• 제목/요약/키워드: medicine consultation

검색결과 395건 처리시간 0.034초

500병상 이상 의료기관에서의 전문지원인력의 직군별 업무 수행빈도 분석 (The Frequency of Job Performance of the Korean Professional Medical Support Staff at Medical Institutions over 500 Beds)

  • 김민영;최수정;설미이;김정혜;김희영;변숙진
    • 중환자간호학회지
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    • 제11권1호
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    • pp.15-27
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    • 2018
  • Purpose : This study was intended to investigate the frequency of job performance of the Korean professional medical support staffs (PMSS). Method : The data of 1,666 PMSS from 36 hospitals and over 500 beds were analyzed. The participants were divided into 5 groups: advanced practice nurses (APN), clinical nurse experts, physician assistants (PA), coordinators, and others. Results : Among the 5 main domains of job performance, advanced clinical practice has the highest frequency (111.36 d/y), followed by consultation/collaboration (75.66 d/y), education/counseling (53.54 d/y), leadership (23.90 d/y), and research (19.14 d/y). There was a significant difference in the frequency of job performance between the 5 groups of participants. The invasive activities were more frequent in the PA group. In the education and counseling domain, APNs had a higher level of job frequency than others (p < .001). In the research and leadership domains, APNs and coordinators had more prominent performance frequency than other groups (p < .01). However, there are some ambiguities in the job performance of the 5 groups depending on institutional characteristics. Conclusion : To establish the scope of work of PMSS, organizational and individual efforts are needed to promote and expand the leadership and research domains. To resolve the ambiguities of PMSS' roles, it is necessary to reorganize their titles.

제조업 남성 이주노동자의 직무스트레스와 수면의 질이 우울수준에 미치는 영향 (Effect of Occupational Stress and Sleep Quality on Depression among Male Immigrant Workers Manufacturing Industry, Korea)

  • 김지경;김종은;문덕환
    • 한국산업보건학회지
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    • 제22권3호
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    • pp.244-256
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    • 2012
  • Objectives: This study was conducted to assess the level of depression and its association with sociodemographic characteristics and health related characteristics, job-related characteristics, sleep quality, occupational stress among manufacturing male immigrant worker in Korea. Methods: Total number of subject were 287 workers employed in 19 manufacturing industry. A structured self-administered questionnaire was used to assess each responder's sociodemographic and health related characteristics, job-related characteristics, sleep quality (PSQI), Korean occupational stress (KOSS), Depression (CES-D). The job stress questionna ire was used according to KOSS-26 and depression symptoms were measured using CES-D, which was translated into Korean. We used multiple logistic regression analysis to assess the relationship between risk factors included job stress, sleep quality and depression. Results: The prevalence of depression in survey subjects was 63.9%and poor group (PSQI) (5 point and over at PSQI score)among all subjects were 83.28%. Adjusting for confounding factor, higher the occupational stress (KOSS), depression levels were significantly higher (${\beta}=0.5575$), worse quality of sleep, the more depressed the level was slightly high ${\beta}=0.118$) did not reach statistical significance. Conclusions: The prevalence of depressive symptoms among the study subjects was higher than that among the Korean workers. Especially, the level of depression was more influenced by occupational stress than quality of sleep. Therefore, the author recommend to prepare the effective strategy for reducing the depression and also reducing the occupational stress among immigrant male workers, and the author consider that it need to support the convenient working environment such as consultation for difficulty or health care among immigrant male workers.

체계적인 통증자가조절기에 대한 교육이 수술 후 통증자가조절기 사용에 대한 지식과 태도, 통증 및 진통제 사용량에 미치는 효과 -대장암 수술 환자를 중심으로- (Effects of a Structured Patient Controlled Analgesia (PCA) Education on Knowledge and Attitude Regarding PCA Usage, Pain, and Consumption of Analgesics in Colorectal Surgery Patients)

