• 한국콘텐츠학회논문지
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• 제15권10호
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• pp.626-635
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• 2015

건강에 대한 사회적인 욕구와 관심에 따라 만성질환 예방 및 식생활관리 서비스의 새로운 모델로 U-Healthcare 서비스가 주목 받고 있다. 본 연구는 50세 이상의 남녀 중장년층을 대상으로 U-Healthcare 서비스 관련 요구 특성을 조사하였다. 조사대상의 U-Healthcare 서비스에 기대하는 부분으로 개인 맞춤형 진료 및 관리 부분(37.7%), 개인의 건강상태의 체계적인 파악(21.4%)이 높게 나타났다. 건강관리 이용 분야에서는 식이요법 관리(43.9%)가 가장 높게 나타나 U-Healthcare 서비스에서 개인 맞춤형 식이요법 서비스가 필요할 것으로 보였다. 건강 정보 검색 관심분야는 질병관리(35.6%), 식재료(28.6%), 건강음식 조리법(22.7%) 순으로 나타나 조사대상의 50% 이상이 식품에 관심이 있었다. 식단 정보에 대한 요구사항은 영양성분, 건강상태별(질환별) 맞춤형 식단 등을 5점 척도로 조사한 결과 모든 항목이 3.9 이상의 필요성이 있다고 답변하였다. 이상의 결과를 통해 현재의 중장년층은 U-Healthcare 서비스를 통해 질병관리와 더불어 식생활 관리 서비스를 요구하고 있는 것을 확인하였다. 따라서 본 연구의 후속 연구로 남녀 중장년층 집단의 요구 특성을 반영하여 원격 진료를 통해 매일매일 개인의 건강상태 및 질환의 진행 정도를 파악하고 그에 따라 필요한 식재료, 식단, 조리법에 대한 처방을 U-Healthcare 서비스로 제공할 수 있는 데이터베이스를 구축하고자 한다. 이를 통해 식생활 관리 콘텐츠의 활용도를 높이고 미래의 고령자들이 건강한 삶을 영위할 수 있을 것으로 기대한다.

• 치위생과학회지
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• 제17권4호
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• pp.323-332
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• 2017

본 연구는 20세 이상 경제활동자의 구강검진 수진에 영향을 미치는 요인을 파악하기 위해 제6기 국민건강영양조사(2014) 자료를 이용하여 복합표본설계로 분석하였다. 구강검진 여부에 응답한 2,843명을 대상으로 다음과 같은 결론을 얻었다. 첫째, 20세 이상 경제활동자의 건강검진 수진율은 66.5%, 구강검진 수진율은 30.1%로 건강검진 수진율 절반 수준에도 미치지 못하였다. 둘째, 소인성 요인에 따른 구강검진 수진 여부를 비교한 결과 연령에서 40대(34.3%)와 50대(34.3%)가 가장 높고, 30대(30.1%), 20대(27.5%), 전기노인(24.9%), 후기노인(12.0%) 순이었다. 셋째, 가능성 요인에서는 개인소득이 상위집단일수록, 교육수준이 높을수록 구강검진 수진율이 높았다. 개인소득이 하위그룹에 비해 상위그룹이 구강검진을 받을 확률이 1.50배 높았고, 대졸 이상인 사람에 비해 초졸 이하인 사람은 0.37배, 중졸인 사람은 0.49배 구강검진을 받을 확률이 낮았다. 건강보험종류에 따라 직장보험(33.5%) 가입자가 지역보험(24.2%) 가입자에 비해, 민간의료보험 가입자(31.7%)가 비가입자(22.7%)에 비해 구강검진 수진율이 높게 나타났다. 넷째, 필요성 요인에서는 치통을 경험한 사람(36.9%)이 치통을 경험하지 않은 사람(25.9%)에 비해, 구강검진 수진 확률이 0.55배 낮았다. 영구치우식 유병자(23.2%)가 영구치우식 비유병자(33.0%)보다 구강검진 수진 확률이 0.62배 낮았다. 이상의 결과로 볼 때 20세 이상 경제활동자의 구강검진 수진에 영향을 미치는 요인은 의료자원의 이용을 가능하게 하는 외적요인인 가능성 요인(개인소득, 교육수준, 건강보험종류, 민간의료보험가입 여부), 상병의 수준을 의미하는 필요성 요인(치통 경험 유무, 영구치우식유병 여부), 질병 이전부터 존재해 온 개인의 특성을 의미하는 소인성 요인(연령) 등이 복합적으로 작용하는 것으로 나타났다. 따라서 효과적인 구강검진 및 치료체계를 확립하기 위해서는 개인의 구강관리라는 행태적 요인뿐만 아니라 의료자원의 이용을 가능하게 하는 가능성, 소인성, 필요성 등 다양한 요인을 종합적으로 고려할 필요가 있음을 본 연구결과는 시사해 주고 있다.

