• 근관절건강학회지
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• 제2권1호
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• pp.17-40
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• 1995

Rheumatoid arthritis is the one of the chronic diseases, one of its major symptoms is a chronic pain. Despite developing medical treatment and surgical techniques, it is suggested that to control the pain is the goal of the treatment. But pain is an inner experience and even those closest to the patient cannot truly observe its progress or share in its suffering. The National Academy of Sciences Institute of Medicine's report on Pain and Disability concluded that there is no objective measure of pain-(exactly) no pain thermometer-nor can there ever be one, because the experience of pain is inseparable from personal perception and social influence such as culture. To explore chronic pain experience is to understand the process and property of the patient's perception of pain through the response to pain, the coping with pain, and the adaptation to pain. Therefore a qualitative study was conducted in order to gain an understanding of pain experience of patients with RA in korea. I used naturalistic inquiry as a research methodology, which had 5 axioms, the first is that realities are multiple, constructed, and holistic, the second is that knower and known are interactive, inseparable, the third is only time and context bound working hypotheses(idiographic statements) are possible, the forth is all entities are in a state of mutual simultaneous shaping, so that it is impossible to distinguish causes from effects and the last is that inquiry is value-bound. Purposive sampling was conducted as a sampling. 20 subjects who experienced pain over 10 years, lived in middle-sized city and big city in Korea, and 17 women and 3 men. The subject's age was from 32 to 62 (average 48.8), all were married, living with their spouse and children, except two-one divorced and the other widow before they became ill. I collected data using In depth structured interview. I had interviews two or three times with each subject, and the interviews were conducted at each subject's home. Each interview lasted about two hours an average. A recording was taken with the consent of the subject. I used inductive data analysis-such as unitizing and categorizing. unitizing is a process of coding, whereby raw data are systematically transformed and aggregated into units. Categorizing is a process wherby previously unitized data are organized into categories that provide descriptive or inferential information about the context or setting from which the units were derived. This process is used constant comparative method. The pain controlling process is composed of behavior of pain control. The behaviors of pain control are rearranging of ADL, hiddening role conflict, balancing treatment, and changing social relation. Rearranging of ADL includes diet management, sleep management, and the adjustment of daily life activities. The subjects try to rearrange their daily activities by modified style of motions, rearranging time span & range of activities, using auxillary facilities, and getting help in order to keep on the pace of daily life. Hiddening role conflict means to reduce conflicts between sick role and their role as a family member. In this process, the subjects use two modes, one is to control the pain complaints, and the other is to internalize the value which is to stay home is good for caring her children and being a good mother. To control pain complaints is done by 'enduring', 'understanding' the other family members, or making them undersood in order to reduce pain. Balancing treatment is composed of two aspects. One is to keep the pain within the endurable level, the other is to keep in touch with medical personnel in order to get the information of treatment and emotional support. Changing social relation is made by information seeking and sharing, formation of mutual support relation, and finally simplification of social relationships. The subjects simplify their social relationships by refraining from relations with someone who makes them physically and psychologically strained. In particular the subjects are apt to avoid contact with in-laws, and the change of relation to in-laws results in lessening the family boundary. In the course of this process, they confront the crisis of family confict result in family dissolution. This crisis is related to the threat of self-existence. Findings from this study contribute to understanding the chronic pain experience. To advance this study, we should compare this result with other cases in different cultural contexts. I think to interpret these results, korean cultural background should be considered. Especially the different family concept, more broader family members and kinship network, and the traditional medical knowledge influences patients' behavior.

• 한국경제지리학회지
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• 제8권1호
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• pp.31-50
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• 2005

본 연구의 목적은 IMF 외환위기 기간(1996-2001)동안의 지역 자료를 활용하여, 지식기반경제에 있어서 지역의 지식연계망 기능을 분석하는데 있다. 특히, 지역혁신과 관련하여 지역간 지식연계망에 관한 다음과 같은 사항을 구명하고자 하였다. 첫째, 지역에서 지역간 지식연계망을 어떻게 구별할 수 있는가? 둘째, 실물 경제와 지역간 지식 연계망의 관계는 무엇인가? 이러한 의문 사항을 해결하기 위하여, 본 연구에서는 실물 경제의 변화와 지역간 지식연계망 간의 관계를 분석하기 위해서 사회 연계망 분석법을 활용하였으며, 실증분석을 위해서 1996년부터 2001 년까지의 16개 시도의 지역 고용 자료를 사용하였다. 주요 분석 결과로는 먼저 지역간 지식연계망의 집중도와 실물 경제의 경제성장률과는 양의 상관관계를 갖고 있는 것으로 나타났으며, 또한 지역간 지식연계망의 밀도와 표준편차는 실물 경제의 경제성장률과는 음의 상관관계를 갖고 있는 것으로 분석되었다.

