• 제목/요약/키워드: general pain

검색결과 1,882건 처리시간 0.037초

사무 자동화에 따른 사무직 근로자의 건강과 연관된 자각 증상에 대한 조사연구 (An Investigation on the self-consciousness Symptoms of the Clerical Workers attendant upon Office Automation)

  • 정미화
    • 한국직업건강간호학회지
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    • 제3권호
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    • pp.54-70
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    • 1993
  • According as the automation of clerical work(OA ; Office Automation) develops, the use of VDT(Visual or Video Display Terminal) is increasing suddenly. But, in proportion to the spread of office automation(OA tendency), the self-conciousness syptom attendant upon the work is appearing also (Kim, Jung Tae, Lee, Young Ook, 1990). The apparatuses of office enable the clerical workers to be convenient and perform mass businesses. But, they are increasing the opportunity to be exposed to VDT syndrom, techno stress, computer terminal disease, pain by muscle strain(RSI), bradycausia of noise nature, and electromagnetic waves, etc. which are referred to as the new type of occupational diseases to the workers. It is the real situation that the workers to use VDT is complaining of the physical inconvenience sense in the recent newspaper and literature, it is the point of time that the sydrome to come from VDT use and computer terminal disease, etc. must be classified into the occupational disease(Lee, Kwang Young 1990, Lee, Kyoo Hak 1990, Lee, Won Ho 1991, Lee, Si Young 1991, Lee, Joon 1991, Choi, Young Tae 1991, Heo, Seung Ho 1989). In addition, it is the real situation that the scientifitic study result about the scope that electromagnetic waves has influence on the human body has not been suggested yet, and criticism on the stable exposure permission standard about electromagnetic waves to be emitted from VDT and on the problem in the health about electromagnetic waves is continuing. (IEEE Spectrum, 1990). In addition according to the experience of nursery business of industry field, it is the real situation that the patients who consult complaining of physical and mental inconvenience sence, among the users of apparatus of office automation, are reaching 10% of the patients coming to doctor's room. Therefore, it is necessary to confirm the self-consciousness symptom that the clerical workers complain of multilaterally with the actual state examination about the use of the apparatuses of offices automaton. Thus, this study was tried as th basic data for the cosultation and education for the maintenance and furtherance of the health of workers as the nurse of industry field, by confirming the contents of self-consciousness symptom attendant upon the use of the apparatus for office outomation making the financial institution in which the spparatus for office automation in most frequently used as the subject, and by examining whether there is the difference according to the subject of study, the data were collected, by using the questionnaire method, making 200 workers who consented to the study participation as the subject, among the persons who have spent over 3 months since they used the apparatuses for office automation and didn't receive the treatment in hospital due to the clerical disease for recent 3 years. The period of data collection was from Oct. 9, 1991 to Oct. 12. As for the measurement instrument about the complaint if self-consciousness symptom attendant upon the use of apparatuses fo office automation, the question item on the complaint symptom of health problem attendant upon the treatment of VDT that Kim(1991) developed and on CMI health problem and the question items on the fatigue degree due to industry were used by previous examination to 25 persons. Collected data were analyzed with the statistical method such as percentage, arithmetic mean, Person correlation coeffient, Kai square verfication, t-test, ANOVA, etc. by using SPSS/PC+ program, and the result is as follows : 1. The self-consciousness symptom that the clerical workers complained of most frequetly appeared high in 'My eyes are tired'(99.4%), 'I feel fatigue and weariness'(99.4%), 'I feel that my head is heavy5(90.0%), 'eyesight fell'(88.8%), 'I have a stiff neck'(88.8%), 'I fell pain in the shoulder'(85.0%), 'I feel cold and painful in the eyes'(76.9%), 'I feel the dry sense of eyeball'(76.2%), 'My nerves are edgy, and I an fretful, (75.6%), 'I feel pain in the waist'(73.2%) and 'I fell pain in the back'(72.8%). It emerged that the subject use the apparatuses for office automation complained of self-consciousness symptoms related to visual symptoms and musculoskeletal symptoms. 2. As for the general feature of examination subjects, the result to see the distribution by classifying into sex, age, school career, use career of apparatuses for office automation, skillfulness degree of the use of apparatus for office automation, use hours of the apparatuses for office automation per 1 day, type of business of the apparatus for office automation, rest hours during the use of apparatus for office automation, satifaction degree of business of office automation, and work circumstance, etc. emerged as follows : As for the sex of subjects, the distribution showed that men were 58.8% and women were 41.3%, Age was average 26.9. As the distribution of school career, the distribution showed that4below the graduation of high school' was 58.8%, 'graduation from junior college-university' was 35.0%, and 'over graduate school' was 6.3%. In the question to ask the existence or non-existence of experience of health consultation in connection with the work of office automation, the response that I had the consultation exprience and I feel the necessity emergerd as 90.1% And, the case that the subject who didn't wear the glasses or lens before using the OA apparatus wear glasses or lens after using OA apparatus emerged as 28.3% of whole. As for the existence or non-existence of use career of OA apparatus, the case under 3 years was highest as 52. 7%. As for the skillfulnness degree about the use of apparatus for office automation, most of them are skillful with the fact that 'common' was 44.4%, 'skill' was 42.5%, and 'unskillful' was 13.1% As for the use average hours of the apparatus for office automation per 1 day, the distribution showed that the case under 3-6 hours was 33.1%, the case under 6-9 hours was 28.1%, the case under 3 hours was 30.6%, and the case over 9 hours was 8.1% Main OA business and the use hours for 1 day showed in the order of keeping and retrieval, business of information transmission(162min), business of information transmission(79.3 min), business of document framing(55.5 min), and business of duplication and printing(25.4min). as for the rest during the use of apparatus for affice automation, that I take rest occasion demands the major portion, but that I take after completing the work emerged as 33.8%. Though the subiness gets to be convenient by the use of the apparatus for of office automation, respondents who showed the dissatisfaction about the present OA business emergd high as 78.1%. The work circumstances of each office was good with the fact that the temperature of office was 21.8, noise was average 42.7db, and the illumination was average 364.4 lx, in the light of ANSi/HFS 100 Standard. 3. Sight syptom, musculoskeletal symptom, skin and other symptoms showed the significant difference according to the extent of skillfulness of the apparatus for office automation. All the symptoms exept skin symptom showed the difference according to the use hours of the apparatus for office automation. All the question items exept the sytoms of digestive organs and the rest hours during the apparatus for office automation showed the signicant difference. The question item which showed the signicant difference from the satisfaction degree of present OA business showed the significant difference from all the question item classified into 6 groups. But, age and school career didn't significant difference from the complaint of any self-consciousness symptoms.

