• 제목/요약/키워드: general health

검색결과 9,155건 처리시간 0.041초

방사선사의 근골격계 증상과 유해 요인에 관한 연구 (The Study on Musculoskeletal Symptoms and it's Related Factors in Radio-Technologists)

  • 이향섭;한만석
    • 대한방사선기술학회지:방사선기술과학
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    • 제31권3호
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    • pp.239-247
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    • 2008
  • 본 연구는 방사선사를 대상으로 신체 부위별 근골격계 질환의 유병률과 이런 증상에 영향을 주는 요인을 파악함으로써 방사선사의 직업성 근골격계 질환을 예방하고 관리하는데 목적이 있고 조사대상으로 대전광역시에 소재한 5개 종합병원의 현 근무부서에 1년 이상 근무하고 있는 방사선사 219명을 대상, 조사기간은 2007년 6월 13일부터 2007년 6월 27일까지였고, 설문지는 전체 방사선사 219명 중 180명에게 무작위로 배부하였으며, 그 중 143명을 분석대상으로 하였다. 조사는 자기기입식 설문서(self-administered questionnaire)를 이용하였고 조사 내용은 근골격계 자각증상부위 및 증상 유해 요인에 대해 구성해 보았다. 자각증상에 대한 조사는 미국의 국립산업안전보건연구소(National Institute for Occupational Safety and Health; NIOSH)에서 정한 근골격계 증상 기준을 근거로 한국 산업안전공단(2003)에서 작성한 근골격계 부담 작업 유해요인 조사지침(KOSHA code H-30-2003)의 근골격계 질환 증상조사표를 이용하였고 증상 유해 요인은 노동부 고시 2003-24의 11가지 부담 작업 기준을 가지고 유해 요인 조사 항목에 사용하였다. 분석 방법은 각 신체 부위별 증상에 영향을 주는 요인의 교차비를 계산하기 위하여 증상호소 유무를 종속 변수로 하고, 일반적 변수 및 다른 변수들을 보정한 상태에서 노동부 고시 작업 부담 11개 항목을 독립변수로 하여 로지스틱 회귀분석을 실시하였다. 다음으로 11개 항목 중 신체 부위별로 통계적으로 유의한 변수들만 선택하여 Forward Wald 방법을 이용한 다중 로지스틱 회귀분석을 실시하여 각 위험 요인의 교차비를 계산하였다. 통계분석은 SPSSWIN(버젼 12.0)통계 프로그램을 사용하였다.

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정상인에서 혈중 연과 zinc protoporphyrin과의 상관관계 및 HPLC 와 Hematofluorometer로 측정한 zinc protoporphyrin량간의 비교 (The Relationship between Zinc protoporphyrin and Lead levels in Normal Adults' Blood And Comparison of Zinc protoporphyrin values by High Performance Liquid Chromatograph and Hematofluorometer)

