• 제목/요약/키워드: transition care

검색결과 192건 처리시간 0.025초

조선시대(朝鮮時代) 의원(醫員)의 변화와 자기의식(自己意識) 형성 (Study about the formation of doctors' identity in the Joseon(朝鮮) Dynasty)

  • 김성수
    • 한국한의학연구원논문집
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    • 제17권2호
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    • pp.1-15
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    • 2011
  • In the latter half of the Joseon(朝鮮) Dynasty, the medical world was encountering a great change. It is said that a large stream between the first half and the latter half of the Joseon Dynasty was a qualitative transition from official relationships to private relationships, that is, from adjustments by governmental power to contractual relationships between individuals. Doctors who can be said to be the core of the medical world became to be left in severer competition. The fact that the number of people engaged in medical practice increased to the extent that doctors had to compete with each other implies that not only demand for medical care was increasing but also that medical care was becoming social service that must be shared by all people in the Joseon Dynasty rather than by small numbers of men of power. Anyway, it seems like that, in the competition that was becoming fiercer, they tried to establish their authority in diverse methods unlike before. As an authority to determine the social positions of doctors in the latter half of the Joseon Dynasty, the government was still occupying an important position, but doctors tried to show off their medical techniques utilizing excellent teachers or books. Meanwhile, they were making efforts to improve treating skills and thereby they were contributing to the development of medical techniques although they were sometimes criticised because of radical treatment or fierce drugs. In this process, it seems like that some doctors made efforts to establish the social meaning of medicine and their identity. In the short dialogue with Hong Yangho(洪良浩), Cho Gwangil(趙光一) was presenting the image of doctors as active and subjective beings. Pointing out the fact that in the society where feudal position systems were still impregnable, even the Confucian scholars who could be considered as a leading group could not but be passive in front of the sovereign power, he emphasized the fact that doctors could practice treatment as they liked. In that he re-discovered the meaning of treating people's diseases as a professional intellectual and that he was forming a subjective sense that medical techniques are active self expression, it can be carefully said that Cho Gwangil was obtaining his identity as a doctor. In the society in the Joseon Dynasty where the position systems were still valid and the value system under Neo-confucianism(性理學) supporting the system was impregnable, this change can be thought to be small yet quite meaningful.

HIV/AIDS에 관한 국내 약학대학 학생들의 지식, 태도와 위험인식 평가 (An Assessment of HIV/AIDS Knowledge, Attitudes, and Risk Perceptions among Korean Pharmacy Students)

  • 허완;양영모;정은;이지은;제남경;이재준;임성실;최은주
    • 약학회지
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    • 제58권5호
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    • pp.349-356
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    • 2014
  • With the advent of highly active anti-retroviral therapy (HAART), the perceptions of HIV therapy have changed from treating acute and terminal diseases to managing complex chronic diseases. Due to needs for specialists with professional knowledge on anti-retroviral therapies, pharmacists have been recognized as established and integral members in HIV multi-disciplinary care teams. Nevertheless, the roles of Korean pharmacists for HIV/AIDS therapy were highly limited. According to the transition of '2+4'-year pharmacy school curricula in Korea, it is necessary for pharmacy students to possess improved knowledge about and proper attitudes toward HIV/AIDS as future pharmacists. However, there have been little studies regarding the assessment of HIV/AIDS knowledge, attitudes, and risk perceptions of pharmacy students in Korea. Thus, this study was to examine Korean pharmacy students' knowledge levels, attitudes, and risk perceptions about HIV/AIDS and compare them according to pharmacy educational systems. The self-reported questionnaire was utilized to collect data. Total 238 students responded to the survey questionnaires. Most pharmacy students who participated in this study knew that the main transmission routes of HIV were unprotected sex, unscreened blood, occupational exposure, and intravenous drug use. However, they did not properly know post exposure prophylaxis for HIV. The pharmacy students under '2+4'-year curricula were more competent with treatment, care, counseling for HIV patients than those under 4-year curricula. Most pharmacy students thought that all healthcare students and professionals should receive mandatory HIV testings. The results from this study may contribute to developing new educational programs about HIV/AIDS. Additionally, further studies regarding the changes of Korean pharmacy students' attitudes and risk perceptions will need to be performed after they participate in these kinds of the programs.

