• 제목/요약/키워드: after-school care

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'실버케어 전문가' 미래직업 연계형 STEAM 프로그램이 초등학생의 미래지향 시간관, 진로인식 및 과학적 태도에 미치는 영향 (The Effects of 'Silver Care Expert' Future Career-related STEAM Program for the Elementary Students' Future Time Perspective, Career Awareness and Scientific Attitudes)

  • 유미현;최정진;박문숙;채수진;김보라;손미현;임은경;유화수;서종원;김주미;김수현
    • 과학교육연구지
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    • 제41권1호
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    • pp.111-134
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    • 2017
  • 이 연구의 목적은 '실버케어 전문가' STEAM 프로그램을 개발하고 초등학교에 적용하여 효과를 알아보는 것이다. 이 연구를 위해 경기도 소재 초등학생 110명이 참여하였다. 54명은 실험 집단으로, 56명은 비교집단으로 배치하였으며 프로그램 적용 전후에 미래지향 시간관, 진로인식, 과학적 태도 검사를 실시하였다. 본 연구에서 얻어진 결과는 다음과 같다. 첫째, '실버케어 전문가' STEAM 프로그램을 적용한 실험집단 학생의 미래지향 시간관 전체 점수와 2개 하위 영역 모두에서 비교집단에 비해 유의미하게 향상되었다(p<.05). 둘째, '실버케어 전문가' STEAM 프로그램을 적용한 실험집단 학생의 진로인식 전체 점수와 4개 하위영역 점수가 비교 집단에 비해 유의미하게 향상되었다(p<.05). 셋째, '실버케어 전문가' STEAM 프로그램을 적용한 실험집단 학생의 과학적 태도 전체 점수와 7개 하위영역 점수가 비교집단에 비해 유의미하게 향상되었다(p<.05). 넷째, '실버케어 전문가' STEAM 프로그램에 대한 실험집단 학생의 만족도를 조사한 결과 '나는 과학기술 분야와 관련된 직업에 대한 관심이 생겼다'라는 항목에서 가장 높은 긍정적 인식을 보여주었다. 결론적으로 본 연구에서 개발 적용한 STEAM 프로그램이 초등학생의 미래지향 시간관, 진로인식, 과학적 태도를 향상시키는 데 효과적임을 시사한다.

Prognostic Factors of Patients Requiring Prolonged Mechanical Ventilation in a Medical Intensive Care Unit of Korea

  • Kim, Mi Hyun;Cho, Woo Hyun;Lee, Kwangha;Kim, Ki Uk;Jeon, Doo Soo;Park, Hye-Kyung;Kim, Yun Seong;Lee, Min Ki;Park, Soon Kew
    • Tuberculosis and Respiratory Diseases
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    • 제73권4호
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    • pp.224-230
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    • 2012
  • Background: We evaluated the clinical outcomes and prognostic factors of patients requiring prolonged mechanical ventilation (PMV), defined as ventilator care for ${\geq}21$ days, who were admitted to the medical intensive care unit (ICU) of a university hospital in Korea. Methods: During the study period, a total of 2,644 patients were admitted to the medical ICU, and 136 patients (5.1%) were enrolled between 2005 and 2010. Results: The mean age of the patients was $61.3{\pm}14.5$ years, and 94 (69.1%) were male. The ICU and six-month cumulative mortality rates were 45.6 and 58.8%, respectively. There were 96 patients with tracheostomy placement after admission and their mean period from admission to the day of tracheostomy was $21.3{\pm}8.4$ days. Sixty-three patients (46.3%) were successfully weaned from ventilator care. Of the ICU survivors (n=74), 34 patients (45.9%) were transferred to other hospitals (not university hospitals). Two variables (thrombocytopenia [hazard ratio (HR), 1.964; 95% confidence interval (CI), 1.225~3.148; p=0.005] and the requirement for vasopressors [HR, 1.822; 95% CI, 1.111~2.986; p=0.017] on day 21) were found to be independent factors of survival on based on the Cox proportional hazard model. Conclusion: We found that patients requiring PMV had high six-month cumulative mortality rates, and that two clinical variables (measured on day 21), thrombocytopenia and requirement for vasopressors, may be associated with prognostic indicators.

