• 제목/요약/키워드: specialized medical support

검색결과 68건 처리시간 0.025초

일부 지역 치위생학과 학생들의 장애인 환자 관리에 대한 역량 (Clinical Competency of Dental Hygiene Students to Manage Disabled Patients in Some Areas)

  • 황현정;김아현;김정희;서보련;이다혜;황수정
    • 치위생과학회지
    • /
    • 제18권6호
    • /
    • pp.349-356
    • /
    • 2018
  • 일부 지역 치위생(학)과 3, 4학년 학생 196명을 대상으로 장애인의 전반적인 인식, 장애인 치과학에 대한 교육 여부, 장애인 환자 구강관리 역량 자가평가를 자기기입식 설문지를 이용하여 조사하였다. 그 결과, 대상자의 대부분이 장애인이나 장애인 환자에 대한 긍정적인 인식을 가지고 있었으며 84.7%는 장애인 전문 치과위생사 양성이 필요하고 76.5%는 졸업 후에 장애인 치과진료 관련 세미나에 참가할 의향이 있다고 하였다. 그러나, 전체 대상자의 각 장애인별 업무역량에 대한 자가평가는 보통 수준 미만으로 장애인 치과치료에 대한 업무역량이 충분하지 않다고 생각하고 있었다. 대상자의 71.4%는 교과 및 비교과 교육과정에서 장애인 치과진료를 경험하였으며 경험을 한 대상자가 장애인 환자에 대한 지식, 구강보건교육, 구강병 예방처치, 진료보조, 의사소통의 대부분 영역에서 본인의 역량을 유의한 수준으로 높게 평가하였다. 이론교육이 충분하였다고 응답한 군에서도 충분하지 않았다고 응답한 군에 비해 장애인 환자 관리 역량에 대해 유의하게 높은 수준으로 자가평가를 하였다. 이를 토대로 보았을 때 현재 교육과정상 치위생(학)과 학생들의 장애인 치과치료에 대한 업무역량은 부족한 것으로 보이나 장애인 환자의 구강건강 관리 및 치과진료 보조에 대해 긍정적이며 장애인 환자에 대한 경험과 이론 교육 등이 효과를 나타낸다고 판단된다. 따라서, 교육과정에 장애인 치과학이 포함될 수 있도록 제도적 뒷받침이 필요하고 충분한 이론교육과 실습교육을 병행하여 장애인 환자의 구강건강 향상에 이바지할 수 있는 인력을 양성하도록 해야 한다. 또한, 현장 임상실습 교육 시 장애인 환자를 경험할 수 있는 여건을 마련하고 장애인 전문 치과위생사 양성에 대한 심도 있는 논의도 이루어져야 할 것이다.

Do some patients receive unnecessary parenteral nutrition after pancreatoduodenectomy? Results from an international multicentre study