  • 이진희;조현숙
    • 임상간호연구
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    • 제17권3호
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    • pp.455-466
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    • 2011
  • Purpose: The purpose of this study was to investigate the effects of a structured preoperative PCA education on the knowledge and attitude regarding PCA usage, level of pain, and the consumption of analgesics after operation for colorectal surgery patients. Methods: This study was conducted from 18 Feb to 2 May, 2008. Participants were 80 colorectal cancer patients who would use the IV-PCA after colorectal surgery in a cancer hospital in Gyeonggi-do, Korea. Two groups, experimental and control were consisted of 40 patients each. The 20-minute structured education regarding PCA usage was applied to each patient individually in the experimental group but only the routine anesthetic consultation was given to each patient in the control group the day before the surgery. The SPSS/PC 10.0 program was introduced to analyze the collected data on frequency, percentage, mean, standard deviation, $x^2$-test, t-test and paired t-test. Results: The experimental group with the structured preoperative PCA education showed higher knowledge and more positive attitudes regarding the PCA usage than the control group. Also the experimental group showed better pain control and lower consumption of analgesics at 4, 8 and 24 hours after than the control group. Conclusion: The structured preoperative PCA education is an effective nursing intervention for improving the knowledge and attitude of the colorectal surgery patients on the PCA usage, and enabling the patient to take the analgesic more effectively with lower consumption, while reducing the patients' pain after operation.

인체 골격의 좌표형 임상용어체계 표준 개발 : SNOMED CT 기반의 융복합 연구 (Development of Clinical Terminology System for Human Body : Convergence Research of SNOMED CT)

  • 최병관;최은아;남문희
    • 디지털융복합연구
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    • 제17권4호
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    • pp.177-185
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    • 2019
  • 본 연구는 인체 골격의 좌표형 임상용어체계 표준을 개발하기 위한 방법론적 연구이다. 문헌고찰과 자료 수집을 통해 연구 계획을 수립하여 예비 표준(안)을 만들고 전문가 세미나와 자문을 통해 수정 표준(안)을 만든 후 내용타당도 검증 후 최종(안)을 제시하는 4단계를 거쳐 표준을 개발하였다. 좌표형 임상용어체계 표준은 인체 이미지를 2D는 x, y축, 3D는 x,y,z축으로 좌표화하고, 좌표의 개념과 정의는 SNOMED CT의 FSN, Synonym, Preferred name으로 선조합하고 후조합은 개발 된 18개의 Relationship을 통해 정의되고, 개발된 Relationship 표준의 내용타당도 지수는 평균 4.01점이었다. 본 연구를 통해 인체 골격 이외의 뇌, 장기, 조직 등의 인체의 다른 부분에 대한 후속 표준 개발을 제언하고 임상에서 활용성을 높이기 위한 방법 연구를 제언한다.

구급상황관리사에 의한 심폐소생술 안내 실태 연구 (A study on the cardiopulmonary resuscitation by the emergency medical dispatcher)

  • 김창성;피혜영;이슬기;이현범
    • 한국응급구조학회지
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    • 제25권1호
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    • pp.223-234
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    • 2021
  • Purpose: The purpose of the study is to check up the status of 119 emergency control centers usage. Therefore, the status of use of 119 emergency control centers and the incidence of pre-hospital cardiac arrest patients were investigated. Methods: The emergency activity daily reports and first aid diaries of 119 emergency control centers from January to December 2018 were reviewed. For more accurate status analysis, Among the first aid guidance received in the emergency rescue standard system, the cardiopulmonary resuscitation guide log was reviewed. Results: In 2018, the total usage of the 119 emergency control centers was 1,358,356 calls, hospital guidance werethe most commom (n=629,676, 46.4%), followed by first aid (n=428,027, 31.5%), disease consultation (n=170,238, 12.5%), medical oversight (n=111,188, 8.2%), and interhospital transfer (n=5,052, 0.4%). Regarding the user number per 1,000 persons, Jeju was the greatest at 48.0, whereas Changwon was the lowest at 13.0. A total number of dispatcher-assisted cardiopulmonary resuscitation was 12.181. The time from report to chest compression were 156.2±80.8 seconds for those with previous cardiopulmonary resuscitation training and 168.0±79.3 seconds for those without such training (p<.05). Conclusion: The ratio of first aid instructions, including dispatcher-assisted cardiopulmonary resuscitation, among total usage of the 119 emergency control centers increased. Therefore, additional efforts are required to improve the quality and expertise of information provided through the 119 emergency control centers.

