• 대한지역사회영양학회지
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• 제13권5호
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• pp.674-681
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• 2008

Hospital malnutrition could be caused by not completing the food served in the hospital. This has been a big problem since it delays the recovery of the patient and extends the length of hospital stay. The purpose of the study was to reduce the plate waste for the DM diet by performing several nutrition service improvement activities. The study was performed in a general hospital with 900 beds. A questionnaire survey was taken by 39 DM patients to obtain their aspect of the hospital foodservice systems and the quality of the meals at the beginning of the study. The amounts of foods served in the hospital kitchen and returned were measured by weights. After the improvement activities, the measurement of the plate waste was performed again for comparison. The average percentage of plate waste for the DM diet was 23.2%. The survey showed no difference by sex, age or duration of admission in plate waste. However, this food wastage percentage showed differences between the patients having a chance to get information about the diet therapy (12.21%) and not having one (26.06%) (p < 0.05). Using a five-point Likert-type scale, the quality of food by its taste was 2.49 (1: very poor, 5: excellent), the temperature score was 3.56 (1: very poor, 5: excellent), and the amount of food served score was 2.95 (1: very poor, 5: excellent), and the preference score was 3.13 (1: very dislike, 5: very like). Nutritional care improving activities were performed by adjusting seasonings, developing new menus, and standardizing cooking methods in order to increase the satisfaction of meal quality. The dietitian's inpatients care protocol was adjusted to expand the nutritional counseling chance for the DM patients. After the improvement activities, the average plate waste was reduced to 14.6%, and the satisfaction of food taste and preference increased to 3.21 (p < 0.001), and 3.36 (p < 0.05) correspondingly. The result shows that, for therapeutic diet patients, food intake could be increased by improving the food service satisfaction by controlling the meal quality and clinical nutritional service activities.

• 대한지역사회영양학회지
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• 제7권6호
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• pp.852-862
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• 2002

The purposes of this study were 1) to review the Medical Nutrition Therapy (MNT) Act of the United States, 2) to introduce the efforts of the American Dietetic Association (ADA) to expand the Medicare coverage for MNT and 3) to provide information about the reimbursement under Medicare Part B for the cost of MNT. The MNT Act defined MNT services as “the nutritional diagnostic, therapeutic, and counseling services provided by a Registered Dietitian or nutritional professional for the purpose of managing diabetes or renal diseases”. Also, the MNT Act defined “conditions for coverage of MNT”, “limitations on coverage of MNT”, and “qualifications of MNT service provider”. To expand the coverage of Medicare to include MNT, the ADA realized the need for development of a protocol for MNT, as well as studies to evaluate the effectiveness and cost-effectiveness of the MNT protocol developed. Therefore, the ADA supported the studies to develop a strong database of scientific investigations of nutritional services. Furthermore, the ADA needed credible data that could be used by Policy makers, so the ADA contracted with the Lewin Group to if out the study to gather the additional data needed to strengthen the ADA's position. In the report of the Lewin Group, which was entitled, “The Cost of Covering Medical Nutrition Therapy under Medicare : 1998 through 2004”, it was concluded, that if coverage for MNT in the Part B portion of Medicare had begun in 1998, by 2004, approximately $ 2.3 billion would have been saved through reduced hospital spending under Part A of Medicare ($ 1.2 billion) and reduced physician visits under Part B ($ 1.1 billion) Effective January 1 2002, the US Congress extended Medicare coverage to include MNT to beneficiaries with diabetes or renal diseases. The Centers for Medicare and Medicaid Services (CMS) established the duration and frequency for the MNT based on published reports or generally accepted protocols (for example, protocols suggested by the ADA). The number of hours covered by Medicare is 3 hours for the initial MNT and 2 hours for a follow-up MM. In 2002, a Medicare coverage policy was made to define the Physician's Current Procedural Terminology (CPT) codes 97802, 97803, and 97804 for MNT.