  • Thomas B. Russell;Peter L. Labib;Paula Murphy;Fabio Ausania;Elizabeth Pando;Keith J. Roberts;Ambareen Kausar;Vasileios K. Mavroeidis;Gabriele Marangoni;Sarah C. Thomasset;Adam E. Frampton;Pavlos Lykoudis;Manuel Maglione;Nassir Alhaboob;Hassaan Bari;Andrew M. Smith;Duncan Spalding;Parthi Srinivasan;Brian R. Davidson;Ricky H. Bhogal;Daniel Croagh;Ismael Dominguez;Rohan Thakkar;Dhanny Gomez;Michael A. Silva;Pierfrancesco Lapolla;Andrea Mingoli;Alberto Porcu;Nehal S. Shah;Zaed Z. R. Hamady;Bilal Al-Sarrieh;Alejandro Serrablo;Somaiah Aroori
    • 한국간담췌외과학회지
    • /
    • 제28권1호
    • /
    • pp.70-79
    • /
    • 2024
  • Backgrounds/Aims: After pancreatoduodenectomy (PD), an early oral diet is recommended; however, the postoperative nutritional management of PD patients is known to be highly variable, with some centers still routinely providing parenteral nutrition (PN). Some patients who receive PN experience clinically significant complications, underscoring its judicious use. Using a large cohort, this study aimed to determine the proportion of PD patients who received postoperative nutritional support (NS), describe the nature of this support, and investigate whether receiving PN correlated with adverse perioperative outcomes. Methods: Data were extracted from the Recurrence After Whipple's study, a retrospective multicenter study of PD outcomes. Results: In total, 1,323 patients (89%) had data on their postoperative NS status available. Of these, 45% received postoperative NS, which was "enteral only," "parenteral only," and "enteral and parenteral" in 44%, 35%, and 21% of cases, respectively. Body mass index < 18.5 kg/m2 (p = 0.03), absence of preoperative biliary stenting (p = 0.009), and serum albumin < 36 g/L (p = 0.009) all correlated with receiving postoperative NS. Among those who did not develop a serious postoperative complication, i.e., those who had a relatively uneventful recovery, 20% received PN. Conclusions: A considerable number of patients who had an uneventful recovery received PN. PN is not without risk, and should be reserved for those who are unable to take an oral diet. PD patients should undergo pre- and postoperative assessment by nutrition professionals to ensure they are managed appropriately, and to optimize perioperative outcomes.

간호개념에 대한 기초조사 (The Empirical Exploration of the Conception on Nursing)

