• 대한간호학회지
• /
• 제30권5호
• /
• pp.1156-1169
• /
• 2000

The study was aimed at developing an independent hospice center model that would be best suited for Korea based on a literature review and the current status of local and international hospices. For the study, five local and six international hospice organizations were surveyed. Components of the hospice center model include philosophy, purpose, resources (workers, facilities, and equipment), allocation of resources, management, financial support and hospice team service. The following is a summary of the developed model: Philosophies for the hospice center were set as follows: based on the dignity of human life and humanism, help patients spend the rest of their days in a meaningful way and accept life positively. On the staff side, to pursue a team-oriented holistic approach to improve comfort and quality of life for terminally ill persons and their families. The hospice center should have 20 beds with single, two, and four bed rooms. The center should employ, either on a part-time or full-time basis, a center director, nurses, doctors, chaplains, social workers, pharmacists, dieticians, therapists, and volunteers. In addition, it will need an administrative staff, facility managers and nurses aides. The hospice should also be equipped with facilities for patients, their families, and team members, furnished with equipment and goods at the same level of a hospital. represented by a center director who reports to a board and an advisory committee. Also, the center director administers a steering committee and five departments, namely, Administration, Nursing Service, Social Welfare, Religious Services, and Medical Service. Furthermore, the center should be able to utilize a direct and support delivery systems. The direct delivery system allows the hospice center to receive requests from, or transfer patients to, hospitals, clinics, other hospice organizations (by type), public health centers, religious organizations, social welfare organizations, patients, and their guardians. On the other hand, the support delivery system provides a link to outside facilities of various medical suppliers. In terms of management, details were made with regards to personnel management, records, infection control, safety, supplies and quality management. For financial support, some form of medical insurance coverage for hospice services, ways to promote a donation system and fund raising were examined. Hospice team service to be provided by the hospice center was categorized into assessment, physical care, emotional care, spiritual care, bereavement service, medication, education and demonstrations, medical supplies rental, request service, volunteer service, and respite service. Based on the results, the study has drawn up the following suggestions: 1. The proposed model for a hospice center as presented in the study needs to be tested with a pilot project. 2. Studies on criteria for legal approval and license for a hospice center need to be conducted to develop policies. 3. Studies on developing a hospice charge system and hospice standards that meet local conditions in Korea need to be conducted.

• 한국보육지원학회지
• /
• 제9권2호
• /
• pp.23-46
• /
• 2013

본 연구는 초임 보육교사의 적응에 도움을 주기 위한 기초 정보를 제공할 목적으로 수행되었다. 초임 보육교사 5명을 대상으로 심층인터뷰와 교사에 의한 메모일기, 저널, 보육일지등의 자료를 수집하였다. 연구결과, 초임 보육교사의 경험은 어려운 인간관계, 난감한 업무, 잦은 실수의 긴장, 받았거나 받기를 원하는 도움, 경험을 통한 현장 이해와 자기 성찰, 교사로서 보람이 느껴진 순간으로 분류할 수 있었다. 근거이론 접근법으로 조직 적응과정에 대한 이론적 모델을 구성하였다. 초임 보육교사의 적응과정은 부정적인 정서 반응의 현상을 중심으로 인과적 조건, 맥락과 중재적 조건, 부정적 정서를 다루는 전략과 그 결과로 설명할 수 있다. 인과적 조건은 업무 실수와 인간관계의 미숙함이다. 맥락은 학급 유아의 연령, 근무시간과 공간, 업무의 양과 낯섦, 구성원의 성격 특성 그리고 학부모와의 잦은 만남으로 구성된다. 중재적 조건은 초임교사 안내프로그램, 구성원의 도움과 지지, 보상, 교사의 개인성격 특성으로 구성된다. 초임 보육교사는 부정적 정서를 다루기 위해 잊어버리기, 가족이나 친구와 나누기, 긍정적 정서로 전환하도록 노력하기의 세 가지 전략을 사용한다. 전략 사용의 결과는 성장하기, 살아가기, 이직과 전직 고려로 구성된다.

