• 제목/요약/키워드: self-discharge

검색결과 341건 처리시간 0.031초

아동양육시설 퇴소를 앞둔 경증지적장애 청소년의 자립준비를 위한 단일 사례연구 (A Single Case Study of an Adolescent with a Mild Intellectual Disability in Preparation for Independence after Discharge from a Childcare Institution)

  • 유진희;김민경
    • 한국융합학회논문지
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    • 제11권5호
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    • pp.229-239
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    • 2020
  • 본 연구의 목적은 퇴소를 앞둔 경증지적장애 청소년의 심리치료 상담과정과 자립준비 생활경험에 도움을 주고자 실시하였다. 사례연구의 범주화 내용은 다음과 같다. "서툴고 힘들었지만 추억이 있는 시설생활" "아프고 성장하고 쓸쓸한 나의 사춘기" "의지할 수 없는 존재" "기대감과 두려움의 자립과정"등의 주제로 범주화 할 수 있다. 연구 참여자는 퇴소와 자립준비과정에 대해서 두려움을 가지고 있었으나 심리치료적 개입으로 변화되고 극복되는 의미 있는 결과가 나타났다. 따라서 퇴소를 앞둔 경증지적장애 청소년에 적합한 자립준비와 직업탐색에 치료적 의의가 있다고 할 수 있다.

Status of Oral Care according to the Type of Surgery for Inpatients at Dental Hospitals

  • Kim, Jae-Eun;Yoon, Young-Jae;Kwon, Yong-Dae;Oh, Sang-Hwan
    • 치위생과학회지
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    • 제21권4호
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    • pp.275-281
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    • 2021
  • Background: The aim of this study was to understand the importance of professional oral care for inpatients by examining the type and frequency of surgery and hospital discharge period at dental hospitals, and identify the types of professional oral care actually in progress. Methods: In this study, the type of surgery and length of hospitalization were investigated among patients admitted to the dental hospital for oral and maxillofacial surgery, and the professional oral care status of inpatients who had difficulty self-managing their oral care was retrospectively identified by collecting data on oral care before and after surgery, including the type and frequency. Results: The majority of inpatients at dental hospitals were male (57.6%), elderly patients over 60 years accounted for 20% of patients, and the average length of hospitalization was 4 days. In the 20s (aged 20~29 y), the number of orthognathic surgery patients (73.1%) was high, and the incidence of cysts was high in middle-aged patients. Regarding the oral care of hospitalized patients, scaling was performed once by a dentist before surgery. After surgery, surgical dressings using H2O2 balls were applied and oral care education was introduced before discharge. Conclusion: Based on the results of this study, professional oral care is essential to prevent infection and complications caused by oral bacteria among inpatients at dental hospitals. It is necessary to use various oral hygiene aids for inpatients and to conduct effective oral care instruction according to each patient's situation. In addition, it is necessary to raise awareness and the role of dental hygienists in professional oral care.

자갈하상 하천에서 부착미생물군집의 거동 (Dynamics of Attached Microbial Community on the River with Gravel Riverbed)

  • 박재영;최이송;오종민
    • 한국수자원학회논문집
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    • 제38권3호
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    • pp.235-244
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    • 2005
  • 본 연구는 국가하천인 오산천에서 수행되었으며, 하천의 자정기능을 증대시키기 위해 부착미생물군집을 중심으로 하천에서 거동을 정량적으로 조사하였다. 하천현장에서 장기간에 걸친 모니터링을 통해 다음과 같은 결과를 도출하였다. 부착미생물군집의 현존량은 소보다는 여울구간에서 더 높았으며, 여울구간에서도 흐름 유속이 상대적으로 빠른 급여울지역에서 더 많았다. 또한, 부착미생물군집이 하상기질에 부착하는 초기에는 빠른 유속이 부착미생물군집의 증식에 부정적으로 작용하지만, 부착미생물군집이 기질에 적응하여 증식하게 되는 중${\cdot}$후반기에는 유속이 오히려 증식을 돕는데 긍정적으로 작용하였다. 강우, 댐이나 저수지 방류와 같은 외부압력에 의해 교란이 발생하였을 때, 흐름의 세기와 외부압력의 형태에 따라 탈리되는 정도가 서로 다르고, 부착미생물군집 전량이 탈리되지 않기 때문에 회복속도는 비교적 빠른 것으로 관측되었다. 따라서 본 연구를 통해서 부착미생물군집은 하천의 자정작용에 부정적 혹은 긍정적으로 작용하는 것을 알 수 있었다. 따라서 하천의 자정작용을 향상시키기 위해서는 그 하천의 수질특성에 적합한 하상형태가 적용되어야 하며, 각 구간에 적합한 하도구조물을 설치하여 각 구간별 정화작용을 극대화 시킬 수 방법이 모색되어야 할 것으로 사료된다.

