• 제목/요약/키워드: medical social work

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구급대원의 외상성 스트레스 영향요인 (Factors Affecting Posttraumatic Stress of Emergency Medical Personnels)

  • 백미례
    • 한국방재학회 논문집
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    • 제11권1호
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    • pp.29-35
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    • 2011
  • 본 연구는 구급대원의 외상성 스트레스, 사회적지지, 업무부담감과 대처형태를 알아보고 외상성스트레스와 적극적 대처에 영향을 주는 영향변수들을 알아보고자 하였다. 2009년 4~5월까지 중앙소방학교에서 교육 중인 전국과 C도에서 근무하는 구급대원들을 편의표집하여 총143부가 SPSS WIN 14.0 program을 이용하여 분석되었다. 외상성스트레스 검사는 Weiss(1997)가 다시 제작한 IES-R 도구를 사용하였고 최은숙(2000)이 수정, 개발한 업무부담감 측정도구와 오진환(2006)의 연구에서 수정 보완한 사회적 지지 측정도구와 이장호(1988)등의 연구에서 총 62문항으로 구성된 대처방식을 측정도구를 사용하여 분석하였다. 외상성스트레스 고위험군은 74명(51.7%)로 나타났고 일반적 특성에 따른 외상성스트레스 정도는 나이, 결혼, 학력, 직급에서 유의한 차이를 보였다. 유의수준 p=0.000에서 고위험군이 외상성 스트레스의 모든 세 하위영역(t=20.25), 업무부담감(t=5.75), 소극적 대처(t=4.19)와 적극적 대처방법(t=5.61)에서 높은 것으로 나타났다. 외상성스트레스와 주요변인간 상관관계는 유의수준 p=0.000에서 사회적 지지를 제외한 업무부담감(r=0.508), 적극적 대처(r=0.375), 소극적 대처(r=0.505)와 상관관계가 있는 것으로 나타났다. 구급대원들의 외상성스트레스에 가장 큰 영향을 미치는 요인으로는 업무 부담감(0.371)과 소극적 대처(0.366)로 나타났고 또한 외상성 스트레스 고위험군에 가장 영향을 주는 변수로도 업무 부담감(odds ratio=1.064, 95% 신뢰구간:1.031-1.103)과 소극적 대처(odds ratio=1.050, 95% confidence interval:1.022-1.080)로 나타나 일치하였다. 적극적 대처에 가장 큰 영향을 미치는 요인으로는 외상성 스트레스(0.392)와 사회적지지(0.158)로 나타났다. 따라서 구급대원의 외상성 스트레스를 감소하기 위해 업무부담감을 줄이고 소극적 대처를 감소시키고 대신 사회적 지지를 높여 적극적 대처를 할 수 있는 정책적 대안이 필요하다.

종합병원 외래진료부의 공간구성과 규모계획에 관한 조사연구 - 최근 계획된 500병상 이상 규모의 종합병원을 중심으로 - (A Study on the Spatial Organization of Outpatient Department in General Hospital - Focused on the Latest Planned General Hospital of Scale more than 500 Beds -)

  • 손재원;이특구
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제13권2호
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    • pp.53-60
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    • 2007
  • Various changes in medical environments including growing elderly population, chronic diseases, deepening competition among hospitals since opening to foreign medical service, economic strategy for improvement of profit system have caused hospitals to be specialized. In this backgrounds, the purpose of this study is to receive basic data for architectural planning on the spatial organization of outpatient department in general hospital. The results of this study were as follows; First, major changes of outpatient department in general hospital are composed of 'co-work in medical examination and treatment', 'decentralization of diagnosis and treatment(D/T)' and 'patient-oriented medical service'. Changes by co-work system include appearance of medical offices for co-work, activation of specialized clinics, grouping of E/T section for outpatient and various types of specialized centers. Second, the grouping of E/T sections means the modification of E/T system and organization in general hospitals, and a new spatial organization will be needed. Third, the types of specialized centers are getting varied. they are classified into several types including disease-resource, social stratum-resource, human organ-resource, health-resource, rehabilitation-resource, alternative medical center and so on.