    . In conclusion, the self-consciousness symptoms of the subjects to use OA apparatus appeared differently, according to sex distiction, skillfull degree of OA apparatus, use hours of OA apparatus, the rest hours during th use of OA apparatus, and the satiafaction degree of persent business. Therefore, it is necessary that the nurse in the inuctry field must recognize to receive the education about the human technological physical condition which is most proper for te use of OA apparatus and about the proper rest method until they get accustomed to the use of OA apparatus. In addition, the simple exercise relax the tention of muscle due to the repetitive simple movement, and the education for the protection of eyesight are necessary.

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  • 의료사고 및 의료분쟁에 대한 치위생사의 인식도 조사 (A Survey on the Perception of the Counterplans of Medical Accident and Dispute of Dental Hygienist)

    • 오진호;권정승;안형준;강진규;최종훈
      • Journal of Oral Medicine and Pain
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      • 제32권1호
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      • pp.9-33
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      • 2007
    • 치의학계에서는 의료사고를 일으킬만한 중환자나 응급환자의 빈도가 상대적으로 낮아 의료분쟁에 휘말리는 경우가 적었으나 요즈음은 의료분쟁이 증가하고 있는 추세이다. 치과진료의 특성상 항상 보조인력이 한, 두명씩 치과의사의 진료를 도와주어야 하고, 치과의사의 의료사고로 인해 의료분쟁으로 발생하는 경우도 있지만 의료법에서 정한 치과 보조인력의 진료영역에서 의료사고 및 분쟁이 발생할 수 있다. 또한 의료기관의 친절도, 서비스 불만 등 진료외적인 요인은 치과 보조인력의 역할을 무시할 수 없다. 본 연구는 2006년 현재 종합병원, 치과병원 및 의원에서 치과진료 보조업무를 하고 있는 치과위생사를 대상으로 설문조사를 하였다. 회수된 275명의 설문분석을 통하여 응답자에 관한 기본적인 자료조사 및 환자의 불평, 불만 및 의료분쟁 경험도와 함께 의료관계법의 이해도를 측정하고, 치과진료 및 의료분쟁에 대한 전반적인 의식성향을 비교분석하여 다음과 같은 결과를 얻었다. 1. 설문응답자 중에서 향후 의료사고 및 분쟁이 발생할지도 모른다는 불안감 또는 의구심을 어느 정도 가지고 있는 경우가 274명 중 251명(91.3%)이었다. 2. 치과위생사의 업무, 진료에 대한 환자의 불평, 불만 경험률은 29.5%(81명)으로 나타나 치과관련 의료분쟁의 원인이 될 수 있는 것으로 조사되었다. 3. 전체유형별 항목에 따른 환자의 문제제기 건수를 보면 직접적인 진료행위와 관련된 문제보다 불친절 및 진료비 등의 진료이외의 문제 제기가 1805건 중 349건(19.3%)으로 가장 높게 나타났다. 4. 세부유형별 항목에 따른 환자의 문제제기 건수를 보면 환자가 치료와 관련하여 충분한 사전설명이나 동의를 구하지 않았다고 문제시 한 경우가 1805건 중 129건(7.1%)으로 가장 높았다. 5. 치과위생사가 스케일링 시술 후 환자 진료기록부에 기록하는 경우는 267명 중 252명(94.4%)으로 나타났으나, 스케일링 시술 후 주의사항 설명 사실을 진료기록부에 기록하는 경우는 55명(20.8%)에 불과했다. 6. 치과진료에 있어서 환자가 언급하지 않으면 특별히 전신질환 유무를 조사하지 않는 경우가 6명(2.2%)으로 조사되었다. 7. 환자 진료와 관련되어 응급상황 발생 시 응급조치를 시행할 수 있다고 생각하는 치과위생사는 104명(38.0%)으로 조사되었다. 8. 근무지에 응급상황 발생 시 조치에 필요한 장비 및 약품을 구비해둔 경우는 115명(41.8%)으로 나타났다. 9. 