• 대한방사선기술학회지:방사선기술과학
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• 제44권5호
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• pp.545-554
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• 2021

According to the changes of the medical environment of the times, it is necessary to discuss the issues of the doctor's medical guidance and to conduct continuous research so that alternatives can be prepared systematically. Furthermore, in order to enhance the professionalism of radiological technologists and to develop the medical technician system, the new Radiological Technologist Independent Act has been established, which contains the overall contents of the scope of work, professional qualifications, and specialized education of radiological technologists, and provides quality medical services to patients through professional procedures and treatment. In order to increase the level of medical care, the purpose, definition, mission, role, and scope of work specified in the Medical Act, Medical Service Technologists, etc. Act, the Enforcement Decree, and the Enforcement Rules were variously analyzed and new directions were presented. First, the definition of a medical technician should use a generic term so that the factors of conflict and prejudice could be resolved. Second, change the doctor's guide to doctor's prescription; and then legislate the authority to sign and write medical records after examination by radiological technologists, thereby prohibiting unlicensed technicians that seriously endanger patient safety. Third, an accurate definition of radiological technologists' roles should be established; not only selection and management of radiological technologists' work but also procedures and treatment for each radiology field should be specified to suit the current medical system. Fourth, a professional radiological technologists' qualification system and a specialized education system should be established in order to secure human resources that could provide patients trust in procedures and treatment based on professional knowledge and experience in the field of radiology. Fifth, the Education and Evaluation Institute should be operated in Korea education system to educate the professional knowledge and competency for students. In addition, it is necessary to in-depth analysis of foreign cases could be applied to the medical system and education system in Korea; it could strive to nurture systematic human resources.

• 한국융합학회논문지
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• 제10권6호
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• pp.299-308
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• 2019

본 연구는 문제중심학습(PBL)의 수업 효과를 촉진하기 위한 전략으로 팀 퍼실리테이션 프로그램 적용 후 팀 활동 역량에 미치는 효과를 확인하기 위해 팀 역동성을 측정한 융합연구이다. 연구방법으로 실험군에게는 팀 퍼실리테이션 프로그램을, 대조군에게는 인간관계 프로그램을 적용한 후 효과를 분석하였다. 연구결과, 팀 퍼실리테이션 프로그램을 교육 받은 실험군이 인간관계 교육을 받은 대조군보다 팀 활동을 위한 개인기여 역량(F=5.12, p<0.05), 팀원들의 팀 역동성(F=10.35, p<0.01)에서 통계적으로 유의한 차이를 보였고, 팀 역동성 항목 중 팀원 간 신뢰(F=9.86, p<0.01), 의사소통(F=5.69, p<0.05), 팀 학습행동(F=4.57 p<0.05)이 통계적으로 유의한 차이가 있었다. 연구 결과, PBL 수업에서 팀 퍼실리테이션 프로그램이 팀 역동성을 촉진하였다는 것을 알 수 있었다. 향후 PBL과 같은 소그룹 협동 학습에서 팀 역동 활성화에 필요한 교육적 프로그램을 사전에 적용할 필요성이 있다.

• 한국산학기술학회논문지
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• 제22권6호
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• pp.90-99
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• 2021

본 연구의 목적은 간호관리학실습 교과내용의 중요도와 실습 참여 경험에 대한 학생과 임상현장지도자의 인식을 비교·분석해 간호관리학실습 개선의 기초자료를 제공하고자 하였다. 3개 대학 4학년 학생과 임상현장지도자를 대상으로 Mann-Whitney test와 교차분석 등으로 최종 343부 분석하였다. 연구 결과 간호대학생과 임상현장지도자 모두 간호관리학실습의 평가항목 중 '의사소통', '대인관계', '책임', '신뢰', '도덕성'을 중요 요소로 인식하였고 간호관리학실습 교과내용 중 가장 중요하게 인식한 상위 10개 항목 중 6개 항목('감염관리', '간호기록관리', '환자간호관리', '약품관리', '환자안전', '간호과오')은 두 그룹이 일치했다. 또한 임상현장지도자는 대인관계 및 관계윤리를 중요하다고 인식한 반면 간호대학생은 간호사의 '법적책임'을 중요하다고 인식했다. 두 그룹간의 실습경험 분석 결과, 간호대학생은 모두 간접 참여 경험이 높았으나 현장지도자는 직접 지도 경험이 높았다. 이와 같은 인식 차이가 확인된 교과내용은 학교와 실습기관의 유기적 파트너쉽 관계를 구축해 차이를 개선하고 간호대학생의 직접 실습 경험을 증대시키는 방안 마련이 필요하다.

