• Journal of Preventive Medicine and Public Health
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• 제56권4호
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• pp.319-326
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• 2023

Objectives: The coronavirus disease 2019 (COVID-19) pandemic has increased the workload of healthcare workers (HCWs), impacting their health. This study aimed to assess sleep quality using the Pittsburgh Sleep Quality Index (PSQI) and identify factors associated with poor sleep among HCWs in Vietnam during the COVID-19 pandemic. Methods: In this cross-sectional study, 1000 frontline HCWs were recruited from various healthcare facilities in Vietnam between October 2021 and November 2021. Data were collected using a 3-part self-administered questionnaire, which covered demographics, sleep quality, and factors related to poor sleep. Poor sleep quality was defined as a total PSQI score of 5 or higher. Results: Participants' mean age was 33.20±6.81 years (range, 20.0-61.0), and 63.0% were women. The median work experience was 8.54±6.30 years. Approximately 6.3% had chronic comorbidities, such as hypertension and diabetes mellitus. About 59.5% were directly responsible for patient care and treatment, while 7.1% worked in tracing and sampling. A total of 73.8% reported poor sleep quality. Multivariate logistic regression revealed significant associations between poor sleep quality and the presence of chronic comorbidities (odds ratio [OR], 2.34; 95% confidence interval [CI], 1.17 to 5.24), being a frontline HCW directly involved in patient care and treatment (OR, 1.59; 95% CI, 1.16 to 2.16), increased working hours (OR, 1.84; 95% CI,1.37 to 2.48), and a higher frequency of encountering critically ill and dying patients (OR, 1.42; 95% CI, 1.03 to 1.95). Conclusions: The high prevalence of poor sleep among HCWs in Vietnam during the COVID-19 pandemic was similar to that in other countries. Working conditions should be adjusted to improve sleep quality among this population.

• 한국수자원학회논문집
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• 제56권12호
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• pp.939-953
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• 2023

천수방정식(shallow water equations, SWE)은 물의 거동을 수치적으로 해석하기 위한 지배방정식으로 수리수문 분야에 널리 활용되고 있으며, 비선형 연립방정식으로 일반적으로 수치적으로 해석할 수 있다. 하지만 기존의 여러 수치 해석법은 격자망 생성에 민감하며 복잡한 지형에서의 해석에 한계가 발생할 수 있다. 이러한 한계점을 극복하기 위하여 본 연구에서는 물리 정보 신경망(Physics-Informed Neural Networks, PINNs)을 사용하고자 하였다. PINNs은 물리 법칙을 신경망에 직접적으로 도입하여 지배방정식을 해석하고자 하는 기법이며 지배 방정식에 대한 물리적, 수학적 정보를 손실함수로 변환하여 최적화하고 해를 산정할 수 있다. 본 연구에서는 지배방정식을 PINNs 구조 내에서 사용할 수 있도록 신경망 구조, 학습 전략, 데이터 생성 기술과 같은 포괄적인 방법론을 제시하고 결과를 ANN 기법과 비교하였다. 물리적 사전지식이 반영되지 않은 ANN과 달리 PINNs은 천수방정식에 대하여 매우 정확한 수치적 솔루션을 효과적으로 제공하는 것으로 나타났다. 따라서 PINNs은 지배방정식의 수치해석적 연구에 많은 잠재력이 있는 것으로 판단되며, 정확하고 효율적인 천수방정식의 솔루션을 위한 기법으로 활용될 수 있을 것으로 기대된다.