의료분쟁 발생 시 문제해결에 있어 의무기록이 중요한 역할을 한다고 응답한 경우는 268명(97.81%)으로 나타났다. 10. 의료분쟁 시 문제해결에 있어서 치료 전 설명 및 동의의 의무의 이행 여부가 중요한 역할을 한다고 응답한 경우가 272명 (99.3%)으로 나타났다. 11. 의무기록의 의무보관연도가 10년이라고 옳게 응답한 경우는 160명(58.4%)에 불과했다. 12. 치과위생사의 업무를 벗어난 파노라마사진 촬영을 해도 된다고 응답한 경우가 124명(45.3%), 치경부 레진수복을 해도 된다고 응답한 경우가 71명(25.9%), 유치발치를 해도 된다고 응답한 경우가 37명(13.5%)으로 나타났다. 13. 환자의 비밀누설 금지와 관련하여 환자의 상태를 다른 사람에게 이야기하는 것은 큰 문제가 되지 않는다고 응답한 경우가 24명(8.8%)으로 나타났다. 14. 의료분쟁의 예방 및 대책에 관한 교육의 필요성에 대해서 272명(99.3%)이 필요하고, 167명(61.0%)이 시급하다고 답하였다. 15. 재학 중 의료분쟁의 예방 및 대책에 관한 관련교육을 수료한 적이 없다는 경우가 186명(64.2%), 졸업 후 의료분쟁의 예방 및 대책에 관한 보수교육을 수료한 적이 없는 경우가 212명(77.4%)으로 나타났다. 16. 향후 의료분쟁이 증가할 것으로 생각된다는 응답은 256명(93.4%)이었고, 그 원인으로는 83.3%가 인터넷, 방송 등의 매체를 통한 정보습득 기회의 확대를 꼽았다. 이상의 결과를 종합해보면 치과위생사와 관련한 환자의 불평, 불만 및 분쟁도 경험률이 응답한 치과위생사의 29.5%를 차지하고 있으며, 의료법에서 정한 의료인의 의무와 치과위생사의 직무범위에 대한 인식이 부족한 것으로 조사되어 앞으로 의료분쟁이 더욱 증가할 수 있는 가능성을 내포하고 있다. 그러므로 주의의무, 설명 및 동의의무 등의 의무를 다함은 물론, 이에 대한 인식을 제고하여야 하며, 의료법과 의료분쟁에 대한 예방 및 대책과 관련된 교육기회를 확대하여야 할 것이다.

    말기 암환자와 가족을 위한 집단상담 프로그램 - 서울대학교병원 경험의 분석- (The Group Counseling Program for Terminal Cancer Patients and their Family Members in the Seoul National University Hospital)

    • 이영숙;허대석;윤영호;김현숙;최경숙;윤여정
      • Journal of Hospice and Palliative Care
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      • 제1권1호
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      • pp.56-64
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      • 1998
    • 목적 : 본 연구는 서울대학교병원의 말기암환자와 가족을 위한 집단상담 프로그램을 소개하고, 현황 및 문제점을 파악하고자 하였다. 방법 : 1996년 한 해동안 상담에 참석한 말기암환자 및 가족들의 상담기록지를 중심으로 연구자들이 상담한 내용을 분석하였다. 결과 : 참석자 312명은 가족(84%)이 환자(16%)의 4배 이상 참석했고, 대부분 1회만 참석하고 있음을 보여주었다. 참석한 환자 또는 가족이 돌보는 환자의 현황은 나이별로 60대, 50대, 40대가 많았고, 암의 종류는 폐암, 위암, 간암 순으로 많았다. 가족의 특성은 261명으로 배우자, 자녀, 며느리, 형제자매, 부모순으로 많았다. 프로그램에 오게된 경로는 의사의 권유(69%), 병원 포스터(26%), 기타 순이었다. 이것은 의사가 환자와 가족을 집단에 참여시키는데 중요한 역할을 담당하고 있음을 보여준다. 질문은 우선적으로 의료적인 정보에 대한 욕구가 많았다. 이것은 환자나 가족이 의료진으로부터 정보를 제대로 전달받지 못하고 있음을 보여준다. 또한 가족은 환자를 돌보는데 있어서 정보의 제공만으로 해결될 수 없는 여러가지 실제적인 어려움을 주고 있었다. 그 결과 계속적인 24시간 전화상담 서비스 호스피스 시설 가정간호 서비스의 확대, 3차 의료기관과 1,2차 의료기관과의 의뢰 체계 등을 필요로하고 있었다. 따라서 병원에서 제공될 수 있는 프로그램과 지역사회에서 제공될 수 있는 자원, 호스피스 시설과의 연계가 필요하며 이를 관리해줄 수 있는 환자 관리 전담 인력이 필요하다. 결론 : 본 프로그램은 1회(single-session)적인 성격이 강하지만 환자와 가족이 궁금해하는 점들을 만족시켜주므로서 암에 대한 인식이 증가하고 대처능력이 향상되고 있음을 볼 수 있다. 이것은 이 프로그램이 위기에 처한 말기암환자와 가족을 지지하는 프로그램으로서 활용가치가 높다고 볼 수 있다. 추후 연구는 프로그램의 효용성에 대한 평가가 검토되어야 할 것이며, 다른 병원에서도 각 병원의 특성과 참석자들의 특성을 고려하여 보다 발전된 프로그램이 나오기를 바란다.