• 지역사회간호학회지
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• 제5권2호
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• pp.203-215
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• 1994

The purpose of this study was to investigate the needs for exercise of adult inpatients and ultimately to provide basic data for planning nursing intervention of patients who need exercise. The tool used for this study was a structured questionnaire which consisted of 42 items. The test items were classified into seven factors. The seven factors of the needs for exercise were need for achievement, need for activity, need for affiliation, need for autonomy, need for catharsis, need for homeostasis, and need for exhibition. Subjects of this study were 127 patients in two general hospitals in Seoul, and one general hospital in Chun Ann City. The needs of exercise were identified and the data were analyzed by gender, age, occupation, education level, monthly income, size of patient room, patient group who requires exercise and the other patient group who requires bed rest, using one-way ANOVA and Scheffe test as post-hoc. The findings of this study were as follows ; 1) Among the needs for exercise of adult patients, the highest level of the needs was the need for homeostasis. The next highest was the need for achievement, then need for activity, need for catharsis, need for autonomy, need for affiliation, and the lowest was the need for exhibition. 2) Maintaining physical fitness stood first in the need for homeostasis, relieving psychological and physical powerlessness in the need for activity, mood diversion in the need for catharsis, happiness of the family in the need for affiliation, maintaining the balanced body figure in the need for exhibition, practicing planned life in the need for achievement, and improving the ability to overcome the crisis in the need for autonomy. 3) Male patients exhibited the higher level of the needs than female patients in all factors except the need for exhibition and homeostasis. 4) There was no statistical difference in the needs between age, occupation, monthly income, and the size of patient room. 5) The need for achievement was high as the level of education goes higher. 6) The patients who performed regular exercise before admission had higher needs for activity, achievement, and autonomy, compared with the patients who did not perform the regular exercise before admission. 7) There was no statistical difference in the needs between patient group who requires exercise and the other patient group who requires bed rest. The need for homeostasis was the highest in both groups. The results from this study suggest that the need for exercise of adult inpatients should be assessed before planning exercise intervention.

• Asian Pacific Journal of Cancer Prevention
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• 제14권9호
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• pp.5023-5029
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• 2013

Background: To evaluate knowledge about screening tests and tests without proven screening value in a Greek Breast Unit population undergoing benign vacuum-assisted breast biopsy (VABB). Materials and Methods: This study included 81 patients. Three knowledge-oriented items (recommended or not, screening frequency, age of onset) were assessed. Regarding screening tests two levels of knowledge were evaluated: i). crude knowledge (CK), i.e. knowledge that the test is recommended and ii). advanced knowledge (AK), i.e. correct response to all three knowledge-oriented items. Solely CK was evaluated for tests without proven screening value. Risk factors for lack of knowledge were assessed with multivariate logistic regression. A second questionnaire was administered 18 months after VABB to assess its impact on the performance of tests. Results: Concerning screening tests considerable lack of AK was noted (mammogram, 60.5%; Pap smear, 59.3%; fecal occult blood testing, 93.8%; sigmoidoscopy, 95.1%). Similarly lack of CK was documented regarding tests without proven screening value (breast self-examination, 92.6%; breast MRI, 60.5%; abdominal ultrasound, 71.6%; barium meal, 48.1%; urine analysis, 90.1%; chest X-Ray, 69.1%; electrocardiogram, 74.1%; cardiac ultrasound, 75.3%). Risk factors for lack of AK were: place of residence (mammogram), age (Pap smear), personal income (sigmoidoscopy); risk factors for lack of CK included number of offspring (breast MRI, chest X-Ray), BMI (abdominal ultrasound), marital status (urine analysis), current smoking status (electrocardiogram). VABB's only effect was improvement in mammogram rates. Conclusions: A considerable lack of knowledge concerning screening tests and misperceptions regarding those without proven value was documented.

• 한국미생물생명공학회:학술대회논문집
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• 한국미생물생명공학회 2000년도 Proceedings of 2000 KSAM International Symposium and Spring Meeting
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• pp.3-6
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• 2000