  • 김강윤;김현욱
    • 한국산업보건학회지
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    • 제3권2호
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    • pp.141-151
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    • 1993
  • Blood samples obtained from 200 adults who had visited the "S" general hospital were analyzed to compare the zinc protoporphyrin (ZPP) levels quantified by high performance liquid chromatograph (HPLC) and by hematofluorometer (HF) to investigate the methodological difference if any and the relationship between the levels of blood lead and ZPP among no-lead exposed adults. Also investigated were the distribution of ZPP and protoporphyrin IX (PPIX) concentrations, the establishment of normal levels of blood ZPP and blood lead, and the contribution of age and sex factors to these values. These subjects had no previous occupational exposure to lead. The results obtained were as follows : 1. The mean values of blood lead for male and female subjects were $9.46{\pm}2.44{\mu}g/dl$ and $8.09{\pm}2.17{\mu}g/dl$, respectively. The difference observed in the mean concentrations between male and female subjects was statistically very significant. 2. The mean values of blood ZPP by HPLC for male and female subjects were $15.94{\pm}4.55{\mu}g/dl$ and $22.26{\pm}6.61{\mu}g/dl$, respectively. The difference observed in the mean concentrations between male and female subjects was statistically not significant. The mean values of blood PPIX by HPLC for male and female subjects were $2.51{\pm}1.78{\mu}g/dl$ and $2.81{\pm}1.56{\mu}g/dl$, respectively. The difference observed in the mean concentrations between male and female subjects was statistically not significant. 3. The mean values of blood ZPP by HF for male and female subjects were $28.44{\pm}7.11{\mu}g/dl$ and $37.77{\pm}8.04{\mu}g/dl$, respectively. The difference observed in the mean concentrations between male and female subjects was statistically very significant. 4. No statistically significant correlation was found between the levels of blood ZPP and blood lead. 5. The ratio of ZPP and protoporphyrin IX (PPIX) concentration to erythrocyte protoporphyrin (EP, EP=ZPP+PPIX) concentration was 87.4% and 12.6%, respectively. 6. A statistically very significant correlation was found between the ZPP concentrations determined by HPLC and the values by HF (r=0.7565). The ZPP concentraitons quantified by HF were 1.75 times as high as the values obtained by HPLC. 7. The blood ZPP concentrations quantified by HPLC, HF, and spectrofluorometer (SF) from the blood samples obtained from 14 lead-exposed workers and from 16 no-lead exposed adults showed wide variations. The ZPP concentrations by HF were the highest followed by the levels obtained by SF and by HPLC. In the exposed group, no statistically significant difference was found among three methods of quantifying blood ZPP levels. In the no-lead exposed group, however, statistically significant difference was observed among these methods. The ZPP concentrations by HF were about twice as high as those of by HPLC or by SF. Among three methods of quantifying blood ZPP (HPLC, SF and HF), the results revealed significant difference. Therefore it is suggested that objective methods of quantifying blood ZPP and a system of correcting different ZPP levels be developed by the ministry of Labor.

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우리나라 일부 사무직과 생산직 여성근로자에서 근골격계 자각증상과 관련요인 (Related factors on musculoskeletal symptoms in selected Korean female office and blue-collar workers)

  • 이경재;한성현;안연순;황정호;김주자
    • 한국산업보건학회지
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    • 제17권4호
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    • pp.289-299
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    • 2007
  • 이 연구는 우리나라 40세 이하 여성근로자들을 대상으로 직종에 따른 직업적 특성과 근골격계 자각증상을 조사하여 사무직과 생산직 여성근로자에서 근골격계 자각증상의 호소율을 파악하고, 근골격계 증상과 관련요인을 알아보고자 하였으며 우리나라 여성근로자의 근골격계 질환 예방 및 건강관리를 위한 기초자료를 제공하고자 하였으며, 그 결과는 다음과 같다. 사무직 여성이 1,002명(53.4%)이고 생산직 여성이 873명(46.6%)를 차자하고 있으며, 흡연과 음주 경험에서도 생산직 여성에서 사무직 여성에 비해 유의하게 높게 나타났다(p<0.001). 사무직 여성들은 생산직 여성에 비해서 하루 4시간 이상의 컴퓨터 작업에 많이 종사하고 있는 반면, 생산직 여성들은 지나친 반복 업무와 부자연스러운 자세를 유지하는 업무 및 무거운 물건을 다루는 작업, 진동공구 등을 이용하는 작업에 상대적으로 더 많이 종사하는 것으로 나타났다. 유해물질에 대한 인식을 살펴본 결과도 사무직 여성들은 전자파에 대한 노출이 있다고 응답한 반면, 분진, 소음 등 기타 유해물질에 대한 노출이 있다고 응답한 경우는 생산직 여성에서 보다 많은 것으로 나타났다. 두 군 모두에서 어깨와 허리가 주요 통증 부위로 나타났다. 근골격계 자각증상 호소율을 비교해 보면, 두 군간에 유의한 차이를 보여 생산직 여성에서 사무직 여성에 비해서 유의하게 높게 나타났다(p<0.01). 이 연구를 통하여 생산직 여성에서 근골격계 자각증상의 호소율이 사무직 여성에 비해 유의하게 높게 나타났으며, 사무직 여성에서도 컴퓨터 작업과 부자연스러운 손목 자세를 유지해야 하는 업무 등을 하고 있는 것으로 나타나 근골격계자각증상 예방을 위한 관리대상에서 제외될 수는 없는 직종으로 생각된다. 따라서 근골격계 증상과 관련될 수 있는 관련작업 형태에 대한 예방대책과 보건교육이 필요하다고 생각되며, 더 나아가 우리나라 여성근로자의 건강보호를 위해서는 사업장 내에서 근무형태와 근무환경에 따른 건강영향을 줄일 수 있는 예방대책이 필요할 것으로 생각되어 향후 이에 대한 보다 많은 연구가 이루어질 필요가 있다고 생각된다.