• 한국의료질향상학회지
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• 제5권2호
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• pp.324-334
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• 1998

Background : Strategic planning is an organizationwide or systemwide, ongoing look into the future usually of 2~3 years, based on objective analysis of the current environment and trends, but it can incorporate both short-term and long-term goals. The strategic planning process includes external analysis, internal analysis, issue analysis, development of mission, vision and values, and lastly development of organizational goals and objectives. As a part of the strategic quality planning process, certain service lines, important organizationwide functions, or key processes supporting these functions can be prioritized to expedite and roll out certain strategic goals. This is called strategic quality initiatives. Methods : We organized a quality improvement team, a subgroup of 21st century vision planning corps of our medical center, and pursued QI activities for improvement of healthcare environment, particularly in the admission setting. We developed a strategic quality initiative based on the results of patient satisfaction surveys, and carried out functions of self-directed work team. Results : The strategic goal was to be the benchmark for peer group hospitals in Korea for providing cost-effective best-practice. The QI team included 3 medical doctors, 1 nurse, 1 social worker, and 1 QI consultant as well as many operational members to support services and quality initiatives met every Tuesday for 18 weeks. Outcome objectives were to improve patient satisfaction score. The issues included in the objectives were comfort, temperature, noise, cleanliness of the admission wards, quality and education of patient meals, matters regarding the admission process, and an appurtenant facility such as restaurant or convenience store. Every issue was discussed and recommendations, conclusions and opportunities were implemented. Conclusions : By developing a strategic quality initiative as a part of the strategic quality planning process, and pursuing a self-directed work team, certain sen/ice lines, important organizationwide functions, or key processes supporting these functions can be improved effectively within a short period. Strategic quality initiatives serve to support, or roll out, certain strategic goals that are relevant to performance improvement and development of specific measurable outcome objectives, and associated performance measure for each initiative. Each strategic quality initiative should include a statement of intent outcome objectives, and performance measures. We will come back with follow up of the strategic quality initiative, for improvement of healthcare environment, and results of patient satisfaction re-survey.

• 대한통합의학회지
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• 제12권3호
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• pp.163-178
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• 2024

Purpose : This study aimed to evaluate the effectiveness of an integrative medical service model applied to breast cancer patients and their caregivers, exploring its feasibility and challenges within the context of South Korean healthcare system. Methods : A case study approach was chosen to assess the integrative medical service model's efficacy, involving one breast cancer patient and her primary caregiver from W University Hospital. The patient had completed reconstructive surgery and chemotherapy and was undergoing radiotherapy. The model included standard treatments alongside psychological counseling, aromatherapy, axillary rehabilitation exercise, make-up program, art therapy, laughter therapy, horticultural therapy, and yoga programs, and meditation programs delivered over eight weeks. Quantitative and qualitative data were collected through surveys, psychological tests, and feedback assessments. Results : The integrative medical service model demonstrated notable improvements in the quality of life for both breast cancer patients and their caregivers. Participants reported enhanced emotional well-being, reduced stress levels, and improved coping mechanisms throughout the treatment journey. Qualitative feedback highlighted the positive impact of holistic interventions in alleviating psychological distress and fostering resilience. Quantitative data corroborated these findings, showing statistically significant improvements in various psychosocial parameters assessed. Conclusions : Our findings underscore the benefits of integrative medical service model with standard medical treatments in the care of breast cancer patients and their caregivers. The holistic approach not only addresses physical symptoms but also enhances overall well-being and quality of life. However, the implementation of such models faces challenges within the South Korean healthcare system, including fragmented service networks and financial constraints. Addressing these structural barriers is crucial for the widespread adoption and sustainability of integrative care models in oncology practice. Future research should focus on larger-scale studies to further validate these findings and inform policy decisions aimed at optimizing cancer care delivery.