노인간호 교과목 교육현황 분석 - 미국노인간호역량 중심으로 - (Analysis of the educational status of gerontological nursing subjects - Focusing on the American gerontological nursing competency-)

  • 박성지;김은미;유명환;강지숙
    • 문화기술의 융합
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    • 제7권4호
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    • pp.583-590
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    • 2021
  • 본 연구는 전국 간호대학의 노인간호 교과목의 운영 현황을 파악하고 미국간호대학협회에서 제시한 19개 노인간호역량이 교과목에 반영되어 있는지 확인하고자 시도되었다. 연구대상은 한국간호교육평가원 인증을 받은 간호교육기관 198개로 각 대학의 홈페이지, 학과 홈페이지, 대학편람, 입시관련 정보, 교육과정표, 강의계획서를 인터넷 검색엔진을 통한 자료 수집 후 분석하였다. 수집된 노인간호 교과목의 강의계획서와 가장 최근의 교과과정표를 확인하여 SPSS 23.0을 사용하여 분석하였다. 노인간호 교과목 운영 현황은 빈도와 백분율을 산출하여 제시하였고, 강의계획서에 나타난 교육 내용은 미국간호대학협회(AACN)가 제시한 19개 노인간호 역량을 기반으로 분석하였다. 185개 기관(93.43%)는 노인간호 교과목을 운영하였고, 98개 기관(49.49%)은 이론과목, 84개 기관(42.42%)은 이론과 실습을 병행하였다. 전공필수인 경우 52.92%, 4학년 1학기 편성이 27.84%, 2학점 운영 53.54%로 가장 많았다. 강의계획서를 분석한 결과, 의사소통 관련 교육역량이 포함된 경우가 40%이었고, AACN 노인간호역량으로 '노인에게 효과적인 정보제공능력', '윤리적이고 비강압적인 의사결정', '억제대 비사용 케어', '급성기 재가 장기요양서비스 간 안전하고 효과적인 전환'은 교육내용에 없었다. 결론적으로 현재까지 노인간호 교과목은 질병중심으로 교육이 되고 있었고 노인의사소통을 포함한 효과적인 정보제공역량이 반영될 필요가 있다.

음악요법이 초산부의 경막하 무통 분만 중 분만통증, 분만경험, 자아존중감에 미치는 효과: 유사실험 연구 (The effects of music therapy on labor pain, childbirth experience, and self-esteem during epidural labor analgesia in primiparas: a non-randomized experimental study)

  • 안성연;박은지;문유리;이보영;이은별;김동연;정성희;김진경
    • 여성건강간호학회지
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    • 제29권2호
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    • pp.137-145
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    • 2023
  • Purpose: This non-randomized study was performed to evaluate the effects of music therapy on labor pain, the childbirth experience, and self-esteem in women during vaginal delivery. Methods: In total, 136 primiparous women over 37 weeks of gestation receiving epidural analgesia during vaginal delivery were recruited via convenience sampling. To minimize diffusion effects, data from the control group (n=71) were collected first (April 2020 to March 2021), followed by data from the music group (n=65; April 2021 to May 2022). Participants in the music group listened to classical music during labor, while the control group was offered usual care (no music). Labor pain was measured using a numeric rating scale (NRS), and self-esteem and childbirth experience were collected using self-report questionnaires. Data were analyzed using the independent t-test, chi-square test and Cronbach's α coefficients. Results: The overall pain level (NRS) at baseline was 0 in both groups. Mothers in the music therapy group had lower levels of latent pain (t=1.95, p=.005), active pain (t=3.69, p<.001) and transition-phase pain (t=7.07, p<.001) than the control group. A significant difference was observed between the two groups, and the music therapy group expressed more positive perceptions of the childbirth experience (t=-1.36, p=.018). For self-esteem, the experimental group's score was slightly higher, but without a statistically significant difference from the control group. Conclusion: Using music therapy during labor decreased labor pain and improved the childbirth experience. Music therapy can be clinically recommended as a non-pharmacological, safe, and easy method for nursing care in labor.

할머니의 양육경험 이야기 : 자녀 세대와 손자녀 세대 양육을 중심으로 (The Story of Grandmothers' Experience Raising Children)

