• 제목/요약/키워드: nursing care institution

검색결과 139건 처리시간 0.026초

건강보험과 자동차보험의 선택적 우선적용에 대한 고찰 -경과실 자기신체피해 교통사고를 중심으로- (A Study How to Decide the Priority on choosing between National Health Insurance and Automobile Insurance In Korea -Focused on medical expenses of the Insured's own bodily Injury Coverage-)

  • 송기민;최호영;김진현
    • 의료법학
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    • 제10권2호
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    • pp.287-307
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    • 2009
  • A person is injured in car accident caused by his/her slight negligence except he / she causes accident by his / her willfulness or gross negligence. Because the National Health Insurance Corporation (hereinafter called "Corporation") shall not provide any insurance benefit "when he has intentionally or through gross negligence caused a criminal conduct or intentionally contributed to the occurrence of an accident" referred to in Article 48 (1) 1 of the National Health Insurance Act. So, if he / she is insured by his / her own bodily injury coverage, he / she can be compensated for his / her medical expenses. The injured have the rights to file either National Health Insurance claim and Automobile Insurance claim but there is no clear and definite adjustment clause. The claim disputes between National Health Insurance (hereinafter called "NHI") and Automobile Insurance (hereinafter called "AI") in the own bodily injury coverage makes some problems. Firstly, there are some differences in co-payments which he / she chooses between NHI and AI. Profit per a patient is higher in the NHI than in the AI. Secondly, it can provoke criticism that people shall unnecessarily pay double contributions. Lastly, it can raise moral hazards. For example, if he / she can cover the compensations when the insured receives the compensations from his / her insurer, the Corporation can be claimed by medical care institution payment of the health care benefit costs. In conclusion, first of all, to improve the national health and preserve the insured's rights the Corporation shall keep notice these facts.

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한국의 장기이식과 관련된 윤리적 고려사항의 분석 (A study of the current ethical situation in organ transplantations in Korea)

  • 한성숙;황경식;맹광호;이동익;엄영란
    • 대한간호학회지
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    • 제28권1호
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    • pp.26-36
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    • 1998
  • This primary study was done to develop an ethical guideline for organ transplantation, a life-saving treatment which helps improve the quality of life. This study tried to identify the current situation in Korea, in terms of ethical considerations in organ transplantations. This study collected basic data in organ transplantations, in the hope that procedure of organ transplantations could be developed that would be fair to both organ donors and recipients. The immediate goals of this study were : 1)to identify staff in charge of organ transplantations and their jobs in the hospital, 2)to survey whether there exists a Hospital Ethics Committee(HEC), 3)to research what consideration are formally taken in selecting recipients, and 4)to accumulate data on how consent from donors are currently obtained. The study used a survey questionnaire and received responses from 31 hospitals out of 45 hospitals where organ transplantation are being done. Organ transplantation coordinators were found in 16 hospitals, but the job description varied among hospitals. The survey showed that all 16 hospitals with an HEC that health care personnel unnecessarily dominate the committee. The study notes that HECs should be vitalized by recruiting, as members, ethicists, theologians, patients, guardians, as well as the general public outside of the hospital. The study revealed that in selecting recipients the hospital take into account ABO blood type, histocompatibility, age, waiting time. and level of patient compliance. Finally, it was shown that in the cases of living donors the transplanting hospitals seek a formal consent, whereas there are no common consenting practice established for cadaveric donors. The study concludes with three proposals. First, a nationwide institution responsible exclusively for procurement and distribution of cadaveric organs for transplantation should be established. Second. we should rebuild the national health insurance system so that have costly organ transplantation expenses are substantially covered. Last, but certainly not least. there is a need to emphasize the HEC's committment to prepare a proper ethical guideline for organ transplantation in general.

