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.

8년간(1992~1999) 산업안전보건연구원에 의뢰된 직업병 심의 사례 분석

강성규,김규상,김양호,최정근,안연순,진영우,최병순,양정선,김은아,채창호,최용휴,김대성,박정선,정호근 대한산업의학회 2000 대한직업환경의학회지 Vol.12 No.2

Objectives : Pneumoconisis and noise-induced hearing loss (NIHL) have been reported as main occupational diseases by the Special Health Examination. The Industrial Accident Compensation Insurance has reported various work-related diseases, however, these two diseases occupied almost a half of compensated cases. Therefore, it was not well known about the status of occupational diseases other than pneumoconiosis, NIHL, and cardio-cerebrovascular accident (CVA). This study was conducted to analyze claimed cases as an occupational disease, that was requested to the Korea Industrial Safety and Health Agency (KOSHA). Methods : The local office of the Korea Labor Welfare Corporation (KLWC) has asked the KOSHA for confirmation of claimed cases as an occupational disease. We analyzed 379 cases requested from KLWC, the Ministry of Labor, employers, unions and occupational health agencies from 1992 to 1999. Results : Male was 80.7 % of the requested cases. Their mean age was 42 years old and 75.5 % of them were more than 35 years old. The requested cases were increased rapidly from 25 cases in 1992 to 108 cases in 1999 and the accept rate was 50.7 %. The majority of requested cases were respiratory diseases(22.4%), cancers(18.5%), Neuropsychiatric problems(14.5%), and musculoskeletal problems(13.5%). The accept rate was high in reproductive, respiratory, musculoskeletal and digestive disorders and low in neuropsychiatric, renal and otologic problems and occupational cancers. 73.6% of them were caused by chemical agents, especially 28.5 % were by organic solvents. 67% of them were clinically confirmed at university hospitals. A half of the cases were from KyongIn area, even the request came from the whole country. Conclusions : A claim was common in workers whose age was over 35 years old and exposure history was over 10 years. The respiratory diseases and neuropsychiatric disorders were still main problems in occupational health and occupational cancers was increasing even though its accept rate was not high yet.

Isoquinolinium Dichromate에 의한 Alcohol류의 산화반응 속도론과 메카니즘

최선도,박영조,이은주 三陟大學校 産業科學技術硏究所 2003 産業科學技術硏究論文集 Vol.8 No.2

Isoquinolinium dichromate[(C_(9)H_(7)NH)₂Cr₂O_(7)] was synthesized by the reaction of isoquinoline with chromium(VI) trioxide in water. isoquinolinium dichromate[(C_(9)H_(7)NH)₂Cr₂O_(7)] structure was verified by IR. EA and ICP. The oxidation of benzyl alcohol by isoquinolinium dichromate[(C_(9)H_(7)NH)₂Cr₂O_(7)] in carious solvents showed that the reactivity increased with the increase of the dielectric constant s order: cyclohexen < chloroform < acetone < acetonitrile. In the presence of acid, isoquinolinium dichromate [(C_(9)H_(7)NH)₂Cr₂O_(7)] oxidized the substituted benzyl alcohols in N,N-dimethylformamide. The Hammett reaction constant p was -0.69 at 303K. The observed experimental data was used to rationalize the hydride ion transfer in the rate-determining step.

