• 제목/요약/키워드: exercise programs

검색결과 1,055건 처리시간 0.035초

노인들의 건강증진생활양식에 관한 연구 - 전북 농어촌지역을 중심으로 - (Study on Life Style of Health Promotion for the Elderly - Centering on farming villages in Jeollabuk-do Province -)

  • 이진우;정명수;이춘우;권소희;고광재;정재열;장두섭;송용선;이기남
    • 대한예방한의학회지
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    • 제5권2호
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    • pp.8-28
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    • 2001
  • This investigation grasps the level and relevant elements of performance of health promotional activities for the elderly in Korea. It provides fundamental data on health promoting projects targeting the elderly population from farming villages. Hence, this study gropes for an effective approach and measures of health promoting programs. The program needs to be developed with a focus on elderly people from farming villages. In addition, it was carried out in order to provide basic data for development of health projects for local communities. Data gathering was based on survey data targeting patients from the free clinic service. Service was rendered for the residents of farming villages, and conducted at the Offices of CheonBuk Province from October 2000 to December 2000. Analytical results were used to examine the health promotional method for the elderly in the aspect of Oriental Medicine. SPSS 9.0 version as well as T-test and ANOVA were used for survey data analysis. Piersons correlation coefficient was utilized for the relationship for each area, obtaining the following analytical results. 1. The average score for the activities of health promotion was 2.28. Looking at each subcategory, stress management was the highest at 3.65; interpersonal relationship, 3.00; nutrition, 2.55; health responsibility, 2.15; self-realization, 2.03; and exercise was the lowest at 1.89. 2. With respect to lifestyle of the health promotion secondary to general features of elderly people from farming villages, the level of activities of health promoting lifestyle was shown to be higher for males than that of females. Self-realization area was high among males in detailed particulars while the level of execution was high as age decreases in the stress area. 3. Regarding health promoting life style secondary to socioeconomic characteristics, the level of execution was higher for the individuals with a higher level of education and further utilization of spare time. With respect to occupation, the level was highest for people from the fishery. The level decreased in the order of other occupations such as trade, unemployed and agriculture, which was shown to be the lowest. In detailed particulars, it revealed that higher the individuals educational level, the higher the self-realization and stress management areas. The level of interpersonal relationship was the highest among people with little or no education. With respect to self-realization area, the level was highest among the cases where one paid living expenses along with their children. The lowest level of living expenses was seen in the cases where an individual pays for living expenses by himself/herself. There were significant results in all areas except for nutrition areas depending on occupation. The fishery was shown to be the highest. The level of activities was higher as one utilizes more spare time in all areas except for the area of interpersonal relationship.

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병원중심 가정간호사업 관리대상범위 확대를 위한 기초연구 (A Preliminary Study for Expending of Hospital-Based Horne Health Care Coverage - Focused on Accident Inpatients Who has the Workers Compensation Insurance -)

