지역사회 거주 심장질환 환자들을 위한 모바일 건강중재: 통합적 문헌고찰

고지운,강현욱 한국중환자간호학회 2020 중환자간호학회지 Vol.13 No.1

Purpose : The purpose of this study was to review mobile health (mHealth) interventions based on studies from online databases for community-dwelling patients with heart diseases. Methods : Six databases (RISS, KISS, PubMed, CINAHL, EMBASE, and SCOPUS) were searched to select studies conducted from January 1 to September 30, 2010. After this, quality appraisals were carried out using the Scottish Intercollegiate Guidelines Network checklist and a total of 11 studies were selected. Results : The selected 11 studies included 7 randomized controlled studies, 1 quasi-experimental study and 3 pilot studies. The main components of mHealth interventions included symptom monitoring at home, provisions for individualized messages for health management using text messaging, telephone or smart phone applications, and running websites for symptom monitoring or health education. Intervention periods varied from 6 weeks to 12 months. The findings of the studies suggested that the mHealth interventions were effective in improving self-management of heart diseases, quality of life, and decreasing symptoms. Conclusions : The results of the review suggested that mHealth interventions had positive effects on community-dwelling patients with heart diseases. More mHealth intervention studies need to be conducted in Korea to aid community-dwelling patients with heart diseases.

지역사회 노인들의 사전의료의향서 작성의향과 불안과의 상관관계

고지운 한국농촌간호학회 2013 한국농촌간호학회지 Vol.8 No.2

의학지식과 생명연장 의료기술의 발달은 죽음의 본질 의 변화를 가져왔다. 더 이상 '순간'이 아닌, 죽음은 연속 적인 과정이 되었으며 이 과정은 무기한으로 늘어났다“ (Schwarz, 1992, p. 92). 사전의료의향서(Advanced Directives: AD)에 대한 관 심은 온정주의에 치우친 임종기 치료의 지속과 결정 능 력을 상실한 환자를 원하지 않는 무의미한 삶의 연장을 위한 치료로 부터 보호하기 위한 방법에 대한 모색에서 시작되었다(Chan, 2004). AD는 대상자 스스로가 본인의 임종기 에 이루어지는 의료행위의 지속여부 혹은 방향에 대하여 의사결정 능력이 있을 때 원하는 바를 결정하여 문서화한 것으로 생전유언 혹은 대리인 지정을 통하여 이루어진다(김신미, 홍영선, 김현숙, 2010; 박재원, 송준아, 2013). 우리사회에서 AD에 대한 관심은 1997년 보라매 병원 사건을 계기로 치료적 결정권에 대한 관심의 증가 와 함께 2000년대에 본격적으로 시작되었으며 2009년 세 브란스병원의 김할머니 사건에 대하여 대법원이 자기결 정권의 행사를 인정함으로써 AD에 대한 집중적인 논의 가 이루어지기 시작하였다(김신미, 홍영선, 김현숙, 2010; 홍선우, 김신미, 2013). AD 작성에 대하여 사전의료의향 서 쓰기운동을 진행하거나 병원별 문서작성 또는 AD관 련 법안이 상정되기는 하였으나(박재원와 송준아, 2013; 허대석, 2009) 아직 우리나라 실정에 맞는 표준서식이나 관련 제도는 미흡하다(김신미, 홍선우, 은영, 고수진, 2012).

흡수기의 실험변수에 따른 열전달 특성 분석

고지운,배경진,권오경 대한기계학회 2024 大韓機械學會論文集B Vol.48 No.2

본 연구에서는 흡수식 냉동기용 흡수기 전열관의 열전달 특성을 알아보기 위한 실험을 수행하였다. 실험은 흡수기에 주로 사용되는 전열관 3종(bare, floral, end-cross floral)을 대상으로 실제 흡수식 냉동기 운전조건 범위를 고려한 실험조건에서 진행되었다. 1차적으로 주요인자 분석을 통해 실험조건 및전열관의 형상이 반응값(, , )에 미치는 영향을 알아보았으며, 주요 실험조건 인자는 , 으로 나타났다. 및 가 증가함에 따라 반응값은 일제히 상승하는 경향을 보였다. 실험결과에서 성능이 가장 우수한 전열관은 end-cross floral로 나타났으며, 총괄 열전달계수의 경우 액막 레이놀즈수가 30일 때, bare에 비해 32.49% 성능이 향상 되었다. 흡수기에 사용된 전열관 3종에 대하여 각각 관외측 누셀트수 상관식을 제안 하였으며 오차범위 ± 25% 내에서 대부분 일치하였다. In this study, experiment was conducted to investigate the heat transfer characteristics of the absorber for the absorption chiller. The experiment was conducted under experimental conditions including the operating range of the actual absorption chiller, targeting three types of heat transfer tubes (bare, floral, end-cross floral) mainly used in absorbers. In the first analysis, the experimental conditions affecting the response value(, and ) were analyzed, and and for as the main experimental conditions. According to the experimental results, end-cross floral was the best performing heat transfer tube, and when the was 30, the performance was improved by 39.29% compared with the bare tube. Finally, we proposed the experimental correlations of Nusselt numbers for the three types of heat transfer tubes that yielded a ± 25% error band.