• 동양고전연구
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• 제72호
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• pp.127-156
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• 2018

김유신은 살아 있을 때는 물론이고 죽은 뒤에도 신라에서 높은 평가를 받았다. 살아 있을 때는 태종과 문무왕을 보필하여 '일통삼한'의 대업을 이룩한 최고의 신하로 평가받았다. 당나라는 물론이고 고구려와 일본에서도 김유신의 정치적 위상을 높이 평가했다. 김유신은 죽은 뒤에도 태종을 도와 대업을 이룬 '좋은 신하' 또는 '성스런 신하'라고 인식되었다. 또, 문무왕과 함께 '두 명의 성인'으로 추앙되었으며, 불교적으로 33천의 한 사람이 내려온 것이 김유신이라고 인식되었다. 신라 하대에는 '흥무대왕'으로 추봉되어 '무(武)를 일으킨 대왕'이라는 극찬을 받았다. 고려시기에는 신라에 이어서 진천현 태령산의 사당에서 국가제사로 받들어졌다. 김부식은 김유신과 태종무열왕 문무왕의 관계를 빗대어 자신의 처지를 보여주려 했는데, 김유신을 두 왕의 절대적인 신임을 받아 큰 공을 이룬 인물로 평가했다. 또 윤관은 김유신이 신령스러운 기적을 많이 일으킨 장군으로 인식했고, 이승휴는 김유신이 오묘한 병서를 얻어 무예에 뛰어났다고 말했다. 고려 말의 정추도 김유신이 기이한 능력을 가진 장수이고 큰 무공을 세웠다고 인식했다. 조선시기에서도 태종무열왕 문무왕과 신하 김유신의 절대적인 신임관계로 인해 김유신이 큰 공적을 세웠다는 평가가 지속되었다. 그리고 김유신은 신라의 무(武)를 대표하는 인물이거나 신라 왕조 전 역사에서 가장 뛰어난 인물이라고 보았다. 나아가 중국의 인물에 견줄만한 능력과 공훈이 있는 인물이라고 인식되었다. 조선에서도 김유신이 병법에 뛰어났고 쇠뇌와 같은 훌륭한 무기를 활용했다고 보았으며, 특히 임진왜란을 겪으면서 그들은 김유신이 왜적을 소탕해주기를 바랐다. 김유신은 우리나라 역사에서 무(武)를 대표하는 인물로 평가되었다. 그리고 성리학적 관점에서 이러한 김유신의 행적을 통해 그를 충신이라고 인식했다.

• 해양환경안전학회지
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• 제28권7호
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• pp.1222-1230
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• 2022

