8.48. p=.0064). 3) The hypothesis 2-3, "The subjects of experimental group will show a higher level of intention to visit hospital again than the subjects of control group" was rejected(F=1.95. p=.1723). 4) The hypothesis 2-4. "The subjects of experimental group will show a higher level of intention to recommend the hospital to others than the subjects of control group" was rejected(F=1.43. p=.2411) . From the results of this study, the telephone follow-up can be regarded as an effective nursing intervention for the discharged patients.

• 대한간호학회지
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• 제26권3호
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• pp.576-590
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• 1996

Advanced countries such as the USA and Japan are eagerly seeking ways to improve health and welfare of the elderly. One of the services is home health care service using the telephone. Various types of services using the telephone have been developed, improved and are being utilized ranging from the basic consulting to emergency response systems in the area of health care for the elderly. A demonstration project was launched to study the feasibility of a consulting system and telemedicine for the elderly using the public phone system in Korea. For this project, a gathering site for the elderly was selected and those who visited this place were interviewed to find out what kinds of services they wanted and what kind of system they needed to provide the required services. Based on the users' requests and the surrounding environment, a telephone consulting facility was established at the Research Institute of Nursing Science at Seoul National University and consulting personnel was recruited, trained and posted at the center. An Application program for home health care nurses to use when they visited the patients at their homes was developed. This system operates on a notebook Computer and allows nurses to communicate with a doctor at a local hospital through a modem and telecommunication line. These systems were implemented for three months and problems which developed during operation of the systems were identified and progressively modified. Through system evaluation, it was found that a consulting system using phone service will be an invaluable system for the welfare of the elderly in the future. But in order to meet the elderly's need, more services than mere consultation are needed. That is, communication with physicians and hospitals are needed. Thus, when there is any need for physicians' attention, physicians or hospitals should be contacted directly. Similarly for telemedicine, when the home health care nurse visits elderly patients she can assess the patient's problem and provide nursing care, access a physician or hospital to refer her patient to or consult directly using the telecommunication the system. The above mentioned system is a basic form of futuristic telemedicine for the elderly and those who have chronic disease problems. This kind of system will be of great value when it is used on the national information super-highways in the future. In order to get to that stage, of course, this project needs great improvement in the technical, academic, and legal aspects.

• 간호행정학회지
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• 제16권4호
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• pp.381-388
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• 2010

Purpose: The purpose of the study was to compare recipients' health behavior, attitude to using medicaid, medication compliance, and the changes in hospital cost and visit-day of in-patient and out-patient care between tele-care regions (TCR) and general care regions (GCR) in Korean medicaid. Method: The design of the study was ex-post facto comparing recipients in TCR and GCR. The sample included 625 persons in TCR and 410 persons in GCR. To collect materials, the case manager interviewed recipients of medicaid and filled out questionnaires which were analyzed through SAS/PC 9.1. Results: In studying health behavior and medication, compliance was not significant. However, the attitude to using medicaid was significantly more positive in TCR than in GCR. In out-patients, the change of hospital visit-day was not significant between TCR and GCR, but TCR showed a reduction in hospital cost compared to GCR. For in-patient recipients, GCR showed a greater reduction in changes in hospital cost and visit-day compared to TCR. Conclusions: The results of the study show that attitudes to using medicaid via telephone are positive and results are more effective than hospital visit consultation, and the cost of out-patient care could be reduced.

• 농촌지도와개발
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• 제14권1호
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• pp.59-91
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• 2007

The objectives of this study were 1) to explore the present status of extension services of agricultural experiment station, and 2) to get some implications for ameliorating extension services of agricultural experiment station. The data were collected through the semi-constructed interviews with 11 agricultural researchers in 6 local agricultural experiment stations and 11 farmers who have ever made contact with the researchers. The major findings of this study were as follows: The agricultural experiment stations were providing extension services as expedients to accommodate to new markets and structural changes of organizations, though they are originally research-oriented agencies. The extension methods of agricultural experiment stations were similar with those of extension agencies, and the extension methods used mainly were 'experiment plot demonstration exhibition', 'consultation using telephone, internet, face to face meeting', 'visiting farms and consulting'. These were generally carried out by farmer's request, therefore the extension services of agricultural experiment stations were provided in a passive way so far. Based on the results of this study, the followings are recommended for further development of extension services of agricultural experiment station: The rural development organizations should set principles and support for extension services of agricultural experiment stations. The alternative plans to strengthen the linkage between research and extension have to be made, and these plans should include financial, personnel and systematic arrangements for further development of extension services of agricultural experiment stations.