  • 백혜자
    • 대한간호학회지
    • /
    • 제11권1호
    • /
    • pp.65-87
    • /
    • 1981
  • The study is aimed at exploring concept held by clinical nurses of nursing. The data were collected from 225 nurses conviniently selected from the population of nurses working in Kang Won province. Findings include. 1) Nurse's Qualification. The respondents view that specialized knowledge is more important qualification of the nurse. Than warm personality. Specifically, 92.9% of the respondents indicated specialized knowledge as the most important qualification while only 43.1% indicated warm personality. 2) On Nursing Profession. The respondents view that nursing profession as health service oriented rather than independent profession specifically. This suggests that nursing profession is not consistentic present health care delivery system nor support nurses working independently. 3) On Clients of Nursing Care The respondents include patients, family and the community residents in the category of nursing care. Specifically, 92.0% of the respondents view that patient is the client, while only 67.1% of nursing student and 74.7% of herself. This indicates the lack of the nurse's recognition toward their clients. 4) On the Priority of Nursing care. Most of the respondents view the clients physical psychological respects as important component of nursing care but not the spiritual ones. Specially, 96.0% of the respondents indicated the physical respects, 93% psychological ones, while 64.1% indicated the spiritual ones. This means the lack of comprehensive conception on nursing aimension. 5) On Nursing Care. 91.6% of the respondents indicated that nursing care is the activity decreasing pain or helping to recover illness, while only 66.2% indicated earring out the physicians medical orders. 6) On Purpose of Nursing Care. 89.8% of the respondents indicated preventing illness and than 76.6% of them decreasing 1;ai of clients. On the other hand, maintaining health has the lowest selection at the degree of 13.8%. This means the lack of nurses' recognition for maintaining health as the most important point. 7) On Knowledge Needed in Nursing Care. Most of the respondents view that the knowledge faced with the spot of nursing care is needed. Specially, 81.3% of the respondents indicated simple curing method and 75.1%, 73.3%, 71.6% each indicated child nursing, maternal nursing and controlling for the communicable disease. On the other hand, knowledge w hick has been neglected in the specialized courses of nursing education, that is, thinking line among com-w unity members, overcoming style against between stress and personal relation in each home, and administration, management have a low selection at the depree of 48.9%,41.875 and 41.3%. 8) On Nursing Idea. The highest degree of selection is that they know themselves rightly, (The mean score measuring distribution was 4.205/5) In the lowest degree,3.016/5 is that devotion is the essential element of nursing, 2.860/5 the religious problems that human beings can not settle, such as a fatal ones, 2,810/5 the nursing profession is worth trying in one's life. This means that the peculiarly essential ideas on the professional sense of value. 9) On Nursing Services. The mean score measuring distribution for the nursing services showed that the inserting of machine air way is 2.132/5, the technique and knowledge for surviving heart-lung resuscitating is 2.892/s, and the preventing air pollution 3.021/5. Specially, 41.1% of the respondents indicated the lack of the replied ratio. 10) On Nurses' Qualifications. The respondents were selected five items as the most important qualifications. Specially, 17.4% of the respondents indicated specialized knowledge, 15.3% the nurses' health, 10.6% satisfaction for nursing profession, 9.8% the experience need, 9.2% comprehension and cooperation, while warm personality as nursing qualifications have a tendency of being lighted. 11) On the Priority of Nursing Care The respondents were selected three items as the most important component. Most of the respondents view the client's physical, spiritual: economic points as important components of nursing care. They showed each 36.8%, 27.6%, 13.8% while educational ones showed 1.8%. 12) On Purpose of Nursing Care. The respondents were selected four items as the most important purpose. Specially,29.3% of the respondents indicated curing illness for clients, 21.3% preventing illness for client 17.4% decreasing pain, 15.3% surviving. 13) On the Analysis of Important Nursing Care Ranging from 5 point to 25 point, the nurses' qualification are concentrated at the degree of 95.1%. Ranging from 3 point to 25, the priorities of nursing care are concentrated at the degree of 96.4%. Ranging from 4 point to 16, the purpose of nursing care is concentrated at the degree of 84.0%. 14) The Analysis, of General Characteristics and Facts of Nursing Concept. The correlation between the educational high level and nursing care showed significance. (P < 0.0262). The correction between the educational low level and purpose of nursing care showed significance. (P < 0.002) The correlation between nurses' working yeras and the degree of importance for the purpose of nursing care showed significance (P < 0.0155) Specially, the most affirmative answers were showed from two years to four ones. 15) On Nunes' qualification and its Degree of Importance The correlation between nurses' qualification and its degree of importance showed significance. (r = 0.2172, p< 0.001) 0.005) B. General characteristics of the subjects The mean age of the subject was 39 ; with 38.6% with in the age range of 20-29 ; 52.6% were male; 57.9% were Schizophrenia; 35.1% were graduated from high school or high school dropouts; 56.l% were not have any religion; 52.6% were unmarried; 47.4% were first admission; 91.2% were involuntary admission patients. C. Measurement of anxiety variables. 1. Measurement tools of affective anxiety in this study demonstrated high reliability (.854). 2. Measurement tools of somatic anxiety in this study demonstrated high reliability (.920). D. Relationship between the anxiety variables and the general characteristics. 1. Relationship between affective anxiety and general characteristics. 1) The level of female patients were higher than that of the male patient (t = 5.41, p < 0.05). 2) Frequencies of admission were related to affective anxiety, so in the first admission the anxiety level was the highest. (F = 5.50, p < 0.005). 2, Relationship between somatic anxiety and general characteristics. 1) The age range of 30-39 was found to have the highest level of the somatic anxiety. (F = 3.95, p < 0.005). 2) Frequencies of admission were related to the somatic anxiety, so .in first admission the anxiety level was the highest. (F = 9.12, p < 0.005) 0. Analysis of significant anxiety symptoms for nursing intervention. 1. Seven items such as dizziness, mental integration, sweating, restlessness, anxiousness, urinary frequency and insomnia, init. accounted for 96% of the variation within the first 24 hours after admission. 2. Seven items such as fear, paresthesias, restlessness, sweating insomnia, init., tremors and body aches and pains accounted for 84% of the variation on the 10th day after admission.