  • 이숙자;이진경;유호신
    • 가정∙방문간호학회지
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    • 제6권
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    • pp.5-18
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    • 1999
  • This study was attempt to encourage for developing on rehabilitation delivery system and programs as a substitute service instead of hospitalization for accident patients at work, such as hospital based home health care nursing service. It needs vary substitutes service of hospitalization to curtail the length of stay for inpatients who were hospitalized with workers compensation insurance. It focused on developing an estimation of early discharge day of accident inpatients based on a detail statement of treatment for 115 inpatients who were hospitalized at General Hospital in 1997. This study has four specific purpose as follows. First, to find out the status of health service utilization. Second, to estimate the early discharge days and income increasing effect based on the early discharge for those patients. Third, to identify the factors to affect total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze of the length of stay and medical expenditure for inpatients who were hospitalized due to the accident, the authors conducted with micro-analysis and macroanalysis from medical records and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria. such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the tests consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, stable conditions. In addition to identify affected variables for medical expenditure. the length of stay and income effect due to early discharge day, the data was analyzed with multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study as follows. First, the mean length of stay was 37.1 days, whereas the mean length of stay due to early discharge was 28.2 days at the hospital. The estimation of early discharge days were shown that depends on the length of stay. The longer length of stay, the longer length of early discharge days, such as under 7 days length of stay patients was to estimated the mean length of stay was 4.9 days and early discharge days was 4.6. whereas the mean length of stay was 122.6 days and early discharge days was 92.0 respectively. The mean medical expenditure per day were found to be 133.409 Won. whereas the mean medical expenditure per day was shown negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to 11 early discharge days per bed was around 2,150,000 won. However, it means not the real benefits from early discharge, but the income increasing amount without considering medical prime cost in general hospital. Therefore, it needs further analysis on the cost containments and benefits under the considering as well turn over rates per bed as the medical prime costs. The length of stay was most significant and the sign was positive to the total medical expenditure, as expected. Surgery and patient's residential area also an important variable in explaining medical expenditure. The level of complications was most significant variable in explaining the length of stay. The level of the needs on horne health care nursing service which can be used for early discharge accident patients were shown very high. The needs distribution varied from 65.5% of patients and 88.9% of caregivers, to 96.4% of doctors, and 99.1% of nurses. In addition horne health nurse responded that they can be managed the accident inpatients from early discharge. From these research findings. the following suggestions has been drawn it needs to develop strategies on rehabilitation delivery system in order to focused on consumer's side which is planned for 21 century health policy in Korea. Vary intermediate facilities and horne health care would have been developed in the community based for comprehensive rehabilitation services as a substitutes of hospitalization for shortening the length of stay of hospitalizations. In hospital based horne health care nursing service, it's available immediately to utilize for the patients who wanted rehabilitation services as a substitutes of hospitalization under the cooperations with workers compensation insurance company.

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뇌졸중 환자의 발병전후 건강행위의 변화 (Change in Health Behaviors of Patients Before and After Stroke)

  • 장상현;강복수;이경수;김석범;윤성호
    • 농촌의학ㆍ지역보건
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    • 제27권1호
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    • pp.9-19
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    • 2002
  • 본 연구는 뇌졸중 발병 전과 후의 건강관련행위를 비교 분석하여 뇌졸중 발병전후의 건강행위 변화정도를 파악하고, 뇌졸중 환자의 건강행위 변화와 관련된 요인을 분석하여, 뇌졸중의 재발에 관련된 위험요인을 제거하거나, 감소시킬 수 있는 보건교육 프로그램을 개발하는 기초자료를 제공하고자 수행되었다. 자료는 1999년 7월 1일부터 8월 30일까지 경주시 보건소에 등록된 뇌졸중 환자 88명을 대상으로 수집하였으며, 구조화된 설문지를 이용하여 면접조사 하였다. 설문 조사 내용은 일반적 특성, 건강관련행위, 가족관련 특성, 뇌졸중 발병전후 건강행태 등이었다. 대상자의 흡연율은 51.1%에서 발병 후 25.0%로 감소하였고, 음주율은 52.3%에서 발병 후 17.0%로 감소하였고, 일일 흡연량은 뇌졸중 발병 전 20.1개피에서 발병 후 14.9개피로 유의하게 감소하였고, 1회 음주량은 92.4ml에서 23.7ml로 유의하게 감소하였다. 성별에 따른 흡연율은 남자의 흡연율이 뇌졸중 발병전 70.2%에서 발병 후 31.6%로 유의하게 감소하였으나, 발병 후에도 흡연율이 31.6%로 높았고, 여자의 흡연율은 뇌졸중 발병 전 16.1%에서 발병 후 12.9%로 감소하였다. 뇌졸중 발병 환자들의 건강관련행위 변화정도를 관찰한 결과 흡연율, 음주율, 규칙적 식사율 등의 행위 변화가 배우자가 있는 군, 재발방지 교육을 받은 군에서 높게 나타났다. 뇌졸중 환자들에게는 금연, 절주, 저지방 식이, 운동 및 규칙적인 식사에 대한 집중적인 교육이 필요할 것으로 생각되며 뇌졸중 환자를 대상으로 한 구체적이고 지속적인 보건교육프로그램이 개발되고, 교육이 제공되어야 할 것으로 생각된다.

