• Tuberculosis and Respiratory Diseases
• /
• 제58권2호
• /
• pp.160-166
• /
• 2005

연구배경 : 최근 국내에서도 만성폐질환을 가진 저산소증 환자에게 재택산소요법이 증가하고 있으나 그 실태는 잘 알려져 있지 않다. 이에 한 대학병원 호흡기내과에서 재택산소요법을 처방 받은 환자들의 실태를 알아보고자 하였다. 방 법 : 2000년 1월부터 2003년 8월까지 서울아산병원 호흡기내과에서 재택산소요법을 처방 받은 환자들을 대상으로 의무기록 검토와 설문조사를 시행하였다. 산소를 중단한 4명의 환자는 제외하였다. 결 과 : 총 86명의 환자가 산소요법을 처방받았고, 2000년 이후로 매년 빈도가 증가되는 추세였다.남/녀비는 52/34명, 평균연령은 61.3세였다. 환자들의 기저질환으로 만성폐쇄성폐질환 29명, 결핵파괴폐 18명, 기관지확장증 15명, 간질성폐질환 12명, 척추후측만증 7명 등으로 다양한 질환을 보였다. 산소 처방 당시 평균 53명의 폐기능 소견은 $FEV_1/FVC$ 비 $58.4{\pm}25.2%$, FVC $54.5{\pm}17.1$ (% pred.), $FEV_1$ $41.7{\pm}20.6$ (% pred.)로 측정되었다. 산소요법은 1.5 L/min에서 시작하여 평균 14.5시간 동안 사용하였다. 산소 처방 당시 동맥혈 산소농도는 77.7 mm Hg, 동맥혈 이산화탄소농도는 49.6 mm Hg 정도로 조절하였다. 전체 환자 중에서 가정간호사 방문이나 맥박산소측정기로 집에서 산소포화도를 모니터링 하는 경우는 16.5%에 불과하였고 대부분의 환자는 외래 방문시 시행하는 동맥혈가스분석이나 증상에 따라 산소량을 조절하였다. 재택산소치료를 하는 환자들의 3년 생존율은 56%였고 고탄산혈증을 가지는 환자에서 더 좋은 예후를 보였다. 결 론 : 재택산소치료는 다양한 폐질환 환자에게 시행되고 있고, 점차 빈도도 증가하고 있어 효율적인 관리 체계의 확립을 위한 보험제도의 개선이 필요할 것으로 사료된다.

• 가정간호학회지
• /
• 제6권
• /
• pp.5-18
• /
• 1999

This study was attempt to encourage for developing on rehabilitation delivery system and programs as a substitute service instead of hospitalization for accident patients at work, such as hospital based home health care nursing service. It needs vary substitutes service of hospitalization to curtail the length of stay for inpatients who were hospitalized with workers compensation insurance. It focused on developing an estimation of early discharge day of accident inpatients based on a detail statement of treatment for 115 inpatients who were hospitalized at General Hospital in 1997. This study has four specific purpose as follows. First, to find out the status of health service utilization. Second, to estimate the early discharge days and income increasing effect based on the early discharge for those patients. Third, to identify the factors to affect total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze of the length of stay and medical expenditure for inpatients who were hospitalized due to the accident, the authors conducted with micro-analysis and macroanalysis from medical records and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria. such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the tests consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, stable conditions. In addition to identify affected variables for medical expenditure. the length of stay and income effect due to early discharge day, the data was analyzed with multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study as follows. First, the mean length of stay was 37.1 days, whereas the mean length of stay due to early discharge was 28.2 days at the hospital. The estimation of early discharge days were shown that depends on the length of stay. The longer length of stay, the longer length of early discharge days, such as under 7 days length of stay patients was to estimated the mean length of stay was 4.9 days and early discharge days was 4.6. whereas the mean length of stay was 122.6 days and early discharge days was 92.0 respectively. The mean medical expenditure per day were found to be 133.409 Won. whereas the mean medical expenditure per day was shown negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to 11 early discharge days per bed was around 2,150,000 won. However, it means not the real benefits from early discharge, but the income increasing amount without considering medical prime cost in general hospital. Therefore, it needs further analysis on the cost containments and benefits under the considering as well turn over rates per bed as the medical prime costs. The length of stay was most significant and the sign was positive to the total medical expenditure, as expected. Surgery and patient's residential area also an important variable in explaining medical expenditure. The level of complications was most significant variable in explaining the length of stay. The level of the needs on horne health care nursing service which can be used for early discharge accident patients were shown very high. The needs distribution varied from 65.5% of patients and 88.9% of caregivers, to 96.4% of doctors, and 99.1% of nurses. In addition horne health nurse responded that they can be managed the accident inpatients from early discharge. From these research findings. the following suggestions has been drawn it needs to develop strategies on rehabilitation delivery system in order to focused on consumer's side which is planned for 21 century health policy in Korea. Vary intermediate facilities and horne health care would have been developed in the community based for comprehensive rehabilitation services as a substitutes of hospitalization for shortening the length of stay of hospitalizations. In hospital based horne health care nursing service, it's available immediately to utilize for the patients who wanted rehabilitation services as a substitutes of hospitalization under the cooperations with workers compensation insurance company.