• 한국의료질향상학회지
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• 제30권1호
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• pp.120-131
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• 2024

Purpose: This study aimed to evaluate the impact of implementing a clinical pathways (CPs) on the clinical outcomes and costs of patients undergoing breast cancer surgery. Methods: This retrospective cohort study included patients who were newly diagnosed with primary breast cancer at the Samsung Medical Center between 2014 and 2019 (N=8482; 2931 patients in the pre-path and 5551 patients in the post-path). Clinical outcomes included reoperation during hospitalization, readmission, and emergency room visits within 30 days of discharge. The cost data for each unit were obtained from an activity-based management accounting system. We performed an interrupted time series analysis. Results: The post-path period showed a significantly shorter hospital length of stay (LOS) than the pre-path period (6.3 days in pre-path vs. 5.0 days in post-path; -1.3 days' difference; p=.001), and fewer reoperations during hospitalization and within 30 days after discharge than the pre-path period. After adjusting for inflation rates and relative value scores, the model demonstrated savings of $146 per patient in the post-path for total costs, and $537 per patient for patient out-of-pocket costs (p=.001). Conclusion: CPs can help reduce costs without compromising the quality of care by reducing the number of reoperations, readmissions, and complications.

• 산업융합연구
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• 제22권7호
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• pp.1-13
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• 2024

전자정부 서비스 중 지능형 CCTV 관제 플랫폼은 인공지능을 활용하여 사람, 자동차 등 주요 객체가 CCTV상에 나타났을 경우, 관제요원에게 표출해 주는 선별 관제 서비스이다. 지능형 CCTV 관제 플랫폼을 운영할 경우 비상 상황 발생 시 신속한 대처가 가능하고 민원 해결 증가로 시민들의 삶의 질 제고가 가능할 것으로 기대를 모으고 있다. 이에 본 연구는 비(非)시장재화인 지능형 CCTV 관제 플랫폼의 편익을 선택실험기법인 조건부가치측정법(CVM)을 적용하여 가구당 평균 지불의사액을 추정하고, 이를 토대로 사회적 편익을 계산하였다. 분석 결과 가구의 평균 지불의사액은 연간 6,908원, 국가 전체의 경제적 편익은 연간 약 1,504억 원으로 추정되었다. 본 연구는 그간 환경·공공재의 적용되던 CVM의 적용 범위를 지능형 전자정부 서비스 분야로 확장한 점에서 학술적 의의가 있다. 나아가, 지능형 CCTV 관제 플랫폼 도입이 활발하게 논의되는 현 상황에서, 이에 대한 편익을 화폐가치로 추정하였다는 점에서 실무적 시사점을 지닌다.

• 산업융합연구
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• 제22권7호
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• pp.15-21
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• 2024

등산스틱은 일반적으로 산행하는 등산객 등이 보행 시 자신의 신체를 의지하면서 보행이 가능하도록 하는 보행 보조도구의 하나이다. 이러한 보조기구인 등산스틱에 다양한 기능을 수행할 수 있도록 하기 위해 충전용 배터리가 내장되어야 한다. 충전용 배터리를 충전하기 위해 별도의 전원공급장치가 필요하다. 본 연구는 자가발전 전원장치에 대한 것으로 기존의 방식보다 발전효율이 높은 스크루를 이용한 발전장치를 개발한다. 기존의 발전 방식 등과 비교 분석하고 이에 대한 문제점을 파악하여 본 연구에서 제시한 방식과 차별화를 둔다. 스크루 방식의 발전장치는 등산스틱이 지면에 접촉할 때와 지면과 떨어질 때 발전하도록 한다. 발전장치의 내장으로 별도의 전원공급장치가 필요 없고, 휴대폰 보조배터리의 역할과 조명등을 부착하여 사용할 수 있고, GPS 센서 등을 내장하여 위치 추적을 통해 길을 잃었을 때 찾을 수 있고 조명을 이용해 조난 등 위급한 상황에서 사용자의 안전을 지킬 수 있는 효과가 있다. 기존의 등산스틱 내장형 발전장치는 전류가 매우 약해 충전이 어렵고 실용성이 낫다. 본 연구에서 개발한 발전장치는 고효율을 실현하여 충분한 전류를 얻을 수 있어 배터리 충전이 가능하고 실용성이 높다.