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일부 중년여성의 식습관이 인지된 건강관련 체력에 미치는 영향 -창원지역을 중심으로- (The Impacts of Dietary Habits on Self-perceived Health-related Physical Fitness in Middle-aged Women -Focused on Changwon Province-)

  • 이혜진;이경혜
    • 한국식품영양과학회지
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    • 제43권6호
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    • pp.916-925
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    • 2014
  • 본 연구에서는 45~60세 중년여성을 대상으로 인지된 건강관련 체력 수준에 따라 대상자를 분류하여 그룹 간에 식습관 및 생활습관을 비교하고, 식습관이 인지된 건강관련 체력수준에 미치는 영향을 알아보고자 하였다. 조사 대상자의 평균 나이는 48.5세로 인지된 건강관련 체력 수준이 '높음' 군의 제지방량이 유의적으로 더 많았다(P<0.05). 혈중지질성분 중에서는 중성지방만이 체력 수준에 따른 유의적인 차이를 보였는데, 인지된 건강관련 체력 수준이 '낮음' 군에서 유의적으로 더 높았다(P<0.05). 생활습관 특성을 분석한 결과 인지된 건강관련 체력 수준이 '높음' 군에서 활력 수준(P<0.001), 주관적인 건강상태(P<0.001), 정기적인 건강검진 여부(P<0.05), 규칙적인 운동 실천(P<0.05) 항목 모두 유의적으로 높았다. 평상시 식습관에 있어서도 인지된 건강관련 체력 수준이 '높음' 군의 식습관 평균 점수가 유의적으로 높았으며(P<0.05), 개별 항목에서도 '일정한 식사 시간(P<0.05)', '일정한 식사량(P<0.05)', '식사 시 즐거움(P<0.01)', '단백질 섭취 빈도(P<0.05)', '채소 섭취 빈도(P<0.01)', '식욕', '적정한 에너지 섭취(P<0.05)' 항목의 점수가 인지된 건강관련 체력 수준이 '높음' 군에서 유의적으로 높았다. 또한 식습관은 교란 인자를 보정한 회귀분석 결과에서도 인지된 건강관련 체력과 유의적인 양의 상관성(P<0.001)을 보였다. 이상의 결과로 평상시 바람직한 식습관이 인지된 건강관련 체력에 긍정적인 영향을 미칠 수 있으며, 중년 여성의 체력 향상을 위해 건강한 식습관의 실천이 필요할 것으로 보인다. 또한 이를 위해 중년 여성의 식생활에 관심을 갖고 올바른 식생활을 실천할 수 있도록 관련 프로그램과 교육의 기회가 마련되어야 할 것으로 사료된다. 본 연구에서 식습관이 인지된 건강관련 체력과 유의적인 관계가 있다는 결과는 그 자체로 의미가 있다고 생각되나 18개 식습관 문항의 평균점수를 독립변수로 처리하여 회귀분석 하였으므로 개별 식습관이 체력수준에 미치는 영향은 보지 못한 연구의 한계점이 있어 추후 분석이 더 요구된다.

노인의 건강증진을 위한 율동적 운동프로그램의 적용효과 (An Application Effect of Rhythmic Movement Program for the Health Promotion in the Elderly)

