• 대한영양사협회학술지
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• 제20권4호
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• pp.235-246
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• 2014

The purpose of this study was to evaluate nurses' perception of clinical nutrition services. A cross-sectional survey design was performed. The research was accomplished by using questionnaires developed for this study and administered from September 12 to December 31, 2013 to 343 nurses at 43 tertiary hospitals and 20 general hospitals. The percentage of nurses who recognized clinical nutrition certificate as issued from nation was 27.8%. The mean scores of perceived usefulness on clinical nutrition services was 4.23/5.00, whereas that of perceived implementation was 3.76/5.00. The mean scores of necessity of disease-specialized clinical dietitian at capital hospitals were significantly higher for obesity (P<0.01), cancer (P<0.05), and infant & childhood disease (P<0.01) than at local hospitals. The rates of nurses' experience in group education on cancer at capital hospitals (21.7%) was significantly higher than that at local hospitals (10.3%) (P<0.05). The mean scores of perceived importance of clinical nutrition services were 4.46/5.00 for 'group nutrition education', 4.46/5.00 for 'individual consultation', and 4.40/5.00 for 'nutrition management for enteral nutrition (EN) patients'. The most common reason why clinical nutrition services are important was 'improving malnutritional status'. To activate clinical nutrition services especially at local hospitals, clinical dietitians should give systematic assistance to patients and also institutional supports are needed.

• 지역사회간호학회지
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• 제1권1호
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• pp.107-114
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• 1989

기존의 통계자료를 이용하여 1985년과 1986 년의 부산 경상남도 지역 보건소를 중심으로 본 보건간호사의 사업 활동에 대한 조사연구는 다음과 같았다. 1. 연도별 사업분야별 간호사 수 사업분야별 간호사 수는 1985년, 1986년 모두 부산지역은 가족계획 사업에, 경남지역은 진료실 사업에 활동하는 수가 가장 많았다. 2. 연도별 보건소당 인구수 부산지역의 보건소당 인구수는 1985년에 351,681명에서 1986년의 357,884명으로 dir간 증가하였고, 경남지역은 1985년에 130,247명, 1986년의 130,252명으로 비슷하였다. 3. 연도별 보건간호사당 인구수부산지역의 보건간호사당 인구수는 1985년의 30,008명에서 1986년에는 31,120명으로 증가하였으나, 경남지역은 오히려 1985년에 22,590에서 1986년에 16,747명으로 감소하였다. 4. 연도별 사업분야별 활동 상황 연도별 사업분야별 활동 상황에서 부산지역은 가족계획사업을, 경남지역은 영유아 보건사업을 가장 많이 하였다. 5. 연도별 사업분야별 간호사당 인구수 부산지역은 1986년 모자보건 사업 대상자 수가 353,665멍으로 가장 많았으며, 경남지역은 1985년에 모자보건 대상자가 46,220명으로 가장 많았다. 6. 연도별 사업분야별 간호사당 관리된 수 사업분야별 간호사당 관리된 수는 부산 경남지역 모두 모자보건 사업이 가장 많이 관리되었다.

• 대한임상검사과학회지
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• 제52권3호
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• pp.271-277
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• 2020

"건강검진"이란 건강상태 확인과 질병의 예방 및 조기발견을 목적으로 건강검진기관을 통하여 진찰 및 상담, 신체계측, 진단검사, 병리검사, 영상의학 검사 등 의학적 검진을 시행하는 것을 말한다. 건강검진의 종류에는 일반건강검진, 종합건강검진, 특수건강검진, 기타건강검진이 있다. 건강검진센터에서 근무하고 있는 임상병리사들의 일반건강검진 업무의 비중은 전체 업무에서 50% 이상 기여를 하고 있는 것으로 추정할 수 있다. 질환의심 비용적인 측면은 25% 이상 기여하는 것으로 추정할 수 있다. 진단검사 비용은 약 5%로 추정되며 의학진단 사용 비율은 70%를 차지하고 있다. 본 연구 결과에서 임상병리사들이 건강검진 업무에서 사회적, 경제적, 정책적인 타당한 처우를 받고 있는가를 검토되어져야 할 것이다. 임상병리사의 미래는 향후 업무적으로 정밀의료와 원격의료에서 진단검사 및 질 관리에서 전문성이 더욱 확대될 것으로 예측된다. 따라서 임상병리사들은 국가건강검진 관련 정부정책결정에 적극적으로 참여하고 더불어 처우개선의 노력이 필요할 것이다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권14호
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• pp.5927-5936
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• 2014

