오늘날의 시장 경제는 소비자 중심으로 빠르게 변모하고 있다. 이는 점점 가속화 되어가는 소비자의 생활수준과 교육수준의 향상, 다양한 대중매체를 통한 구매자의 상품에 대한 접근의 용이성에 기인한다. 다양한 선택의 대안 속에서 자신의 가치를 만족시킬 수 있는 상품을 선택할 수 있는 소비자 중심의 시장 경제체제는 소비자의 소득수준의 증가와 전 국민 의료보험의 실시로 인한 의료 수요확대를 통해 의료분야에서도 그 두각을 나타내고 있다. 최근 우리나라의 의료계는 의료기관의 수 및 의료 인력의 증가로 인해 경쟁이 강화되고 있는 실정이고, 이러한 경쟁 강화를 통해 소비자의 시장 선택의 폭은 넓어지게 되었다. 이런 시점에 소비자의 입장에서 본 의료서비스에 있어서의 고객만족도에 영향을 미치는 요인, 서비스의 문제점, 개선점에 대한 조사와 연구는 필요 불가결하다고 하겠다. 이 연구는 2006년 1월 23일부터 4월 15일 까지 서울시에 소재한 연세대학교 치과병원에 내원한 환자 784명을 대상으로 진행되었으며 구조화된 설문지를 이용하여 자기기입식 방법으로 자료를 수집하여 이를 분석하였다. 본 연구의 결과를 살펴보면 다음과 같다. 1. 응답자의 사회인구학적인 특성은 성별이나 결혼여부는 적절하게 표본이 추출 된 것으로 보이나 직업에서는 학생 및 대학(원)생, 내원이 유와 현재 받고 있는 치료에 있어서는 교정치료가 높은 비율로 나타났다. 2. 치과병원에 대한 전반적인 만족도는 전체의 74%가 높은 만족을 나타내었다. 3. 독립변수들 중 구체적 서비스 항목에 대해서는 '서비스시스템', '친절도', '설명', '대기시간설명', '예약시스템', '응급상황에의 대처', '치과진료경험의 풍부', '치과적 지식의 유무', '병원의 규모', '소독', '내부시설', '주차' 에 대한 만족도는 높게, '치료비', '치료 준비시간', '대기시간', '치료시간', '예약기간' 에 대한 만족도는 낮게 나타났다. 4. 독립변수들 간의 상관관계 분석을 실시하였고 이들 사이에는 높은 선형관계가 없었다. 5. 독립변수들과 종속변수 사이의 상호관련성을 평가하기 위한 프로빗 회귀분석 결과 총 34개의 독립변수 중에서 불편감 해소, 서비스 시스템, 친절도, 설명, 한 번 내원 시 치료시간, 예약시스템, 지식의 유무, 내부시설에 대한 만족도의 8개 독립변수가 유의수준 1%하에서 서로 높은 상호관련성을 보였다. 고객의 만족은 전적으로 고객의 주관적인 평가에 의존한다. 환자들의 욕구가 다양화되고 고급화되면서 의료서비스에 대한 기대수준이 높아지고 있기 때문에 이에 부합하는 서비스를 제공하는 것이 의료서비스의 고객인 환자를 만족시키는 필수 요건이 된다. 많은 의료기관이 환자를 중심으로 하여 고객만족을 위한 병원, 고객감동을 위한 병원이 되기 위하여 노력을 하고 있으며, 이는 치과의료 분야에 있어서도 적용되고 있는 현실이다. 내원환자들의 만족도를 향상시키기 위해서는 이 연구의 결과를 기초로 한 새로운 병원 경영 전략의 수립과 그로 인한 의료 서비스의 질 향상으로 고객이 만족하는 양질의 의료서비스를 제공하는 노력이 필요하리라 여겨진다.
본 연구는 남극반도 북서부에 해당하는 South Shetland 군도 북쪽 해역에서 과학어군탐지기를 이용한 연속 관측 자료를 이용하여 크릴의 공간적인 분포 (수평, 수직분포) 및 자원량 파악을 주목적으로 하였다. 또한 자원량 계산을 위하여 플랑크톤 네트를 이용한 채집을 실시하였으며, CTD를 이용한 연구 해역의 수온 구조의 수직적 특성을 파악하여 크릴 군집과의 상호 관련성을 규명하고자 하였다. 고밀도의 크릴군은
연구는 경북지역 여자 중 고등학교 학생의 체형인 식도와 식생활 행동 비교를 알아보기 위하여 경북의 여자중학생 194명과 여자고등학생 170명을 대상으로 2014년 9월에 설문 조사를 실시하였다. 설문지는 총 364부를 배부한 후 364부(100% 회수)를 회수하여 최종 연구 분석에 사용하였다. 1. 조사 대상자의 평균 BMI는 21.29로 정상 수준이었으며, 여고생이 여중생에 비해 신장, 체중, BMI가 모두 높은 수치를 보였고 신장(p<0.001)과 체중(p<0.01)은 유의한 차이를 나타냈으나 BMI는 유의한 차이를 보이지 않았다. 2. 조사대상자의 체형인식에서, 조사대상자 전체 중 51.4%가 보통체형, 37.4%가 뚱뚱한 체형, 11.3%가 마른 체형 순으로 응답하였으며, 여고생(43.9%)이 여중생(31.6%)에 비해 뚱뚱한 체형이라고 응답한 비율이 높게 나타나 유의한(p<0.05) 차이를 보였다. 체형에 대한 만족도에서, 조사대상자 전체 중 52.2%가 '불만족이다'고 응답하였으며 32.7%가 '보통이다', 15.1%가 '만족이다'고 응답하였으며, 특히 '불만족이다'고 응답한 비율이 여고생(64.1%)이 여중생(44.0%)에 비해 유의하게(p<0.001) 높게 나타났다. 3. 조사 대상자의 체형인식과 BMI를 비교 분석한 결과, 조사대상자 전체에서 자신을 마른 체형으로 응답한 군의 63.4%가 저체중으로, 보통 체형으로 응답한 군의 70.0%가 정상체중으로, 뚱뚱한 체형으로 응답한 군의 53.3%가 과체중과 비만으로 나타나 뚱뚱한 체형으로 응답한 군이 다른 두군에 비해 올바른 체형인식 비율이 낮았다. 특히 자신을 뚱뚱한 체형으로 인식하는 대상자들 중 5.2%가 저체중, 41.5%가 정상체중으로 조사되어 자신을 뚱뚱하다고 인식하는 여학생의 절반이 왜곡된 체형인식을 하는 것으로 나타났다. 여중생과 여고생의 차이를 비교한 결과, 자신을 뚱뚱한 체형으로 응답한 여학생 중 여중생 39.3%, 여고생 53.3%는 정상체중과 저체중으로 나타났으며, 자신을 마른 체형이라고 응답한 여학생 중 과체중 이상이 여중생은 0.0%, 여고생은 18.8%로 나타나 여고생이 여중생에 비해 자신의 체형에 대해 잘못 인식하는 비율이 유의하게(p<0.001) 높은 것으로 조사되었다. 4. 조사대상자 전체 중 63.7%가 체중조절 경험이 있는 것으로 나타났으며, 여고생(67.3%)이 여중생(60.6%)에 비해 체중조절 경험이 많은 것으로 조사되었으나 유의한 차이를 보이지 않았다. BMI가 높을수록, 자신을 뚱뚱한 체형으로 인식할수록 체중조절 경험이 유의하게(p<0.001) 많은 것으로 나타났다. 체중조절 방법으로는 '음식의 조절과 운동을 병행한다'(22.0%), '식사량을 조절한다'(20.9%), '운동을 한다'(18.7%), '간식과 야식을 줄인다'(17.4%) 순으로 나타났다. 5. 조사대상자의 비만 관련 식행동 평가를 15항목에 대해 5점 척도로 조사한 결과, 조사대상자들의 총 평균 점수는 3.19/5.00점으로 조사되었다. 