• 콘크리트학회논문집
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• 제25권5호
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• pp.485-496
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• 2013

2001년 9.11테러로 인한 미국 세계무역센터 및 미국 국방성 펜타곤이 붕괴된 이후, 전 세계적으로 충돌, 폭발 등의 극한하중에 의한 테러가 빈번하게 발생하고 있으며, 극한하중에 의한 구조물의 거동에 대한 사회적 불안감은 더욱 증가되고 있다. 그러나 지금까지의 사회기반시설구조물에는 폭발 및 충돌 등과 같은 극한하중에 대한 방호 및 방재개념을 설계에 고려하지 못하고 있는 실정이며, 원전격납건물, 가스탱크, 교량, 터널 등에 널리 사용되는 프리스트레스트 콘크리트 구조물에 대한 극한하중 연구는 전 세계적으로 미흡하다. 충돌과 같은 극한하중은 집약된 에너지의 급작스런 방출로 인한 높은 충돌압력을 형성하므로, 극한하중의 특성 및 전파 메커니즘을 이해하는 것이 필요하다. 그러므로 이 연구에서는 이방향 비부착 프리스트레스트 콘크리트 패널의 충돌저항성능을 비교검토하기 위하여, $1400mm{\times}1000mm{\times}300mm$의 철근콘크리트(RC), 프리스트레스 텐던으로만 보강된 콘크리트(PS), 프리스트레스 텐던과 철근으로 보강된 콘크리트(PSR, 일반적인 PSC) 시편을 제작하였다. 실험 조건에 맞춰 14 kN의 추를 10 m, 5 m, 4 m 높이에서 낙하하는 예비 실험과 3.5 m 높이의 본 실험으로 구성하여 충돌하중에 대한 프리스트레스트 콘크리트 구조물의 실험적 평가를 수행하였다. 또한, 충돌실험을 위한 기본적인 실험 구성 및 계측시스템을 구축하였다. 충돌 저항성능은 균열형상, 손상면적, 에너지 흡수, 처짐, 변형률, 가속도 등의 충돌에 의한 계측데이터를 이용한 거동분석 뿐만 아니라, 충돌 후 잔류구조성능 실험을 수행하여 이방향 비부착 프리스트레스트 콘크리트 패널의 충돌저항성능을 검토하였다. 본 실험은 향후 국내외 프리스트레스트 콘크리트에 대한 충돌 방호설계 및 충돌해석 등 관련 연구분야의 기초자료가 될 것이라고 판단되는 바이다.

• 한국환경보건학회지
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• 제40권6호
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• pp.454-468
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• 2014

Objectives: This study was conducted to investigate the actual condition of the farm work environment and personal protective equipment as part of the effort to improve livestock work for the safety and health of poultry farmers and provide basic data for establishing plans to improve and develop personal protective equipment. Methods: For this purpose, a questionnaire survey on general information about stables, the poultry work environment, accidents, the wearing of work clothes and personal protective equipment, and the level of awareness related to personal protective equipment was conducted among 148 poultry farmers. Results: As a result, it was found that poultry workplace environment was exposed to such risks as fine dusts; organic dusts; poisonous gases; odorous substances; chicken excrement; contact with chickens, bacteria or viruses; and accidents related to machine operation. Thirteen percent of respondents suffered severe respiratory diseases, and the most frequently injured sites due to accidents were the hands (25.7%), knees (23.8%), arms (17.3%), and head (10.9%). The most frequent type of accident was collisions between the body and obstacles or machinery during movement (36.4%), followed by erroneous machine operation such as feeders and electric shocks (8.5%). Regarding the wearing of work clothes and personal protective equipment, 51.7% of the respondents wore worn-out clothing or everyday clothes, whereas only 32.0% wore work clothes. The percentage of farmers who wore proper protective equipment for the work environment during poultry work was 48.4%. The most frequently used type of protective equipment was boots (38.9%), followed by mask (36.7%), gloves (36.3%), appropriate work clothes (22.6%), quarantine clothes (17.6%), helmets (13.4%), and goggles (12.6%). The rate of wearing goggles was low because they were considered inconvenient and lowered work efficiency. Furthermore, they purchased everyday products available on the market for their personal protective equipment which were not appropriate for maintaining safety in an actual harmful environment and its consequent risks. As a result of the survey of the awareness level related to personal protective equipment, their levels of awareness of accidents and attitude proved to be average or higher, but the practice of wearing protective equipment and the level of knowledge and management of personal protective equipment were lower. Conclusion: This survey found that the wearing status of personal protective equipment among poultry farmers was insufficient even though they were exposed to risks. Most respondents were aware of the necessity of wearing personal protective equipment and of the potential for accidents, but they did not wear proper protective equipment. Their wearing rate was low due to a lack of knowledge about protective equipment, as well as the inconvenience of wearing it. Therefore there is a need to improve and develop specialized personal protective equipment for respiration, hands, and eyes, as well as work clothes that can protect farmers from major harmful matter that is generated in the poultry workplace. Based on the results of this investigation, we will conduct further studies on the required performance and design directions of personal protective equipment while collecting more objective data through field-oriented assessments.