• 헤리티지:역사와 과학
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• 제51권3호
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• pp.4-31
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• 2018

홍주읍성의 초축 연대는 명확히 알 수 없으나 문종 1년 축조 이후 수십 차례에 걸친 보수와 정비를 거쳤으며, 일제강점기에 일부 성벽이 훼철되면서 오늘날의 형태를 갖게 되었다. 홍성은 지구조적으로 지진의 발생 가능성이 높은 지역이다. 역사지진 기록이 남아 있으며, 1978년과 1979년에 각각 규모 5.0과 4.0의 지진이 발생하여 성벽 일부가 붕괴된 바가 있다. 2010년에는 집중강우에 의해 성벽이 붕괴되기도 하였다. 홍주읍성 성벽은 구간에 따라 다양한 구성암종, 치석형태, 축조방식, 채움재료 등이 적용되었다. 또한 보수과정에서 기존의 성벽을 훼철하지 않고 재사용 가능한 부분을 그대로 사용하여 시대에 따른 특성이 성벽에 수직적으로 반영되어 나타난다. 따라서 홍주읍성의 유형분류는 성벽의 수직적 분포를 기준으로 나누었으며, 축성유형의 수직적 개수에 따라 유형 I, 유형 II, 유형 III으로 구분하였다. 성벽에 사용된 암석은 주로 조립질화강암이나 성벽유형에 따라 암종의 차이가 명확하다. 성벽 하부는 자연석 내지 할석을 사용하여 다양한 암종이 혼재되어 나타나나, 중앙부의 치석한 암석은 대부분 조립질 화강암이다. 보수석재는 담홍색화강암이나 수구지와 조양문의 구성 암종은 성벽과 상이하다. 홍주읍성의 대표적인 손상유형은 배부름, 성돌의 돌출, 기초부 성돌의 유실, 부재의 이격, 균열 및 단열, 기초불안정 및 구조적 변형이다. 성벽에 발생하는 거동의 양과 방향을 확인하기 위해 수동 간이계측 및 광파측정을 수행하였다. 수동계측 결과, 성벽의 구조적 변형이 진행되는 구간을 분류할 수 있다. 광파측정 자료와 비교한 결과, 두 모니터링 방법은 상호 상관관계가 있는 것으로 나타났다. 따라서 장기적인 보존관리 방안으로 두 계측방법은 상호 보완적으로 활용할 수 있으며, 홍주읍성의 안정화를 위해 계측시스템은 유지, 관리 및 개선되어야 할 것이다. 남문지 일대의 계측결과를 종합할 때, 붕괴된 성벽 또한 강우에 의한 거동변화가 지속적으로 진행되었을 것이다. 오랜 기간 변위가 누적된 상태에서 집중강우에 의해 발생한 이상거동에 따라 임계점을 초과하여 붕괴에 이르렀을 개연성이 충분하다. 홍주읍성 성벽의 효율적 관리를 위해 연구결과를 토대로 0등급부터 5등급까지 총 6단계의 관리등급을 제안하였다. 이 관리등급을 적용한 결과, 1등급 501.9m (61.10%), 2등급 29.5m (3.77%), 3등급 10.4m (1.33%), 4등급 241.2m (30.80%)로 나타났다. 4등급 구간은 홍화문 서쪽과 치성의 동쪽에 밀집된 양상으로 나타나며, 상시 모니터링 수행을 통해 위험상황에 대비해야 한다. 6단계로 분류한 관리등급은 전체적인 안정성 검토를 통해 수리와 보수가 수행된다면 다시 0등급으로 회귀하는 윤회적 시스템이다. 이를 위해서는 주기적인 정밀 모니터링을 통한 관리등급의 평가가 필요하다.