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외상성 급성 경막하 혈종 환자의 생존 관련 요인 (Survival-related Factors in Patients with Traumatic Acute Subdural Hematoma)

  • 하혜진;우상준;이승우
    • 한국융합학회논문지
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    • 제12권4호
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    • pp.285-291
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    • 2021
  • 본 연구는 외상성 경막하 혈종 환자의 생존 여부에 영향을 미치는 요인을 규명하기 위해 시도된 후향적 조사연구이다. 연구대상자는 G광역시에 소재한 C대학교 병원에 2017년 1월부터 2019년 2월까지 응급실로 내원한 외상성 경막하 혈종 환자 207명이다. 자료분석은 SPSS 23.0 프로그램을 이용하였으며, χ2-test, t-test, 로지스틱 회귀분석을 시행하였다. 연구결과 대상자의 생존 여부에 영향을 미치는 요인은 기저질환, 입원 시 합병증, 내원 시 GCS로 나타났다. 따라서 대상자의 과거력을 확인할 수 있는 의료시스템 구축과 합병증 예방을 위한 의료진의 교육이 이루어져야 할 것이다. 이와 함께 의료기관 이송 전 단계부터 대상자의 GCS를 측정하여 신속히 치료 가능한 병원으로 이송될 수 있도록 이송체계의 개선이 필요하다.

스마트 글래스를 활용한 공중보건의 대상 의료장비 원격교육 (Remote Medical Equipment Training for Public Health Doctors in Vulnerable Medical Areas Using Smart Glasses)

  • 최종명;최소은;문지현
    • 사물인터넷융복합논문지
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    • 제9권3호
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    • pp.75-80
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    • 2023
  • 국내 의료취약지에서 공중보건의는 지역민의 일반의료는 물론 응급의료에서 큰 역할을 수행하고 있다. 그러나 공중보건의는 일반적으로 현장 경험이 부족하기 때문에 응급 환자에 대한 대처 능력이 부족하고, 의료장비를 효과적으로 다루지 못하는 것으로 나타났다. 본 연구는 공중보건의에게 필요한 의료장비에 대한 사용법을 스마트 글래스를 이용하여 원격교육으로 진행 후 교육의 효과를 확인하였다. 구체적으로 의료장비 활용 교육을 위해서 스마트 글래스는 리얼웨어를 사용하였으며, 신안군 10개의 섬 지역 공중보건의 10명을 대상으로 하였다. 교육 후 장비 활용 효과와 만족도 모두 3점 이상이었다. 따라서 스마트 글래스를 활용한 원격교육이 의료취약지의 공중보건의를 대상으로 유용하게 활용될 수 있다는 것을 확인하였다.

영세사업장 보건관리 지원사업 실시 전후의 산업보건수준 비교 분석 (A Comparative Analysis of the Level of Occupational Health : Before and After the Subsidiary Program on Health Care Management of Small Scale Industries)

