• 제목/요약/키워드: treatment satisfaction

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작업치료사로서의 갈등 경험에 관한 연구: Parse의 인간되어감 연구방법 적용 (Conflict Experience as an Occupational Therapist: Parse's Theory of Human Becoming)

  • 한상우;함보현;홍덕기;최성열;전병진
    • 대한지역사회작업치료학회지
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    • 제4권1호
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    • pp.47-58
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    • 2014
  • 목적 : 작업치료사로서의 보편적으로 경험한 갈등의 의미를 밝히고, 현상에 대한 질적인 정보를 제공하여 임상치료사들을 위한 직무발전방안에 기여하고자 하였다. 연구방법 : 본 연구에서는 Parse의 인간되어감 연구방법을 사용하여 자료를 수집하고 분석하였다. 연구 참여자는 연구목적을 이해하고 연구자와의 대화를 통해 자신의 체험을 진솔하게 구술할 수 있는 임상작업 치료사 8명으로 선정하였다. 대화 기간은 2012년 1월부터 2월 까지였으며, 시간은 근무 후 약 30~40분씩, 참여자마다 3회 이상 실시하였다. 결과 : 작업치료사로서의 갈등 체험은 작업치료의 정체성 혼란과 인식 부족을 느끼고, 열악한 근무 환경과 사회생활에서 오는 심적 갈등, 급여 문제로 걱정하지만, 치료에 대한 고민과 노력들로 미래를 희망하는 체험 과정이었다. 그러나 외적, 내적 갈등으로 불안한 현실 속에서도 학문에 대한 자기 개발과 성장을 경험하면서 긍정적인 미래를 향해 발전하며 극복해나가고 있었다. 결론 : 치료사들이 내적 외적인 갈등에서 벗어나, 작업치료의 정체성 확립과 치료에 대한 만족 및 치료의 질을 높일 수 있도록 지속적인 물리적 사회적 환경 개선이 필요하다.

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흉강경하 흉부교감신경절제술을 이용한 안면다한증 치료 -증례보고- (Thoracoscopic Sympathectomy for a Patient with Facial Hyperhidrosis -A case report-)

  • 문동언;박병철;김병찬;김성년
    • The Korean Journal of Pain
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    • 제9권2호
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    • pp.399-402
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    • 1996
  • Endoscopic transthoracic sympathectomy (ETS) has recently become estabilished as a successful treatment for severe palmar and axillary hyperhidrosis. Descriptions have been published of neurolytic, operative and alternative endoscopic procedures involving thermocoagulation, laser coagulation, or or nonvideo-assisted ganglionectomy using equipment not widely available, with low morbidity and excellent results. All methods have advantage and disadvantages. A 19-year-old male who suffered from severe hyperhidrosis on face, palms and axillary areas, has been initially treated with stellate ganglion block in other pain clinic. He was transfered to our pain clinic for endoscopic thoracic sympathectomy. The patient was intubated left side 34 Fr. double lumen tube and positioned left semi-lateral position for right sympathectomy. Right side pneumothorax was created by clamping the ipsilateral side of the double lumen tube and aspiration of air. 11-mm trocar was introduced through incision at the third intercostal space in anterior axillary line, and then additional two 11-mm and 5-mm trocar was introduced through second and fifth intercostal space in mid axillary line. The lung was gently retracted and the parietal pleura over the heads of the appropriate ribs excised using 5-mm sharp insulated coagulating microprocesss. The T4, T3, and T2 ganglions, as well as accompanying rami communicantes, and other branchs arising from upper thoracic nerves to the brachial plexus and surrounding tissues were carefully dissected, coagulated. During sympathectomy, skin temperature of middle was continuously monitored. Elevation of palmar skin temperature intraoperatively indicated an adequate sympathectomy with a definite therapeutic effect. A No. 28 Fr. thoracotomy tube was introduced through a troca under video guidance, placed under water seal after the lung was reinflated. the controlateral side was performed same procedure. After bilateral sympathectomy, chest tubes were removed, and then, he was discharged 2 days after operation with great satisfaction. The ETS provides a well-tolerated, cost-effective alternative to thoracic sympathectomy for primary hyperhidrosis and sympathetic mediated neuropathic pain disorder. And T2 ganglion is considered the key ganglion for the treatment of primary hyperhidrosis. The low incidence of compensatory sweating may by explained by the limited extent of the sympathectomy.