  • 김윤숙;전연우;조희숙
    • 한국보육지원학회지
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    • 제8권3호
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    • pp.185-208
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    • 2012
  • 본 연구는 할머니의 양육경험을 자녀 세대와 손자녀 세대 중심으로 살펴보고자 하였다. 이를 위해 자녀 세대와 손자녀 세대의 양육을 경험한 세 할머니를 대상으로 심층면담을 통하여 분석하였다. 연구결과 할머니의 양육경험은 양육 환경의 변화, 양육 문화의 변화, 양육가치관의 변화로 크게 3가지 범주로 나타났다. 구체적으로는 양육 환경의 변화는 '혼자 하는 양육에서 성인 자녀와 함께 하는 양육으로', '체력으로 이겨낸 양육에서 체력이 달리는 양육으로' 으로 나타났다. 양육문화의 변화에서는 '전통을 답습하는 양육에서 시대의 흐름을 따라가는 양육으로', '보편적인 양육에서 차별화된 양육으로', '계획되지 않은 양육에서 계획된 양육으로' 으로 나타났다. 마지막으로 양육가치관의 변화에서는 '무조건적 사랑의 양육에서 사랑과 훈육이 조화된 양육으로', '학습최우선의 양육에서 건강최우선의 양육으로', '조바심 내는 양육에서 기다려주는 양육으로' 으로 나타났다. 이러한 결과는 양육 환경, 양육 문화, 양육 가치관에 따라 과거와 현재를 양육하는 할머니의 양육경험이 변화되고 있음을 시사해준다.

Genetic Features of Lung Adenocarcinoma with Ground-Glass Opacity: What Causes the Invasiveness of Lung Adenocarcinoma?

  • Kim, Dohun;Lee, Jong-Young;Yoo, Jin Young;Cho, Jun Yeun
    • Journal of Chest Surgery
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    • 제53권5호
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    • pp.250-257
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    • 2020
  • Background: Lung adenocarcinoma (LUAD) with ground-glass opacity (GGO) can become aggravated, but the reasons for this aggravation are not fully understood. The goal of this study was to analyze the genetic features and causes of progression of GGO LUAD. Methods: LUAD tumor samples and normal tissues were analyzed using an Illumina HiSeq 4000 system. After the tumor mutational burden (TMB) was calculated, the identified mutations were classified as those found only in GGO LUAD, those present only in nonGGO LUAD, and those common to both tissue types. Ten high-frequency genes were selected from each domain, after which protein interaction network analysis was conducted. Results: Overall, 227 mutations in GGO LUAD, 212 in non-GGO LUAD, and 48 that were common to both tumor types were found. The TMB was 8.8 in GGO and 7.8 in non-GGO samples. In GGO LUAD, mutations of FCGBP and SFTPA1 were identified. FOXQ1, IRF5, and MAGEC1 mutations were common to both types, and CDC27 and NOTCH4 mutations were identified in the non-GGO LUAD. Protein interaction network analysis indicated that IRF5 (common to both tissue types) and CDC27 (found in the non-GGO LUAD) had significant biological functions related to the cell cycle and proliferation. Conclusion: In conclusion, GGO LUAD exhibited a higher TMB than non-GGO LUAD. No clinically meaningful mutations were found to be specific to GGO LUAD, but mutations involved in the epithelial-mesenchymal transition or cell cycle were found in both tumor types and in non-GGO tissue alone. These findings could explain the non-invasiveness of GGO-type LUAD.

임상 간호사의 도덕성 발달과 윤리적 가치관에 대한 연구 (A Study of Moral Development and Ethical Values of the Nurse)

  • 김미정;김명희
    • 간호행정학회지
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    • 제5권2호
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    • pp.337-353
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    • 1999
  • This study is to provide the basic sources to develop educational data that can establish ethical values with research on the interrelation between moral development and ethical values of nurses. The subjects of this study are the convenience sample from 111 nurses working in clinical settings from 5 general hospitals located in Pusan area. The questionnairs for this study are comprised two parts: Part 1 is SRM-SF(1995) guestionnaire, and translated by Kil, 1m Ju(1997): Part 2 is the guestion papers about the ethical values, and disigned by Jung, Hee Ja. The data were collected from June lth to 31th, 1997 and analyzed by S.A.S(Statistical Analysis System) Package for frequency, percent, and Pearson's correlation coefficient. The results of the study is as the followings: 1) According to the moral development. the nurses are in the levels of Stage3 or Transition3/4, which are generally focused on the personal relations or personality. Thus, nurses are considered to need to get the stage4 of education that helps them recognize a person as a member of society. a family as an unit of society, and human life as the values of human dignity. 2) According to the ethical values, nurses have the positive ethical values of respecting the right of the patients, providing information, keeping the secret, truth. and credit of patients. But they also experience some troubles by the patients to care and the clinical situation. Thus, to overcome the problems, nurses are considered to need to get the education that establishs the right ethical values. 3) The analysis result on the interrelation between moral development level and ethical values shows as r=0.28 and p=0.003. This indicates that the interrelation between them is low. In conclusion, it is considered that the moral development level is viewed broadly from a person and family to a society, and then it can affect to the ethical values positively.

