• Journal of Korean Neurosurgical Society
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• 제63권6호
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• pp.827-833
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• 2020

Objective : Spine surgery is associated with higher morbidity and mortality rates in elderly patients. The modified Frailty Index (mFI) is an evaluation tool to determine the frailty of an individual and how preoperative status may impact postoperative survival and outcomes. This study aimed to determine the usefulness of mFI in predicting postoperative complications in patients aged ≥75 years undergoing surgery with instrumentation. Methods : We retrospectively reviewed the perioperative course of 137 patients who underwent thoracolumbar-instrumentation spine surgery between 2011 and 2016. The preoperative risk factors were the 11 variables of the mFI, as well as body mass index (kg/㎠), preoperative hemoglobin, platelet, albumin, creatinine, anesthesia time, operation time, estimated blood loss, and transfusion amount. The 60-day occurrences of complication rates were used for outcome assessment. Results : Major complications after spinal instrumentation surgery occurred in 34 of 138 patients (24.6%). The mean mFI score was 0.18±0.12. When we divided patients into a pre-frail group (mFI, 0.09-0.18; n=94) and a frail group (mFI ≥0.27; n=44), only the rate of sepsis was statistically higher in the frail group than in the pre-frail group. There were significantly more major complications in patients with low albumin levels or in patients with infection or who had experienced trauma. The mFI was a more useful predictor of postoperative complications than the American Society of Anesthesiologists physical status score. Conclusion : The mFI can successfully predict postoperative morbidity and mortality in patients aged ≥75 years undergoing spine surgery. The mFI improves perioperative risk stratification that provides important information to assist in the preoperative counselling of patients and their families.

• The Journal of Korean Physical Therapy
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• 제3권1호
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• pp.123-149
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• 1991

This study has been attempted to be helpful for the back rehabilization of Korean workers by analyzing the general, occupational, social aspects of low back pain and to identify possible risk factors for back pain in White and Blue collar workers. The primary data were collected from 380 workers in Seoul city by means of a Questionnaire with random which was distributed from March 10 to 31, 1990. For the test of statistical significance, chi-square analysis was used to compare the back pain characteristics between above two groups. The results were as follows : 1. The incidence of low back pain in all walkers studied was $79.7\%$. The incidence of Blue collar with low back pain $(87.2\%)$ was higher than that of White collars $(75.0\%)$. 2. With regard to the relationship of back pain to the occupational characteristics, statistically significant differences were observed between workers with and without back pain concerning the job factors on work-time, job satisfaction, mental stress, chair fittness, work posture, work rotation, weight lifting, monotonous repetitive movements, vibration, and heavy noise (p<0.05). 3. With regard to the relationship of back pain to the social characteristics, there were no differences with respect to having car, personality types, drinking habits, and leisure-time activities. However, significant differences were showed between no pain and pain groups for the using bed, sleeping posture, traffic time amount, walking health state, smoking habits, and physical exercise (p<0.05). 4. The comparative analysis of back pain related to work factors showed highly significant differences with respect to mental stress, chair fittness, work posture, trunk rotation, weight lifting, monotonous repetitive work in White collar group (p<0.01) ; and job satisfaction, mental stress, trunk rotation, weight lifting, monotonus repetitive work, exposure to vibration and heavy noise in Blue collar group(p<0.01). 5. The comparative analysis of social factors in two groups showed differences with respect to the using bed, sleeping posture, walking amount, health state, physical exercise, smoking habits in White cellar group (p<0.05) ; and walking amount, traffic time amount, health state, smoking habits, physical exercise in Blue cellar group (p<0.05). 6. In regard to the general aspects of back pain between two groups, there were differences concerning etiolgy of back pain, counselling partners, treatment types, and sick-leaves(p<0.05), except pain duration, and awareness of back pain.

• 동서간호학연구지
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• 제1권1호
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• pp.22-39
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• 1997

