• 한국재난정보학회 논문집
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• 제16권1호
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• pp.34-43
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• 2020

연구목적: 본 연구는 소방공무원 보건안전 및 복지기본계획, 그리고 매년 연도별 계획이 실질적으로 소방공무원의 보건과 복지에 기여하는지 여부를 실증검증하여 현재 계획에 근거한 정책들의 문제점과 개선방안을 도출하고자 하였다. 연구방법: 현황분석과 더불어 해당분야 전문가들로부터의 델파이분석기법에 의해 연구결과: 소방공무원 보건안전정책에서의 문제점으로 소방관 전문병원의 부재, 일선 소방서차원의 정신건강교육프로그램 미흡, 현장활동 위험평가 체계 미흡의 문제, 심신건강관리사업의 효과성 문제, 심신안정 프로그램의 내실화 부족, 정신건강관련 교육의 부재, 정신건강관련 프로그램 이용자의 은닉성 보장문제가 주요 문제점으로 도출되었으며, 소방공무원 복지정책에서의 문제점으로 부모소방관에 대한 지원부족, 퇴직소방관에 대한 노후설계대비 미흡, 여성소방관에 처우개선 미흡이 도출되었다. 결론: 개선방안으로 소방전문병원설립, 정신건강교육프로그램의 내실화 및 소방서내 CISD 리더 양성프로그램 마련, 재난현장 위험평가체계의 마련, 찾아가는 심리상담실사업등에 대한 효과성 측정등의 평가체계 도입, 수요자 만족도 조사등을 통한 프로그램 내실화, 정신건강관련 교육시스템 마련, 인사시스템 개선을 통한 은닉성 보장 방안, 육아 휴직제도 장려 및 소방서내 육아시설 도입, 퇴직소방관 활용 방안 수립 및 사업 활성화, 여성소방공무원을 위한 정책마련 방안이 도출되었다.

• 가정간호학회지
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• 제2권
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• pp.5-18
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• 1995

While the socioeonomic status of Koreas has been dramatically increasing in recent years, chronic and geriatric diseases have also been on the rise, bringing about many changes in our health care system. The basic goals of the home health care are to reduce health care costs, to increase the attrition rate in general hospitals, and to care for patients effectively and conveniontly at home. The purpose of this paper is to review and examine the current status of the home health care in Korea throughout the reports, surveys, other informations and education system of home health nurse. We identified the various types of home health care services programs, such as hospital-based home health care operated in public sector(demonstration project) and community-based home health care in health centers or in private sector, that is, Korean Nurse Association. Hospital based home heatlh care model was established as an alternative to traditional in-patiet services. Quality assurance and client satisfaction is an important measure of care received and establishment of payment and reimbursement for home health care services is important in promotng the home health care. We found out a fee-per-visit system composed of three kinds of fees : a basic service fee(16,000 Won), a travel fee(5,000 Won), and per-service fees (variables). Like fees paid for in-patient care, insureds pay 20% and insurers pay 80% of the basic and per-service fee. The travel fee is borne totally by the insured. Home health care continues to be viewed as not only the most preferred way to provide care to clients, but also the most cost effective. Home health care is that component of a continuum of comprehensive health care whereby health services are provided to individuals and families in their places of residence for the purpose of promoting, maintaining, or restoring health, or of maximizing the level of independence, while minimizing illness. Services appropriate to the needs of the individual patient and family should be planned and provided, nursing is to be a force for positive change and enhanced the nursing professionalism. Whatever type of involvement of home health care, it is essential to remember that home health care is highly service-oriented and highly touch health car deilvery system.

• 한국보건간호학회지
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• 제13권1호
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• pp.41-62
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• 1999