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자바 애플릿을 이용한 2차원 혼합형 비정렬 격자 생성 프로그램의 개발 (DEVELOPMENT OF 2-D UNSTRUCTURED HYBRID GRID GENERATION PROGRAM USING JAVA APPLET)

  • 이장훈;조금원;김병수
    • 한국전산유체공학회:학술대회논문집
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    • 한국전산유체공학회 2009년 추계학술대회논문집
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    • pp.65-70
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    • 2009
  • In this paper a hybrid grid generation program for general 2-D region is introduced. The program is developed by using JAVA programming language, and it can be used either as an application program on a local computer or as an applet in the network environment. The hybrid grid system for a 2-D problem means a combination of triangular cells and quadrilateral cells, and it can offer both of the high flexibility of triangular cells and the high accuracy and efficiency of structured-type quadrilateral cells. To accommodate a quadrilateral-cell region and a triangular-cell region into one computational domain, it is importance to take good care of the interface between two different regions so that overall good grid quality can be maintained. In this research advancing layer method(ALM) augmented by elliptic smoothing method is used for the quadrilateral-cell region and advancing front method(AFM) is used for the triangular-cell region. A special treatment technique for the interface between those two regions is also developed. The interface treatment technique is basically to prevent the propagation of small cell size due to ALM method into the triangular region and maintain the smooth transition of cell-size scale between two different regions. By applying current technique high-quality hybrid grids for general 2-D regions can be easily generated, and typical grid generation results and flow solutions are demonstrated.

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모유의 무기질과 면역물질함량에 영향을 미치는 요인에 관한 연구 (Effect of Maternal Factors on the Concentrations of Minerals and Immunological Substance in Breast Milk)

  • 권미소;윤인숙;조미숙;이현숙;김화영
    • Journal of Nutrition and Health
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    • 제37권9호
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    • pp.809-816
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    • 2004
  • The purpose of this study was to evaluate the effect of maternal nutritional status and health behaviors on the concentrations of minerals (Zn, Fe, Ca) and the immunological substances (lactoferrin, sIgA, Iysozyme) in breast milk. Breast milk was collected from 193 healthy Korean women from obstetric clinics and postpartum care centers in Seoul. : 99 colostrum (1 - 5 days postpartum), 33 transitional milk (6 - 10 days postpartum), 61 mature milk (11 - 50 days postpartum). The concentrations of minerals and immunological substance were highest in colostrum and decreased with lactational period. Concentrations of Zn and Fe reduced significantly from colostrum to mature milk, however, Ca concentration stayed constant throughout the lactational period. Contents of lactoferrin, sIgA, and lysozyme were significantly lower in mature milk than in colostrum. Mother's nutritional status, assessed by prepregnancy BMI, had an effect only on colostrum, but not on transition and mature milk. Fe concentration of colostrum was significantly lower in underweight (prepregnancy BMI < 18.5) than in overweight mothers (prepregnancy BMI $\geq$ 23.0). Also lower tendency was observed for sIgA and lysozyme contents, even though the difference was not statistically significant. Pregnancy weight gain had no effect on the breast milk component. Since nutritional factors had some effect on colostrum, the health behaviors of mothers providing colostrum were assessed. The mother's behavior of smoking, drinking, morning sickness, parity, disease, nutrient supplement use had no significant effect on the breast milk component, however, Zn, sIgA, and lysozyme were the somewhat affected components by maternal health behavior.

애도상담자 전문역량 향상을 위한 교육과정 탐색 (A Study on Curriculum to Improve Grief Counselor's Competency)

  • 전희정
    • 한국콘텐츠학회논문지
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    • 제18권2호
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    • pp.602-615
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    • 2018
  • 상실은 죽음 뿐 아니라 인생 전환기의 변화까지 포함하는 개념으로 확대되었다. 이와 더불어 자연재해, 예기치 않은 사고 등으로 주변의 죽음을 직 간접적으로 경험하는 비율도 증가하였다. 따라서 애도 상담에 대한 수요 증가와 전문 애도 상담에 대한 필요성이 제기되고 있다. 이에 본 연구는 애도 상담자의 전문역량 향상을 위해 애도 상담 역량 요인을 조사하고, 무엇을 학습하고 훈련해야 하는지 문헌을 검토하고 조사하는데 초점을 두었다. 구체적으로 애도 상담 이론 및 모델, 애도의 평가, 죽음 교육, 상담자 자기-관리로 나누었고 각 교육 내용을 기존 상담교육과정에 통합시키고 경험적 실습 방법을 제시하였다. 본 연구는 애도 상담자 교육에 대한 관심을 고취시키고 애도 상담자 역량 모형 및 체계적인 교육과정 개발에 기초자료로 활용될 수 있다.