Introduction: Breast cancer is the most common cancer among Jordanians. Breast cancer patients suffer from several negative consequences after treatment and these include pain, fatigue, sexual problems, appearance and body image concerns, with psychological dysfunction. This could affect the patient quality of life and psychological well-being. To the best of our knowledge, there is no published quantitative data on the quality of life and psychological well-being of breast cancer patients in Jordan. The objective of this study was to obtain such data and assess predictors with calculated scores. Methods: In this cross-sectional study conducted among breast cancer patients in Jordan diagnosed in 2009 and 2010, assessment was performed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), the Breast Module (QLQ-BR23) and the Hospital Anxiety and Depression Scale (HADS). Clinical, demographic and psychosocial indicators that could predict patient quality of life scores were collected. Results: The number of patients interviewed was 236 (mean age=$50.7{\pm}10.7$ years). The mean Global Health score for the QLQ-C30 was $63.7{\pm}20.2$ SD. Among functional scales, "social functioning" scored the highest ($mean=78.1{\pm}28.6$ SD), whereas "emotional functioning" scored the lowest ($mean=59.0{\pm}SD\;33.5$). For the QLQ-BR23, the worst scores within the functional scales were for "body image" ($mean=52.1{\pm}36.8$ SD) and "future perspective" ($mean=52.9{\pm}38.5$ SD). The worst symptom was "upset by hair loss" ($mean=69.8{\pm}43.0$). The mean HADS scores was $18.{\pm}9.0$ SD. Out of study participants, 53% scored abnormal on the anxiety scale and 45% on the depression scale. Severe depression and severe anxiety were detected among 8% and 14% of study participants, respectively. Statistically significant predictors for individual scores were similar to those reported in published studies, such as the presence of recurrence since baseline, family history of cancer, low educational status, current social problems, extent of the disease, presence of financial difficulties, and employment status. Conclusions and Recommendations: Breast cancer survivors in Jordan have overall good quality of life scores when compared with patients from Western countries. However, their psychological wellbeing is more impaired. There is an urgent need for psychosocial support programs and psychological screening and consultation for breast cancer patients at hospitals of the Ministry of Health in Jordan.

• 한국산학기술학회논문지
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• 제13권1호
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• pp.274-283
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• 2012

본 연구는 대학생의 자아존중감과 정신건강과의 관계를 파악하여 대학생활에서 자아존중감을 향상시키고 건전한 정신건강을 유지 향상시킬 수 있도록 효과적인 교육 및 상담 활동을 위한 기초자료로 활용하고자 본 연구를 시도하였다. G시에 소재한 2개 종합대학, 3개 전문대학 재학생을 대상으로 2010년 10월 2일부터 12월 2일까지 설문조사를 실시하여 468부를 최종 분석하였다. 연구결과는 첫째, 일반적 특성과 인지적 자아, 평가적 자아 및 자아존중감 간의 관계에서는 유의하지 않았다. 둘째, 일반적 특성과 정신건강과의 관계에서는 경제상태, 입학동기, 학과 만족도, 교우관계, 건강상태에서 정신건강 하위영역과 유의한 결과를 보이고 있다. 셋째, 인지적 자아, 평가적 자아 및 자아존중감 간에는 순상관관계를 나타내고 있다. 인지적 자아, 평가적 자아 및 자아존중감은 강박증, 적대감, 대인예민, 신체화, 불안, 편집증, 정신증에서 역상관관계가 있은 것으로 나타났다. 결론적으로, 본 연구결과를 기초로 하여 대학생들의 자아존중감을 증진시키고 정신건강을 완화할 수 있는 정규적인 건강교육 프로그램의 개발과 적용이 요구되며, 그에 따른 효과를 검증할 수 있는 후속 연구가 필요하다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제26권1호
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• pp.85-92
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• 2000