• 대한간호학회지
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• 제19권2호
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• pp.212-222
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• 1989

When the head nurse who is pivotal in the nursing service administration of the hospital performs efficiently as a first-line manager, the effectiveness of the nursing unit, which includes the quality of nursing care, the jab satisfaction of staff members, and the cohesiveness of staff members is increased. With this point of view in mind, the researcher carried out a study to determine the actual work (the content of the work, the work process, the role of the head nurse, the activity media, and the purpose of the work) of the head nurse in a university hospital in Korea. In addition, this study was also carried out for the purpose of preparing an ideal model for the work of the head nurse. The research subjects were 39 head nurses. This included all the head nurses in two university hospitals except those who were working in outpatient care, operating rooms, central supply, nursing administration, in-service education and emergency care. Data were collected from September 24th to October 21th, 1987 and April 4th to 12th, 1988. A work activity record on which the head nurse recorded directly in a chronological narrative form, was used as the research instrument. The 234 work activity records, 39 head nurse's continuous recording over 6 days(from Monday to Saturday) were collected and analysed. The results were as follows ; 1. With regard to the work content for the total daily work of the head nurse, 45.2% of the activities were managerial activities but 58.1% of the head nurse' s time was spent in direct patient care. 2. With regard to the work process of the head nurse, specifically the location, the size and membership of groups contacted, the results were as follows : 1) Of the total daily work activities 92.4% were carried out in the nursing unit and this occupied 84.5% of total daily work time. Direct patient care was generally performed on the nursing unit and managerial work was performed in other areas. 2) Of the total daily work activities, 73% was with one or more persons and 51.2% of total daily work time was spent in groups. 3) A total of 51 persons, working in different capacities were contacted. These included 21 persons giving patient care, 19 persons working in nursing unit management, and 7 persons working in human resource management. 3. With regard to the head nurse's role in work activity, 53.3% of total daily work activities involved the informational role, 26.9%, the interpersonal role and 19.9%, the decisional role. With regard to time, 57.7% was spent in the informational role, 23.9%, in the interpersonal role and 18.3%, in the decisional role. When the head nurse performed managerial work, she gave nearly equal emphasis to all three roles when she gave direct patient care the informational role was increased. 4. With regard to the activity media, the number of unscheduled activities accounted for 27.1% of the activities, scheduled activities, 24.3%, desk work activity, 22.1%, rounds, 12.5% and telephone calls, made or received, 14.0%. In daily total work time managerial work related to desk work and scheduled activities were high, ranging from 29.8% to 29.9% but for direct patient care time, scheduled activities and unscheduled activities were high, ranging from 23.6％ to 35.3%. 5. With regard to the purpose of the work performed, 54.4% of the total daily work was concerned with the team and 41.4% was concerned with the agency. The managerial work was concerned mainly with the team and the direct patient care was concerned mainly with the patient. When the frequency of an activity and time were compared no significant difference was found between the days for which the work was recorded for any of the variables : the work content, the work process, the work role, the activity media and purpose of the work. On the basis of this study the following are proposed as an ideal model for head nurse work in Korea : The managerial work should be increased to 70%. The decisional role activities should be increased to 40%. Twenty percent of the work activity should be allocated to agency, community and profession. It is believed that this model for the head nurse's work can contribute to guidelines for job description development. Finally, educational programs, organizational and structural devices, and administrative support are needed for the proper function of the head nurse in this proposed model.

• 한국보건간호학회지
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• 제15권2호
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• pp.301-313
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• 2001

