• 치과방사선
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• 제29권2호
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• pp.507-521
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• 1999

Osteopetrosis is an uncommon hereditary bone disorder whose prominent radiologic feature characterized by increased bone density. The authors reported a 7-year-old male patient who referred from local dental clinic for dental problems such as early exfoliation of deciduous teeth(#54,73,83) and delayed eruption of permanent teeth(#31.41.36.46). The patient appeared as a poorly developed. Dental X-ray films showed early exfoliation of deciduous teeth, delayed eruption of permanent teeth, and rampant caries. Lateral view of skull demonstrated increased opacity of calvarium, facial bones, and skull base. Generally the skeletal density is greatly increased throughout all bones. Facial CT showed poor development of paranasal sinuses and mastoid air cells. No hematopoietic and neurologic complications such as anemia, thrombocytopenia, blindness and deafness were found. Also mental retardation was not found. The final diagnosis of this case was a osteopetrosis tarda. Sometimes patient with osteopetrosis tarda may be developed dental problems prior to severe systemic symptoms. The dentist can be the first clinician to see the patient. It is very important for the dentist to have the knowledge of the osteopetrosis and to care the patient's dental problems to prevent complication such as osteomyelitis of jaws.

• Journal of Hospice and Palliative Care
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• 제24권3호
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• pp.135-143
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• 2021

End-of-life patients experience physical, mental, social, and existential distress. While medical personnel provide medication and care to alleviate patients' distress, listening to and interacting with patients remains essential for understanding their psychological condition. The most important tool, though difficult to implement in practice, is end-of-life discussion (EOLD). EOLD has been shown to have positive effects on end-of-life treatment choices, achievement of patients' life goals, improvements in the quality of life of patients and their families, and the prevention of depression and complicated grief among bereaved family members. EOLD is not often undertaken in clinical practice, however, due to hesitancy among medical personnel and patients for various reasons. In order to conduct an EOLD, the patient's judgment, psychiatric illnesses such as delirium and depression, and psychological issues such as the side effects of psychotropic drugs, denial, and collusion must be evaluated. Open and honest conversation, treatment goal setting, the doctor's familiarity with the patient's background, and attentiveness when providing information are important elements for any dialogue. Meaning-centered psychotherapy was developed to alleviate the existential distress of cancer patients, and its application may promote EOLD. The future development of meaning-centered psychotherapy in practice and in research is expected to further promote EOLD.

• 대한장애인치과학회지
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• 제5권2호
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• pp.87-91
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• 2009

The purpose of this study were to investigate the chief complain and dental treatment needs in handicapped patient. This study examines treatment records of 1025 patients in free dental clinic for handicapped patients during 10 years from 1999 to 2008. The results were as follows : 5.8 average visit per patient; mean patient age was 25; 544 patients was younger than 20. Handicapped patients classified according to types of disability. Crippled disorder were 19.1%, brain disorder were 4.5%, visual disorder were 3.1%, auditory disorder were 4.1%, speech disorder were 0.9%, mental retardation were 67.1%, and developmental disorder were 25.1%. Performed treatments were 322 scaling, 13 fluoride varnish, 727 preventive resin restoration, 1296 resin restoration, 600 amalgam restoration, 46 GI restoration, 612 extraction, 289 pulp treatment of primary teeth, 75 pulp treatment of permanent teeth and 138 stainless steel crown restoration. Many handicapped patients have some difficulty to dental treatment. They have limited access to dental care, which is compounded by a shortage of skilled dental professionals who are willing to treat these population and financial problems.

• 대한간호학회지
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• 제24권1호
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• pp.58-69
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• 1994

