• 한국HCI학회논문지
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• 제3권1호
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• pp.19-26
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• 2008

오늘날 급격한 통신기술의 발전은 우리 삶의 다른 모든 분야와 마찬가지로 의료 환경에도 많은 변화와 새로운 패러다임을 요구하고 있다. 그러나 새로운 컴퓨터 기술이 의료산업을 급속도로 변화시켜 나가고 있음에도 불구하고 그 변화가 실제로 이루어지고 있는 현장을 보는 것은 그리 쉽지 않다. 본 연구에서는 근 미래의 수술실에서 마취과 간호사의 시각으로 마취 과정에 관한 새로운 인터랙션 컨셉을 탐색하고자 하였다. 연구는 5년의 기술적 사회적 시각이 반영되었으며, 근 미래의 수술실에서 새로운 기술이 어떻게 환자 만족을 높이고 간호사의 업무 효율을 향상시켜 궁극적으로 의료 서비스의 품질을 향상시키는지를 보여주고 있다. 연구 결과인 "KEY" 는 다양한 직관적인 인터랙션방식을 통하여 마취과 간호사의 업무에 새로운 비전을 가져왔으며, 이것으로 인해 간호사는 수술과 관련된 기기들로부터 완전히 자유로워 모든 시간동안 환자에게 주의를 기울일 수 있게 되었다. 본 연구의 결과는 안정성, 비용 등의 문제로 아직 초기 단계에 불과하다. 실제적 측면에 있어서 완성도를 높이기 위해 보다 높은 수준의 프로토타입 제작을 통한 논리적 사용자 테스트와 사용자 평가가 요구되며 이를 바탕으로 컨셉의 세밀한 보완 연구가 뒤따라야 한다.

• 지역사회간호학회지
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• 제1권1호
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• pp.299-317
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• 1989

This study was attempted to find out the distribution of industrial nurses, analyze job performance by function and utilization state of medical dispensary among workers. The subjects for this study were 32 nurses working at industry located in Kyungpook and Taegu area. The data was collected through questionaire during the period of August 5-31, 1986, and analysed by the method of frequency and percentage. The following is the main findings of the study; 1. 72.2% of respondents was engaged in manufacturing industry, 33.3% in workplace whose regular workers was more than 2,000 workers. 67.7% in occupational health physicians was part-time system. 2. 93.1% of respondents was 20-29 years age group, 93.1% was graduates of junior nursing college, 96.6% was unmarried. 448% had 1-4 years of total working experiences. 3. For the motives which made them becomes industrial health nurse, 'good employment condition' was 62.1%. For the job satisfaction, 'moderate' was 586%. For the interest about the industrial health, 'moderate' was most frequent (58.6%). In the inservice education, 86.2% of the subjects was received education. 4. For the attitude of the dispensary and industrial nursing of employer, 'necessary' was most frequent (72.4%, 62.6%). 5. All establishment had dispensary facilities, 65.5% of them had independent dispensary. 6. In duty shift, 93.1% of respondents was working in one shift system. 41.4% of respondents was received from 250,000 won to 290,000 Won and 41.4% was belong to personnel section and 24.1% was direct controlled by general business section chief. 7. In the main health problem of their factories, 48.3% of respondents was work-environmental state, 24.1% was health education. 8. In the Dispensary budget, 60% of respondents was under 3,000 won per worker. 9. In the job performance rate by function, nursing service 73.1%, industrial health and nursing management 63.7%, environmental hygiene and safety management 54.5%, medical insurance 44.9%, welfare 38.4%. 10. Main health complaints among workers utilizing medical dispensary was 35.9% of respiratory system, 21.5% of gastro-intestinal system, 11.0% of skeletomuscular system.