• 한국지리정보학회지
• /
• 제10권1호
• /
• pp.113-123
• /
• 2007

본 연구는 응급의료서비스를 제공하는 주요 시설인 소방파출소와 응급의료기관의 공간적 입지의 적절성 분석과 함께 응급처치를 위한 출동체계 및 후송체계와 관련된 119응급의료 활동권역의 진단을 연구 목적으로 한다. 이를 위해 부산시 119 구급관련 자료를 GIS상에서 분석 가능하도록 우선 환자 발생위치를 지번데이터와 주소를 기반으로 매칭시킴으로써 개별 개체로 입력하였으며 환자로의 출동 및 병원으로의 후송에 따른 시간을 초단위로 구축하였다. 또한 119 파출소의 위치 및 관할 구역, 응급의료기관 등을 입력하여 시간적 권역은 물론 공간적 권역의 분석을 실시하였다. 구축된 부산지역 16개 구군과 226개 읍면동별 GIS데이터를 활용한 분석결과 부산시 응급의료서비스의 5분이내 비율이 약 41%에 그쳤으며 각 구별로는 5분 초과 10분 이내의 비율이 가장 높음을 알 수 있었다. 또한 병원이용패턴에 있어서도 매우 비효율적인 활동이 이루어지고 있음을 알 수 있었다. 이와 같이 소방파출소와 응급의료기관의 출동시간대별, 후송시간대별 시공간적 분포에 대한 진단결과와 함께 이상적인 출동 및 후송 패턴을 제시하여 이를 비교함으로써 응급의료서비스 체계를 구성하는 공공시설들의 효율적 자원 활용방안을 제시하고자 하였다.

• 디지털융복합연구
• /
• 제15권10호
• /
• pp.327-337
• /
• 2017

본 연구는 재활의료 기관의 공간 환경에 대한 환자의 만족도를 조사하여, 환자들의 만족도가 미흡한 영역을 파악하는데 목적이 있으며, 궁극적으로 환자 중심의 재활의료 공간 환경 실현에 기여하고자 한다. 대전지역 6개 종합병원 및 전문재활기관의 물리치료실에서 치료를 받는 308명의 환자들을 대상으로 설문 조사를 시행하였다. 공간 환경 만족도를 7개 구성 부문요소로 분류하였고, 환자의 특성에 따라 비교 분석하기 위해 t-검정과 ANOVA를 실시하였다. 그 결과, 층간 이동성에서 상대적으로 가장 낮은 만족도를 보였고 입원환자에게 있어서 특히 그러했다. 치료실이 위치한 층은 두 번째로 낮은 만족도를 보였다. 쾌적성은 상대적으로 만족도가 높은 구성 부문요소이긴 했으나, 신경계환자의 경우 근골격계 환자보다 덜 만족하였다. 20대 환자가 60대에 비해 길 찾기에서 낮은 만족도를 나타냈고 실내디자인에 있어서는 50대가 70대에 비해 상대적 만족도가 떨어졌다. 이러한 조사결과와 분석은 향후에 환자들이 더 만족할 수 있도록 재활기관의 공간 환경디자인을 개선해가는 데에 있어서 근거기반으로 활용될 수 있을 것이다.

• 한국응급구조학회지
• /
• 제10권3호
• /
• pp.5-20
• /
• 2006

Purpose: This study examines the degree of empowerment recognized by the 1st paramedics and the trend of their critical thinking, analyzes correlations between empowerment and critical thinking to reveal whether there is statistically significant difference between them and then is to provide basic materials necessary for research on empowerment and critical thinking. Method: This study distributes 105 structured self-report questionnaires to the 1st emergency medical technicians working at fire fighting police boxes, general hospitals, clinics and emergency medical information centers in G Metropolitan City and J province from April 29 to May 28, 2006, collects their responses directly and analyzes results with t-test, F-test(ANOVA) and Pearson's Correlation Coefficient. Result: 1. First, average score of empowerment of subjects was 4.68 out of 6 and according to scores by area, capacity 5.98 was highest, followed by significance 5.41, self- determination 4.44 and effectiveness 3.79. 2. degree of empowerment according to general characteristics of subjects showed statistically significant differences in final education(F=2.714, p= .049), level of salary (F=3.298, p= .014) and satisfaction of current job (F=5.399, p= .001). 3. average score of critical thinking of subjects was 3.28 out of 7 and according to areas, no bias 3.95 was highest, followed by maturity 3.68, structure 3.35, inquisitiveness 3.11, pursuit of truth 3.07, critical thinking and self-confidence 3.00, analyticity 2.98. 4. degree of critical thinking by general characteristics of subjects showed statistically significant differences in age(F=2.577, p= .041), final education (F=7.877, p= .000), current workplace (F=3.513, p= .018), level of salary(F=4.628, p= .002), satisfaction with current job(F=6.879, p= .000) and intention to transfer current job(t=15.21, p=.000). 5. as a result of correlations between empowerment and critical thinking of subjects, Pearson correlation coefficients between whole empowerment and critical thinking were r= .21, p=.013. Conclusion: It is considered that the 1st paramedic managers must seek how to keep and manage empowerment and development of education and training program which can enhance critical thinking is needed. Further, emergency educators must develop educational program based on the concept of empowerment to establish early awareness of a desirable organization culture and increase understanding of empowerment in the process of education.