로터 블레이드는 조류발전 터빈의 매우 중요한 구성 요소로서, 해수의 높은 밀도로 인해 큰 추력(Trust force)와 하중(Load)의 영향을 받는다. 따라서 블레이드의 형상 및 구조 설계를 통한 성능과 복합소재를 적용한 블레이드의 구조적 안전성을 반드시 확보해야 한다. 본 연구에서는 블레이드 설계 기법인 BEM(Blade Element Momentum) 이론을 이용해 1MW급 대형 터빈 블레이드를 설계하였으며, 터빈 블레이드의 재료는 강화섬유 중의 하나인 GFRP(Glass Fiber Reinforced Plastics)를 기본으로 CFRP(Carbon Fiber Reinforced Plastics)를 샌드위치 구조에 적용해 블레이드 단면을 적층(Lay-up)하였다. 또한 유동의 변화에 따른 구조적 안전성을 평가하기 위해 유체-구조 연성해석(Fluid-Structure Interactive Analysis, FSI) 기법을 이용한 선형적 탄성범위 안의 정적 하중해석을 수행하였으며, 블레이드의 팁 변형량, 변형률, 파손지수를 분석해 구조적 안전성을 평가하였다. 결과적으로, CFRP가 적용된 Model-B의 경우 팁 변형량과 블레이드의 중량을 감소시켰으며, 파손지수 IRF(Inverse Reserce Factor)가 Model-A의 3.0^*V_r를 제외한 모든 하중 영역에서 1.0 이하를 지시해 안전성을 확보할 수 있었다. 향후 블레이드의 재료변경과 적층 패턴의 재설계뿐 아니라 다양한 파손이론을 적용해 구조건전성을 평가할 예정이다.

• 한국문헌정보학회지
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• 제57권3호
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• pp.325-350
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• 2023

본 연구는 바이오 분야 연구데이터플랫폼인 K-BDS를 대상으로, 연구데이터 메타데이터의 품질이 연구데이터플랫폼의 활성화에 미치는 영향 및 이 관계에서 연구데이터플랫폼 이용에 관한 동기부여 요인의 매개효과를 밝히고자 하였다. 먼저 세 변인 간 구조적 관계를 구조방정식모형, 부트스트랩을 통해 분석하였으며 분석 결과, 연구자가 메타데이터의 품질에 대해 중요하다고 생각할수록 연구데이터플랫폼 이용의 동기부여 정도, 그리고 플랫폼의 활성화 의도가 높아지는 것으로 나타났다. 또한 동기부여 요인의 매개효과도 확인되었다. 추가적으로 각 변인의 하위요인간의 세부적인 구조를 회귀분석과 Sobel test를 통해 파악하였다. 그 결과 바이오 분야의 연구데이터 공유의 활성화를 위해서는 검색가능성을, 연구데이터 재이용의 활성화를 위해서는 발견가능성을 높이는 것이 가장 효과적이며, 인용가능성은 플랫폼의 활성화에 영향을 미치지 않는 것으로 나타났다. 따라서 플랫폼을 활성화하기 위해서는 우선적으로 메타데이터 품질을 향상시킴으로써 시스템적인 지원을 충분히 하는 것이 중요하며, 이를 통해 플랫폼에 대한 신뢰를 높이고 인용에 대한 혜택을 제도적으로 정착시켜 갈 필요가 있다는 시사점을 얻을 수 있다.

• 한국정보처리학회:학술대회논문집
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• 한국정보처리학회 2020년도 추계학술발표대회
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• pp.858-861
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• 2020

로봇이 사람과 같이 다양하고 복잡한 사물 조작을 하기 위해서 휴먼형 로봇손의 사물 파지 작업이 필수적이다. 자유도 (Degree of Freedom, DoF)가 높은 휴먼형(anthropomorphic) 로봇손을 학습시키기 위하여 사람 데모(human demonstration)가 결합된 강화학습 최적화 방법이 제안되었다. 본 연구에서는 강화학습 최적화 방법에 사람 데모가 결합된 Demonstration Augmented Natural Policy Gradient(DA-NPG)와 NPG 의 성능 비교를 통하여 행동 복제의 효율성을 확인하고, DA-NPG, DA-Trust Region Policy Optimization (DA-TRPO), DA-Proximal Policy Optimization (DA-PPO)의 최적화 방법의 성능 평가를 위하여 6 종의 물체에 대한 휴먼형 로봇손의 사물 조작 작업을 수행한다. 그 결과, DA-NPG 와 NPG를 비교한 결과를 통해 휴먼형 로봇손의 사물 조작 강화학습에 행동 복제가 효율적임을 증명하였다. 또한, DA-NPG 는 DA-TRPO 와 유사한 성능을 보이면서 모든 물체에 대한 사물 파지에 성공하여 가장 안정적이었다. 반면, DA-TRPO 와 DA-PPO 는 사물 조작에 실패한 물체가 존재하여 불안정한 성능을 보였다. 본 연구에서 제안하는 방법은 향후 실제 휴먼형 로봇에 적용하여 휴먼형 로봇 손의 사물조작 지능 개발에 유용할 것으로 전망된다.