평균점수보다 낮은 평가점수를 나타낸 항목은 총 7개로 '음식의 영양소를 따져 가면서 먹는다'(2.15), 'TV나 컴퓨터를 보면서 식사를 한다'(2.94), '자주 과식을 한다'(2.98), '맛있는 음식이 있으면 배가 불러도 계속 먹는다'(3.03), '다른 식사보다 저녁을 많이 먹는다'(3.03), '밤 9시 이후에 간식을 먹는다'(3.07), '배가 고프지 않아도 뷔페의 음식을 모두 먹는다'(3.14) 순으로 나타났다. 여중생과 여고생의 비만관련 식행동을 비교한 결과, 총평균 점수는 여고생(3.06)이 여중생(3.33)에 비해 유의하게(p<0.001) 낮은 점수를 보여 비만관련 식행동이 나쁜 것으로 나타났다. 이상을 살펴볼 때, 조사대상 여중생과 여고생의 BMI는 유의한 차이가 없었으나 여고생이 여중생에 비해 뚱뚱한 체형이라고 응답한 비율과 자신의 체형에 대해 잘못 인식하는 비율이 높고 체형만족도가 낮으며, 비만관련 식행동이 나쁜 것으로 나타났다. 부적절한 식습관이 체중증가로 이어지고 사춘기에 가지는 예민한 감수성으로 단지 날씬해져야 한다는 생각에 스스로 체중감량을 시도하는 학생들이 많아지고 있는 것으로 여겨진다. 학교에서 양질의 급식이 이루어지고 있음에도 불구하고 학교 안에서 이를 해결할 수 있는 체계적인 영양교육이 이루지지 않고 있는 실정이다. 무엇보다 체형에 관심이 많은 여학생들이 불충분한 지식과 잘못된 상식으로 바람직하지 않은 방법의 체중조절을 하지 않도록 학교 안에서 체계적인 영양교육 프로그램을 운영하는 것이 중요하다. 특히 본 연구결과에서 도출된 바를 토대로 여고생들에 대한 체형인식 및 체중조절에 관한 영양교육 프로그램을 실시하여 올바른 체형인식과 식행동이 이루어질 수 있도록 하는 것이 시급한 것으로 사료된다.
Out of a total of 58 species of helminthic and protozoan parasitic infections in Korea, so far 38 species were reported as intestinal parasites of man. Quite a few species of the intestinal parasitic infections have long been prevalent throughout the country and this has been a significant public health problem. In this paper, current status and transition of the intestinal parasitic infections in the past years were presented. Chronological reviewing of data show background and prospects of change in the prevalence of infections. In the national prevalence survey on parasitic infections conducted once every five years since 1971, stool examinations were done by both cellophane thick smear and brine flotation techniques. Every egg positive case of Ascaris lumbricoides and Clonorchis sinensis was further examined by Stoll's dilution egg counting technique. In 1981, perianal swab using adhesive cellulose tape was added for Enterobius infection. For protozoan cyst examination conducted by province and city in '81, fecal specimens were fixed in SAF solution and examined by the formalin-ether concentration technique. High prevalence of parasitic infection in ana before the 1960s can be easily understood from the data given by the Ministry of Health and Social Affairs in 1967. From a parasite control point of view, the 1960s was the preparatory period particularly for control of soil-transmitted helminthiasis. Several organizations which have contributed to parasite control were founded in this period and the prevention law of parasitic infections was passed in '66. In the '70s, overall prevalence rates of the common intestinal parasitic infections, which were highly prevalent in the past were turned into reduction phase for the first time. The '80s can be said to be an active control period of parasitic infections. Intestinal helminths According to the reports of the national prevalence survey on parasitic infections, the prevalence of helminthic infections was 84.3%(number of person examined:24,887) in '71, 63.2%(27,178) in '76, and 41.1%(35,018) in '81. By area, the prevalence rate in '81 was 35.1%(20,569) in urban areas and 49.6%(14,447) in rural areas. Intestinal nematodes Ascaris lumbricoides The prevalence of Ascaris infection has decreased significantly in recent years. Among students, the prevalence was 55.4%, in '69 and decreased to 4.7% in '83. In the national prevalence surveys, the prevalence decreased to 13.0% in '81 from 54.9% in '71. By