퇴원손상심층조사 자료를 이용한 최근 5년간의 충청북도 거주민의 퇴원 분석

김혜숙(Hae-Sook Kim) 한국엔터테인먼트산업학회 2021 한국엔터테인먼트산업학회논문지 Vol.15 No.8

본 연구는 질병관리청이 퇴원한 환자를 대상으로 조사 보고한 퇴원손상심층조사 결과 중 충북지역에 거주하는 퇴원환자의 특성을 파악하여 충청북도 지역 주민의 건강증진계획수립을 위한 기초자료로 제시하고자 시도되었으며 2013년부터 2017년까지 100병상 이상의 병원에서 퇴원한 환자를 대상으로 인구 · 사회학적 특성, 의료기관이용 특성, 의료이용 특성, 질병 특성을 파악하였다. 2013년부터 2017년까지 입원 후 퇴원한 환자 중 보정 값을 적용하여 산출한 총 환자는 1,656,590명으로 추정되었으며 퇴원율(인구10만은 21,089명이었고 2016년 전국 평균 퇴원율 13,882명보다 높았다. 이 기간 동안 퇴원율이 증가한 지역은 괴산, 영동, 보은, 옥천, 증평, 음성군으로 주로 농촌지역이었으며, 서울을 포함한 타 지역 병원에서 퇴원한 환자는 서울 지역은 감소하였으나 인천, 경기, 대전, 충남지역은 증가하였다. 충북지역 주민의 악성종양으로 인한 퇴원율은 폐암(기관, 기관지암 포함)이 가장 높았으며, 주 진단별 퇴원율은 호흡기계통 질환이 가장 많았고, 퇴원율이 증가하고 있는 감염, 순환기계통, 소화기계통, 비뇨생식계통, 근골격계통질환의 퇴원율을 낮추기 위한 노력이 필요함을 알 수 있었다. This study was performed to generate basic data to establish a health promotion plan for residents of Chungcheongbuk-do by identifying characteristics of discharged patients residing in the Chungcheongbuk-do area from an In-Depth Post-Discharge Injury Survey reported by the Korea Centers for Disease Control and Prevention(KCDCP). The Report provided data on demographic characteristics, medical institution use characteristics, medical use characteristics, and disease characteristics of patients discharged from medical institutions with 100 or more beds from 2013 to 2017. The total number of Chungcheongbuk-do residents who were admitted and discharged from 2013 to 2017 was estimated to be 1,656,590, and the discharge rate was 21,089, which was higher than the national average of 13,882 in 2016. The regions where the discharge rate increased during this period include Goesan, Yeongdong, Boeun, Okcheon, Jeungpyeong, and Eumseong-gun, which are mainly rural areas. Among the patients hospitalized and discharged from hospitals outside the Chungcheongbuk-do area, the discharge rate of patients who used hospitals in Incheon/Gyeonggi areas and Daejeon/Chungnam areas increased slightly. Among the malignant tumor patients, the number of lung cancer(included trachea & bronchial cancer) patients was the highest. In addition, the discharge rate was highest for patients with respiratory diseases. This study suggests that efforts need to be made to lower the discharge rate for infection, circulatory disease, genitourinary disease, and musculoskeletal disorder patients.

