• 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.

• The Journal of Korean Physical Therapy
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• 제15권1호
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• pp.82-95
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• 2003

Our health is intimately connected to the health of our environment. The contemporary world view which sees a radical distinction between humans as subjects and world as object can obscure our recognition of how much we rely on nature for health and survival. Indigenous traditions and contemporary scholars remind us that we live in a universe in which all things are connected, and in which nature continues to offer its gifts in co-creative partnership for the health and wellbeing of all. Living in awareness of our relationship with nature enables us to open more to the experience of nature's nurturing. Many complementary therapies derive from ancient practices that involve nature in healing partnership. Essential oils have been used for thousands of years. Hippocrates claimed that the way to health was through aromatic baths and massages. Much anecdotal evidence exists regarding aromatherapeutic positive effects on recipients. Aromatherapy is a branch of complementary or alternative therapy which is increasing in popularity, yet has scant scientific credibility. Aromatherapy should be defined as treatment using odors and practised as such. However, essential oils are usually used in conjunction with therapeutic massage and often combined with counselling of some kind. Aromatherapy complements and enhances the therapeutic powers of massage. Massage is one of the most wonderful ways to relax and is throughly beneficial to health. Massage can help unknot tense and aching muscles and other minor symptoms of stress, leaving patients fresh and energized. As the use of aromatherapy within a health care setting has grown so rapidly in recent years, and will continue to do so, the need for suitable training has become apparent. No health service can afford the risk of having staff who are inadequately trained in the practice of aromatherapy using essential oils incorrectly on those in a state of ill-health, especially if the essential oils used are not to a standard suitable for therapeutic use. Training to an acceptable level in aromatic therapy is essential for safety and effectiveness. Knowledge of the nature and make-up of essential oils, their effect on the body and the emotions, and how, when, and where to apply them is imperative in order for them to be beneficial to a patient's health. In order to achieve best practice, further research is necessary to explore the use of aromatherapy in the management of multiple disorder.

• 대한한방내과학회지
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• 제30권1호
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• pp.144-152
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• 2009

Background : Ephedra (Ephedra sinica) has been widely used to treat respiratory disease in traditional medicine of East Asia for over a hundred years. Despite safety concerns raised by some, the use of ephedra in traditional medicine is documented over more than 1,800 years. It is well established that ephedra is one of the central medicines in Korean 'Seseng constitution' medicine. In Sasang constitution medicine, all humans can be divided into one of four types: Soeumin, Soyangin, Taeumin or Taeyangin, and each constitution type has their own typical characteristics. Accordingly, it is hypothesized that the adverse effects of ephedra differ depending on the Sasang constitution classification. Objectives : The aim of this study was to determine adverse effects of ephedra which is classified as a Taeumin herb, and to observe whether the response differs or not. according to Sasang constitution classification. Methods : The study design was a double-blind randomized controlled trial. The subjects were healthy adults 20 - 50 years old who agreed to participate in this study. They were allocated through randomization to either ephedra group (N=55) or placebo group (N=24). where ephedra extract (6 g of dried ephedra) and placebo with similar opaque capsules were given twice for one day. To compare the adverse events of ephedra according to Sasang constitution classification, we analyzed blood pressure (systolic and diastolic), pulse rate, the morning questionnaire, and patient's global assessment scale score for well known adverse events: palpitation, headache, sweating, tiredness, dyspepsia, and dry mouth. Results : After ingestion of ephedra, the pulse rate had a significant increase in all constitution types. The changes of diastolic pressure in Soeumin and the changes of pulse rate in Soeumin, Soyangin and Taeumin had a significant increase in the ephedra over the control group. In the ephedra group, the palpitation and dyspepsia score of the patients' global assessment scale had a significant increase in Soeumin, with palpitation and sweating score increasing in Soyangin. Others observations were insignificant results. Conclusion : The results of this study may confirm that the physical responses or adverse effects of herbs differ for each type of Sasang constitution. Future studies using other herbs will be required to ascertain the herbal drug reaction of Sasang constitutions.