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『상한론(傷寒論)』 변병진단체계(辨病診斷體系)에 근거하여 갈근황연황금탕(葛根黃連黃芩湯) 투여 후 호전된 성인, 소아 ADHD 4례 (Case Series Reporting 4 Cases of Attention Deficit Hyperactivity Disorder (ADHD) Treated with Galgeunhwangryeonhwanggeum-tang based on Disease Pattern Identification Diagnostic System by Shanghanlun)

  • 윤효중;김민환;두인선;이성준
    • 대한상한금궤의학회지
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    • 제15권1호
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    • pp.85-115
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    • 2023
  • Objectives : This study reports on the cases of four ADHD patients who treated with herbal medication based on Disease Pattern Identification Diagnostic System (DPIDS). Methods : Two children and two adults were diagnosed with ADHD according to DSM-V, and Galgeunhwangryeonhwanggeum-tang was administered. The parents of the two children completed the Korean ADHD Rating Scale (K-ARS) before and after treatment, while the other patients used the Korean ADHD Self Rating Scale (K-ASRS). The patients' somatic symptoms and other issues were evaluated through interviews. Results : In the first case, the K-ARS scale exhibited a change from 28 to 3. The patient demonstrated improvements in attention, concentration, and social behavior, along with the elimination of self-injurious behavior. In the second case, the K-ARS scale showed a change from 41 to 9. The patient in the third case demonstrated improved chronic fatigue, increased attention, work efficiency, and enhanced social skills, leading to maintaining employment for over six months for the first time in their life after the treatments. Additionally, the patient in the fourth case demonstrated improved work concentration and relief in nocturia. Conclusions : In this study, four patients exhibited improvements in symptoms of attention deficit, hyperactivity, and impulsivity before and after herbal treatment, leading to enhanced academic and social relationships. As the patients progressed in their health restoration, symptoms related to the genitourinary system also showed improvement.

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교대근무 부적응 증후군의 개념 분석 (Concept Analysis of Shift Work Maladaptation Syndrome)

  • 윤미정;이은남;원윤희
    • 근관절건강학회지
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    • 제21권2호
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    • pp.135-144
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    • 2014
  • Purpose: The purpose of this study was to analyze and clarify the concept of shift work maladaptation syndrome and to facilitate development of interventions for the shift work adaptation. Methods: This study used Walker and Avant's concept analysis process. Results: Shift work maladaptation syndrome can be defined as the following attributes: 1) destruction of the circadian rhythm, 2) existence of a threshold, 3) individual characteristics (year of career, type of personality, and type of coping) 4) somatization, and 5) negative emotional conditions. The antecedents of shift work maladaptation syndrome consist of counterclockwise shift work, irregular shift cycle, night work which is breaking circadian rhythm, and lifestyle changing. The consequences as a result of shift work maladaptation syndrome are deterioration of health (gastrointestinal, neuro-psychic, cardiovascular function), reduction of social relationships, and turnover or resign. Conclusion: The results of this study can be useful as the foundation of shift work adaptation implementation.

Coping and Quality of Life in Turkish Women Living with Ovarian Cancer

  • Tuncay, Tarik
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권9호
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    • pp.4005-4012
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    • 2014
  • Background: This study investigated the utilization of both problem and emotion focused coping strategies and their association with aspects of quality of life among Turkish women with ovarian cancer undergoing chemotherapy. Materials and Methods: The convenience sample consisted of 228 patients in all disease stages. The data were collected using the brief COPE, QOL-Cancer patient tool, sociodemographic sheet, and medical variables were gathered from patients' medical charts. Results: Findings reveal that quality of life is moderately high for this group of cancer patients, despite some specific negative facets of the illness and treatment experience. Acceptance, emotional support and religion were the most frequently used problem-focused coping strategies and self-distraction, venting and behavioral disengagement were the most frequently used emotion-focused coping strategies reported by patients. Overall quality of life and, particularly, psychological and spiritual well-being scores of younger patients were lower. Patients reported using significantly more problem-focused coping than emotion-focused coping, and more problem-focused and less emotion-focused coping predicted greater quality of life. Problem-focused coping was related to patients' physical and spiritual well-being and emotion-focused coping was related inversely with psychological and social well-being. Conclusions: Coping strategies are influential in patient quality of life and their psychosocial adaptation to ovarian cancer. Psycho-oncology support programs are needed to help patients to frequent use of problem-focused coping and reduce emotion-focused coping strategies to improve overall quality of life.