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    한국 전·후기 노인의 삶의 질 관련요인과 성별 차이 (Gender Difference in Quality of Life After Controlling for Related Factors among Korean Young-old and Old-old Elderly)

    • 정영해;조유향
      • 농촌의학ㆍ지역보건
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      • 제39권3호
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      • pp.176-186
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      • 2014
    • 본 연구는 노인의 삶의 질 관련 요인을 파악하고, 관련 요인을 통제한 상태에서 남 녀 노인의 삶의 질에 차이가 있는지 국민건강영양조사 제5기 1차년도 자료를 사용하여, 65세 이상 노인 1,339명을 대상으로 하였다. 자료분석 방법은 층과 집락 가중치를 지정하여 SPSS 20.0 복합표본분석방법으로 분석하였는데, 연령과 성별에 따른 일반적 특성과 건강행위 및 건강상태의 차이는 로지스틱회귀분석을, 삶의 질 차이는 일반선형모형분석을, 삶의 질 관련 요인은 후진제거방법을 이용한 일반선형모형으로 파악하였으며, 성별의 차이 역시 일반선형모형을 이용하여 검증하였다. 일반적 특성에서는 교육수준(p<.001)과 경제수준(p=.005), 동거여부(p<.001)가 성별에 따라 차이가 있었으나, 거주지역은 차이가 없었으며, 건강행위는 흡연(p<.001), 음주(p<.001), 운동(p=.045)에서 차이를 보였고, 건강상태에서는 비만정도(p<.001), 만성질환유무(p<.001), 스트레스(p<.001), 우울(p=.005), 자살사고(p<.001), 주관적 건강상태(p<.001)이 성별에 따라 차이가 있는 것으로 나타났다. EQ-5D는 노년전기, 후기 모두 여자노인보다 남자노인의 점수가 높았으며, 운동능력, 자가간호능력, 일상생활불편감, 통증/불편감, 불안/우울 등 모든 하위영역에서는 여자노인의 삶의 질이 남자보다 낮았다. 삶의 질 관련변수는 교육수준(p=.001), 경제상태(p=.001), 만성질환유무(p=.052), 동거여부(p=.002), 주관적 건강상태(p<.001), 연령(p<.001), BMI(p=.045)로, 이 변수들은 노인 삶의 질의 31.5%를 설명하였다. 노년기에서도 성 인지적 차이를 감안한 접근방안이 필요함을 제언한다.

    일 대학병원 유방암 환자의 우울증상과 삶의 질 (A Study of the Depressive Symptoms and the Quality of Life in Patients with Breast Cancer in a University Hospital)