• Tuberculosis and Respiratory Diseases
• /
• 제66권5호
• /
• pp.349-357
• /
• 2009

Background: The treatment success rates in patients with tuberculosis are known to be lower in the private sector compared to the public sector. To improve treatment outcomes in the private sector we developed a public-private collaboration model for strengthening health education and case holding activities with public health nursing in the private sector. Methods: We performed a prospective cohort study in new smear positive pulmonary tuberculosis patients treated at private hospitals, selected by non-randomization, with an intervention consisting of health education and case holding activities by specially trained public health nurses (intervention group) results were compared with cases treated without the intervention (conventional group). Physicians were asked to treat both groups routinely. The treatment outcomes of patients under treatment by the National Tuberculosis Programme were also analyzed for comparison. Results: There were 172 cases each in the intervention and conventional groups. The mean age was 48.9${\pm}$19.0 and 48.2${\pm}$19.7 in the respective groups (p=0.66). The PHN interacted with the cases in the intervention group by initial face to face interview and telephone calls an average of 7.1${\pm}$9.2 times during the initial six months. The intervention group showed a significantly higher treatment success rate, 91.6%, (Rate Ratio [RR]; 1.23, 95% Confidence Interval [CI]; 1.12-1.36), lower default, 3.6%, (RR; 0.31, 95% CI; 0.13-0.75) and transfer-out rate, 3.0%, (RR; 0.32, 95% CI; 0.12-0.86) than the conventional group where they were: 75.0%, 11.6%, 9.3%, respectively. The success rate was even higher than the rate (80.5%) of 1,027 cases treated in health centers (RR; 1.11, 95% CI; 1.05-1.17). Of the completed cases in the intervention group, 82.2% regarded the role of the public health nurse as very helpful. Conclusion: The treatment success rate, of tuberculosis patients in the private sector, was significantly improved by an intervention using a public-private collaboration model.

• Journal of Trauma and Injury
• /
• 제20권2호
• /
• pp.77-82
• /
• 2007

Purposes: There have been many efforts to improve the service of emergency centers. In spite of these, no evidence is showing any landmark advancement of emergency services, especially in the hospital stage, exists. We need some efficient standard criteria to evaluate emergency service in the hospital stage, and a useful method might utilize the overcrowding index. We want to know the change in the overcrowding index at a regional emergency center after injury area administration. Injury area means an area in which only an assigned duty physician manages patients with injuries such as those from traffic accidents, falls, assualts, collisions, lacerations, amputations, bums, intoxication, asphyxia, drowning, animal bites, sexual assualts, etc. Methods: We started to operate an injury area in our emergency department from late 2004, and from January to June in 2004 and in 2005, we collected patients' data, age, sex, assigned department, and result from hospital order communication system to figure out overcrowding indices and result indices. We found the daily number of patients, the turnover rate, the admission rate, the ICU admission rate, the emergency operation rate, the ED stay duration, and the ED patient volume to be overcrowding indices. Also we found the withdrawal rate, the transfer rate, and mortality to be result indices. We compared these indices between 2004 to 2005 by using a t-test. Results: There was a significant increase in the daily number of visiting patients in 2005, overcrowding indices, such as the turnover rate, the admission rate, the ICU admission rate, and the emergency operation rate, also showed statistically significant increases in 2005 (P<0.001). As for the result indices, there was a noticeable decrease in the number of withdrawals (11.77/day in 2004 to 4.53/day in 2005). Conclusion: Operating an injury area in a mildly overcrowded local emergency center is beneficial. Evaluating the effect of operating an injury area and it's impact on hospital finances by conducting a similar study analyziing patients for a longer duration would be valuable.