  • 이숙자
    • 대한간호학회지
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    • 제30권3호
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    • pp.776-790
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    • 2000
  • Every year the number of the elderly increases in Korea thanks to the improvemen of social and economical levels and the development of medicine. However, many problems such as insufficent care and the isolation of the elderly have been commonplace. This trend exists not only because of increased lifespan but also the changing social structure of the nuclear family. Accordingly, inspite of the development of medicine, geriatric diseases including circulatory diseases are increasing in proportion of elderly population, as well as the severity. Therefore, it is important to emphasize that health care programs provide the best possible health care and functional capacities in terms of healthy elderly lifestyles. Especially, the phenomena of aging and geriatric diseases taking place with the elderly naturally are affected by lifestyle and the drastic changes in exercise patterns. This study aims to improve geriatric health by introducing a rhythmic movement program for the elderly to estabilish a health-promoting self-care system and by developing quality of life, perceived health status, their physical and physiological functions and emotional state. The theoretical framework used in this dissertation is derived from the Health-Promoting Self-Care System Model (Simmons, 1990), which integrates the Self-Care Deficit Nursing Theory (Orem, 1985), the interaction model of Client Health Behavior (Cox, 1982) and the Health Promotion Model (Pender, 1987). As a quasi-experimental design, the nonequivalent control group pretest-posttest design is utilized for this study. The subjects of this study consist of 64 people, over 65 years old who live in 2 nursing homes for the aged located in S city , Kyong-gi province and volunteered for this study from July, 12, 1999 to September, 17, 1999. They are divided into two groups:33 in the experimental group and 31 in the control group. The experimental group particpated in the Rhythmic Movement Program at the nursing home, which was comprised of 45 minutes a session, 5 sessions a week during 9 weeks. In order to measure the results of the Rhythmic Movement Program, aspects of perceived health status, balance, flexibility, grip strength, leg strength, heart rate, blood pressure, depression, anxiety and the quality of life were measured before and after participating in the Rhythimic Movement Program for the experimental group after 9 weeks, as well as the control group. The collected data were processed by SPSS PC+ and analyzed by the X2 test, t-test, ANCOVA and the Pearson Correlation Coefficient. The results of this study are as follows: 1. The perceived health status conditions in the experimental group show statistically significant improvement when compared to the control group (F=17.51, p=.000). 2. The physical and physiological functions, that is, balance (F=17.51, p=.000), flexibility (F=8.01, p=.006), grip strength (F=3.21, p=.018) and leg strength (F=25.78, p=.000) in the experimental group are higher than the control group. The vital signs, that is, the number of heart rate (F=.022, p=.884), systolic pressure (F=1.73 p=.193), and diastolic pressure (F=2.74, p=.103) in the experimental group compared to the control group decreased, but doesn't show statistically significant differences. Immune responses (F=5.13, p=.003) showed statistically significant increases in the experimental group when compared to the control group. 3. The emotional state are improved, that is, degree of depression (F=11.56, p=.001) and degree of anxiety (F=9.14, p=.004) in the experimental group showed statistically significant decreases. 4. The quality of life in the experimental group (F=3.03, p=.037) showed statistically significant differences compared to the control group. 5. The observations of the relationships among the perceived health status, emotional state , the quality of life, the relationships between the perceived health status, the degree of depression (r=-.653, p=.000) and the degree of anxiety (r=-.786, p=.000) were in contrary propotions, while the relationships between the perceived health status and the quality of life (r=.234, p=.008) were in direct propotion. In conclusion, the Rhythmic Movement Program used in this study for geriatric nursing care is simple and safe for application to the elderly and shows significant effects by implementing 5 sessions a week for 9 weeks. The Rhythmic Movement Program improves the quality of life, maintains as well as improves the physical and physiological fuctions and emotional state, therefore this program is strongly recommended for positive applications for independant geriatric nursing health care.

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북한산국립공원 둘레길 탐방객 만족도에 따른 구간별 특성화 연구 (A Study on the Characteristics of Each Section Based on Visitor's Satisfactions of the Dulegil in Bukhansan National Park)

  • 한봉호;최진우;허지연;김선희;안경진
    • 한국조경학회지
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    • 제41권2호
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    • pp.69-82
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    • 2013
  • 본 연구는 북한산국립공원 둘레길의 정상정복형 수직 탐방객의 분산 효과를 진단하고, 둘레길 구간별 특성화 및 개선방향을 제공하는데 목적이 있다. 조사방법은 이용자 자기 기입식 조사 방법으로 현장조사를 통해 둘레길 전체 21개 구간에서 탐방객을 대상으로 이루어졌다. 둘레길 조성 후 북한산 탐방 횟수가 증가하였으며, 둘레길에 처음 방문한 만 18~29세의 젊은 연령층 비율이 높아, 둘레길로 인해서 새로운 계층의 탐방객이 유입된 것으로 판단된다. 북한산 정상탐방 이용빈도는 '감소하였다' 7.6%, '증가하였다' 46.2%로 정상정복형 수직 탐방객의 분산효과는 아직 없는 것으로 판단된다. 둘레길 만족도는 7개의 측면 중 여가장소적 측면이 3.74, 보행만족 측면이 3.61로 높았고, 역사문화 측면이 3.09로 가장 낮았다. 둘레길 구간별 특성과 탐방객의 방문동기, 만족도 결과를 통해 둘레길이 가벼운 운동, 산책 등의 건강증진을 위한 개념으로 인식되고 있음을 보여주었다. 그러나 저지대 길에서의 자연, 생태, 역사, 경관 등 국립공원 자원에 대한 다양한 시각의 이용문화가 창출되어 장기적으로 긍정적인 효과를 예상할 수 있었다. 또한 둘레길의 구간별 특성과 여건, 인프라 및 프로그램에 따라 차이가 있어 둘레길 구간별 특성을 고려한 인프라 및 프로그램이 보완된다면 장기적으로 정상탐방객의 저지대 탐방문화 유도 효과를 기대할 수 있을 것이다.