• 대한간호학회지
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• 제24권4호
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• pp.545-556
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• 1994

Medical insurance and health care delivery system enabled Korean people to get the necessary medical service, but it caused increased needs for medical service, and resulted in the occurence of some problems such as a lack of manpower and medical facilities. In order to solve these problems, many countries, which already had medical insurance system had developed home care system and it has been regarded effective both in reducing costs and in increasing the rates of turnover of bed. Recently, Korea has included home nursing care in its health care delivery system, and some models of the hospital based home nursing care had been tried and its effects had been evaluated. So, author tried to run a home nursing care for the Cesarean section mothers and evaluate Its effects both in the mother's health and costs. This study was designed as a Quasi-experimental study. Subjects were thirty mothers who got Cesarean section operation in hospital in Seoul. Experimental group consisted of 15 volunteers, and control group were selected by means of matching technique. Data were gathered from February 1st to March 26th by two assistants who were trained by author. Experimental group were discharged on the 4th day after their operation, and got nursing care and assessment about their home three times on the 5th, 6th, and 7th day. Control group stayed in the hospital until 7th day as usual and were checked on the same day as above mentioned To evaluate the state of physiological recovery, vital signs, H.O.F, presence of edema in the legs, bathing, appetite, sleep, presence of pain or discomfort in the breasts, amount of lochia, color of lochia, defecation urination. To compare incidence of complication in experimental group with that in control group, specific assessment was done such variables as smell of lochia, presence of inflammation of operation wound, dizziness, and presence of immobilization in the extremities. The activities of daily living were checked Satisfaction of nursing were checked To calculate costs, author asked subjects to specify expenditure including hospital charge, traffic enpenses, and food expenses. The results were as fellows. 1. On effectiveness of home nursing careThere were n significant differences between experimental and control group in incidence of abnormal symptoms and any complication. The number of taking a bath [POD #5 P=0.001, #6 P=0.0003, #7 P=0.001] and the degree of appetite [POD #5 P=0.03, #6 P=0.02, #7 P=0.013] were significantly higher in experimental group than in control group. Contrary to author's expectation, the degree of the activities of daily living in experimental group was not higher than that of control group. All of the experimental group said they were satisfied with the home nursing care. 2. Cost analysis 1) Hospital charge of experimental group was lower than that of control group. ［P=0.009］ By taking home nursing care, average period of hospitalization was shortened to 3.1 days, and family members could save 22.8 hours. Total amount of money saved by early discharge was 3,443,093 Won. It is estimated that total amount of money saved by early discharge in a year will be 40,398,956 Won. 2) Home nursing care charge of 15 mothers was 1,781,633 Won. It is estimated that total amount of money Saved by it in a year Will be 20,904,493 Won. It was lower altogether than hospital charge of the three days which is 5th, 6th, 7th day of operation. The average cost of single home visit was calculated 10,940 Won. It took 87 minutes per round and it costed 1,017.3 Won. The average hour of home care was 39.0 minutes. 3) It is expected that early discharge can bring forth the increase of hospital income. On the condition that the rate of running bed is 100%, the expected increase of hospital income will be 202,374, 026 Won in a year. Suggestions for further study and nursing practice are as follows : 1. For the welfare of patients and the increased rates of running bed, home nursing care system should be included in the hospital nursing care system. 2. Studies to test effect of home nursing care on the patients with other diseases are needed. 3. Establishment of law on the practice of home nursing care is strongly recommended.

• Journal of Oral Medicine and Pain
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• 제31권4호
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• pp.283-296
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• 2006