Facilitators and Barriers in the Use of a Checklist by Insurance Physicians during Work Ability Assessments in Depressive Disorder

  • Blok, Sebastiaan;Gouttebarge, Vincent;Slebus, Frans G.;Sluiter, Judith K.;Frings-Dresen, Monique H.W.
    • Safety and Health at Work
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    • 제2권4호
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    • pp.328-335
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    • 2011
  • Objectives: Depressive disorder (DD) is a complex disease, and the assessment of work ability in patients with DD is also complicated. The checklist depression (CDp) has recently been developed to support such work ability assessments and has been recommended for implementation in insurance medicine, starting with an analysis of the organisational and social contexts. The aim of this study was to identify the potential facilitators and barriers in the use of the CDp by insurance physicians (IPs) during work ability assessments of employees on sick leave due to DD. Methods: A qualitative research was conducted based on semi-structured interviews. The participants were IPs with at least one year of work experience in performing work ability assessments. The interviews were audiotaped, transcribed and analysed qualitatively. Results: Ten IPs (7 males, 3 females; mean 53 years) were interviewed. Important facilitators, which emerged for use of the CDp, were an oral introduction for colleagues and staff, support from management, valuing the increased transparency in work ability assessments with using the CDp, having adequate time for assessments as well as modification of the appearance (colour, plasticised form) and content (clarifying aspects of the examples) of the assessment tool. The fear of the loss of autonomy, lack of added value of the CDp, high workload, inadequate instructions and lack of time were mentioned as barriers. Conclusion: Adequate introduction to the use of CDp and the fear of the loss of autonomy of IPs need special attention in planning its implementation.

119구급대원의 저혈당 환자에 대한 병원 전 응급처치현황과 개선방안 (Prehospital Treatments of the Patient with Hypoglycemia by 119 Emergency Medical Technicians - Analysis of the Current Data and Survey -)

  • 안희정
    • 한국응급구조학회지
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    • 제14권1호
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    • pp.31-46
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    • 2010
  • This study was intended to analyze the clinical characteristic of the patient with hypoglycemia and the status of prehospital treatments by 119 emergency medical technicians well as the cause of inappropriate emergency treatment by 119 emergency medical technicians in a bid to seek the measures for improvement, thereby enhancing the emergency medical services before medical treatment at hospital. Examination of the daily work log on 430 patients suffering with hypoglycemia who were sent to the university hospital in Gyunggi-Province by 119 emergency medical technicians, beginning on Jan 1, 2004 till Dec 31. 2008 was carried out and the survey of 206 119 emergency medical technicians working at the region of Gyunggid-Province was conducted from Sep 19 through Oct 6, 2009. Evaluation of the frequency and percentage and ANOVA analysis using SPSS WIN 14.0 program was carried out. In view of the examination of daily emergency work log and questionnaire, prehospital treatment for the patients with hypoglycemia needs to be further improved in general, and to provide the emergency treatment in accurate and timely manner, improvement of the system such as assignment of licensed rescue members and development of protocol that will replace the medical consultant system, mandatory emergency treatment, constant and efficient training and maintenance of emergency rescue records shall be implemented, and furthermore, social recognition to 119 emergency medical technicians shall be improved to encourage them to perform more positive way and manner.

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고용불안정과 가구소득 대비 개인 의료비 지출 비중의 연관성 (Relationship between Work Unstability and Personal Medical Expenditure Ratio)

  • 정우영;한윤수;김찬호;황윤태;이예진;노영민;노진원
    • 한국병원경영학회지
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    • 제24권2호
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    • pp.1-11
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    • 2019
  • Purpose: The purpose of this study is to identify relationship between work unstability and personal medical expenditure ratio focusing on wage workers' contract period. Method: This study analyzed 2015 yearly data beta version of Korea Health Panel, co-managed by Korea Institute for Health and Social Affairs and National Insurance Corporation for data analysis. When executing linear regression, Household income was applied with equivalized income, and the proportion of personal medical expenditure was naturally logged to perform linear regression and the demographic and socioeconomic factors were taken into account. The demographic and socio-economic factors were also considered. Findings: As a result of reviewing the used factors, it was found that the more unstable work status, the higher personal medical expenditure ratio. This result corresponds to 'The Theory of Fundamental Causes' by Link & Phelan. Conclusion : It indicates that policy efforts should be made to improve the working environment and health level of socially unstable workers.