• 보건행정학회지
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• 제33권2호
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• pp.185-193
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• 2023

Background: This study focuses on the establishment and operation of a stroke patient hotline program to help patients and their caregivers determine when acute neurological changes require emergency attention. Method: The stroke hotline was established at the Gyeonggi Regional Cerebrovascular Center, Seoul National University Bundang Hospital, in June 2016. Patients diagnosed with stroke during admission or in outpatient clinics were registered and provided with stroke education. Consulting nurses managed hotline calls and made decisions about outpatient schedules or emergency room referrals, consulting physicians when necessary. The study analyzed consultation records from June 2016 to December 2020, assessing consultation volumes and types. Outcomes and hotline satisfaction were also evaluated. Results: Over this period, 6,851 patients were registered, with 1,173 patients (18%) undergoing 3,356 hotline consultations. The average monthly consultation volume increased from 29.2 cases in 2016 to 92.3 cases in 2020. Common consultation types included stroke symptoms (22.3%), blood pressure/glucose inquiries (12.8%), and surgery/procedure questions (12.6%). Unexpected outpatient visits decreased from 103 cases before the hotline to 81 cases after. Among the 2,244 consultations between January 2019 and December 2020, 9.6% were recommended hospital visits, with two cases requiring intra-arterial thrombectomy. Patient satisfaction ratings of 9-10 points increased from 64% in 2019 to 69% in 2020. Conclusion: The stroke hotline program effectively reduced unexpected outpatient visits and achieved high patient satisfaction. Expanding the program could enhance the management of stroke-related neurological symptoms and minimize unnecessary healthcare resource utilization.

• 정신신체의학
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• 제11권2호
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• pp.149-158
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• 2003

목 적: 고전적 정신신체질환인 내과 외래의 소화성 궤양과 고혈압 환자를 대상으로 하여 불안, 우울의 정도와 그 심리적인 특성을 관찰하고, 그러한 특성이 내과 치료에 미치는 영향과 정신과 자문 현황 등을 알아 보고자 하였다. 방 법: 1999년 3월에서 4월까지 본원 내과 외래를 방문하였던 소화기계와 심혈관계 환자에게 State Trait Anxiety Inventory(STAI), BDI, SCL-90R과 발병 원인 및 심각성, 약물 순응도, 의사와의 관계에 대한 만족도 등으로 구성된 설문을 시행하였다. 이후 병록지 검토, 전화 인터뷰를 통하여 소화성 궤양 환자 56명, 본태성 고혈압 환자 44명을 선택하였다. 대조군은 1999년 9월 한 달 동안 본원 건강 검진 센터를 방문한 환자 중 설문조사에 응한 153명 중 116명을 선택하였다. 결 과: BDI 우울군은 21점을 기준으로 소화성 궤양 환자 중 39.3%, 본태성 고혈압 27.7%, 대조군 12.1%였다. 상태특성불안척도에서 45점을 기준으로 하였을 때 상태 불안군은 소화성 궤양 환자 중 44.6%, 본태성 고혈압 54.5%, 대조군 18.1%였고, 특성 불안군은 궤양 환자에서 42.9%, 고혈압 환자에서 34.1%, 대조군이 25.8%로 나타났다. 환자들이 인식하고 있는 질환의 심각도와 불편함은 고혈압 환자들이 소화성 궤양보다 높았고, 심각성의 인식 정도는 BDI, STAI와 통계적으로 의미있는 상관관계를 나타냈다. SCL-90R 중 SOM 척도, BDI, STAI 가 높은 환자들은 의사의 설명에 대한 만족도나 약물 순응도가 낮게 나타났다. 소화성 궤양 환자의 48.2%, 본태성 고혈압 환자의 45.7%가 심리적인 요인을 가장 큰 발병 원인으로 생각하였다. 향정신성 약물이 처방된 예는 소화성 궤양에서 16.1%, 본태성 고혈압 환자에서 9.1%였으나 정신과에 자문된 경우는 각 1명씩으로 1.8%, 2.3%에 불과하였다. 결 론: 내과 외래 환자들은 입원환자와 같이 높은 수준의 불안과 우울을 보였으며, 특히 소화성 궤양 환자들은 우울에서, 본태성 고혈압 환자들은 상태 불안이 높았다. 환자들의 심리적인 특성은 약물에 대한 순응 정도와 관련이 있어 치료 결과에 영향을 주는 것으로 여겨졌다. 많은 환자들이 발병 원인으로 심리적인 요인을 들고 있었으나 정신과 자문율은 낮아서, 내과 질환의 심리적인 특성에 따른 정신의학적 접근 방법이 필요하다고 생각되었다.

• 기본간호학회지
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• 제7권3호
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• pp.366-378
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• 2000

Type 2 Diabetes Mellitus patients have chronic metabolic disorder and they need self care for their lifetime. But most Diabetes Mellitus patients don't know how to do a self care due to the lack of adequate support from health care professionals. It has been reported that lack of exercise therapy compliance guide is very important one. This study was conducted to develop an exercise therapy protocol applied to an efficacy expectation promoting program based on Bandura's self efficacy model for type 2 Diabetes Mellitus patients. Firstly, a conceptual framework was developed through efficacy expectation promoting Program based on Bandura's self efficacy model. In order to identify the contents of program and to design a preliminary protocol, a with the consultation experts was made. A clinical validity was tested using twenty type 2 Diabetes Mellitus patients who received follow-up care regularly through the diabetic out-patient clinic from October, 1998 to May, 2000. After this process, the final protocol was developed. The results of this study are summarized as bellows : The final exercise therapy protocol applied to an efficacy expectation promoting program for type 2 Diabetes Mellitus Patients consists of individualized exercise test and prescription, a small booklet relating personal experience with Diabetes Mellitus and a telephone coaching program for 12 weeks on performance accomplishment, vicarious experience and verbal persuasion, which are all induction modes of efficacy expectation. It is concluded that the exercise therapy protocol applied to an efficacy expectation promoting program is applicable to type 2 diabetes mellitus. And this exercise therapy protocol could show a positive effect on the exercise compliance of Diabetes Mellitus patients.