• 교육시설 논문지
• /
• 제20권4호
• /
• pp.11-22
• /
• 2013

The concept of Green campus has recently become an issue with the fact that universities are classified as energy gluttons. This study clearly defines the meaning of domestic green campus, and explores the operating system of green campus and related associations. Then, it draws implications from the case of Harvard University. For the research, reports and research papers of the University are examined thoroughly, and detailed information were confirmed through visiting to the official home page and emails with authorities. The green campus support institutions of the United States are making efforts to integrate overlapping functions and create a synergy effect through internal interchange and information exchange, and substantive collaboration. Also, it is drawing active participation from students and faculties of American universities by publicizing and raising various methods of funding to manage them. The primary factors of Harvard University's success are: voluntary participation from all members, the coordinated operation of the administrative division to be the center of the green campus initiative and the cooperation of each department. Other critical factors of Harvard's success are their fundraising capability, and specialized management institution. The study has significance in that it draws applicable implications on domestic Green campus through in-depth analysis, which surpasses introduction of preceding studies.

• 한국실내디자인학회논문집
• /
• 제21권1호
• /
• pp.228-239
• /
• 2012

This study aims to propose the improvement direction of spatial organization of orphanage facilities by reflecting the international trend of child welfare facilities including 'enhancement of habitability', 'opening to the local community' and 'multi-functionality' on the basis of ideas of 'right of housing' and 'normalization'. Orphanage facilities are evolving from 'facilities' to accommodate unfortunate children to the concept of the 'community-care', and the residential space is also rapidly shifting to 'cottage' type resembling a residential type of ordinary family so as to enhance the self-esteem and relationship. To suggest the future-oriented changeability of current orphanage facilities, the present study conducted a nationwide survey of child welfare facilities and four Visiting researches of cottage type orphanage with different locations to investigate the appropriateness of housing type, organization of common use space, mode of management and facilities criteria. The results of this study are following: 1) For enhancement of habitability it is suggested that cottage type with various plans in the form of ordinary housing is appropriate, that the number of children per cottage is six or so, and that the number of less than two or three children per room is recommended. At the same time the adjustment of facilities criteria, simplified or complex, is suggested to support a similar residence pattern to ordinary home. 2) Specialized programs must be introduced to establish a base of welfare-network for community children according to features of location and a complex management must be sought in the connection with neighboring public facilities. 3) To secure the residential environment and quality of life for children, the concept of a simple playground space by the current facilities criteria must be broken away to reinforce the network of various outdoor spaces closely connected with living space.

