• 한국학교보건학회지
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• 제12권1호
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• pp.131-141
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• 1999

The purpose of this study was to serve as a basis for the planning of oral health education and the development of an oral health-promotion program for patients who visited dental clinics by examining how much dental hygienists offered oral health education to adult patients at dental clinics. A parent group was selected, being made up of 1,600 dental hygienists who registered with the Dental Hygienist Association and worked in Seoul. The questionnaire survey was carried out and an ${\chi}^2-test$ was made using the data collected from 218 subjects to determine how their practice of oral health education was different according to certain general characteristics(the sort of organization for which they worked, age, the term of their service, and the mean number of patients per day). As a result, the following findings were obtained: 1. Thees general characteristics made the following differences to the content of oral health, education: The sort of organization for which the subjects worked made a significant difference in the following tooth brushing instruction (p<0.05), the effect of oral prophylaxis or education about aftereffects (p<0.05), the regular examination of prosthesis (p<0.05), smoking-prohibition education (p<0.05), and the prevention poor-quality fillings (p<0.01). The mean number of patients per day made significant differences to the regular examination of prosthesis (p<0.05) and the prevention poor-quality fillings (p<0.01). But no significant disparity was generated by age or the term of service. 2. The general characteristics made the following differences to education about nutrition and diet counseling: The sort of organization for which the subjects worked had a significant effect just on the importance of a balanced menu (p<0.05). Age made significant differences in advice for vitamin, mineral, protein or other nutrients (p<0.01), and the importance of balanced menu (p<0.001). The term of service made significant differences in the importance of balanced menu (p<0.01), and advice for nutrients including vitamin, mineral or protein (p<0.01). 3. The general characteristics made the following differences to the recommendation and use of oral hygiene aids: The sort of oragnization for which they worked made significant differences only to a gingival massager and water pick (p<0.05). No significant difference was produced by age, the term of service or the mean number of patients per day. 4. The use of educational media for oral health was different according to the general characteristics: The use of pamphlets or booklets significantly varied depending on the organization for which they worked and with the mean number of patients per day (p<0.05). The use of slides or slide projectors was significantly affected by age (p<0.05). But no significant disparity was yielded by the term of service. 5. The general characteristics made the following difference as to whether a continued oral management system was carried out or not: The sort of organization for which they worked had very a significant effect on this result (p<0.001), and no significant disparity was made by age, the term of service or the mean number of patients per day. 6. The place where oral health education was giver differed according to the following general characteristics: The sort of organization for which they worked made very a significant difference as to the use of an examination room's dental unit chair or waiting room (p<0.01), and to the use of an oral health education room or reception counter (p<0.001). The term of service had a significant effect on the use of a counseling room (p<0.01). And the mean number of patients per day made significant differences in the use of a dental unit chair or reception counter (p<0.05), and to the use of an oral health education room or waiting room (p<0.01).

• 농촌의학ㆍ지역보건
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• 제37권3호
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• pp.167-180
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• 2012