카테콜아민계 승압제를 투여중인 패혈성 쇼크 환자에서 아르기닌 바소프레신(AVP)의 효과 (Effects of Arginine Vasopressin(AVP) Infusion on the Patients with Catecholamine-dependent Septic Shock)

  • 신승수;임승관;조숙경;송경은;이형노;오윤정;박광주;황성철
    • Tuberculosis and Respiratory Diseases
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    • 제55권5호
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    • pp.506-515
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    • 2003
  • 연구배경 : 패혈성 쇼크에서는 혈압이 저하됨에도 불구하고 혈중 AVP의 농도가 낮은데, 그 이유는 미생물에서 유리된 독소에 따른 염증반응을 매개로 증가한 산화질소(NO)가 혈관을 확장시켜 이차적으로 AVP의 고갈을 유발하기 때문인 것으로 알려져 있다. 한편 패혈성 쇼크의 치료를 위해 사용하는 노르에피네프린과 카테콜아민계 승압제는 다량 사용시 내부 장기의 혈류감소를 유발할 수 있다. 이에 본 저자들은 페혈성 쇼크 환자에게 AVP를 정주함으로써 승압제의 감량과 신기능의 향상이 일어나는지 알아보았다. 방 법 : 혈압의 유지를 위해 다량의 승압제를 투여중인 여덟 명의 패혈성 쇼크 환자들을 대상으로 AVP를 4시간 동안 정주하였다. 투여전, 투여중 및 투여 종료 4시간 경과후 시점을 기준으로 평균 동맥압 및 노르에피네프린의 투여속도, 시간당 소변량을 측정하였다. 결 과 : AVP의 정주 결과, 세 측정 시점 사이에서 평균 동맥압의 유의한 변화는 일어나지 않은 채로(p=0.197) 노르에피네프린의 투여속도(${\mu}g/min$)을 유의하게 감소시킬 수 있었다(p=0.001). 그러나, 시간당 소변량은 측정 시점 사이에 차이가 없었다(p=0.093). 결 론 : 패혈성 쇼크 환자에게 AVP를 정주한 결과, 카테콜아민계 승압제의 투여속도를 유의하게 줄일 수 있었다. 그러나 단시간 AVP 정주에 따른 시간당 소변량은 유의한 변화를 나타내지 않아 향후 AVP 투여가 주요 장기 및 생존율에 미치는 영향에 대한 추가 연구가 필요할 것이다.

초등학생 식생활교육을 위한 '바른식생활 길라잡이' 교재의 개발과 활용방안 (The Development of 'Good Dietary Life Guide' Textbooks for Elementary School Students)

  • 상은영;김정원
    • 대한지역사회영양학회지
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    • 제22권1호
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    • pp.74-83
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    • 2017
  • Objectives: This study aimed to develop dietary education textbooks for elementary school students by focusing on the three core values of environment, health and gratitude from the National Food Education Plan. Methods: The contents of textbooks and teacher's guidebooks were developed with brainstorming of the authors as well as consultation with experts and by considering not only the three core values of environment, health, and gratitude, but also the performance indicators of the 2nd National Food Education Plan and the key competencies and creative convergence approach of the 2015 revised national curriculum. Results: A total of 12 different dietary education textbooks named 'Good Dietary Life Guide' and the teachers' guidebooks from the first to the sixth grade of elementary school were developed. The textbooks were fundamentally developed connecting the three core values, the outcome indices of the 2nd National Food Education Plan and the key competences of the 2015 revised national curriculum. Various educational activities such as thinking, debate, writing, cooperative learning, experience, practice were included to promote students' participation. These books could be utilized in every field of dietary education targeting elementary students such as creative experiential activity, convergent classes (integrated subjects, Practical arts, Social studies, Science, Moral education and Korean), after school classes, rural experience, general agricultural education, after-school child care services and community child care centers. Conclusions: The continuous and repetitive use of the textbooks from the first to the sixth grade would contribute to the improvement of food habits and the personalities of elementary school students, and consequently make the students grow up as healthy citizens.