觀光 心理現象에 關한 硏究

金惠淑(Kim Hae Sook) 한국관광레저학회 1991 관광레저연구 Vol.- No.3

어린이집 다문화교육 프로그램 개발을 위한 요구 분석 -경상북도를 중심으로-

김혜숙 ( Hae Sook Kim ),김판희 ( Pan Hee Kim ) 한국아동교육학회 2008 아동교육 Vol.17 No.4

몸으로 드리는 예배를 위한 교수-학습과정

김혜숙(Hae-Sook Kim) 한국기독교교육정보학회 2010 기독교교육정보 Vol.25 No.-

This study reflects on Worship Dance from a historical viewpoint as well as the aspect of systematic theology. It suggests the actual process of embodied worship so that it can be put into practice in churches. In other words, it is to create the teachinglearning methods for embodied worship and to search for the specific process of embodied worship. As shown in the worship of the Israelites in the Old Testament as well as in Christian worship, dancing in worship, though it varied over time, has been a channel to express their gratitude, joy, and praise to God. They made their worship to God holistic by using their bodies, minds, and souls altogether, without the alienation of their bodies. It represented collective and historic experiences of a community rather than the showing of individualities. In short, dancing was a way of worship by Christian communities as well as the Israelites through which they confessed their faith in God, stated their history, and expressed their lives. The teaching­learning process of embodied worship is achieved through informal educational methods as well as creative and esthetic educational methods. When Christian education is conducted through these methods, a learner's body becomes activated, the soul and the body of the learner kept in harmony and thereby their faith and spirituality reaching a full maturity. Currently, we live in a period that calls us to keep our mind, feelings, spirituality, and bodies balanced in every aspect of religion, education and daily lives as well. Christians are especially demanded to carry out our holy mission, which means to fulfill it through the movement of our bodies creatively and with holistic traits endowed upon us by God. Prayers and praise through embodied worship can be our response to the demands of this era.

Development and Effect of Resilience Promotion Program on Cancer Patient

김혜숙(Hae Sook Kim),이연복(YeonBok Lee) 한국자료분석학회 2018 Journal of the Korean Data Analysis Society Vol.20 No.1

The objective of this study is to develop a comprehensive resilience program and measure the effects of the program. The components of program were identified in the areas of knowledge of cancer treatment, attitude for resilience, and skills for resilience improvement. After developed, the program was applied to 22 cancer patients at the regional cancer center. To evaluate the program effects, pre- and post- program social support, resilience, and quality of life were carefully examined. The results were the level of social support (t=2.97, p=.0073) and resilience (t=2.32, p=.031) were increased in the post-program compared to pre-program, and there is statistically significant difference. The physical function (t=2.89, p=.009), among the quality of life, was increased, and nausea and vomiting were decreased (t=-2.22 p=.038). In conclusion, this program was applied to cancer patients in community and it was found that social support and coping ability were significantly improved. However, it was confirmed that the quality of life was significantly improved only in physical function, nausea and vomiting symptoms.

소도 (昭道) 김수영박사 (金水暎博士) 화갑기념호 : 제3부 도시 및 지방행정 ; 한국 관광정책에 관한 연구 - 진행정책을 중심으로 -

김혜숙(Hae Sook Kim) 단국대학교 정책과학연구소 1991 정책과학연구 Vol.3 No.-

관광 산업 인지도에 관한 연구

金惠淑(Kim Hae Sook) 한국여행학회 2005 여행학연구 Vol.22 No.-

Incheon is geographically situated as a gateway to China, Russia and Japen. Historically Incheon has been the gateway city to Seoul, the capital city of Korea due to its location as a port. Recent opening of the Incheon International Airport confirms more evidently that it will become the center of international traffics and exchanges. not only by traditional way but by new means. In this regard, Incheon will have a lot of potential role as a hub airport connecting all over the world in the near future, and help accelerating the globalization. Thus this study will analyze the acknowledgement of tourism industry of college students whose major is tourism. Also it compares the different thoughts of tourism industry between the tourism majored students and the non majored students. This study also shows what tour places are the best tourists resources in students thought and ideas in Incheon area and the major problems to be shown through students mind in order to make Incheon for an attractive tourist city in future.

