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      • KCI등재후보

        약국서비스 만족에 영향을 미치는 요인 분석 : 환자체감시간과 실 조제시간 비교를 중심으로

        박성희,서준규,윤혜설,홍진영,박군제 한국의료QA학회 1998 한국의료질향상학회지 Vol.5 No.2

        Purpose : To shorten processing time for variety of medical affairs of the patient at the outpatient clinic of a big hospital is very important to qualify medical care of the patient. Therefore, patient's waiting time for drug delivery after doctor's prescription is often utilized as a strong tool to evaluate patient satisfaction with a medical care provided. We performed this study to investigate factors influencing patient satisfaction related with waiting time for drug delivery. Methods : The data were collected from July 21 to August 12, 1998. A total 535 patients or their families who visited outpatient clinics of Inha University Hospital were subjected to evaluate the drug delivery time and the level of their satisfaction related, which were compared with those objectively evaluated by Quality Improvement Team. The reliability of the scale was tested with Cronbach's alpha, and the data were analyzed using frequency, t-test, ANOVA, correlation analysis and multiple regression. Results : The mean drug delivery time subjectively evaluated by the patient (16.1 13.0 min) was longer than that objectively evaluated (10.9 7.6 min) by 5.2 min. Drug delivery time objectively evaluated was influenced by the prescription contents, total amount or type of drug dispensed, etc, as expected. The time discrepancy between two evaluations was influenced by several causative factors. One of those proved to be a patient's late response to the information from the pharmacy which the drug is ready to deliver. Interestingly, this discrepancy was found to be more prominent especially when waiting place for drug delivery was not less crowded. Other factors, pharmaceutical counseling at the pharmacy, emotional status or behavior of a patient while he waits for the medicine, were also found to influence the time subjectively evaluated. Regarding the degree of patient satisfaction with the drug delivery, majority of patients accepted drug delivery time with less than 10 min. It was also found to be influenced by emotional status of the patient as well as kindness or activity of pharmaceutical counselor. Conclusion : The results show that, besides prescription contents, behavior pattern or emotional status of a patient, environment of the waiting place, and quality of pharmaceutical counseling at the pharmacy, may influence the patient's subjective evaluation of waiting time for drug delivery and his satisfaction related with the service in the big hospital. In order to improve patient satisfaction related with waiting time for drug delivery, it will be cost effective to qualify pharmaceutical counseling and information system at the drug delivery site or waiting place rather than to shorten the real processing time within the pharmacy.

      • KCI등재

        한국어 판 구조화 임상면담도구 개발 : 신뢰도 연구

        한오수,안준호,송선희,조맹제,김장규,배재남,조성진,정범수,서동우,함봉진,이동우,박종익,홍진표 대한신경정신의학회 2000 신경정신의학 Vol.39 No.2