• 한국방사선학회논문지
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• 제13권6호
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• pp.857-864
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• 2019

캐나다 등 많은 국가들이 초음파사(sonographer) 면허제도를 방사선사면허와 별도로 운영하고 있다. 그러나 한국에서는 방사선사가 의사의 지도아래 초음파영상검사를 수행하고 있다. 이에 방사선사의 초음파영상검사에 대한 직무역량을 분석하여 체계적으로 교육할 기회를 갖기 위하여 캐나다 초음파사의 표준직무역량(National Competency Profile)을 토대로 한국에서 방사선사가 초음파영상검사를 수행함에 있어 요구되는 직무역량과 세부역량들에 대한 직무 내용타당도를 측정하였다. 한국 방사선사 직무역량에 포함된 핵심역량의 중요도과 직무수행 정도를 비교분석한 결과 전체 중요도의 평균은 4.087점, 전체 수행도의 평균은 3.640점으로 중요도가 더욱 높았으며, 통계적으로 유의한 차이를 보였다. 그 결과 'A 의사소통', 'B 전문가적 책임', 'D 장비취급', 'G 근무 장소의 건강 및 안전'은 직무 내용타당도가 높았다. 그러나 'C 환자 평가와 돌봄', 'E 비평적 사고와 문제해결', 'H 영상'은 직무 내용타당도가 낮게 나타나 이들 역량을 강화하고 보완할 수 있는 방안이 모색되어야 한다.

• Journal of Trauma and Injury
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• 제28권2호
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• pp.60-66
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• 2015

Purpose: Cultivator accidents are frequent and often lead to abdomino-perineal organ injury and, if severe, to death. This study presents the clinical characteristics, outcomes, and factors associated with mortality in patients who sustained an abdomino-perineal organ injury in cultivator accidents. Methods: We retrospectively analyzed the records of 53 patients who visited the emergency department of a tertiary hospital with abdomino-perineal organ injuries caused in cultivator accidents from April 2005 to March 2010. Results: All 53 patients had visited other medical institutions before visiting our hospital. Their mean age was $64.0{\pm}11.1$ (range, 20-80) years and 32 (60.4%) patients were 65 or older. The male-to-female ratio was 46:7. The chief complaint was abdominal pain (38 cases, 71.7%). The 53 patients included 41 cultivator operators (77.4%), 11 passengers (20.8%), and 1 passerby (1.9%). The causes of the injuries included a direct impact of the handlebar in 20 cases (37.7%), a rollover in 21 cases (39.6%), a fall in 10 cases (18.9%), and a wheel in two cases (3.8%). Several of the 53 patients had injuries to multiple abdomino-perineal organs, and the injured organs included the liver (23 cases, 26.4%), spleen (16 cases, 18.4%), pancreas (7 cases, 8.0%), small bowel (7 cases, 8.0%), mesentery (6 cases, 6.9%), adrenal gland (5 cases, 5.8%), and other organs. According to the abbreviated injury scale (AIS) dictionary, a thoracic injury was the most frequent co-injury (33 of 53 cases, 62.3%). Abdomino-perineal surgery was performed in 31 cases (58.8%) and angio-embolization was performed for six liver and two kidney injuries. Thirteen patients died (24.5%); all were males. The Injury Severity Scale (ISS) was lower in the survivors ($17.8{\pm}8.5$ vs. $27.0{\pm}16.0$; p=0.010). Conclusion: With the aging of agricultural workers, safety education programs should be implemented. Furthermore, the patient transfer system in agricultural areas must be improved.