유전정보 차별금지의 법적문제 - 외국의 규율 동향과 그 시사점을 중심으로 - (Legal and Regulatory Issues in Genetic Information Discrimination - Focusing on Overseas Regulatory Trends and Domestic Implications -)

  • 양지현;김소윤
    • 의료법학
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    • 제18권1호
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    • pp.237-264
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    • 2017
  • 인간게놈프로젝트의 시작과 함께 그 사회적 부작용의 하나로 거론되었던 '유전정보 차별'의 문제가 아직 우리나라에서 크게 부각된 적은 없다. 그러나 2016년 6월 30일부터 시행된 "생명윤리 및 안전에 관한 법률"이 의료기관이 아닌 유전자검사기관의 유전자검사를 예외적으로 허용하자, 국내의 한 보험회사가 신규 암보험 가입자를 대상으로 DTC 유전자 검사를 별도의 무료 서비스로 제공하겠다고 하여 유전자 검사와 관련된 사회적 변화를 실감케 한 바 있다. 정밀의료가 의료의 새로운 표준으로 성큼 다가온 현 시점에서 유전정보 차별에 관한 규율은 더 이상 미룰 수 없는 문제가 되었다. 우리나라는 생명윤리법 제46조, 제67조에서 유전정보를 이유로 한 차별의 금지와 그 위반행위에 대한 벌칙을 규정하고 있지만, 이러한 광범위한 원칙 규정만으로는 보험, 고용 등 구체적인 유전정보 활용 영역에서의 문제점들을 충분히 해결할 수 없다. 미국, 캐나다, 영국, 독일은 상이한 방식으로 유전정보 차별의 문제를 다루고 있다. 미국의 "Genetic Information Non-Discrimination Act"의 경우, 건강보험과 관련된 부분은 기존의 법에 유전정보 차별금지에 관한 내용을 추가하는 형식을 취하고 있다. 또 개인과 그 가족의 유전자 검사 결과 외에 '가족력'까지 포함하여 유전정보의 범위를 매우 넓게 규정하고 있다. 캐나다는 2017년 비교적 최근에 법을 제정하였는데, 보험과 고용 외에 '상품이나 서비스의 거래'에까지 적용범위를 확장하고 있다. 영국은 유전자 검사 중 '개인의 예측적 유전자 검사'에 대해서만 다루고 있는데, 보험의 경우 영국정부와 보험협회의 '협약'을 통해 유전정보의 활용을 2019년까지 유예하는 방식으로 규율하고 있고, 고용의 영역은 ICO가 만든 'Employment Practices Code(2011)'가 기준으로 활용되고 있다. 독일은 유전자 검사에 관한 법 "Gesetz ${\ddot{u}}ber$ genetische Untersuchungen bei Menschen"에서 고용과 보험에서의 유전자 검사 및 그 결과 제출 요구의 원칙적 금지를 규정하고 있다. 이와 같이 각 나라마다 규율형식, 적용범위 뿐만 아니라 규율의 실효성에 대한 평가도 매우 상이하다. 이러한 점에 비추어 보았을 때 우리나라의 유전정보 차별에 관한 규제 역시 관련 규정의 검토, 전문가 집단의 참여 및 이해관계자의 협력을 통해 여러 규제안의 장 단점을 충분히 검증한 후 입법의 단계로 나아가는 것이 바람직할 것이다.