Purpose: The purpose of this study is to evaluate the effect of rehabilitation education on the reduction of the stress of family members who have patients suffering from stroke and to find a new way to nurse the patients and their family. Subjects & Methods: The subjects were sixty-one family members with the patients who had been hospotalized in K hospital of oriental medicine from september the 9th, 1996 to september the fourteen, 1996. This study was performed by simulated control group pretest-posttest design; pretest was done on the control group through a questionnaire, counselling and observation while posttest was done on the experimental group 1-2 days after systemic rehabilitation education. To teach the patients and their family, the amended version of a book written by Lee Hae-jin was used as a tool for systemic rehabilitation education. As a method to estimate ADL score, modified Kang's method was applied and ADL score was measured by well-trained technician. As for the tool to estimate the degree of family stress, Choi's method adjusted to this study was applied. In the analysis of the data, social property of the patient and the characteristic of the disease were surveyed in $X^2$ examination to confirm the consistency between the experimental group and the control group. The diffrence in the degree of the stress, which is a dependent factor, was examined by t-test. The difference in ADL score between the experimental group and the control group was examined by t-test. The difference in the degree of the stress according to the general feature of the family with stroke patient, social property of the patients and the characteristic of the disease were surveyed by F examination. The difference in family stress according to the degree of ADL was surveyed by F examination. RESULTS: 1. After hypothetically-examined systemic rehabilitation education, the total of the score of family stress surveyed in 34 items of three domains was compared between the experimental group and the control group. There was no statistically significant difference between two groups; mean score of experimental group=2.28, that of control group=2.93(t=.17, df=59, p=. 66). 2. In the survey on family stress in 34 items, the items over mean score 3.0 were firstly the anxiety of possible disability and relapse of the disease and secondly to watch the patient's suffering without doing anything in the domain of the change of the disease and the difficulty in caring. And the items of the lowest stress with less than mean 2.0 score were little chance to meet the relative and friends, inconsistent treatment and attitude of the medical workers and the change of the attitude of the relative due to the patient orderly in the domain of social and personal relation and the responsibility as the family. The items which showed the difference between two groups were aggravation of neighboring patient(t=3.36, df= 59, p=.001) and the possibility of patient's death(t=2.19, df=58.38, p=.033) in the domain of the change of the disease and the difficulty in caring. 3. In the study on the stress difference according to general features of the family with the stroke patient, the score of family stress with the occupation was higher with mean 2.49 than that of the family stress without occupation with mean 2.16, but there was no significant difference. (F=5.21, df=1/59, p=.026). 4. In the study on the stress difference according to social property of the patient and the characteristic of the disease, there was significant difference in the age of the patients (F=2.98, df=3/57, p=.039). These results show that even if there is no statistically significant difference between two groups, sixteen of the experimental group are less than 3.0 in ADL score(standard 6 score)while eight of the control group are less than 3.0 and that ten of the experimental group are in the year range of 39-49 while four of the control group are in the year range of 39-49 which showed significant difference in family stress. These imply that there is a possibility that the experimental group have serious and fundamental stress resulting in high pretest stress compared with the control group. It might be due to the characteristic of simulated control group pretest-posttest design that the psychologic-supportive effect by the education was not observed. On the basis of these results, the followings are suggested. 1) A study on the nursing-mediated method to reduce the stress in the items which are not resolved by rehabilitation education, a study on nursing according to the patient's age and a study on the supportive nursing toward the family with occupation are required. 2) More than two times consecutive nursing-mediated rehabilitation education to measure the family stress is required. 3) Comprehensive and multilateral systemic education program including the instruction on western-eastern medicine, physical therapy, exercise and diet through collaboration of the experts in each field is required. 4) Family stress at home as well as in the hospital needs to be estimated and home rehabilitation and home-nursing needs to be continued.

• 벤처창업연구
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• 제11권6호
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• pp.71-81
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• 2016

2000년에 접어들어 고령화 사회로 진임하게 된 대한민국은 2017년 고령사회로의 진입하게 됨에 따라 장기적으로 청년 노동력의 감소와 그로인한 숙련된 중장년 및 고령인구의 감소가 국가경제의 중요이수로 부각되고 있다. 따라서 은퇴 및 실직자들의 창업 및 재취업이 사회의 중요한 화두가 되고 있다. 본 연구는 중년기를 위한 창업 및 재취업교육이 재취업불안, 재취업스트레스 그리고 창업의도에 미치는 영향을 분석하고자 실시하였다. K에 소재한 G교회에 출석중인 은퇴자 67명을 선정한 후 각각 실험집단 32명과 통제집단 35명으로 구분하였다. 매주 1회 총 13회기의 창업 및 재취업교육을 실시하였으며, 본 연구에서 나타난 주요 결과를 요약하여 제시하면 다음과 같다. 첫째, 창업 및 재취업 교육에 참여한 실험집단은 참여하지 않은 통제집단보다 재취업불안이 감소되었다. 둘째, 창업 및 재취업 교육에 참여한 실험집단은 참여하지 않은 통제집단보다 재취업스트레스가 감소되었다. 셋째, 창업 및 재취업 교육에 참여한 실험집단은 참여하지 않은 통제집단보다 창업의도가 향상되었다.

