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초등학교 저학년 아동의 글씨쓰기와 실행능력과의 상관관계
유승복,김진주,김경미 대한감각통합치료학회 2006 대한감각통합치료학회지 Vol.4 No.1
Objective : The purpose of this study was to examine the correlation between handwriting skills and praxis. Method : Participants consisted of 50 normal children who were the second-grade students at an A elementary school in Kim-hae. They didn't have a visual dysfunction, an auditory dysfunction, and a disease or an injury in arms and hands. They could follow examiners' directions properly. They were administered the Postural Praxis and the Praxis on Verbal Command of the Sensory Integration and Praxis Tests(SIPT)(Ayres, 2000) and the handwriting skill test which was made with reference to foreign literatures. It was conducted from October 19, 2004 to December 17, 2004. The data were analyzed with non-paired t-test, ANOVA, and Pearson correlation coefficient. Results : 1. Total handwriting score and praxis according to gender of children showed the statistically significant differences(p<0.05). 2. Total handwriting score correlated with praxis(p<0.05) and handwriting speed did not correlate with praxis. 3. Postural Praxis and Praxis on Verbal Command according to handwriting groups showed the statistically significant differences(p<0.05). 4. Among the standards of the handwriting skill test, accuracy of letter form, identity of letter size, spacing between letters and words, placing text on lines, error existence, and letter out of regular square correlated with the Postural Praxis(p<0.05), and accuracy of letter form, identity of letter size, and placing text on lines correlated with the Praxis on Verbal Command(p<0.05). Conclusions : The correlation between handwriting skills and praxis will help occupational therapists to provide fundamental and various treatment programs for children who are referred for the poor handwriting. But more studies in handwriting skills and praxis are necessary to decide which component of handwriting skills is related to praxis.
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중환자의 욕창 예방 연구 : 욕창 예방 QI팀을 중심으로
강소영,최은경,김진주,주미정 한국의료QA학회 1997 한국의료질향상학회지 Vol.4 No.1
Background : A pressure sore was defined as any skin lesion caused by unrelieved pressure and resulting in damage to underlying tissue. The health care institutions in the United States were reported the incident rate of pressure sores ranging from 6 to 14%. United states were reported the incident rate of pressure sores in patients rate of pressure sore. Also, Annual expenditures for the care of pressure sores in patients in the United States have been estimated to be $7.5 billion; furthermore, 50 percent more nursing time is required to care for patients with pressure sore in comparison to the time needed to implement preventive measures against pressure sore formation. However, In Korea, there were little reliable reports, or researches, about incidence rates of pressure sore in health care institution including intensive care unit and about the integrated approach like CQI action team for risk assessment, prevention and treatment of pressure ulders. Therefore, this study was to develop pressure sore risk assessment tool and the protocol for prevention of pressure sore formation through CQI action team activities, to monitor incident rate of pressure sore and the length of sore formation for patients at high risk, and to approximately estimate nursing time for sore dressing during research period as the effect of CQI action team. Method : CQI action team in intensive care unit, launched since early 1996, reviewed the literature for the standardized risk assessment tool, developed the pressure sore assessment tool based on the Braden Scale, tested its validity, compared on statistics including incidence rate of pressure sore for patients at high risk. Throughout these activities, CQI action team was developed the protocol.called as St. Marys hospital Intensive Care Unit Pressure Sore Protocol, shifted the emphasis from wound treatment to wound prevention, After applied the protocol to patients at high risk, the incident rate and the period of prevention against pressure development were tested with those for patients who received care before implementation of protocol by Chi-square and Kaplan-Meier Method of Survival Analysis. Result : The CQI action team found that there was significant difference of incidence rate of pressure sores between patients at high risk( control group) who received care implementation of protocol (p<.05). 25% possibility of pressure sore formation was shown for the patients with 6th hospital day in ICU in control group. In experimental group, the patients with 10th hospital day had 10% possibility of pressure sore. Therefore, there was significant difference(p< .05) in survival rate between two groups. Also, nursing time for dressing on pressure sore in experimental group was deceased as much as 50% of it in control group. Conclusion : The collaborative team effort led to reduced incidence, increased the length of prevention against pressure sore, and declined nursing care times for sore dressing. However, there have had several suggestions for future study. The preventive care system for pressure sore should be appleed to patients at moderate, or low risk throughout continuous CQI team activities based on Bed sore Indicator Fact Sheet. Hospital-wide supports, such as incentives, would be offered to participants for keeping strong commitment to CQI team. Also, Quality Information System monitoring incidents and estimation cost of poor quality. like workload(full time equivalence) or financial loss, regularly in a hospital has to be developed first for supporting CQI team activities as well as empowering hospital-wide QI implementation. Being several limitations, this study would be one of the report cards for the CQI team activities in intensive care unit of an acute hospital and a trial of quality improvement of health care in Korea.
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