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임상실습교육의 교수효율성과 임상실습만족도에 관한 상관성 연구 (대구지역을 중심으로) (A study on correlation of teaching efficiency and satisfaction of clinical training in Daegu)

  • 김정숙;정영해
    • 대한치과기공학회지
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    • 제28권1호
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    • pp.121-142
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    • 2006
  • Collecting materials for study on teaching efficiency and satisfaction of clinical training, it changes. Dental technology's educational procedure to many ways of a prospect. In a circumstance that needed higher level of education, this study is aimed on realizing an importance of clinical training through the various materials that previously carried out and offering basic knowledge to take better clinical training for the students. Study results below 1. This Investigation conducted on 123 of sophomores(70.3%) and 52 of juniors(29.7%) who have been taken clinical training, and men's proportion(51.45%)is a bit higher than girls(48.6%). The 64% of respondents taken largest proportion were 20 to 24 years old. As 67.9% of respondents attended daytime school and 30.3% of them attended nighttime one, their school time shows a little difference. In a question about relation ship, one answered "Harmonious" took largest proportion by 72.6% during training, and about the degree of satisfaction of campus life who answered "normal" were the most with 59.4%. 2. About the reason choosing dental technology as a major, 41.1% taken the most answered "due to the specialized job", "Getting job easily" was second with 26.9%, and third was "recommended from around" with 18.3%. 50.3% of the respondents answered "normal" about the Satisfaction of their major, student marked in grade "B" most with 51.4% 3. In a investigation result about clinical training statues and preference, most(72.6%) choose place less than 10 for clinical training, and 60.6% of them resided own home. About their commuting time from home to training place, 44% was under 30min, 40% took time 30-60min. It shows students prefer shotter distance in terms of choosing training place. 4. Each part manager took large proportion as a clinical trainer with 33.7%, Training curriculum reform and developing method were most answer as a improvement measure after completing training with 30%. 5. The average of total score about clinical training was 3.15 of 5. In the detailed question, 'satisfaction of clinical training' got 3.38 as a highest score, the lowest score was 2.86 that is about satisfaction of clinical training period. The average score about efficiency of study was 2.86 and in detailed question, 'a Role model' got 3.26 as a highest score and participation of student got 3.05 as a lowest score. 6. The result of T-test to see the difference of the satisfaction according to the general character and clinic training condition between teaching efficiency is that the degree of satisfaction of clinical training showed statistical significance only in the degree of satisfaction of campus life(p<0.05), and teaching efficiency has a statistical significance with their age, grade, and satisfaction of campus life (p<0.05). 7. The relation between of teaching efficiency of clinical training and satisfaction of clinical training of dental technologic student has a statistical meaning in significance leveler 0.01. Now, therefore we suggest following based on these result. 1. To elevate satisfaction of clinical training, it agentry needs development of consistent clinical training curriculum. 2. To grasp the satisfaction and requirement, in needs to measure anxiousness and satisfactory degree after completing training 3. To train efficiently and evaluate efficiency over the teaching activities, it needs to develop measuring tools for teaching efficiency in terms of teacher's important rules in a clinical training. 4. Strengthen the relations with the study developing and managing curriculum gathering theoretical knowledge and practice. And make an effort to apply to their students. 5. Let the trainee take a class setting a belief, sense of value, function and obtain behavior by making the students comfort over clinical training as increasing teaching efficiency.

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한국 표준시 제도의 타당성에 대한 연구 (On the Suitability of the Korean Standard Time)