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산업보건에의 한의학적 참여방안에 관한 연구 (Research on the Plan of Oriental Medical Participation in the Industrial Health)

  • 이은경;정명수;천은주;김삼태;강성호;이수경;한종민;김성천;유택수;정재열;송용선;이기남
    • 대한예방한의학회지
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    • 제3권2호
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    • pp.55-77
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    • 1999
  • Oriental Medical Service established foundation that Oriental medical clinic can take part in industrial health service by being specified industrial calamity medical treatment organ, but research which develope program that Oriental Medical Service approach on the occupational disease and industrial health only dealt in the Western Medical System was insufficient. So we studied on theoretical foundation and basic bearing about .program of oriental medical health examination in the workplace, it is based on explanation and assessment reformed by western medicine. We reached the conclusion as follows, 1. We must reconsider the concept that mind of Oriental medicine is preventive medicine, and assess positively result of social medicine. 2. Importance of industrial health is being enlarged in the category of health care. 3. Western medical health in including industrial health have faced much problems at this time, we can search by alternative proposal grafting on Oriental Medicine. 4. Oriental medical participation in the industrial health have various benefits at side satisfaction of workers, effect of prevention, efficiency of cost, and increasing rate of medical treatment and return to workplace of workers with industrial calamity. 5. We must consider Oriental Medical Health Examination as one way of health management program of workers, not as formality. 6. The advantage of Oriental Medical Health Examination can increase ability of individual health management in preventive medicine and the production in workers' health management.

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한방의료의 이용행태 및 이용결정요인 분석 - 일부 대도시 지역주민을 중심으로 - (Utilization Patterns and Determinants of Oriental Medical Services : Focused on the Residents of Taegu City)

  • 유왕근;류경아
    • 대한예방한의학회지
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    • 제4권2호
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    • pp.1-24
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    • 2000
  • This study was conducted to examine utilization patterns and determinants of oriental medical services. Data were collected from 545 residents in Taegu city The results of this study are summarized as follows 1) 37.8% of subjects used oriental medical services in the past year. Especially, the female, the ages of 50 and 60 over, the single. low-educated. high-income class, white-collar class, medical insured tended to use more oriental medical services than another groups. 2) 46.7% of users of oriental medical services reported that number of visits in the past year was 2 - 5 times 37 1% of them was 1 times, and 4.5% over 10 times. 3) According to the reasons to choose the oriental medical facilities, most was 'on their own judgement'(48.8%) and 'by the advice of relatives and friends'(42.0%) Regarding to the objectives of using oriental medicine, 68.3% was 'treatment', 31.7% 'health counselling and promotion'. And among diseases of users, diseases of musculo-skeletal system was the highest(54.5%). 4) 57.9% of oriental medical services users had experience of utilizing western medicine on the same diseases. Among peoples with experiencing western medicine on the same diseases. 54.4% received oriental medical services 'in addition to western medicine', 45.6%'in place of western medicine 'And 41.2% of using both services reported that they had difficulty in deciding to choose the type of services -oriental medical services or western medicine-for their diseases. 37.3% of them answered that 'providing relevant information' was the most desirable measure to solve this problem, 27.3% 'establishment of effective referral system between oriental and western medical facilities '23.6% 'cooperative medical treatment systems in the same facilities', 11.8%'integration of oriental medicine into western medicine 5) According to the satisfaction level with each items of oriental medical services, the respondents had positive views on efficacy, kindness, and side-effects. They, however, had negative view on the cost of oriental medical services. 6) In regarding to the priority of improvement of oriental medical system,'expansion of insurance benefit package 'ranked first. 'expansion of insurance benefit Package 'ranked second, 'improvement of scientific methods and diagnostic technique 'third, and 'safety of herbal medicine' fourth in order. 7) The significant factors influencing the utilization of oriental medical services were kindness of oriental medical practitioners, efficacy , travel time, age To be brief, utilization rate of oriental medical services in urban area generally tends to be high. There, however, have been various barriers to limit oriental medical services, such as incomplete benefit package of oriental medical insurance and lack of coordination and referral system between oriental and western medical services, lack of scientific diagnostic procedures, high price etc . For the development of oriental medical services, Much attention to remove these limiting factors should be placed. In addition, kindness of oriental medical practitioners , which is expected to be more important factor in the consumer - focused health care environment than ever, should be kept high consistently. Since this study was conducted for specific residents of an urban city. further research including more sampling in different urban areas should be required to generalize the results of the study.

