다발성 골수증

최은숙,고광준,Choi Eun-Suk,Koh Kwang-Joon 대한영상치의학회 1993 Imaging Science in Dentistry Vol.23 No.2

This is a report of multiple myeloma occurred in the left mandibular body and skull. 66-year-old patient was referred to our hospital with a complaint of painful swelling on the left mandibular body area. The author diagnosed it as a multiple myeloma by the clinical examination, radiographic findings, laboratory findings and the histopathological findings. The purpose of this report is to aid in the diagnosis of multiple myeloma and to aid to differentiate it from malignant tumours. The characteristic features are as follows: 1. In clinical examination, painful swelling was observed in left mandibular body area. 2. In radiographic findings, radiograms showed relatively ill-defined radiolucency without sclerotic border in left mandibular body area. And also represented multiple punched-out radiolucency in the skull and pathologic fracture of vertebral body on lumbar 3 level. 3. In histopathologic findings, infiltration of abnormal plasma cells was observed. 4. In laboratory findings, decreasing of albumin/globulin ratio, hypercalcemia, renal impairment was observed, but we could not find the Bence-Jones protein in urin.

보건소의 자원봉사자 요구도 및 활용도에 대한 관련요인 분석

최은숙,Choi, Eun-Sook 한국지역사회간호학회 2000 지역사회간호학회지 Vol.11 No.1

Volunteers activities in Health Centers are strategically important for the efficient utilization of human resource and local people's health promotion in community. With these backgrounds. this study is conducted to examine significant factors in relation to demand and utilization of volunteers in Health Centers. and the factors are the characteristics of Health Centers. volunteer management factors and external environment factors. Subjects in this study were 245 Health Centers all chosen. Data were collected from April. 12. 1999 to May. 31. 1999. and the data for analyses were ones of 116 respondents. Then. the data coded and submitted to Fisher's exact test. NPAR1WAY ANOVA, Correlation analysis. multiple regression analysis, multiple logistic regression analysis with SAS program. The key results from this study can be epitomized as follows: 1. 43.1% of responding health centers answered that they 'utilize volunteers'. The average number of volunteers who were engaged in responding health centers was 43, out of which 7 were men and 36 were women. As for the adequacy of the number of the volunteers. 55.1% responded 'not enough' and 30.6% responded 'adequate'. The more the number of volunteers needed. the more the number of utilizing volunteers is. When asked about their views concerning the utilization of volunteers in Health Centers. 88.7% of all respondents answered in the affirmative. The accountable factor for the utilization of volunteers was the present utilization of volunteers. 2. Concerning the reasons for using volunteers. 'to induce local people's participation in health services' was the highest comprising 76% of the responding health centers. 3. Most of volunteers were housewives and independent enterprisers. The most type of volunteer activities was 'just simple labor'. 4. As for the action duration of volunteers. 69.4% answered 'under 6 months'. The factor was significant difference with the action duration of volunteers was 'to provide social meeting' in the middle of rewards for volunteers. 5. Asked about the problem in utilizing volunteers. 53.2% answered 'the difficulty of recruitment and education for volunteers'. and 42.6% answered 'lack of budget and manpower needed for the utilization of volunteers.' 6. Concerning the evaluation of the performance by volunteers. 88% answered 'satisfactory'. With regards to the reason for that. 29.3% answered 'volunteers can provide various kinds of services' 7. 88.7% of responding health centers answered that they will continuously or newly utilize volunteers in the future. 8. The main health program services which expect utilization of volunteers were visiting health services(63.2%). old people's health services (25.3%). These were not significant difference with any explanatory variable. 9. The average number of volunteer needed in responding health centers was 38. The more the average number of utilizing volunteers. the more the number of volunteers needed is. The more the degree of financial independence. the more the number of volunteers needed is. In conclusions. Health centers are necessary to promote their role of recruitment. education and training for volunteers. the development of volunteer activities programs.