        연구목적: 정신장애의 정확한 진단과 평가는 임상에서뿐만 아니라 신뢰성 있는 연구를 위해서도 매우 중요하다. Structured Clinical Interview for DSM-IV(SCID)는 임상전문가들이 사용하는 진단도구로서, 비교적 짧은 시간에 정확한 진단을 내릴 수 있다. 본 연구는 한국어판SCID를 개발하고 그 신뢰도를 평가하기 위해 수행되었다. 방법: 국문학자가 포함된 번역위원회를 통하여 연구용판 SCID를 번역한 후, 정신과 의사 2인과 임상심리학자 1인에게 한국어판SCID 실시방법을 교육시킨 뒤 한국어판SCID를 이용한 면담의 평가자간 신뢰도 (interrater reliability)를 검증하였다. 면담 대상은 1999년 2월에서 3월까지 2개 병원 정신과에 치료중인 환자 90명(남:41명, 여:29명)이었다. 결과: 현재 장애(current disorder) 평가에서 주요 우울장애, 기분부전장애, 정신분열병, 알코올 남용 및 의존, 기타 물질 남용 또는 의존, 여러 불안장애들 및 섭식장애 등과 같은 대부분 장애의 kappa값은 .70이상으로 매우 높았다. 그 이외의 양극성 장애, 망상장애, 광장공포증, 감별 불능 신체화 장애 및 건강염려증의 kappa값도 .69에서 .40사이로 수용할 수 있는 정도였다. 평생 장애(lifetime disorder)에서는 양극성 장애(k=.69)와 감별 불능 신체화장애(k=.59)를 제외한 다른 모든 장애의 kappa값이 .70이상이었다. K-SCID 면담시 Ⅰ축 질환에 대하여 흔하게 다중 진단이 내려졌으며, 평균 진단 수는 1.5∼1.7개로 나타났다. 결론: 한국어판 SCID는 신뢰도가 높은 진단도구로 생각되며, 향후 정신질환의 정확한 진단과 임상연구에 유용하게 사용될 수 있다. Objectives: Accurate diagnosis and assessment for psychiatric disorders is crucial for research, as well as for clinical practice. Structured Clinical Interview for DSM-Ⅳ(SCID-RV) is a less time-consumimg and more accurate structured diagnostic interview form. It can be used by clinical professions and is known for a reliable diagnostic tool. Present study was conducted to develop Korean version of SCID-RV and to test the inter-rater reliability. Methods: The authors have translated original SCID-RV into Korean, and revised in parallel with sociocultural background of Korea. Ninety patients from two psychiatric hospitals, both outpatient and inpatient, were interviewed and rated independently by three raters. Results: The kappa coefficients for most of illnesses, such as major depressive disorder, dysthymia, schizophrenia, alcohol abuse and dependency, anxiety disorder and eating disorder were excellent(>0.70) in the evaluation of current disorders. And the kappa coefficients for bipolar disorder, delusional disorder, agoraphobia, undifferentiated somatoform disorder, and hypochondriasis were acceptable(>0.40) in the evaluation of current disorders. In the evalua-tion of lifetime disorders, the concordant rates of all the diagnoses except bipolar disorder and undifferentiated somatoform disorder were excellent. Lack of hierarchy in DSM-Ⅳ allows for multiple Axis I diagnoses. Mean numbers of Axis I diagnoses per subject assigned by the three raters were 1.5-1.7. Conclusions: Our findings confirm that SCID-RV yields highly reliable diagnoses. SCID-RV is recommended for accurate diagnosis in clinical practice and research on psychiatric disorders.

      • 추비시기가 양파의 수량 및 저장성에 미치는 영향

        김희대,이찬중,정은호,서전규 한국식품저장유통학회 ( 구 한국농산물저장유통학회 ) 2003 한국식품저장유통학회지 Vol.10 No.3

        토양분석 결과 시험전에 비해 P_(2)O_(5), K, EC의 함량이 시험 후에 높았고, 식물체 분석결과 늦게까지 추비한 처리에서 C_(a)O의 함량이 높았다. 생육은 처리간 일정한 경향이 없었고 수량은 농가관행의 고형비료 처리가 시험장 및 농가포자에서 ㏊당 53.MT 및 56.6MT인 것에 비해 2월과 3월 액비처리는 58.2MT 및 60.8MT, 3월과 4월 액비처리는 53.6MT 및 59.1MT 였다. 8월 하순까지의 부패율은 농가관행 고형비료 처리가 각각 23.6% 및 41.0%인 것에 비해 2월과 3월에 액비로 추비한 것이 15.8% 및 28.9%로 가장 낮았으며, 3월과 4월에 액비로 추비한 것은 20.7% 및 31.7%였다. This study was carried out to investigate the yield and storability of onions on top-dressing period. Top-dressing period was applied in February, March and March, April with liquid fertilizer and solid fertilizer of farmhouse practice during the onion growing season. The yields of onion in experimental station field and farmhouse field treated with conventional fertilization were 53.2 and 56.6MT, respectively. However, they were 58.2 and 60.8MT with application of liquid fertilizer in February August were lower with application of liquid fertilizer on February and March(15.8%, 28.9%, compared with application of solid fertilizer by farmhouse practice(23.%, 41.0%), and were 20.7% and 31.7% by treatment of liquid fertilizer on March and April. In conclusion, treatment of liquid fertilizer on February and March decreased the rotting rate.