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일부 청년기 성인의 정신건강과 구강습관이 턱관절 증상에 미치는 영향 (Effects of Mental Health Levels and Oral habits on Temporomandibular Joint Symptom in Some Adolescents)

  • 홍민희
    • 한국산학기술학회논문지
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    • 제21권2호
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    • pp.381-387
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    • 2020
  • 본 연구는 일부 성인의 정신건강 수준, 평소 구강 습관이 턱관절 증상에 미치는 영향을 살펴보고자 시행하였다. 연구 대상은 2019년 9월 1일부터 30일까지 청년기 성인을 대상으로 설문 조사를 시행하였으며 총 402명을 대상으로 하였다. 그 결과 불안, 우울, 사회적 부적응 영역의 정신건강 수준은 삶의 만족도(p<0.001)와 주관적 건강 상태(p<0.001), 외상 경험(p<0.01)과 유의한 차이를 나타냈다. 턱관절 치료 경험자는 사회적 부적응 영역(p<0.05)의 정신건강 수준에서 유의한 차이를 나타냈다. 턱관절 증상은 여성(p<0.05), 음주자(p<0.01), 외상(p<0.01)과 턱관절 치료 경험자(p<0.001)에서 높게 나타났으며, 통계적으로 유의한 차이를 나타냈다. 정신건강 수준(p<0.001), 구강 습관(p<0.001)과 턱관절 증상(p<0.001)은 모두 양의 상관성을 나타냈다. 구강 습관(p<0.001)이 턱관절 증상에 가장 큰 영향을 미쳤으며 외상(p<0.05)과 턱관절 치료 경험(p<0.001)도 턱관절 증상에 영향을 미치는 것으로 나타났다. 이상의 결과로 볼 때 턱관절 증상을 치료 시 구강 습관을 개선하는 것이 가장 중요하며, 정신건강 상담치료와 평소 생활습관의 개선 노력을 병행하여 턱관절 건강을 효과적으로 개선하고 적용할 수 있는 프로그램의 개발이 필요할 것으로 생각된다.

상악 전치부 잔존 유치와 매복 견치 발치 후 즉시 임플란트 식립: 증례 보고 (IMMEDIATE IMPLANT PLACEMENT AFTER EXTRACTION OF RETAINED DECIDUOUS TEETH AND IMPACTED CANINES: REPORT OF A CASE)

  • 유지연;김여갑;이백수;권용대;최병준;김영란;백진
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제31권4호
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    • pp.330-333
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    • 2009
  • 저자들은 본 증례의 경우 치근이 흡수된 전치와 매복 견치의 발치 후 심한 치조골의 흡수와 연조직의 변화가 예상되는 것을 고려하여 발치 후 즉시 임플란트 수술을 결정하였다. 초기 안정성을 확보하기 위해 가능한 적은 골삭제, 보다 큰 직경과 치근형태의 임플란트를 선택하여 발치 후 즉시 임플란트를 식립하였고, 장골에서 채취한 망상골로 골결손부를 채우고 부가적으로 상순 지지를 위해 흡수성 차폐막과 순측 골면에 onlay형태의 골이식술을 시행하여 자연스럽고 심미적인 결과를 얻을 수 있었다.

뇌질환아 어머니의 스트레스와 대처방법 (A Study on Stress and Coping Methods of Mothers of Children with Brain Disease)