    • 장승호;이대보;최운정;이광만;이상열
      • 정신신체의학
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      • 제21권1호
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      • pp.11-17
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      • 2013
    • 연구목적 유방암 환자에서 우울증상의 동반 빈도는 매우 높은 것으로 알려져 있으며 우울증상은 건강과 연관된 삶의 질에 영향을 미칠 수 있다. 본 연구는 일 대학병원 유방암 환자의 우울증상의 유병율을 알아보고 우울증상이 건강과 연관된 삶의 질과, 우울증상과 삶의 질에 미치는 인구 사회학적 및 임상적 변인을 알아보고자 하였다. 방 법 원광대학교병원 외과에서 2010년 11월 1일부터 2011년 5월 31일까지 유방암으로 진단 및 수술을 받고 통원치료 중인 19세 이상 75세 미만인 여성 환자 52명에서 이전에 기분장애로 진단을 받았거나 평가 설문지 및 의학적 정보가 부족한 11명을 제외한 41명을 연구대상으로 하였다. 연구 대상자의 인구통계학적 변인 및 유방암에 대한 임상적 특성은 의무기록지를 통하여 조사하였다. 우울증상은 Beck 우울척도, 불안은 성격평가질문지의 불안 하위 척도를 이용하였으며, 건강과 관련된 삶의 질은 한국판 단축형 36항목 건강 설문지(Short Form 36 health Survey-Korean Version)를 사용하였다. Beck 우울 척도에 따른 우울증상 군과 비우울증상 군의 건강과 관련된 삶의 질을 비교하였으며, 인구사회학적 변인 및 임상적 변인을 예언 변인으로 하고 우울증상과 삶의 질을 준거 변인으로 한 중다회귀분석을 시행하였다. 결 과 유방암 환자 중 우울증상의 유병율은 36.4%였다. 우울 증상을 나타내는 유방암 환자의 건강과 연관된 삶의 질에서 신체 기능(p<.01), 신체 역할(p<.001), 전반적 건강(p<.05), 사회 기능(p<.001), 정서 역할(p<.001), 정신 건강(p<.001)의 하위 척도가 우울증상을 동반하지 않은 환자군에 비하여 유의하게 낮았다. 그러나 신체 통증 및 활력의 하위척도에서는 유의한 차이가 없었다. 유방암 환자의 우울증상은 불안과 교육 정도, 항암치료 시행 여부와 유의한 것으로 나타나 전체 우울증상의 63.6%의 설명 변량을 나타냈다. 유방암 환자의 건강과 관련한 삶의 질은 우울증상, 수술형태, 연령이 유의하였으며 55.8%의 설명 변량을 나타냈다. 결 론 유방암 환자의 우울증상은 36%에서 나타났으며 우울증상은 건강과 연관된 삶의 질을 낮추었다. 우울증상은 삶의 질에 높은 설명 변량을 가지고 있으며, 불안은 우울증상을 동반한 유방암 환자에서 높은 설명 변량을 갖고 있었다. 따라서 유방암 환자의 삶의 질을 높이기 위하여 우울증상에 대한 평가 및 치료가 필요할 것으로 여겨진다.

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    소아 식도 이물의 내시경적 적출방법 변화에 대한 고찰 (A Review of Endoscopic Removal Methods in 127 Cases of the Esophageal Foreign Bodies)

    • 김점수;양정수;정혜성;이민혜;박찬후;최명범;우향옥;윤희상
      • Clinical and Experimental Pediatrics
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      • 제45권4호
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      • pp.459-465
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      • 2002
    • 목 적 : 식도 이물의 내시경적 적출의 최근 경향과 내시경적 적출의 유용성에 대해 알아보고 소아에서 유연형 내시경을 통한 식도 이물 제거술이 정착되기를 바라는 마음으로 이 연구를 시작하였다. 방 법 : 1987년 1월부터 2001년 7월까지 14년 6개월간 경상대학교병원 소아과와 이비인후과에서 식도 이물로 진단하여 유연형 내시경과 강직형 내시경으로 치료하였던 127례를 대상으로 하였다. 유연형 내시경의 경우는 소아과에서 Olympus사의 XP-20, XQ-240과 Pentax사의 2731와 다양한 보조 기구를 사용하고 전신마취나 midazolam이나 diazepam 등의 약제는 사용하지 않았다. 결 과 : 1) 연도별 분포 : 1998년까지는 이물의 제거에 강직형 내시경이나 유연형 내시경이 비슷하게 이용되어 왔다. 1999년 이후부터 유연형 내시경에 의한 이물의 제거가 활발히 이루어졌다. 2) 연령별, 성별 분포 : 유연형 내시경을 사용한 경우는 1세 미만의 경우 4례(6%)였고, 1-5세의 경우 43례(65.1%), 5-10세의 경우 17례(25.7%), 10-15세의 경우 2례(3.2 %)로 총 66례였다. 강직형 내시경을 사용한 경우는 1세 미만의 경우 8례(13.5%), 1-5세는 42례(68.8%), 5-10세는 7례(11.5%), 10-15세는 4례(6.6%)로 총 61례였다. 두 경우 모두 1-5세가 호발 연령이었다. 남녀 비를 보면 유연형 내시경을 사용한 경우 1.64 : 1이었고 강직형 내시경을 사용한 경우에는 1.13:1로 남아에서 다소 많았다. 3) 이물의 종류, 증상, 제거까지 걸린 시간 및 합병증 : 이물의 종류로는 유연형 내시경으로 제거한 경우는 54례, 강직형 내시경으로 제거한 경우 42례로 동전이 제일 많았고 임상 증상은 유연형 내시경의 경우에는 무증상이, 강직형 내시경의 경우에는 연하 곤란이 제일 많았다. 식도 이물을 제거까지 걸린 시간은 대부분 이물을 삼킨 후 24시간 이내였다(108례, 85%). 24시간 이후에 이물을 제거 한 경우는 병원에 늦게 온 경우이며 17례(5%)였다. 이중 합병증이 발생한 경우는 11례로 미란이 7례, 궤양소견을 보인 1례, 출혈 2례, 천공 소견을 보인 1례가 있었다. 4) 동반 질환 : 동반된 질환아 있었던 8례(7.5%)였으며 식도 협착이 5례, 뇌성 마비가 3례였다. 결 론 : 본 병원에 소아 내시경실이 생긴 이후 과거 10년 동안 소아 내시경에 의한 이물의 제거가 많이 이루어졌지만 뚜렷한 이점을 발견 할 수 없었던 강직형 내시경을 이용한 이물의 제거가 최근 2-3년 전까지도 활발히 이루어져 왔다는 것을 알 수 있었다. 유연형 내시경은 전신 마취의 불편함 없이도 쉽게 할 수 있는 안전하고 효과적인 방법이며, 최근 2-3년 간 유연형 내시경에 의한 식도 이물의 제거가 빈번해졌다. 앞으로도 내시경의 발달과 그 보조 기구의 발달로 인하여 전신 마취 없이 유연형 내시경을 사용한 이물의 제거는 활발히 이루어져야 할 것이고 처음에 시도하는 치료 방법으로 선택되어져야 할 것이다.