In order to see the development of Nursing related research activities in Korea over the last three decades, abstracts of almost all of the Master and Ph.D theses that appeared from 1961 up to August 1991 were collected. The number of theses was 2354, from which an index of key words has been constructed. Key words were defined as those terms in each thesis title that convey major objectives of the given thesis study and the important nursing concepts dealt with in the thesis. Although all the key words were picked from the thesis title only, full use was made of the abstracts in deciding the principal objectives and essential contents of the thesis studies and their important concepts as well. In total, 539 kinds of key words were identified from the 2354 titles, and the identified words were all found to be in the International Nursing Index. On an average each title has two key words. Which key words were most frequently used, how they have changed with time, what kind of concept is preferably dealt with by each graduate school, and the concepts to which a given key word is likely to be connected were examined. The results are summerized below : 1) For each decade the theses numbers were as follows : 54(2.3%) from the 60’s, 413(17.5%) from the 70’s, 1523(64.7%) from the 80’s, and 364(15.5%) from the 90’s. Master’s thesis contributed 96% (2252) of the papers and Ph. D’s theses filled the remaining 4%(102). 2) A total of 539 key words were used, averaging about 2 for each thesis. The most frequently used key words were ‘Nurse’, ‘Anxiety’, ‘Knowledge / Attitude /Practice’, ‘Stress /Stressor’, ‘Attitude’, ‘Job-Satisfaction’, ‘Mental Disorder’, ‘Operation’, ‘Elderly’, ‘Nursing Role’. 3) Each decades key words can be classified as : the 60’s : ‘Nursing Education’, ‘Pulmonary Tuberculosis’, ‘Mother-Child Health’, ‘Growth & Development’, ‘Public Facilities’, ‘Mental Disorder’ : the 70’s : ‘Nurse’, ‘Family Planning’, ‘Attitude’ / ‘Knowledge, Attitude / Practice’, ‘Curriculum in Nursing Education’, ‘Clinical Practice in Nursing’, ‘Analysis of the Work of the Nurse’, ‘Health Education of School’, : the 80’s : ‘Nurse’, ‘Anxiety’, ‘Stress /Stressor’, ‘Operation’, ‘Nursing Role’, ‘Job Satisfaction’ : the 90’s : ‘Nurse’, ‘Elderly’, ‘Family-Support’, ‘Stress /Stressor’, ‘Home Care’. Key word ‘Nurse’ appears continuously and most frequently through the years, which indicates that there has been active study of the characteristics of nurses and related fields. The concept ‘Anxiety’ has been studied steadly from the 80’s and it shows that interest in health and disease are increasing Which comes as a result of society changing to an industrial and informational community. 4) Looking into each graduate school’s study area key words ‘Anxiety’, ‘Nurse’, ‘Mental Disorder’, ‘Stress /Stressor’, ‘Operation’, ‘Attitude’, ‘Hemo-dialysis’, were studied in the regular graduate school : ‘Family Planning /Contraception’, ‘Knowledge / Attitude /Practice’, ‘Physical Health-State /Physical Health Examination’, ‘Nurse’, ‘Using Clinical Facilities’, ‘Health Education of School’, were studied in the Graduate School of Public Health’ ; ‘Nurse’, ‘Anxiety’, ‘Stress / Stressor’, ‘Job-Satisfaction’, ‘Clinical Practice Education’, ‘Nursing Education’, were studied in the Graduate School of Education : ‘Nurse’, ‘Job Satisfaction’, ‘Nursing Role’, ‘Administration - Employment /Employment Management’, ‘Leadership’, ‘Personnel Profile’, ‘Nursing Manpower / Changing Working Place’, were studied in the Graduate School of Public Administration. 5) The Connection between key words were : ‘Nurse Job Satisfaction’, ‘Stress / Stressor ⇔ Coping / Ajustment’, ‘Nurse ⇔ Nursing Role’, ‘Anxiety ⇔ Giving Information’, ‘Nurse ⇔ Stress / Stressor’, ‘Anxiety ⇔ Operation’, ‘Nurse ⇔ Burnout’, ‘Knowledge, Attitude, Practice ⇔ Family Planning’, ‘Nurse Administration ⇔ Employment’, ‘Anxiety Muscle ⇔ Relaxation Technic’, ‘Anxiety ⇔ Mental Disorder’. From the above it can be noted that many nursing concepts were handled in the thesis titles. But there were more than enough papers on the characteristics of the nurse. It is suggested that in depth research be made on ‘Nursing Accidents’, t-‘Ethics’, ‘Nurse - Patient Interactions’, ‘Spritual Care’, ‘Dying’, ‘Hospice’, ‘Resident Helper’ and that there should be in depth research relating to the physical and mental development of youth and in particular physical concepts like ‘Drug - Abuse’, ‘Child -Abuse and Teaching’.