  • 정혜선
    • 한국직업건강간호학회지
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    • 제4권호
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    • pp.58-83
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    • 1995
  • The small scale industries which have less than 30 employees occupy 86.5% of total number of industries in Korea. And though they have higher accident rate and lower environmental condition than big industries, it has been not mandatory to appointing health care manager at factory. So, from 1993, government subsidizes to the health care management of small industries. The purpose of this study is to identify the real feature of health care status in small industries, and to evaluate the level of health care management, before and after the subsidiary program. 65 small plating industries which have been managed by the same health care management support institution in 1993 were selected for study. Of the 65 industries, 3 which have not taken both environmental evaluation and health screening in 1994, and 9 which have closed were excluded from study sample. And the remaining 53 were analyzed by using the results of environmental evaluation and health screening, reported to the Ministry of Labor, before and after the subsidiary program, the analysis was done by the comparison of the two year paired data of the same industry. Over-permissible-limit rate, health screening implementation rate, above grade C rate were calculated and compared. The status of health care management ; 1. Of the sample industries, 96.9% provide protective equipment and 80.0% set up ventilating system. Protective gloves (89.2%) and protective clothing (80.0%) are widely provided, but ear plugs (4.6%) are rarely provided. 21.5% of the protective equipment are well put on, and 40.4% of the ventilating systems function well. 2. In 1993, 35 industries, 53.8% of the sample, checked working environment twice. Over-permissible-limit rates of heavy metal (12.2%), suspended particle (11.1%), noise (5.5%) were high. To put on protective equipment and to set up local ventilating system were pointed out by the examiners. 3. General health screening was done at 63.1% of the sample industries and 35.3% of total workers were examined. Specific health screening was done at 93.8% of the sample industries and 75.4% of workers were examined. 15.5% of workers was provided to be above grade C and to have digestive system disease (43.3%), circulatory disease (18.9%), and hematopoietic disease (14.2%), etc. 4. In 1993, the subsidiary program of health care management was provided in forms of health education, health counseling, and rounding check of working field. And 61.5%, 83.0%, 55.4% of sample industries respectively received it. The average visit per industry was 1.8. Comparisons of the level of occupational health before and after the subsidiary program ; 1. Over-permissible-limit rates of hazardous factors of 1993 and that of 1994 were compared. The rates of suspended particle, noise, organic solvent of 1994 (37.5%, 13.4%, 24.2% respectively) were higher than that of 1993 (25.0%, 6.0%, 6.3% respectively). In the case of acid, there was no difference between the rate of 1993 and that of 1994. Only the rate of heavy metal decreased from 12.9% in 1993 to 3.0% in 1994. 2. General health screening was done at 38.7% of the sample industries in 1993 and at 44.6% in 1994. But the implementation rate of specific health screening decreased from 72.4% in 1993 to 64.6% in 1994. 3. The implementation rate of specific health screening was analyzed by some health factors. The rate of suspended particle increased from 61.8% in 1993 to 91.2% in 1994. But the rates of the others-noise, organic solvent, heavy metal, specific chemical substances-decreased. 4. Above grade C rate in health screening increased from 27.8% in 1993 to 35.5% in 1994. But that of endocrine disorders and pulmonary disease decreased.

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계획된 행동 이론을 적용한 화재안전교육이 요양보호사 교육생들의 화재안전행동에 미치는 효과 (Effect of Fire Safety Education Based on the Theory of Planned Behavior on the Fire Safety Behavior of Care Worker Trainees)

  • 변도화
    • 한국화재소방학회논문지
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    • 제33권1호
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    • pp.147-155
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    • 2019
  • 본 연구는 요양보호사 교육생들을 대상으로 화재안전교육의 효과를 규명하기 위한 유사실험연구로 비동등성 대조군 전후시차설계(Non-equivalent control group no-synchronized design)이다. 연구대상자는 S요양보호사 교육원의 교육생으로 실험군 28명, 대조군 29명으로 총 57명 이었다. 실험처치기간은 2018년 5월 21일부터 6월 14일까지 주 1회씩 총 4회로 구성하여 화재안전교육을 실시하였다. 자료분석은 ${\chi}^2-test$, t-test로 분석하였다. 연구결과 화재안전교육은 요양보호사 교육생들의 화재안전에 대한 지식, 화재안전에 대한 태도, 화재안전에 대한 지각된 행동통제, 화재안전 행동의도, 화재안전 행동을 증진시키는데 효과적인 교육으로 일상생활에서 화재안전행동실천에 유용하게 활용될 수 있을 것이라 기대된다. 반면 화재안전에 대한 주관적 규범은 유의한 차이가 없는 것으로 나타나 화재안전에 대한 주관적 규범의 효과를 검증하는 후속연구를 제언한다.

입원환자 가족의 호스피스 인지 및 요구도 (The Knowledge and Needs of Hospice for Inpatients' Family)