여가 활동 참여와 정신건강 및 생활만족도와의 관계

최선,고은주 韓國舞踊敎育學會 2003 韓國舞踊敎育學會誌 Vol.14 No.1

Purpose of this paper was to identify relation of leisure activity with mental health and life satisfaction. Under this purpose, the subjects of the study are housewives who are engaged in some forms of dance activities at present. They were selected by random sampling method. The considerations in selecting the sample were the regions of residence and the kinds of dance they participated in. Out of the randomly sampled subjects in Daejeon and Cheongju, a total of 199 surveys were selected to be reliable materials. The population consists of 126 participants in Korean traditional dancing and 73 participants in the 'life dancing' (aerobic and jazz dancing). The tools used in the study are Stress Scale (Thomas Holms, 1985; Richard, 1989); Geriatric Depression Scale (1988, mainly used at neuropsychiatric clinics), and Life Satisfaction Inventory (Jin Yun, 1982). A survey was conducted by means of self-administration. For data analysis, ANOVA was carried out using the SPSS Ver. 10.0 for Windows. Schette' (.05) was used in the post-test. The result of this analysis is as follows: First, Relations of General Characteristics (age, education, income, health conditions, etc.) of the Women with Their Mental Health and Life Satisfaction - age, education and income don't seem to make a significant difference in their stress and life satisfaction, but they do make a difference in their depression (p<.01). On the other hand, their health conditions contribute to the significant difference in their stress (p<.05), depression (p<.001), and life satisfaction (p<.001). This result indicates that healthy housewives have less stress and depression and more life satisfaction. Second, Comparison of Mental Health and Life Satisfaction Levels in the Women Depending on Their Participation in Dancing Activities (kinds, frequency, time, and experience of the dancing activities) - there is a significant difference in their stress (p<.01) and life satisfaction (p<.05) depending only on the kinds of dancing activity. Specifically, when they participate in Korean traditional dancing, their stress and depression are lower and life satisfaction is higher. Other variables, such as frequency, time, or experience in dancing, don't seem to make a significant difference. This result is consistent with the previous studies suggesting that participation variables have significant effects only when they are comprehensive. Third, Comparison of Life Satisfaction Levels in the Women Depending on Their Mental Health Conditions (stress, depression) - the levels of their life satisfaction are significantly different depending on the degree of stress (p<.01) and depression (p<.001). In conclusion, among all their general characteristics (background variables), age, education, and income make a significant difference only in the degree of depression. Their health conditions significantly contribute to the differences in all the stress, depression and life satisfaction. Among the participation variables, 'kind of dance' seems to have an influence: When they participate in Korean dancing, their stress and depression are significantly alleviated. Especially, Korean traditional dance seems to be an more affective leisure to mental health and life satisfaction.