저강도 운동프로그램이 입원노인의 일상활동 기능회복에 미치는 영향 (Effects of Low-intensity Exercise on Functional Ability in Hospitalized Elderly)

  • 송라윤;서연옥;엄영란;전경자
    • 대한간호학회지
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    • 제27권4호
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    • pp.807-819
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    • 1997
  • The purpose of the study was to identify the effects of a 12-week low-intensity exercise program on muscle strength, flexibility, balance, and cognitive characteristics related to the performance of activity of daily living(ADL). A total of 16 patients who were admitted to the medical unit of a general hospital in ChoongChung province were recruited, eight for the exercise group and eight for the comparison group. Four levels of low-intensity exercise from 'ROM on bed' to 'exercise while walking' were then applied to the exercise group according to their physical condition. During hospitalization, patients in the exercise group performed each level of the prescribed exercise with the researchers until they felt comfortable doing it independently. The researchers also visited the patients' homes after discharge to make sure they could perform the exercise with Theraband in their living environment. The exercise group was contacted by phone once a week to assess the frequency and intensity in which they performed the exercise as well as their physical condition. The subjects in the comparison group participated in measurements for the study without performing the exercise and were contacted by phone after discharge, in a matched time frame with the exercise group, to assess physical condition. Muscle strength, flexibility, balance, cognitive characteristics, and performance of ADL for the two groups were compared at the pretest and the posttest after the low-intensity exercise program by utilizing SPSSWIN and the results are as follows : 1) At the postest, measurements of muscle strengths showed that the strength of the dorsal flexor in the exercise group was significantly higher than in the comparison group. 2) Objective balance for the exercise group was significantly better than for the comparison group as measured by 'standing on one foot' and Tinetti gait and balance control. 3) The exercise group showed significantly higher task self-efficacy than the comparison group. 4) Perceived exertion for ADL for the exercise group was significantly lower than for the comparison group. 5) Improvement of performance of ADL without assistance was significantly higher for the exercise group than the comparison group. The findings suggest that a low-intensity exercise program would be useful for the elderly who show decline in their physical functioning due to hospitalization by partly improving physical strength, task self-efficacy, and performance of ADL. Directions for further research on issues of motivating people to exercise as well as of standardizing various types of exercise were discussed.

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의료소송에서 의사의 설명에 대한 최신 지견 (A Study on Recent Discussions ahout the Pysician's Explanation in Medical Litigation)

  • 백경희
    • 의료법학
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    • 제24권4호
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    • pp.37-63
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    • 2023
  • 의료소송에서 의사의 환자에 대한 '설명'이 문제되는 경우는 다양하다. 진단의 초기부터 시작하여 수술 등의 치료과정, 치료를 위해 입원이 필요한 경우, 입원 중과 퇴원 시, 그리고 퇴원 후에 이르기까지 의학적인 설명과 지도가 의사에게 요구된다. 나아가 의료행위로 인하여 발생하게 될 경제적 비용에 대하여도 의사 혹은 의료기관의 고지가 요청되기도 한다. 우리나라 사법부는 이와 같은 의사의 설명에 대하여 진료의 단계 및 의료법 등 관계법령을 고려하여 의료행위에 대한 동의를 구하기 위한 설명과 환자의 요양방법 지도와 관련된 진료상 설명을 구분하여 법리를 전개해 오고 있다. 또한 헌법재판소는 경제적 비용에 관한 설명과 연계된 비급여 비용 고지 제도에 관하여 최근 판단하기도 하였다. 그런데 의사의 설명이 불충분하였다는 것만을 이유로 의사에게 책임을 추궁을 하는 것은 임상현실의 실제 상황과 부합하지 않는 측면이 존재하고, 오히려 의권의 위축을 초래하는 반사적인 불이익이 있을 수 있다. 따라서 의사의 설명은 환자의 자기결정권 보장과 의권 보호라는 양측면에서 살펴보아야 할 필요가 있다.