• 직업교육연구
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• 제30권4호
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• pp.161-177
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• 2011

본 연구는 의과대학생들의 진로적응에 대한 자기조절학습의 영향을 알아보기 위한 것이다. 이를 위하여 대구지역 K 의과대학에 재학 중인 252명의 학생들을 대상으로 자기조절학습과 진로적응 검사를 실시하였으며, 진로적응 수준에 따라 고 저 집단으로 나눈 후 이들 집단 간 자기조절학습 정도에 대하여 집단 간 차이검증(독립표본 t검증)을 실시하였다. 그 결과 시험불안을 제외한 모든 자기조절학습 영역에서 진로적응이 낮은 집단에 비하여 높은 집단의 점수가 높은 것으로 나타났다. 또한 진로적응의 하위요인인 책임감, 대인관계, 주도성, 긍정적 태도에 대한 자기조절학습의 영향력을 알아보기 위하여 회귀분석을 실시해본 결과, 전체 진로적응점수에 대하여 인지조절과 행동조절이 통계적으로 유의한 영향을 미치는 반면, 동기조절은 유의한 영향을 미치지 않는 것으로 나타났다. 그러나 진로적응의 하위요인인 책임감과 대인관계에서는 통계적으로 유의한 영향을 미치지 않았지만 주도성과 긍정적 태도에 대해서는 동기조절의 유의한 영향력이 검증되었다. 이러한 결과에 따라 본 연구자들은 개인적인 메타인지, 동기, 행동 전략의 구사와 조절능력이 개인의 진로적응성에 미치는 영향에 대하여 논하였으며, 의과대학에서의 학생적응을 돕기 위한 자기조절과 관련된 중재의 필요성과 진로적응을 돕기 위한 상담 및 교육의 필요성을 제안하였다.

• 한국보육학회지
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• 제18권4호
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• pp.51-63
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• 2018

본 연구의 목적은 자기격려와 사회적 지지가 보육교사의 심리적 소진에 어떠한 영향을 미치는지 살펴보고자 하는데 있고, 연구대상은 제주특별자치도에 위치한 어린이집 교사 329명이었다. 본 연구에서 사용된 측정도구는 자기격려 척도, 사회적 지지 척도, 심리적 소진 척도이며, 수집된 자료는 SPSS win 18.0을 활용하여 분석하였다. 본 연구에 의해 도출된 결론은 다음과 같다. 첫째, 보육교사의 개인변인에 따른 자기격려, 사회적 지지, 심리적 소진의 차이를 살펴보면, 자기격려는 연령대에서, 사회적 지지는 연령대와 경력에서, 심리적 소진은 연령대 및 결혼유무에서 차이를 나타냈다. 둘째, 보육교사의 자기격려와 사회적 지지는 심리적 소진과 부적 상관을 나타내어, 자기격려와 사회적 지지가 높을수록 심리적 소진이 낮음을 알 수 있었다. 셋째, 자기격려와 사회적 지지는 보육교사의 심리적 소진에 부적 영향을 미쳤다. 자기격려의 하위 요인 중에서는 인지적 자기격려와 정서적 자기격려가 심리적 소진에 부적 영향을 미치는 것으로 나타났으며, 사회적 지지의 하위 요인에서는 정서적 지지가 보육교사의 심리적 소진에 부적 영향을 미치는 것으로 나타났다. 특히 자기격려는 사회적 지지보다 보육교사의 심리적 소진을 감소시키는 주요한 요인임을 확인하였다. 이는 보육교사의 개인변인을 고려한 자기격려 및 사회적 지지 증진 전략과 심리적 소진 감소 방안과 보육교사의 심리적 소진의 효과적인 완화와 예방을 위한 자기교수전략이 필요함을 시사한다. 따라서 상담적 접근을 통해 보육교사들의 심리적 안녕감 증대와 심리적 부적응 등으로 인해 나타나는 복합적인 문제들에 대한 예방과 치료가 필요하다.

• 한국노년학
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• 제30권4호
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• pp.1179-1195
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• 2010

본 논문은 독거노인의 자아통합감이 삶의 질에 미치는 영향을 검증했다. 또한 주관적 건강의 다양한 영역별 차이에 따라서 자아통합감이 삶의 질에 미치는 영향이 다름을 검증했다. 설문조사를 위해서 전주시의 노인복지관 이용자 중에서 독거노인을 편의 추출하였고 265명이 분석대상이 되었다. 신뢰도와 타당도 분석을 위해 자아통합감, 삶의 질 그리고 SF36 주관적 건강을 확인요인분석 하였으며, 구조방정식 모델을 이용하여 인과분석과 주관적 건강요인별로 조절효과를 분석했다. 분석결과로 첫째, 독거노인의 자아통합감이 클수록 노인의 삶의 질은 높아지는 것을 확인할 수 있었다. 둘째, 신체기능이 저조할수록 자아통합감은 삶의 질에 더 큰 영향을 미치고 있음을 검증했다. 셋째, 신체로 인한 역할 제한이 많을수록 자아통합감은 삶의 질에 더 큰 영향을 미치는 것으로 확인되었다. 연구를 통해서 주관적 건강이 노년의 삶에 미치는 영향에 대한 상반된 견해가 발생하는 원인을 설명할 수 있었으며, 주관적 건강의 영역과 정도에 따라 개입 방향이나 효과가 다를 수 있음을 제시하였다.