  • 홍성길;류찬수;김영성
    • 한국지구과학회지
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    • 제23권6호
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    • pp.494-506
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    • 2002
  • 우리 나라는 현재 표준시로 경도 135 E를 기준으로 하는 I-시간을 사용하고 있으면서 I-시간대역의 서쪽 경계에 위치하고 있어 표준시가 태양시보다 30분 정도 빠르게 운용되고 있다. 우리 나라가 적용하고 있는 이 I-시간이 우리나라의 표준시로 적합한가를 판단하기 위하여 세계 각국의 표준시 사용 현황을 조사 분석하여 다음과 같은 결론을 얻었다. 현재 세계의 각 국가가 사용하고 있는 표준시를 검토해보면 주요 국가 중 56% 정도는 그 지리적 위치가 태양시와 표준시가 어느 정도 일치하고 있으며(Table 4 참조), 18% 정도는 태양시보다 30분 정도 빠른 표준시를, 그리고 또 21% 정도는 태양시보다 1시간 이상 빠른 표준시를 운용하고 있어서 대체로 태양시보다 빠른 표준시 운용을 긍정적으로 받아들이고 있다. 표준시를 태양시보다 늦게 운용하는 국가는 5% 정도가 있을 뿐이다. 이와 같이 세계 대부분의 나라에서 표준시를 태양시보다 30분${\sim}$1시간, 또는 그 이상까지도 앞세워 적용하고 있으면서 그 중에서 또 많은 나라가 서머타임까지를 시행하고 있다는 사실은 태양시에 대해 표준시를 어느 정도 앞세워 생활하는 것은 인간의 생체리듬에 악영향을 미치지 않으면서 오히려 시간 이용을 효율화하는 장점이 있다는 결론을 얻을 수 있다. 이는 한국의 경우에도 적용될 것으로 보아 태양시보다 30분 정도 빠른 현재의 표준시 I-시간이 한국인의 생체리듬에 나쁜 영향을 주지 않으면서, 오히려 하루의 시간을 효율적으로 사용할 수 있는 장점을 가진 시간환경인 것으로 판단된다. 뿐만 아니라 이러한 시간환경은 여름철에 일광절약시간제(서머타임제) 시행의 필요성을 완화시켜주는 효과도 있어 표준시를 안정적으로 운용하는 데에도 크게 기여하고 있는 것이다. 또한 이 I-시간은 UTC와 정수 시간차를 유지하면서 안정적으로 운영하려는 세계 각국의 표준시 운영 경향과도 잘 일치한다. 따라서 우리 나라가 태양시에 맞게 H$^{\ast}$-시간을 사용해야 한다는 것은 태양시와 비슷한 표준시를 사용한다는 장점은 인정되지만, 그에 못지 않게 UTC와는 비 정수 시간차 시간을 운용하게 되며, 또한 하절기에는 서머타임을 도입해서라도 태양시보다 1시간 빠른 시간을 이용해야 한다는 필요성을 유발하게 된다는 점에서 결코 바람직하지 않다고 생각된다.

어린이의 식습관(食習慣)이 체위(體位)에 미치는 영향(影響)에 관한 연구(硏究) (The Influence of Food Habits on Body Stature of Children)

  • 이미숙;모수미
    • Journal of Nutrition and Health
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    • 제9권1호
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    • pp.7-15
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    • 1976
  • The Purpose of this study was to determine every possible correlation between food habits and body statures of primary school children, aged ten years old. This study was conducted from July to October of 1975. In July, prepared questionaires concerning life style, anthropometry, food preference, and food behavior were distributed through school teachers to 425 children; 219 boys and 206 girls, in the 5th grade of three elementary schools in the city of Seoul. Then, in October, when subjects had been classified into underweight/obese by statistical analysis, mothers of obese or underweight children were interviewed by the authors to determine weaning history, daily food consumption of their children, and opinions of various snacks for children. Analysis of results in terms of correlation coefficient, chisquare test and percentage calculations, are as follows: 1. Physical growth and development Boys Girls Height (cm) $134.8{\pm}5.74\;134.4{\pm}5.97$ Weight (kg) $30.0{\pm}4.27\;29.5{\pm}5.16$ Chestgirth (cm) $64.1{\pm}3.59\;63.3{\pm}3.81$ Arm circumference (cm) $18.3{\pm}1.61\;18.2{\pm}1.70$ Triceps skinfold thickness (mm) $10.9{\pm}5.13\;12.7{\pm}4.86$ Various indices of nutrition such as relative weight, relative chestgirth, $R{\ddot{o}}hrer's$ index, Kaup index, Vervaeck index were determined. 2. Food habits 1) Food $preference{\cdots}{\cdots}A$ varying number of foods were selected from 60 items were accepted. It was found that the food which children liked best was fruit and snacks were popular one. Lowest ranking among LIKED foods were from strongly flavored vegetables and organ meat. In general, girls had more food dislikes than did boys. Selected as liked foods were fruits, rice noodle soup, biscuits, and peanuts. Disliked foods were liver, green onions, onions, green pepper, mushrooms, oysters, shellfish, and pork. Items which children never ate before were liver, mushrooms, fish cake, boiled rice mixed with sorghum, mayonnaise, and fresh water firsh. Reasons which children gave for dislike were undesirable flavor and odor. 2) Food $behavior{\cdots}{\cdots}It$ was found that boys liked sweet and salty flavors more than did the girls who more often liked sour flavor. The majority of children enjoyed evening meals more than lunch and breakfast. A number of children skipped breakfast because of lack of appetite or lack of time before going to school. Snacks were the most popular food, especially among girls. Their snacking habits were formed by the encouragement of the mother, and the relieve boredom. Educational backgrounds of mothers and family economical levels of children were remarkable correlated with mothers' attitudes toward feeding of children. There were several interesting findings relating body stature to some other responses; such as that the obese child has a small number of brothers, higher birth order, higher educated mothers and higher family cultural background. It was also discovered that food perference, except for fat and oil group foods was not related to body stature. Sweet taste was liked best and pepperly taste was mostly disliked. Sour taste was popular in the group of underweight. Underweight children were more finicky, disliked snacking, and didn't get much attention from their mothers. 3) Correlation between body stature and nutrition during their infancy. The majority of children, both from obese and underweight, were breast fed as infant. Twenty five per cent of obese children and 17.4 per cent of underwight children started weaning at $1{\sim}6$ months old. The most popular supplemental food of weaning was cereal gruel for the obese group, while boiled white rice and cereal gruel were most common for the underweight group. Highly significant relationships were found between stature of parents and their children. In the obese group 47.8 per cent of fathers and 45.9 per cent of mothers were overweight; however, none of the fathers and only one mother was found to be underweight. In daily food consumption patterns, meals consisting of bread or noodle were popular in the obese group but disliked by the underweight group. The study found clear contrast in that the obese group liked meat and fish while the underweight group liked fruits and vegetables, especially kimchee. The obese children desired to eat cereal foods, milk and milk products, and fat foods while the underweight group desired to eat fruits and vegetables. Frequency of snacks per day was much greater in the obese group. Foods which mothers believed to be good for the health were carrots, cucumbers, fruits, milk, potatoes, sweet potatoes, and breads, while sweet foods such as candies, drinks. chocolate were considered not good for the teeth. Watching television was not significantly related to statures of children. Most significant relationships were found beween frequencies of family guest meals/and eating-out, and children's statures. Nutritional problems which have been considered for the malnourished children in addition to those of children who have a tendency toward obesity, must be taken into consideration in the development of proper nutrition education through the channels of regular school teaching and teaching by parents in the homes. Korean standards of anthropometric measurements for children should be revised, current measurements show much higher figures than present Korean standards.