물리치료 임상실습 교과내용 개선을 위한 조사연구 (The Survey for Improvement in Clinical Practice Curriculum of Physiotherapy)

  • 장수경
    • 대한물리치료과학회지
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    • 제5권3호
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    • pp.659-674
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    • 1998
  • This Study was to investigate elaborated research themes and direction through specifying the problems of clinical practice education and looking for the direction of improvement. It was in the basis of the viewpoint of the educators that professors and therapists who were the subjects of this study. Perform this study, the 15 colleges' professors and the 55 hospitals' therapists was made up questionnaire, and the data was analysing by Chi-square test and percentage. The results were as follow : ${\cdot}$ In a personal history among the general qualities, professors have little clinical practice history(l-5 years, 53.3%), and therapists have little lecture career(1-5 years, 43.6%, have no 49.0%), ${\cdot}$ The 78.6% subjects were unsatisfied of clinical practice systems. ${\cdot}$ The correlation between clinical history, school career and lecture career and the satisfaction level of clinical practice systems has no(P<.005), ${\cdot}$ The subjects were agreed to that clinical practice curriculum should be changed(67.1%), reinforced(82.9%), and specified(90.0%). ${\cdot}$ The clinical practice credits are 11 points averagely. ${\cdot}$ In the clinical practice curriculum, it made no difference in the practicum of diseases, modality, and the therapeutic techniques between professors and therapists. ${\cdot}$ The 100% professors said that the practicum of the patients' assessment is necessary, and the 63.6% therapists were training for that. ${\cdot}$ The 66.7% professors said that the practicum of the clinical psychology is necessary, and only the 20.0% therapists were training for that. ${\cdot}$ The 93.3% professors said that the practicum of the patients' management is necessary, and the 50.9% therapists were training for that. ${\cdot}$ The 66.7% professors said that the practicum of the medical ethics is necessary, and the 34.5% therapists were training for that. ${\cdot}$ The 46.7% professors said that the practicum of the hospital administration is necessary, but the 54.5% therapists have not training. ${\cdot}$ The 33.3% professors said that the practicum of the pharmacology is necessary, but the 81.8% therapists have not training. ${\cdot}$ The 86.7% professors said that the practicum of the patient's education is necessary, and the 43.6% therapists have training. ${\cdot}$ The 66.7% professors said that the practicum of the prosthesis and brace is necessary, but the 14.5% therapists have not training. ${\cdot}$ The 60.0% professors said that the practicum of the exercise prescription is necessary, but the 25.5% therapists have not training. ${\cdot}$ The 53.5% professors said that the practicum of the emergency treatment is necessary, but the 52.7% therapists have not training. ${\cdot}$ Drawing up the plan about the curriculum of clinical practice, the professors (46.7%) were agreed to national master plan framing by an expert advisor, but the therapists (58.2%) said that the plan that make the most of hospitals' characteristics should be specified. ${\cdot}$ It was found that a clinical special therapists(54.5%) was good as a person in charge of clinical practice education, in that each therapist's own good time (34.5%) was. ${\cdot}$ It made use of the form framing by college(40.0%) as the clinical practice textbook, the form framing by hospital (42.9%) and each therapist(22.9%) as the plan, and the form framing by college (74.3%) as the measurement. ${\cdot}$ The most difficult point in clinical practice education was the lacks of the theory-praciticum linkage(78.2%). ${\cdot}$ It was found that the period of clinical practice was in the second semester-third grade (40.0%) and the desirable period was in the first semester-third grade(50.0%). ${\cdot}$ Professors (53.3%) were agreed that the desirable clinical practice duration was from four months to six months(60.0%), and the therapists (60.0%) were agreed that from one month to three months. ${\cdot}$ This study presented the lacks of rearing the experts, the lacks of cultural education, and the lacks of the theory-clinical practice linkage. There were need to develop the systematic programs, clinical practice textbooks, the measurements and the special hospital for clinical practice. And it was need to reduce the gab between of the hospitals for clinical practice, to cut down the costs. and to improve the labour conditions of leaders. In view of this findings, it takes notice of that both professor and therapist were dissatisfied at the present clinical practice systems. These results point out the problems of clinical practice systems, and do not make expect to us the successive and positive clinical practice. The general, specific and intensive plan about the problems and the direction of improvement that establishing the level of hospital for clinical practice and physiotherapy can be elaborated.