과학기술의 발전과 더불어 보건의료분야는 괄목할 성장을 가져왔고 국민생활 수준의 향상과 건강에 대한 관심이 고조됨에 따라 의료서비스의 수요가 급증하고 있다. 이 과정에서 국민의 권리의식의 신장, 의료행위의 본질에 대한 이해부족, 의료기술에 대한 지나친 기대, 상업화된 의료공급체계, 의사의 윤리의식 저하 및 의료법리에 대한 무지 그리고 사회적 불신풍조의 만연, 분쟁해결을 위한 제도적 장치의 결여 등이 요인으로 작용하여 의료사고 및 분쟁이 급증하는 추세이다. 본 연구는 치과관련 단체에서 보유하고 있는 소송과 관련된 자료 및 연세대학교 치과대학병원 구강내과에서 신체감정을 시행한 재판기록을 중심으로 하여 판결전문을 확보할 수 있는 치과 의료사고 판례 중 1994년부터 2004년까지의 민사소송 30례의 판례를 분석하여 다음과 같은 결과를 얻었다. 1. 소송의 연도별 분포에서 2000년 이후 급증하는 추세를 보였다. 2. 소송의 유형별 분포에서 발치와 관련된 소송이 전체의 36.7% 이었다. 3. 소송의 원인을 분석한 결과 불편감, 치료불만족과 관련된 것이 전체의 36.7%, 사망 및 영구손상이 각각 16.7% 이었다. 4. 원고의 소송결과 승소 및 강제조정, 화해권고결정이 60.0% 이었다. 5. 소송에 관련된 병원유형은 치과의원이 60.0%로 가장 높게 나타났다. 6. 소송의 심급별 구성비율에서 2,3심 이상 진행된 경우가 전체의 30.0% 이었다. 7. 손해배상 청구금액은 5천만원 이상 1억원 미만이 36.7%, 1억원 이상이 13.3% 이었고 손해배상 판결금액은 1천만원 이상 3천만원 미만이 40.0%, 1억원 이상이 6.7% 이었다. 8. 소송과 관련된 치과의사수는 2명 이상이 26.7%이었다. 9. 판결까지의 소요기간은 11개월에서 20개월이 46.7%, 21개월에서 30개월이 36.7% 이었다. 10. 의료과실 유무에서는 과실을 판정한 경우가 46.7% 이었고 소송과정에서 신체감정이나 사실조회가 이루어진 경우는 70.0% 이었다. 11. 의사패소 판례(18건)에서 판결의 주안점은 주의의무위반이 72.2% 이었고, 설명의무위반이 16.7% 이었다. 치과 의료분쟁의 경우 치료의 긴급성이 상대적으로 적어 의사의 설명의무 중요성이 폭넓게 요구되며, 주관적인 치료 만족도가 중요시되는 분야이기 때문에 결국 분쟁을 줄이는 방법으로 기술적인 과실도 줄여야 하지만 치과의사와 환자와의 신뢰 관계를 개선하는 것과 의사집단의 자율성(autonomy)의 회복이 중요하다. 그리고 불합리하게 시행되고 있는 의료배상책임보험의 보완과 함께 치과의사단체와 학계가 주도하는 교육 및 의료분쟁시 자문을 구할 수 있는 체계의 확립으로 의료분쟁에 대한 대처가 이루어져야 할 것이다.

• 보건교육건강증진학회지
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• 제2권1호
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• pp.56-80
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• 1984

The main objectives of the present study is to evaluate Physician's Health Education Activities by means of physician's direct response to the prepared questionnaire and patient's perception to the physician in the course of medical care. For the data collection, the present study was conducted from Aug. 16 to Oct. 7, 1983 for 739 patients and 91 physicians who were attended outpatient clinics of 5 general hospitals in Seoul. The major findings are summarized as follows: 1. Self-evaluation on Physician's Health Education Activities (1) In consideration of health education services for the patient, the data revealed that 9.9% of the sampled physician wanted to strength public health and preventive medicine lecture in the curricula at medical education. On the other hand, only 1.1% expressed that they wanted to make it short. (2) In consideration of the necessity of health education service, it was shown that 95.6% of physicians agreed to take it into consideration. Self expression for the practice of health education was placed on the 3.15 score when 5 point scale used. (3) To evaluate the degree of an explanation about medical care for the patient, Index score with 4 point scale was employed. The Index score for the first time was shown that scale was placed on 3.23 for 'diagnosis', 3.12 for 'progress of the disease', 3.11 for 'discription of procedure' and 3.02 for 'cause of the disease' respectively. In comparison of the physician's explanation about the status of disease for the first and the second visitors to clinic, they evaluated themselves as giving more detailed explanation for the second visitors rather than the first visitors. 2. Physician's Health Education Services evaluated by patients (1) To evaluate physician-patient communication at beginning time for taking history about disease, the Index score with 5 point scale was employed. The data on taking history have shown that the score placed on 3.07 for those patients who visited the first time and 2.53 for second visitors. And the score about listening from the patients was placed on 3.52 and 3.42 respectively. (2) The Index score with 5 point scale, as used before, was also employed to evaluate medical care services for the patient. The data evaluated by the patients was shown that the score placed on 4.21 for patient treatment in general, 4.58 for physician's credibility, and 3.6 for physician's kindness. However, approximately 80% of those who failed to understand physician's explanation was caused by highly sophisticated medical terminology. (3) According to the Index score with 4 point scale, to evaluate physician's explanation, the data was shown that the patient who visited the first time gave 2.51 for 'diagnosis', 2.35 for 'progress', 2.11 for 'cause of the disease' and so on. It is acknowledged on the whole that the patients who visited the second time have more satisfaction in physician's explanation about their disease, than those who visited the first time. 3. Comparison of self-evaluation of Physician's Health Education Activities and patient's perception. (1) There was communication barriers between physicians and patients in expressing some medical terminology. For example physician understood that they explained more than 50% of medical terminology into common words for the patient, but 30% of patient complained medical terminology used by physician. (2) Comparing the index score of health education practice recognized by patients and physicians for both first visit and revisit groups, it was shown that the Index score of health education activities evaluated by physicians themselves were slightly higher than the score evaluated by patients.