• 대한치과마취과학회지
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• 제2권2호
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• pp.101-106
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• 2002

Background: The management of the behavior of handicapped children when providing required dental care is often a problem, whether in the dental office or in a hospital setting. Because of the high incidence of poor cooperation, many of these patients are scheduled for dental care under general anesthesia with preoperative medical assessment. The purpose of this study was to carry out a clinico-statistical survey on dental treatment for handicapped children under general anesthesia. Methods: After approval from the institutional review board, the medical records of 64 handicapped children between 1997 and 2002 were reviewed to determine the patient profiles, anesthesia management, and complications. The charts of these patients, who underwent dental examination, scaling and prophylaxis, and restoration and extraction of teeth under general anesthesia, were reviewed. Results: The mean age was 12.8 years old, and males (53%) predominated females (47%). Twenty-four patients had mental retardation, twelve had autism, six had cerebral palsy, 4 had behavior disorder, others had heart disease, convulsive disorder, etc. Sixty-two had intravenous thiopental with neuromuscular blocker, 2 had intravenous ketamine induction. Nasotracheal intubation was uneventful in 55 patients, nine had orotracheal intubation because of difficult visualization of the larynx. Twenty-one patients experienced postoperative complications in the recovery room, including epistaxis, nasal obstruction, vomiting, airway obstruction, respiratory depression. Conclusions: General anesthesia is a very effective way of completing the dental treatments for disabled children. We emphasize the need to train anesthesiologists in the care of disabled patients.

• 한국산학기술학회논문지
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• 제16권11호
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• pp.7501-7507
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• 2015

이 연구는 장애인 대상 치과진료 필요자 중 치과의료 서비스 미충족율과 그 이유를 조사하고, 미충족 치과치료에 따른 구강상태를 분석하였다. 국민건강영양조사 참여 대상 중 만 19세 이상 장애등록 응답자 444명을 선정하였고, 그 중 구강검진과 설문조사를 완료한 대상자 375명을 최종분석하였다. 장애유형은 6종류(지체장애, 뇌병변장애, 감각장애, 발달장애, 정신장애, 내분비장애)로 분류하였다. 연구대상자 중 미충족 치과치료 대상자는 128명이었으며, 최근 1년 동안 치과진료를 받지 못한 가장 주된 이유는 '경제적인 이유로'에 대한 항목이 49.2%으로 가장 많았으며, '다른 문제에 비해 덜 중요하다고 느껴서'에 대한 항목이 18.0%이었다. 치주질환과 영구치우식경험을 가진 장애인 중 미충족 치과치료 빈도와 진행정도가 높은 것으로 확인하였다. 치과진료 자원의 가용성 측면에서 장애인 수 대비 적절한 치과진료 서비스를 충분히 제공하여 치과진료 서비스의 원활한 이용이 요구된다.

• 의료법학
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• 제24권3호
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• pp.155-206
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• 2023

의사결정능력이 저하된 자가 필요한 의료서비스를 거부하거나 적절히 의사를 표현하지 못하는 경우, 외부로부터의 후견주의적·예방적 개입이 언제 정당화될 수 있는지에 대한 규범적 판단이 쟁점이 된다. 이러한 어려움은 정신의료에서의 비자의 입원의 경우 더욱 명확하게 드러나며, 국내에서는 전통적으로 '정신질환의 존재'와 '자타해 위험'을 주된 요건으로 하는 정신건강복지법에 근거하여 비자의 입원을 시행해 왔다. 그러나 2011년 민법 개정으로 민법상 후견제도를 통한 비자의 입원의 방식이 새롭게 도입되며, 국내의 비자의 입원은 형식상 이원화된 체계를 갖추게 되었다. 이때, 후견제도를 통한 비자의 입원은 당사자에게 '의사결정능력의 저하'가 있고, 개입이 '당사자의 복리 증진'에 부합할 것을 실행의 요건으로 한다는 점에서 정신건강복지법에 근거한 비자의 입원과 그 목적과 성질을 달리한다. 정신적 능력이 저하된 당사자에 대한 비자의 입원이 이처럼 정신보건법을 통한 방식과 후견제도를 통한 방식으로 이원화되는 양상은 해외에서도 유사한 양상으로 전개되었다. 그러나 대상자가 고령화되어 정신질환과 신체질환의 치료가 동시에 이루어지는 경우가 많아지고 정신질환과 신체질환의 구분이 모호한 노인성 정신질환의 문제가 대두됨에 따라, 민법상 '최선의 이익-대리의사결정' 패러다임과 정신보건법상의 '사회방위-예방적 구금' 패러다임이 정신장애인에 대한 법적 규율 영역에서 중첩되고 서로 충돌하는 현상이 발생하기 시작했다. 해외에서는 이러한 이원화된 체계가 비효율적이고 형평성에도 어긋난다는 지적이 이어졌으며, 나아가 '정신질환'이 있을 것을 근거로 하여 후견주의적·예방적 개입을 정당화하는 정신보건 법제의 비자의 입원 요건은 정신장애인에 대한 부당한 차별에 해당한다는 비판도 꾸준히 이루어졌다. 이에 해외에서는 '의사능력'을 기초로 후견제도와 정신보건 법제를 융합(fusion)하여, 능력이 저하된 개인에 대한 후견적·예방적 개입을 일관되게 규율하고자 하는 시도가 이루어졌다. 이는 의사능력 저하자의 신체질환과 정신질환에 대한 의료서비스 제공을 동일한 체계 속에서 할 수 있을 뿐만 아니라, 단지 '정신장애'를 지니고 있다는 것만으로 차별적으로 대우하는 정신보건법의 한계를 극복하는 것이기도 했다. 본 연구에서는 의사능력을 기반으로 후견제도와 정신보건법을 융합(fusion)하여 정신의료 서비스 체계를 새롭게 재구성한 전 세계 최초의 사례인 영국 북아일랜드 정신능력법(Mental Capacity Act 2016)의 제정 과정과 구체적 작동방식을 분석하였다. 후견제도와 정신보건 간의 충돌의 문제를 1990년대부터 고민하여 최근 2016년 '의사능력' 이라는 단일하고 비차별적인 기준을 제시한 영국 북아일랜드의 사례를 분석함으로써, 국내 후견 및 정신보건 제도에의 함의와 앞으로 나아가야 할 방향에 대해 제언하고자 하였다.