• 간호행정학회지
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• 제2권1호
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• pp.97-114
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• 1996

INSTRODUCTION Service quality is, unlike goods quality, an abstract and elusive constuct. Service quality and its requirements are not easily understood by consumers, and also present some critical research problems. However, quality is very important to marketers and consumers in that it has many strategic benefits in contributing to profitability of marketing activities and consumers' problem-solving activities. Moreover, despite the phenomenal growth of medical service sector, few researchers have attempted to define and model medical service quality. Especially, little research has focused on the evaluation of medical service quality and patient satisfaction from the perspectives of both the provider and the patient. As competition intensifies and patients are demanding higher quality of medical service, medical service quality and patient satisfaction has emerged as a critical research topic. The major purpose of this article is to explore the concept of medical service quality and its evaluation from both nurse and patient perspectives. This article attempts to achieve its purpose by (1)classfying critical service attibutes into threecategories(satisfiers, hygiene factors, and performance factors). (2)measuring the relative importance of need criteria, (3)evaluating SERVPERF model and SERVQUAL model in medical service sector, and (4)identifying the relationship between perceived quality and overall patient satisfaction. METHOD Data were gathered from a sample of 217 patients and 179 nurses in Seoul-area general hospitals. From the review of previous literature, 50 survey items representing various facets of the medical service quality were developed to form a questionnaire. A five-point scale ranging from "Strongly Agree"(5) to "Strongly Disagree"(1) accompanied each statement(expectation statements, perception statements, and importance statements). To measure overall satisfaction, a seven-point scale was used, ranging from "Very Satisfied"(7) to "Very Dissatisfied"(1) with no verbal labels for scale points 2 through 6 RESULTS In explaining the relationship between perceived performance and overall satisfaction, only 31 variables out of original 50 survey items were proven to be statistically significant. Hence, a penalty-reward analysis was performed on theses 31 critical attributes to find out 17 satisfiers, 8 hygiene factors, and 4 performance factors in patient perspective. The role(category) of each service quality attribute in relation to patient satisfaction was com pared across two groups, that is, patients and nurses. They were little overlapped, suggesting that two groups had different sets of 'perceived quality' attributes. Principal components factor analyses of the patients' and nurses' responses were performed to identify the underlying dimensions for the set of performance(experience) statements. 28 variables were analyzed by using a varimax rotation after deleting three obscure variables. The number of factors to be extracted was determined by evaluating the eigenvalue scores. Six factors wereextracted, accounting for 57.1% of the total variance. Reliability analysis was performed to refine the factors further. Using coefficient alpha, scores of .84 to .65 were obtained. Individual-item analysis indicated that all statements in each of the factors should remain. On 26 attributes of 31 critical service quality attributes, there were gaps between actual patient's importance of need criteria and nurse perceptions of them. Those critical attributes could be classified into four categories based on the relative importance of need criteria and perceived performance from the perspective of patient. This analysis is useful in developing strategic plans for performance improvement. (1) top priorities(high importance and low performance) (in this study)- more health-related information -accuracy in billing - quality of food - appointments at my convenience - information about tests and treatments - prompt service of business office -adequacy of accommodations(elevators, etc) (2) current strengths(high importance and high performance) (3)unnecessary strengths(low importance and high performance) (4) low priorities(low importance and low performance) While 26 service quality attributes of SERPERF model were significantly related to patient satisfation, only 13 attributes of SERVQUAL model were significantly related. This result suggested that only experience-based norms(SERVPERF model) were more appropriate than expectations to serve as a benchmark against which service experiences were compared(SERVQUAL model). However, it must be noted that the degree of association to overall satisfaction was not consistent. There were some gaps between nurse percetions and patient perception of medical service performance. From the patient's viewpoint, "personal likability", "technical skill/trust", and "cares about me" were most significant positioning factors that contributed patient satisfaction. DISCUSSION This study shows that there are inconsistencies between nurse perceptions and patient perceptions of medical service attributes. Also, for service quality improvement, it is most important for nurses to understand what satisfiers, hygiene factors, and performance factors are through two-way communications. Patient satisfaction should be measured, and problems identified should be resolved for survival in intense competitive market conditions. Hence, patient satisfaction monitoring is now becoming a standard marketing tool for healthcare providers and its role is expected to increase.