• 한국병원경영학회지
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• 제22권1호
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• pp.40-50
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• 2017

The purpose of this study is to develop the KPIs(Key Performance Indices) needed to improve management and strategy in the dental clinic based on the four perspectives of BSC(Balanced Scorecard). The questionnaire was conducted on 52 dentists approved by Dental Managment Research Committee in Seoul National University as a panel. Using the Delphi technique, the top five KPIs for each point of perspective in BSC were extracted from KPI pools. In the third survey, the top five KPIs of all points were compared with each other through AHP(Analytic Hierarchy Process) method, and priority and overall importance rankings were calculated. The biggest difference in the three level AHP results was the customer perspective took priority to others. In the second survey, the financial perspective, which was number one, was pushed back. The overall significance of KPIs was in the order of customer, internal process, finance, learning and growth perspective, with the exception of medical profits (5th of 20) and new patient growth (10th of 20). We were able to overcome the limitations of the Delphi Technique with the AHP method. In general, the financial perspective in BSC is known to be the most important, but we conclude that the customer perspective is more important through the pairwise comparison survey. In the current dental service market, which is a long-term recession, excessive competition, customer satisfaction and customer relationship management seem to be the first goal to pursue in dental clinic.

• 대한영양사협회학술지
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• 제14권1호
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• pp.23-35
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• 2008

Improved nutritional intake contributes to maintaining health and quality of life in elderly population and also reducing individual and social medical costs. Most of nutrition assistance programs for elderly, such as congregate or home-delivered meal programs, are not currently serviced in rural communities mainly due to low cost efficiency of program operation. However, the needs and necessity of such programs are presumed to be higher in rural area where the population density of elderly at nutritional risk is relatively high. Therefore, the purpose of this study was to develop a community-based meal program for the rural elderly. In 2007, four rural communities located in Jeon-Nam province were selected and the pilot meal program was applied for three months. Following are key features of the meal program model developed in this study: 1) meal production and service are operated by elderly participants to overcome the voluntary personnel shortage 2) utilization of locally-produced foods is maximized to reduce the meal cost, 3) traditional cooking methods are applied to adjust the food preference of elderly, and 4) foods are serviced on site to minimize the food safety problem possibly caused by delivery process. The pilot programs resulted in high satisfaction with the programs of participating elderly. The community-based meal program model developed in this study is expected to be used as an effective nutrition and health intervention model for the rural elderly.

• 한국산학기술학회:학술대회논문집
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• 한국산학기술학회 2009년도 추계학술발표논문집
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• pp.778-781
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• 2009