• 농촌의학ㆍ지역보건
• /
• 제32권1호
• /
• pp.27-39
• /
• 2007

Objectives: The challenge of an increasing elderly population has coupled with everpresent social concerns in Korea. A major problem in health center for the frail older people is that medical, healthcare, and welfare services are often fragmented in terms of providers and settings without appropriate coordination. The purpose of this study was to investigate the need of health center-based integrated healthcare services and its related factors for the elderly. Methods: A total of 110 elderly people who had visited at a county Health Center were interviewed using a self-administered questionnaire from November to December, 2005. The questionnaire consists of five domains according to the Program of All-inclusive Care for the Elderly. Results: Respondents had high need (total mean score with the 5-point Likert-type sacle: 3.67) of health center-based integrated healthcare services including home visiting service (mean: 4.08), chronic disease care service (mean: 4.06), and transportation service (mean 4.05). According to the results of hierarchical multiple regression analysis, among three regression models the magnititude of the variance of full model that is explained by the need of welfare-domain service was significantly larger than two reduced model. Income was a significant variable in increasing the need of health care and welfare services. Conclusions: This study suggests that the health center-based integrated healthcare services for the elderly must be continuously developed and provided for the health promotion and improved the quality of life of the elderly who live in rural area in Korea.

• 한국주거학회논문집
• /
• 제27권6호
• /
• pp.125-136
• /
• 2016

This study specifies daily behaviors that elderly residents perform in their living space and verifies the behaviors that they have difficulties in performing. The study categorized elderly people according to the level of difficulties they have when performing household activities (independence of behavior performance) and verified characteristics of the sub-behaviors and the level of difficulties of performing them in each type. For this purpose, the study conducted observation investigation on the behavior of elderly people by directly visiting houses of 52 elderly people over the age of 65. The characteristics of sub-behavior were also examined through photograph shooting and in-depth interview. In this study, behaviors of elderly people inside living space were categorized into the following nine behaviors. The study investigated the difficulties of performing these sub-behaviors according to the elderly people's level of independence by each behavior. Analyzing the difficulties of sub-behaviors according to the independence level, elderly people felt more structural problems and inconvenience in using facilities when they have lower independence level. Moving from independence to dependence, their performance of behaviors gradually became difficult, making them inevitable to use tools. At last, they came to need caregiver's help. For continuous sustenance of elderly people's independent living inside house, policy measures are required that can address the difficulties of sub-behaviors that are observed in a series of process of one's becoming dependent from independent in this study.

• 대한의용생체공학회:의공학회지
• /
• 제30권1호
• /
• pp.23-33
• /
• 2009

It can be used easily to reduce rehabilitation and treatment time if diagnostic and therapeutic devices are attached to cloth or body. Therefore we developed neuromuscular wearable ultra-miniature lighting modules which can improve the neuromuscular function and verified its clinical effectiveness. The system is based on the ultra-miniature lighting treatment module and there are two types of systems. One of them is designed as an attached type and the other type is combined with clothing. The wearable ultra-miniature lighting module is composed of controller (battery, MCU, bidirectional transmitter and receiver), cable, treatment medium generating device and other peripheral devices. To verify the clinical effectiveness of this device, we observed the difference of the strength of a muscle before and after 650nm and 25mW laser irradiation on the reflex point for 1 to 4 seconds. Among 48 patients having the degenerative osteoarthritis, the muscle strength before and after irradiation of laser was $21.8{\pm}7.99$ and $27.3{\pm}8.43$. According to the result, the muscle strength after treatment was significantly increased (p<0.01). To whom having difficulty in visiting to OPD(Out-Patient Department), doctors medically examine the patients and find the therapeutic point, attachment of this wearable ultra-miniature lighting module can function as self treatment (treating instrument) and treatment assist at home. If doctor can remotely control the patient and take part in treatment, the therapeutic device could contribute to prevention and care device.