• 대한간호학회지
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• 제22권1호
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• pp.81-115
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• 1992

The problem addressed by this study was to determine the effect of nurse - patient agreement on the means to achieve nursing goals in the early postpartum period of primiparous mothers. It was hypothesized that the experimental treatment would result in hegher self-confidence and satisfaction in maternal role performance. This purpose was to contribute to the planning of nursing care to enhance self- confidence and satisfaction in maternal role performance and to the development of relevant nursing theory. Especially, the early postpartum period is crucial toward in recovery from childbirth and attainment of the maternal role. Maternal role attaintment is a complex social and cognitive process of stimulus -response accomplished by learning. Most women attain the maternal role sucessfully. But, some primiparous mothers experience difficultites in attainment of the maternal role due to lack of experience and knowledge. Self-confidence and satisfaction in maternal role performance are important factors in attainment and adjustment to the maternal role (Mercer, 1981a, 1981b ; Lederman, Weigarten, and Lederman, 1981 :Bobak and Jensen, 1985). Nursing is defined as behaviors of nurses add patients that attain nursing goals through action, reaction, interaction, and transaction. For attainment of nursing goals, active participating transactions must occur by agreement on the means to achieve those goals through nurse -patient mutual goal setting and establishment of their active relationships(King, 1981, Ha, 1977). Based on King's theory of goal attainment (1981), this stuy was planned as a non-equivalent control group, non -synchronized quasi -experimental design using agreement on the means to achieve nursing goals in early postpartum as the experimental treatment. The data were collected from July 20 to Sep. 1, 1991 by questionnaires with 60 primiparous mothers planing to breast feed after normal deliveries at W hospital in Pusan, Korea. The subjects were divided into a control group(conventional group) -those admitted from July 20 to Aug. 12, and an experimental group(agreement group) - those admitted from Aug. 13 to Sep. 1. The instument for agreement on the means to nursing goals in the early postpartum period included five steps - identification of disturbances of problems through action, reaction, and interaction with primiparous mothers : mutual early postpartal nursing goal setting : exploration of the means to achieve goals ; agreement on the means (self- care, ealry maternal -infant contact, performance of mothering behavior, and communicating about the infant's behavior and health condition) : implementation of the means. This instrument was developed on the basis of King's elements that lead to transactions in nurse-patient interactions. Lederman et al's (1981) scale for Confidence in ability to cope with tasks of motherhood and Lederman et al's(1981) scale for Mother's satisfaction with motherhood and infant care were used to measure self-confidence and satisfaction in maternal role performance ·with the subjects immediately after admission and on the day of discharge. Self-care performance in the experimental group was measured by self -evaluation tool developed by the investigator from the literature concerned. The tools to measure Pelf-confidence and satisfaction in maternal role performance, and the tool to measure self-evaluation of self-care performance were tested for internal reliability. Cronbach's Alphas were 0.94, 0.94, and 0.63. The data were analysed by using in S.P.S.S. computerized program and included percentage, x²-test, t-test, ANOVA, and Pearson Correlation Coefficient. The conclusions obtained from this study are summerized as follows : 1. The degree of self-confidence in maternal role performance of the total subjects group measured before the experimental treatment was above average with a mean score of 2.77(range 2.14-3.64). Out of 14 items, those with relatively high mean scores were ‘I would like to be a better mother than I am’(3.95), and ‘I have my doubts about whether I am a good mother’(2.87). Those with low mean scores were ‘I know that my baby wants most of the times’(2.28), ‘When the baby cries, I can tell what she /he wants’(2.37), and ‘I have confidence in my