Recently the request of the patients to participate in the medical courses has been expanding due to elevated sense of right on the people's health. merchandised medical treatment by mass supply, human right declaration of the patients, generalized medical informations by the mass media and the change of human relation between the medical personnels and the patients. Under these phenomena the accident by the nurses have been increasing by the area of the nurses having been expanded and their independent roles having been increased. Such nursing accidents are the important subject which the professional occupation of the nurses has been facing but legal protective capability of the nurses has been very weak. Therefore this study has examined the degree of the experience of the nursing accident that happens in the clinical nursing scenes in the general hospital to provide the basic materials for the protection and the counter measures of the nursing accidents. The following is the conclusion based by the above examination. 1) The general characters of the subjects of this study is that they are mostly single in their twenties and graduate from nursing college. Their total clinical career is above 5 years$(44.8\%)$ and their current clinical parts' career is between 1-3 years$(40.1\%)$. So these facts suggest that most hospitals has taken the working rotation policy on nurses. 2) The level of nurses' knowledge on the nursing law is accurate partially but isn't it patially. So it is suggested that nurses need the accurate information and education about the nursing law. But the nurses' attitude is very approved of the establishment of a unilateral nursing law. 3) The relation between the demographic characters of the subjects and their attitudes on the nursing law shows that there is no significant differences except the relation between the attitude 6(the sufficient level of education on nursing law in formal education course) and age. total clinical career. 4) The perception of the nurses shows that the cause of the nursing accident has been due to the heavy work$(78.2\%)$. short of professional knowledge and skill$(60.2\%)$, discordance with Doctors. patients and patients' families. They report the accident to the head nurse first$(81.8\%)$ and within 30 minute$(75.1\%)$. The hour of nursing accident frequently happened is regardless of service hour with $49.4\%$ in response rate. the highest rate. and the nursing accident happens in the night more than the daytime. Even though most nurses think that they are themselves responsible for nursing accident. it is found that the chief cause of the nursing accident is due to the nurses' heavy work$(78.2\%)$. So the causes of nursing accidents is analysed. it may be suggested that the endeavor of hospital and nursing organizations to decrease nursing accidents is very important. 5) The coping patterns of patients with nursing accidents are mostly active attitude such as a violent words$(69\%)$. sue or accusation$(36.4\%)$, monetary compensation $(35.6\%)$ except a understanding cases$(38.7\%)$. But the coping patterns of hospitals with nursing accidents are mostly to investigate the accurate cause.

• 지역사회간호학회지
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• 제12권1호
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• pp.278-287
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• 2001

The purpose of this study is to provide with basic information on application of hand acupuncture as a complementary and alternative therapy by giving some recognition of efficiency and effectiveness of hand acupuncture. And so, answers for questionnaires of 290 respondents were used for this research and collected from June 5 through 13, 1999 from adults twenty and over who were participating in the hand acupuncture training program in Seoul and had some direct experiences with hand acupuncture therapy, whatever they had been treated and/or had treated. To secure reliability of measurement tool. Cronbach'a has been calculated and Factor Analysis was done as Validity Analysis of question classification. Demograprucal characteristics of hand acupuncture experienced people and factors related to hand acupuncture experiences are calculated based on the real number and percentage. The degree of recognition of efficiency and effectiveness of hand acupuncture is made as average and standard deviation, while the degree of recognition of efficiency and effectiveness based on general characteristics come from one-way ANOVA. 1. According to socio-demographical analysis. the questioned could be classified firstly as age (40-49 : 32.5%. 30-39 : 24.9%. 50-59 : 21.9%. 60-69 : 14.7%. 20-29 : 6.0%). secondly gender (male 36.6%. female 63.4%). thirdly occupation (housewife: 43.8%. self-employed: 15.5%. company-employee: 14.8%). fourthly education (high school graduate: 41.9%, college graduate: 37.9%), and lastly monthly-income (1 to 2 million: 51.4%. 2 to 3 million: 20,3%) 2, As for the general aspects related to hand acupuncture. 80,0% of the respondents answered almost zero for the monthly average number of visit to hospital and 15.5% responded 1 to 2 visits, 6,2% of the respondents is complaining of a disorder of digestive system. 19,0% circulatory disease, 10.7% bad nervous system. By utilizing hand acupuncture, 84% of the questioned have following experiences in curing diseases: digestive system 47.3%, circulatory system 9.3%, nervous system 8.3%, 54,1% are curing 1 to 2 and 10.3% 3 to 4 patients on a daily basis with hand acupuncture. Research on the demerits of giving medical treatment with hand acupuncture shows 23,8% are feeling economic burden. 16.6% difficulty of learning and 16.2% weak theoretical backgrounds. 3. Among the efficiency recognition, possibility of general application is average 4,29 and simple treatment is 4,19. economic merits 4.36. possibility of establishment with supplementary and alternative medicine 4.17, medical effectiveness 4.09. 4, As a result of demographical analysis on the efficiency and effectiveness of hand acupuncture therapy, it appears that the recognition of efficiency based on occupation and the recognition of effectiveness based on monthly income are most significant to be noticed. In an orderly fashion. government-employee, self-employed, company-employee. and then housewife have perceived hand acupuncture very efficiently, And those who recognize hand acupuncture to be most effective are people earn 1 million to 2 million won a month, 5. The efficiency(p = .003) and effectiveness (p= .049) of hand acupuncture therapy by number of visit to hospital were statiscally significant, and effectiveness of hand acupuncture therapy by disease exist was statiscally significant (p= .033).