• 지역사회간호학회지
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• 제7권2호
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• pp.313-332
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• 1996

This study was conducted to grasp the condition of freshman's knowledge and attitudes on abortion and to offer the basic materials to prevent abortion in family planning and health promotion. The objects were comprised of 290 who volunteered from 3 Junior colleges. The material of this study was by questionaire(chronbach a=.8589, .8959) suited to the purpose of this research which has been made through studying references. All the questionaires were collected immediately without explanation. The data was collected from the 29th of April to the 17th of May in 1996. Analysis of the data was done utilizing SPSS program for percentage, $mean{\pm}$ standard deviation and ANOVA. The results are as follows: 1. General features of the objects of study. Mean age was 20.47, mean of brothers and sisters was 2.93. Those who had no experience in abortion with her mother was 59.0%, and the middle social level was the highest (95.5%). 2. The conditions of attitudes about abortion. 5 points were given to 'very affirming' and, 1 point was given to 'strong denial' the total average was 4.00, and the range was $4.83\sim2.99$. 3. The condition of knowledge about abortion. 5 point were given to 'very affirming' and, 1 point was given to 'strong denial', the total average was 2.75, the range was $3.65\sim2.18$. Also knowledge of abortion was 6.2 points. Knowledge of medical and therapeutic abortion was 9.4 points. Knowledge of the physical complications of abortion was 3.4 points. 4. Correlation between general features and attitude variables. Age groups may have a higher affirmative attitude score in abortion(F=8.097, p<.000). The having 2 sisters group may have a low attitude towards abortion(F=10.34l, p<.000). Experience in abortion with mother group may have a lower affirmative score concerning abortion (t=8.925, p<.000). 5. Correlation between general features and knowledge variables. Age groups may have a higher knowledge score in abortion (F=10.829, p<.000). The having brothers group may have more high knowledge in abortion(F=2.534, p<.050). The $22\sim23$ years group may have higher knowledge in abortion (F=3.075, p<.028). The having more than 2 sisters group have more higher knowledge in abortion(F=5.605, p<.004). The having more the 3 brothers group may have higher knowledge the physical complications in abortion(F=4.022, p<.019). 6. Correlation between regions of the major variables and knowledge, attitude variables. There was no significance in the statistics.

• 재활치료과학
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• 제8권1호
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• pp.51-62
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• 2019

목적: 본 연구의 목적은 다양한 인지기능 수준을 가진 고령자를 위한 실감객체 기반 인지재활시스템을 개발하고, 사용성을 검증하는 것이다. 방법: 사용성 연구는 시스템의 강점과 약점을 확인하기 위해 15명의 환자 집단과 4명의 작업치료사 집단에 설문조사를 실시하였으며 응답에 근거한 수정을 통해 시스템을 보완 및 개선하였다. 응답자들은 세 종류의 훈련-실행기능 훈련, 기억력 훈련, 집중력 훈련을 20분~30분간 경험해본 후, 구조화된 설문에 응답하였으며 설문의 영역은 각 훈련 영역별 콘텐츠, 중앙처리장치이자 화면 제시 매체인 태블릿 PC 및 실감객체를 포함하는 하드웨어, 시스템 이용에 따른 만족도로 구성되었다. 결과: 설문 응답 결과 환자 집단과 작업치료사 집단 모두에게 가장 흥미로웠던 영역은 실행기능으로 나타났고 가장 흥미롭지 않은 영역은 집중력으로 나타났다. 하드웨어 사용성 설문에서 태블릿 PC의 화면의 크기가 부적절하다는 응답이 6건, 실감객체의 크기가 부적절하다는 응답이 5건으로 나타났다. 시스템 이용에 대한 만족도 설문에서 전체 응답자의 40%가 시스템에 만족하는 것으로 응답하였다. 결론: 본 시스템은 훈련과제를 수행하기 위해 필요한 실감객체 도구의 조작이 용이하다는 점과 사용자의 요구에 따라 인지훈련의 영역을 쉽게 선택하여 훈련할 수 있다는 점, 사용자의 수행도에 의해 난이도가 자동으로 조정된다는 점을 특징으로 갖는다. 본 시스템에서 입력장치로 사용되는 실감객체도구는 양손에 쥐고 사용함으로써 훈련환경을 자연스러운 일상에서의 도구 사용과 유사하도록 고안하였다. 본 시스템은 지역사회 인지 재활전문가 부족의 대안으로 사용가능 할 것으로 기대된다.