• Asian-Australasian Journal of Animal Sciences
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• 제17권11호
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• pp.1615-1634
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• 2004

A review was undertaken to obtain information on the sustainability of pig free-range production systems including the management, performance and health of pigs in the system. Modern outdoor rearing systems requires simple portable and flexible housing with low cost fencing. Local pig breeds and outdoor-adapted breeds for certain environment are generally more suitable for free-range systems. Free-range farms should be located in a low rainfall area and paddocks should be relatively flat, with light topsoil overlying free-draining subsoil with the absence of sharp stones that can cause foot damage. Huts or shelters are crucial for protecting pigs from direct sun burn and heat stress, especially when shade from trees and other facilities is not available. Pigs commonly graze on strip pastures and are rotated between paddocks. The zones of thermal comfort for the sow and piglet differ markedly; between 12-22$^{\circ}C$ for the sow and 30-37$^{\circ}C$ for piglets. Offering wallows for free-range pigs meets their behavioural requirements, and also overcomes the effects of high ambient temperatures on feed intake. Pigs can increase their evaporative heat loss via an increase in the proportion of wet skin by using a wallow, or through water drips and spray. Mud from wallows can also coat the skin of pigs, preventing sunburn. Under grazing conditions, it is difficult to control the fibre intake of pigs although a high energy, low fibre diet can be used. In some countries outdoor sows are fitted with nose rings to prevent them from uprooting the grass. This reduces nutrient leaching of the land due to less rooting. In general, free-range pigs have a higher mortality compared to intensively housed pigs. Many factors can contribute to the death of the piglet including crushing, disease, heat stress and poor nutrition. With successful management, free-range pigs can have similar production to door pigs, although the growth rate of the litters is affected by season. Piglets grow quicker indoors during the cold season compared to outdoor systems. Pigs reared outdoors show calmer behaviour. Aggressive interactions during feeding are lower compared to indoor pigs while outdoor sows are more active than indoor sows. Outdoor pigs have a higher parasite burden, which increases the nutrient requirement for maintenance and reduces their feed utilization efficiency. Parasite infections in free-range pigs also risks the image of free-range pork as a clean and safe product. Diseases can be controlled to a certain degree by grazing management. Frequent rotation is required although most farmers are keeping their pigs for a longer period before rotating. The concept of using pasture species to minimise nematode infections in grazing pigs looks promising. Plants that can be grown locally and used as part of the normal feeding regime are most likely to be acceptable to farmers, particularly organic farmers. However, one of the key concerns from the public for free-range pig production system is the impact on the environment. In the past, the pigs were held in the same paddock at a high stocking rate, which resulted in damage to the vegetation, nutrient loading in the soil, nitrate leaching and gas emission. To avoid this, outdoor pigs should be integrated in the cropping pasture system, the stock should be mobile and stocking rate related to the amount of feed given to the animals.