area, the prevalence decreased to 8.5% in '81 from 46.4% in '71 in urban area and 19.4% in '81 from 59.6% in '71 in rural area. By age, the prevalence has become in recent years relatively even in all age groups, although higher prevalence used to be seen in young age groups of around 10 years old, particulary in the highly prevalent rural areas. By sex, the prevalence was higher in the female than in the male. Unfertilized egg positive rates among the ascariasis cases increased gradually up to 55.4% on the average in '81. The intensity of the infection was also significantly decreased. Trichuris trichiura Trichuris infection had also decreased to 23.4% in '81 from 65.4% in '71. By area, the decreasing tendency of the prevalence became faster in urban areas than in the rural areas. The prevalence in urban and rural areas in '71 was 69.7%, and 63.1% respectively and decreased to 19.5% and 29.0% respectively in '81. By age, the prevalence reached a peak at the 10-14 age group and showed relatively even distribution throughout all age groups. By sex, the prevalence was close in young age groups, but in the 30s or over age group, especially in rural area, the prevalence was significantly higher in the female than in the male. The prevalence has much fluctuated depending in the area. The prevalence in rural areas surveyed in the '80s shows a range between 20.9% and 73.7% by locality. It is anticipated that the prevalence of Trichuris infection will drop more rapidly, when mass treatment is conducted. Hookworms Hookworm infection by mostly Ancylostoma duodenale and a few by Necator americanus has decreased to a negligible levels in recent years. In the national prevalence surveys, the prevalence was 10.7% in '71, 2.2% in '76, and 0.5% in '81. The prevalence was higher in rural areas than in urban areas. Wide application of multi-specific anthelminthics in the ascariasis control programmes conducted in the past decade appear to have been effective against hookworm infection. Trichostrongylus orientalis As in the case with hookworm infection, the prevalence of Trichostrongylus infection has reached a negligible levels. In the national prevalence surveys, the prevalence was 7.7% in '71, 1.0% in '76 and 0.2% in '81. Enterobius vermicularis In the national prevalence survey in '81, the egg positive rate was 12.0%. Higher prevalence is expected when examined repeatedly. The prevalence rate was 10.3% in urban area and 14.6% in rural area. In recent surveys conducted in rural areas among schoolchildren, the prevalence was 32.4% in Gimhae Gun in '82 and 64.1% in Yeongyang Gun in '83. By age, the egg positive rate was higher in young age groups of around 10 and sharply decreased in age groups of around 20 and then somewhat increased again in middle age groups. By sex, the prevalence was higher in the female than in the male. Strongyloides stercoralis Strongyloides stercoralis infection has rarely been found in Korea. Three cases were reported in 1914. And 0.1-0.5% were found infected out of 2,642 persons examined at the prisoner-of-war camp on Geojedo in 1956. One case was reported in '54 and '82, respectively. Anisakis spp. No systematic survey has been conducted for anisakiasis In Korea. So far, only several cases have been found 1 case in Seoul in '71, 