응급구조(학)과 교육과정의 표준화에 대한 연구

최은숙,홍성기,권혜란,고봉연,이경열,정한호,이명렬,윤성우,박시은,조근자,Choi, Eun-Sook,Hong, Sung-Gi,Kwon, Hay-Rran,Koh, Bong-Yeun,Lee, Kyoung-Youl,Jung, Han-Ho,Lee, Myung-Lyeol,Yun, Seong-Woo,Park, Si-Eun,Cho, Keun-Ja 한국응급구조학회 2017 한국응급구조학회지 Vol.21 No.2

Purpose: This study describes current curricula for paramedic students in South Korea and proposes a standardization of the curriculum. Methods: Data were collected from 38 colleges and universities from March 1 to 31, 2016. Descriptive statistics were calculated using SPSS 23.0. Results: The proposed standard curriculum was below. Requisite liberal arts consisted of 2 subjects and 6 credits including biomedical ethics, communications and human relationships. Common major subjects were composed of 6 areas, 22 subjects, and 78 credits. The areas of basic medicine consisted of 6 subjects and 16 credits including medical terminology. Introduction to paramedicine consisted of 3 subjects and 7 credits. Emergency patient management consisted of 2 subjects and 9 credits. Particulars to paramedic care consisted of 8 subjects and 31 credits. The law area consisted of 1 subject and 3 credits. Other major areas consisted of 2 subjects and 12 credits including integrated simulation and physician assistance. Common field practice area consisted of 3 to 4 subjects and 9 to 12 credits. Conclusion: It is important to establish and adapt a standardized curriculum for paramedic students in order to ensure competence and to provide high quality emergency medical services.

Pender 모형을 활용한 응급구조학과 학생의 건강증진행위에 영향을 미치는 요인

최은숙,Choi, Eun-Sook 한국응급구조학회 2007 한국응급구조학회지 Vol.11 No.2

Purpose: The purpose of this study was to supply basic data for a health promoting program and to elevate the level of it by examining whether EMT-P Students' health promoting behaviors were related to health percetion, health concept, health status, self-esteem, perceived benefits of action, perceived barriers of action, perceived self-efficacy, activity-related affect, social support, preference, prior related behavior, and a plan for action. Method: Subjects were 116 EMT-P Students in K city. Data collection method was a structured questionnaire. Data was analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation analysis, and stepwise multiple regression. Result: The most powerful predictor was prjor related behavior(28.8%). Altogether prjor related behavior, health status, perceived barriers of action, a plan for action were proven to account for 44.6% of health promoting behaviors of EMT-P Students. Conclusion: It suggested that prjor related behavior, health status, perceived barriers of action, a plan for action should be considered when developing a EMT-P Students' health promoting program.

심폐소생술 제공자의 발판 높이와 자세가 기본심폐소생술의 정확도에 미치는 영향

최은숙,조근자,Choi, Eun-Sook,Cho, Keun-Ja 사단법인 한국응급구조학회 2008 한국응급구조학회지 Vol.12 No.3

Purpose : The purpose of this study was to supply basic data for the impact on the accuracy of basic CPR according to position and foot-board height of basic CPR provider. Methods : Study design was within - group design. Subjects were 25 EMT-P Students in K city. Interventions was basic CPR performed on a resuscitation manikin placed on a hospital bed, kneeling on the bed adjacent to the manikin. Data was analyzed using descriptive statistics and Friedman test. Results : In case of the basic CPR performed on a resuscitation manikin placed on a hospital bed, ventilation accuracy was the highest in less than 160 cm height, foot-board height : $34.2{\pm}1.48cm$, 91.4% and in 161-165 cm height, foot-board height : $26.0{\pm}2.14cm$, 88.4% and in 171-175 cm height, foot-board height : $23.0{\pm}1.41cm$, 91.3% and in the above 176 cm, kneeling on the bed, 95%. Chest compression accuracy was the highest in less than 160 cm height, foot-board height : $30.2{\pm}1.48cm$, 95.6% and in 161-165 cm height, kneeling on the bed, 97.6% and in 171-175 cm height, kneeling on the bed, 98.5% and in the above 176 cm, kneeling on the bed, 98.7% and foot-board height : $20.5{\pm}1.91cm$, 98.7%. Chest compression error was due to too weak : 2.0-35.4 times. There were ststistically significant differences in 191-195 cm group according to chest compression mean depths($x^2=10.824$, p = .013) and chest compression error (p = .040). Conclusion : In contrast to current guidelines, the position and foot-board height of basic CPR provider are very important to the accuracy of the basic CPR. Furthermore, we recommend that a using real time audiovisual feedaback system significantly improve the quality of chest compression and ventilation during resuscitation.