Antimicrobial resistance has been a well-recognized problem ever since the introduction of penicillin into clinical use. History of antimicrobial development can be categorized based on the major antibiotics that had been developed against emerging resistant $pathogens^1$. In the first period from 1940 to 1960, penicillin was a dominating antibiotic called as a "magic bullet", although S.aureus armed with penicillinase led antimicrobial era to the second period in 1960s and 1970s. The second stage was characterized by broad-spectrum penicillins and early generation cephalosporins. During this period, nosocomial infections due to gram-negative bacilli became more prevalent, while those caused by S.aureus declined. A variety of new antimicrobial agents with distinct mechanism of action including new generation cephalosporins, monobactams, carbapenems, ${\beta}$-lactamase inhibitors, and quinolones characterized the third period from 1980s to 1990s. However, extensive use of wide variety of antibiotics in the community and hospitals has fueled the crisis in emerging antimicrobial resistance. Newly appeared drug-resistant Streptococcus pneumoniae (DRSP), vancomycin-resistant enterococci (VRE), extended-spectrum ${\beta}$-lactamase-producing Klebsiella, and VRSA have posed a serious threat in many parts of the world. Given the recent epidemiology of antimicrobial resistance and its clinical impact, there is no greater challenge related to emerging infections than the emergence of antibiotic resistance. Problems of antimicrobial resistance can be amplified by the fact that resistant clones or genes can spread within or between the species as well as to geographically distant areas which leads to a global concern$^2$. Antimicrobial resistance is primarily generated and promoted by increased use of antimicrobial agents. Unfortunately, as many as 50 % of prescriptions for antibiotics are reported to be inappropriate$^3$. Injudicious use of antibiotics even for viral upper respiratory infections is a universal phenomenon in every part of the world. The use of large quantities of antibiotics in the animal health industry and farming is another major factor contributing to selection of antibiotic resistance. In addition to these background factors, the tremendous increase in the immunocompromised hosts, popular use of invasive medical interventions, and increase in travel and mixing of human populations are contributing to the resurgence and spread of antimicrobial resistance$^4$. Antimicrobial resistance has critical impact on modem medicine both in clinical and economic aspect. Patients with previously treatable infections may have fatal outcome due to therapeutic failure that is unusual event no more. The potential economic impact of antimicrobial resistance is actually uncountable. With the increase in the problems of resistant organisms in the 21st century, however, additional health care costs for this problem must be enormously increasing.

• 지역사회간호학회지
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• 제13권3호
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• pp.556-565
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• 2002

Due to the fact that nurses may deal with diverse populations in the work place, it is very important for then to maintain appropriate interpersonal relationships with clients. Nurses should maintain diverse types of relationships appropriately with patients with special needs and their families during crisis, other nursing colleagues and staff on the same team, clients in the school or work place as well as the community. In particular, a hospital is a society with a system and hierarchy, and the importance of interpersonal relationships is much more emphasized. In interpersonal relationships, it is very important for a person to communicate with others in an accurate manner, and when the communication is not achieved appropriately, the person may have troubles and experience distress and conflicts because of the inaccurate communication of thoughts. According to the findings of previous studies, nurses actually experience much distress in the work place because of the miscommunication that they have with others. The purpose of this study was to observe a correlation between Myers-Briggs Type Indicator and assertiveness behavior, and to exam the effects of assertiveness training on the assertiveness behavior and conflict management mode. The subjects of this study included 20 persons in the experimental group and 20 persons the in control group. Myers-Briggs Type Indicator was applied before the study. The assertiveness training group received six, 120 minutes sessions over a 3 week period. Pre-test on assertiveness behavior, Communication Conflict Inventory-General, Role Conflict Inventory- General, Conflict Management Mode was achieved for all the subjects prior to the training. Post-test was administered to all the subjects one week following the last session. The data were analyzed using SPSS PC program to obtain findings on mean. standard distribution, t-test, and Pearson correlation. The results are as follows: (1) Myers-Briggs Type Indicator Introvert/Extrovert was correlated to assertive behavior and avoid- response type conflict management mode. (2) The assertiveness training was correlated to assertiveness behavior, communication conflict degree, and avoid- response type conflict management mode. (3) The post-test scores between the training group and the control group were significantly different in assertiveness behavior and avoid-response type conflict management mode. It is suggested that more studies need to be done to differentiate the effects of Myers-Briggs Type Indicator and assertiveness training on assertiveness behavior and avoid-response type conflict management mode.

• 한국사회복지학
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• 제63권1호
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• pp.5-28
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• 2011

본 연구는 정신장애인의 정신질환 발병 이후 생애경험을 '생애사적 진행과정구조'에 주목하여 재구성함으로써 발병이후 위기의 진행과 전환의 과정을 이해하고자 한다. 정신장애인 5명이 연구에 참여했으며, 수집된 자료는 Sch$\ddot{u}$tze의 생애사적 이야기식 인터뷰(narrative interview)분석에 의하여 이루어졌고 위기 상황의 전환을 중심으로 '발병과 혼란단계'와 '집중적 치료 재활단계로' 나누어 재구성하였다. 전자는 '질환에 압도당함, 고통스런 삶의 반복과 감내, 가족으로부터의 분리', 후자는 '정신보건법 제정과 지역사회정신보건서비스의 확대, 사회적 역할변화를 통한 자신의 재발견, 생애사적 잠재성을 깨닫게 해준 중요한 타인, 지역사회통합의 장애물 경험, 가족관계의 재통합, 발병이전의 삶에 대한 고찰을 통한 질병경험의 재해석, 미래에 대한 기대'라는 주제로 분석했다. 그리고 두 단계를 전체적으로 비교분석하였다.