• 대한간호학회지
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• 제8권2호
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• pp.79-88
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• 1978

Utilizing Foley catheter in therapy of inpatient cause bacteriuria and urinary tract infection that leads to first ranked factor's in hospital infection (nosocomial infection). To protect the patient from such infections, emphasis should be placed on catheterization technique and management of the closed drainage system, this reducing the chances of introducing organisms. This study has been done at Intensive Care Unit of A and B hospitals from May-Oct. 1978 on 20 male and 18 female adult patients. Each patient was screened and found to have nonbacteriuria in clean catch specimen before catheterization. Clean catch specimen via foley catheter were obtained after 48 hours and 96 hours from catheterization. The findings are as follows: A. The occurrence of bacteriuria in patients according to duration of indwelling catheter. 1 213.9% of the patient showed evidence of bacteriuria 48h post catheterization specimen, while 57.9% of the patient showed evidence of bacteriuria 96h post catheterization specimen. 2 25% of male patients had infection 48h post catheterization and 45% displayed bacteriuria post catheterization. 33％ of female patients displayed infection 48h post catheterization and 72.2% having infection 96h post catheterization. Statistically there were significant differences between female patients and the duration of insertion. (P < 0.025) B. The occurrence of bacteriuria with the administration of bacteriuria with the ad-ministration of antibiotic in 24 patients was in 41,7%. The occurrence of bacteriuria without the administration of antibiotic in 14 patients was in 92.3%. Statistically there were very significant difference between the administration of the antibiotis and bacteriuria. (P < 0.005) C. Studies were done according to the consciousness level of the patients, 71.4% of those patient who displayed mental disorder developed bacteriuria, while 30.0% of those patient who displayed non mental disorder developed bacteriuria.

• 보건행정학회지
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• 제34권2호
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• pp.129-140
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• 2024