• Asia pacific journal of information systems
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• 제19권2호
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• pp.179-193
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• 2009

As the common saying attests, a publish-or-perish world, publishing is absolutely critical for academic researchers' successful careers. It is the most objectively-accepted academic performance criteria and the most viable way to attain public and academic recognition. Asia Pacific Journal of Information Systems(APJIS) has been recognized as the most influential domestic journal in Korean MIS field since July, 1991. Therefore, publishing in APJIS means your research is original, valid, and contributive. While most researchers learn how to publish an article in APJIS through a repetitive review process, thereby improving their chance of the' accepted' through their personal trial and error experiences, such valuable lessons and know-how tend to be kept personally and rarely shared. However, useful insights into research and publication skills could be also gained from sharing others' errors, neglect, and misjudgments which are equally critical in improving researchers' knowledge in the field (Murthy and Wiggins, 2002). For this reason, other academic disciplines make systematic efforts to examine the paper review process of major journals and share the findings from these studies with the rest of the research community members (Beyer et al., 1995; Cummings et al, 1985; Daft, 1995; Jauch and Wall, 1989; Murthy and Wiggins, 2002). Recognizing the urgent need to provide such type of information to MIS research community in Korea, we have chosen the most influential academic journal, APJIS with an intention to share the answer to the following research question: "What are the common problems found in the manuscripts either 'rejected' or 'required a major revision' by APJIS reviewers?" This study analyzes the review results of manuscripts submitted to APJIS (from January, 2006 to October, 2008), particularly those that were 'rejected' or required a 'major revision' at the first round. Based on Daft's(1995) study, twelve most-likelihood problems were defined and used to analyze the reviews. The twelve criteria for classification, or "twelve problems", are as follows: No theory, Concepts and operationalization not in alignment, Insufficient definition--theory, Insufficient rationale--design, Macrostructure--organization and flow, Amateur style and tone, Inadequate research design, Not relevant to the field, Overengineering, Conclusions not in alignment, Cutting up the data, and Poor editorial practice. Upon the approval of the editorial board of APJIS, the total 252 reviews, including 11 cases of 2005 and 241 cases from July, 2006 to October, 2008, were received without any information about manuscripts, authors, or reviewers. Eleven cases of 2005 were used in the pilot test because the data of 2005 were not in complete enumeration, and the 241 reviews (113 cases of 'rejection' and 128 ones of 'major revision') of 2006, 2007, and 2008 were examined in this study. Our findings show that insufficient rationale-design(20.25%), no theory(18.45%), and insufficient definition--theory(15.69%) were the three leading reasons of 'rejection' and 'major revision.' Between these two results, the former followed the same order of three major reasons as an overall analysis (insufficient rationale-design, no theory, and insufficient definition-theory), but the latter followed the order of insufficient rationale--design, insufficient definition--theory, and no theory. Using Daft's three major skills-- 'theory skills', 'design skills', and 'communication skills'-- twelve criteria were reclassified into 'theory problems', 'design problems', and 'communication problems' to derive more practical implications of our findings. Our findings show that 'theory problems' occupied 43.48%, 'design problems' were 30.86%, and 'communication problems' were 25.86%. In general, the APJIS reviewers weigh each of these three problem areas almost equally. Comparing to other disciplines like management field shown in Daft's study, the portion of 'design problems' and 'communication problems' are much higher in manuscripts submitted to the APJIS than in those of Administrative Science Quarterly and Academy of Management Journal even though 'theory problems' are the most predominant in both disciplines.