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제20권4호
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• pp.227-235
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• 2017

Purpose: Crohn's disease (CD) can involve any site of the gastrointestinal tract (GIT). However, the characteristics of upper GIT involvement in CD are unclear, especially in the Eastern pediatric population. This study aimed to estimate the prevalence of upper GIT involvement and identify the clinical features of Korean children with CD. Methods: This was a retrospective multicenter cohort study that included 52 pediatric patients with CD who underwent esophagogastroduodenoscopy and biopsy. The clinical symptoms and endoscopic and histologic features of the upper GIT were identified according to the presence or absence of upper gastrointestinal symptoms. Results: Among the 52 patients, upper GIT involvement was noted in 50.0% (26/52). The mean age at CD diagnosis was $14.1{\pm}2.1$ years. Gastric ulcer was the most common lesion (19.2%) found on upper GIT endoscopy, followed by duodenal ulcers (15.4%). Chronic inflammation was the most common histopathologic feature (75.0%), followed by gastric erosion (17.3%). Granuloma was found in 9.6% of patients. Helicobacter pylori infection was identified in 5.8% of patients. Endoscopic and histologic findings were not significantly different, but the mean values of erythrocyte sedimentation rate ($60.7{\pm}27.1$ vs. $43.0{\pm}27.6mm/h$, p=0.037) and C-reactive protein ($16.5{\pm}28.2$ vs. $6.62{\pm}13.4mg/dL$, p=0.014) were significantly different between patients with and without upper gastrointestinal CD symptoms. Conclusion: Upper GIT involvement was relatively common in pediatric patients with CD irrespective of upper gastrointestinal symptoms, and H. pylori infection was relatively uncommon. The results of this study should aid the establishment of regional guidelines for upper GIT examination.

• Clinical and Experimental Reproductive Medicine
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• 제32권2호
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• pp.133-147
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• 2005

Objectives: This study was carried out to establish human embryonic stem cells derived from frozen-thawed embryos using mouse embryonic fibroblasts (mEFs), human fetal skin and muscle fibroblasts as feeder cells, and to identify the characteristic of embryonic stem cells. Methods: When primary mEFs, human fetal skin and muscle fibroblasts were prepared, passaging on 4 days from replating could have effective trypsinization and clear feeder layers. Eight of 23 frozenthawed 4~8 cell stage embryos donated from consenting couples developed to blastocysts. Inner cell mass (ICM) was isolated by immunosurgery. ICM was co-cultured on mEFs, human fetal skin or muscle fibroblasts. The ICM colonies grown on mEFs, human fetal skin or muscle fibroblasts were tested the expression of stage specific embryonic antigen-3, -4 (SSEA-3, -4), octamer binding transcription factor-4 mRNA (Oct-4) and alkaline phosphatase surface marker. Results: We obtained 1 ICM colony from 2 ICM co-cultured on mEFs as feeder cells and did not obtain any ICM colony from 6 ICM clumps co-cultured on human fetal skin or muscle fibroblasts. The colony formed on mEFs could be passaged 30 times every 5 days with sustaining undifferentiated colony appearance. When the colonies cultured on mEFs were grown on human fetal skin or muscle fibroblasts, the colonies could be passaged 15 times every 9 days with sustaining undifferentiated colony appearance. The colonies grown on mEFs and human fetal fibroblasts expressed SSEA-4 and alkaline phosphatase surface markers and positive for the expression of Oct-4 by reverse transcription-polymerase chain reaction (RT-PCR). The produced embryoid body differentiated spontaneously to neural progenitorlike cells, neuron-like cells and beating cardiomyocyte-like cells, and frozen-thawed embryonic stem cells displayed normal 46,XX karyotype. Conclusions: The human embryonic stem cells can be established by using mEFs and human fetal fibroblasts produced in laboratory as feeder cells.