내과계중환자실에서 인공호흡기관련 폐렴 번들 적용의 효과 (Impact of the Ventilator-associated Pneumonia Bundle in a Medical Intensive Care Unit)

  • 유송이;정재심;최상호;김미나
    • Journal of Korean Biological Nursing Science
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    • 제20권4호
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    • pp.205-213
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    • 2018
  • Purpose: The purpose of this study was to confirm the compliance of the application of a ventilator-associated pneumonia bundle and understand its effects on the decrease in the incidence of ventilator-associated pneumonia. Methods: This was a retrospective observational study with history control group design. Subjects were selected from January to June 2014, prior to the intervention using the ventilator-associated pneumonia bundle. Subjects were also selected from October 2014 to March 2015, 3 months after the intervention. The number of subjects was 112 before the intervention, and 107 after the intervention. Results: The number of nurses who followed the bundles increased from 8 out of 29 (27.6%) before the intervention to 19 out of 29 (65.5%) after the intervention (odd ratio= 4.99, confidence interval= 1.63-15.25, p= .004). There were 3 cases of ventilator-associated pneumonia before the intervention and 1 case after the intervention. The ventilator days were 2,143 days before the intervention and 2,232 days after the intervention. The ventilator-associated pneumonia rate of the 1,000 ventilator days was 1.40 before the intervention and decreased to 0.45 after the intervention. Conclusion: This study is meaningful, as there has been little research conducted regarding the application of the ventilator-associated pneumonia bundle in South Korea.

혈액투석환자의 자가간호 역량 및 자기효능감에 대한 연구 (A Study on Self-Care Agency & Self Efficacy of Hemodialisis Patients)

  • 박형숙;조징림
    • 가정간호학회지
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    • 제9권2호
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    • pp.78-89
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    • 2002
  • The purpose of this study was to identity degree on self-care agency & self efficacy of hemodialisis patients. The subjects for the study consisted of 260 hemodialisis patients and the data were collected from April 1st. 2002 to April 30. 2002. The instruments used for this study were the Self-carer As Inventory Scale(Genden & Taylor. 1998) and Concrete Self Efficacy Scale(Joo-Hyen Kim. 1995). The Self-carer As Inventory translated by So Hyang-Sook and was modified by auther of this study. The data were analysed by using SPSS/WIN program and included number. percentange. t-test, ANOV A and Pearson Correlation Coefficient. The results of the study are summarized as follows. 1. As the average score Self-care agency indicated $132.21\pm19.11$ points and Self efficacy showed $597.33\pm130.95$points. it can be said that Self-care agency and Self efficacy were high. 2. In the relationship between general and hemodialisis cure characteristics and Self care agency were significant difference in age(F=3.065. p=0.018). married(F=3.160. p= 0.029). religion(F=4.128. p=0.003). hemodialisis cure duration(F=2.615. p=0.049). 3. In the relationship between general and hemodialisis cure characteristics and Self efficacy were significant difference in age (F=2.992. p=0.019). married(F=4.427. p=0.013), job(before attack-F=1.926. p=0.044. after attack-F=1.784. p=0.048). incomes (F=2.235. p=0.041), hemodialisis cure frequency (F=1.718. p=0.042). diet practice (F=2.248. p=0.025). 4. Self efficacy was significantly related to Self-care agency(r=0.474. p<(0.001). That is the higher the self efficacy. the higher the level of Self-care agency. The result in the above showed that more concern and endeavors need to improve hope. medical support. self efficacy, self-care agency of hemodialisis patients.

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일개 시지역의 가정간호 수혜자들의 만족도 조사 (A Survey on Clients' Home Care Satisfaction in Taejon City in Korea)