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우리나라 직장인 스트레스의 역학적 특성 (Epidemiology of Psychosocial Distress in Korean Employees)

  • 장세진;강명근;차봉석;박종구;현숙정;박준호;김성아;강동묵;장성실;이경재;하은희;하미나;고상백
    • Journal of Preventive Medicine and Public Health
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    • 제38권1호
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    • pp.25-37
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    • 2005
  • Objective : To estimate the magnitude of psychosocial distress and examine eligible factors associated with the development of psychosocial distress in Korean employees, using a nationwide sample. Methods : A total of 6,977 workers were recruited from 245 companies. A structured questionnaire was used to assess sociodemographics, health-related behaviors, job characteristics, social support at work, personality traits (locus of control, type A behavior pattern), self-esteem, and psychosocial distress. Results : The results showed that 23 % of workers were categorized as high stress, 73% as moderate, and 5% as normal. Hierarchical multiple regression analysis showed that psychosocial distress was more common in younger workers, both male and female. Regular exercise was negatively associated with increase of psychosocial distress. In job characteristics, as expected, low decision latitude, high job insecurity, and low social support at work were related to high psychosocial distress. Personality traits such as locus of control and type A behavior pattern, and self-esteem were more powerful predictors of psychosocial distress than general characteristics, health-related behavior, and job characteristics. There were some gender differences. While men who are less educated and single (unmarried, divorced, and separated) experienced higher levels of psychosocial distress than those who are educated and married, women who feel high job demand experienced higher levels of psychosocial distress than those who feel low job demand. Conclusions : The proportion of the high stress group was higher than expected, and psychosocial factors like social support and personality characteristics (e. g. locus of control, type A behavior pattern and self-esteem) were more significant factors for psychosocial distress than other variables. This finding suggests that some psychosocial factors, especially inadequate social support, low self-esteem and lack of internal locus of control for the development of psychosocial distress, will also operate as an intervention strategy in the worksite stress reduction program. It is strongly required that worksite stress reduction programs should be established in at both occupational and level as well as in individual levels.

병원중심 가정간호관리대상 범위 확대를 위한 기초연구(II) - 자동차보험가입 입원환자를 대상으로 - (A Preliminary Study for Expending of Hospital-Based Home Health Care Coverage - Focused on Car Accident Inpatients Who has the Compensation Insurance -)

