의료종사자의 환자안전문화와 표준주의 인식과 상관관계

권혜경,정재심,이복임,김장한,Kwon, Hye-kyung,Jeong, Jae-sim,Lee, Bok-im,Kim, Jang-han 한국의료질향상학회 2015 한국의료질향상학회지 Vol.21 No.2

Objectives: This study was conducted as descriptive correlation research in order to survey healthcare personnel(HCP)'s awareness of patient safety culture and their recognition of standard precautions, and to examine the correlation between the two factors. Methods: The subjects were 400 HCPs including 80 doctors, 240 nurses, and 80 medical technicians from two general hospitals. The questionnaire used in the survey consisted of 9 questions on general characteristics, 44 on the perception of patient safety culture, and 21 on the recognition of standard precautions. Results: According to the subjects' general characteristics, the score was significantly higher in those aged over 40 than in those aged 30-39. In addition, it was significantly higher in managers than in practitioners, in those with work experience of less than a year than in those with 5-9 years. The score was also significantly higher in those working 8 hours a day than in those working over 10 hour a day. The number of medical accident reports according to the subjects' general characteristics was significantly larger in nurses than in doctors, in managers than in practitioners, and in those with 10 years' or longer experiences than in those with less than a year. In the awareness of standard precautions according to the subjects' general characteristics, the score was significantly higher in female workers than in male workers, and in managers than in practitioners. As a whole, the subjects' awareness of patient safety culture and their recognition of standard precautions showed a significant correlation with each other. Conclusion: From the result of this study, sufficient work force and the promotion of organizational culture for safety is needed in order to guarantee patient safety. Likewise, these results suggest that experience, job skill, and adequate working hours have a positive effect on the awareness of patient safety culture and the recognition of standard precautions.

권정생 초기 단편동화의 서사 양상 고찰

권혜경(Kwon, Hye-kyung) 한국아동문학학회 2017 한국아동문학연구 Vol.- No.32

권정생은 한평생 병고와 싸우면서도 동화작가로서 치열하게 작품 활동을 했다. 이와 같은 강한 의지력과 치열한 작가 정신 때문인지 당대 다른 동화 작가들에 비해 그의 삶과 문학에 대한 연구가 비교적 많이 이뤄진 편이다. 하지만 양적으로 방대한 연구 결과에 비해 상대적으로 그의 작품에 대한 깊이 있는 연구가 아직까지 제대로 이뤄지지 않고 있다는 비판도 제기되고 있다. 그런 점에 착안하여 권정생의 첫 번째 동화집, 강아지똥(1974)에 수록된 그의 초기 단편동화들에 나타난 문학 형식적 특징 중에서 지금까지의 기존 연구들에서 상대적으로 간과되었던 플롯과 서사 양상에 대해 구체적으로 살펴보고자 하였다. 우선, 권정생은 초기 단편동화들에서 일상에서 흔히 지나치기 쉬운 하찮은 존재들에게까지 미치는 생명 존중의 의식을 나타내기 위해 ‘비극적 플롯’을 선택하였다. ‘비극적 플롯’이야말로 원죄적 존재를 자각하며 자기희생을 통해 ‘죽음’을 극복하는 실천적 사랑의 삶을 지향한다는 점에서 그의 주제의식을 구현할 수 있는 가장 효과적인 서사 방식이기 때문일 것이다. 한편, 권정생은 초기 단편동화들에서 그의 주요 작중 등장인물들을 대체로 ‘고아’로 설정하였다. 이러한 그의 ‘고아 유형’을 세분화시키면 ‘태어나자마자 고아가 된 유형’, ‘한시적 고아 유형’, ‘중간에 고아가 되는 유형’ 등 크게 세 유형으로 나눌 수 있다. 이 중에서 특히 ‘중간에 고아가 되는 유형’과 ‘태어나자마자 고아가 된 유형’이 자주 등장하는데, 이것은 일제강점기와 한국전쟁을 직접 겪은 작가의 개인사와 일맥상통한다는 점에서 당대 시대적 현실을 반영한 결과라 할 수 있다. 또한, 권정생의 초기 동화들에는 주제의식을 확장시키고 깊이 있게 표출하기 위해 ‘상호텍스트성’의 서사 방식이 자주 활용되고 있다. 주로 옛이야기, 전래동요, 성서에 나오는 이야기 등을 액자식 구성으로 보여주었다. 그중에서 특히 성서에 나오는 이야기를 동화속에서 자주 제시한 것은 평생 기독교인으로 살아온 그의 삶과 깊은 관련성이 있다고 할 수 있다. 끝으로 권정생은 다양한 알레고리를 활용하여 비참한 현실과 함께 이상적이며 영원한 삶을 나타낸 작가이다. 그의 초기 동화들에서 ‘별’, ‘하늘’, ‘달나라’를 통해 영원한 삶을 나타낸 반면, ‘시궁창’, ‘눈길’, ‘땅’을 통해 비참한 현실을 형상화하였음을 알 수 있었다. Despite a serious lifelong illness, Kwon Jeong Saeng tried intensely to write fairy stories for children literature before he died in 2007. More studies have been conducted on his life and work than those of other contemporary writers, perhaps as a result of his strong will and intense struggle to be a good writer. However, some critics say that the quality of studies on his works is not adequate. This paper aims to study narrative elements such as plot, intertextuality, and allegory in early short fairy stories from Kwon Jeong Saeng’s first anthology, Puppy Poo(1974), which has not been well researched by previous studies. Kwon Jeong Saeng used the tragic plot to show his respect for the lives of insignificant characters whose existence could be easily ignored. The tragic plot is the most effective narrative mode to realize the theme of practical love to overcome death through the self-sacrifice and the consciousness of original sin. Most of the main characters in Kwon Jeong Saeng’s early short fairy stories are orphans. They fall into three types: born orphans, temporary orphans, and orphans who lost their parents during their lives. Among these types, orphans who lost their parents during their lives appeared most frequently. They represent his tragic life, since he had similar experiences during the period of Japanese colonial rule and the Korean War. In other words, we can say that his early short fairy stories reflect the spirit of the age and his personal experience. Kwon Jeong Saeng also used intertextuality frequently in his early stories, using folk tales, traditional folk songs, and stories from the Bible. His usage of many bible stories in his fairy stories reflects his Christianity. Finally, he used allegory to represent both the tragic reality on earth and the idealistic eternal life in heaven. Eternal life is represented by words like “star,” “sky” and “moon,” while the tragic reality is represented by words like “ditch,” “snowy road,” and “land.”