    만성관절염 여성 환자의 산후조리 경험과 건강상태와의 관계 (A Study on the Relationship between the Experience of Sanhujori, the Traditional Postpartal Care in Korea and Present Health Status of Chronic Arthritis Female Patient)

    • 유은광;이선혜;김명희
      • 여성건강간호학회지
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      • 제4권2호
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      • pp.217-230
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      • 1998
    • The purpose of this descriptive correlational study was to define the relationship between the experience of Sanhuujori, Korean traditional non-professional postpartal care after delivery and abortion and present health status of chronic arthritis female patient who visited to outpatient clinic of rheumatic internal medicine at a hospital located in Seoul, Korea. A convenience sample of 64 women who orally agreed to be a participant and data were collected form October 1996 to May, 1997 for sis months by way of interview with semistructured questionnaire. The data were analyzed by the SPSS pc program using t-test, ANOVA and Scheffe test as a post hoc and Pearson Correlation Coefficient. The results of the study were as follows ; Mean age of participants was 53.2 years and mean number of children was 3.1. Mean frequency of abortion was 2.1 times per woman. Seventy four percentage of respondents did not have Sanhujori after abortion. The mean period of Sanhujori after delivery was 17.7, 15.2, 13.8 days from the first child to third child and shorter than that of general woman such as 20.0, 19.0, 17.3 days in the previous study. On the subjective evaluation of whether the women did Sanhujori well or not, the rate of 'did Sanhujori wrongly' was the highest rank in each child where as general woman 'did Sanhujori well' at the first child, 'moderate' at the second and third child and 'did Sanhujori wrongly' at the 4th and fifth child. The health status implies both subjective health status women perceived and the rate of complaints of physical symptom distress women are experiencing presently. The respondents of 82.5% perceived them as unhealthy or sick and 68.9% of women complained more than two symptoms. Mean number of physical symptom distress women complained was 2.33. The main sites of physical symptom distress were upper & lower extremities 69.1% including knee and hand, whole body 19.1%, neck 3.7%, waist & shoulders 2.7% respectively. The characteristics of the symptoms were mostly pain 60%, swelling 19.8%, rigidity & deformity 7.9% respectively, sensation of heat 6.8% and weakness 1.7%. Women perceived the etiology of the chronic arthritis as stress 25.8%, 'did Sanhujori wrongly' & overwork 23.4% respectively, genetic 12.9%, malnutrition, 4.8%, and aging process 3.2%. There were significant positive correlation between subjective health status and the period of Sanhujori after delivery of the second child(r=-0.22) and negative correlation with the number of child at the level of 5% of significance statistically(r=0.27). There were significant negative correlation between the rate of complaints of physical symptom distress and the subjective evaluation whether she did Sanhujori well or not at the level of 5% of significance statistically(r=-0.23). And the rate of complaints of physical symptom distress in the group of women who experienced abortion was significantly higher than that of women who did not experience it at the level of 5% significance statistically(t=2.00) In conclusion, this finding reconfirmed the possible relationship between health status of chronic arthritis female patient and the experience of Sanhujori after delivery & abortion. It provides a challenge to the professional care givers to research further on the effects of Sanhujori on the health status, health recovery after abortion or delivery from the various aspects through the crosssectional and longitudinal research for the refinement of the reality of not only as cultural phenomenon but as conceptual model for the appropriateness of intervention and quality of care for desirable health outcomes.