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수도권 거주 노인들의 여가활동 유무에 따른 정신건강 수준, 식생활 실태 및 영양상태 비교 분석 (A Comparative Analysis of Mental Status, Dietary Life and Nutritional Status among Senior Citizens With or Without Leisure Activities in Urban Area)

  • 김윤혜;하태열;이복희
    • 한국식품영양과학회지
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    • 제35권4호
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    • pp.422-429
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    • 2006
  • 본 연구는 여가활동 여부가 노인들의 정신건강 수준, 식생활 및 영양상태에 미치는 영향을 알아보기 위하여 경기도 수원에 거주하는 60세 이상의 남 여 노인 104명(여가활동을 하는 노인과 하지 않는 노인 각각 82명씩)을 대상으로 실시되었다. 조사항목은 노인 대상자의 일반 환경 요인, 생활습관, 정신건강 수준, 식생활 및 영양소 섭취 등이다 일반환경요인으로는 연령, 성별, 가족관계, 교육정도, 한달 용돈, 용돈의 출처, 직업의 유무와 종류, 주거형태를, 생활습관으로는 음주, 흡연, 수면시간을, 식습관 특성으로는 식사의 규칙성, 결식 여부와 이 유, 식욕정도, 식사소요시간, 식사량, 저작형태 및 치아상태 등을 조사하였다. 영양소 섭취 상태 조사는 24시간 회상법으로, 정신건강 수준은 한국어판 우울증검사를 통하여 조사하였다. 노인 대상자의 평균 연령은 72세정도로서 여가활동을 하는 노인들은 여가활동을 하지 않는 노인들에 비해 교육수준과 소득수준이 높았고 용돈도 많아 경제수준이 높았으며, 노령임에도 불구하고 자신의 일을 가지고 있는 비율이 더 높았다. 생활습관의 경우 여가활동을하지 않는 노인의 경우 음주와 흡연율이 높게 나타났으며 우울증 검사결과, 여가활동을 하지 않는 노인에서 우울증의 비율이 훨씬 높았다. 식생활습관에서도 여가활동을 하지 않는 노인의 경우, 불규칙인 식습관을 갖는 노인의 비율이 높았고, 식욕은 보통정도였으나 식사장애요인이 더 많았으며, 치아상태가 불량하여 식사를 제대로 못하는 것으로 나타났다. 열량 섭취량은 여가활동을 하는 노인이 하지 않는 노인에 비해 약 300 kcal 정도 많았으나 전체 노인 대상자들은 한국인 영양권장량에 비해 적게 섭취하고 있었다. 개별 영양소 섭취량의 경우 여가활동을 하는 노인에서는 아연과 비타민 $B_2$를 제외하고는 영양소 섭취상태가 매우 좋은 것으로 나타났으나 여가활동을 하지 않는 노인의 경우는 대부분의 영양소 섭취량이 매우 낮아 영양문제가 심각한 것으로 나타났다. 결론적으로 노인의 경우 여가활동을 하는 노인들은 여가활동을 하지 않는 노인에 비해 정신건강 수준, 생활습관, 식생활습관 및 영양소 섭취상태가 매우 좋았는데 반해 여가활동을 하지 않는 노인들은 음주와 흡연율이 높고, 불규칙적인 식습관과 심리적인 식사장애요인을 가지고 있었으며, 식사섭취방법이 불량하고 영양소 섭취량도 매우 낮아 심각한 영양문제가 있음을 알 수 있었다. 따라서 노인기의 적절한 여가활동은 육체적, 정신적 건강 유지에 매우 중요한 요인으로 생각되며, 노인 스스로 건강한 생활양식으로의 태도 변화가 이루어지도록 하기 위해서 노인복지를 위한 적극적인 정책이나 영양개선 방안을 수립하는 것이 시급하다고 하겠다.