Policy suggestions to educate and produce outstanding paramedics in Korea

최은숙,고봉연,박희진,김효식,권혜란,최혜경,이경열,윤종근,홍성기,조근자,Choi, Eun-Sook,Koh, Bong-Yeun,Park, Hee-Jin,Kim, Hyo-Sik,Kwon, Hay-Rran,Choi, Hea-Kyung,Lee, Kyoung-Youl,Yun, Jong-Geun,Hong, Sung-Gi,Cho, Keun-Ja The Korea Society of Emergency Medical Services 2018 한국응급구조학회지 Vol.22 No.1

연구 목적: 본 연구는 우수한 1급 응급구조사 인력 양성 및 배출을 위해 응급구조사의 역량을 도출하여 교육제도를 재정립하고 국가시험 및 자격제도를 개선하기 위한 정책 제안을 하고자 하였다. 연구 방법: 본 연구는 전문가 회의 및 설문지를 이용하였다. 설문 자료는 교육 전문가(응급구조학과 대학교수)와 현장 전문가(소방 119구급대원 및 병원에 근무하는 1급 응급구조사) 총 277명으로부터 수집되었으며, 자료수집 기간은 2016년 9월 7일부터 9월 20일까지였다. 수집된 자료는 SPSS 22.0을 이용하여 분석하였다. 연구 결과: 1급 응급구조사 교육과정 강화를 위해 표준교육과정안으로 총 27과목 94학점을 제안하였고 1급 응급구조사의 핵심역량 9가지를 도출하였다. 국가 자격시험은 필기시험 과목을 통합하는 방안과, 실기시험에 시나리오형의 문제를 추가하고, 실기를 절차대로 수행하는 단순실기시험에 낙제기준(critical criteria)를 적용하며, 실기시험은 통과/실패만 결정하는 것을 제안하였다. 또한 1급 응급구조사의 보건의료적 업무특성을 반영하여 자격은 면허로 바꾸는 것을 제안하였다. 결 론: 본 연구 결과를 토대로 표준교육과정 운영으로 핵심역량을 갖추고 배출된 인력들이 신뢰성 있는 국가시험제도를 통해 자격을 취득하고 1급 응급구조사로서 전문성을 강화할 수 있는 자격관리제도가 선순환을 이룰 때 우리나라 응급의료서비스의 질적 수준이 향상될 것이다. Purpose: With the purpose of educating and producing outstanding paramedics by enhancing their competencies, this study aimed to make policy suggestions to re-establish the education system and improve the national examination and the certification scheme. Methods: This study used focus group interviews and questionnaires to collect data. Totally, there were 277 subjects, including experts from the education and field. Data were collected from September 9 to 20, 2016, and analyzed using SPSS 22.0. Results: To strengthen the curriculum of paramedics, this study suggested 27 courses with 94 credits as the standardized curriculum and derived 9 core competencies of paramedics. For the national examination, this study suggested consolidating written test subjects, adding scenario questions to practical tests, and applying critical criteria to simple practical tests that performs a procedure, grading these tests on a pass/fail basis. In addition, this study suggested converting certification into license, reflecting paramedics' healthcare job characteristics. Conclusion: The quality of emergency medical services in Korea will improve when those with core competencies that originated from the standardized curriculum based on the results of this study acquire their certification through the national test scheme, and the certification management system creates a virtuous cycle to further enhance paramedics' professionalism.

일 호스피스실 이용 환자와 가족의 상담내용 분석

최은숙,김금순,Choi, Eun-Sook,Kim, Keum-Soon 한국재활간호학회 2005 재활간호학회지 Vol.8 No.1

Purpose: The purpose of this study was to increase our understanding of the terminal cancer patients and their families concerns. I analyzed the counseling contents of terminal cancer patients and their relatives who referred to hospice office. Method: Data was collected from January 2004 to November 2004. During the counseling, I took notes the key points and contents. 109 patients and/or their families's counseling records were analyzed with the descriptive statistics and content analysis. Result: 73.4% of patients knew their current terminally ill status. The mobility of 86.2% of the patients was worse than ECOG 3 level. Patients have uncontrolled pain(28.4%), emotional distress(55.0%), and physical distress(49.5%). Caregivers of the patients were spouse(46.8%), sons and daughters(24.8%). Family members had problems to tell the bad news to their family cancer patient. 95.4% of the patient and family members was informed about the hospice and palliative care services, and 35.8% of them was referred to the hospice and palliative organizations. Frequently asked questions were 'what is hospice?', 'how much is the cost of hospice services?' etc. Conclusion: Care planning for terminal cancer patients must include patient. Also, professionals should consider and offer accessible, effective and empathetic counseling services to patients and families.