병원간호사의 직무스트레스와 직무만족, 이직의도와의 관계에서 자기효능감의 조절효과

민순(Min, Soon),김혜숙(Kim, Hye-Sook),하윤주(Ha, Yun Ju),김은아(Kim, Eun A),김희영(Kim, Hee Young),김혜정(Kim, Hae Jeong),김영자(Kim, Young Ja) 대한경영학회 2011 大韓經營學會誌 Vol.24 No.1

Waldenstrom`s Macroglobulinemia 에 의해 유발된 사구체 신염 1 예

박창근(Chang Keun Park),신태원(Tae Won Sin),권대식(Dae Sik Kwon),김지섭(Ji Sub Kim),정재성(Jae Sung Chung),공진민(Jin Min Kong),김호균(Ho Gun Kim),김병창(Byung Chang Kim),김혜숙(Hae Sook Kim),김용진(Yong Jin Kim) 대한신장학회 2001 Kidney Research and Clinical Practice Vol.20 No.5

Waldenstrom's macroglobulinemia(WM) is a disorder of malignant proliferation of plasmacyoid lymphocytes and monoclonal immunoglobulin M. The renal complications of WM are less common and severe than that of multiple myeloma. We present a case of WM which involved the kidney as massive proteinuria, hematuria and renal failure. A biopy specimen of the kidney reveals the intraglomerular hyaline thrombi of immunoglobulin M paraprotein. Three cycles of plasmapheresis and systemic chemotherapy with chlorambucil and prednisolone show improvement in his renal manifestations. We suppose the glomerulonephritis caused by hyaline thrombi in WM may be reversible, at least in its early stage.

중등도 신생아 호흡 곤란 증후군에서 폐 표면 활성제 조기 투여 후 Nasal CPAP의 치료 효과

김은지,김혜숙,허만회,이상길,Kim, Eun Ji,Kim, Hae Sook,Hur, Man Hoe,Lee, Sang Geel 대한소아청소년과학회 2002 Clinical and Experimental Pediatrics (CEP) Vol.45 No.10