영화기반 간호중재 프로그램이 뇌졸중 환자의 재활동기와 우울에 미치는 효과

권혜경(Kwon, Hye Kyung),이숙자(Lee, Sook Ja) 한국간호과학회 2017 Journal of Korean Academy of Nursing Vol.47 No.3

Purpose: The aim of this study was to develop and measure the effect of a movie-based-nursing intervention program designed to enhance motivation for rehabilitation and reduce depression levels in stroke patients. Methods: The study used a quasi-experimental, nonequivalent control group and a pretest-posttest design. The 60 research subjects were assigned to the experimental (n=30) or control group (n=30). The movie-based nursing intervention program was provided for the experimental group during 60-minute sessions held once per week for 10 weeks. The program consisted of patient education to strengthen motivation for rehabilitation and reduce depression, watching movies to identify role models, and group discussion to facilitate therapeutic interaction. Results: After 10 weeks of participation in the movie-based nursing intervention program, the experimental group’s rehabilitation motivation score was significantly higher, F=1161.54 (within groups df=49, between groups df=1), p<.001, relative to that observed in the control group. In addition, the experimental group’s depression score was significantly lower relative to that observed in the control group, F=258.97 (within groups df=49, between groups df=1), p<.001. Conclusion: The movie-based nursing intervention program could be used for stroke patients experiencing psychological difficulties including reduced motivation for rehabilitation and increased depression during the rehabilitation process.

임신 중기 양수천자의 임상적 고찰

권혜경(Hye Kyung Kwon),조재성(Jae Sung Cho),박용원(Yong Won Park),김세광(Se Kwang Kim),양영호(Young Ho Yang) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.4