This study was to explore the relationship between nurses' personality type and their job satisfaction level. The subjects of the study were the 364 nurses who were serving at the general surgical department, psychiatric department, pediatric department and emergency room. The hospitals for which they were working were four university hospitals in Daegu and Busan, and six other university hospitals in Seoul were selected as sample hospitals. For data collection, questionnaires were self-reported to the subjects, under their agreement, from May to June, 2000. The following two instruments were used in the study: One was MBTI Test whose Korean version designed and verified to reliability and validity by Kim Jung Taek and Shim Hae Sook(1990): the other was the Nursing Job Satisfaction Instrument, 'The Index of Work Satisfaction' developed by Slavitt, et al.., (1978). The data were analyzed by frequency, t-test, one-way variance analysis, scheffe's post hoc contrast, and Pearson correlation coefficient with SPSS Win 10.0 program. The results this study were as follows ; 1. As a result of testing nurse's personality type by function at each career, it's found that the most personality type was expressed by the ST-type$(37.3\%)$ at 1-5 years, the SF-type$(29.4\%)$ at 6-10 years, the ST-type$(43.3\%)$ at more than 11 years. 2. As a result of testing the disparity in job satisfaction according to career, it appeared that the 6-10 years group showed higher job satisfaction, followed by the 6-10 years$(119.6\%),\;1-5 years(118.6\%)\;and\;more\;than\; 11 years(117.7\%)$ groups. 3. As a result of testing job satisfaction level according to nurse's personality type by function at each career, it's found that the most job satisfaction was expressed by the SF-type(F=8.50, p=0.00l) at 1-5 years. the ST-type(F=30.61, p=0.001) at 6-10 years. the SF-type(F=4.98, p=0.003) at more than 11 years groups. 4. As a result of testing a significant correlation between nurse's personality type by function and job satisfaction level. the SF(r=0.279, p=0.001) and ST(r=0.222, p=0.001) types showed significant positive correlation. and the NF(r=-0.201, p=0.001) and NT(r=-0.402, p=0.001) types revealed significant negative correlation. The nursing management is likely to be done more effectively, if managers in charge of nursing administration carefully reflect nurses' personal opinions in posting and personnel management, keeping in mind that there is a specific personality type that serves to raise job satisfaction at a specific career.

• 호스피스학술지
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• 제2권1호
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• pp.58-74
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• 2002

This paper constitutes a descriptive investigation and used a structured questionnaire to investigate nurses' and doctors' recognition of cancer patients. The subjects were extracted from the medical personnel working at the internal medicine, the surgery ward, the obstetrics and gynecology department, the pediatrics department, the cancer ward, and the emergency room of five general hospitals located in Seoul and Gyeonggi Province. The research lasted from August, 2001 to September 2001. Total 137 nurses and 65 doctors were included and made out the questionnaires directly distributed by the investigator. The study tool was also developed by the investigator and consisted of such items as the demographic and social characteristics, the medical personnel's recognition degree of cancer and cancer patients, their recognition of the management of cancer patients, and their participation in a hospice. The results were analyzed using the SPSS Window program in terms of technological statistics, ranks, t-test, and ANOVA. The reliability was represented in Cronbach' α=.75. The nurses' and doctors' recognition degree of cancer and cancer patients had an overall average of 3.86 at the 5 point-scale. The items that received an average of 4.0 or more included 'Medical personnel should explain about the cancer cure plans to the cancer patient and his or her family', 'A patient whose case has been diagnosed as a terminal cancer should be notified of it, 'If I were a cancer patient, I would want to get informed of it,' and 'Cancer shall be conquered whenever it is'. In the meantime, the items that received an average of 3.0 or less was 'My relationship with the cancer patient's family has gotten worse since I announced his or her impending death.' And according to the general characteristics and the difference test, the recognition degree of cancer and cancer patient was high among the subgroups of nurses, females, married persons, who were in their 30s, who had a family member that was a cancer patient, and who received a hospice education. The biggest number of the nurses and doctors saw 'a gradual approach over several days'(68.8%) as a method to tell a cancer patient about his or her cancer diagnosis or impending death. Those who usually tell tragic news were the physician in charge(62.8%), the family members or relatives(32.1%) and the clergymen(3.8%) in the order. The greatest number of them recommended a cancer patient's home as the place where he or she should face death because they thought 'it would stabilize his or her mentality'(91.9%) while a number of them recommended the hospital because they 'should give the psychological satisfaction to the patient'(40%) or 'should try their best until the last moment of the patient's death'(30%). A majority of the medical personnel regarded 'smoking or drinking' and 'diet' as the causes of cancer. The biggest symptom of a cancer patient was 'pain' and the pain management of a cancer patient was mostly impeded by the 'excessive fear of drug addiction, tolerance to drugs and side effects of drugs' by medical personnel, the patient, and his or her family. The most frequently adopted treatment plan of a terminal cancer patient was 'to do whatever the patient or his or her family wants' to resort to a hospice' and 'to continue active treatment efforts' in the order. The biggest reasons why a terminal cancer patient went to see a doctor were 'pain alleviation' 'control of symptoms other than pain(intravenous supply)' and 'incapability of the patient's family' in the order. Terminal cancer patients placed their major concern in 'spiritual(religious) matter' 'emotional matters' their family' 'existence' and 'physical matters' in the order. 113(58.5%) of the whole medical personnel answered they 'would recommend' an alternative treatment to a terminal cancer patient mostly because they assumed it would 'stabilize the patient's mentality.' Meanwhile, 80(41.5%) of them chose 'not to recommend it mostly due to the unverified effects and high cost of it(78.7%). A majority of them, I. e. 190(94.1%) subjects said they 'would recommend' a hospice to a terminal cancer patient mostly because they thought it would help the patient to 'mentally prepare'(66.6%) Only 17.3% of them, however, had received a hospice education, most of which was done through the hospital duty education(41.4%) and volunteer training(34.5%). The follows are results of this study: 1. The nurses and the doctors turned out to be still passive and experience confusion in dealing with a cancer patient despite their great sense of responsibility for him or her. 2.Nurses and Doctors realize the need of a hospice, but an extremely small number of them participate in a hospice education or performance. Thus, a whole recognition of a hospice should be changed, for which purpose a hospice education for nurses and doctors should be provided. 3.Terminal cancer patients preferred their home to a hospital as the place to face their impending death because they felt it would bring 'mental stability.' And most of nurses and doctors think it would be unnecessary for them to be hospitalized just for control of their symptoms. Accordingly a terminal cancer patient can be cared at home, and a home hospice care needs to be activated.