편마비 환자의 재활과정에 따른 스트레스와 대처의 변화양상 (Stress and Coping for Patients with Hemiplegia during the Rehabilitation Process)

  • 강현숙
    • 대한간호학회지
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    • 제24권1호
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    • pp.18-32
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    • 1994
  • It is important to understand that patients with hemiplegia are under stress during the rehabilitation process. This study was designed to determine what changes occur in the stress perceived by these patients during the rehabilitation process. and what changes occur in the ways they coped with stress. A decriptive study with a longitudinal design was conducted. A total of 57 patients with hemiplegia who were admitted to one general hospital made up the sample for this study. A questionnaire, observations and interviews were used for the data collection which was done in three phases(within one week after admission : within one week before discharge ; within one month after discharge ). Data were analyzed using t-test, ANOVA repeated measures of ANOVA, and post hoc paired t -test, Bonferroni correction. The results of this study are : 1. Changes in the perception of stress during the rehabilitation process : There was a statistically significant differencs in the perception of stress among these patients during the rehabilitation process. On the post-hoc test. the perception of stress showed a statistically significant decrease from admission to discharge. The perception of psychological stress was high during the rehabilitation process as compared with the perception of physical and social stress. 2. Changes in the way the patients coped during the rehabilitation process : On admission passive coping was used by most of the subjects(91.2%). Passive coping showed an decrease from admission to discharge, but an increase from discharge to follow-up at one month post discharge. There was, however, no statistically significant changes in the way the patients coped during the rehabilitation process. 3. Changes in perception of stress during the rehabilitation process according to variables. Perception of stress among patients classified as So-Um was higher during the rehabilitation process, when compared with patients classified as So- Yang and Tae-Um. There was, however, no statistically significant difference in perception of stress over time. The patients with right sided paralysis perceived higher stress than those with left sided paralysis. There was, however, no statistically significant difference in perception of stress over time. Hence, stress was not influenced by which side was paralyzed th frequency of the relapse of the disease, or the time in the rehabilitation process. 4. Changes in coping during the rehabilitation process according to variables. There was a statistically significant difference in the way the patients coped at follow- up according to the three different kinds of the constitution groups. In other words, coping was not used by patients classified as Tae-Um but was used by those classified as So-Um. On the repeated measures of ANOVA, there was a statstically significant difference in stress over time, and an interaction between constitution and time. But the way of coping during the rehabilitation process was not influenced by which side was paralyzed nor by the frequency of the relapse of the disease. In conclusion, perception of psychological stress was high during the rehabilitation process, as compared to perception of physical and social stress. There was a statistcally significant difference in the perception of stress over time, Perception of stress showed a gradual decrease from over admission to follow-up period. There was. however, no statistically significant difference in the way of coping over time. Passive coping was used by most of patients. In the study, these findings suggest a need for nursing care related to the psychological support for patients with hemiplegia both in the hospital as well as at home, and the need for education and counseling on independent self-care to help the hemiplegic patients adapt to stress using active coping.