목 적 : 신생아 호흡 곤란 증후군에서 폐 표면 활성제의 조기 투여와 연성 환기, 고빈도 환기요법과 공격적 인공호흡기 이탈은 신생아 호흡 곤란 증후군 치료의 기본이다. 하지만, 침습적인 기도삽관에 의한 인공호흡기 치료보다 비침습적인 폐 표면 활성제의 조기투여와 nasal CPAP 병용치료의 적용 가능성을 확인하고자 본 연구를 시행하였다. 방 법 : 1999년 1월부터 2001년 8월까지 본원 출생아로서 중등도 신생아 호흡 곤란 증후군으로 진단된 환아 중 생후 2시간 이내 폐 표면 활성제의 조기 투여 후 nasal CPAP의 호기 말 양압을 5-6 cm $H_2O$로 설정하여 임상경과를 관찰한 14례를 연구군으로 하고, 인공호흡기 치료 후 5일 이내 조기이탈이 가능했던 15례를 대상으로 병력, 흉부 방사선 소견, SMR, 임상경과, 산소화 지수를 병력지를 이용하여 후향적으로 분석 하였다. 결 과 : 1) 대상아의 특징 : 평균 재태 연령은 연구군이 $32.3{\pm}1.7$주이고, 대조군은 31.3${\pm}1.5$주이었고, 평균 출생체중은 연구군이 $1,730{\pm}290gm$, 대조군이 $1,620{\pm}350gm$이었으며, 남녀 성비는 연구군이 10 : 4, 대조군이 6 : 9로 양군간에 유의한 차이가 없었다. 2) 양군에서 출생시 RDS의 정도 및 검사 소견의 비교 : 연구군에서 SMR은 $9.8{\pm}6.5$개, 대조군에서 $10.7{\pm}3.1$개, 흉부방사선 소견상 Bomsel grade 2 이상이 연구군에서 12례, 대조군에서 15례, 임상증상은 빈호흡이 연구군에서 11례, 대조군에서 9례, 흉부함몰은 연구군에서 10례, 대조군에서 8례, 신음호흡은 연구군에서 10례, 대조군에서 7례였고, 1분과 5분 Apgar 점수는 연구군이 각각 $6.9{\pm}1.3$, $8.4{\pm}0.8$, 대조군이 각각 $6.5{\pm}1.2$, $8.1{\pm}0.5$, 동맥혈 가스 분석상 pH, $PaCO_2$는 연구군이 각각 $7.3{\pm}0.1$, $51.3{\pm}14.1mmHg$, 대조군이 각각 $7.3{\pm}0.1$, $45.6{\pm}14.6mmHg$으로 신생아 호흡 곤란 증후군의 중등도 비교에서 양군은 유의한 차이가 없었다. 3) 양군에서 치료과정 중 동맥혈 가스 분석 및 호흡지표의 변화(생후 6-12시간 사이의 경과) : 호흡기치료과정 중 동맥혈 가스 분석 검사상 pH 및 $PaCO_2$의 평균치는 연구군에서 각각 $7.39{\pm}0.1$, $39.1{\pm}7.9$, 대조군에서 각각 $7.38{\pm}0.1$, $35.4{\pm}8.5$, 산소화 지수의 평균치는 연구군에서 $9.1{\pm}1.3$, 대조군에서 $8.34{\pm}1.7$로 양군에서 유의한 차이가 없었다. 4) 연구군에서 임상적 경과 및 CPAP 치료에 대한 반응도 : 연구군에서 임상적 경과가 악화되어 인공호흡기 치료가 필요했던 경우는 14례 중 2례(14.3%)이었고, 12례(85.7%)에서는 성공적으로 치료되어 인공호흡기 치료가 필요없었다. 실패한 2례 중 1례는 임상경과 중 호흡지표의 악화로 인공호흡기 치료로 전환된 경우이고 나머지 1례는 장치 후 6시간 이내에 제반증상의 악화로 보존적 인공호흡기 치료로 전환된 경우이다. 성공적으로 치료된 경우 지속적 양압 환기기간은 평균 5일이었고 평균 호기말 양압은 $5.4{\pm}0.5cm$ $H_2O$이었다. 5) 양군에서 합병증의 비교 : 동맥관 개존증은 대조군에서 2례(14.3%)있었고, 병기(stage) 3 이상의 미숙아 망막증은 연구군에서 1례, 대조군에서 3례 있었으며, 뇌실내 출혈은 연구군에서 3례, 대조군에서 2례 있었고, 뇌실주위백질연화증은 연구군에서 1례, 대조군에서 3례 있었으며, 공기 누출 Purpose : Early surfactant therapy with either gentle ventilation, high-frequency ventilation or aggressive weaning of mechanical ventilation are principles for the treatment of respiratory distress syndrome(RDS). We studied to determine the accessibility of noninvasive nasal continuous positive airway pressure(CPAP) rather than mechanical ventilation by invasive intubation after early surfactant therapy. Methods : The study group consisted of 14 infants who were born and diagnosed with moderate respiratory distress syndrome and received early surfactant therapy with nasal CPAP of PEEP 5-6 cm $H_2O$ within two hours after birth in the Fatima neonatal intensive care unit for two years from January 1999 to August 2001. The control group consisted of 15 infants who were diagnosed with the disease and could be weaned from mechanical ventilator within five days after birth during the same period. Results : The characteristics, the severity of clinical symptoms and laboratory findings in the two groups at birth showed no significant difference. Neither did the interim analysis of laboratory data in two groups. Of 14 infants in the study group who received nasal CPAP after early surfactant therapy, only two infants showed weaning failure with this therapy. In the response cases, duration of CPAP was five days and mean airway pressure was $5.4{\pm}0.5cm$ $H_2O$. Two had the complication of CPAP with abdominal distension. Final complications and outcomes in the two groups showed no signifcant difference(P>0.05). Conclusion : The clinical courses in the two groups showed no significant difference. Therefore, we suggest that early surfactant therapy with noninvasive nasal CPAP is a simple and safe method rather than aggressive weaning after invasive mechanical ventilation in moderate respiratory distress syndrome.