• Asian Pacific Journal of Cancer Prevention
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• 제13권10호
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• pp.5011-5017
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• 2012

Background: Overexposure to sunlight in childhood and the adolescent period and associsated sunburns significantly increase the risk of skin cancer in adulthood. In Turkey, the incidence of skin cancer in the general population is 0.8%. The incidence is 0.6% and the mortality rate is 0.4% for men, while these rates are 1.0% and 0.7%, respectively, for women. If skin cancer is found early, its treatment is facilitated. Therefore, personal skin examination is important for early diagnosis. Objectives: Our aim was to determine the effects of training for raising consciousness among adolescents to protect against skin cancer by influencing skin self examination behavior. Method: This quasi experimental intervention study was conducted between February and April 2012 in Izmir. The study population consisted of students attending $6^{th}$, $7^{th}$ and $8^{th}$ classes of a primary school (n:302). No sampling was performed. Data were collected with a form developed by the researchers based on the literature. The first part of form is aimed to determine demographic characteristics of adolescents (3 questions) and their risk status of skin cancer (6 questions). The second part was prepared for skin cancer risks of adolescents (8 questions) and indications of skin cancer (12 questions). The last part was intended to determine their knowledge about skin self examination (4 questions) and behavioral stages of skin self examination (1 question). Data collection was achieved with a questionnaire form in three phases. In the 1st phase, data about demographic characteristics of students, risk status of skin cancer, knowledge level of skin cancer and behavior stages were collected. In the $2^{nd}$ phase, skin self examination training based on the transtheoretical model was performed within the same day just after obtaining preliminary data. In the $3^{rd}$ phase, adolescents were followed up three times to establish the efficacy of the training (on the $15^{th}$ day after training program and at end of the $1^{st}$ and $2^{nd}$ months). Follow-up data were evaluated by questioning skin self examination performing behavior stages through electronic mail. Results: Half of the adolescents (50.5%) are male, and 58.4% of them are 13 years old with a mean age of $12{\pm}1.15$ years. About 29.4% of adolescents had brown hair color, 37.9% had brown/hazel eye color, 29.4% had white skin, and 47.2% had fewer than 10 moles in their body. The pretest mean score on knowledge level about risks of skin cancer was found to be $4.19{\pm}1.96$, while the post-test mean score was $6.79{\pm}1.67$ (min:0, max:8).The pretest mean score about indications of skin cancer was $7.45{\pm}3.76$, while the post-test mean score was $10.7{\pm}2.60$ (min:0, max:12). The increases were statistically significant (p<0.05). The behavior "I do not perform skin self examination regularly in every month and I do not think to perform it in the next 6 months" was reduced from 52.8 to 35.5% after training. Conclusion: The training program organized to raise consciousness among adolescents for protection against skin cancer increased the knowledge level about risks and indications of skin cancer and it also improved the behavior of performing skin self examination.

• 한국도서관정보학회지
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• 제11권
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• pp.69-99
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• 1984