• 여성건강간호학회지
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• 제5권3호
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• pp.379-388
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• 1999

Breastfeeding is an excellent way of feeding infants and continues to be an important source of nutrition and antibodies for infants. Although breast-feeding is believed to be important, the rate of breastfeeding among Korean women is very low. One reason for the low breastfeeding rate is that the health professionals in the past have given little practical help couples to overcome difficulties encountered during breastfeeding. The promotion of breastfeeding has recently become a high priority among health professionals because of the undisputed physiological, psychological, social, economic, and nutritional benefits. Fathers have been found to influence the course of breastfeeding, but no one has conducted a systematic investigation into in and included fathers perspectives of breastfeeding in Korea. It is important to find strategies to solve the problems by assessing the knowledge, attitude and practice of breastfeeding with fathers as well as mothers. The purpose of this research is to find ways to promote primiparous(first child) couples's breastfeeding by assessing their general knowledge, attitude and practice of it. More specifically its purposes is to identify the relationship between knowledge, attitude, practice and the background factors of breastfeeding of primiparous couples in order to promote and support breastfeeding. The data will help health professionals to guide first-pregnancy couples to prepare and overcome any difficulties encountered during breastfeeding. Data were collected through a questionnaire which included both structured and open-ended questions. The questionnaire was composed referencing earlier literature, studies and surveys. This survey was made postpartum 2-3days after childbirth on 96 couples. The numbers of subjects for data analysis were selected 51 couples through pilot screening test. Data were coded and analyzed using the Statistical Package for Social Sciences : Cronbach's alpha coefficient, T-test, ANOVA, Stepwise pearson's correlation coefficient. The relations between the variables of breastfeeding were examined using a Pearson's correlation coefficient. This study showed that, the internal validity of the instrument was tested by Cronbach's alpha. The result was : mother knowledge 0.72, mother attitude 0.88, and father knowledge 0.70, father attitude 0.92, practice 0.76 and planning of breast feeding 0.95. The average age of mothers in the sample was 28.9 years old, and the average age of fathers in the sample was 31.3 years old. The other descriptive informations available included. the study also found that fathers were more important than doctors or nurses. However results of the study indicate that there were no differences between father and mother knowledge of breastfeeding(t=-0.39, p=0.698), and father attitude was statistically significant higher than mother attitude of breastfeeding (t=2.24, p=0.030). In analysis, the variable 'practice' with breastfeeding was the relationship with mother knowledge (p=0.031) and mother attitude(p=0.015). In this study, the correlation between one couple' knowledge and attitude was not significant. Primiparous couples surveyed in the postpartum period regarding knowledge, attitude and practice about breastfeeding might be affected by recall bias, the effects of the euphoria of the first 24-48 hours postpartum, but these variables were not examined. This study results add to the body of knowledge about nursing care for breastfeeding mothers and fathers. This indicates that a need for education about breastfeeding and, that fathers be included in it as well as mothers.

• 정신신체의학
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• 제25권2호
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• pp.200-209
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• 2017