욕창예방을 위한 체위변경 중재 효과의 비교순위: 네트워크 메타분석

고지운 대한근관절건강학회 2022 근관절건강학회지 Vol.29 No.1

Purpose: A network meta-analysis was conducted to assess the comparative effects and ranks of repositioning forpressure ulcer prevention in adults. Methods: A network meta-analysis was performed in a frequency method, using the"netmeta" package of R software version 4.1. The effects of repositioning intervention were confirmed by the odds ratio. The comparative ranking of the repositioning effects was confirmed using the cumulative probability (P-score). Results:Seven intervention studies were included in this study. Based on the P-score, the use of the repositioning system wasranked as the most effective among all interventions (P-score 78.7%). Next was 3~4-hour repositioning combined withmemory foam mattress use (P-score 77.2%), use of wearable sensor (P-Score 61.4%), 2-hour repositioning combinedwith memory foam mattress use (P-score 59.1%), 2-hour repositioning combined with powered air pressure redistributionmattress use (P-score 18.0%), and 4-hour repositioning combined with powered air pressure redistribution mattress use(P-score 18.0%). Conclusion: This study provides information on the relative comparative value of various repositioninginterventions to prevent pressure ulcers using network meta-analysis. This is expected to be useful for nurses'decision-making when applying repositioning interventions in clinical practice

Development and Effect of a Geriatric Nursing Convergence Education Program for Nursing Students

고지운,양윤경,정미영,차선경 한국융합학회 2020 한국융합학회논문지 Vol.11 No.5

This study was conducted to understand the effects on the attitude toward the elderly, willingness to geriatric nursing practice, and global competencies by developing a geriatric-nursing convergence education program. This program that combines the theory of elderly care and practical education and applies it to nursing students. This is a nonequivalent control group pretest–posttest design. The study participants consisted of 19 in a control group and 17 in an experimental group. They were the second-year of the nursing students in A city, Chungcheongnam-do. This program, including character building, elderly care competence, global competence, and community contribution, was held for 80 hours from August 28, 2017 to December 8, 2017. The experimental group compared to the control group, attitude toward the elderly (Z =-.46, p =.66), willingness to geriatric nursing practice (Z =-.64, p =.53), global competence (Z =-1.08, p =.29) showed no statistically significant difference. As a result of this study, it is suggested to develop and implement a convergence education program that nursing students can form positive attitudes toward the elderly and interact directly with the elderly.