A dramatic development in the new technology of copying materials has presented us with massive problems on reconciling the conflicts between copyright owners and potential users of copyrighted materials. The adaptation to this changing condition led some countries to revise their copyright laws such as in the U. S. in 1976 and in Korea in 1984 for merging with the international or universal copyright conventions in the future. Copyright defined as exclusive rights given to copyright owners aims to secure a fair return for an author's creative labor and to stimulate artistic creativity for the general public good. The exclusive rights on copyrightable matters, generally for reproduction, preparation of derivative works, public distribution, public performance, and public display, are limited by fair use for scholarship and criticism and by library reproduction for its preservation and interlibrary loan. These limitations on the exclusive rights are concerned with all aspects of library services and cause a great burden on librarian's daily duty to provide balance between the rights of creators and the needs of library patrons. The fair use as one of the limitations on it has been coupled with enormous growth of a new technology and extended from xerography to online database systems. The implementation of the fair use and library reprography in Korean law to the local practices is examined on the basis of the new American copyright act of 1976. Under the draft revision of Korean law, librarians will face many potential problems as summarized below. 1. Because the new provision of 'life time plus 50 years' will tie up substantial bodies of material longer than the old law, until that date librarians would need permissions from the owners and should pay attention to the author's death date. 2. Because the copyright can be sold, distributed, given to the heirs, donated, as a whole or a part, librarians should chase down the heirs and other second owners. In case of a derivative work, this is a real problem. 3. Since a work has its protection from the moment of its creation, the coverage of copyrightable matter would be extended to the published or the unpublished works and librarian's work load would be heavier. Without copyright registration, no one can be certain that a work is in the public domain. Therefore, librarians will need to check with an authority. 4. For implementation of limitations on exclusive rights, fair use and library reproduction for interlibrary loan, there can be no substantial aggregate use and there can be no systematic distribution of multicopies. Therefore, librarians should not substitute reproductions for subscriptions or purchases. 5. For the interlibrary loan by photocopying, librarians should understand the procedure of royalty payment. 6. Compulsory licenses should be understood by librarians. 7. Because the draft revision of Korean law is a reciprocal treaty, librarians should take care of other countries' copyright law to protect foreign authors from Korean law. In order to solve the above problems, some suggestions are presented below. 1. That copyright clearinghouse or central agency as a centralized royalty payment mechanism be established. 2. That the Korean Library Association establish a committee on copyright. 3. That the Korean Library Association propose guidelines for each occasion, e.g. for interlibrary loan, books and periodicals and music, etc. 4. That the Korean government establish a copyright office or an official organization for copyright control other than the copyright committee already organized by the government. 5. That the Korean Library Association establish educational programs on copyright for librarians through seminars or articles written in its magazines. 6. That individual libraries provide librarian's copyright kits. 7. That school libraries distribute subject bibliographies on copyright law to teachers. However, librarians should keep in mind that limitations on exclusive rights are not for an exemption from library reprography but as a convenient access to library resources.

• 대한원격탐사학회지
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• 제36권5_3호
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• pp.1053-1066
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• 2020

이산화황(SO₂)은 대기 중 화학 반응을 통해 2차 대기오염물질을 생성하는 전구체로, 주로 산업활동이나 주거 및 교통 활동 등을 통해 배출된다. 장기간 노출 시 호흡기 질환이나 심혈관 질환 등을 유발하여 인체 건강에 부정적인 영향을 미칠 수 있기 때문에 이에 대한 지속적인 모니터링이 필요하다. 우리나라에서는 SO₂에 대해 관측소 기반의 모니터링이 수행되고 있으나 이는 공간적으로 연속적인 정보를 제공하는 데에 한계가 있다. 따라서, 본 연구에서는 위성자료와 수치모델 자료를 융합하여 일별 13시를 타겟으로 하는 1 km의 고해상도로 공간적으로 연속적인 SO₂ 지상농도를 산출하였다. 2015년 1월부터 2019년 4월까지의 기간 동안 남한 지역에 대하여 스태킹 앙상블 기법을 이용하여 SO₂ 지상농도 추정 모델을 개발하였다. 스태킹 앙상블 기법이란 여러가지 기계학습 기법을 두 단계로 쌓는 방식으로 융합하여 단일 모델 대비 더 향상된 성능을 도출하는 방법이다. 본 연구에서는 베이스 모델로는 RF (Random Forest)와 XGB (eXtreme Gradient BOOSTing) 기법이, 메타 모델로는 MLR (Multiple Linear Regression) 기법이 사용되었다. 구축된 모델의 교차검증 결과 메타 모델은 상관계수(R) = 0.69와 root-mean-squared-error(RMSE) = 0.0032 ppm의 결과를 보였으며 이는 베이스 모델의 평균 대비 약 25% 향상된 안정성을 보였다. 또한 모델 구축에 사용되지 않은 기간에 대한 예측 검증을 수행하여 모델의 일반화 가능성을 평가하였다. 구축된 모델을 이용하여 남한 지역의 SO₂ 지상농도 공간분포를 분석한 결과 일반적인 계절성과 배출원의 변화를 잘 반영하는 패턴을 보임을 확인하였다.