ability to care for the baby’(2;50). That is, the self - confidence of Primiparous mothers was considerably high in mothering, but rather low in activities concerning the infant care and understanding of the infant behavior. The degree of satisfaction in maternal role performance of the total subjects group measured before the experimental treatment was high with a mean score of 3.18(range 1.92-3.92). Out of 13 items, those with relatively high mean scores were ‘I am glad 1 had this baby now’(3.75), ‘I play with the baby between feedings when s/he is awake and quiet’(3.67), and ‘I enjoy being a mother’(3.27). Those with low mean scores were ‘I am upset about having too many responsibilities as a mother’(2.78), ‘It bothers me to get up for the baby at night’(2.82), and ‘I get annoyed if the baby frequently interrupts my activities’.(2.82), That is, the satisfaction of primiparous mothers was considerably high in mothering and infant care, but rather low in restraints in time or on the mother's self accomplishment and development. 2. Agreement on the means to achieve nursing goals in the early postpartum period included process of mutual goal setting, exploration of the means to achieve goals, and ahreement in concert means to achieve goals based on the mothers' condition, concerns, self-perception of the nurse - patient interactions. In the process of agreement, there was agreement that the means to achieve goals should be through trust and establishment of active relationships with the nurse through identification of problems according to planned nursing goals and active interaction, such as explanations, teaching, changing of opinions, acceptance or rejection of explanations, and proposing of questions. Therefore agreement on the means to achieve nursing goals in the early postpartum period appears to be an effective nursing intervention for primiparous mothers. 3. The degree of self- confidence in maternal role performance of the exprimental group was higher than that of the control group(t＝3.95, p＜0.01). Out of 14 items, those with higher score in the experimental group were ‘I would like to be a better mother than I am’(t＝1.93, p＜0.05), ‘I know that my baby wants most of the times’(t＝2.75, p＜0.01), ‘When the baby cries, 1 can tell what she/he wants’(t＝2.10, p＜0.05), ‘I have confidence in my ability to care for the baby’(t＝3.72, p＜0.01), ‘I trust my own judement in deciding how to care for the baby’(t＝1.96, p＜0.05), ‘I feel that I know my baby and what to do for him /her’(t＝2.44, p＜0.01), ‘I am concerned about being able to meet the baby's needs’(t＝2.87, p＜0.01), ‘I know what my baby likes and dislikes’(t＝3.26, p＜0.01), ‘I don't know to care for the baby as well as I should’(t＝2.07, p＜0.05), and ‘I am unsure about whether I give enough attention to the baby’(t＝3.04, p＜0.01), That is, the degree of self-confidence in mothering, activities concerning infant care, and understanding of infant behavior of the experimental group was higher than that of the control group. Therefore, the first hypothesis, that the degree of self-confidence in maternal role performance of the experimental group would be higher than that of the control group, was supported(t＝3.95, p＜0.01). 4. The degree of satisfaction in the maternal role performance of the exprimental group was higer than that or the control group(t＝2.31, p＜0.05). Out of 13 items, those with higher score in the experimental group were ‘I am glad I had this baby now’(t＝2.29, p＜0.05), ‘I enjoy taking care of the baby’(t＝2.4g, p＜0.01), ‘It is boring for me to care for the baby and do the same thing over and over’(t＝2.87, P＜0.01), ‘I am unhappy with the amount of time I have for activities other than childcare’(t＝2.51, p＜0.01), and ‘When bathing and diapering the baby, I would like to be doing something else’(t＝2.43, p＜0.01). That is, the degree of satisfaction in mothering, infant care, and restraints in time of on the mother's self accomplishment and development in the experimental group was higher than that of the control group. Therefore, the second hypothesis, that the degree of satisfaction in maternal role performance of the experimental group would be higher than that of the control group, was supported(t＝2.31, p＜0.05). 5. The third hypothesis, that the higher the degree of satisfaction in materenal role performance, the higher the degree of self-confidence in materenal role performance in the experimental group, was supported (r＝0.57, p＜0.01)