중환자실 욕창예방 프로그램 효과의 비교순위: 네트워크 메타분석

고지운 한국융합학회 2021 한국융합학회논문지 Vol.12 No.12

This study conducted a network meta-analysis to compare the effectiveness and ranking of pressure ulcer preventive programs in intensive care units. A frequency network meta-analysis was performed to identify evidence from relevant randomized control trials. A total of 10 randomized control trials involving 5 intervention subgroups were included in this study. Based on the ranking probabilities(P-Score), preventive materials was ranked as the most effective among all programs (P-Score 85.3.%: OR=0.12, 95% CI: 0.03, 0.49). Next was silicone foam dressing(P-Score 84.5%: OR=0.14 , 95% CI: 0.05, 0.38), care bundle(P-Score 60.0%: OR=0.29, 95% CI: 0.07, 1.25), reposition (P-Score 32.3%: OR=0.66, 95% CI: 0.21, 2.09) and synthetic fabrics (P-Score 23.8%: OR=0.85, 95% CI: 0.20, 3.65). It is necessary to develop practical and efficient interventions that can prevent pressure ulcers in intensive care unit patients, improve patient safety, and reduce nurses' workload. 본 연구의 목적은 네트워크 메타분석 방법을 활용하여 중환자실 환자들의 욕창예방 중재의 비교효과와 순위를 평가하기 위하여 수행하였다. 네트워크 메타 분석은 R software의 “netmeta” 패키지를 이용한 빈도주의 방법을 이용하였다. 최종적으로 10편의 논문이 선정되었으며. 네트워크 메타 분석에 결과에 따른 욕창예방의 프로그램의 중재 간 비교우위는 욕창 표준중재와 비교하여 순위는 피부보호 용품 사용이(P-Score 85.3.%: OR=0.12, 95% CI: 0.03, 0.49) 가장 효과적일 확률이 높았으며 두 번째는 실리콘 폼 드레싱(P-Score 84.5%: OR=0.14 , 95% CI: 0.05, 0.38)으로 나타났다. 그 다음으로는 통합중재 (P-Score 60.0%: OR=0.29, 95% CI: 0.07, 1.25), 체위변경 (P-Score 32.3%: OR=0.66, 95% CI: 0.21, 2.09) 그리고 마찰을 감소시킬 수 있는 직물의 사용(P-Score 23.8%: OR=0.85, 95% CI: 0.20, 3.65) 순이었다. 본 연구의 결과는 중환자실 욕창예방 프로그램의 효과적인 적용을 위한 정보를 제공 할 수 있을 것으로 생각된다.

Experimental study on film condensation heat transfer characteristics of R1234ze(E) and R1233zd(E) over horizontal plain tubes

고지운,전동순,김영렬,김선창 대한기계학회 2018 JOURNAL OF MECHANICAL SCIENCE AND TECHNOLOGY Vol.32 No.1

In this study, experimental investigations were carried out to evaluate the film condensation heat transfer characteristics of R1234ze(E) and R1233zd(E) over horizontal plain tubes. Experiments were conducted at saturation temperatures of 36, 38 and 40 °C with different surface sub-cooling temperatures in the range of 3~18 °C. Experimental results showed that the film condensation heat transfer coefficient decreased with increase in the surface sub-cooling temperature. The effect of tube diameter on film condensation heat transfer coefficient was also examined, and it was found that the smaller the tube diameter, the higher the film condensation heat transfer coefficient. In the present study, experimental correlations of the Nusselt number for R1234ze(E) and R1233zd(E) were also proposed respectively, with ±20 % of error band.

액체질소 냉각용 극저온 열교환기의 최적설계를 위한 열전달 및 압력강하 특성 분석

고지운,전동순 대한설비공학회 2018 설비공학 논문집 Vol.30 No.1

In this paper, analytical studies were conducted to obtain optimal design factors and analysis parameters of liquid nitrogen cooling exchanger applied in cryogenic refrigerator. The target value of heat transfer rate was more than 1 kW and pressure drop was less than 40 kPa. Design factors of cryogenic heat exchanger included width of channel and configuration of paths. Analytical factors of liquid nitrogen cooling exchanger included temperatures of coolant header surface and inlet liquid nitrogen. The width and number of channels in the design parameters were 0.0050~0.0150 m and 4~8, respectively. The configuration of channel path was 4 ways. Temperatures of coolant header surface and inlet liquid nitrogen in analytical parameters were 74 to 78K and 82 to 86K, respectively. As result, the design factor and analysis parameter satisfying the target values were obtained. The biggest heat transfer rate was 1.36 kW with pressure drop of 32.26 kPa.

