의료정보 보호행동 실천에 관한 연구

권은하(Eun-Ha Kweon) 한국전자통신학회 2013 한국전자통신학회 논문지 Vol.8 No.12

본 연구는 환자 간접 접촉군인 병원행정관리자와 환자 직접 접촉군인 작업치료사의 환자 의료정보 보호행동 실천도를 알아보기 위해 시도되었다. 담당직무별로 비교해 보았을 때는 환자의료정보 보호․관리․감독에 대한 정기적인 교육은 병원행정관리자(3.16±1.037)보다는 작업치료사(3.17±1.129)가 잘 받고 있었음에도 불구하고, 환자 직접 접촉군인 작업치료사(3.52±.809)가 환자 간접 접촉군인 병원행정관리자(3.92±.724)보다 의료정보 보호행동 실천도는 낮게 나타났다. 작업치료사는 환자와 많은 대화 및 소통을 하는 동안 항상 의료정보 누설의 위험성에 노출되어 있으면서도, 대부분의 항목에서 의료정보 보호에 관한 관심이 비교적 적고 그 내용에 대해 거의 인지하지 못하는 것으로 나타났다. 이에 각 직업군별 맞춤형 교육시스템을 마련하고, 의료정보 보호에 관한 질 관리 활동을 정기적으로 실행하면서 지속적인 홍보와 교육을 하고, 본인들의 수준을 점검하고, 그 러한 활동을 통하여 의료정보 보호에 관한 인식을 고취 시킬 필요가 있다고 제언하는 바이다. Attempts were made in this paper to compare the practice of protective actions for information of patients' medical treatment between hospital administrators who do not make direct contact with patients and occupational therapists who usually do. The comparison between jobs in charge showed that occupational therapists did not practice much protective actions for information of patients' medical treatment (3.52±.809) compared to hospital administrators (3.92±.724), even though the former had received regular education about protection, management and supervision of patients' medical information more often (3.17±1.129) than the latter (3.16±1.037). In spite of the fact that occupational therapists were exposed frequently to the danger of revealing medical information in the process of their job performance through talks and communications with patients, they displayed relatively little concern for and awareness of keeping information of medical treatment from being leaked by them. It is thus suggested to promote awareness of medical staff to protect medical information by means of flexible educational system for each occupational group, periodical monitoring, continuing public relation, training and quality control for protection of medical information, as well as routine self-examination of such practice.

환자 프라이버시 보호행동 실천에 관한 연구 - 물리치료사와 작업치료사를 중심으로 -

김정자,권은하,Kim, Jeong-Ja,Kweon, Eun-Ha 한국전자통신학회 2012 한국전자통신학회 논문지 Vol.7 No.2

본 연구는 물리치료사와 작업치료사의 환자 프라이버시 보호행동 실천도를 알아보기 위해 시도되었다. 전국에 소재한 종합병원 및 재활치료 전문병원의 물리치료사와 작업치료사 297명을 대상으로 2012년 1월 2일부터 1월 13일까지 설문조사를 실시하였다. 연구결과 총 실천도 평균은 $3.54{\pm}.733$으로 나타났으며, 각 영역별 평균은 의사소통 영역 $3.62{\pm}.766$ 직접접촉 영역 $3.57{\pm}1.013$, 유지 관리 영역 $3.53{\pm}.780$ 순으로 나타났다. 일반적 특성 중 각 영역별로 분석한 결과 연령이 증가 할수록, 근무경력이 많을수록 실천도가 높았다. 환자 의료정보의 프라이버시는 100% 보호되어져야 하는 것이며, 실천도는 매우 잘 하고 있음의 수준(5)에 근접해야 할 것이나 환자의 기능 개선의 중추적 전문가인 치료사로서 의료정보 보호에 관한 관심이 적고 그 내용에 대해 거의 인지하지 못하는 것으로 나타났다. 이에 지속적인 홍보와 교육을 통하여 환자 프라이버시 보호에 대한 인식을 고취시고, 윤리의식을 확고하게 심어주는 마인드에 대한 제고가 필요하다. The present study was carried out with a view to examine the protective actions of physical and occupational therapists for patients's privacy. For this purpose, a survey was conducted with the questionnaires that were distributed to 297 physical and occupational therapists engaged in general hospitals as well as in rehabilitation clinics across the country from January 2 to 13, 2012. From the survey, it was made known that the overall extent of protective actions practiced by them was $3.54{\pm}.733$ in average. Divided by area, the average protective action in communication was $3.62{\pm}.776$, followed by $3.57{\pm}1.013$ in direct contact and $3.53{\pm}.780$ in maintenance and management, respectively. The analysis of general characteristics by each area showed that the older their age gets and the longer their career is, the more the protective action is practiced by them. Although they are well aware of the fact that the medical information of patients should be kept 100% secret and they practice it to almost excellent grade (5), the physical and occupational therapists, as key experts in charge of improving functions of patients, were found to have little concern for and little knowledge about contents of protecting medical information. It is thus required to perform public relation and instruction continuously to intensify their awareness of needs to protect patients' privacy and to implant ethical sense in this regard deep in their mind.