• 한국임상약학회지
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• 제25권2호
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• pp.94-101
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• 2015

Background: In order to achieve the goals of community pharmacy practice, its legal, labour-related, and economic barriers need to be identified. This study examined pharmacists' perceptions of constraints on providing optimal pharmacy services in order to identify underlying factors and analyse the associations between barriers and pharmaceutical services in community pharmacies. Methods: A survey targeting pharmacy owners was conducted from May to June 2012 using a structured questionnaire including nine pharmaceutical service items. According to the service provision level, we classified pharmacists as inactive (fewer than 5 items among the listed 9 service items) and active providers (5 or more items). Principal component analysis was used to group significant factors for barriers into four thematic components. Associations between the participants' demographics and pharmacy characteristics and the services provided were explored by logistic regression analyses. Results: Participants were 402 pharmacists. Over 60% provided disease management services for hypertension, diabetes, and hyperlipidaemia. Variables that affected pharmaceutical services included the lack of separate areas for patient counselling (OR: 2.12, 95% CI: 1.18-3.80), and clinical knowledge and information-related barriers (OR: 0.59, 95% CI: 0.36-0.97). Conclusion: Strategies for improving clinical knowledge and providing expeditious information are necessary in order to improve community pharmacy services.

• 아동학회지
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• 제38권1호
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• pp.95-116
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• 2017

Objective: Middle school girls who belonged to the concerned group in their school assessment were treated by sandplay for relieving their emotional and behavioral difficulties. The purpose of this study was to explore the change of the internal world of the girls through sandplay. Methods: Analytical psychology and sandplay theories were used for this exploration, especially Turner's (2005) content themes in sandplay. The participants were four first-grade girls. Pre-test measures, a 12-session sandplay program, and post-test measures were administered. Results: For the first girl, the initial phase was 1-6 (time trip), the intermediate phase was 7-9 (seeking for an inner island), and the final phase was 10-12 (seeking for a real stone). For the second girl, the initial phase was 1-5 (my heart was like cold weather), the intermediate phase was 6-10 (fallen, sick, and risen), and the final phase was 11-12 (trophy given to me). For the third girl, the initial phase was 1-5 (seeking for oasis), the intermediate phase was 6-10 (difficult trip for climbing with camel), and the final phase was 11-12 (discovering oasis). For the fourth girl, the initial phase was 1-3 (an island drowning shortly ), the intermediate phase was 4-10 (my unknowable mind), and the final phase was 11-12 (a tree growing well). Conclusion: This study showed psychological phenomena in the sandplay of four girls such as opposites and the union of masculinity and femininity as they explored their own identity. Drawing tests and counselling objects indicated positive changes; thus, these findings support the effectiveness of sandplay therapy for transforming the psyche of middle school girls.

• 한국콘텐츠학회논문지
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• 제15권8호
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• pp.304-312
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• 2015

본 연구는 간호대학생의 진로자기효능감, 진로적응성 및 진로스트레스에 대한 진로교육 프로그램의 효과를 확인하기 위하여 시도되었다. 실험 전 후 차이를 비교하는 단일군 전후 실험 설계로 95명의 간호대학생을 대상으로 실시되었다. 진로교육 프로그램은 4개 영역들(1) 진로 탐색, (2) 자기 이해, (3) 진로 계획 수립 (4) 진로 계획 실천으로 구성되었으며 상담, 전문가 특강, 모의면접 및 면접결과 분석으로 진행되었다. 수집된 자료는 SPSS 20.0 program을 사용하여 평균과 표준편차, paired t-test와 ANCOVA로 분석하였다. 진로교육 중재 후 간호학생들의 진로 자기효능감 점수(t=4.48, p<.011)와 진로응성 점수(t=3.02, p=.003)는 유의하게 증가하였고 진로스트레스 점수(t=-2.45, p=.015)는 유의하게 감소하였다. 본 연구는 간호대학생에게 진로교육 프로그램이 진로자기효능감과 진로적응성 증가시키고 진로스트레스를 개선시키는 역할을 실증적으로 확인하였다는 점과 진로스트레스 관리를 위한 진로교육 프로그램의 개발에 기초 자료를 제공하였다는 점에서 의의를 찾을 수 있다.