Transitional care for high-risk elderly patients pre/post discharge by collaboration between general hospital and community pharmacy: a pilot study

  • Park, Mi Seon;Lee, Ji Hee;Lee, Heung Bum;Kim, Ju Sin;Choi, Eun Joo
    • 한국임상약학회지
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    • 제32권1호
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    • pp.27-36
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    • 2022
  • Background: Medication-related problems (MRPs) frequently occur during the discharge period. Elderly patients, particularly, are at high risk for these problems due to polypharmacy and the use of potentially inappropriate medications. The purpose of this study was to build and implement collaboration between general hospital and community pharmacies to address MRPs among high-risk elderly patients before/after discharge. Methods: This retrospective study was conducted between June and December of 2020. The inclusion criteria were patients with aged ≥65 years; residents of Jeonju; discharged from Jeonbuk National University hospital; either on medication of exceeding 10 medications (or high-risk medications) after hospitalization through the emergency room, or having severe illness. Patients received medication reconciliation and counselling by hospital pharmacists before discharge and home-visit pharmaceutical care as follow-up by community pharmacists after discharge. Results: Twenty-two patients agreed to home-visit pharmaceutical services. Fifteen and 11 patients completed the first and second home-visit pharmaceutical care service, respectively. Forty-two MRPs were identified in 15 patients. The types of high-frequency MRPs were incorrect administration of drug, adverse drug reactions, medication non-compliance, drug-drug interactions, lifestyle modifications, and expired medication disposal. After consultation with the pharmacist, 34 out of 42 MRPs were resolved. Conclusions: Transitional care for high-risk elderly patients before and after discharge was successfully built and implemented through a collaboration between general hospital and community pharmacies. This study suggests that home-visit pharmaceutical services may have positive effects on the safe use of drugs during the transition period; however, additional research is needed to expand on these findings.

The association between adverse childhood experiences and self-harm among South Korean children and adolescents: a cross-sectional study

  • Scott Seung W. Choi;Jeong-Kyu Sakong;Hyo Ju Woo;Sang-Kyu Lee;Boung Chul Lee;Hyung-Jun Yoon;Jong-Chul Yang;Min Sohn
    • Child Health Nursing Research
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    • 제29권4호
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    • pp.271-279
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    • 2023
  • Purpose: Adolescent self-harm is a public health problem. Research suggests a link between adverse childhood experiences (ACEs) and self-destructive behaviors. Few studies, however, have examined the effects of ACEs on self-harm among Asian adolescents. This study explored the association between lifetime ACEs and a history of self-harm among Korean children and adolescents in elementary, middle, and high schools. Methods: A cross-sectional, retrospective medical record review was conducted on a dataset of a national psychiatrist advisory service for school counselors who participated in the Wee Doctor Service from January 1 to December 31, 2020. The data were analyzed using multiple logistic regression to predict self-harm. Results: Student cases (n=171) were referred to psychiatrists by school counselors for remote consultation. Multiple logistic regression analyses revealed that the odds of self-harm were higher among high school students (adjusted odds ratio [aOR]=4.97; 95% confidence interval [CI]=1.94-12.76), those with two or more ACEs (aOR=3.27; 95% CI=1.43-7.47), and those with depression (aOR=3.06; 95% CI=1.32-7.10). Conclusion: The study's findings provide compelling evidence that exposure to ACEs can increase vulnerability to self-harm among Korean students. Students with a history of ACEs and depression, as well as high school students, require increased attention during counseling. School counselors can benefit from incorporating screening assessment tools that include questions related to ACEs and depression. Establishing a systematic referral system to connect students with experts can enhance the likelihood of identifying self-harm tendencies and offering the essential support to prevent self-harm.

한국 소아 ${\cdot}$ 청소년정신의학 - 과거 ${\cdot}$ 현재 ${\cdot}$ 미래 - (KOREAN CHILD AND ADOLESCENT PSYCHIATRY - A REVIEW OF THE PAST, THE PRESENT AND THE FUTURE -)