본 연구는 대구광역시 심뇌혈관질환 고위험군 등록관리 시범사업단 고혈압 당뇨병 교육정보센터를 방문한 고위험군환자와 교육자의 교육요구도를 반영하여 질환, 영양, 운동 3영역의 기본, 심화, 개별 3단계로 단계별 교육프로그램을 개발하였다. 이 프로그램의 효과평가를 위하여 교육정보센터에 방문한 기본교육군 32명, 단계교육군 37명을 대상으로 교육 전후 임상적 지표, 행동변화단계, 자아효능감을 측정하였고 주요 연구결과는 다음과 같다. 교육요구도조사결과 고위험군과 교육자의 요구도가 높은 소그룹형태, 30분-1시간이내 수업 및 이론 50%와 실습 50%의 구성과 형태로 이루어지며 3개월의 교육과정인 질환, 영양, 운동영역의 단계 교육프로그램을 개발하였다. 교육요구도조사 결과 교육영역별 교육내용은 고위험군과 교육자의 필요도와 지식정도의 통계적으로 유의한 차이에 따라 5가지 범주로 분류하여 프로그램 구성에 적용할 수 있었다. 첫째, 고위험군과 교육자간의 요구도에 유의한 차이가 없는 항목은 기본과정내용으로 반복하게 하였고 둘째, 고위험군의 인지도가 평균점수 이하인 항목은 기본교육과정내용을 조정하여 효과적인 실습방법으로 모든 단계에서 반복할 수 있도록 하였다. 셋째, 고위험군의 지식정도 평균 편차가 큰 항목은 개별교육과정에 포함시켜 문제를 해결할 수 있는 기술습득을 목표로 이루어지도록 하였다. 넷째, 고위험군과 교육자간 지식정도의 유의한 차이가 있는 항목과 다섯째, 고위험군과 교육자간 요구도에서 유의한 차이가 있는 항목은 고위험군의 참여도가 높은 실습 중심의 심화교육으로 구성하며 교육자도 표준 매뉴얼에 따라 교육방법, 교육환경을 일관성 있게 유지하도록 교육훈련을 강화하여 교육자 간 격차를 줄이도록 하였다. 교육자와 고위험군과의 격차를 줄이기 위하여 자가관리 목표, 단기 계획 설정을 고위험군과 교육자 상호약속에 의해서 계획하여 실천동기와 문제해결능력을 향상시키도록 하는 과정을 단계마다 필수적으로 포함시켰다. 교육프로그램의 평가는 기본교육군, 단계교육군을 대상으로 임상적 지표, 행동변화단계 자기 효능감을 측정하여 비교하였다. 임상지표 중 허리둘레, 수축기혈압, 이완기혈압(p<0.05), 자기효능감 중 혈압/혈당조절 불량시 병원방문, 의사의 지시에 따라 약 복용, 식사량 일정유지(p<0.05), 정기적으로 합병증 검사, 정상적인 혈압/혈당을 유지, 허리둘레 유지, 체중 유지(p<0.01), 행동변화단계에서는 싱겁게 먹기(p<0.05)에서 유의적인 차이가 있었다. 환자와 교육자의 교육요구도를 반영하여 개발된 실습 중심의 단계별 교육프로그램은 이론중심의 기본교육프로그램과 비교한 결과 임상지표, 자기효능감, 행동변화단계에서 유의한 차이가 있었다. 대상자 수가 적고 추구관리기간이 짧았으며 임상지표측정이 부족했던 한계점은 있으나 환자가 노인이며 만성질환환자로서 유병기간이 긴 점을 감안하면 이 프로그램을 지속적으로 시행한다면 환자의 심뇌혈관질환 예방에 기여할 수 있을 것이다.

• 간호행정학회지
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• 제3권2호
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• pp.61-80
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• 1997

The purpose of this study is to measure the direct and indirect nursing care hours with establishment of nurse substations and compare the experimental nursing units with the existing nursing units For this study, two experimental nursing units: (1) a medical nursing unit and (2) a surgical nursing unit with a nurse substation were selected. And two control nursing units : (1) a medical nursing unit and (2) a surgical nursing unit without a nurse substation were selected. After a three-month experimental operation from June 1 to August 31,1996, research data were collected for three days from September 2 to 4, 1996. We investigated the effects of the direct & indirect nursing care hours with establishment of the nurse substations (improved nursing environment) without adding the staff nurses. The effect of establishment of the nurse sub-station was measured for the differences direct & indirect nursing care hours between experimental and control nursing units. An investigator measured the time for a staff nurse to practice each nursing activity and recorded it every minute. Percentage, average, standard deviation, t-test and ANOVA were used for data analysis. The results are as follows: 1. There was no significant difference between the experimental and control nursing units in staffs' working hours during their shift. 2. There were significant diffferences between the experimental and control nursing units in dierct nursing care hours (t=0.0288, p=0.0001) and indirect nursing care hours (t=0.3886, p=0.0103) per patient. 3. There was significant difference between the experimental and control nursing units in direct nursing care hours done by nurses(t=0.0012, p=0.0111) and aids(t=0.3011, p=0.0027). There was significant difference between the experimental and control nursing units in indirect nursing care hours done by head-nurses(t=0.0051, p=0.0253), nurses(t=0.0071, p=0.0024) and aids (t=0.3227, p=0.0351). There was significant difference between the experimental and control nursing units in indirect nursing care hours done by nurses(t=0.0005, p=0.0015) and aids(t=0.2400, p=0.0013) per patient. There was significant difference between the experimental and control nursing units in indirect nursing care hours done by head-nurses(t=0.0005, p=0.0379) and nurses (t=0.0035, p=0.0198) per patient. 4. Thre were significant differences between the experimental and control nursing units in direct nursing care hours (t=0.1134, p=0.0010) and indirect nursing care hours (t=0.7106, p=0.0008) per staff during the day shift. There were significant differences between the experimental and control nursing units in direct nunsing care hours during the day(t=0.0723, p=0.0003) and evening shift (t=0.0004, p=0.0285) per patient, and indirect nursing care hours during the day shift(t=0.5565, p=0.0036) per patient. 5. There were differences between the experiemental and control nursing units in dircet nursing activities including measurement and observation, medication, communication, teratment, hygiene, and nutrition, and in indirect nursing activities including confirmantion, communication, record, computer work, management of goods. But it was not statistically proven. 6. There was difference between the experimental and control nursing units in unmet-need nursing care hours per patient, but not statistically proven.