• 대한수혈학회지
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• 제23권2호
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• pp.136-144
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• 2012

배경: 신선동결혈장은 응고인자의 보충을 위한 치료적 투여를 주된 목적으로 하지만, 실제로 적응증이 아닌 경우에도 부적절하게 사용되는 경우가 종종 있다. 방법: 년 2010년 7월부터 2011년 6월까지 1년간 세브란스병원 혈액은행에서 출고된 신선동결혈장의 적정 사용에 대한 평가를 시행하였다. 평가기준은 2009년 대한수혈학회에서 발간한 수혈가이드라인과 세브란스병원의 수혈적정성 평가 전산시스템에 기초하였다. 결과: 신선동결혈장은 1년 간 총 1,949명에게 4,982회에 걸쳐 17,733단위가 출고되었고, 이 중 1,990회(총 건수의 39.9%)가 부적절 수혈로 평가되었다. 진료과별 사용 건수는 소화기내과 등의 내과 계열이 흉부외과나 일반외과 등의 외과 계열보다 많았다. 그러나 부적절 사용 비율은 외과 계열이 내과 계열보다 높았다. 질병분류별 사용건수와 이들의 부적절 사용 비율은 유사한 양상을 보였는데, 종양, 소화 계통의 질병, 순환 계통의 질병군이 높은 사용 건수와 부적절 사용 비율을 보였다. 결론: 수혈의 적정성 유지를 위해서는 각 의료기관에서 수혈 적정성이 항상 평가되고, 그 결과를 임상의사들에게 정기적으로 피드백하는 과정이 중요하며, 이와 더불어 신선동결혈장 수혈 적응증에 대한 새로운 고찰이 필요할 것으로 사료된다.

• 한국임상약학회지
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• 제31권3호
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• pp.180-187
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• 2021

Objective: We investigated arthralgia and myalgia associated with the use of oral bisphosphonate (BP) by conducting a survey of patient. Methods: The pharmacists conducted a survey between 1 Oct 2019 and 30 Sep 2020 among patients who were dispensed BP in community pharmacies to assess their demographic and medical characteristics, and their experiences with, and process for pain. Logistic regression analyses were performed to find the risk factors associated with the pain, and the odds ratios (OR) and 95% confidence intervals (CI) were determined. Results: A total of 160 patients who used BP participated in the survey (74 [46.3%] used risedronate; 61 [38.1%] used alendronate; 23 [14.4%] used ibandronate), and 20 (12.5%) of them experienced pain. Significant statistical differences of the characteristics between patients who experienced pain or not were observed regarding menopause, and parity. Compared with women who had one or two parity, women who had more than three parity were associated with the decreased risk of pain (OR, 0.24; 95% CI, 0.04-0.98). Moreover, steady exercise was associated with the decreased risk of pain compared to less exercise (OR, 0.37; 95% CI, 0.14-0.98). Conclusion: Our findings suggest that the risk of pain in BP-treated patients might be different regarding the different ingredients of BP, and dosing frequency. This survey highlights a need for a further safety research to understand the factors influencing the pain associated with the BP treatment.

• 대한방사선기술학회지:방사선기술과학
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• 제44권2호
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• pp.101-107
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• 2021

The purpose of this study was to evaluate optimal CT scan parameters to minimize patient dose to the irradiation and maintain satisfactory image quality in low-dose chest computed tomography (CT) scans. In a chest anthropomorphic phantom, chest CT scans were performed at different kVp and mA within reference of 3.4mGy in volume CT Dose Index (CTDI_vol). The following quantitative parameters had been statistically evaluated: image noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and figure of merit (FOM). Nine radiographers conducted the blind test to select the optimal kVp-mA combination. Results indicated that the kVp-mA combination of 80kVp-90mA, 100kVp-50mA, 120kVp-30mA and 140kVp-30mA were obtained high SNR and CNR. The 120kVp-30mA combination offered good compromise in the FOM, which showed the quality and dose performance. In the blind test, an image of 80kVp-90mA obtained a high score with 4.7 points, and 120kVp-10mA or 140kVp-10mA with a low tube current were observed severe noise and poor image quality, thus resulting in decreased diagnostic accuracy. On the other hand, in the combination of high kVp and high mA(140kVp-90mA), the image quality was improved, but the radiation dose was also increased. the FOM value of 140kVp-90mA was lower than 120kVp-30mA. The application of appropriate scan parameters in low-dose chest CT scans produced satisfactory results in dose and image quality for the accuracy of the clinical diagnosis.

