• 한국사회복지학
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• 제69권2호
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• pp.143-169
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• 2017

본 연구는 서울특별시 북부병원 301 네트워크 사업에 참여한 이용자들의 경험을 통해, '보건-의료-복지' 네트워크를 통한 통합적 지원의 의미와 운영의 구체적인 맥락을 탐색한 연구이다. 이를 위해 일반적 질적연구 방법을 적용하여, 총 10명의 연구 참여자와의 심층면접을 통해 얻어진 자료를 주제분석하였다. 분석 결과, 이용자들은 301 네트워크 서비스 참여 이전 가난과 질병의 악순환으로 삶의 의지를 상실하였으나, 서비스 참여를 통해 '치료-케어-생활안정'의 통합적인 지원을 받을 수 있었고 이를 통해 종국에 그들의 삶의 의지가 재생성되는 경험을 하였다. 이러한 경험의 기저에는 다전문직의 팀의 구성, 병원 내외의 연계 체계의 구축, 치료 지원금 확보를 통한 치료연계 체계 구축, 조정 수준의 자원연계 등의 운영전략과 조건이 작동되고 있었다. 연계의 전략과 조건이 잘 갖추어진 '보건의료복지'의 통합 지원의 시도는 우리나라 보건복지 지원 체계의 한계를 보완할 수 있다는 가능성을 보여주었기에 관련 사업의 확장을 주장하였으며, 이를 위해 연계체계의 더욱 공고한 안정화와 제도적 측면의 개선을 제언하였다.

• 동서간호학연구지
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• 제5권1호
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• pp.90-101
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• 2000

The study attempts to examine the degree of cognition and demand on health promotion center of oriental nursing. It puts unique nursing intervention using traditional health promotion connected with oriental medicine to practical use for residents' health promotion and prevention of disease. With the study design of cross-sectional descriptive study, 516 residents who live in 26 Dongs, Dongdaemoon-gu were selected. The tool of study consists of 30 questions which the study team made for the degree of cognition and demand on health promotion center of oriental nursing. Cronbach's $\alpha$ in the degree of cognition was .8028. Collection of research data had been done from October 1 to October 30, 1999 with help of Dongdaemoon-gu office after pretest from 20 residents. Collected data were analyzed into the number and percentage in the characteristic of a subject and connected with demand on the establishment of center, the mean and the standard deviation in the degree of cognition and F-tests in the difference of the degree of cognition by characteristics. The results were as follow; 1) The characteristic of subject of this study was male 50.6%, and average age was 38.5 years old and 30-39 years old occupied the highest percentage with 31.6%. The married were 71.8%, over high school graduates was 85.6%, monthly income from 500 thousand won to 2 million won was 86.1%. 50.8% was the type living with parents, children and sibling. 2) When they were sick, the institution which residents used at first was a pharmacy(69.2%) and hospital(27.5%), but oriental medicine hospital was just 1.4%. As for subjective health condition, 82.5% answered over average, and 28.7% answered that they had chronic illness such as arthritis, chronic digestion problem, hypertension and so on. As for information collection on health, mass communication(34.9%) and medically concerned people(28.1%) occupied relatively high rate. Free health diagnosis system(36.8%) and establishment of health promotion center(31.5%) among welfare programs that residents want to enjoy were high ranked. The rate using a special institution for health was 17.8%, and among these institutions, the rate using aerobic exercises, health center(7.0%) and steamed room(5.4%) was high. Besides, other institutions such as breathing at the abdomen, finger-pressure therapy, meridian massage, foot massage, and so on were being used. 3) As the average of the degree of cognition on health promotion center of oriental medicine was 2.92, the degree of cognition was medium. The description, "health promotion center of oriental medicine is necessary for health keeping of healthy people, including people who have a problem in health" showed the highest degree of cognition(3.04, ${\pm}0.64$). 4) As for the intention on using health promotion center of oriental nursing, 61.4% said "yes", "no" was just 1.4%. The services that people relatively high wanted to be served from the center were measures reducing stress(68.0%) (relaxation therapy, meditation, breathing at the abdomen and so on), acupuncture(66.5%), finger-pressure(61.6%), moxibustion(57.6%), meridian massage(44.2%), postpartum care(40.3%) and so on. 5) As for the degree of cognition on the establishment of health promotion center of oriental nursing by characteristics of subject, there was significant difference(F=4.03, p=.046) between male(3.01) and female(2.91). But there was no significant difference by age, marital status, level of educational achievement and monthly income. As the above result, cognition on the establishment of health promotion center of oriental nursing was relatively low because people were not familiar with about the health promotion center of oriental nursing yet. However once the center will be established, the degree of demand on the center will be relatively high. So positive advertisement will be necessary, and the management of useful programs will be also required in order to make people recognize the advantage when they actually will use the center. On the other hand, as the subject of the study consists of many young people of below 30, the health problem came to be low. And in the case of sampling, the study using random sampling that can represent population will be required.