• 한국콘텐츠학회논문지
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• 제20권12호
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• pp.646-658
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• 2020

본 연구는 코로나19 자가격리자의 심리적 건강을 돌보는 심리치료 개입의 필요성을 바탕으로 원격 디지털 미술치료 체험을 현상학적 사례연구 방법으로 파악하였다. 연구 참여자는 캐나다에서 입국한 17세 청소년(여)으로, 자가격리를 하는 동안 7회기, 회기당 90~120분의 원격 디지털 미술치료 프로그램에 참여하였다. 자료분석은 내용분석을 통한 유의미한 진술을 파악하고, 연구자의 선이해와 판단중지를 바탕으로 주제를 도출하는 과정으로 진행되었다. 연구 결과 34개의 주제가 도출되었으며, 이는 공통된 10개의 주제묶음과 최종적으로 '자가격리 심리·정서', '원격 디지털 미술치료의 제한성', '원격 디지털 미술치료의 긍정성'이라는 3개의 대주제로 파악되었다. 본 연구는 코로나19 자가격리자에게 최초로 실시된 원격 디지털 미술치료 실천 사례연구로서, 코로나19라는 위기의 중심에서 자가격리자의 심리적 건강을 위한 적극적인 자기돌봄인 '심리방역'의 중요한 시사점을 제공할 것이라고 기대한다.

• 지역연구
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• 제37권1호
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• pp.3-14
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• 2021

코로나19 이후 공공의료시설, 특히 감염병전문병원의 중요성이 높아졌다. 그러나 메르스 사태 이후 정부의 강력한 정책의지에도 불구하고 공공의료시설과 감염병전문병원의 공급은 충분히 이뤄지지 않았다. 여러 가지 이유가 있겠지만 가장 큰 문제로 대두된 것이 바로 사회·경제적 변화와 시대의 흐름을 충분히 반영하지 못한 예비타당성조사이다. 본 연구의 목적은 공공의료시설과 관련된 현행 예비타당성조사제도의 문제점을 도출하고 그 대안을 제시하는 것이다. 본 연구는 그 대안으로 '선택가치'를 제안한다. 선택가치는 불확실한 상황에 대한 지불의 사이므로 감염병에 대비한 공공의료시설의 편익항목으로 반영하는 것이 학술적으로 가능하다. 선택가치는 비시장 재화이므로 조건부가치추정법과 선택모형을 통해 추정가능하다. 본 연구에서는 두 가지 방법론의 장단점과 활용대안을 제시하였다. 일상에서는 그 존재가치가 보이지 않지만 위기 상황에서 나타나는 것이 바로 의료와 보건시스템이다. 따라서 의료·보건분야의 예비타당성평가에서도 보이지 않는 편익을 찾고, 후생변화를 반영할 수 있는 방법론 개발이 지속적으로 이뤄져야 할 것이다. 본 연구가 그 촉매제가 될 것으로 기대한다.

• 한국재난정보학회 논문집
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• 제19권3호
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• pp.656-664
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• 2023

연구목적: 고용노동부에서는 사업장 내 화재·붕괴 등의 대형재난이 발생하면 사업장 대규모 인적사고 위기관리 표준매뉴얼에 근거하여 재난을 관리하고 있다. 현재 운용중인 표준매뉴얼을 점검하고 미흡한 항목에 대해 개선방안을 제시하고자 한다. 연구방법:이에 따라, 재난관리 매뉴얼 내·외부 전문가, 본부·지방관서의 재난업무 담당자 등과 함께 표준매뉴얼을 점검하였고 우선적으로 개선해야 할 항목을 도출하였다. 연구결과: 붕괴사고의 경우에는 재난관리 주관부처 선정의 논란을 제거하기 위해 행정안전부에서 선정기준을 정확히 제시할 필요가 있으며, 인파밀집사고의 경우에는 표준매뉴얼 보다는 행동·실무 매뉴얼에 구체적으로 반영하여 유사시 근로자 대피 안전성을 확보해야 할 것이다. 이 외에도 재난안전 통신망 운영 및 대피요령에 대해 상세한 내용의 추가 보완이 필요해 보인다. 결론: 향후에도 국민의 눈높이에 부응하는 재난관리 제도 개선을 위해서 해당 분야별 전문가, 재난업무 담당자, 그리고 일반시민 등의 의견수렴을 통해 근로자의 생명과 안전을 보장하고 좀 더 현장감 있는 사업장 대규모 인적사고 위기 관리 표준매뉴얼 마련을 기대한다.