  • 김선숙;소희영;이태용
    • 가정간호학회지
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    • 제5권
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    • pp.73-83
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    • 1998
  • This study enrolled one thousand five hundred twenty one clients that were receiving home care services at five health centers and a home care services center in the city of Taejon from November 17 through December 7, 1997. The purpose of this study was to analyze satisfaction levels, general characteristics and efficacies, of the client served home care. The main results were as follows; The age group of most of the subjects was 70-79 years: 76.9% of them were female and 87.3% were over 65 years. In education variables, over 90% of the clients were below primary school. In marital status variables, 63.4% of them had no spouse, 57.5% of them were widows and widowers. In living arrangement variables, alone(35.8%) was the most. In insurance status variables, medical aid(69.9%) was the most. In household income variables, below 000 won(72.6%) was the most. In hospitalization variables, 53% of the clients had no hospitalization. The satisfaction level of home care service of male and female was similar. The older the age, the higher the satisfaction level. The satisfaction level of the group having religion was higher than the group having no religion and the Christianity group had the highest satisfaction level(p<0.001). In education variables, the over high school group was the highest satisfaction level(p<0.01). In living arrangement variables, the other (sisters or neighbors etc.) group indicated the highest satisfaction level(p<0.001). In insurance status variables, the other group(except for medical aid) was the highest satisfaction level(p<0.001). In household income variables, below 390,000 won was the highest satisfaction level(p<0.001). In hospitalization variables, 'over 4 times' group indicated the highest satisfaction level (p<0.01). Home care took place more in health centers than in home care services center. In frequency of home care per month three times was the most. In opinion of home care frequency per month 82.8% of the people answered 'proper'. A lot of present illness was neuralgia, arthritis, digestive disease, hypertension & CVA. In contents of home care services variables, education & counselling was the most and medication was second. In duration of illness variables, over 10 years was the most. In place of treatment before home care service variables, hospital(57%) was the most. In illness condition after home care variables, 'moderate' was the most and 'much better'(85.5%) was second. In help of home care variables, 'much help'(71.5%) was the most and 'moderate'(28.1%) was second. In contents of counselling variables, treatment method of illness was the most. Home care services center indicated higher level of satisfaction than health center(p<0.001). In opinion of home care frequency per month variables, 'less' was the highest satisfaction level (p<0.001). In duration of illness variables, below one year was the highest and over 10 years was second(p<0.001). In place of treatment before home care service variables, health center was the highest (p<0.001). In illness condition after home care variables 'much better' was the highest and 'worse' was second (p<0.001). I n help of home care variables, 'much help' was the highest (p<0.001). In contents of counselling variables, cause of illness was the highest(p<0.001). According to the 14 items which consisted of 3 point scales the total level of satisfaction of home care service was very high, with total mean score 36. According to the above results, most clients taking home care services are satisfied. However, organization and a fund are required to support high quality home care services to those who need them. Furthermore, a follow-up survey should be accomplished to evaluate the status of clients.

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중학교 청소년의 수면시간과 수면의 질이 우울에 미치는 영향: 한국아동·청소년패널조사를 중심으로 (Association of Sleep Duration and Quality of Sleep with Depression in Middle School Students: Based on the Korean Children and Youth Panel Survey)

  • 윤현정
    • 가정간호학회지
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    • 제27권2호
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    • pp.189-197
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    • 2020
  • Purpose: The purpose of this study was to examine the relationship between sleep duration, quality of sleep and depression, and to identify the factors associated with depression in middle school students. Methods: This study used a cross-sectional design with secondary data, middle school student panel data from the Korean Children and Youth Panel Survey (2018), and data from a total of 2,590 students was used for analysis. For the statistical analysis, t-test, ANOVA, and hierarchical multiple regression were performed using SPSS ver. 26. Results: The mean depression score in adolescents was 17.99±6.38. Depression had significant differences according to sleep duration and quality. Adolescents with less than eight hours of sleep showed the highest depression, and poor sleepers showed higher depression scores than good sleepers. Gender, school achievement, school satisfaction, economic status, and exercise time were found to significantly relate to depression. After controlling for general characteristics, depression explained 17.2% of the variance in quality of sleep (β=-.15, p<.001) and sleep duration (β=-.04, p=.022). Conclusion: These findings indicate that it is necessary to develop intervention strategies to enhance the quality of sleep and appropriate sleep duration for preventing depression in adolescents.