  • PDF

노인장기요양보험제도 내 가정방문물리치료 도입에 관한 인식도 및 필요성 조사 (The Survey of Awareness and Necessity on Introduce Home Physical Therapy in the Long-term Care Insurance)

  • 정대인;김찬규;고대식
    • 한국콘텐츠학회논문지
    • /
    • 제14권6호
    • /
    • pp.298-306
    • /
    • 2014
  • 본 연구는 노인장기요양보험제도에서 가정방문물리치료 제도의 도입과 정착을 위해 수급자 측면의 환자와 공급자 측면의 물리치료사의 인식 및 필요성에 대한 의견을 알아보고자 하였다. 조사 참여자는 광주광역시 소재 의료기관에 근무하는 물리치료사(130명)와 환자(96명)를 대상으로 설문조사를 실시하였다. 연구결과 환자(60.4%)와 물리치료사(75.4%)는 장기요양보험제도에서 간호사 및 간호조무사에 의해 제공되는 신체활동 지원서비스는 전문성이 부족하며, 가정방문물리치료를 통해 질적인 치료가 가능할 것이라고 응답하였다(환자 47.9%, 물리치료사 59.2%).또한 장기요양보험제도 개선 시 가장 우선순위에 대한 질문에서 환자는 급여비 절감(35.4%)과 대상자 확대(32.3%), 치료사는 전문인력 확대(73.8%)와 다양한 재활서비스의 도입(20.2%)순으로 응답하였고, 재활팀의 도입이 필요하다고 응답하였다. 가정방문물리치료가 필요한 이유는 환자가 의료기관에 가기 힘듦(PT 30.0%)과 노인의 신체기능이 향상(pt47.1%)되기 때문이라고 응답하였다. 결론적으로 물리치료사뿐만 아니라 수요자인 환자 대부분에서 노인장기요양보험제도 내에 가정방문물리치료 도입에 관한 필요성 및 인식도가 현저히 높은 것으로 나타나 제도의 시행이 시급한 것으로 판단된다.

재난 시 소아청소년 정신건강 평가 및 치료의 주요 요소: 전문가 델파이 예비 조사 (The Major Elements of Psychological Assessment and Intervention for Children and Adolescents after a Disaster: A Professional Delphi Preliminary Survey)

  • 박장호;이미선;장형윤;황준원;이주현;김지연;이철순;김은지;배승민;방수영
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
    • /
    • 제27권3호
    • /
    • pp.164-172
    • /
    • 2016
  • Objectives: This study attempted to evaluate the usefulness and direction of development of post-traumatic assessment and interventions based on the opinions of psychiatrics and disaster and trauma-related experts using the Delphi survey technique. Methods: In-depth individual interviews served as the pre-survey and were followed by Delphi primary and secondary surveys. Specialists in child and adolescent mental health, psychological support professionals specialized in disasters and related practitioners with experience of disasters in Korea completed a set of questionnaires and participated in focus group interviews and in-depth individual interviews on post-traumatic assessment and intervention. Results: We found that the following issues have a significant impact on the interventions after disasters: the proper time of the initial interview in the event of a disaster, assessment notices, aged assessment services, mandatory enforcement measures, scale screening and treatment intervention elements, symptoms degree classification, intervention standardization, the use of a levelled program, care unit environment, and operation plan. Conclusion: This study proposed effective mental health intervention measures and has implications for the development of evaluation treatment protocols after disasters.

Sensing the Stress: the Role of the Stress-activated p38/Hog1 MAPK Signalling Pathway in Human Pathogenic Fungus Cryptococcus neoformans