연구배경: 트라우마가 초래한 정신건강 문제는 사건의 특성에 따라 다르게 나타날 수 있다. 특히 성적 외상사건 경험자는 다른 유형의 외상사건을 경험한 사람들보다 정신건강 결과가 부정적이라고 알려져 있을 뿐만 아니라, 디지털 성범죄 등 성적 사건에 노출될 수 있는 새로운 형태의 위협이 커지고 있다. 이 연구는 성적 트라우마 사건을 중심으로 트라우마 사건의 유형이 정신건강의 차이를 유발하는지 확인하고, 자살생각과 잠재적 post-traumatic stress disorder (PTSD) 위험수준에 영향을 미치는 요인을 확인하고자 하였다. 방법: 전국 20대부터 50대까지 성인을 대상으로 실시한 온라인 설문조사를 토대로, 경험한 트라우마 사건의 유형에 따라 분석대상자를 구분하였다(성적 트라우마 경험자, 비성적 트라우마 경험자). 성적 트라우마 사건 경험 여부를 제외하고 정신건강(자살생각, 잠재적 PTSD 위험수준)에 영향을 미칠 수 있는 인구사회학적 요인(성, 연령, 주관적 경제수준, 결혼상태)과 회복 보호요인(사회적 지지, 회복 가능성 인지, 아동기 보호경험)을 공변량으로 propensity score matching (PSM)을 실시하였다. 이후 정신건강에 영향을 미치는 요인을 확인하기 위해 이분형 로지스틱 회귀분석을 하였다. 결과: PSM 후에도 성적 트라우마 경험자는 비성적 트라우마 경험자보다 자살생각과 잠재적 PTSD 위험수준이 부정적이었다. 이분형 로지스틱 회귀분석 결과, 성적 트라우마 경험자는 비성적 트라우마 경험자보다 자살생각이 1.9배(odds ratio [OR], 1.911), 잠재적 PTSD 위험수준은 2.5배(OR, 2.472) 높았다. 또한 트라우마 회복 인식, 사회적 지지, 아동기 보호 경험과 같은 회복 보호요인이 부정적일수록 자살생각과 잠재적 PTSD 위험수준의 가능성이 높아졌다. 결론: 이 연구는 성적 트라우마 경험에 대한 이해와 지원의 중요성을 강조하고, 성적 트라우마 경험자의 자살생각과 잠재적 PTSD 위험을 완화하고 회복을 돕기 위해 회복 보호요인을 촉진하는 전략의 필요성을 시사한다.

• 가정∙방문간호학회지
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• 제9권2호
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• pp.114-128
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• 2002

In order to provide information for the establishment and maintenance of a rehabilitation day care center for stroke patients. this study is to assess needs for the rehabilitation day care center of the stroke patients and to identify the factors influencing the needs for the center. The data were collected face-to-face interview with 223 stroke patients. using a structured questionnaire. from September 24. 2001 to November 20. 2001. Major findings are as follows. 1. Most of the participants($94.6\%$) needed rehabilitation day care center for stroke patients. $95.5\%$ of participants were willing to use the rehabilitation day care center. 2. Also the score of the needs for the center's health services was $2.84\pm60$ out of 4.00. In regards to the sub-contents. while the physical exercise therapy showed the highest mark($3.54\pm71$) in the needs. the following marks showed physical therapy($3.48\pm79$), training for the memory. thinking and judgment($3.30\pm93$). training for ADL($3.09\pm99$). health education program($3.04\pm93$). In the meantime. the expected effects from the use of the center are $2.89\pm61$ out of 4 and its sub-contents showed that the center would promote their physical and mental well-being($3.30\pm74$) and the center would be more effective than in home care($3.12\pm70$). 3. Meanwhile. the desired frequency of use in the future and distance had significant interrelation with their families living together(p<.05). In addition those who paid to use it differentiated significantly according to their ages and the types of insurance they had(p<.05). 4. The needs in degrees of speech disorder therapy and hobbies & amusements. the patients with other disease had significantly higher degrees than those patients without it (p<.05). Also in regard to the need degrees for physical therapy. healthy education programs and individual counseling including their families. the degrees of the patients with speech disorders were significantly lower than those of the patients without the disorder (p<.05). On the other hand. the patients with speech disorders were significantly higher than those patients without it in the need degree of the speech disorder therapy (p=.000). And the needs in degree concerning about speech disorder therapy. physical exercise therapy. training for ADL. medicinal substances therapy and family education were negatively correlated with the ADL (r=-.236$\sim$.305, (p<.005). 5. Finally. the expected effect of using the rehabilitation day care center showed significant differences statistically according to whether or not they had other disease (p<.05). In conclusion. the study showed the stroke patients were willing to use the center and had a high requirements for it and they especially had relatively high need degrees for the physical exercise therapy. physical therapy. training for memory. thinking and judgment. and healthy education program. And significant factors for the use of the center were their ages. types of insurance. family cohabitation. complications and speech disorders. ADL and so forth. Accordingly. the rehabilitation day care center needs to be established for the stroke patients and the center should develop rehabilitation care programs. which are individual and special programs customized for each patient's characteristics and health conditions.