  • 홍강의
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제14권2호
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    • pp.139-149
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    • 2003
  • 연구목적:대한소아청소년정신의학회 창립 20주년을 맞아 한국 소아청소년정신의학의 발전 과정(과거)을 돌아보고, 현재의 상황과 문제점을 짚어보고, 앞으로 나아가야할 방향과 주요과제를 살펴 보고자함. 연구방법:학회기록, 관련논문, 원로들과의 개인통신, 저자개인기록과 참여경험을 토대로 함. 결 과:한국소아정신과의 공식출범은 1979년 서울대학교병원외래에 소아정신과클리닉의 개설과, 다음해 동대학병원에 소아정신분과 설립으로 볼 수 있음. 대한소아, 청소년정신의학회는 1983년 한국소아정신의학연구회로 시작하여 1986년 동학회가 공식 창립되었음. 창립후 지난 20년간 학회는 괄목할만한 성장과 발전을 하였는데 그 원동력은 소아청소년정신과 전임의 수련프로그람이 주요대학병원(현재 총 7개)에 생겼고, 1994년부터 한국소아청소년정신의학회지 발간, 1996년 대한소아청소년정신과 수련심사위원회의 발족과 역할수행에서 찾을 수 있음. 현재 한국에 77명의 소아청소년정신의학 분과전문의와 48명의 부가수련중인 전문의, 18명의 전임의가 수련 중에 있음. 현재 한국소아청소년정신과는 국내적으로는 중흥기를 맞이하고 있고 인접전문분야의 발전에도 크게 기여하고 있음, 국제적으로도 아시아소아청소년학회의 창립과 학술활동에 중추적 역할을 하고 있을 뿐 아니라 미국 및 국제 소아청소년정신의학회등 국제무대로 역할을 확대 중임. 결 론:한국소아청소년정신의학은 지난 20년간 성공적인 발전을 해왔고, 의학계와 일반 사회에 크게 기여하고 있음. 그러나 청소년문제에 대한 적극적 개입, 병원 및 정신질환 관련기관에서의 자문, 연결, 학교자문서비스에 좀더 적극적인 참여가 필요함. 우리나라는 지난 30여년간 급격한 정치적, 경제적, 사회문화적 변화를 겪었고, 특히 가족체계의 변화와 붕괴현상은 날로 심각해져, 소아청소년의 정신건강문제는 증가일로에 있는 것이 분명함으로 앞으로 소아청소년정신과 전문의의 역할은 중차대함. 뿐만 아니라, 우리는 아시아지역 국가들의 낙후된 소아청소년정신과서비스 개발과 발전에도 기여하여야할 사명이 있는 것으로 제안함.

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한방공중보건서비스 만족도와 개선방안 (A Study on Satisfaction level with Herbal Public Health Services and its Improvement Plans)

  • 이재원;구진숙;서부일
    • 한국한의학연구원논문집
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    • 제18권2호
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    • pp.65-89
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    • 2012
  • Objective : In order to investigate and improve public Korean medical health service satisfaction level, this study was designed. Method : A questionnaire has been conducted on 212 patients who received treatments at six public health centers in the northern part of Gyeongbuk during 15 days between Sep. 24 and Oct. 8, 2011. Result : 1. An Investigation on the usage of herbal clinics in public health centers reveals that 63.7% have received three times or more medical treatments previously and 61.8% have had their illness treated at other medical institutions. In regard to illness 32.1% have had arthritis or muscle aches. 50.9% have taken insurance medication after having had treatments at the public health centers. 66% have assessed acupuncture and moxa cautery the most satisfying. 2. To a question regarding whether herbal health treatment costs higher than that of physician's, the highest response at 31.6% is 'No'. And to a question regarding whether herbal medicines administered at public health centers have more side effects than that of physician's, the highest response at 39.6% is 'No'. 3. To a question regarding whether herbal treatment of public health centers has little effect against acute disease, 48.1% of responses are 'Fair'. To a question regarding whether herbal treatments, when compared with physician's treatments, boost better recovery of patients, 48.1% of responses are 'Fair'. To a question regarding whether herbal medicine is unscientific, when compared with that of western medicine, 38.2% of responses are 'Fair', To a question regarding whether herbal medicine has faster effect on disease than western medicine, 41.0% of responses are 'Fair'. To a question regarding whether herbal medicine is more effective on disease prevention and promotion of health than disease treatment, 38.2% of responses are 'Fair'. And to a question regarding whether the lack of various types of physical therapy devices in herbal medicine, when compared with western medicine causes inconvenience in herbal treatment, 42.0% of responses are 'Fair'. Those responses take up highest portion at each questionnaire. 4. A comparative study between herbal treatments and physician's treatments has also been conducted. To questions regarding which one of the two considering types of disease is the better, responses are the latter accounted for 43.9% against 'Cancer', the latter accounted for 45.3% against 'Endocrine disorders', the former accounted for 30.7% against 'Psychiatric disorders', the latter accounted for 38.2% gainst 'Otolaryngological(ENT) disease', the former accounted for 47.6% against 'Post traumatic stress disorder', and the former accounted for 52.4% against 'Muscle-skeletal disease'. 5. An investigation on frequency of patients' visits via (p<0.05) of subjects show a statistically significant difference. 6. First, an investigation on frequency of reasons of medical treatments reveal that age, occupation, monthly income, and insurance type (p<0.05) of subjects show a statistically significant difference. Secondly, an investigation on frequency of subjects taking insurance medicines after herbal health treatments reveal that monthly income (p<0.05) of subject shows a statistically significant difference. 7. First, an investigation on frequency of a claim that herbal treatments of public health center does not have great effect on acute disease reveals that age, education, and insurance type (p<0.05) of subjects show a statistically significant difference. Secondly, an investigation on frequency of analysis that herbal treatments has faster effect on disease compared with western treatments reveals that education level, religion, monthly income, and insurance type (p<0.05) of subjects show a statistically significant difference. 8. When herbal clinics of public health centers and general herbal medicine institutions are compared, a survey on additional treatments that herbal clinics need the most reveals that education level, monthly income, and insurance type (p<0.05) of subjects show a statistically significant difference. Secondly, an investigation on frequency of subjects who want various forms of herbal medicines reveals that occupation and insurance type (p<0.05) of subjects show a statistically significant difference. Conclusion : In order to improve efficiency of treatments and enhance patient's satisfaction level, this study suggests measures such as providing a differentiated acupuncture treatments as a whole, streamlining an reception procedure, adopting more elaborated computer system for a patient to get proper medical attention, standardizing a treatment duration in order for a maximum result, keeping regular office hours, and optimizing a consultation time for a patient.