연구목적 본 연구는 일지역사회의 노인 불면 및 우울 증상과 인구사회학적 변수들과의 상관관계에 대해 분석하고, 이들 변수들이 우울증에 미치는 영향을 확인하고자 하였다. 방 법 광명시에 거주 중인 60세 이상의 노인을 대상으로 불면 및 우울 정도를 평가하고 그와 관련되는 인구사회학적 요인에 대하여 조사하였다. 2016년 4월 20일부터 2016년 12월 1일까지의 기간 동안 ${\bigcirc}{\bigcirc}{\bigcirc}$병원 정신건강의학과 위탁 광명시 정신건강증진센터에서 광명시에 위치한 복지관과 경로당을 방문하여 경기도 광명시에 거주하는 노인 총 837명을 대상으로 설문조사와 면담을 시행하였다. 인구사회학적 항목과 불면 증상, 우울 증상의 연관성을 살펴보기 위해 ISI와 S-GDS를 사용하여 구조화된 면담을 시행하였다. 결 과 연령(70대 미만, 70대, 80대, 90대 이상), 의료보장형태(건강보험, 의료보호), 주거 형태(자가, 비자가), 결혼 상태(미혼, 기혼, 이혼 및 사별)에 따른 S-GDS 평균 점수에서 유의한 차이가 나타났다. 학력에 대해서는 초졸 또는 무학인 경우와 대졸 이상인 경우를 비교했을 때 평균에 유의한 차이가 나타났다(F=3.227, p=0.012). S-GDS 10점 이상과 미만군으로 나누어 인구사회학적 인자들을 비교한 결과, 연령, 의료보장형태, 주거 형태, 동거 가족의 수에서 유의한 차이가 나타났다(p<0.05). ISI로 측정한 불면 증상은 인구사회학적 항목과는 유의한 관련성이 나타나지 않았으나(p>0.05), 우울 증상과는 유의한 연관성이 나타났다(p<0.05). 불면 증상이 심할수록 우울 증상이 나타날 확률이 더 높았으며 또한 우울 증상을 보이는 노인들의 경우 더 심한 불면 증상을 갖는 것으로 나타났다. 결 론 노인 우울증은 인구사회학적 요인 중 연령, 의료보장형태, 주거 형태, 결혼 상태, 학력 및 동거 가족의 수와 유의한 연관성을 갖는다. 또한 노인 우울증의 주요 증상인 불면 증상은 우울 증상의 심각도와 진단을 예측할 수 있는 중요한 의미를 갖는 것으로 나타났다.

• Asian Journal of Atmospheric Environment
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• 제7권2호
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• pp.72-84
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• 2013

In the study, pollution levels of indoor polycyclic aromatic hydrocarbons (PAHs) in public facilities (vapor phase or particulate phase) were evaluated, and a health risk assessment (HRA) was carried out based on exposure scenarios. Public facilities in Korea covered by the law, including underground subway stations, funeral halls, child care facilities, internet cafes (PC-rooms), and exhibition facilities (6 locations for each type of facility, for a total of 48 locations), were investigated for indoor assessment. For the HRA, individual excess cancer risk (ECR) was estimated by applying main toxic equivalency factor (TEF) values suggested in previous studies. Among the eight public facilities, internet cafes showed the highest average $PM_{2.5}$ concentration at $110.0{\mu}g/m^3$ (range: $83.5-138.5{\mu}g/m^3$). When assuming a risk of facility exposure time based upon the results of the surveys for each public facility, the excess cancer risk using the benzo(a)pyrene indicator assessment method was estimated to be $10^{-7}-10^{-6}$ levels for each facility. Based on the risk associated with various TEF values, the excess cancer risk based upon the seven types cancer EPA (1993) and Malcolm & Dobson's (1994) assessment method was estimated to be $10^{-7}-10^{-5}$ for each facility. The excess cancer risk estimated from the TEF EPA (2010) assessment was the highest: $10^{-7}-10^{-4}$ for each facility. This is due to the 10-fold difference between the TEF of dibenzo(a,e)fluoranthene in 2010 and in 1994. The internet cafes where smoking was the clear pollutant showed the highest risk level of $10^{-4}$, which exceeded the World Health Organization's recommended risk of $1{\times}10^{-6}$. All facilities, with the exception of internet cafes, showed a $10^{-6}$ risk level. However, when the TEFs values of the US EPA (2010) were applied, the risk of most facilities in this study exceeded $1{\times}10^{-6}$.

• Tuberculosis and Respiratory Diseases
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• 제82권1호
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• pp.27-34
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• 2019

Background: Understanding the burden of disease is important to establish cost-effective treatment strategies and to allocate healthcare resources appropriately. However, little reliable information is available regarding the overall economic burden imposed by chronic obstructive pulmonary disease (COPD) in Korea. Methods: This study is a multicenter observational research on the COPD burden in Korea. Total COPD costs were comprised of three categories: direct medical, direct non-medical, and indirect costs. For direct medical costs, institutional investigation was performed at 13 medical facilities mainly based on the claims data. For direct non-medical and indirect costs, site-based surveys were administered to the COPD patients during routine visits. Total costs were estimated using the COPD population defined in the recent report. Results: The estimated total costs were approximately 1,245 million US dollar (1,408 billion Korean won). Direct medical costs comprised approximately 20% of the total estimated costs. Of these, formal medical costs held more than 80%. As direct non-medical costs, nursing costs made up the largest percentage (39%) of the total estimated costs. Costs for COPD-related loss of productivity formed four fifths of indirect costs, and accounted for up to 33% of the total costs. Conclusion: This study shows for the first time the direct and indirect costs of COPD in Korea. The total costs were enormous, and the costs of nursing and lost productivity comprised approximately 70% of total costs. The results provide insight for an effective allocation of healthcare resources and to inform establishment of strategies to reduce national burden of COPD.