간호사를 위한 호스피스 완화의료 교육과정 개발

최은숙,김현숙,이소우,유양숙,Choi, Eun-Sook,Kim, Hyun-Sook,Lee, So-Woo,Yoo, Yang-Sook 한국호스피스완화의료학회 2006 한국호스피스.완화의료학회지 Vol.9 No.2

목적: 호스피스 완화간호 실무를 향상시키기 위하여 간호사를 위한 호스피스 완화의료 기본 교육과정을 개발하기 위함이다. 방법 간호사를 대상으로 하는 국내외 호스피스 완화의료 7개 교육과정의 내용을 비교하였으며, 전국의 호스피스 완화의료 기관에서 근무하는 간호사 162명에게 우편으로 교육 요구도를 조사하였다. 결과: 1. 국내외 교육과정에서 공통적으로 다루고 있는 내용은 호스피스 완화요법의 이해, 삶과 죽음의 이해, 말기 환자의 통증 및 증상관리, 기관견학 및 실습, 호스피스 병동 운영의 실제, 가정 호스피스, 건강사정(신체사정), 치료적 의사소통, 아동 호스피스, 호스피스 운영관리, 호스피스 완화의료 팀, 호스피스 완화의료의 윤리와 법, 심리적 사회적 영적 돌봄, 임종 관리, 사별가족관리 등이었다. 2. 간호사의 호스피스 완화의료에 대한 교육 요구도가 3.5점 이상인 문항은 34개였다. 교육 요구도가 높았던 문항은 '죽음의 이해 ', '죽음에 대한 태도와 반응', '통증의 이해와 평가' 등이었고, 이전에 교육받은 경험이 많았던 문항은 '통증 및 증상완화', '호스피스의 윤리와 법', '호스피스 협력 및 홍보체계 구축'이었다. 3. 17개 내용을 강의, 토론 및 증례 등의 교육방법을 통하여 이론교육 48시간과 실습교육 30시간, 총 78시간의 기본 교육과정 을 구성하였다. 결론: 앞으로 개발된 교육과정으로 교육을 시행하여 효과를 평가하고, 호스피스 완화의료기관 실무자들의 교육 요구도를 정기적으로 파악하여 실무의 발전에 기여할 수 있는 표준 교육과정을 개발하는 것이 필요하다. Purpose: The purpose of this study is to develop the basic curriculum for the nurses who work at hospice and palliative care settings. Methods: Seven curricula of hospice and palliative care for the nurses in Korea and other countries were reviewed, and Education Need for hospice and palliative care was surveyed from 162 nurses by mailing the questionnaires to hospice palliative care settings. Results: 1. The curricula of hospice and palliative care for the nurses in Korea and other countries in common include 'understanding of hospice and palliative care', 'understanding of lift and death', 'pain and symptom management for person with terminal disease', 'on-the-spot study and practical training', 'management of hospice and palliative ward', 'hospice and palliative care at home', 'physical assessment', 'therapeutic communication skills', 'children's hospice', 'administration and management of hospice and palliative care', 'interdisciplinary team of hospice and palliative care', 'ethics and laws in hospice and palliative care', 'psychological, social and spiritual care', 'care of the dying', 'bereavement care', etc. 2. The scores above 3.3 were marked for 34 items in education Need Survey. The highest scores were given in the order for the items 'understanding of death and dying', 'attitude and response to death and dying', 'understanding and assessment of pain' etc. respondents marked that they have been trained for 'pain and symptom management', 'ethics and laws in hospice and palliative care', 'building the system for cooperation and publicity activities in hospice' etc. 3. The basic curriculum of hospice and palliative care for the nurses requires 78 studying hours for 17 subjects, comprising 48 hours of theory education and 30 hours of practical training. The education methods are lectures, discussions, and case studies. Conclusion: The efforts of developed basic curriculum should be evaluated after educating nurses. It is necessary to develop the standard curriculum and regularly update it based on the result of education Need Survey for actively working nurses in hospice and palliative care settings.