측후방융합술을 시행한 요추관협착증 환자의 Critical Pathway 적용효과 (Effects of a Critical Pathway of Posterolateral Fusion in Patients with Lumbar Spinal Stenosis)

  • 박혜옥
    • 간호행정학회지
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    • 제7권2호
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    • pp.265-284
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    • 2001
  • The case management has been applied to improve the quality of care and the cost-effectiveness in the most health care institutions. In a way of case management, the critical pathway(CP) has been executed in many acute care settings, focused on the diagnoses with high cost, high volume, and high risk. This study was conducted to develop a case management program using CP as an intervention of patients with lumbar spinal stenosis for the surgery of posterolateral fusion, and to find out the effects of the critical pathway on the quality of nursing care, patient satisfaction as an outcome of care, length of stay and medical charge, and nurses' job satisfaction. At the same time, patients' functional states were checked with the Oswestry Low Back Pain Index, to show that the CP would not decrease the patients' function compared to the control group. The subjects were 25 control patients with a usual operation of lumbar fusion and 25 experimental patients with CP. They were all female, aged $50s{\sim}70s$, admitted in the Orthopedic surgery ward of a university hospital. Also nurses on the floor using CP were asked to respond to measurement tool of job satisfaction before and after the application of CP, and compared with other nurses on the different wards. Data were analyzed with t-test for continuous variables and chi-square for non-parametric variables in addition to the reliability test of the measurement tools. The results of this study were as followings: 1. Patients' functional states The differences in Oswestry scores of the experimental and control groups assessed at preoperation and at discharge were not statistically significant. The change in scores of the experimental group measured at preoperation and at discharge was larger than that of the control group, however the difference was not statistically significant. The results indicate that the CP did not decrease the patients' functional status. 2. The quality of nursing care The total of quality of nursing care given to the experimental group was better than that of the control group(P=.000). In addition, the experimental group showed better scores of quality of every item of care than the control group(P=.000 -.004). 3. Patient satisfaction Patients of the experimental group were not more satisfied with general care than the control group. But they were more satisfied with discharge care of 'explanation about medication, body posture, and brace application' and 'explanation about the adjustment of daily living and exercise during recovery'(P= .047, P=.028). 4. Nurses' job satisfaction Nurses working with the CP showed more job satisfaction than before the CP introduction(P=.048). But the control group of nurses on a different floor showed no change in job satisfaction at the same period of time. 5. Length of stay and medical charge The mean length of stay of the experimental group was shorter than that of the control group without statistical significance. The charge of medication and treatment of the experimental group were smaller than that of the control group(P=.011, P=.000). The results of the study support that the case management using critical pathway enables to improve the quality of care and job satisfaction, to reduce the medical charge, and consequently to increase satisfaction with care. However, the case management should be instituted focusing on the quality improvement of nursing and the client satisfaction, not just for the purpose of cost-effectiveness of health care facilities.