• Journal of Korean Dental Science
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• 제1권1호
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• pp.4-9
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• 2008

Purpose : This study sought to examine the aspects of crestal bone resorption and to evaluate the clinical outcomes of the TiUnite$^{(R)}$ (Nobel Biocare, Sweden) anodized implant system. Materials and Methods : Among the 67 patients (211 fixtures) who were treated using TiUnite(r) implants at Seoul National University Bundang Hospital between March 2004 and January 2007, 26 (91 fixtures) were considered in this study. Initial and secondary stabilities were measured using Periotest$^{(R)}$ and Ostell(tm) Mentor. The radiographic evaluation of crestal bone resorption was carried out by measuring the change in crestal bone level at the time of surgery compared to that 1 year after loading. Panoramic radiograph and periapical radiograph were used. Based on the radiographic findings, the shapes of crestal bone resorption were classified. Results : The average amount of crestal bone resorption after 1 year of functional implant loading was 0.30 mm. There was no saucerization in 40 implant fixtures (43.9%), although more than 1 thread were exposed in 51 implant fixtures (56.6%). The success rate of the implants was 94.5%, and the survival rate was 100%. Conclusions : Good clinical outcomes and minor crestal bone resorption were noted in this study. Saucerization for the establishment of biological width was not a general finding in the TiUnite$^{(R)}$ anodized implant system.

• 한국의료질향상학회지
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• 제6권1_2호
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• pp.136-149
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• 1999

Background : Although a number of studies are related to QA improvement, there are few studies applied various method of QA tools. This study reviewed the availability of general quality assurance(QA) tools according to ten steps in performing quality improvement activities at emergency room of a tertiary teaching hospital which has more than 1,000 beds. Methods : All patients in emergency room from 15th Oct. 1997 to 5th Sep. 1998 were surveyed. The survey data based on the patient's records of emergency room were evaluated according to length of stay, and we tried to identify problems with management of emergency room. To solve the problems, our team applied general QA tools(brainstorming, flow chart, nominal group technique, benchmarking, cause-and-effect diagram, run chart, control chart) to quality improvement activities and discussed the availability of the tools. Results : After the activities such as changes of staffing, the establishment of local area network and chest pain clinic, application of triage and so on, the percentage of patient who had stayed more than six hours was reduced from 56.0% to 46.8%. The mean number of patients per day in emergency room was increased from 49 to 62. But the reporting time for laboratory test was not changed after these activities. Conclusion : Each QA tool has unique benefit and limitation, but we can implement and evaluate the quality improvement activities more scientifically and systematically by applying these tools to practice according to QA ten steps.