Factors associated with clinical nurses' preconception health behavior in Korea: a cross-sectional survey

  • Yoon-Jung Park;Sun-Hee Kim
    • 여성건강간호학회지
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    • 제30권1호
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    • pp.79-89
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    • 2024
  • Purpose: Nurses have been reported to be at an increased risk for miscarriage and preterm labor. However, there is limited knowledge regarding nurses' preconception health behaviors. Therefore, this study aimed to identify factors influencing these behaviors. Methods: One hundred sixty nurses, who were planning their first pregnancy within the upcoming year, participated in an online survey from August 11 to October 31, 2021. Data on preconception health behavior, perceived health status, pregnancy anxiety, nursing practice environment, and social support were analyzed using the t-test, Pearson correlation coefficients, and multiple regression analysis. Results: Age (p=.024), educational level (p=.010), marital status (p=.003), work experience (p=.003), satisfaction with the work department (p<.001), smoking status (p=. 039), and previous health problems related to pregnancy outcomes (p=.004) were significantly associated with nurses' preconception health behaviors. Furthermore, perceived health status (p<.001), pregnancy anxiety (p=.011), nursing practice environment (p=.003), and social support (p<.001) showed significant correlations with preconception health behaviors. Social support (β=. 28, p=.001), satisfaction with the work department (β=.23, p=.032), marital status (β=.22, p=.002), and perceived health status (β=.23, p=.002) were confirmed as factors associated with preconception health behaviors. These factors explained 40.9% of the variance in preconception health behaviors (F=6.64, p<.001). Conclusion: Clinical nurses' preconception health behaviors were influenced by social support, perceived health status, satisfaction with the work department, and marital status. Interventions to improve clinical nurses' preconception health behaviors should target social support and perceived health status. A preconception health behavior education program considering clinical nurses' marital status and satisfaction with the workplace can also be implemented.

의과대학 교수들의 탈진: 부산·경남지역 3개 의과대학 교수 탈진 빈도와 양상 (Burnout among Medical School Faculty Members: Incidence and Demographic Characteristics at Three Medical Schools in the Busan and Gyeongnam Area of Korea)

  • 서지현;김부경;배화옥;임선주;김경한
    • 의학교육논단
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    • 제16권2호
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    • pp.67-76
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    • 2014
  • Few studies have examined burnout among the faculty of medical schools in the Republic of Korea. The aim of this study was to determine the level of burnout and its associated factors among the faculty members of three medical schools in the Busan-Gyeongnam area, and to summarise the available literature on burnout. We conducted the survey using a validated questionnaire that incorporated the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) as well as questions about demographic characteristics, working experience, health, lifestyle, most time spent and most difficult work, and suicidal ideation and job quitting ideation of the survey participants. MBI-HSS scores were analysed in the three dimensions of emotional exhaustion (EE), depersonalization (De), and personal accomplishment (PA). Through the survey, the 186 professors, 49% among the total, provided data which were included in the present analysis. More than thirty per cent (37.1%) of the professors reported at least 1 symptom of burnout. For burnout dimensions, 11.8% of the respondents scored high for EE burnout, 25.3% for De, and 14.5% for PA, with 1.6% scoring high on all three dimensions of burnout. High burnout was found to be strongly associated with several of the variables under study, especially hours worked per week, self-rated health, career (range, 4 to 9 years), and age (range, 50 to 59 years). The EE score was highest for the professors who chose 'patient care' as the most difficult type of work. This study showed that just over one-third of professors have at least 1 symptom of burnout and working more hours per week, short length of work (years), and especially suicidal ideation seem to be associated with the burnout of medical school faculty members in the Busan-Gyeongnam area. In summary, a greater risk of burnout of physicians (including medical professors) seems to be associated with specialties at the front line of care, working more hours per week, work-life imbalance, low self-efficacy, depression, and conflicts with colleagues and patients.