• 농촌의학ㆍ지역보건
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• 제16권2호
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• pp.165-171
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• 1991

Two patients with confirmed cerebral cysticercosis were treated with Albendazole(Zentel$^{(R)}$) at a daily dose of 1.200mg t.i.d. for 14 consecutive days and evaluated for tolerance and therapeutic effects. First case was 29 year old male, who had experience of 4 times of grand mal seizures during 1 year period before administration in Korea University Hospital. His chief complaints were seizure and moderate degree headache. He also had 4 subcutaneous nodules on the thorax, right and left upper arms. Among them one nodule was biopsied and confirmed microscopically as Cysticercus cellulosae hominis. Computed tomography of the brain showed four round low density lesions in right postero-frontal area, sylvian area, intra-occipital area and left parietal area. Second case was 48 year old male, who also had experience of seizures at 3 years, 5 months and 3 months before administration. In this case, no subcutaneous nodules and no headaches were noted. Brain CT showed four round low density lesions in right postero-parietal area and temporo-parietal area, and left temporo-parietal and parietal area. Serum antibody against cystic fluid antigen was detected by ELISA in both cases. The efficacy of the treatment of cerebral cysticercosis was assessed by the frequency of convulsions after treatment for 22 months follow-up. by the disappearance of the densities in cystic lesions at brain CT for 6 months follow-up, and disappearance of subcutaneous nodules, headache and so on. As the results, all low density lesions in both cases were disappeared in films of brain CT, and 4 nodules in first case were also disappeared. No more seizure and complain of headache occurred during the last 22 months after treatment in both cases. Post-treatment complete blood count and liver function test revealed no remarkable change compared to pre-treatment test. In the nations of Latin America, the physicians do not initially recommended the simultaneous administrations of steroids, reserving them only for patients whom the adverse reactions such as severe headache and/or seizures are occurred. According to them, in most patients these symptoms are controlled with aspirin and symptomatic drugs. But our experience using praziquantel is different, and most cerebral cysticercosis patients who takes PZQ had complaint of severe headache and sometimes seizure. So we simultaneously used dexamethasone as 6mg q.i.d. for 14 consecutive days and 6 days tapering thereafter in both cases for prevention of reactions produced by the host in response to the deaths of the parasites. As the conclusion, albendazole is effective in patients who presented cerebral cysticercosis and albendazole may help in the control of cysticercosis.

• 대한지역사회작업치료학회지
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• 제10권3호
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• pp.15-26
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• 2020

목적 : 국내의 빠른 고령화로 인하여 노인 인구가 증가하고 있고, 작업치료의 주요 영역들에서 노인들과의 대면하는 비율이 높은 현 상황에서 작업치료사들을 대상으로 노인들에 대한 전반적 인식 및 노인들과의 의사소통 현황을 파악하고자 하였다. 연구방법 : 2020년 4월부터 6월까지 전국의 병원 및 보건소 등에서 노인들을 대상으로 중재를 제공하는 작업치료사들을 대상으로 온라인 설문을 활용하여 데이터를 수집하였다. 노인에 대한 인식, 노인과의 의사소통 저해요소, 노인과의 의사소통 방식을 묻는 3종의 질문지를 배포하였으며 최종 82부를 자료 분석에 활용하였다. 결과 : 작업치료사의 노인에 대한 인식은 대체적으로 부정적인 항목인 높은 것으로 나타났다. 또한 노인들과의 의사소통 저해요소로서 청각 관련, 언어이해 관련, 조음 관련 순으로 응답하였다. 노인들과의 의사소통 방식을 확인한 결과 작업치료사들은 대화반응 관리, 정서표현, 이해증진, 관계조절 순으로 노인들과의 원활한 의사소통을 유도하는 것으로 나타났다. 결론 : 작업치료사들은 대상자들의 사회참여와 삶의 질 증진에 주요한 역할을 수행하는 보건의료전문가인 만큼 노인들의 의사소통 방식 및 자신의 의사소통 기술에 대해 면밀히 파악하고, 개선된 의사소통 방법을 통하여 전문적인 치료적 중재 및 관련 교육들을 제공해야 할 것이다.