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입.퇴원 수속창구 중앙화와 분산화에 따른 이용자의 만족도와 재이용 의사 (The Study of Comparison Satisfaction and Re-use Intention between Central and Ward Reception Desk Users)

  • 함태훈;이경우;손태용;유승흠
    • 한국병원경영학회지
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    • 제14권4호
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    • pp.149-162
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    • 2009
  • The purpose of this study is to design strategic hospital service based on each hospital's features. For this study, an assessment was conducted by 398 in-patents of one university hospital located in Seoul. The self-questionnaires, which were investigated from Oct. 15th to 29th in 2008, compared central reception desk with ward reception desk in satisfaction and re-use rate of patients. The major results of this study are as follow. First, according to each reception desk user, they have different satisfaction of it. As for the staff kindness, admission procedure, discharge procedure and manner of staff, those made patients be gratified as well. Second, when it comes to the intention of re-use, there were no significant features between them. Only convenience in admission and discharge procedure, however, was an attractive factor for the recommendation. Third, this study found out the reasons for higher re-use rate of central reception desk users. Regarding service, they were contented with the time for test and treatment. As for the hospital service, they would like to re-use this hospital because of convenient steps of paying interim fee and getting certificates. Forth, this study found out the reasons for higher re-use rate of ward reception desk users. As a point of hospital service view, they responded that respected privacy, hospital facility and general service were good for staying. As for the manner of staff, they mentioned nurses and staff in charge and whole staff members were kind. When it comes to the procedures of patient management, steps of discharge and paying interim fee were convenience. In conclusion, the results of this study suggest that providing a ward reception desk service can boost the satisfaction and re-use rate of in-patients. Furthermore, this strategic management method would be good for not only cutting the moving line but also efficient in-patient care system. These results can be used for the strategic hospital marketing field, as well. Even though this study has a limitation of the targeted populations which were only in a ward reception desk running hospital, it can say that having competitiveness in satisfaction of hospital service is good for promoting and differencing each hospital. Consequently, whole general management system would be adjusted first for differencing each hospital; however, this sort of additional factor should be concerned as well. I expect that this study would give meaningful data for designing strategic and differencing marketing method to lots of hospitals.

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상용자동차용 직·병렬 AGM 배터리 시스템의 충·방전 거동 모델링 (Modeling of the charge and discharge behavior of the 2S2P(2 series-2 parallel) AGM battery system for commercial vehicles)

  • 이정빈;김의성;이재신;신치범
    • 에너지공학
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    • 제21권4호
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    • pp.346-355
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    • 2012
  • 최근 전 세계가 환경문제와 에너지 자원 고갈 문제에 대해 관심을 집중하고 있다. 이런 문제들을 해결하기 위한 여러 가지 방법들 중 하나가 하이브리드자동차(HEVs)이다. 그래서 하이브리드자동차 기술에 대한 사람들의 관심이 높아지고 있다. 하이브리드 자동차의 에너지 저장 시스템의 후보들은 AGM 배터리, Ni-MH 배터리 및 리튬배터리 등이다. AGM 배터리는 상대적으로 낮은 가격, 높은 충전 효율, 낮은 자가 방전 및 높은 안전성 등이 장점이다. 상용자동차에 하이브리드 자동차 시스템을 적용하기 위해서는 4개의 AGM 배터리를 2개의 직렬과 2개의 병렬로 연결해야한다. 본 연구에서는 상용차용으로 사용될 직 병렬로 연결되어 있는 AGM 배터리 시스템의 충 방전 특성을 예측하기 위하여 AGM 배터리의 충 방전 모델링을 수행하였다. AGM 배터리의 충 방전 모델링을 위해 내부에서 일어나는 전기화학 반응, 전하 보전과 물질 보존 법칙을 통해 배터리의 지배방정식으로 세웠다. 모델링 결과의 정확성을 검증하기 위해 다양한 조건에서의 실험결과와 비교하였다.

제왕절개분만 산욕부와 신생아의 가정간호 사례분석 (A Case Analysis of Home Health Care for Cesarean Postpartum Women and Their Newborns)