• 한국노년학
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• 제38권3호
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• pp.501-519
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• 2018

본 연구의 목적은 초기 치매환자 가족 돌봄제공자의 공유 의사결정에 대한 인식을 탐색하는 데 있다. 이를 위해 서울시 3개 치매지원센터에 등록된 초기 치매환자를 돌보는 가족 돌봄제공자 12명(여성 8명, 평균연령=$71.4{\pm}10.4$세)을 대상으로 반 구조화된 개별 심층면담을 이용하여 수집된 자료에 대해 질적 내용분석을 시행하였다. 본 연구를 내용 분석한 결과 6개 범주, 17개의 하위 범주가 도출되었는데 구체적인 연구결과는 다음과 같다. 초기 치매환자 가족 돌봄제공자의 공유 의사결정에 관한 인식은 치매환자와의 의사소통 촉진 수단과 치매환자의 자율성 보장 수단, 치료 촉진 기회, 가족 돌봄제공자의 부담감 증가 원인, 치매환자와의 관계 악화 원인, 우선순위 변화에 따른 선택 사항의 여섯 가지 범주로 나타났다. 또한, 공유 의사결정의 상황과 시기 및 공유 의사결정에 대한 인식이 가족 돌봄제공자의 경험을 통해 만들어졌다는 점을 알 수 있었다. 따라서 치매 관련 교육 시 간접경험을 통해 공유 의사결정을 선택 사항으로 생각하는 가족 돌봄제공자들에게 공유 의사결정을 경험할 수 있는 기회 등을 제공하는 것이 공유 의사결정에 대한 인식 제고에 도움이 될 수 있을 것으로 사료된다. 이상 결과에 근거하여 초기 치매환자의 자기결정권 존중과 가족 돌봄제공자들의 부담감을 감소시키기 위해 공유 의사결정을 성공적으로 할 수 있는 실제적이고 총체적인 교육 프로그램의 개발 및 평가 연구를 제언한다.

• 한국산학기술학회논문지
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• 제19권11호
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• pp.411-420
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• 2018

본 연구는 종합병원 의료인의 교육훈련 인식이 의료인 상호간 커뮤니케이션에 미치는 영향을 파악하기 위한 목적으로 수행된 연구이다. 자료조사는 광주광역시, 전라남도 소재 29개 종합병원에서 근무하는 의료인 433명을 대상으로 2018년 6월 8일부터 2018년 6월 25일까지 자료를 수집하였다. 자료 분석은 t-검정과 분산분석, 사후검정, 상관관계 및 단계적 회귀분석을 실시하였다. 연구결과 인구사회학적 특성 및 건강관련 특성과 의료인 상호간 커뮤니케이션 차이를 검정한 결과 연령, 학력, 병상규모, 직업만족도, 소재지, 건강상태, 건강관리 교육경험, 우울경험에서, 교육훈련 인식은 연령, 병상규모, 직종, 급여수준, 의료기관 종류, 직업만족도, 소재지, 건강상태, 건강관리 교육경험, 만성질환 여부에서 통계적으로 유의한 차이가 있었다. 의료인 상호간의 커뮤니케이션에 미치는 영향 요인으로 학력, 건강관련 교육경험에서 긍정적인 영향을 미쳤고, 연령과 병상규모(801병상 이상), 직업만족도에서는 연령이 높을수록, 병상규모가 801병상 이상인 경우, 직업에 만족하지 못할수록 부정적인 영향을 미쳤으며, 교육훈련 하부요인인 지원환경, 학습전이, 성과에서 영향을 미쳤다. 이러한 연구를 바탕으로 교육훈련 계획수립 시 성과와 지원환경, 학습전이를 높일 수 있는 교육훈련 프로그램 구축이 필요하며, 의학 및 간호학생들의 교육 과정에 커뮤니케이션의 정규 교육과정을 도입. 의료인 상호간 커뮤니케이션을 높여 환자에게 안전한 의료서비스를 제공해야 할 것이다.