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    암환자의 희망 예측요인 (Predictive Factors of Hope in Patients with Cancer)

    • 이화진;손수경
      • 성인간호학회지
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      • 제12권2호
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      • pp.184-195
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      • 2000
    • It has been believed that cancer is an omnious factor threatening the future and life itself. Patients having the disease experience anxiety, fear, feeling of weakness, depression and feelings of uncertainty and hopelessness. Most cancer patients, however, have expectations of possible recovery and a better future, very different from the patients who feel hopeless. Therefore. hope allows people to respond effectively to the fatal disease they have and prevents them from detoriorating physically and spiritually, positively influencing their survival, response to treatment and sense of security. Studies previously performed showed that hope is positively correlated with social and family supports, self-esteem, spiritual well-being, responsive action, health promotion behavior and quality of life. Thus, the study attempted to provide basic information on nursing cancer patients by investigating their levels of hope and determining predictive factors which influence hope. For the study 200 cancer patients in two university hospitals located in Pusan were sampled as subjects. Data were collected for twenty nine days from Feburary 1, 1999 to March 1. Instrumets for the study included 10 items from the self-esteem scale by Rosenberg (1965), 39 hope measurements by Kim and Lee(1965), 16 of the social support scale by Tae(1986) and 16 of the general characteristics scale, all of which totaled 81 items. The data were analyzed using the SPSS program. General characteristics of the investigated based on numbers and percentage. Hope, self-esteem and social support were analyzed using means, minimum, maximum and standard deviation. Relations among the foregoing three factors were analyzed using Pearson' correlation coefficient. Levels of hope in cancer patients were determined using t-test, ANOVA and Scheffe test. Predictive factors influencing hope were investigated using multiple stepwise regression analysis. Results of the study are summarized as follows: 1. An average level of hope was $185.55{\pm}23.39$ points(96 min. and 234 max.) 2. Levels of hope showed a significant difference among them according to sex (t=-3.69, P=.000), age(F=4.714, P=.000), job(F=3.247, P=.008), monthly income (F=6.113, P=.003), treatment charge (F=3.796, P=.011), supportive resources (F=10.554, P=.000), diagnosis(F=2.287, P=.029), perceived health status(F=22.184, P=.000), level of pain(F=3.334, P=.021), religion (F=4.911, P=.001) and religion's effect in life (F=11.706, P=.000), 3. For the subjects, self-esteem and social support were $38.32{\pm}7.21$(13 min, and 50 max.) and $52.97{\pm}8.49$points(28 min, 80 max.). Concerning social support, average levels of family support and medical support were found $35.95{\pm}6.05$(18 min, and 40 max) and $27.02{\pm}4.99$ points(20 min and 40 max). The hope the cancer patients showed significant correlations with self-esteem (r=.588, P=.000), family support(r=.224, p=.001) and medical support(r=.221, P=.002). 4. The five variables related to hope (self-esteem, religion's effect in life, perceived health status, social support and age) accounted for 54.2 percent of the hope level; especially, self-esteem was the highest at 34.6%. As shown in the above results, predictive factors which most influence hope in cancer patients were self-esteem and religion's effect of life. Therefore, nursing interventions to increase self-esteem should be developed. Regarding religion's effects, studies on spiritual aspects should be carried out in a way that contributes to promotion of hope.

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    산모와 간호원이 본 선택된 산욕기 간호활동의 중요도에 관한 탐색적 연구 (An Exploratory Study about the Importance of Selected Nursing Activities during the Puerperal Period, as Viewed by Women in the Puerperal Period and by Nurses Caring for Them)

    • 박주봉
      • 대한간호학회지
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      • 제8권1호
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      • pp.152-162
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      • 1978
    • The desire to maintain health is increasing, consequently the role of nursing which has as one chief aim the solving of man′s basic problems is more and more important. Today, in spite of a growing concern about the nursing activities which nurses provide for individual human having specific needs, clinically in fact, it is questionable that individual′s expectation of nursing activities agrees with nurse′s performance of nursing activities. In this study the importance and agreement of the importance of the nursing activities during the hospitalized puerperal period as viewed by women in the puerperal period and by nurses caring for them, were assessed. The present study was undertaken in an attempt to furnish the basic data for expediting the progress of research activities in this area and further to be helpful in planning maternity nursing practice. The study population defined and selected was nurses (13) caring for women in the puerperal period and doing duty on obstetric & gynecologic ward at Y. hospital, and the women in puerperal period (39) as sum of 3 women selected by each nurse during the period of May 13th-June 4th 1976. The study data was collected by the direct interview method based on the questionnaire which the investigator made out. The study result was analyzed by percentage, t - test. The findings can be summarized as follows: 1. General characteristics of nurses doing duty on puerperal ward: a. Nurses′average age was 24.8 years old. b. 84.6% had educational background of 4 years of college. c. 69.2% had a religion. d. 53.8% were married. e. 53.8% had clinical experience of 1 year -3 years. f, 61.5% did duty on puerperal ward during 1 year -3 years. g. 46.2% desired to do duty on obstetric ? gynecologic ward. 2. General characteristics of the women who were studied during their puerperal period: a. Women′s average age was 26.4 years old. b. 79.5% had educational background above high school. c. 56.4% had a religion. d. 84.6% had living standard above medium. e. 89.7% had no occupation. f, 53,8% had previous hospitalization experience. g. 56.4% had previous delivery experience. 3. Examining the importance of 39 nursing activities during puerperal period selected by investigator, studied group of women considered that the most important nursing activity was "Record precisely about condition, medical treatment and nursing activity results etc". Nurses considered that the most important nursing activity was "Notice whether having pain and care for that". Both groups considered that the least important nursing activity was "Talk with her about topics such as news, hobbies, other interests". 4. Examining the importance of nursing activities in 4 specific categories, studied group of women considered that the most important nursing activity in physical nursing category was "Be sure of safety measure to prevent accidents, injuries", and nurses considered that the most important nursing activity was "Make her sleep and rest sufficiently". Studied group of women considered that the most important nursing activity in psychological category was "Explain about medical treatment and nursing activity ahead of time so she knows what to expect" , and nurses considered that the most important nursing activity was "Explain about puerperal period so she understands". Studied group of women considered that the most important nursing activity in relation to medical care was "Record precisely about condition, medical treatment and nursing activity results etc.", and nurses considered that the most important nursing activity was "Observing, cleaning and protecting the perineum" Studied group of women considered that the most important nursing activity in nursing category in preparation for discharge was "Instruct about personnel hygiene during puerperal period", and nurses considered that the most important nursing activity was "Instruct self-care to protect the perineum". 5. The analysis of this study showed a significant amount of disagreement computed by subtracting the nurse′s score from the patient′s score. Studied group of women put greater importance on physical nursing category, psychological nursing category, nursing in relation to medical care, than the nurses. These results were statistically significant at 0.01 level.