  • 박은숙;이숙자;박영주;유호신
    • 가정∙방문간호학회지
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    • 제7권1호
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    • pp.58-72
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    • 2000
  • This study was an attempt to encourage the development of a rehabilitation delivery system and programs as a substitute service for hospitalization on the case of car accident patients, such as hospital based home health care nursing services. Various substitute services for hospitalization are required to curtail the length of stay for inpatients who were hospitalized with car accident compensation insurance. It focused on developing an estimation an early discharge day for car accident inpatients based on detailed statements of treatment for 111 inpatients who were hospitalized at the General Hospital in 1997. This study had four specific purposes as follows. First. to find out the utilization of medical services. Second, to estimate the time of early discharge and income increasing effect based on early discharge for those patients. Third, to identify the factors affecting total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze the length of stay and medical expenditure for inpatients who were hospitalized due to car accidents, the authors conducted micro- and macro-analysis of medical and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria, such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the test consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, and stable conditions. In addition to identifying variables affecting medical expenditure, and the length of stay and income effect due to early discharge day, the data was analyzed with a multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study were as follows. First. the mean length of stay was 50.3 days. whereas the mean length of stay due to early discharge was 34.3 days at the hospital. The estimation of time of early discharge depended on the length of stay. The longer the length of stay, the longer the length of time of early discharge : for instance a length of stay under 10 days was estimated as correlating to a mean length of stay of 6.6 days and early discharge of 6.5. The mean length of stay was 217.4 days and the time of early discharge was 110.1 respectively. The mean medical expenditure per day was found to be 169.085 Won and the mean medical expenditure per day showed negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to being discharged 16 days early was around 2,244,000 won per bed. However. this sum does not represent the real benefits resulting from early discharge, but rather the income increasing amount without considering medical prime cost in the general hospital. Therefore, further analysis is required on the cost containments and benefits as turn over rate per bed as the medical prime costs. The length of stay was most significant and was positive to the total medical expenditure, as expected. Surgery and patient's residential area was also an important variable in explaining medical expenditure. The level of complications was the most significant variable in explaining the length of stay. There was a high level for need a home health care nursing service which further supports early discharge for accident patients. In addition, when the patient was discharged. they needed follow up care for complications suffered during the car accident. $86.8\%$ of discharged patients responded that they needed home health services after early discharge. From these research findings, the following suggestions have been drawn. Strategies on a health care delivery system must be developed in order to focus on the consumer's needs and being planned for 21 century health policy in Korea. Community based intermediate facilities or home health care should be developed for rehabilitation services as a substitute for hospitalization in order to shorten the length of stay would be. A hospital based home health care nursing service. it would be available immediately to utilize by patients who want rehabilitation services as a substitute for hospitalization with the cooperation of car insurance companies.

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일부 치위생과 학생의 임상실습 시 경험하는 피로수준에 관한 연구 (A Study on the Self Perceived Fatigue of Dental Hygiene Students in Clinical Practice)

  • 한세영;한양금
    • 치위생과학회지
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    • 제14권3호
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    • pp.325-331
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    • 2014
  • 본 연구는 임상실습을 경험한 치위생과 재학생 262명을 대상으로 피로수준을 파악하여 임상실습을 효과적으로 수 행할 수 있도록 하고자 2013년 1월부터 9월까지 구조화된 설문지를 이용하여 조사 분석하였다. 다음과 같은 결과를 얻었다. 1. 조사대상자의 피로수준의 하위영역별 평균점수는 전반적 피로도가 $41.74{\pm}9.06$점, 일상생활기능장애가 $28.34{\pm}7.03$점, 상황적 피로도가 $22.45{\pm}7.21$점으로 나타났다. 2. 피로수준은 주관적 건강상태가 건강하지 못하다는 군에서(p=0.000), 전공만족도가 불만족군에서(p=0.000), 임상실습만족도가 불만족군에서(p=0.000) 임상실습기간은 5주 이상 군에서(p=0.000), 1일 평균 환자수는 100명 이상인 군에서(p=0.000), 직원갈등은 갈등이 있는 군에서(p=0.000), 규칙적 운동여부는 규칙적인 운동을 하지 않는 비운동군에서(p=0.016) 유의하게 높았다. 3. 다중회귀분석을 실시한 결과, 피로수준에 영향을 미치는 요인으로는 주관적인 건강상태, 임상실습만족도, 임상실습기간, 1일 평균 환자수, 직원갈등이 유의한 변수로 선정되었으며 이들 변수에 대한 설명력은 44.5%였다. 이상의 연구결과를 종합하여 볼 때 치위생과 학생들의 피로수준을 감소시켜 임상실습을 효율적으로 수행할 수 있도록 하기 위해서는 임상실습교육자들이 공동체 의식을 가지고 임상실습 시 피로 개선을 위한 프로그램 개발 및 실천과 같은 노력이 시급할 것으로 본다. 또한 피로에 영향을 주는 다양한 변수를 확인하는 추후 심층연구가 필요할 것으로 생각된다.