• 치위생과학회지
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• 제17권4호
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• pp.341-351
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• 2017

본 연구는 보건계열 대학생의 메르스에 대한 지식, 태도 및 예방행위 실천도를 파악하고, 메르스 및 호흡기 감염예방과 교육을 위한 기초자료를 제공하고자 하였다. 자료수집은 2015년 6월 8일부터 6월 13일까지 전주시 소재 일개대학교 보건계열 대학생 251명을 대상으로 설문조사하였다. 연구 대상자는 치위생과 46.6%, 임상병리과 30.7%, 응급구조과 22.7%로, 메르스 감염예방 교육은 69.7%가 받았다. 메르스에 대한 지식은 메르스 감염예방 교육을 받은 경우(t=3.457, p=0.001), 여학생이 높았으며(t=-2.945, p=0.005), 메르스에 대한 태도는 치위생과(F=8.048, p<0.001), 3학년 학생(F=3.978, p=0.020)이 높았다. 메르스에 관한 지식, 태도 및 예방행위 실천도, 감염에 대한 두려움간의 상관관계는 지식(r=0.133, p=0.036)이 높고, 태도(r=0.158, p=0.012)가 긍정적이고, 감염에 대한 두려움(r=0.312, p<0.001)이 높을수록 예방행위 실천도가 높았다. 이상의 연구결과를 종합해볼 때 보건계열 대학생이 신종감염병인 메르스 감염을 예방하기 위해서는 메르스에 관한 지식을 향상시키고, 의료기관에서 메르스 감염관리에 대해 긍정적인 태도를 갖도록 하여 메르스 감염 예방행위를 실천할 수 있도록 해야할 것이다. 또한 의료기관 임상실습 전 신종감염병을 포함한 감염병에 대한 감염원인, 전파 기전, 예방법 등의 감염관리 교육 프로그램을 구체적으로 개발하여야 할 것이다.