• The Journal of Korean Physical Therapy
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• 제10권1호
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• pp.75-80
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• 1998

To survey the recognition of Community Based Rehabilitation (CBR) by Public Health Center(PHC) Physical Therapists in Kyoungki Province. This study analysed general characteristic of Physical Therapists and congnition, participation, education, problems and requireanents for CBR. The objects of this study were 37 therapists who work at 27 of 39 PHC in Kyoungki province and data was collected for 20days from Jan. 12 to 31. 1998 and the results computed from 32 responses. First, Female therapists outnumber males. The age category 30 to 35 old represneted $56.2\%$ of the total number studied. $59.4\%$ of therapists had worked more than 7 years and therapists usually$(46.9\%)$ worked from 6 month to 2 years at the PHC. Junior college graduates were $84.4\%$, and respondents with family responsibilirt were $65.6\%$. Second, Recently pain control has become the major requirment of patiants at PH$(53.1\%)$. If they offered expaneded services - a rehabilitation program $(53.1\%)$, home vistation $(31.3\%)$. when asked about a working guide book, nobody had one. Third, $68.7\%$ of therapists were aware of the present level of CBR, $40.9\%$ of them had gotten an information from educated colleagues, and $68.7\%$ of therapists were aware of the present level of CBR, $86.4\%$ of therapists felt responsible to provide rehabilitation Fourth, For CBR, $93.7\%$ had positive ideas in which they could participate. $73.3\%$ wished to composed a team of various rehabilitational specialists. $73.3\%$ wished for the meeting day to be flexible and $86.6\%$ desired to meet once or twice a week. Fifth, Almost all$(96.9\%)$ desired more educational opportunity about CBR. Example, once or twice a year$(56.2\%)$ and training period of 4-7 days $(43.7\%)$. They wanted to learn theory and practice together$(74.2\%)$ and $74.2\%$ wanted the mational multi-rehabilitation center as a educational managing organization. Sixth, The most important requirment for accomplishing CBR by physical therapists was job security and an adequate number of therapists$(84.4\%)$ Required number of physical therapists in the PHC was 3 $(43.7\%)$. The cooperative agency should be the district goverment organization $(56.2\%)$. Factors inhibiting the execution of CBR were lack of administrative support, physical therapists, and equipments for pain control and for therapeutic exercise.

• 대한지역사회작업치료학회지
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• 제6권1호
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• pp.49-60
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• 2016

목적 : 본 연구는 국내에서 로봇치료가 중재도구로 사용된 연구 사례들을 PICO (Patient, Intervention, Comparison, Outcome) 형식에 따라 체계적으로 정리하여 국내 로봇치료의 연구 현황을 알아보고자 하였다. 연구방법 : 한국학술연구정보서비스(RISS)와 국가전자정보도서관(NDSL) 데이터베이스에서 최근 9년간의 연구를 주요 검색용어 '로봇치료'로 하여 국내 학술지와 학위논문 총 710개의 연구를 검색하였다. 로봇을 치료적 중재도구로 사용한 국내연구 중 원문을 구할 수 있는 연구를 기준으로 최종 15개를 선정하였다. 선정된 연구는 PICO 형식을 통해 체계적으로 정리하여 제시하였다. 결과 : 연구도구의 질적 수준은 근거기반 연구수준 5단계 분류 방법을 사용하였다. 그 중 질적 수준이 3단계 이상인 연구는 13개(86.6%)였다. 로봇치료를 사용한 연구를 중재 분야별로 나눈 결과 언어, 보행, 인지, 발달 그리고 상지의 다섯 가지 영역에 대한 연구가 진행되었음을 알 수 있었다. 결론 : 국내에서 로봇치료는 상지와 하지의 중재를 포함한 언어, 인지, 발달 등의 다양한 영역의 재활을 위해 사용되고 있었다. 본 연구가 국내 로봇치료와 관련된 다양한 영역의 적용에 필요한 기초자료로 활용되기를 바란다.