• 한국병원경영학회지
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• 제5권1호
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• pp.105-128
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• 2000

This study was conducted to investigate the prospects and issues for the implementation of the annual salary system in Korean hospitals. Data were collected from the top management of 669 hospitals in Korea through the self-administerd questionnaires. Of the 175 respondents, 171 questionnaires were used as final data and analyzed using $X^2$ test. The results of the study are as follows. 1) It is found that 49.7% of the study hospitals are operating the annual salary system. 2) Among the hospitals which are not operating the annual salary system, 49.2% have the plan to implement the system and 44.5% have not decided yet whether they introduce the system or not. 3) The proportion of the hospitals which have the plan to implement the annual salary system within 5 years is 96.8%. 4) The proportion of the hospitals which will begin the system only with full-time physicians and middle level managers is 36.2%, while that of the hopsitals which will apply the system to all employees is 30.5%. 5) Hospital Administrators seems to prefer to 10-20% salary gap for the introduction period among the employees with same salary. 6) Most of the respondents are willing to accept the payment system based on the performance. 7) The major issues which should be dealt with before the implementation of the annual salary system are the establishment of the objectivity of performance evaluation criteria, the improvement of teamwork, and the maintenance of organizational commitment. 8) The desirable criteria for employee evaluation are found to be the mixture of the ability, job position, tenure, and the job difficulty.

• 한국콘텐츠학회논문지
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• 제10권11호
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• pp.189-197
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• 2010

본 연구는 치과코디네이터의 업무만족도 및 업무수행효과를 분석하여 보다 체계적인 치과코디네이터 업무를 파악하여 고객만족과 더불어 의료기관 경영효율화를 위한 기초자료를 제공함에 그 목적이 있다. 이를 위하여 부산광역시 행정 각 구에 위치한 치과 의료기관을 비율분포에 의거하여 표집하되, 그 중 치과 코디네이터를 채용하고 있는 226개 치과 의료기관을 대상으로 2009년 8월25일부터 9월25일까지 연구자가 직접 방문하여 설문조사를 실시하였다. 설문내용은 일반적인 특성, 치과코디네이터 업무 만족도와 필요성, 치과코디네이터 채용에 따른 의료서비스 실적 등에 따른 효과 항목으로 구성하였으며 분석결과는 다음과 같다. 첫째. 치과코디네이터의 주요 업무는 고객관리 업무에서 가장 많은 분포를 보였으며, 그 중 상담부분의 업무비율이 가장 높았다. 둘째, 치과코디네이터의 직무수행 만족도에서는 접수 및 상담, 고객관리, 행정조직관리 등 모든 업무에서 비교적 높은 점수를 보였으며, 만족도가 가장 높은 업무는 접수 및 상담업무였다. 셋째, 치과코디네이터 채용 이후 환자진료와 병원수익에서도 효율성이 높게 나타났다. 마지막으로 치과코디네이터 업무개선 부분으로는 고객 서비스마인드 제고, 정확한 업무체계 확립, 코디네이터 임금개선, 코디네이터의 교육내용 개선 등의 순으로 나타났다.

• 가정∙방문간호학회지
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• 제19권1호
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• pp.63-73
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• 2012

Purpose: The purpose of this study was to determine the factors related to the social support, family and friend support as well as home care nurse support, in family caregivers of patients with home care service. Method: The participants were 111 family caregivers of patient, who were receiving home care services from home health care centers of 3 different general hospitals located in Seoul. The data was collected, using self-administered questionnaires. Result: The level of family and friend support varied significantly according to patients' mental status, period of home care nursing, frequency of home care service, caregiver's education level, family income, and family functioning level. On the other hand, home care nurse support varied significantly according to patients' mental status, caregiver's age, existence of interchangeable family caregivers, and family functioning level. There was a significantly positive correlation between the social support the family caregivers' perceived and family function while there was a negative correlation between family and friend support and the period of home care service. Conclusion: Thus, the establishment of nursing interventional program, with understanding of their social support, is needed for both patients and their caregivers.