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    일부지역(一部地域) 노인(老人)들의 주체적(主體的) 건강수준(健康水準)에 영향을 미치는 IADL에 관한 연구(硏究) (A Study on the IADL Affecting Subjective Health Index of the Aged in Some Area)

    • 김근조;박흥기;권혁수;배수찬
      • 대한정형도수물리치료학회지
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      • 제7권1호
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      • pp.29-50
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      • 2001
    • This research have been made to define how the IADL (Instrumental Activity of Daily Living) performance and the subjective health index of the Aged are affected by their residential circumstance, gender and age, and how deeply these two factors are related and interact. For the period of June 1 to July 31, 2000, we had conducted a questionnaire and direct interview with 693 persons over age sixty-five (65) in Daejon and in other adjacent area, grouping into three different residential types The Aged living at home, The Aged living at welfare facilities and The Aged living alone, and studied on how the IADL performance and the subjective health index of the Aged are influenced and interact as per their characteristics, daily activity and mentality. We had analyzed all the data obtained through this research by the method of : - analysis of frequency as per specific factors by SPSS 1O.0/PC+, - $x^2$ test, - t-test, - ANOVA, - multiple regression analysis by factors. The research concludes followings : a. It appears that the three (3) factors such as gender, age and residential circumstance of the Aged deeply affect the IADL performance and subjective health index of the Aged. (p<0.01) b. With regard to IADL performance of the Aged by the gender, it was analyzed that the female-Aged gains 23.8 point on average, which shows the performance of the female-Aged is less independent. (p<0.01). In addition, it was also found that the IADL performance is becoming less and less independent following their age increasing. In analyzing IADL performance by the residential type, it appears that the Aged living at welfare facilities gains the lowest 21.5 points and is least independent. It was also found that the Aged living at welfare facilities need some assistances from others for their performing IADL. (20-24 point) (p<0.001) c. With regard to the subjective health index of the all-Aged participated in this research, the analysis indicates 8.8 point and this is considered as a point of general standard (7-10 point). In analyzing this index by the gender, the female-Aged gains only 8.6 point which explains a lot of female-Aged consider they are not really healthy. (p<0.001) In analyzing this index by the residential type, the Aged living at welfare facilities and the Aged living alone gain the comparatively lower point, - respectively 8.4 point for the Aged living at welfare facilities and 8.8 point for the Aged living alone. The Aged living at these two residential types express they are obviously in a bad situation of health. (p<0.001) d. With regard to the factors affecting the IADL performance and the subjective health index of the Aged, it was analyzed that the IADL performance can largely be affected by the factors such as depression, frequency of going-out and age rising, and that the subject health index can also deeply be affected by depression, pain and by how much they are satisfied with their current living conditions. e. It was analyzed that the interacting between the IADL performance and the subjective health index is not that strong but even weak. As a result, we were able to conclude that the IADL performance is less independent in case of the female-Aged, the Aged living at welfare facilities, and following the age rising. As for the subjective health state the Aged themselves are aware of, we concluded that the female-Aged, the Aged living at welfare facilities and the Aged living alone, are more critical about their health. From this research, we were able to realize that, when the OMT (Orthopedic Manual Therapy) needed, the physical therapists are really required to have a correct and cautious understanding of the situation in which the aged persons are, and take care of them with more concerns and more improved treatment.

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