N/A Objectives : Amniocentesis is the most commonly used invasive method for prenatal diagnosis of genetic disorders. But this invasive study may induce preterm labor, endanger both the mother and the fetus, cause infection and abortion. This study was performed to clarify the safety and confidency of amniocentesis. Material and methods : 1,500 amniocentesis cases were performed from 1987 to 1996 at Severance hospital for prenatal diagnosis of genetic disorders. Of 1,500 cases, 499 cases whose pregnancy outcomes were proven were finally analized. We compared incidence of complications such as spontaneous abortion, vaginal spotting, premature rupture of membranes, preterm labor or chorioamnionitis according to placental location, frequency of needle insertion and amniotic fluid color. Results : 1) Indications for amniocentesis were ① advanced maternal age - 47.3%, ② positive maternal serum triple test - 13.8%, ③ fetal chromosomal anomaly suspected in ultrasonography - 10.0%. 2) 6.6% of the amniocentesis samples had color changes due to bleedng or meconium passing. 3) 18.8% of the cases were performed at 16th gestational weeks followed by 20th, 18th and 17th weeks. 4) 2.2% had complications such as spontaneous abortion, vaginal bleeding, premature rupture of membranes, preterm labor and chorioamnionitis in 4 weeks after amniocentesis. 5) No correlation was found between the placental location, frequency of needle insertion(below 3 times) and complication rate. The spontaneous abortion rate in the group with amniotic fluid discolorization was 6.1% whose only 0.4% had spontaneous abortion to the group with clear amniotic fluid. 6) Median value of amniotic fluid alphafetoprotein(αFP) of pregnant women in midtrimester were 15,769.4ng/ml at 15 weeks, 13,160.3ng/ml at 16 weeks, 11,539.3ng/ml at 17 weeks, 9,569.8 mg/ml at 18 weeks, 8,423.4mg/ml at 19 weeks, 6,527.1ng/ml at 20 weeks, 5,979.3ng/ml at 21 weeks, 4,363.2ng/ml at 22 weeks, 3,555.2ng/ml at 23weeks, respectively. In midtrimester amniotic fluid αFP declined gradually as gestational weeks increase. Conclusions : Fetal loss rate of midtrimester amniocentesis was 0.8%, proving that it outstanding in the aspects of safty and confidency. Since the fetal loss rate significantly increases in case with amniotic fluid discoloration, it is needless to mention the importance of close follow-up.

채팅 메시지에서 추출된 단어를 이용한 자동 맛집 추천 시스템

권혜경(Kwon Hye Kyung),최용석(Choi Yong Suk) 한국정보과학회 2015 한국정보과학회 학술발표논문집 Vol.2015 No.6

임신 제2분기 후 자궁동맥 도플러 파형 분석 상 함요를 이용한 임신성 고혈압 및 태아발육지연 예측

권혜경(Hye Kyung Kwon),김영한(Young Han Kim),이창희(Chang Hee Lee),이재성(Jae Sung Lee),김태윤(Tae Yoon Kim),조재성(Jae Sung Cho),박용원(Yong Won Park) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.3

N/A Objectives : The objective of this study is to evaluate the predictability of pre-eclampsia and fetal growth restriction(FGR) using the notch of uterine artery Doppler velocimetry after the second trimester of pregnancy, and to evaluate the hemodynamic changes preceeding the onset of symptoms of pre-eclampsia, therefore determining the significance of the notch in uterine artery Doppler velocimetry. Materials and methods : Between March 1996 and April 1999, in Severance Hospital, 99 pregnant women who showed notches in uterine artery Doppler velocimetry at the 24th to 32nd gestational weeks were studied. Those already manifested by pre-eclampsia and FGR were excluded. The study population were divided into two groups, women in their 24-26th gestational weeks and in their 27-32nd gestational weeks, and the prevalence of pre-eclampsia and FGR were evaluated in each group. Also, the prevalence of the mentioned diseases according to the bilaterality of the notch, and the duration to the onset of the symptoms of pre-eclampsia were compared. Results : Among 42 patients who showed the notch in the 24-26th gestational weeks, 14 developed pre-eclampsia/FGR(33.3%), and among 57 in the 27-32nd gestational weeks, 17 developed the mentioned diseases(31.5%). No significant difference in prevalence rate was observed. In those who showed bilateral notches, 11 out of 24 cases developed pre-eclampsia/FGR(45.8%). In those with unilateral notch, 20 out of 75 cases had the disease(26.7%). The difference in the two groups were statistically significant(p<0.05). Among 42 patients who showed the notch in the 24-26th gestational weeks, 7 developed pre-eclampsia(16.7%), and among 57 in the 27-32nd gestational weeks, 17 developed pre-eclampsia(15.7%). No significant statistic difference was observed. The duration to the onset of symtoms of pre-eclampsia were 5.3 and 5.5 weeks each group. Conclusion : The notch means early marker of hemodynamic changes preceeding the onset of symptoms of pre-eclampsia. Therefore, patients who show the notch of uterine artery Doppler velocimetry in the second half of pregnancy should be considered as high risk patients for either pre-eclampsia or FGR, and especially those with bilateral notches require close observation and follow-up.