  • 고성희;김현경
    • Journal of Hospice and Palliative Care
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    • 제8권2호
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    • pp.131-142
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    • 2005
  • 목적: 본 연구는 일개 종합병원에 입원한 환자의 가족을 대상으로 호스피스에 대한인지 및 요구도를 사정하기 위해 시도되었다. 방법: 2003년 3월부터 5월까지 J 종합병원에 입원한 환자가족 277명을 대상으로 자기보고식 설문지를 통해 자료를 수집하였고, SPSSWIN 10.0으로 분석하였다. 결과: 대상자 중 호스피스에 대해 들어 본 적이 있는 경우가 232명(83.8%)이었고, 매스컴을 통해 들은 경우가 107명(38.6%)으로 가장 많았으며, 213명(76.9%)이 호스피스란 환자의 남은 생을 끝까지 충만하게 살고 편안한 죽음을 맞도록 돕는 일이라고 제대로 알고 있었다. 233명(84.1%)이 호스피스가 필요하다고 인식하였고, 220명(79.4%)이 본인이나 가족이 호스피스 간호가 필요하다면 받겠다고 응답한 반면 가족이나 주변사람이 호스피스 간호를 받아본 경험이 있는 경우는 25명(9.0%)에 불과하였다. 만약 불치병(말기암)이라면 미리 죽음을 준비해야 한다고 생각한 응답자는 212명(76.5%)이었고, 243명(87.7%)이 그 상태에 관하여 진실을 알고 싶어하였다. 불치병에 걸린 사람에게 이루어져야 할 조치로는 최소한의 통증과 평화로운 죽음을 위한 신체적, 정신적, 영적 간호가 필요하다고 올바르게 지적한 자가 173명(62.5%)으로 가장 많았다. 임종시 가족과 함께 있고 싶다고 응답한 경우가 177명(63.9%)으로 가장 많았고, 73명(26.4%)은 가장 도움이 되는 호스피스요원으로 간호사를 꼽았다. 임종환자들만을 위한 호스피스 병동 운영에 대하여 226명(81.6%)이 찬성하였고, 대상자들이 선호한 호스피스시설의 운영형태는 병동형 66명(23.8%), 시설형 57명(20.6%), 공공의료형 56명(20.2%), 산재형 47명(17.0%), 가정형 34명(12.3%)의 순으로 나타났다. 결론: 본 연구의 결과 입원환자 가족의 호스피스에 대한 인지 및 요구도는 전반적으로 높았으며 일반적 특성에 따라 호스피스 인지 및 요구도에 차이를 보였다. 따라서 대상자의 일반적 특성을 고려한 개별적이고 다양한 접근을 시도할 수 있는 호스피스 교육 및 중재 프로그램을 개발하여 수행해야 할 것이다.

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입원 시 상병의 수집 및 활용에 관한 보건의료정보관리사의 관점: 질적 연구 (Perceptions of Hospital Health Information Managers Regarding Present on Admission Indicators in Korea: A Qualitative Study)

  • 표지희;최은영;오혜미;이원;김주영;옥민수;김소윤;이상일
    • 한국의료질향상학회지
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    • 제26권1호
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    • pp.23-34
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    • 2020
  • Purpose: This qualitative study was conducted to examine the current status and problems concerning the collection of present on admission (POA) indicators and determine how to use these indicators for evaluating the quality of care and degree of patient safety. Methods: A total of 11 health information managers were divided into two groups according to the size of their hospitals. Two focus group discussions (FGDs) were conducted, one for each group, which followed a pre-developed semi-structured guideline. The verbatim transcriptions of the FGDs were analyzed. Results: The majority of participants were concerned about entering POA flags honestly because they did not know how future POA indicators would be used. In particular, for some participants, POA N was a burden that could imply a signal of mismanagement within the medical institution. In addition, the lack of awareness and indifference of physicians regarding POA indicators were some of the difficulties for POA flag entry. Although medical institutions are making efforts to improve the accuracy of POA flagging, many participants mentioned the need to develop real case-oriented POA entry guidelines to improve the accuracy of POA flagging. Conclusion: To increase the validity of POA indicators, it is necessary to increase the level of awareness of POA indicators in physicians and other medical professionals. Furthermore, efforts related to POA indicators by individual medical institutions need to be reflected in the process evaluation.