• Radiation Oncology Journal
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• 제11권1호
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• pp.97-102
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• 1993

1983년 4월부터 1991년 9월까지 가톨릭 의과대학 강남성모병원 치료방사선과에서 국한된 폐소세포암으로 확진되어 방사선치료받은 32명의 환자를 대상으로 치료성적을 후향 분석하였다. 이중 5명은 방사선 치료 단독으로 치료받았으며 27명은 화학요법과 방사선치료 병용요법을 하였다. 남녀의 비는 4.3:1 이었으며 연령분포는 24세에서 78세였다(중앙값 : 63세). 6 MV X 선에의한 방사선치료선량은 일일 160-180 cGy씩 치료하여 총 1000-6660 cGy (중앙값 4500 cGy)였다. 치료 후 완전관해율은 $37.5{\%}$ (12/32), 부분관해율은 $34.4{\%}$(11/32)였고, 무반응은 $28.1{\%}$(0/32)였다. 생존기간의 중앙값은 10개월이었고 1년생존율과 2년생존율은 각각 $59.4{\%}$와 $28.1{\%}$였다. 1년생존율을 유의하게 증가시키는 요소로서는 70이상의 Karnofsky수행상태(p<0.04), 화학요법의 병행(CAV, PV, CAV+PV) (p<0.04), 화학요법 6회 이상(p<0.007) , 45 Gy 이상의 방사선량(p<0.03)와 방사선치료에 반응있었던 경우(CR+PR) (p<0.003)등이었다. 나이, 성별, 상대정맥증후군, 예방적 전뇌조사 및 방사선 치료기간은 유의한 영향을 미치지 않았다. 방사선 치료에의한 부작용은 식도염이 $34{\%}$(11명), 전신피로 $28{\%}$(9명)에서 있었으며 오심 구토 같은 위장관 증상은 $15{\%}$(5명) 그리고 백혈구감소증이 $3{\%}$(1명)에서 관찰되었다.

• 핵의학기술
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• 제12권1호
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• pp.19-26
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• 2008

목적: 방사성옥소 치료병실로부터 발생한 오 폐수는 반드시 전용 정화조에서 일정시간 자연 감쇄(decay)시켜 수중 방사능 농도치가 $8.1{\times}10^{-13}$ Ci/ml 이하가 될 때에만 비로소 방류를 하여야 한다. 현재까지 서울아산병원에서는 60 ton 용량의 전용정화조 3개를 구비하여 운영하고 있었지만 2005년 10월부터 방사성옥소 치료병실을 2병상에서 4병상으로 증설 운영함에 따라 급격히 늘어난 방사성 오.폐수량으로 인하여 본원의 정화조 용량으로는 충분한 감쇄(약 125일 이상)여력이 부족하게 되었다. 따라서 본 연구에서는 치료병실 정화조의 오 폐수 유입유량에 기여하는 원인 및 요인들을 밝혀내어 합리적인 개선 조치를 함으로써 정화조 용량 부족 문제를 해결하여 1차적으로는 엄청난 병원의 경제적 손실을 유발시키는 새로운 정화조의 증설을 피하고 방사성 물질의 인위적 배출로 인한 사회적 문제 유발에 따른 대형의료기관의 신뢰도 추락의 예방에 큰 목적이 있다. 대상 및 방법: 2006년 1월부터 10월까지 고용량 옥소 치료 환자 중 150~200 mCi 이상을 투여 받고 2박3일간 입원치료를 하는 환자 402명을 대상으로, 환자 1인당 평균 물 사용량 (변기사용량, 샤워량, 세면량, 기타 등등)을 측정하였으며, 본원의 정화조 60 ton 3개의 만수 후 배출까지의 감쇄 기간을 측정하였다. 또한 본원의 치료 업무 절차를 단계별로 분석하여 정화조 유입유량의 증가 요인을 찾아보았다. 결과: 다음과 원인에 대한 개선을 통하여 본원의 방사성 오 폐수 보관일수를 정화조 1개당 84일에서 2005년 12월말 현재 약 130일로 증가시킬 수 있었다. (1) 기존 변기의 과다한물 소모량 개선 $\rightarrow$ 절수형 변기로 교체 (2) 불필요한 샤워 및 세탁 방지 $\rightarrow$ 샤워 노즐 사용 자제 및 세면대 이용 교육 (3) 치료기간 중 잦은 배뇨를 유발하는 이뇨제 복용 중지 (4) 수분 섭취량과 퇴원시 체내 잔류선량과의 상관관계 분석 (5) 입실 후 치료 전까지의 대기시간에는 외부 화장실 사용 교육 (6) 정화조 만수위 용량 한계치를 최대 85%에서 90%로 증대 운용 결론: 근래에 들어 급격하게 증가된 갑상선질환 관련 환자로 인하여 전국적으로 거의 모든 의료기관에서 방사성옥소치료의 대기일 수가 크게 증가되고 있다. 이러한 시점에 발생된 방사성 오 폐수 관련 문제는 비단 어느 한 의료기관의 문제가 아닌 관련 우리 모두가 해결해야 하는 큰 과제임에 틀림 없을 것이다. 따라서 본 개선 활동은 그 시작을 알리는 신호탄이 될 것이라 생각되며 방사성 치료병실을 운영하고 있는 타 의료기관에서도 이와 관련된 유사상황이 발생된다면 합리적인 정화조운영의 모델방안으로 제시 될 수 있을 것으로 기대된다.