• 한국응급구조학회지
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• 제15권3호
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• pp.31-44
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• 2011

Purpose : The purpose of emergency medical services(EMS) is to save human lives and assure the completeness of the body in emergency situations. Those who have been qualified on medical practice to perform such treatment as there is the risk of human life and possibility of major physical and mental injuries that could result from the urgency of time and invasiveness inflicted upon the body. In the emergency medical activities, 119 emergency medical technicians mainly perform the task but they are not able to perform such task independently and they are mandatory to receive medical direction. The purpose of this study is to examine the recognition and request for medical direction by 119 emergency medical technicians in order to provide basic information on the development of medical direction program suitable to the characteristics of EMS as well as for the studies on EMS for the sake of efficient operation of pre-hospital EMS. Method : Questionnaire via e-mail was conducted during July 1-31, 2010 for 675 participants who are emergency medical technicians, nurses and other emergency crews in Gyeongbuk. The effective 171 responses were used for the final analysis. In regards to the emergency medical technicians' scope of responsibilities defined in Attached Form 14, Enforcement regulations of EMS, t-test analysis was conducted by using the means and standard deviation of the level of request for medical direction on the scope of responsibilities of Level 1 & Level 2 emergency medical technicians as the scale of medical direction request. The general characteristics, experience result, the reason for necessity, emergency medical technicians & medical director request level, medical direction method, the place of work of the medical director, feedback content and improvement plan request level were analyzed through frequency and percentage. The level of experience in medical direction and necessity were analyzed through ${\chi}^2$ test. Results : In regards to the medical direction experience per qualification, the experience was the highest with 53.3% for Level 1 emergency medical technicians and 80.3% responded that experience was helpful. As for the recognition on the necessity of medical direction, 71.3% responded as "necessary" and it turned out to be the highest of 76.9% in nurses. As for the reason for responding "necessary", the reason for reducing the risk and side-effects from EMS for patients was the largest(75.4%), and the reason of EMS delay due to the request of medical direction was the highest(71.4%) for the reason for responding "not necessary". In regards to the request level of the task scope of emergency medical technicians, injection of certain amount of solution during a state of shock was the highest($3.10{\pm}.96$) for Level 1 emergency rescuers, and the endotracheal intubation was the highest($3.12{\pm}1.03$) for nurses, and the sublingual administration of nitroglycerine(NTG) during chest pain was the highest($2.62{\pm}1.02$) for Level 2 emergency medical technicians, and regulation of heartbeat using AED was the highest($2.76{\pm}.99$) for other emergency crews. For the revitalization of medical direction, the improvement in the capability of EMS(78.9%) was requested from emergency crew, and the ability to evaluate the medical state of patient was the highest(80.1%) in the level of request for medical director. The prehospital and direct medical direction was the highest(60.8%) for medical direction method, and the emergency medical facility was the highest(52.0%) for the placement of medical director, and the evaluation of appropriateness of EMS was the highest(66.1%) for the feedback content, and the reinforcement of emergency crew(emergency medical technicians) personnel was the highest(69.0%) for the improvement plan. Conclusion : The medical direction is an important policy in the prehospital EMS activity because 119 emergency medical technicians agreed the necessity of medical direction and over 80% of those who experienced medical direction said it was helpful. In addition, the simulation training program using algorithm and case study through feedback are necessary in order to enhance the technical capability of ambulance teams on the item of professional EMS with high level of request in the task scope of emergency medical technicians, and recognition of medical direction is the essence of the EMS field. In regards to revitalizing medical direction, the improvement of the task performance capability of 119 emergency medical technicians and medical directors, reinforcement of emergency medical activity personnel, assurance of trust between emergency medical technicians and the emergency physician, and search for professional operation plan of medical direction center are needed to expand the direct medical direction method for possible treatment beforehand through the participation by medical director even at the step in which emergency situation report is received.