일부 도시지역 주민의 약물 장기복용에 관한 사회의학적 연구 (A Study on the Long-Term Use of Drugs Among Some Urban Residents)

  • 유호상;송동빈;염용태;차철환
    • 농촌의학ㆍ지역보건
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    • 제12권1호
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    • pp.102-110
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    • 1987
  • One of the familiar medical facility that most people reach easily in Korea is the drug store. In Korea, it is possible to purchase all kinds of common drugs without physician's prescriptions, which caused some problems. In other words, such treatment without professional supervision has led to medical, social and economical problems. In view of the above, this study is aimed at revealing the actual status of long-term use of drugs in some urban residents. Long-term use of drugs is operationally defined as using certain drugs at least once a week for more than 3 months. This survey took the residents of Guro 6-Dong where was one of the target areas for Community Health Development Project managed by Korea University as a target population. A sample of 1,517 residents was selected by the multistage sampling method. The interview was conducted on September 21st and 22nd in 1985. The object of this study was to compare the result with that of the rural area which was obtained by the same method, tools and research team, prior to this study in 1984. The results were as follows; 1) The age-standardization of the study showed that 97 per 1,000 urban residents were actually on long-term drug use. The prevalance of long-term use is high in accordance with aging and low with education level. 2) Out of 1,000 urban samples the most popular item involved in the long-term drug use was antipyretic-analgesic-antiinflammatory drug (26), and next in order was vitamin (23), antibiotics (13), digestives (10) and antacids (7). In the rural samples as for compare, that was antipyretic-analgesic-antiinflammatory drug (100), antacids (36), digestives (23), adrenocortical hormones (12) etc. 3) With antipyrctic-analgesic-antiinflammatory drugs, 50% of the urban samples were taking for more than a year, whereas such were 82.7% of the rural samples. Using such a high percentage of antipyretic-analgesic-antiinflamatory drugs in the rural residents is probably due to the high prevalence rate of musculo-skeletal diseases. 4) The urban long-term drug users of antipyretic-analgesic-antiinflammatory drugs were influenced mostly by the mass media (43.6%), next in order was pharmacist (35.9%) and physician (10.3%). Comparing with the result from the rural areas the role of mass media was much more influencial in the urban areas. 60% of them consulted with pharmacists, 14.3% with physicians and 25.7% had no history of consultation in the urban samples. 5) Considering the incidence of knowing the possible side-effects of each drug, 28.2% of the urban residents had no recognition about side-effects prior to use antipyretic-analgesic-antiinflammatory drugs. In the rural residents, 29.67o had no knowledge about the side-effects before using the drug. 6) For the solution of the above problems, it is necessary to limit the advertisement of some drugs by the parmaceutical company. And therapeutic drugs which may bring on side effects in case of long-term use should not be sold at drug stores without physician's prescription.

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