  • 김혜숙;최연순;전은미
    • 대한간호학회지
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    • 제24권4호
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    • pp.696-705
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    • 1994
  • This study was done to provide a basis for home health care management for women following Cesarean delivery. Furthermore it was initiated as an possible application of home health care in the future. In this study, client selection criteria was developed by the researcher and assessment tools for home health care, recording system and problem oriented recording system were revised from Jun's(1993) methods. The selection criteria tool for home health care for women who had a Cesarean delivery was structured and consisted of five areas : physical status, functional status, psychological-emetional status, educational needs status and environmental status. The structured assessment tool consisted of general items, obstetric history, past medical history, methods of feeding, medications taken before ad-mission, laboratory results, discharge instructions, discharge medications, family tree, economic status, environmental status, a map, health assessment of women and their newborns. The visit note consisted of the date : nursing problems : nursing process including initial assessment : nursing goals : visit plan : health status of the postpartum women and their newborn : nursing diagnoses : nursing implementation evaluation : summary : next visit plan and revision. The problem oriented recording system consisted of the date, problem numbers, nursing diagnoses, problem appearance date, problem resolution date. The results of the research are as follows : The seven cases having had a Cesarean delivery were discharged on an average on the 5th day after the Cesarean birth. The total number of home visits was 13. According to Cordon's functional health patterns the total possible nursing diagnoses was 34 diagnoses for the methers and their newborns. Among the 34 diagnoses, there were 13 diagnoses in the health perception /management pattern, 7 in the psychosocial health perception / management pattern, 8 in the psychosocial self-perception, 2 in the nutrition / metabolism pattern of physical function, 2 in the knowledge deficit of newborn management, anxiety related to newborn management, knowledge deficit related to disease process of new-born, anxiety related to disease process of newborn anxiety related to prognosis of baby's condition, knowledge deficit related to newborn jaundice each appeared once. The changes in the number of nursing diagnoses was related to not the number of visits but to the number of nursing diagnoses decreasing. The con-tent of the home health care was categorized ac-cording to assessment, direct care, counseling, education, family care. The recommendation based on the results of this research are Home health care nurses for Cesarean postpartum women and their neonates requires comprehensive knowledge of pregnancy, delivery, and the postpartum period and of the neonate so that they can provide appropriate care and holistic views. Most of cases terminated after the second visit, this outcome may be related to the subjects being discharged on the 5th day after delivery. Therefore, study done with earlier discharge after delivery may have different outcome. It is very hard to assess psychological aspects that need follow-up and to develop communication channels.

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폐암환자를 위한 웹기반 교육프로그램 개발 및 평가 (The Development and Evaluation of Web-based Education Program for Lung Cancer Patient)

  • 유한진
    • 종양간호연구
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    • 제5권1호
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    • pp.11-21
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    • 2005
  • The purpose of this study were to develop an web-based education program for Lung cancer patients and to test its effects on patients' self-care knowledge, compliance to medical regimen, nutrition status and pain. The program was developed by the following process: first, Lung cancer patients demand on the web-based program was investigated. and second, the program was developed with the help of various reference books and then validation of experts group. last, educations effects on the patients is evaluated and compared the differences in self-care knowledge, compliance to medical regimen, nutrition status and pain between on experimental group and a control group on before discharge 1day and 3weeks after. SPSS/Win 11.0 program was used for data analysis. It was proven with $x^2$ test and t-test, and Pearson Correlation coefficient, and Chronbach's alpha coefficient were done for the reliability of measuring instruments. 1. The summary of the Program development is as follows. The program is based on patients' questionnaire and reference material and is made for users friendly. Not only Bigger font size and bright colors but also illustrations or pictures were adopted to help enhance patients' understanding. 2. The summary of the study results is as follows. 1) Compared with control group, the web-based educated experimental group showed a statistical significant difference on self-care knowledge, Especially disease, radiation treatment, medication & analgesics, chemotherapy side effect, but there was no significant difference in the field of chemotherapy, in the fields of operation, diet & general knowledge. 2) Compared with control group, the web-based educated experimental group showed a statistical significant difference on compliance to medical regimen, especially in the field of follow up care, everyday life, diet, but there was no significant difference in the field of medication, exercise. 3) Compared with control group, web-based educated experimental group showed no significant difference in nutrition status, but partially significant difference in body weight. 4) Compared with control group, the web-based educated experimental group showed no significant difference in pain level. 5) The significantly positive correalation self-care knowledge with the compliance to medical regimen. 6) Users satisfaction with the web-based education program of the contents quality, the level of recommendation to others, content layout, medical information quality, but interesting got a low mark.

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