억제대 적용지침 개발을 통한 불필요한 억제대 적용율 감소활동

곽경선,김성은,배은경,이은숙,이은혜,최윤정,이윤경 한국의료QA학회 2009 한국의료질향상학회지 Vol.15 No.2

문제: 억제대 적용에 대한구체적 적용지침 없이 의례적으로 억제대를사용함으로 인해 환자들의 신체적 또는 정신적 안전을 위협할 수 있다. 목적: 완전 진정상태 이거나 근력이 약하여 발관능력이 없는 환자에 대한 예방적 적용, 바빠서 환자를볼수 없 는경우, 간호사본인의 판단이 없이 타인의 요구에 따르는등의 불필요한 억제대 적용이 증가하는 원인을 파악하여 중환자실의 특수성에 맞는 억제대 적용및 제거 지침을 마련하고자 한다. 의료기관: 인천광역시에 소재한 의과대학 소속병원의 집중치료실 개선효과: 억제대 적용에 대한중환자실 간호사에게 미치는 영향을 보면 태도 정도 p=0.09(p<0.1), 올바른 수행 능력은 p= 0.005 (p <0.0히로통계적으로유의한것으로 나타났다. 지식 정도 p=0.172(p<0.05) 통계적으로 유의 하지는 않지만 모든항목이 개선 활동전 에 비해 2,3차 개선 활동후에 향상한 것으로 나타났다. 개선활동전에 8.1%였던 간호 기록, 0.7%였던 간호중재, 0%였던 의사처방율이 3차 개선 활동 후 3가지 모두 100% 달성되었다. 이는 억제대 적용율 갑소 및 부적절한 억제대 적용율은 유의하게 감소하였다. 교훈: 중환자실 간호사의 억제대 적용에 대한태도, 지식, 올바른 간호 수행 능력은 지속적으로 재평가 되어지고, 교육내용은좀더 나은 간호제공을 위하여 개발 되어져야 할 것이다. 억제대 적용 기준과 제거 기준을 Check List 하여 객관성의 유지를 위한 개선 활동은계속적으로 Feedback 되어야 할 것이다.

정맥내 주사로 인한 정맥염 발생의 다기관 공동 역학 조사 : 서울, 경기도 6개 종합병원을 대상으로:Focused on 6 hospitals in Seoul or Gyonggi-do, Korea

최정실,박은숙,진혜영,정선영,박미라,김정은,김금순 대한병원감염관리학회 2003 의료관련감염관리 Vol.8 No.2

중국 운남성 소수민족무용

최미연,천은혜,김주연 세계민족무용연구소 2002 민족무용 Vol.- No.2

디지털 기술의 건강보험 보장방법에 대한 고찰: 5개 국가 중심

엄혜은,김지혜,한승진,최연미,최윤정 건강보험심사평가원 2022 HIRA RESEARCH Vol.2 No.1

자기공명영상에서 발견된 두개내 해면상 혈관기형의 특징 : 위치와 출혈유무와의 상관관계 Correlation between Hemorrhage and Location

최혜영,정은철 梨花女子大學校 醫科大學 醫科學硏究所 1996 EMJ (Ewha medical journal) Vol.19 No.1

The cavernous malformation is increasingly recognized as a vascular malformation of the brain that presents with seizures, hemohhage, or neurologic deficit. We have identified 24 lesions in 12 patients that were diagnosed cavernous malformation of the brain based on the findings of follow-up magnetic resonance image and sugical biopsy. The location of the lesions were the supratentorial area in 20 and infratentorial area in 4. Ten lesions were seen at the periventricular white matter. Combined venous angioma was noted in 4 patients. The app-earance of the lesions classified by signal intensities on MRI was divided into reticular pattern in 11, punctate pattern in 9, hematoma pattern in 3, and cystic pattern in one. Recent hemorrhage was identified at 9 lesions that classified into extralesional type in 5 and intralesion type in 4. Among 9 hemorrhagic lesions, eight lesions were located at the periventricular white matter and six lesions showed reticular patterns. We concludedthat the correlation between the evidence of recent hemorrhage and location and pattern of the lesions should be evaluated to predict possibility of rebleeding of the cavernous malformation.

항만하역 근로자들의 직업적 특성과 사회심리적 스트레스에 관한 연구

최은경,이종태,손혜숙,이성훈 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.5

Objective : The objective of this study is to evaluate the job characteristics of container terminal workers by applying the Job Strain model, and to assess the relationship among the general characteristics, job characteristics and psychosocial distress. Methods and Material : A self-administrated questionnaire survey was performed in Busan. The subjects were consisted of 100 white-collar workers and 100 blue-collar workers. We used Karaseks Job Content Questionnaire for evaluation of the job characteristics and Psychosocial well-being index (PWI) for measuring the extent of their psychosocial stress. Results : In white-collar workers, the skill discretion, created skill, decision-making authority, decision-making latitude, psychological job demand, and supervisor support of the job characteristics were significantly high, while in blue-collar workers physicalexertion was significantly high. PWl reveals that blue-collar workers were mere stressed than white-collar workers, especially, the factor 2, 3 and 4 were significantly increased; whereas, in white-collar workers, only the index of factor 1 was significantly increased. And PWl scores were significantly increased in the lower social support and psychological job demand. blue-collar workers had increased odds ratio of 2.66(95% CI:1.11-6.41) compared with white-collar workers. The unmarried workers increased odds ratio of 3.54(95% CI;1.18-10.62) compared with married workers. And workers who have not own house increased odds ratio of 2.35(95% CI;1.15-4.79) compared with workers who have own house. Particularly, odds ratio of work-shift in blue-collar workers was 11.10(2.14-57.64). (multiple logistic regression analysis PWI). Conclusion : The results of this study correspond with the fact that The more job demand is high and Job control is low, the more job stress is high. Job stress of blue-collar workers was comparatively higher than that of white-collar workers, sleeping, smoking, and work shifting turned out to be a main cause that increases stress. Therefore, in order to decrease the job stress, a health promotion program to change the health behaviors should be activated and an organized job stress management program should be introduced. Especially, working condition for blue-collar such as physical exertion and work-shift should be improved.