서울·경기지역 주민의 치과위생사에 대한 인식도와 선호도 조사연구

최은미,송윤신,이선희 경복대학 2004 京福論叢 Vol.8 No.-

본 연구는 치과위생사에 대한 인식도를 알아보기 위하여 서울·경기 지역주민 200명을 대상으로 2004년 5월 11일부터 25일까지 15일간 자기기입식 방법으로 설문조사하였으며 연구결과는 다음과 같다. 1. 치과위생사의 인식에 대한 조사결과 62%가 치과위생사에 대하여 알고 있는 것으로 나타났다. 2. 치과위생사가 수행하는 업무활동 범위에 대한 복수응답 결과 치과의사보조 업무가 53.3%로 가장 많았고, 스켈링 및 방사선촬영업무 41.5%, 예방업무 24.0%, 구강보건교육 업무 20.0%, 접수 및 수납에 대한 업무 17.0%, 치료에 대한 상담 업무 12.5% 순으로 나타났다. 3. 치과위생사의 근무기관에 대한 지식을 복수응답으로 조사한 결과 치과진료실이 51.5%로 가장 많았고, 보건소 43.5%, 학교구강보건실 35.5%, 치과관련기자재 생산회사 28.0%, 제약회사 14.0%, 연구소 13.5%, 치과기공소 10.5%순으로 나타났다. 4. 치과위생사의 교육 수준에 대한 인식 조사 결과 전문대학 3년 학력에 47.0%, 전문대학 2년 학력에 27.5%, 대학교 졸업 학력에는 15.5%, 고졸학력에 4.5% 순으로 나타났다. 5. 치과위생사의 복장에 대한 선호를 조사한 결과 유니폼은 치마투피스 40.5%로 가장 많았고, 유니폼의 색상은 흰색이 33.5%로 가장 선호되었다. 또한 신발은 샌들이 48.0%로 가장 많았으며, 머리스타일은 뒤로 묶은 머리 44.0%를 가장 선호하였다. 6. 치과위생사 전문 직업 이미지 선호 조사결과 밝은 표정 62.0%, 단정함 24.5%, 세련됨과 지적임은 각각 4.5%로 나타났다. 또한 치과위생사의 이미지 향상을 위한 주관성 중 내·외적 자질로서 중요시 되어야 할 항목은 친절성 34.5%, 성실성과 책임감 32.5%, 전문적 지식인 21.5%, 인격과 소양 8.0%로 나타났다. 7. 치과위생사의 이미지 향상에 영향을 미치는 요인을 살펴본 바 전문분야에 대한 업무를 실행하는 것이 30.3%로 가장 높게 나타났으며, 치과의사와 치과위생사 상호협조적인 관계형성 22.0%, 업무의 전문화 21.5%, 치과위생사 스스로의 태도변화 13.5%, 높은 교육수준 6.5%, 기타가 6.5%로 나타났다. 8. 치과위생사의 상징에는 명찰이 44.0%로 가장 많았고, 직종명칭에 있어서는 치과위생사가 53.3%로 가장 선호되었으며, 치과간호사 35.0%, 구강보건사 6.5%, 구강관리사 1.0% 순으로 나타났다. 치과위생사의 인식을 높이기 위한 홍보방법에서는 대중매체 35.5%, 인터넷 20,5%, 구강보건교육 19% 순으로 선호하는 것으로 나타났다. 이상의 결과를 정리해 보면 치과위생사의 인식을 높이고 이미지를 향상시키는 요인으로 전문분야 업무가 가장 높게 나타났으며, 치과위생사에 대한 홍보방법은 대중매체와 인터넷 등을 통해 다각적인 치과위생사 홍보가 필요하다고 사료된다. The purpose of this study is to analyze the recognition and preference of dental hygienist. The subject of this investigation are 200 inhabitants in Seoul and Kyunggi-do and the analysis was done through questionnaires by direct interview. The results were as follows : 1. 62% of the surveyees recognize dental hygienists. 2. According to the question of a dental hygienist's duty, 53.3% of the subjects answered the assistance of dentists, 41.5% picked out scaling and taking a radiograph, and 24% recognized preventive treatment as the duty. The lowest answer is consultation with a patient on treatment, 12.5%. 3. In case of the working places of a dental hygienist, 51.5% selected dental clinic, 43.5% chose a public health center, and oral health center in school is 35.5%. 4. In an academic background of dental hygienists, 47% of the surveyees responded a dental hygienist have schooling of 3 year-course in college, 27.5% picked out 2 year-course schooling in college, and 15.5% selected college graduate. 5. The uniform of dental hygienists shows a two-piece suit(skirt) is selected by 40.5%, 33.5% answered white as the color of the uniform. Sandal shoes had the highest rate, 48% and the subjects prefer to binding hair at back. 6. 62% of the subjects answered that a dental hygienist have to be a pleasant-face as extrinsic characteristics, kindness and responsibility was selected by 34.5% and 32.5% respectively. 7. In the factors of affecting a dental hygienist's image, the performance of specialized job showed the highest rate, 30.3%, a cooperative relation with dentists and the specialization of a job showed 22% and 21.5% respectively. 8. 44% recognized name card as a symbol of dental hygienists and a dental hygienist was selected as a proper title. Dental nurse and oral health aid showed 35% and 6.5%. In the publicity method of a dental hygienist, mass communications have 35.5%, internet have 20.5%, and the education of oral health have 19%

원자력발전소 증기발생기 수위 제어에 관한 연구

崔琁雄,姜泰垠,崔洪圭 홍익대학교 산업기술연구소 1996 産業技術 Vol.6 No.-

About a half of Electric power is generated by nuclear power plants in korea. So, a stable operation of nuclear power plant is very important for suppling the essential national eletric power. A S/G (Steam Generator) level control is the most difficult system in PWR(Pressurized Water Reactor) nuclear power plant. Because of the non-linear and the non-nominal response of S/G level control, it is very difficult to control the level by automatic mode or manual mode. The goal of this study is to establish and verify a advanced control alogorithm by analyzing, modeling, stability calculation, controller parameter calculation, simulation for S/G level control system. The response of a S/G level was analyzed and understood mathmatically by modeling. Some parameters of nuclear power plant were analyzed by modeling and used to simulate the S/G level control. The S/G level control system was tested and analyzed with the S/G level model, the result of the analyzing the control loop is unstable with the present control parameters. The Nyquist mapping method was used to analyze the stability of a control loop. The phase crossover frequency is calculated and applied to verify the stability of a control loop. By calculation of a control parameter which let the phase crossover point be allways in the stability region with the phase crossover frequency, the control loop applied the caulation control parameter is also stable. The S/G level control is more stable and faster by appling the feed-forward control with the calculated control parameter. The result of this study may be applied to analyze and approve the S/G level control system of the nuclear power plants.