• 지역사회간호학회지
• /
• 제22권3호
• /
• pp.302-314
• /
• 2011

Purpose: This study aimed to validate instruments to classify the frailty of Korean elderly people in community. Methods: For this study, 632 elders were selected from community-based elderly houses and home visiting registries, and data on frailty were collected using three instruments during November, 2008. The Korean Frail Scale (KFS) was composed of 10 domains with the maximum score of 20. The Edmonton Frail Scale (EFS) had 10 domains with the maximum score of 17. The 25_Japan Frail Scale (25_JFS) was composed of 6 domains with the maximum score of 25. Internal consistency was measured with Cronbach's ${\alpha}$. Sensitivity, specificity and area under the curve (AUC) of ROC were measured to see validity with long.term care insurance grade as a gold standard. Results: The Cronbach's ${\alpha}$ was .72 for KFS, .55 for EFS, and .80 for 25_JFS. Sensitivity, specificity, and AUC were 70.0%, 83.2%, and .83, respectively, at cutting point 10.5 for the KFS, 50.0%, 80.9%, and .66, respectively, at 8.5 for EFS, and 80.0%, 85.9%, and .86, respectively, at 12.5 for 25_JFS. Conclusion: KFS and three JFS showed favorable internal consistency and predictive validity. Further longitudinal studies are recommended to confirm predictive validity.

• 가정과삶의질연구
• /
• 제16권2호
• /
• pp.71-82
• /
• 1998

This study aimed to aimed to obtain some basis data for the housing consultation and information about housing through survey of needs for the housing consultation. Respondents were housewives from 395 households living in Seoul area. Questionnaire was used for survey and the collected data were classified by two items such as types of residence and age of housewives. The survey was performed during two weeks in September 1997 and analyzed by frequency mean and percentage using SAS program The finding are as follows; (1) According to the actual conditions of housing consultation the main source of information related to housing was a newspaper Those who had experience detached house had much more opportunities than those of multi-family house. The most frequent agency for housing consultation was a realty dealer showing 65.8%. However the percentage of visiting permanent housing exhibition centers was high among the people aged 20 to 30, noted 20.4%. (2) Level of understanding housing consultation showed 3.45 points among 5. This result indicated that the service system of housing consultation were required. Architects and interior designers were most preferred as specialists whom the respondents wanted to consult with . As to the contents of consultation the most required item was changing of interior space(22.6%). In case the housing information leaflet is sold the respondents were willing to pay 523 won for each of it. (3) Among leaflets related to various information leaflets about housing purchase were most preferred(21.0%) According to the result of the survey the need for the information about housing purchase indicated higher preference than about housing management. The fact could be thought that consumers' consciousness of housing should be changed. Therefore it is desirable to lead consumers to lengthen the expected life span of their house and value happiness of the house by providing them with consulting systems about housing management throug housing consultation materials and development of its programs.

• 한국임상보건과학회지
• /
• 제2권2호
• /
• pp.148-157
• /
• 2014

Purpose. This study compares and analyzes customer service on customer satisfaction and customer royalty on customer satisfaction targeting the customers visiting a hospital or a clinic which is franchised or not. And it aims at helping business rationalization for a medical institution. Methods. This paper conducts a survey and selects a sample of 670 customers except the missing value targeting the customers of 4 primary health care institutions and 4 bigger health care institutions in Seoul and Gyeonggi province. It conducts frequency analysis for the purpose of investigating the respondents' generic characteristic and factor of their medical institution selection, and factor analysis, reliability analysis and regression analysis for the hypothesis testing. Results. The first hypothesis testing result is significant in level of significance of 0.01. The second one is the same as the first one, but the dummy variable shows a negative regression coefficient(-0.479). The third one is significant in level of significance of 0.01, but the forth one is not significant. And the respondents prioritize website(Home page) and convenience in use of a hospital procedure for selecting a hospital or a clinic. Conclusions. The additional analysis finds that the franchised group has more satisfaction than none franchised group. But in case of their royalty, the average of franchised and none franchised groups are not significantly different. Therefore, the results of this paper reveal to support the results of the advanced researches.