• 한국병원경영학회지
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• 제6권2호
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• pp.173-201
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• 2001

This study purports to examine the current management and information technology related strategy of Korean hospitals and suggest the effective management strategy in the 21st century when is digital era. Specifically the study tries to analyze the changing trends of strategic orientation and investigate the general management and information technology strategy of Korean hospitals. Self-administered Questionnaires were distributed to 721 hospitals nationwide and finally 98 Questionnaires were analyzed for the study. The results of the study are as follows : 1) Half of the respondent hospitals reported that they have an analyzer orientation in 2000, whereas 19.4% were prospectors, reactors 16.4%, and defenders 14.3%. However, the respondent hospitals intended to have a prospector orientation in the future (2002), while 29.6% planned on being analyzers, 17.3% reactors, and 3.1% defenders. 2) Hospital services for improving patient satisfaction were the most common. strategy for the respondent hospitals, followed by cost containment, organizational restructuring, employee education, purchasing system change, specialization of clinical services, quality improvement of medical care, strengthening the networking with the stakeholders, public relations and marketing strategy, diversification, and installing the information system. However, the strategies of annual salary system, retrenchment of unprofitable services, merit payment based on performance were still not popular for the respondent hospitals. 3) As for the strategies related with information technology, most hospitals have not implemented actively, except for the establishment of home-pages, order communication systems, and insurance claims through electronic data interchange system. 4) There were significant differences in the level of strategy implementation in terms of the ownership, bed size, financial performance, and the top managers I knowledge of information technology. The larger bed size, the higher financial performance, the better knowledge of information technology the top managers have, the more strategies the respondent hospitals implemented. The managerial and political implications for Korean hospitals in digital era were also discussed.

• The Korean Journal of Pain
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• 제26권1호
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• pp.21-26
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• 2013

Background: Postherpetic neuralgia (PHN) is a serious complication resulting from herpes zoster infections, and it can impair the quality of life. In order to relieve pain from PHN, various treatments, including pharmacological and interventional methods have been used. However, little information on the recommendations for the interventional treatment of PHN, along with a lack of nation-wide surveys on the current status of PHN treatment exists. This multicenter study is the first survey on the treatment status of PHN in Korea. Methods: Retrospective chart reviews were conducted on the entire patients who visited the pain clinics of 11 teaching hospitals from January to December of 2011. Co-morbid disease, affected site of PHN, routes to pain clinic visits, parenteral/topical medications for treatment, drugs used for nerve block, types and frequency of nerve blocks were investigated. Results: A total of 1,414 patients' medical records were reviewed. The most commonly affected site was the thoracic area. The anticonvulsants and interlaminar epidural blocks were the most frequently used pharmacological and interventional methods for PHN treatment. For the interval of epidural block, intervals of 5 or more-weeks were the most popular. The proportion of PHN patients who get information from the mass media or the internet was only 0.8%.The incidence of suspected zoster sine herpete was only 0.1%. Conclusions: The treatment methods for PHN vary among hospitals. The establishment of treatment recommendation for PHN treatment is necessary. In addition, public relations activities are required in order to inform the patients of PHN treatments by pain clinicians.

• 대한임상검사과학회지
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• 제41권2호
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• pp.62-66
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• 2009

HbA1c is the major fraction of glycated hemoglobin, and used primarily to identify the average plasma glucose concentration over prolonged periods of time, mostly 2-3 months. It is used as markers for the diagnosis and monitoring of diabetic patients and increasingly used a marker in health screening check up for general populations. In this study, HbA1c was measured with Cobas integra 800 (Roche Diagnostics, Mannheim, Germany), using immunoturbidimetry principles. We established the reference interval for HbA1c with Cobas integra 800 and evaluated its significance. The study subjects were 36,140 (male 57.5%, and female 42.2%) who visited the Health Promotion Center of a tertiary care center in Seoul for health checkup from January to September, 2008. HbA1c levels were measured with immunoturbidimetric method. Statistical evaluation was done with SPSS. Comparison between male and female was checked with Mann-Whitney test, and among age groups with Kruskal-Wallis test. Reference interval for HbA1c was from 4.8% to 6.1%. There was no significant difference between male and female with Mann-Whitney test (P=0.539). There was significant difference among age groups with Kruskal-Wallis test (P<0.05). Reference interval for HbA1c with Cobas integra 800 was 4.8~6.1%, which was different from conventional one, 4.4-6.4%. Establishment of reference interval for each principle is needed.