      • KCI등재

        한국 정신장애의 역학 조사 연구[I] : 각 정신장애의 유병률

        조맹제,함봉진,김장규,박강규,정은기,서동우,김선욱,조성진,이준영,홍진표,최용성,박종익,이동우,이기철,배재남,신정호,정인원,박종한,배안,이충경 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.4

        Objectives : This study aims to estimate the prevalence of the DSM-IV psychiatric disorders in Korean population using the Korean version of Composite International Diagnostic Interview (K-CIDI). Methods : Subjects were selected by taking multi-stage, cluster samples of 7,867 adult household residents, 18 to 64 years of age, in ten catchment areas. Total 78 trained interviewers administered the K-CIDI to the selected respondents, from June 1 to November30,2001. Results : Total 6,275 respondents completed the interview. Some 33.5% of respondents reported at least one lifetime disorder, 20.6% reported at least one-year disorder, and 16.7% reported at least one-month disorder. The most common lifetime disorders were alcohol abuse/dependence (17.24%), nicotine dependence/withdrawal (11.19%), specific phobia (5.16%), and major de-pressive disorder (4.25%). The lifetime prevalence of substance abuse/dependence (0.25%) and schizophrenia (0.16%) was very low. Nicotine and alcohol use disorder showed very high male/female ratio. Mood disorder and anxiety disorder were more prevalent among female than male. Conclusion : The prevalence of psychiatric disorders was high. In comparison with other studies, remarkable differences in distributions of psychiatric disorders across the areas and times were observed.

      • KCI등재후보

        당뇨병환자에서 뇨증 Fibronectin농도의 증가에 관한 연구

        한승범,조준승,손건영,서성문,박근용,조성래,박규영,박정모,이인규,여준기 啓明大學校 醫科大學 1994 계명의대학술지 Vol.13 No.4

        Plasma fibronectin is an α₂-glyoprotein, which is produced by vascular endothelial cells. Raised level of plasma fibronectin has been observed in diabetic patients particularly in the presence of microvascular complications. However, no available data exist about urine level of this glycoprotein in diabetic patients. We measured urine fibronectin level by ELISA methods in 54 diabetic patients who have microvascular comlications or not. The following results were obtained. 1) Urine fibronectin level(㎍/g creatinine) in diabetic group(1740.0±678.0) is increased compaired with those in normal control group(471.0±59.0). but this results were not significantly different among two groups(P>0.05). 2) Urine fibronectin level(㎍/g creatinine) was significantly increased in patients with nephropathy (6188.0±3144.0) compared with those in normal control group(471.0±59.0) and patients without nephropathy(645.0±251.0)(P<0.001). 3) There were a significant correlation between BUN, creatinine, creatinine clearance, 24hr urine total protein and urine fibronectin level in diabetic patients. Our data suggest that urine fibronectin excretion level might be used as a sensitive guide for diabectic nephropathy.