• Nutrition Research and Practice
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• 제18권1호
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• pp.149-164
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• 2024

BACKGROUND/OBJECTIVES: The economic recession caused by the coronavirus disease 2019 pandemic disproportionately affected poor and vulnerable populations globally. Better uunderstanding of vulnerability to shocks in food supply and demand in the Asia Pacific region is needed. SUBJECTS/METHODS: Using secondary data from rapid assessment surveys during the pandemic response (n = 10,420 in mid-2020; n = 6,004 in mid-2021) in India, Indonesia, Myanmar, and Vietnam, this study examined the risk factors for reported income reduction or job loss in mid-2021 and the temporal trend in food security status (household food availability, and market availability and affordability of essential items) from mid-2020 to mid-2021. RESULTS: The proportion of job loss/reduced household income was highest in India (60.4%) and lowest in Indonesia (39.0%). Urban residence (odds ratio [OR] range, 2.20-4.11; countries with significant results only), female respondents (OR range, 1.40-1.69), engagement in daily waged labor (OR range, 1.54-1.68), and running a small trade/business (OR range, 1.66-2.71) were significantly associated with income reduction or job loss in three out of 4 countries (all P < 0.05). Food stock availability increased significantly in 2021 compared to 2020 in all four countries (OR range, 1.91-4.45) (all P < 0.05). Availability of all essential items at markets increased in India (OR range, 1.45-3.99) but decreased for basic foods, hygiene items, and medicine in Vietnam (OR range, 0.81-0.86) in 2021 compared to 2020 (all P < 0.05). In 2021, the affordability of all essential items significantly improved in India (OR range, 1.18-3.49) while the affordability of rent, health care, and loans deteriorated in Indonesia (OR range, 0.23-0.71) when compared to 2020 (all P < 0.05). CONCLUSIONS: Long-term social protection programs need to be carefully designed and implemented to address food insecurity among vulnerable groups, considering each country's market conditions, consumer food purchasing behaviors, and financial support capacity.

• 대한지역사회작업치료학회지
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• 제8권1호
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• pp.1-10
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• 2018

목적 : 본 연구의 목적은 노인의 지역사회 이동성을 측정하는 평가도구인 한국어판 생활공간 평가(Korean Version of the Life Space Assessment; K-LSA)의 임상적 유용성 및 사용성을 검증하는 것이다. 연구방법 : 작업치료사와 물리치료사 60명을 대상으로 K-LSA의 임상적 유용성 및 사용성 검증에 관한 설문조사를 실시하였다. 설문지는 임상적 유용성에 관한 객관식 문항 및 사용성에 관한 객관식과 주관식 문항을 포함하였다. 객관식 자료 분석은 빈도 분석 및 기술 통계로 처리하였고, 사용성에 대한 주관식 문항은 항목별로 공통적인 요소를 모아 분류하여 분석하였다. 결과 : K-LSA의 임상적 유용성에 긍정적 표현인 '보통(3점)'과 '그렇다(4점)'와 '매우 그렇다'로 응답한 비율이 95~100%이었고, 문항 별 점수 분포가 3.6~4.0점으로 나타났다. 또한 K-LSA의 사용성에 대한 질문에 긍정적 표현인 '보통'과 '쉽다'와 '매우 쉽다'로만 응답한 비율은 88.3~100%이었고, 문항 별 점수 분포가 3.6~4.0점으로 나타났다. 추가적으로 사용성에 대한 개방형 질문에서 생활공간 범위 3과 4에서 기준의 모호함이 언급되었다. 결론 : K-LSA는 국내 보건의료 분야에서 지역사회 이동성을 측정하는 평가도구로 임상적으로 유용하며, 사용이 용이한 도구이다. 따라서 치료사들이 노인의 사회 참여를 증진시키고, 지역사회 이동을 위한 중재 목표를 세우고, 교육하는데 기초자료로 LSA를 활용할 수 있을 것이다.