  • 윤정희;조결자
    • 대한간호학회지
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    • 제24권3호
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    • pp.389-412
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    • 1994
  • This study was done to investigate stress and coping methods of mothers with brain disease children. The subjects for this study were obtained by taking a sample of mothers with brain disease children hospitalized in neurosurgery ward of K medical center in Seoul from Nov. 20, 1992 to Mar. 10, 1993. The collected date were analized by S.P.S.S. program(frequency, percentage, mean, t-test, ANOVA, Pearson Correlation). The results of the study were as follow. 1. The mean of the degree of mothers' stress was 3.681. Of the stress categories, illness treatment (4.216) was highest, and the next were in order of ill-ness status and prognosis(4.154) , family relation-ships and personal roles(3.202), interpersonal relationships(2.916). 2. The mean of the degree of mothers' coping method was 2.930. Of the coping method categories, communication with medical team or parents in similar situations(3.332) was highest, and the next were in or-der of family cooperation and optimistic thought about the situation(3.241), reforcement of self esteem and maintenance of psychological stability(2.538). 3. There was not seen a stastically significant correlation between stress factors and coping methods of mothers. But with categories, the higher the stress to illness status and prognosis was, the hight coping methods' degree of communication with medical team or parents in similar situations was shown a positive correlation, if not high (r=.2776, P=.046) . And the higher the stress to illness treatment was, the higher coping methods' degree of communication with medical team or parents in simial situations was shown a positive correlation, if not high (r=.2727, P=.049). 4. With the difference of stress according to mothers' general characteristics, religion and monthly income shew a statically significant difference. The mothers' group who have a religion shew the higher degree of stress(t=-3.17, P=.003), The group who get the most income shew highest degree of stress (F=.4693, P=.0156). With the difference of coping according to mothers' general characteristics, the most support-ing person, satisfaction with husbands and mothers' own health status shew a statistically significant difference. The group who get the most support from parents-in-law(F=3.7508, P=.013), the group who are much satisfied with husband(F=3.589, P=.016), and the group whose health status are good(F=3.3675, P=.046), shew the highest coping degree. 5. There were no significant difference in degree of stress and coping by children's characteristics The significance of the study will be concluded as follows. 1. Investigating the stress factors, which mothers are perceiving, it will be utilized as the basic materials of nursing plan so as to reduce the stress of mothers. 2. In searching for the ways of mothers' more helpful coping methods, it shows the necessity of the active nursing intervention for the mothers in the process of coping with their stress. That is, the nurse should serve the earnest nursing as counselor, supporter, educator, and information - provider. 3. Recogning mothers as well as children with brain disease as a client, the nurse will be able to help the mother, who is taking care of the children, cope with the stress situation well, and to make a contribution to the recovery, rehabilitation, and health of the children and to the enhancement of the family' health.

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임플란트 보철물 나사의 전하중 유지에 나사 표면에 따른 혐기성 나사 고정제의 효과 (Effects of anaerobic sealing agents on preload maintenance of screw-retained implant prosthesis with surface of screws)

  • 류승범;허성주;곽재영;김성균
    • 대한치과보철학회지
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    • 제58권2호
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    • pp.103-109
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    • 2020
  • 목적: 본 연구의 목적은 임플란트 지대주 나사에 혐기성 나사 고정제의 적용 유무와 나사 종류에 따른 풀림 토크 값의 차이를 평가하는 것이다. 재료 및 방법: 외부 육각형 임플란트 고정체를 사용하였고, 동일한 제조사의 지대주와 지대주 나사가 사용되었다. 지대주 나사는 두 종류로 티타늄 재질의 나사(티타늄 나사)와 텅스텐 카바이드 코팅된 나사(Ebony 나사)가 사용되었다. 티타늄 나사에 아무 처리하지 않은 군(TI군)과 티타늄 나사에 나사 고정제를 사용한 군(TI_AS군), Ebony 나사에 아무 처리하지 않은 군(EB군)과 Ebony 나사에 나사 고정제를 사용한 군(EB_AS군)에 대해 실험을 진행하였다. 총 4가지 군에서 각 10개씩의 임플란트 고정체-지대주 복합체가 사용되었다. 디지털 토크 측정 장비를 사용하여 풀림 토크 값을 측정한 뒤 통계 처리하여 각 군별 비교하였다. 정규성 분포를 만족하여 Two-way ANOVA test (α = .05)를 이용하여 통계 분석하였다. 결과: 각 군에 대한 결과를 살펴보면 TI 군은 20.3 ± 1.6 N.cm, TI_AS 군에서 32.4 ± 6.7 N.cm, EB 군은 20.2 ± 1.5 N.cm, EB_AS 군에서 30.4 ± 4.5 N.cm의 풀림 토크 값을 나타냈다. 결론: 혐기성 나사 고정제를 사용한 경우 티타늄 나사와 ebony 나사 모두에서 고정제를 사용하지 않은 경우 보다 풀림 토크 값이 높게 나타났다. 하지만 두 나사 군 간의 차이는 존재하지 않았다.