Mycobacterium avium Complex (MAC) 폐질환의 치료성적 (Treatment of Mycobacterium avium Complex (MAC) Pulmonary Disease)

  • 고원중;권오정;강은해;서지영;정만표;김호중;정명진;김태성;이경수;이남용;박영길;배길한
    • Tuberculosis and Respiratory Diseases
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    • 제57권3호
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    • pp.234-241
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    • 2004
  • 연구배경 : MAC는 NTM 폐질환의 가장 흔한 원인균이다. Clarithromycin과 같은 새로운 항생제의 사용에도 불구하고, 아직까지 MAC 폐질환의 내과적 치료성적은 만족스럽지 못한 실정이다. 본 연구는 MAC 폐질환 환자를 대상으로 clarithromycin이 포함된 내과적 치료의 효과를 알아보고자 하였다. 대상 및 방법 : 2000년 1월부터 2003년 12월까지 삼성서울병원 호흡기내과에서 진단된 MAC 폐질환 환자 56명 중 clarithromycin이 포함된 병합 항생제 치료를 6개월 이상 시행한 환자 15명을 대상으로 하여 후향적 조사를 시행하였다. 결 과 : 남자가 6명(40%) 여자가 9명(60%)이었고, 연령의 중앙값은 67세(범위 53-87세)였다. 원인균은 M. intracellulare가 12명(80%), M. avium이 3명(20%)이었고, 객담 도말 양성환자가 13명(87%)이었다. 5명(27%)의 환자는 upper lobe cavitary form, 그리고 10명(67%)은 nodular bronchiectatic form이었다. 모든 환자에서 clarithromycin, rifampin, ethambutol을 투여하였고, 8명(53%)의 환자는 streptomycin을 함께 사용하였다. 치료기간은 중앙값 17개월(범위 8-22개월)이었다. 6개월 이상 치료한 15명 중 8명(53%)에서 균음전에 성공하였다. 6개월 치료 후 단순흉부방사선 촬영에서 10명(67%)이 호전되었고 5명(33%)은 변화가 없었다. 균음전에 실패한 1명은 폐절제술을 시행하였다. 폐절제술을 시행한 환자를 제외하고 12개월 이상 내과적 치료를 시행한 9명 중 4명(44%)이 균음전에 성공하였다. 12개월 치료 후 단순흉부방사선촬영에서 6명(67%)이 호전을 보였다. 전체적으로 내과적 치료 후 균음전에 성공한 환자는 9명(60%)으로, 이 중 5명의 환자는 치료 시작 1-2개월 후부터 배양 음성이 유지되었다. 1명의 환자에서 위장관 장애와 시신경염으로 치료를 중단하였다. 결 론 : MAC 폐질환에서 clarithromycin을 포함한 내과적 치료 후 균음전에 성공한 환자는 60%에 불과하였다. 보다 효과적인 치료약제의 개발이 필요하며, 내과적 치료에 반응하지 않는 환자에서는 폐절제술을 고려하여야 할 것으로 사료된다.

Efficacy and Safety of Dexmedetomidine for Postoperative Delirium in Adult Cardiac Surgery on Cardiopulmonary Bypass

  • Park, Jae Bum;Bang, Seung Ho;Chee, Hyun Keun;Kim, Jun Seok;Lee, Song Am;Shin, Je Kyoun
    • Journal of Chest Surgery
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    • 제47권3호
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    • pp.249-254
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    • 2014
  • Background: Delirium after cardiac surgery is associated with serious long-term negative outcomes and high costs. The aim of this study is to evaluate neurobehavioral, hemodynamic, and sedative characteristics of dexmedetomidine, compared with the current postoperative sedative protocol (remifentanil) in patients undergoing open heart surgery with cardiopulmonary bypass (CPB). Methods: One hundred and forty two eligible patients who underwent cardiac surgery on CPB between April 2012 and March 2013 were randomly divided into two groups. Patients received either dexmedetomidine (range, 0.2 to $0.8\;{\mu}g/kg/hr$; n=67) or remifentanil (range, 1,000 to $2,500\;{\mu}g/hr$, n=75). The primary end point was the prevalence of delirium estimated daily via the confusion assessment method for intensive care. Results: When the delirium incidence was compared with the dexmedetomidine group (6 of 67 patients, 8.96%) and the remifentanil group (17 of 75 patients, 22.67%) it was found to be significantly less in the dexmedetomidine group (p<0.05). There were no statistically significant differences between two groups in the extubation time, ICU stay, total hospital stay, and other postoperative complications including hemodynamic side effects. Conclusion: This preliminary study suggests that dexmedetomidine as a postoperative sedative agent is associated with significantly lower rates of delirium after cardiac surgery.