학교 영어 도서관 운영 실태와 효과적인 운영 방법에 대한 기초 연구

장경숙(Chang, Kyung Suk),이병천(Lee, Byengcheon),권혜경(Kwon, Hye Kyung) 한국영어어문교육학회 2010 영어어문교육 Vol.16 No.3

The present study has a dual purpose to investigate the current state of school English library and needs required for its effective use, and to propose a reading program at the school library. The literature on school library was reviewed. A questionnaire survey was done to find out the current situation of English library at the secondary school. The analysis of 26 secondary English teachers’ responses reveals that there was the absence of librarians or reading specialists at the school English library. It was also found that the uses of the English library were limited due to the absence of the specialists, no guidelines, and no link between the curriculum and the library use. A case study on a 2-week special reading program at the school English library was conducted and 15 middle school students took part in the project. The participants took pre- and post-tests to identify their reading level using a software and did a variety of reading activities using the books selected according to their level. The comparison of the tests shows that most of the students’ reading level improved after the reading program. The analysis of their views on the program and its effects reveals that they gained confidence in reading and their vocabulary understanding was improved. Some suggestions are made for the effective management of the school English library.

지속성 국소 융모상피암의 외과적 처치 2 예

강성은(Seong Eun Kang),권혜경(Hye Kyung Kwon),김낙근(Nack Keun Kim),김동현(Dong Hyun Kim),박찬규(Tchan Kyu Park) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.11

Gestational trophoblastic tumors including choriocarcinoma bave become one of the most curable human malignancies with an overall cure rate exceeding 90%. Although systemic chemotherapy is the initial treatment for chorio- carcinoma, some patients with chemotherapy-resistant choriocarcinorna can be treated by integration of cbemotherapy, surgery and radio- therapy. We report two cases of persistent localized choriocarcinoma which was treated by surgical intervention.

재태 연령에 따른 태아 중뇌 동맥 도플러 지수의 기준치

박용원(Yong Won Park),조재성(Jae Sung Cho),권혜경(Hye Kyung Kwon),김영한(Young Han Kim),이창희(Chang Hee Lee) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.4

N/A Materials and Methods : The subjects were selected from pregnant women receiving antenatal care at Severance Hospital between March 1996 and December 1999. Fetal MCA reference resistance index range according to gestational age were obtained through routine Doppler velocimetry for 4621 normal pregnant women between 24-42 gestational weeks. Those manifesting multiple pregnancy, Diabetes Mellitus, drug abuse, chronic hypertension, fetal congenital anomaly, fetal growth restriction(FGR) with discrepencies of more than 7days and pregnancies complicated by pregnancy induced hypertension (PIH) were excluded. Additionally, the fetal MCA hemodynamic changes were compared for 140 pregnant women with FGR or PIH. The normal ranges for fetal MCA Doppler resistance indices were expressed as mean±SD, and a comparative analysis between the PIH or FGR group and the normal control group was performed. Statistical analysis was done using the SPSS 8.0 program, t-test and the Pearson correlation. Result : The fetal MCA doppler flow resistance indices for normal pregnancies were 0.77±0.006 at 24 weeks and 0.79±0.006 at 28 weeks, demonstrating a statistically significant increase(p<0.05). At 40 weeks the index was 0.71±0.009 showing a significant decrease after 28weeks(p<0.05). There was a tendency for the resistance index to be lower in the PIH/FGR group compared to the normal controls. Conclusion : Constructing a normal reference resistance index range for fetal MCA flow is of high clinical value with regards to predicting fetal well being and understanding the hemodynamics of fetal cerebral perfusion.

Sertoli - Leydig Cell Tumor 1 예

한상원 ( Sang Won Han ),김태윤 ( Tae Yoon Kim ),권혜경 ( Hye Kyung Kwon ),강경숙 ( Gyoung Sook Kang ),연혜정 ( Hye Jeong Yeon ),기정혜 ( Jung Hye Kie ) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.7

The Sertoli-Leydig cell tumor is a rare sex cord stromal tumor of the ovary, accounting for less than 0.5% of all primary ovarian neoplasm. This tumor is the most common type of all virilizing ovarian tumors. However, only one-third of patients develop virilization. Recently, we experienced a case of intermediately differentiated Sertoli-Leydig cell tumor with amenorrhea and so we present it with brief review of literature.