간질 환자의 인구학적 특성, 임상 특성, 정신병리 및 대처방식과 심리사회적 적응과의 관계

은헌정,최관호,이선미,김태형,최말례 대한간질학회 2004 대한간질학회지 Vol.8 No.1

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

담즙정체성 간염의 임상적 양상

최선택,은종렬,임상우,김봉준,이헌주,구미진,최준혁 영남대학교 기초/임상의학연구소 2001 Yeungnam University Journal of Medicine Vol.18 No.1

Background: Cholestatic hepatitis is failure of bile to reach the duodenum with hepatocellular damage and no demonstrable obstruction of the major bile ducts. The prognosis is usually good with recovery in less than 4 weeks after withdrawal of the offending drug. However, a prolonged course lasting over 3 months is possible and, in rare cases, progression to ductopenia with development of a vanishing bile duct syndrome occurs. A differential diagnosis with other causes of Chronic liver disease is needed. Materials and Methods: From January 1991 through Jaunary 2000, 14 patients diagnosed as cholestatic hepatitis by liver biopsy were inclouded. The possible causative drug, clinical features, laboatory findings, and progression of cholestatic hepatitis were evaluated. The semiquantitative study of liver lesions was performed by two independent observers. Results: Causes of cholestatic hepatitis are 5 cases of oriental medicine, 3 cases of anti-tuberculosis medication, 1 case of ticlopidine and antibiotics and 4 cases of unknown causes. The clinical features of cholestatic hepatitis were jaundice, itching, urine color change, and general weakness. During 6 to 30 months, LFT of 5 patients showed prolonged elevation. Elevated total cholesterol ≥250 mg/dL in 6 patients, pheripheral blood eosinophilia in 5 patients, auto-antibody positive in 6 patients were observed respectively. The biopsies showed intralobular bilirubinostasis with a mixed portal inflammatory infiltration. Conclusion: In cholestatic hepatitis. durations of abnormal LFT are variable regardless of causative drugs. If cholestatic hepatitis progresses toward chronic course, viral hepatitis, primary biliary cirrhosis, and autoimmune hepatitis should be differentially diagnosed and sequential liver biopsies are needed.

한국판 사건충격척도 수정판의 신뢰도 및 타당도 연구

은헌정,권태완,이선미,김태형,최말례,조수진 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.3

Objectives : The present study was conducted to explore the reliability and validity of the "Impact of Event Scale-RevisedKorean version" (IES-R-K). Methods : The subjects were college students who visited a college counseling center and patients who were admitted to a general hospital and two orthopedic local clinics.Those subjects who experienced catastrophic traumatic events were tested for CAPS, BDI, STAI-I, II, and MMPI-PTSD scale. Results : The range of correlations between item-total were .45 -.89. The coefficients of internal consistency were .69 -.83, of them were the Split-half reliability was .71 and the test-retest reliability was .89, all within expected ranges. Inter-corre-lations of IES-R-K, CAPS, BDI, STAI-I, II, and MMPI-PTSD scale were high. CAPS showed the highest correlation Coef-ficient. Factor analysis indicated 4 factors in IES-R ; avoidance, hyperarousal, intrusion, and sleep problem & numbness. IES-R-K can be a useful self-rating diagnostic instrument for PTSD symptoms to be a clinical concern by using 24/25 cutoff in total score. The partial PTSD cutoff score is 17/18. Conclusion : The IES-R-K was confirmed in it's reliability and validity. IES-R-K could be applied for screening of PTSD.