  • Bahn, Yong-Sun;Heitman, Joseph
    • 한국미생물학회:학술대회논문집
    • /
    • 한국미생물학회 2007년도 International Meeting of the Microbiological Society of Korea
    • /
    • pp.120-122
    • /
    • 2007
  • All living organisms use numerous signal-transduction pathways to sense and respond to their environments and thereby survive and proliferate in a range of biological niches. Molecular dissection of these signalling networks has increased our understanding of these communication processes and provides a platform for therapeutic intervention when these pathways malfunction in disease states, including infection. Owing to the expanding availability of sequenced genomes, a wealth of genetic and molecular tools and the conservation of signalling networks, members of the fungal kingdom serve as excellent model systems for more complex, multicellular organisms. Here, we employed Cryptococcus neoformans as a model system to understand how fungal-signalling circuits operate at the molecular level to sense and respond to a plethora of environmental stresses, including osmoticshock, UV, high temperature, oxidative stress and toxic drugs/metabolites. The stress-activated p38/Hog1 MAPK pathway is structurally conserved in many organisms as diverse as yeast and mammals, but its regulation is uniquely specialized in a majority of clinical Cryptococcus neoformans serotype A and D strains to control differentiation and virulence factor regulation. C. neoformans Hog1 MAPK is controlled by Pbs2 MAPK kinase (MAPKK). The Pbs2-Hog1 MAPK cascade is controlled by the fungal "two-component" system that is composed of a response regulator, Ssk1, and multiple sensor kinases, including two-component.like (Tco) 1 and Tco2. Tco1 and Tco2 play shared and distinct roles in stress responses and drug sensitivity through the Hog1 MAPK system. Furthermore, each sensor kinase mediates unique cellular functions for virulence and morphological differentiation. We also identified and characterized the Ssk2 MAPKKK upstream of the MAPKK Pbs2 and the MAPK Hog1 in C. neoformans. The SSK2 gene was identified as a potential component responsible for differential Hog1 regulation between the serotype D sibling f1 strains B3501 and B3502 through comparative analysis of their meiotic map with the meiotic segregation of Hog1-dependent sensitivity to the fungicide fludioxonil. Ssk2 is the only polymorphic component in the Hog1 MAPK module, including two coding sequence changes between the SSK2 alleles in B3501 and B3502 strains. To further support this finding, the SSK2 allele exchange completely swapped Hog1-related phenotypes between B3501 and B3502 strains. In the serotype A strain H99, disruption of the SSK2 gene dramatically enhanced capsule biosynthesis and mating efficiency, similar to pbs2 and hog1 mutations. Furthermore, ssk2, pbs2, and hog1 mutants are all hypersensitive to a variety of stresses and completely resistant to fludioxonil. Taken together, these findings indicate that Ssk2 is the critical interface protein connecting the two-component system and the Pbs2-Hog1 pathway in C. neoformans.

  • PDF

단기노인보호소 이용자의 간호요구도 및 서비스 실태연구 (A Study on The Nursing Needs of Users and their Service Status at Short-Stay Centers for The Elderly)

  • 신경희;이선자
    • 한국보건간호학회지
    • /
    • 제16권2호
    • /
    • pp.354-377
    • /
    • 2002
  • Aging population is a global trend and Korea is no exception. Due to the progress of the medical and scientific sectors, increase in the average lifetime incurred increase in the number of elderly people. Meanwhile, the family function of supporting the elderly has become a major issue in a society due to the changes in the society's structure and increased entry of the women into the workforce. As a means to substitute the protection of the elderly who are not protected at their respective homes and to replace the tending needs, weekly protection centers and short-stay centers for the elderly were established and operated in Seoul since 1992. However, structured and satisfactory services are not yet to be provided, thus this research intends to understand the current situation at the short-stay centers for the elderly, to identify users' characteristics and to conduct study on nursing need for the health reasons so that the results of the research can be utilized as basic data for the development of nursing care program. Towards this end, this research targeted 142 elderly people who were undergoing treatment at the 11 short-stay centers for the elderly out of total of 13 located in Seoul that were willing to cooperate. The research was conducted from April to May 2002, with the measurement tool developed by Rhee, Seon-ja (2001) to measure the level of nursing need. Then data was collected and analyzed using SPSS program. The results are as follows. The general characteristics of users of the short-stay centers for the elderly were: 123 females $(86.6\%)$, 19 males $(13.4\%)$ and 72 elderly were over the age of 80 $(50.7\%)$. Among these, 24$(16.9\%)$ were living by themselves. Among the illnesses that the subjects were inflicted with were: dementia $(54.2\%)$, stroke $(54.1\%)$ and high blood pressure $(50.7\%)$, in the respective order. Despite the fact that they were diagnosed with illnesses, $47.2\%$ responded that they do not undergo special treatment due to financial reasons. When the level of needs for nursing care among the elderly who use the short-stay centers is divided into informational. physical. and emotional need levels and scored between zero to two, the level of emotional need is the highest with 1.80, followed by physical (1.45) and informational (1.44) need levels. As for the realities of services at the centers and improvement areas, restriction on term was cited as the greatest inconvenience with $38.7\%$, followed by lack of budget (24 respondents, $16.9\%$). Wishful services were financial assistance $(46.5\%)$, medical and nursing services $(40.1\%)$, meal provision service $(8.5\%)$ and counseling service $(4.9\%)$, in the respective order. Based on the above mentioned results, the research identified the need to develop nursing program for the patients of dementia that can be applied onto the short-stay centers and the need to develop volunteer service, backed by societal support. Also, placement of specialized cadre of professionals is needed so that medical and nursing service functions can be provided in a complementary manner.