      • 간세포암에 대한 화학 색전 및 주입 요법 후에 발생한 발열과 감염성 합병증에 관한 전향적 연구

        김양수,이상오,이미숙,정두련,김은옥,정영화,우준희,이영상,서동진,성규보,류지소,고기영 대한감염학회 1998 감염 Vol.30 No.3

        목적 : 간동맥 화학 색전 및 주입 요법을 시행 받은 환자에서 시술 후 나타나는 발열 및 감염성 합병증의 빈도와 특성을 관찰하고, 이들 중 감염성 합병증이 발생한 환자들을 미래 예측할 수 있는 임상적 지표들이 있는 지 알고자 하였다. 방법 : 1997년 6월부터 8월까지 간세포암으로 간동맥 화학 색전 및 주입 요법을 시행받은 환자들을 대상으로 전향적으로 조사하였다. 화학 색전 및 주입 요법 시행 후 발열이 발생하였으나 감염 및 간 회 색전증의 증거 없이 자연히 소실된 경우에 한해 색전술 후 증후군이라고 정의하였다. 결과 : 284명에서 303예의 시술(화학 색전 요법 200예, 주입 요법 103예)이 시행되었다. 이중 108예(35.6%)에서 시술 후 발열이 있었다. 발열의 원인으로 감염성 합병증이 7예 (2.3%), 허혈성 담낭염이 5예(1.7%)였고 1예는 분류가 힘들어 나머지 95예(31.4%)를 색전술 후 증후군으로 분류하였다. 감염성 합병증은 배양 음성 중성구성 복수(culture-negative neutrocytic ascites)가 3예, 원발성 세균성 복막염이 2예(이중 1예는 패혈증 동반), 패혈송 쇽이 1예, 요로 감염증이 1예이었다. 색전술 후 증후군은 발열이 없었던 군에 비해 복수가 있거나(odds ratio [OR], 2.74; 95% contidence interval [CI], 1.30∼5.75) 종양이 클수록 (OR, 1/15; 95% CI, 1.06∼1.24), 도한 좌우 감동맥을 모두 막은 경우 (OR, 1.81; 95% CI, 1.00∼3.28) 빈번하게 발생하였다. 감염성 합병증일 때에는 색전술 후 발열이 있으면서 systemic inflammatory response syndrome(SIRS)의 기준을 만족하거나 (p<0.05) 시술 후 72시간 이후에 복부 동통이 발생하는 경우가 많았다.(p<0.01). 그러나 발열 시 감염을 미리 구별할 수 있는 검사실 소견은 없었다. 결론 : 간세포암에 대한 화학 색전 및 주입 요법 후 색전술 후 증후군은 31.4%, 감염성 합병증은 2.3%에서 발생하였다. 색전술 후 발열이 있으면서 SIRS의 기준을 만족하거나 시술 후 72시간 이 후에 복부 동통이 발생할 때에는 감염성 합병증을 반드시 고려해야 하겠다. Background : Transarterial chemoembolization(TACE) and chemoinfusion (TACI) are the methods used increasingly in hepatocelluar carcinoma patients. In this study, the incidence of fever and infectious complications after TACE or TACI in pateints with hepatocellular cacinoma was investigated and clinical parameters predicting such complications were evaluated. Methods : Prospective surveys were done in hepatocelluar carcinoma patients who had undergone TACE or TACI from June August, 1997. Three hundred three treatment cases with TACE (200) or TACI (103) in 284 patients were analyzed. The postembolization syndrome was defined as fever following TACE or TACI that spontaneously subsided without the evidence of infections or extrahepatic emboilizations. Results : One hundread eight (35.6%) out of 303 cases showed fever after the treatment. Regarding the etiology of the fever, after the treatment. Regarding the etiology of the fever, infections occurred in 7 cases (2.3%), and ischemic cholecystitis existed in 5 cases (1.7%). In one case the cause was not clear and 95 cases (31.4%) were classified as the postembolization syndrome. Out of the infections, three had culture-negative neutrocytic scites, two spontaneous bacterial peritonitis (one was accompanied with sepsis), one septic shock, and one urinary tract infection. The postembolization syndrome was more frequently found in the cases with ascites (odd ratio [OR], 2.74; 95% confidence interval[CI], 1.30∼5.75), with larger tumor (OR, 1.15; 95% CI, 1.06∼1.24) and with embolization both hepatic arteries (OR, 1.81; 95% CI, 1.00∼3.28). In the cases with infections, many satisfied the criteria for systemic inflammatory response syndrome (SIRS, P<0.05) or had abdominal pain 72 hours later (P<0.01) after the treatment. However, no other laboratory data predicted infection among the cases with fever. Conclusion : After TACE or TACI in hepatocellular carcinoma patients, 31.4% of cases showed the postembolization syndrome and 2.3% of cases showed infection. Infection should be considered as a cause of fever in patients satisfying the criteria for SIRS or with abdominal pain 72 hours later after the treatment.

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