5 cases in Busan in '81 and 1 case in Busan in '84. Intestinal trematodes Metagonimus yokogawai In the national prevalence survey conducted in 1981, the egg positive rate was 1.24% on the average. High endemic areas are located in the southwestern part of Korea. The prevalence in Hadong Gun was 29.1% on the average in '79. In a survey conducted in 76, the prevalence was 44.0% in Gwangyang, 55.0% in Gogseung and 29.0% in Gurye. The infection is closely correlated with raw sweetfish consumption in these areas. Other intestinal trematodes A human case of Heterophyes heterophyes was reported in 1914. Several species were reported in the '80s : 17 cases of Fibricola seoulensis, 9 cases of Pygidiopsis summa, 8 cases of Heterophyes heterophyes nocens, 1case of Heterophyopsis continua, 2 cases of Stellantchasmus falcatus, 1 case of Stictodora sp., 1 case of Echinostoma hortense, and 4 cases of Echinochasmus japonicus. As the intermediate hosts, snakes and frogs play a role for F.seoulensis and fish for the rest of the species. Intestinal cestodes Taenia saginata and T. solium Egg positive rates in the national prevalence survey were 0.7% in '76 and 1.1% in '81. The prevalence in '81 was 0.6% in urban area and 1.8% in rural area. The proglottid positive rate in Jeju Do was 19.2% on the average. On Udo, Jeju Do in 1983, the egg positive rate among the inhabitants was 2.9%. Hymenolepis nana In the national prevalence survey, egg positive rates were 0.6% in '76 and 0.4% in '81. No difference was seen in the prevalence by area and sex. Hymenolepis diminuta Infected cases were reported : 3 in '64 and I in '66. Egg positive rate in '81 was 0.01% in the national prevalence survey. Diphylobothrium latum So far, about 30 cases have been reported. The cases have been reported more frequently in recent surveys. Mesocestoides sp. A case was reported from a hospitalized patient in Seoul in '67. Spirometra erinacei Two cases were reported in '84 following reidentification of the adult worms collected in '74. Intestinal protozoa Out of a total of 23 species of human protozoan infections in Korea, 13 species were reported as intestinal protozoa : Entamoeba histolytica, E coli, Endolimax nana, Iodamoeba b
According as the automation of clerical work(OA ; Office Automation) develops, the use of VDT(Visual or Video Display Terminal) is increasing suddenly. But, in proportion to the spread of office automation(OA tendency), the self-conciousness syptom attendant upon the work is appearing also (Kim, Jung Tae, Lee, Young Ook, 1990). The apparatuses of office enable the clerical workers to be convenient and perform mass businesses. But, they are increasing the opportunity to be exposed to VDT syndrom, techno stress, computer terminal disease, pain by muscle strain(RSI), bradycausia of noise nature, and electromagnetic waves, etc. which are referred to as the new type of occupational diseases to the workers. It is the real situation that the workers to use VDT is complaining of the physical inconvenience sense in the recent newspaper and literature, it is the point of time that the sydrome to come from VDT use and computer terminal disease, etc. must be classified into the occupational disease(Lee, Kwang Young 1990, Lee, Kyoo Hak 1990, Lee, Won Ho 1991, Lee, Si Young 