• 지역사회간호학회지
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• 제18권1호
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• pp.165-176
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• 2007

Purpose: The purpose of this study was to investigate the needs of home care nursing services in relation to the patients in hospital. Method: Subjects were 129 patients who admitted hospital and were selected through convenience sampling. Data were collected using the Home Health Care Need Assessment Questionnaire constructed by the Korea Health Industry Development Institute. Data were analyzed using SAS 8.12 program by applying percentage. Results: 1. According to the diagnosis of the subjects, the majority had cancer (25.0%), followed by musculoskeletal disease (15,6%), neuro/cerebral vascular disease (14.1%), digestive (10.9%) and respiratory disease (10.9%). 2. With regard to fundamental nursing service, subjects wanted to receive home care services for the following reasons: Problem identification and diagnosis (77.5%), vital sign check (49.6%); and intake and output measure (20.9%). 3. With regard to clinical laboratory tests, 62.8% wanted to receive blood tests, and followed by urine tests 26.4%, and wound drainage 26.4%. 4. With regard to medication and treatment service, 40.3% of the subjects wanted to receive intravenous fluid therapy, 26.4% intravenous antibiotics, and 26.4% the monitoring of fluid therapy. 5. With regard to therapeutic nursing service, 33.3% wanted to receive wound care, 26.4% ROM exercise, and 27.9% foley catheter change and care. 6. With regard to educational needs, 42.6% wanted education on infection monitoring, 41.4% on medication, and 34.9% on diet. 7. With regard to counseling needs, 65.9% wanted to receive telephone counseling about patient condition, 52.7% counseling about re-admission and 51.9% direct counseling about patient condition. In the group of injury and toxicity, and cardiovascular/circulatory diseases, 100% wanted telephone and direct counseling about the patient condition. Conclusion: Therefore, in order to improve the quality of hospital based home health care services, various factors that affect to the need of home health care should be analyzed and specified nursing care should be looked into.

• 디지털융복합연구
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• 제19권12호
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• pp.549-555
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• 2021

본 연구는 정신질환자의 범죄와 치료에 대한 국내외의 주요 연구 문헌들에 대한 개관을 통해 정신질환의 특성에 따른 효과적인 범죄 예방과 치료 방법을 탐색 및 규명하고자 했다. 본 연구 결과 첫째, 정신질환과 범죄와의 관계에 대해 아직 명확한 결론이 내려지지 않고 있으며, 그 관계와 함께 정신질환자의 환경적 스트레스와 촉발 자극 등도 같이 연구해야 할 필요성이 강조되었다. 둘째, 정신질환의 정의에 여러 가지 개념이 혼재해 있으므로, 조현병이나 망상장애, 반복성 기분장애와 같은 중증 정신장애, 반사회적 성격장애, 지적장애, 분노·충동조절장애, 약물남용 등의 특성에 따른 범죄 예방과 치료에 대해 연구할 필요성을 기술했다. 특히 조현병 등의 중증 정신장애의 경우 약물치료와 사례관리만 잘 된다면, 범죄발생과 재범율이 낮아져 지역사회에서 정상인들과 함께 잘 생활할 수 있음이 많이 보고되어 왔다. 그러나 반사회적 성격장애, 지적장애, 분노·충동조절장애와 약물남용의 경우에는 지역사회에서의 적응과 생활이전에, 심리치료는 물론 강도 높은 의료적, 생물학적 개입과 격리 등이 우선적으로 이루어져야 한다고 할 수 있다. 본 연구결과 정신질환자의 범죄를 효과적으로 예방하고 치료하기 위해서는 정신질환의 특성에 따른 세분화된 연구와 관리가 필요하다고 할 수 있다. 또한 국가적, 사회적으로는 정신질환자에 대한 인식개선, 인권증진과 효율적인 지역사회 돌봄도 함께 이루어져야 할 것이다. 본 연구의 한계점과 향후 연구과제가 논의되었다.