본 연구는 정기적인 건강검진을 받는 수검자들이 검진결과에 대한 상담을 받는 것이 건강증진행위에 좋은 영향을 줄 수 있는가에 대한 목적을 가지고 있으며 연구결과를 요약하면 다음과 같다. 1. 검증결과 인구의 일반적 특성에 따른 건강검진 후 교육 및 상담에 대한 만족도 정도는 성별에서는 여성보다 남성의 만족도가 높았고, 직렬의 경우 기능직공무원이 만족도가 높았으며, 재직기간이 오래 될수록 만족도가 높았다. 2. 건강검진 시 상담서비스 만족도와 건강증진행위의 관계 분석결과 만족도 내용에서 '검진결과 설명시 교정해야할 건강 위험에 대한 지적, '검진결과에 따른 건강 상담', '검진 후 결과에 대해 제공하는 상담 및 보건 교육', '검진 후 결과에 관련된 자료나 진료 혹은 상담안내'에서 건강증진행위와 영향관계를 가지고 있는 것으로 나타났다. 3. '검진결과 설명 시 교정해야 할 건강 위험에 대한 지적'은 식사조절과 건강관리행위, '검진결과에 따른 건강 상담'은 건강관리행위, '검진 후 결과에 대해 제공하는 상담 및 보건 교육'은 신체활동과 심리적 안정, '검진 후 결과에 관련된 자료나 진료 혹은 상담안내'는 건강관리행위와 영향관계를 가지는 것으로 나타났다. 위의 연구결과에서 나타난 건강검진서비스 만족도가 낮은 항목의 불만족요인을 분석하여 건강교육 프로그램 계획 시 교육내용에 포함한다면 건강검진서비스 만족도가 상승할 것이며, 건강증진행위를 높일 수 있다고 생각한다.

• 대한인간공학회지
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• 제33권3호
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• pp.215-227
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• 2014

Objective: The purpose of this study was to evaluate Korea's Honam express train's first- and second-class seat discomfort by using pressure measurement, subjective discomfort rating, and physical compatibility. Background: Over the years, the demand for an express train service is continually increasing. A comfortable ride is important to achieving passenger satisfaction. A train seat plays a significant role in fulfilling passenger seating comfort. With this in view, a field survey and pressure measurements were performed on the selected train seat. Method: The pressure ratio at the body-seat interface (thigh and buttock regions) was measured by the pressure mat system. The interface pressure ratio was calculated and compared. The subjective discomfort rating scale was used to evaluate the subjects' overall feeling. The dimensions of train seats were analysed according to the anthropometric and demographic characteristics of the population data from Size Korea. Results: The results highlighted that the interface pressure ratio was greater while participants sat on the second-class seat than the first-class seat in the left- and right-side thigh regions. Also the pressure ratio was greater for the participants in the 1st~25th percentile height groups (149.8~160.8cm). The subjects rated higher discomfort for the second-class seat than the first-class seat. The physical compatibility results showed that the second-class seat's breadth was inadequate for the 95th and 99th percentile male. Conclusion: Overall, interface pressure measurement, subjective discomfort score and physical compatibility results showed that the second-class seat was more uncomfortable for the passengers than the first-class seat. Application: The adopted methodologies could be used to measure the seating comfort of the train seats.

• 가정과삶의질연구
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• 제35권2호
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• pp.93-112
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• 2017

The adolescent birth rate has doubled in the recent decade. As a result, the Korean government has implemented support for adolescent single-parent families by expanding the scope of coverage of the Single-parent Family Support Act in 2010. In order to understand whether experiences of facility entry programs and the Single-parent Family Support Act for adolescent single-parents were helpful or not, this study verified the relationship to mental health. This study utilized a part of the National Youth Policy Institute's 'Research on the Actual Condition of the Adolescent Pregnancy, Birth and Rearing Children.' Participants of the study were 218 adolescent single-parents at the age of 24 and younger. This study used the research methods of descriptive statistical analysis, ${\chi}^2$test, t-test, and one-way analysis of variance. The findings and discussion of this study are as below: Firstly, the depression level of adolescent single-parents who had been raised by grandparents was higher than other family types to a meaningful standard and adolescent single-parent's cognition of the original family's economic level was related to self-esteem and parenting efficacy. Secondly, the practical single-parent family support policy for adolescent single-parent's pregnancy, birth and rearing children has shown a higher reception rate, and medical service of facility entry programs has a higher satisfaction level. However, some of the facility entry programs and the Single-parent Family Support Act have a low reception rate and it should be considered whether to maintain them or not.Lastly, parts of facility entry programs and the Single-parent Family Support Act for adolescent single-parents have increased self-esteem and parenting efficacy and reduced parenting stress and depression's levels.