1991, Lee, Joon 1991, Choi, Young Tae 1991, Heo, Seung Ho 1989). In addition, it is the real situation that the scientifitic study result about the scope that electromagnetic waves has influence on the human body has not been suggested yet, and criticism on the stable exposure permission standard about electromagnetic waves to be emitted from VDT and on the problem in the health about electromagnetic waves is continuing. (IEEE Spectrum, 1990). In addition according to the experience of nursery business of industry field, it is the real situation that the patients who consult complaining of physical and mental inconvenience sence, among the users of apparatus of office automation, are reaching 10% of the patients coming to doctor's room. Therefore, it is necessary to confirm the self-consciousness symptom that the clerical workers complain of multilaterally with the actual state examination about the use of the apparatuses of offices automaton. Thus, this study was tried as th basic data for the cosultation and education for the maintenance and furtherance of the health of workers as the nurse of industry field, by confirming the contents of self-consciousness symptom attendant upon the use of the apparatus for office outomation making the financial institution in which the spparatus for office automation in most frequently used as the subject, and by examining whether there is the difference according to the subject of study, the data were collected, by using the questionnaire method, making 200 workers who consented to the study participation as the subject, among the persons who have spent over 3 months since they used the apparatuses for office automation and didn't receive the treatment in hospital due to the clerical disease for recent 3 years. The period of data collection was from Oct. 9, 1991 to Oct. 12. As for the measurement instrument about the complaint if self-consciousness symptom attendant upon the use of apparatuses fo office automation, the question item on the complaint symptom of health problem attendant upon the treatment of VDT that Kim(1991) developed and on CMI health problem and the question items on the fatigue degree due to industry were used by previous examination to 25 persons. Collected data were analyzed with the statistical method such as percentage, arithmetic mean, Person correlation coeffient, Kai square verfication, t-test, ANOVA, etc. by using SPSS/PC+ program, and the result is as follows : 1. The self-consciousness symptom that the clerical workers complained of most frequetly appeared high in 'My eyes are tired'(99.4%), 'I feel fatigue and weariness'(99.4%), 'I feel that my head is heavy5(90.0%), 'eyesight fell'(88.8%), 'I have a stiff neck'(88.8%), 'I fell pain in the shoulder'(85.0%), 'I feel cold and painful in the eyes'(76.9%), 'I feel the dry sense of eyeball'(76.2%), 'My nerves are edgy, and I an fretful, (75.6%), 'I feel pain in the waist'(73.2%) and 'I fell pain in the back'(72.8%). It emerged that the subject use the apparatuses for office automation complained of self-consciousness symptoms related to visual symptoms and musculoskeletal symptoms. 