• 환경위생공학
• /
• 제24권1호
• /
• pp.1-12
• /
• 2009

The various environmental problems that we face on today are basically about environmental quality. Since early 1960s affluent material was produced because of remarkable economic growth by many cooperations. However, for the lack of environmental policy, environmental pollutions has been serious. The central government should transfer the producing and consuming structure to environmental affinity through the regulations for developing Korea as a model of environmental nation which takes an active part in global environmental programme and in which the environment and economy are well harmonized. Moreover, the central government should take the lead in prevention of environmental pollution through the direct policies such as strengthening the discharge limit or setting up environmental basic institutions by securing budget for conserving environment. This thesis emphasize on the public institution among many environmental basic institutions for environmental anti-pollution project. It will find the problems with running those institutions, and will suggest the preview of improvement. Also, it is necessary to investigate of variation trend for inflow and pollutant loading to environmental infrastructure as increased of the diffusion rate as established and maintenance of sewer system. The purpose of this study is to investigate for inflow and pollutant loading to environmental infrastructure, and also to provide the method of efficiently maintenance and management. The results obtained were summarized as follows; 1. Survey of actual condition on operation and management of environmental infrastructure was evaluated the propriety of treatment process and problem of plant management. 2. Analysis of pollutant loading contribution for river system of environmental infrastructure with data analysis of water quality measuring network. 3. To investigate on case study for efficiently maintenance and management of environmental infrastructure. The result on this study was provide the method of efficiently maintenance and management with survey for establish and repair of sewer system and survey of actual condition on operation and management of environmental infrastructure in the water area of discharge to Geum River System. Application as guideline for establish and management of environmental infrastructure, and management of Geum River System. Also, application for preliminary data for fulfill-assess of total effluent regulation of water pollution.

• 한국지하수토양환경학회:학술대회논문집
• /
• 한국지하수토양환경학회 2002년도 추계학술발표회
• /
• pp.44-52
• /
• 2002

Low temperature thermal desorption (LTTD) has become one of the cornerstone technologies used for the treatment of contaminated soils and sediments in the United States. LTTD technology was first used in the mid-1980s for soil treatment on sites managed under the Comprehensive Environmental Respones, Compensation and Liability Act (CERCLA) or Superfund. Implementation was facilitated by CERCLA regulations that require only that spplicable regulations shall be met thus avoiding the need for protracted and expensive permit applications for thermal treatment equipment. The initial equipment designs used typically came from technology transfer sources. Asphalt manufacturing plants were converted to direct-fired LTTD systems, and conventional calciners were adapted for use as indirect-fired LTTD systems. Other innovative designs included hot sand recycle technology (initially developed for synfuels production from tar sand and oil shale), recycle sweep gas, travelling belts and batch-charged vacuum chambers, among others. These systems were used to treat soil contaminated with total petroleum hydrocarbons (TPH), polycyclic aromatic hydrocarbons (PAHs), pesticides, polychlorinated biphenyls (PCBs) and dioxin with varying degrees of success. Ultimately, performance and cost considerations established the suite of systems that are used for LTTD soil treatment applications today. This paper briefly reviews the develpoment of LTTD systems and summarizes the design, performance and cost characteristics of the equipment in use today. Designs reviewed include continuous feed direct-fired and indirect-fired equipment, batch feed systems and in-situ equipment. Performance is compared in terms of before-and-after contaminant levels in the soil and permissible emissions levels in the stack gas vented to the atmosphere. The review of air emissions standards includes a review of regulations in the U.S. and the European Union (EU). Key cost centers for the mobilization and operation of LTTD equipment are identified and compared for the different types of LTTD systems in use today. A work chart is provided for the selection of the optmum LTTD system for site-specific applications. LTTD technology continues to be a cornerstone technology for soil treatment in the U.S. and elsewhere. Examples of leading-edge LTTD technologies developed in the U.S. that are now being delivered locally in global projects are described.

• 한국지반공학회논문집
• /
• 제29권7호
• /
• pp.17-36
• /
• 2013

본 연구에서는 해상 교량 현장과 초고층빌딩 현장에서 실시한 암반에 근입된 대구경 현장타설말뚝의 양방향 재하시험(총 4개 현장, 13개 말뚝) 결과를 분석하여 연암에서의 주면마찰력과 선단지지력 산정을 위한 경험식을 제안하였다. 양방향 재하시험을 위하여 각 시험 말뚝의 정 중앙 위치에서 시추 및 지반조사가 이루어졌으며, 각 말뚝에 부착한 계측장치로부터 얻은 데이터를 이용하여 주면의 f-w 곡선과 선단의 q-w 곡선을 작성하였다. 이 곡선들로부터 - 지반조사결과들과 주면마찰력 및 선단지지력에 대한 다중회귀분석을 실시하여 - 변위에 따른 극한 주면마찰력과 선단지지력 산정식을 제안하였으며, 이 결과를 기존의 경험식들과 비교 분석하였다. 변위가 증가할수록 지지력이 증가하는 국내 암반의 f-w 곡선과 q-w 곡선의 특성상, 다양한 말뚝 변위기준에 따라 제안한 경험식들이 변위와 무관하게 일정한 극한값으로 제안된 기존의 경험식들보다 더 합리적인 것으로 판단된다. 본 연구의 제안식들 중에서 일축압축강도의 함수로 나타낸 주면마찰력 및 선단지지력에 대한 제안식이 다른 지반정수들에 의한 경험식보다 좋은 상관관계를 보여주는 것으로 나타났다.