색채액자를 활용한 컬러테라피가 간호사의 직무스트레스와 우울에 미치는 영향 (Effects of Color Therapy using Color Frames on Nurses' Job Stress and Depression)

  • 강미애
    • 사물인터넷융복합논문지
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    • 제7권4호
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    • pp.51-58
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    • 2021
  • 본 연구는 중환자실 간호사를 대상으로 컬러테라피를 적용하여 직무스트레스와 우울에 미치는 효과를 검정하기 위한 유사실험 연구로 비동등성 대조군 전후 설계이다. 연구의 대상자는 500병상 규모의 2차 의료기관인 S시에 소재하는 S병원, B시 소재하는 P병원, 2개의 종합병원 중환자실 간호사를 대상으로 하였다. 자료수집 기간은 2020년 11월 2일부터 12월 25일까지 8주이며, 실험군 29명, 대조군 29명이었다. 자료는 SPSS 22.0 Program을 이용하여 일반적 특성은 빈도와 백분율, 동질성 검정은 chi-square test, independent t-test, 실험처치 전 종속변수에 대한 동질성 검정은 independent t-test, 실험 후 종속변수의 차이는 independent t-test, 집단 내 실험전후의 종속변수의 차이는 paired t-test로 분석하였다. 실험군은 노랑, 빨강, 파랑, 3가지 색상이 그려진 표준화된 캔버스 액자를 활용하여 1일 2회(근무 전, 근무 후), 10일 동안 총 20회 컬러테라피를 적용하였고, 대조군은 컬러테라피를 적용하지 않고 평상시와 같이 생활하며 근무한 결과 실험군은 대조군보다 직무스트레스 점수가 0.43점, 우울 점수가 0.26점 유의하게 감소하였다.

노인의 사회적 지지와 삶의 질에 관한 연구 -일반가정노인과 양로원노인을 대상으로- (A Study on Social Support and the Quality of Life in the Elderly(The comparative analysis between home residents and institution residents))

  • 채수원;오경옥
    • 대한간호학회지
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    • 제22권4호
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    • pp.552-568
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    • 1992
  • Recent improvements in the standard of living, national income and medical care, and a decline in the infant death rate which have occurred related to economic growth and modernization, have led to a longer average life-span and a higher ratio of elderly people in the total population, Therefore, not only in the field of nursing science, but also in the field of many other discipline, issues concerning the elderly have been given increasing interest. A great deal of effort has been spent on increasing the quality of life for elderly people. This study was conducted to analyze the correlation between social support and quality of life. The sample consisted of III subjects residing at home and 107 subjects residing in institutions all of whom were over 65 years of age. The data collection period was from October 23, 1990 to January 26, 1991. Social support was measured using the Norbeck social Support Questionnaire developed by Norbeck, translated by Oh, Ka Sil and quality of life was measured using the QOL scale developed by No, You Ja. Data were analyzed using pereentages, t-test, Pearson Correlation Coefficient and ANOVA. The results of this study are as follows : 1. There was a statistically signifivant difference in the level of social support between the two groups (t=-8.83, p<.001), The elderly at home reported a much higher level of social support. 2. There was a statistically significant difference in the level of QOL between the two groups (t=-5.77, p<.001) . The elderly at home reported a much more positive quality of life. 3. There was a positive correlation between social support and QOL for the elderly at home ard it was statistically significant (r=.32, p<.001). 4. There was a postitive collealtion between social support and QOL for the elderly in institutions and it was also statistically significant (r=.19, p<.05). 5. The relationship between the general characteristics of the elderly at home and the variables of social support and of QOL were as follows ; 1) according to sex(t=10.57, p<.01) and the number of offspring(F=6.19, p<.01), there was a statistically significant difference in social support. 2) according to amount of Pocket money, there was a statistically significant difference in QOL(F=2.98, p<.05). 6. The relationship between the general characteristics of the elderly in institutions and the two variables were as follows ; 1) according to sex(t=6.24, p<.05), the number of offspring(F=6.16, p<.001) and religion (F=2.58, p<.05), there was a statistically significant difference in social support. 2) according to religion, there was a statistically significant difference in QOL(F=2.90, p<.05). In conclusion, it can be said that social support is an important variable related to QOL in the elderly and that social support levels are higher for the elderly residing at home. Therefore, more specific and objective approaches and efforts are needed to effectively use resources to maintain the elderly at home and to enhance social support available to the elderly in institutions and thereby increase QOL regardless of residence.

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