• Journal of Hospice and Palliative Care
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• 제15권1호
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• pp.10-17
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• 2012

목적: 완화의료를 위해서는 완화의료 대상자에 대한 판단을 하고 완화의료를 직접 시행하거나 완화의료에 자문/의뢰하는 의료인의 역할이 중요하다. 이에 본 연구는 한국의 암환자를 주로 진료하는 의사들의 완화의료에 대한 인식과 완화의료 의뢰 시 장애요인에 대해 알아보았다. 방법: 2010년 5월부터 6월까지 암환자를 주로 진료하는 전문의 477명을 대상으로 무기명 자기 기입식 웹 설문 조사를 수행하였다. 결과: 총 128명(26.8%)이 응답하였고, 설문에 응답한 모든 의사들은 말기암환자에게 완화의료가 필요하다고 생각하는 것으로 조사되었다. 80% 이상의 응답자들이 '3차 의료기관 및 암센터는 완화의료 서비스를 제공해야 한다.', '진행 암환자는 항암 화학요법을 받는 중이더라도 완화의료를 받아야 한다.', '말기암환자의 치료에는 여러 과의 협력이 필요하다.'에 동의하였다. 완화의료 수행능력에 대해서는 58% 이상이 자신이 하고 있는 신체 증상 조절 및 정신증상 조절, 말기암환자 가족의 정서적 지지에 만족한다고 응답하였으나 전반적인 말기암환자 및 임종 환자 관리 서비스는 64%에서 '만족스럽지 않다'고 응답하였다. 응답자 중 34명(26.6%)은 '자신의 말기암환자를 완화의료팀으로 자문'하거나 '의뢰한 경험이 없는 것'으로 나타났고 완화의료 의뢰의 장애 요인으로 '환자나 보호자의 거부'가 61명(47.7%)으로 가장 많았으며 다음으로 '믿고 의뢰할 수 있는 완화의료팀이 없어서'라고 응답한 의사가 59명(46.1%)으로 많았다. 결론: 본 연구에서 대부분의 암환자를 주로 진료하는 의사들은 말기암환자의 완화의료 시행에 대해 긍정적 인식을 가지고 있지만 실제 말기암환자 진료에 있어 다학제 간 협력이나 임종관리까지 충분한 완화의료의 제공은 이뤄지지 않는 것으로 나타났다. 효율적이고 수준 높은 말기암환자의 관리를 위해서 보다 적극적인 완화 의료 자문이나 의뢰가 시행되어야 할 것으로 생각된다.