방사선(학)과 학생 임상실습에 따른 스트레스 특성 (Characteristic of Stress According to Student Clinical Training in Department of Radiology)

  • 백창무;채수인;김정구
    • 한국방사선학회논문지
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    • 제6권4호
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    • pp.291-298
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    • 2012
  • 방사선(학)과는 학생들의 실무적응과 진료기술의 수용을 도모하고자 병원 임상실습교육을 실시하고 있다. 그러나 임상실습현장에서 낯선 환경과 진료업무를 체험함으로써 많은 학생들이 복합적이고 다양한 스트레스를 경험하고 있다. 때로는 실습의 부담감과 전공에 대한 회의로 이어져 실습교육에 부정적인 결과를 초래할 수도 있다. 이에 방사선(학)과 학생들의 임상실습 시 경험할 수 있는 스트레스에 대해 그 요인들을 파악하고자 전국 3년제 4년제 대학 중 6개 대학의 방사선(학)과 재학생을 대상으로 2011년 9월 15일에서 10월 25일까지 설문조사를 실시하였다. 방사선(학)과 학생들이 임상실습에서 경험하는 스트레스 정도는 비용적인 측면(3.06)과 임상지도자(3.02)에 관련한 영역에서 높게 나타났으며, 이어서 가치와 이상(2.94), 역할과 실습활동(2.93), 실습환경(2.74), 실습생 간 관계(2.64)의 순으로 나타났다. 임상실습 스트레스 요인에 대해 비용적인 측면을 제외한 모든 요인에서 여성이 남성보다 스트레스 수준이 높게 나타났으며(P<.05), BEPSI-K 구분에 따른 스트레스군 간에는 실습환경, 실습생 간 관계, 역할과 실습활동 영역에서 유의한 차이를 나타냈다(P<.01, P<.001, P<.05). 따라서 임상실습에 임하는 학생들의 스트레스가 임상실습의 만족도와 상호 밀접한 상관관계를 가짐을 확인하였다.

외국인이 인식하는 한의학 의료관광의 가능성 및 사상체질진단 경제적 가치평가 (Potential Ability of Traditional Korean Medical Tourism and Economic Valuation of Sasang Constitutional Typology Diagnosis from Foreigner's Perspective)

  • 김형순;이희승;차병헌;주종천
    • 사상체질의학회지
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    • 제23권1호
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    • pp.115-124
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    • 2011
  • 1. Objectives : This study aimed to provide practical insights on the development of traditional Korean medical tourism and maximize the satisfaction of foreign patients. The main objectives of this study were also to evaluate Sasang Constitutional Medicine(S.C.M.) diagnosis cost from foreigners' perspectives. 2. Methods : For this study, the data were collected from tourists to Korea between January 3, 2010 to February 20, 2010. The sample used in this study was mainly composed of Japanese, Chines and US/Canada, because they are the major national visitor origin group to Korea. The primary data were collected by questionnaire survey using a standardized instrument with a convenience sampling procedure, and efforts of the interviews involved an on-site, self-administrated questionnaire to those sitting or visiting tourist attractions. The total size of the sample was 276 of which 275 showed no missing value against the factors needed for final analysis and were for analysis as an effective sample. SPSS 13.0 for window was used to analyze the collected data on which descriptive statistics and the Limited Dependent(LIMDEP) 8.0 program was used in estimating the willingness-to-pay(WTP) for traditional Korean medical tourism through the Contingent Valuation Method(CVM). A dichotomous choice question form of a CVM was applied to estimating the value. 3. Results and Conclusion: 1. There was significant statistical relationship between attributes when considering medical tourism destination and socio-demographic profiles such as age group, nationality, educational level and occupation. 2. In the level of recognition on Korean medicine, north Americans showed low level of recognition compared to other nationalities. In addition, in terms of age group, 20's and 30's showed low level of recognition on Korean medicine, 3. In relation to the level of interest on Korean medicine, Japanese respondents had higher interesting level on Korean medicine. Also singles had higher level of interest. 4. Regarding preferred Korean medical treatment program, there found significant statistical relationship between Korean medical treatment program and socio-demographic characteristics. 5. The estimating result of the logit model showed that the variables affecting the WTP for Sasang Constitutional medicine diagnosis were offered price and potential ability of medical tourism destination. 6. In relation to WTP for Sasang Constitutional medicine diagnosis, Japanese respondents showed a WTP of USD 62.69 and Chinese respondents showed USD 57.09. On the other hands, respondents from north America and other countries showed a WTP of USD 65.50. In conclusion, from this study, the results found that the opportunities in tradition Korean medical tourism are immense and the possible rewards are numerous. It is time to continue to promote 'Sasang Constitutional medicine' and make the Korean medical tourism programs considering on nationalities, age group, gender and WTP.