• 대한간호학회지
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• 제28권1호
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• pp.117-131
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• 1998

The purpose of this study was to develop a critical pathway for case management for patients who have received Coronary Artery Bypass Graft (CABG) because of Ischemic Heart Disease(IHD) which is a factor of rising medical expenses. For this study. a conceptual framework was developed through a review of the literature including six critical pathways which are currently being used in USA. In order to identify the overall service contents required by these patients and to draw up a preliminary critical pathway, 30 cases of medical records of patients who had CABG because of IHD between January, 1995 to June. 1996 at the Cardiovascular Center of Yonsei Medical Center in Seoul were analyzed. An expert validity test was done for the preliminary critical pathway and clinical validity test was also done using seven IHD patients with CABG between November 11 and 23, 1996. After these processes. the final critical pathway was developed. The results of this study are summarized as follows : 1. The vertical axis of the critical pathway includes the following eight items : tests, nutrition, medications, consultations, activity, assessments, treatments, education discharge planning and the horizontal axis includes the time from the start of hospitalization to discharge. 2. Analysis of the 30 medical records indicated that the average length of stay was 20.2days with the average length of stay from hospitalization day to operation day being 6.2 days, and the average length of stay from operation day to discharge day was 13. 9 days. Analysis of the service contents showed that the horizontal axis of the preliminary critical pathway was set from hospitalization to the 14th post operation day and the vertical axis was set to include eight items, the contents which ought to have occurred, according to the time frames of the horizontal axis. 3. As a result of the experts validity, it was found that among the total of 571 items. there was over 83% agreement for 482 items, less than 83% for 89 items, which were then deleted and a revision of the critical pathway was done. 4. A clinical validity test was done using seven IHD patients with CABG. During the process, three patients were deleted because they were out of the criteria the investigator set. Finally, four patients were used. The result of study indicated that only one patient was discharged on the tenth post operation day, which was one day later than the expected day. Three patients were discharged later than the expected day from three days to nine days. All the cases progressed on schedule until the operation day and the first post operation day, but from the second post operation days, there were differences between the critical pathway and the actual practice. The differences came from tests, assessments, and treatments. 5. On the basis of the results of the clinical validity test. the following revisions in the final critical pathway were made : the transfer from ICU to step down ward would be the second post operation day, and the transfer to a general ward, the fifth post operation day, for patients who complained of lack of sleep from the fifth post operation day to discharge, a sleeping pill would be prescribed, skin observations would be performed routinely from immediately after the operation until the third post operation day, and would continue if there was a sign of skin injury on the fourth post operation day, and assessment of chest pain would be done from the third post operation day, and the “stairs climbing” item, expected to be done on the ninth post operation day would be deleted. In conclusion, this critical pathway is partially applicable to the care of patients with CABG but there are some parts needed to be further investigated.

• 농업생명과학연구
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• 제46권3호
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• pp.97-108
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• 2012

본 연구는 딸기 GAP 모델을 개발하기 위한 기초자료를 제공할 목적으로 서부경남에 소재한 딸기 농장 세 곳을 선정하여 딸기의 재배단계에서의 생물학적(위생지표세균, 병원성 미생물, 곰팡이), 화학적(중금속) 및 물리적(이물) 위해요소를 조사하였다. 먼저 작물, 재배환경, 개인위생을 대상으로 생물학적 위해요소를 분석한 결과, 위생지표세균인 일반세균과 대장균군의 경우 재배환경에서 최대 7.3 및 5.6 log CFU/g, 개인위생에서 6.3 및 5.4 log CFU/hand or $100cm^2$, 잎에서 5.3 및 4.7 log CFU/leaf으로 검출되었다. 병원성 미생물의 경우 Bacillus cereus가 토양에서 최대 6.1 log CFU/g, Staphylococuus aureus가 작업자 손에서 5.4 log CFU/hand로 검출되어 이들 병원균에 의한 식중독 발생 가능성 또한 있는 것으로 나타났으며, 공중낙하균의 경우는 안전한 수준으로 나타났다. 화학적 위해요소인 중금속(Cd, Pb, Cu, Cr, Zn, Ni, Hg 및 As)은 모두 국내 허용기준치 이하로 검출되었고, 물리적 위해요소는 유리조각, 캔 등의 일반쓰레기나 경작지 폐기물 등으로 확인되었다.