종합병원의 암등록 질관리에 관한 상관성 분석

김종인(Jong-In Kim),권은하(Eun-Ha Kweon),고민석(Min-Seok Ko) 한국보건복지학회 2007 보건과 복지 Vol.9 No.-

Objective. This study is to compare and analyze the difference in preciseness and consistency of the cancer registration data kept by the member hospital s of Korea Central Cancer Registry as a part of researches into quality control of the data depending on individual and educational characters of their registration system. Methods. Subjects of this study were selected from among clinical registars engaged in cancer registration at 139 hospitals out of 176 registered with Korea Central Cancer Registry in 2007 across the country and conducting on-the-job training for staff members. Those hospitals which have no outpatients or experience difficulties in registration were excluded from the survey. Out of subjects, 42 hospitals (31%) sent their replies to the Inquiry. Results. From the analysis into difference in individual and educational characters of quality control of the cancer registration data in hospitals, it was found that (1) The average consistency in the data of the surveyed hospitals is found to be lower than the average comparativeness and preciseness. (2) The general characters show no statistically significant correlation with quality control of cancer registration data, but have positive (+) correlation with comparativeness, preciseness and overall average quality control depending on whether the clinical registars have completed the course of cancer registration as an educational factor. A positive (+) correlation is also confirmed among the characters of comparativeness, consistency and overall average quality control depending on whether in-service training for cancer registration is conducted; Conclusions. As a consequence, further studies on quality control of cancer registration data should be done in more depth in a bid to ensure that better data could be acquired. Efforts should also be made to secure more lecture hours for cancer registration-related subjects than currently that may enable to train more qualified manpower practically as well as theoretically. Moreover, it is desired to update the guidebook for cancer registrar ion as soon as there are needs to revise any part of it and to continue to provide chance for persons in charge of cancer registration to be trained in advanced course.

소아 개심술 중 발생한 Aprotinin 에 의한 과민반응

최인철,박종연,심지연,권은하 대한마취과학회 2000 Korean Journal of Anesthesiology Vol.38 No.2

Aprotinin is a serine protease inhibitor that improves the hemostatic function and modulates the antiinflammatory responses. Recently, aprotinin has been widely used in various surgical procedures including open heart surgery. One of the complications of aprotinin is anaphylactic reaction and the incidence increases with reexposure. We experienced a case of anaphy1actic reaction in a 5-year-old female during open heart surgery. After cardiopulmonary bypass weaning, during aprotinin i.v, infusion for reducing blood loss, sudden hypotension and bradycardia occurred. After re-institution of CPB, the patient recovered. In the post-operative review of the chart and patient, we found that this patient had been exposed to aprotinin 20 days ago. In conclusion, we recommend some preventable methods for anaphylaxis of aprotinin; aprotinin should be used after a skin test or i.v. infusion test and used by mixing with CPB priming solution. (Korean J Anesthesiol 2000; 38: 370~373)

당뇨병 환자의 자율신경기능 이상은 관상동맥 우회술시 혈역학적 변화에 영향을 주는가 ?

최인철,전희정,심지연,조삼순,권은하 대한마취과학회 2000 Korean Journal of Anesthesiology Vol.38 No.3

Background : In this study, we examined diabetic patients scheduled for elective coronary artery bypass surgery to determine whether there is an association between autonomic dysfunction and intraoperative hemodynamic instability, and if perioperative autonomic function tests are effective predictors for diabetic patients at greatest risk for hemodynamic events during the intraoperative period. Methods : We examined 52 patients, 25 without diabetes (nonDM group) and 27 with diabetes (DM group). Preoperative autonomic function tests included are the valslava maneuver (valsalva ratio, valsalva index, strain response), change in heart rate with deep breathing 0/E ratio), change in heart rate (30: 15 ratio, stress response) and diastolic blood pressure (L-S(d)) while standing. Anesthesia was established with midazolam, fentanyl, isoflurane and vecuronium. Several hemodynamic variables such as heart rate (HR), mean arerial pressure (MAP), central venous pressure (CVP), mean pulmonary artery pressure (MPAP), pulmonary capillary wedge pressure (PCWP), systemic vascular resistance index (SVRI), pulmo- nary vascular resistance index (PVRI), cardiac output (CO), and cardiac index (C0 were obtained at the following times: before induction; after induction; after intubation; after skin incision and after sternotomy. Results: The DM group had a significantly diminished response compared with the nonDM group in the valsalva ratio, valsalva index, 30: 15 ratio, and L-S(d). The remaining tests (I/E ratio, strain response, stress response) showed similar but nonsignificant diminished trend response in the DM group. Most patients had one or more abnormal test results in this group (76%), whereas in the control group most patients did not show any abnormal test results (74.1%). The comparison of hemodynamic response between the DM group and non-DM group reveal a significant difference between times within each group but not between groups. Conclusions: This study indicates that increased hemodynamic instability during the intraoperative period is not an obligatory association with diabetes and autonomic dysfunction and is not detected by preoperative autonomic function tests in patients with coronary artery disease and diabetes mellitus when anesthesia is induced and maintained with a large dose of opiod and anesthetic agent which has minimal hemodynamic effects, (Korean J Anesthesiol 2000; 38:440~449)