• 디지털융복합연구
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• 제19권5호
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• pp.321-331
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• 2021

본 연구는 웰에이징을 위한 웰다잉 교육과 웰다잉 문화확산, 산업화를 구축하는 데 필요한 기초 자료를 얻고자 2021년 2월 1일~2021년 2월 22일까지 한국갤럽을 통해 자료를 수집하였다. 연구결과 조사 대상자의 웰다잉 교육경험은 4.7%이었고 교육만족도는 2.88점으로 나타났다. 연령층별 웰다잉 교육 요구도 분석 결과 청년과 중년층은 호스피스 교육 및 정보, 연명의료 관련 정보, 장례정보 순이었고, 장년층은 호스피스 교육 및 정보, 장례 정보, 죽음 관련 심리적 극복 순이었으며, 노년층은 호스피스 교육 및 관련 정보, 장례 정보, 연명의료 관련 정보 순서로 조사되었다. 웰다잉 문화 관련 산업화 인식은 삶과 죽음에 대해 이야기할 수 있는 웰다잉 카페, 입관체험, 장지 방문과 같은 웰다잉 체험, 문화와 예술 관련 여행상품 개발 순서로 조사되었다(p<0.05). 이와 같은 결과는 웰에이징을 위한 웰다잉 교육 프로그램 개발과 문화확산 및 산업화 구축에 유용하게 활용될 수 있을 것으로 기대된다.

• 한국병원경영학회지
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• 제29권1호
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• pp.46-55
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• 2024

Objective: This study was conducted to provide basic data for the establishment of effective health policies for the unmet medical experience that may occur among the elderly depending on whether they live in a singleperson household or not. Methodology: This study used data from the 8th National Health and Nutrition Examination Survey (2019-2020) and excluded cases with missing values in variables for the total number of respondent participants of 15,469. Finally, 2,850 subjects aged 65 or older were selected for final analysis. This study examined the relationship between experiences of unmet medical needs, attempting to confirm the relationship between single-person households and unmet medical needs through subgroup analysis considering gender, age, and household income. Results: According to the results, in the case of single-person households, the odds ratio (OR) for unmet medical needs was significantly higher at 1.60 times (95% CI: 1.16-2.21). Upon conducting subgroup analyses for gender, age, and household income quintiles, the OR was significantly higher at 2.24 times (95% CI: 1.14-4.41) for males and 1.48 times (95% CI: 1.02-2.14) for females, statistically significant in both cases. For individuals aged 65-69, the OR was significantly higher at 1.90 times (95% CI: 1.04-3.47), but for those aged 70-74 and over 75, it was not statistically significant. In the case of households with 'low' income, the OR was higher at 1.62 times (95% CI: 1.16-2.26), and for 'middle' income, it was significantly higher at 3.21 times (95% CI: 1.08-9.51). Conclusion: This study confirmed that the experience of unmet medical care is high among men who make up single-person households and low-income seniors. Therefore, this study suggests that policies to expand medical services and support welfare for single-person households should be established to resolve these problems, showing that health policies that take into account individual and regional characteristics are needed to improve medical accessibility for single-person households.

• Tuberculosis and Respiratory Diseases
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• 제43권6호
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• pp.871-881
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• 1996