의료 관광 서비스와 관련한 법 제도 및 영리의료법인 도입의 문제

고지운 이화여자대학교 법학전문대학원 2011 Ewha Law Review Vol.1 No.1

This study was conducted to investigate background and present condition of discussions related to the introduction of for-profit medical corporations. To achieve this study purpose, some improvements are suggested by general argument of medical treatment service. According to the revised regulations of the related medical laws and others, the ultimate issue of the introduction of for-profit medical corporations is considered of relations in terms of commercial viability. Especially by comparing different aspects for the introduction of for-profit medical corporations and for-profit medical corporations with nonprofit medical corporations focusing on quasi public sector of medical system, this study tries to approach several desirable solutions. Aside from that, by analyzing the permission of for-profit medical corporations this study considered the constructive criticism. Based on the analysis, this study suggests that it is more desirable to set aside commerciality and at least to build corporations subjected to commercial law except for company limited by shares. In this case, it is proper to consider and focus on the value of equality or common profits. Concern about the policy of medical service will go far toward solving problem in a right way form the opinion of medical care. 본 논문에서는 영리의료법인의 도입과 관련된 논의의 배경과 현황을 검토하였다. 또한 논의의 출발이 된 의료 관광 서비스에 관한 법적 제도를 우선적으로 검토함으로서 논의의 배경까지 살피고자 하였다. 이를 위하여 영리의료법인의 도입에 대한 찬⋅반 양론을 분석하고, 의료 서비스에 대한 일반적인 논의를 통하여 몇 가지 대안을 제시하였다. 의료법 및 기타 다른 법률의 개정 취지 등을 고려할 때 영리의료법인 도입 문제는 의료의 영리성 추구와 관련되어 있음을 알 수 있다. 특히 본고에서는 의료의 공익성에 초점을 맞추고 영리법인과 비영리 법인을 비교함으로써 바람직한 결론에 도달하려 했다. 이에 덧붙여 현재 논의되는 영리법인 도입 정책을 분석하여 그에 대한 비판을 아울러 고찰하였다. 이러한 논증을 바탕으로 본고는 의료기관의 경우 영리성을 배제한 형태를 취함이 바람직하며, 영리의료법인을 허용한다 하더라도 최소한 상법상 주식회사의 형태는 제외해야한다는 점에 견해를 일치하고 있다. 다만, 이 경우에도 언제나 의료 서비스의 분배 문제를 간과하지 말아야 한다. 본 논문에서 검토한 내용이 향후 정부의 정책수립에 있어서 긍정적으로 작용할 것을 기대해 본다.

흡수식 냉동기용 흡수기 전열관의 형상에 따른 열 및 물질전달 특성

고지운,배경진,권오경 대한설비공학회 2023 설비공학 논문집 Vol.35 No.12

본 연구에서는 LiBr 수용액의 액막 레이놀즈수, 농도, 입구온도와 냉각수의 입구온도 및 유속에 따른 흡수기 전열관 별 열 및 물질전달 특성 비교실험을 통하여 다음과 같은 결론을 얻었다. (1) 흡수기의 열전달량과 총괄열전달계수는 관내 측 레이놀즈수와 LiBr 수용액의 입구온도가 높을수록 증가하는 경향을 나타내었으며, Bare에 비해 End-cross의 열전달량 및 총괄열전달계수는 각각 36.17 및 40.55% 상승하였다. (2) 액막 레이놀즈수와 LiBr 수용액의 농도가 높아질수록 열전달량, 총괄열전달계수, 관외 측 열전달계수 및 누셀트수 모두 증가하는 경향을 나타낸다. 액막 레이놀즈수가 30일 때 Bar 및 End-cross의 관외 측 열전달수는 각각 1.079 및 1.575 kW/m2-K으로 나타났으며, Bar에 비하여 End-cross가 45.97% 성능이 향상된 것을 알 수 있다. (3)흡수기에서 물질전달계수는 액막 레이놀즈수가 30일 때까지 증가하였으며, 이후 대부분 증가폭이 낮아지거나 동등한 수준인 것으로 확인되었다. 실험범위에서 Bare 및 End-cross의 물질전달계수의 범위는 각각 0.129~1.133 및 0.298~1.367 m/h로 나타났다. (4) 본 연구에서는 흡수기에 사용된 전열관 2종에 대하여 관외 측 누셀트수 상관식을 제안하였고, 오차범위 ±20% 내에서 대부분 일치하였다. 해당 연구를 통해 얻은 상관식은 흡수기 설계에 유용하게 활용될 수 있을 것으로 판단된다. This study examined heat and mass transfer characteristics of absorber heat transfer tubes for absorption chillers. The experiments were conducted using bare and end-cross as the absorber heat transfer tube for the absorption chiller. The variables chosen for the experiment were the inlet conditions of the LiBr aqueous solution and the cooling water. The results showed that with an increase in Reynolds number of cooling water and film Reynolds number, the heat transfer rate, overall heat transfer coefficient, and outside heat transfer coefficient increased. Furthermore, it was observed that as the LiBr solution concentration increased, the overall heat transfer coefficient and the outside heat transfer coefficient also increased, while the overall heat transfer coefficient tended to decrease when the cooling water inlet temperature increased. At a film Reynolds number of 30, the outside heat transfer coefficients of the bare and end-cross tubes were determined to be 1.061 and 1.537 kW/m2-K, respectively, and the performance of the end-cross was improved by 44.86%. In the absorber, the mass transfer coefficient increased until the film Reynolds number was 30, after which it was confirmed that the increase was mostly lower or zero. We propose experimental correlations of Nusselt number for bare and end-cross tubes, which yield a ±20% error band.