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입원환자의 투약체계와 방법의 개선을 위한 현장연구 (Field Study For The Improvement of Medication System and Method for Inpatients at General Hospital)

  • 유형숙;권영미;송미숙;김형애;박경숙
    • 간호행정학회지
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    • 제1권1호
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    • pp.147-211
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    • 1995
  • Medication is a kind of medical service and a therapeutic nursing function which takes large portion of nursing service and requires complicated procedures. So many different medical personnel should be involved and cooporate each other in order to accomplish medication. Medication is also a vital nursing service, So nurse feels heavy responsibi lity in that she gives medication to the patient finally, so she has much responsibility if medication error is happened. Therefore it seems very important to clarify the problem of medication system and method, and find the subculture of medication situation because it may promote nursing productivity. The study was conducted to 1. Describe and interpret medication situation. 2. Find out the problem of medication system and method and on alternatives. 3. Compare the medication system and method of hospitals which are located in Seoul with object hospital Ethnographic methodology was used to study medication situation by doing participant observation and interview of health care personnel. Ten nurses and three nurse aids were interviewed. Two residents and internists, two phamacists and two accountants were also interviewed. Data was obtained and analized according to Developmental Research Sequence introduced by Spradly. On the basis of this data the results were as follows. 1. The overall flow of medication system was devided into six stage : first, checking doctor's order : second writing doctor's order, : third, transfering slip into the related departments such as account department, pharmacy : fourth, distribution of medication from pharmacy to unit : fifth, identifing medication by nurses : and finally, medicating to the patient. Behaviorors have been under a lot of stress in that they have to do much works, especially paperworks, So too much time were needed. They also have been suffered interpersonal conflicts among health care personnel and role conflicts in the process of doing medication service. 2. In the process of checking order, the problem was that too much time was required for checking order and paperwork. The more the order changes the more the paperwork is. Nurses have been suffering difficulties in calling internist in order to get bill. Even if writing down slip for medication order is doctor's job, Sometimes nurse has been expected to write slip by doctors or nurse would write slip beacuse of two much complexities and efforts for calling doctors. If the slip were incorrect, much time complicated procedures were more required for correcting it. So delay of administering drug would be resulted consequently. Drugs were delivered from pharmacy to units by delivery agent and phamacist. But because drugs were delivered without arranging room number of patient. Nurse should rearrange drugs in order of the room number So it had made waste time and effort, and Even when emergency drugs were needed, Prompt delivery of drug was not easy because of many reasons. For nurses, it took too long in the identification of the right drug. Actually nurses have heavy burden when medication error happens because nurse is the final actor who gives medication to the patient, So every three shift nurse ought to check drugs as soon as every shift begins. That's why it took too much time due to repeated confirming procedure. When nurses had to go patient room in order to give medications, there were difficulties in watching patient until the patient take medicine correctly. So it was impossible to check every patient wheather he took medicine or not especially in hectic situation. 3. There were many hospitals in Seoul which have similar medication system and method as object hospital according to the results of questionaire. This means that many hospitals have been suffering srimilar problems which were identified in object hospital. 4. Recommendations for promoting simplification of medication system and method were the following : Redesigning of slip from two pieces of paper into one : early discharge announcement system, and slip confirming through computer and controlling of period of prescreption from one day to two or three days : designing personal drug storage box for each patient and using it. If nurses follow the recommendations, they will make medication short & simple, and also have enough time of direct nursing care 5. Even though there were many difficulties in medicating patients. Medication itself has been considered as a caring among nurses because it makes rapport between nurse and patient. So nurses had better accept medication as a portion of nusing service not a original portion of phamacist. There are some limits in this research in terms of confining to only one unit of one hospital, and treating it especially in view of nurses' aspects, So further researchs should be continnued from various kmds of viewpoints of doctors, phamacists and so on. ${\cdot\cdot\cdot}$. Especially esthnographic study of computerized medication system and method seems to be followed.

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