문학 : 고전시가의 텍스트 변이를 활용한 문화 읽기 교수 학습 방안 -<계녀가>류 가사를 중심으로-

최은숙 ( Eun Sook Choi ) 한서대학교 동양고전연구소 2011 동방학 Vol.20 No.-

본 논문은 고전시가 작품 <계녀가>의 텍스트 변이에서 문화읽기와 관련한 교육적 단서를 확인하고, 고전시가 텍스트를 활용한 비판적 문화읽기 교수 학습 방안을 제안하는 것이 목적이다. 이를 위하여 <계녀가>의 텍스트 변이와 의미, 그리고 그것이 교육적으로 어떤 의미를 지니고 어떻게 활용될 수 있는지에 대해 논의하고, 이를 토대로 학교 현장에서의 구체적인 교수 학습 방안을 제시하였다. <계녀가>는 교훈가사의 일종으로 주된 내용은 가정에서의 여성의 역할과 도리이다. 그러나 유통의 과정에서 향유자들의 욕구와 문화의 변동을 수용하면서 다양한 변이를 나타낸다. 이 가운데 자기서사의 확대는 학습자에게 문학의 당대적 자기화의 과정을 보여줄 수 있다는 점, 작가와 독자의 상호성을 특성으로 하는 고전시가의 형식적 특성을 이해할 수 있게 한다는 점, 학습자가 처한 현재의 자기 서사화를 가능하게 한다는 교육적 의미를 지닌다. 또한 인물형과 관련하여, 인물형의 변이를 확인할 수 있다는 점, 이상적 인물 유형이 당대의 요구에 따라 어떻게 새롭게 구성될 수 있는가를 보여준다는 점에서 의미가 있다. 이를 바탕으로 비판적 문화 읽기의 실제적 교수 학습 방안을 텍스트 이해와 당대문화 읽기 단계, 문화사적으로 읽기 단계, 현재 문화 읽기 단계로 제시하였다. 이러한 교수 학습 방법은 교육 대상 및 텍스트 이해 방법의 확장, 문학과 문화 간의 역동성 이해, 비판적 사고 과정으로서 고전문학 읽기 등과 같은 교육적 의의를 가질 수 있다. This paper aims to discover educational clues related to cultural reading in changed text of a classical work of poetry <Gaenyeoga> and to propose a teaching & learning method of critical cultural reading of classical poetic text that utilized the clue. For that, this paper proposed the modification and meaning of <Gaenyeoga> text, its educational meaning and how it can be utilized for the purpose of education, and a concrete teaching & learning method in a school site based on that. The notable thing in text modification of <Gaenyeoga> is extension of self-narration and modification of a figure type. Among them, extension of self-narration has an educational meaning in that, first, it can show the learner a contemporary self-realizing process of literary; second, it allows the learner to understand the formal features of classical poetry characterized by interaction between the writer and the reader; and, third, it leads the learner to express the situation of the current self. Also, related to a figure type, it is significant in that, first, it can look at modification of a desirable figure type; and second, it shows how a desirable figure type can be formed according to needs of the contemporary society & culture. On the basis of that, a detailed teaching & learning method, devised centering around test of <Gaenyeoga>, can be proposed as follows. 1) Step of text understanding and reading contemporary culture : An activity of understanding text as such, reading contemporary culture and meaning related to text production and enjoyment. 2) Step of reading from the view of cultural history : An activity of expanding contemporary cultural reading through <Gaenyeoga> from the view of cultural history. For that, it is possible to examine a process of feminine images being changed, represented in popular songs in the past or in the early 20th century. 3) Step of reading current culture : 이 In this step, the leaner reads how the current culture the learner itself is in is composed. For that, a lesson of studying the figure type indicated in the media and ascertaining its modification phase. Meanwhile, such a teaching & learning method can have an educational meaning such as 1) expansion of persons subject to education and a method of understanding text, 2) understanding dynamism between literature and culture, 3) reading classical literature as a critical thinking process, etc.

말기 암환자 가족의 돌봄 경험

최은숙(Choi, Eun Sook),김금순(Kim, Keum Soon) 한국간호과학회 2012 Journal of Korean Academy of Nursing Vol.42 No.2