Common dental procedures(dental extraction & minor operation) are potentially stress-inducing in many patients, especially medically compromised patients. The body's response to dental stress involves the cardiovascular system(an increase in cardiovascular workload), the respiratory organ and the endocrine system(change in metabolism). To minimize the stress to the medical risk patient, the stress reduction protocol was established. The obtained contents were as follows: (1) Recognize the patient's degree of medical risk (2) Complete medical consultation before dental therapy (3) Schedule the patient's appointment in the morning (4) Monitor and record preoperative and postoperative vital signs (5) Use psychosedation during therapy (6) Use adequate pain control during therapy (7) Short length of appointment : do not exceed the patient's limits of tolerance (8) Follow up with postoperative pain/anxiety control (9) Telephone the higher medical risk patient later on the same day that treatment was given Though the stress reduction protocol above was applied to the dental extraction in medically compromised patients with the advanced infected teeth, the final responsibility for the complications(syncope, bleeding & infection, etc.) in a patient rests with the dentist who ultimately treats him. For the prevention of postextraction complications & poor prognosis, the authors treated the advanced infected teeth with the pulp extirpation, opening drainage through the canal and complete occlusal reduction. The final extraction and wound closure were then done after $1{\sim}2$ weeks. The final prognosis was comfortable without common complications.

• 보건행정학회지
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• 제25권3호
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• pp.185-196
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• 2015

Background: Issues concerning with the classification accuracy of Korean Outpatient Groups (KOPGs) have been raised by providers and researchers. The KOPG is an outpatient classification system used to measure casemix of outpatient visits and to adjust provider risk in charges by the Health Insurance Review & Assessment Service in managing insurance payments. The objective of this study were to refine KOPGs to improve the classification accuracy and to evaluate the refinement. Methods: We refined the rules used to classify visits with multiple procedures, newly defined chemotherapy drug groups, and modified the medical visit indicators through reviews of other classification systems, data analyses, and consultations with experts. We assessed the improvement by measuring % of variation in case charges reduced by KOPGs and the refined system, Enhanced KOPGs (EKOPGs). We used claims data submitted by providers to the HIRA during the year 2012 in both refinement and evaluation. Results: EKOPGs explicitly allowed additional payments for multiple procedures with exceptions of packaging of routine ancillary services and consolidation of related significant procedures, and discounts ranging from 30% to 70% were defined in additional payments. Thirteen chemotherapy drug KOPGs were added and medical visit indicators were streamlined to include codes for consultation fees for outpatient visits. The % of variance reduction achieved by EKOPGs was 48% for all patients whereas the figure was 40% for KOPGs, and the improvement was larger in data from tertiary and general hospitals than in data from clinics. Conclusion: A significant improvement in the performance of the KOPG was achieved by refining payments for visits with multiple procedures, defining groups for visits with chemotherapy, and revising medical visit indicators.

• 한국학교보건학회지
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• 제24권2호
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• pp.141-154
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• 2011