2. As for the general feature of examination subjects, the result to see the distribution by classifying into sex, age, school career, use career of apparatuses for office automation, skillfulness degree of the use of apparatus for office automation, use hours of the apparatuses for office automation per 1 day, type of business of the apparatus for office automation, rest hours during the use of apparatus for office automation, satifaction degree of business of office automation, and work circumstance, etc. emerged as follows : As for the sex of subjects, the distribution showed that men were 58.8% and women were 41.3%, Age was average 26.9. As the distribution of school career, the distribution showed that4below the graduation of high school' was 58.8%, 'graduation from junior college-university' was 35.0%, and 'over graduate school' was 6.3%. In the question to ask the existence or non-existence of experience of health consultation in connection with the work of office automation, the response that I had the consultation exprience and I feel the necessity emergerd as 90.1% And, the case that the subject who didn't wear the glasses or lens before using the OA apparatus wear glasses or lens after using OA apparatus emerged as 28.3% of whole. As for the existence or non-existence of use career of OA apparatus, the case under 3 years was highest as 52. 7%. As for the skillfulnness degree about the use of apparatus for office automation, most of them are skillful with the fact that 'common' was 44.4%, 'skill' was 42.5%, and 'unskillful' was 13.1% As for the use average hours of the apparatus for office automation per 1 day, the distribution showed that the case under 3-6 hours was 33.1%, the case under 6-9 hours was 28.1%, the case under 3 hours was 30.6%, and the case over 9 hours was 8.1% Main OA business and the use hours for 1 day showed in the order of keeping and retrieval, business of information transmission(162min), business of information transmission(79.3 min), business of document framing(55.5 min), and business of duplication and printing(25.4min). as for the rest during the use of apparatus for affice automation, that I take rest occasion demands the major portion, but that I take after completing the work emerged as 33.8%. Though the subiness gets to be convenient by the use of the apparatus for of office automation, respondents who showed the dissatisfaction about the present OA business emergd high as 78.1%. The work circumstances of each office was good with the fact that the temperature of office was 21.8, noise was average 42.7db, and the illumination was average 364.4 lx, in the light of ANSi/HFS 100 Standard. 3. Sight syptom, musculoskeletal symptom, skin and other symptoms showed the significant difference according to the extent of skillfulness of the apparatus for office automation. All the symptoms exept skin symptom showed the difference according to the use hours of the apparatus for office automation. All the question items exept the sytoms of digestive organs and the rest hours during the apparatus for office automation showed the signicant difference. The question item which showed the signicant difference from the satisfaction degree of present OA business showed the significant difference from all the question item classified into 6 groups. But, age and school career didn't significant difference from the complaint of any self-consciousness symptoms.