  • PDF

텍스트 마이닝과 의미 네트워크 분석을 활용한 뉴스 의제 분석: 코로나 19 관련 감정을 중심으로 (Analysis of News Agenda Using Text mining and Semantic Network Analysis: Focused on COVID-19 Emotions)

  • 유소연;임규건
    • 지능정보연구
    • /
    • 제27권1호
    • /
    • pp.47-64
    • /
    • 2021
  • 전 세계적으로 퍼진 코로나 19 상황은 우리의 일상생활의 많은 부분에 영향을 끼쳤을 뿐만 아니라, 경제·사회 등 많은 부분에 걸쳐 막대한 영향력을 미치고 있다. 확진자와 사망자 수가 증가함에 따라 의료진과 대중은 불안, 우울, 스트레스 등 심리적인 문제를 겪고 있다고 한다. 장기적인 부정적인 감정은 사람들의 면역력을 감소시키고 신체적인 균형을 파괴할 수도 있으므로 코로나 19로 인한 심리적인 상태를 이해하는 것이 필수적인 상황이다. 본 연구에서는 코로나 19 감정과 관련된 뉴스 데이터를 수집하여, 텍스트 마이닝을 통해 키워드를 분류하고, 키워드 사이의 의미 네트워크 분석을 통해 단어들의 관계를 시각화하였다. 코로나 감정과 관련된 기사의 키워드에 나타난 단어들의 빈도수를 확인하고 이를 워드 클라우드로 분석하였다. 키워드 빈도 분석 결과 코로나 19 감정과 관련하여 '중국', '불안', '상황', '마음', '사회', '건강'과 같은 단어의 빈도가 높게 나타난 것을 확인할 수 있었다. 각 데이터 간 연결 중심성을 분석한 결과 키워드 중심성 네트워크에서 가장 중심적인 핵심어는 '심리'와 '코로나 19', '블루', '불안'이라는 단어가 높은 연결 중심성을 가지는 것을 확인할 수 있었다. 기사의 헤드라인에 나타난 주요 핵심어 사이의 동시 출현 빈도 네트워크를 그래프로 시각화한 결과, '코로나-블루' 쌍이 가장 굵게 표시되었고, '코로나-감정', '코로나-불안' 쌍이 비교적 굵은 선으로 표시된 것을 알 수 있었다. 코로나와 관련된 '블루'는 우울증을 의미하는 단어로, 코로나와 우울증은 이제 관심을 가져야 할 키워드임을 확인할 수 있었다. 본 연구에서는 장기화한 코로나 19 상황에서 신체적인 방역뿐만 아니라 심리적인 방역에도 힘써야 할 이 시기에 보건 정책담당자가 빠르고 복잡한 의사결정 과정에 도움이 되고자 미디어 뉴스를 모니터링 함으로써, 더욱더 쉬운 소셜 미디어 네트워크 분석 방법을 제시하고자 한다.