척수내 종양의 자기공명영상소견

최혜영,정은철 梨花女子大學校 醫科大學 醫科學硏究所 1996 EMJ (Ewha medical journal) Vol.19 No.3

Purpose : The purpose of this study was to analyze the MR findings of intramedullary tumors and review the literatures for evaluating of characteristic findings of each intramedullary tumors. Materials & Methods : We experienced eight intramedullary tumors from March 1993 to February 1995, including four astrocytomas two ependymoma, one hemangioblastoma, and one cavernoma. MR images were get by 1.5T GE Signa and analized retrospectively. Results : Intramedullary tumor was demonstrated by MR images in eight patients. They were five men and three women ranging in age from 3 to 56 years and complained both motor and sensory changes and symptom duration was between 6 months and 3 years. Ependymoma showed diffuse homogenous enhancing mass at the level of thoracic cord(T2-3) and thoracolumbar level(T11-L2) without cystic change, One had hemorrhage within the mass and massive leptomeningeal metastasis at all spinal cord and brain. Among astrocystomas, one case at the cervical cord unusually revealed hemorrhage in the mass and regional large syrinx. The other one occured at the conus medullaris portion and showed well-defined mass and intratumoral cystic change. We also experienced rare intramedullary hemangioblastoma, which demonstrated typical signal voided vascular structures revealed homogenous enhancing mass. A very rare intramedullary cavernoma at the level of cervical cord showed typical dark signal hemosiderin rim and variable staged hemorrhage in the mass. Conclusion : Although, MR imaging appearance of intramedullary tumors is nonspecific, and it is often impossible to differentiate with certainty between the various possible tumors, especially ependymomas and astrucystomas. However, MR findings of hemangioblastoma and cavernoma are specific and possible to diagnose. MR imaging is the unquestioned technique of choice in demonstrating and differentiating the intramedullary tumors.

서울시내 일부 고등학교 학생들에서 학업성취도가 우울 증상에 미치는 영향

박혜숙,최경희,이보은 韓國學校保健學會 2001 韓國學校保健學會誌 Vol.14 No.2

Depression is one of the most common psychologic disorder and dealt as a major public health concern. School students have heavy school work loads and stress from various evaluations representing school performance. In this study, to examine the effect of school performance and stress on depressive symptoms, we assessed the frequency of risk factors for depressive symptoms among 2,717 high school students. From April 2001 to May 2001, using a self-reported questionnaire, we collected data on the frequency of occurrence of depressive symptoms and potential risk factors for depressive symptoms. Depressive symptoms were measured using Center Epidemiologlc Studies Depression (DES-D) index. Thirty-seven percent of high school students reported having high depressive symptoms for a week Female students had a higher prevalence of depressive symptoms than males (OR=1.44, 95% CI 1.22-1.70). In a multiple logistic regression model, we found that good perceived school performance (OR=0.43, 95% CI 0.31-0.60) had a negative association with depressive symptoms. On the contrary, we also found that stress from school performance (OR=2.03, 95% CI 1.69-2.44) associated with high depressive symptoms. In conclusion, high school students had a relatively high prevalence of depressive symptoms. Students with stress from school performance had the higher risk far depressive symptoms. Key words : Depression, risk factors, prevalence, performance, youths

역류식 충진탑에서 수력학적인 분석과 이산화탄소의 탈착에 관한 연구

楊善惠,崔東勳,지혜미,金恩貞,金彰昊 동아대학교 환경문제연구소 1996 硏究報告 Vol.19 No.1

This study was carried out to interpret hydraulic behavior and CO₂gas desorption in countercurrent packing tower which packed 50 mm plastic Hiflow-ring. The results are as follows: 1. To compare with conventional packing, 50mm Hiflow-ring could save energy because of low pressure drop under high load. 2. As relative error between calculated value and investigated value was less than 6% in the loading point and flooding point we found that we can predict results mathematically which occurres in the packing tower. 3. The unique magnituteds of packing which was used are as follows. C_(L) = 2.1×10^(-4), n = 0.787 so we can predict efficency which occurres.

중환자실 병원감염에 대한 다기관 공동 조사연구

박은숙,박미라,진혜영,김정은,최정실,송영구,최영화,이위교,홍성관,허애정,양동규,김준명 대한병원감염관리학회 2003 의료관련감염관리 Vol.8 No.1