Purpose: The purpose is to provide basic information for establishing improvements on performance-based pay's evaluation method of health teachers. Methods: For subjects, 200 teachers at public elementary schools and 200 health teachers at public elementary schools in Gyeonggi-do were conveniently sampled, and then surveyed through a questionnaire. The questionnaire was to recognize recognition of teachers working under the teacher's performance-based pay system, which was quoted in the questionnaire of Choi ji-hye (2005) and Lee mi-gyeong (2008). Inquiry for the recognition of teachers on evaluation of health teacher's performance-based pay system and improvements on the performance-based pay's evaluation method of health teachers were used after consultation with five incumbent health teachers and a review with the thesis director. Results: The performance-based pay's evaluation method of health teachers has the same method with general teachers in schools, so it is not fair to evaluate the performance of health teachers. The ways to improve the performance-based pay evaluation method of health teachers is as follows: first, the approval on improving 'the number of class hours' which is a detailed item of a teacher's performance evaluation criterion to 'the number of health lesson hours per week and the number of students visiting the school infirmary per week'; second, improving 'life guidance' into 'counseling results of medically-treated students, parents of students and personal hygiene guidance'; third, improving 'a teacher in charge' into 'awarding of points by being recognized as a health teacher in charge of all students and considering the economic situation of the region,; forth, improving 'difficulty of position' into 'the number of health-teacher's annual promotion task items and the treatment number of issuing and receiving of official documents', and improving the 'task difficulty' into 'importance and urgency of emergency patient management, risk level and urgency of infectious diseases and avoiding work in charge' appeared to be more than 90% respectively. Conclusion: The performance-based pay system of teachers being carried out every year should be executed by preparing fair evaluation criteria suitable for task properties and the role of health teachers with different evaluation criteria compared to general teachers.

• 정신신체의학
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• 제29권2호
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• pp.169-175
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• 2021

연구목적 섬망은 뇌 기능의 일시적 장애로 전신 염증반응이 위험 요인으로 알려져 있다. 염증지표 중 하나인 호중구림프구비(neutrophil-lymphocyte ratio, NLR)가 섬망 환자에서 염증지표로 활용 가능할지 C반응 단백질(Creactive protein, CRP)과의 비교를 통해 탐색하였다. 방 법 일병원에서 1년간 섬망으로 협의진료한 환자의 의무기록을 후향적으로 검토하였다. 치료 방법에 따라 내과적 치료군과 수술적 치료군으로 나누어 입원시와 섬망시의 NLR과 CRP 값을 확인하였고, 반복측정 분산분석을 통해 이들 사이의 상호작용을 확인하였다. 결 과 검사 종류, 측정시기, 치료군간 유의한 상호작용을 보였다. CRP는 수술적 치료군에서는 입원시에 비해 섬망일 때 증가하였으나 내과적 치료군에서는 감소하였다. NLR은 두 군 모두에서 입원시와 섬망시에 유의한 차이를 보이지 않았다. 결 론 섬망환자에서 NLR은 일정하게 유지되었으나 CRP는 치료군 및 섬망 유무에 따라 변화하는 양상을 보였다. 이는 NLR이 섬망 환자의 염증지표로 CRP와 상호보완적으로 활용될 가능성을 시사한다.

• 중환자간호학회지
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• 제12권3호
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• pp.35-49
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• 2019

Purpose : This study aimed to propose a common scope of practice (SOP) for 13 specialties of Advanced Practice Nurses (APNs) in Korea. Methods : The first draft of a common SOP was extracted from domestic and international laws with a literature review by 17 experts from the Korean Association of Advanced Practice Nurses (KAAPN). Then, the common SOP was finalized after comparing the activities of APNs in clinical settings. Results : A total of 70 duties were identified and six categories were suggested for the common SOP. The SOP proposed by the KAAPN featured the following: 1) identification of and discrimination between health problems; 2) prescription and implementation of diagnostic tests; 3) treatment of injuries and diseases while implementing measures to prevent exacerbation; 4) prescription of medicinal products in line with 1) to 3); 5) referral and consultation; and 6) education and counseling. It was then confirmed that the proposed six categories in the common SOP reflected all the duties performed by APNs in clinical practice, including all 40 activities. Conclusion : The results of this study can be used as evidence for the legalization of a common SOP for APNs. Given the increasing multidisciplinary team approach adopted in Korean hospitals, it may be desirable to establish a broader SOP to reflect the diverse duties of APNs.