목적: 국가결핵관리 중 초치료 단기 표준요법에서 PZA는 6EHRZ에 포함되어 치료초기에 2개월간만 사용되고 있지만, 약제에 감수성 재발로 재치료에 장기간 사용된 경우와 감수성검사 결과 내성이 획득된 경우는 PZA를 사용하지 않는 것이 바람직 하며 PZA를 추가하여 사용하지 못하는 경우 우리 나라와 같이 결핵의 유병률이 높은 나라의 경우는 재치료 처방에 대하여 100% 신뢰를 하기가 힘든 실정으로 PZA와 대치가 가능하거나 재치료 처방을 보완해 줄 수 있는 약제의 개발이 시급한 실정이다. 최근 4-Fluoroquinolone 제제가 개발되면서 약간 희망을 가질 수 있게 되었으나 현재까지 효과가 있는 것으로 알려진 제제는 Ofloxacin(이후 OFX)과 Ciprofloxacine(이후 CPFX)에 불과하고 일부에서 이러한 제제에 대한 약효가 입증되었다고는 하지만 대부분이 실험실적인 결과와 약제의 살균작용이 강한 약제와 같이 투여하여 얻어진 결과이기 때문에 항결핵제로는 일부에서만 사용되고 있으며, 결핵 치료 효과에 대한 충분한 자료가 없기 때문에 확실한 효과가 알려져 있는 다른 항결핵제 대신에 사용하거나 이 제제를 한가지만 사용해서는 안되고 단지 폐결핵 재치료의 최후에 사용하되 최소한 2-3개의 효과적인 다른 2차약제와 병용해야 한다고 알려져 있다. 또한 우리나라에서 OFX와 CPFX가 사용되고 있는 경우에도 일부에서는 정립된 지침이 없이 무분별하게 사용되고 있으며, 이에 대한 연구 또한 미흡한 실정으로 폐결핵 재치료에 대한 Regi-men의 정립과 이러한 제제의 효과를 검증하기 위하여 본 연구를 실시하였다. 방법: 1994년 1월부터 1995년 12월까지 2년동안 국립마산병원에 입원하였던 재치료 환자로서 2차약제를 처음 처방한 83 명을 OFX +PTA+CS+ PAS + 주사제를 사용하는 처방군(이후, Group I)과 PZA + PTA + CS+PAS+ 주사제를 사용하는 처방군(이후, Group II)으로 분류하여 Group 간에 일반적인 특성에 차이가 있는 가를 검증하고, 치료에 따른 결과를 $\chi$2-test와 T-test를 하여 신뢰성을 검증하였다. 결과: 1 연령분포는 Group I과 Group II 모두 30대가 각각 29.2%, 37.1%롤 많았고, 평균 연령은 Group I 이 43.9세 Group II가 39.0세로 Group 1 이 많았으나 유의한 차이는 아니었다. 성별로는 Group I과 Group II모두 남자가 각각 68.8%, 85.7%로 많았으나 유의한 차이는 아니었다. 2. 가족력이 있는 경우는 Group I이 29.2%로 Group II 28.6%보다 많았으나 유의한 차이는 아니었다. 3. 병변의 범위에 따른 구분은 Group I과 Group II 모두 중증이 각각 60.4%, 74.3%로 많았으나, Group 간에 차이는 없었다. 4. 약제에 대한 부작용을 호소한 경우는 Group II가 65.7%로 Group I 58.3%보다 많았으나 유의한 차이는 아니었고, Group II 에서는 위장장애를 호소한 정우가 25.0%, Group II 에서는 관절통은 호소한 경우가 34.3%로 많아 Group 간에 유의한 차이 (p<0.05)가 있었다. 5. 객담도말검사상 균음전화는 Group I이 87.5%로 Group II 80%보다 높았으나 유의한 차이는 아니었고, 객담배양검사상 균음전화는 Group I이 91.7 %로 Group II 82.9%보다 높았으나 유의한 차이는 아니었다. 6. 치료 성공률은 Group I이 87.5%로 Group II 80.0%보다 높았으나 유의한 차이는 아니었다. 결론: 재치료 병합치료에서 OFX는 PZA를 사용하지 못하는 환자에게 투여하여 PZA를 사용할 때와 유사한 결과를 얻을 수 있는 대체 약제로 사용이 가능할 것으로 생각된다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제11권1호
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• pp.42-55
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• 2008

목 적: 보건복지부 및 국민건강보험공단에 의해 국내 최초로 영유아 건강검진 사업이 2007년 11월에 시작되었다. 본 연구진은 이 사업에서 포함되는 영양상담 프로그램을 개발하였다. 방 법: 연구진은 대한소아과학회에서 발행되는 영양지침 관련 자료와 미국의 Bright Future, 세계보건기구의 지침들을 참고하였다. 또한, 국내의 중요한 영양 관련 역학 연구인 국민건강영양조사 자료 및 2005년 소아청소년 신체발육표준치 결과를 분석하였다. 문진표와 보호자용 설명서, 컴퓨터 프로그램 및 의사용 지침서를 만들기 위해 연구자들과 정책 담당자들 간의 수차례 회의를 거쳤다. 결 과: 다수의 학문적이고 역학적인 근거를 통해 연령별 영양상담 핵심 주제를 선정하였다. 이는 영유아에서의 모유수유, 보다 건강한 보충식, 철 결핍빈혈의 예방, 보다 건강한 소아 식이, 과체중을 예방하기 위한 영양상담, 그리고 신체활동의 강조 등이다. 이에 근거하여 4개월, 9개월, 18개월, 30개월, 그리고 만 5세의 방문 시기별로 새로운 한국 영양상담 및 예방적 지침을 개발하였다. 각 방문 시기별로 5개에서 8개의 문진이 제공되고, 나이에 적절한 설명서와 의사용 지침서가 개발되었다. 결 론: 연구진은 최신의 과학적 근거를 통해 영양상담 및 예방적 지침을 개발하였으며, 이를 새로운 건강증진 정책인 영유아 건강검진 프로그램의 주요 구성 요소로 포함시켰다. 향후 보다 세밀한 영양학적 진단 및 주요 질환 치료로 이어지는 상담을 위한 심층 연구가 요청된다.