소방공무원의 직무별 외상 후 스트레스

백미례,Baek,Mi-Lye 한국방재학회 2009 한국방재학회논문집 Vol.9 No.3

본 연구에서는 소방공무원의 직무형태별 외상 후 스트레스와 사회적지지 및 업무부담감을 알아보고 직무별 고위험군을 확인 하고 외상 후 스트레스에 영향을 주는 변수들을 알아보고자 하였다. 자료는 C도에 근무하는 소방대원 중 구급 96명, 구조 및 화재진압 85명, 기관 83명인 총 264 명이 수집되었다. SPSS WIN 14.0 program을 이용하여 총 22문항으로 구성된 외상 후 스트레스 검사 도구 (IES-R), 20문항으로 최은숙(2000)이 수정하여 개발한 업무 부담감 측정도구와 오진환(2006)의 연구에서 수정보완 한 사회적지지도구로 분석하였다. 직무별 일반적 특성에 따른 외상 후 스트레스증상의 결과는 나이, 결혼, 학력, 직급, 재직기간이 세 직무집단 간에서 유의한 차이를 보였다. 직무별 외상 후 스트레스는 구조 및 화재 진압에서 가장 높았으며 세집단 간에 유의한 차이를 보였다. 직무별 세 변수와의 상관관계에서 구조 직무군에서 업무부담감(r=.317, p<0.01)이 많을수록 외상 후 스트레스는 높았고, 구급 직무군에서는 사회적 지지(r=-.331, p<0.01)가 낮을수록, 업무부담감(r=.522 p<0.001)이 많을 수록 외상 후 스트레스가 높았고, 기관 직무군에서는 업무부담감(r=.454, p<0.01)이 많을수록 외상 후 스트레스가 높게 나타났다. 고위험군에 속한 군은 구조 및 화재 진압 군에서는 51명(60%) 구급은 53명(55.2%), 기관은 38명(45.8%)으로 전체 264명 중 142명(54%)이었고 직무별 외상 후 스트레스 고위험군에 영향 주는 변수로는 구조 및 화재 진압군은 요구조자 위험을 경험시 느끼는 충격이었으며(odds ratio=1.216, 95% 신뢰구간: 1.068-1.383) 구급직무군은 업무부담감과(odds ratio=1.100, 95% 신뢰구간: 1.043-1.159) 재직기간(odds ratio= 1.010, 95% 신뢰구간 1.001-1.018)으로 나타났고 기관 직무군에서는 요구조자의 위험을 경험시 느끼는 충격(odds ratio=1.178, 95% 신뢰구간: 1.010-1.373), 나이(odds ratio=1.129, 95% 신뢰구간: 1.020-1.249), 업무부담감(odds ratio= 1.103, 95% 신뢰구간: 1.034-1.177)이었다. To investigate a posttraumatic stress, social support and work burden and to identify high risk group and related factors which were exerted influence on posttraumatic stress of firefighters. Data were gathered from total 264 firefighters consisting of 85 fire distinguishers & rescue workers, 96 emergency medical personnel and 83 in ambulance & fire truck drivers in C province and were analyzed 22 items by IES-R, 20 work burden items by Choi(2000), 8 social support items by Oh(2006) using SPSSWIN 14.0 program. Posttraumatic stress of general characteristics by work was showed significant difference in age, marriage status, education, position, office duration, mobilization frequency and experience of traumatic events. Posttraumatic stress were showed significant difference in 3 groups and fire distinguishers & rescue workers is the highest group. Posttraumatic stress was correlated with work burden(r=.317, p<0.01) for fire distinguishers & rescue workers, social support(r=-.331, p<0.01) and work burden(r=.522 p<0.001) for emergency medical personnel and work burden(r=.454, p<0.01) for ambulance & fire truck drivers. The high risk groups are fire distinguishers & rescue workers(60%), emergency medical personnel(55.2%)and ambulance & fire truck drivers(45.8%). Related factors are the experience seeing victim`s danger for fire distinguishers & rescue workers(odds ratio=1.216, 95% confidence interval:1.068-1.383), and are work burden(odds ratio=1.100, 95% confidence interval:1.043-1.159) and office duration(odds ratio=1.010, 95% confidence interval 1.001-1.018) for emergency medical personnel, and are the experience seeing victim`s danger(odds ratio=1.178, 95% confidence interval:1.010-1.373), age(odds ratio=1.129, 95%confidence interval:1.020-1.249), work burden(odds ratio=1.103, 95% confidence interval:1.034-1.177) for ambulance & fire truck drivers.

구급대원의 외상성 스트레스 영향요인

백미례,Baek. Mi-Lye 한국방재학회 2011 한국방재학회논문집 Vol.11 No.1

본 연구는 구급대원의 외상성 스트레스, 사회적지지, 업무부담감과 대처형태를 알아보고 외상성스트레스와 적극적 대처에 영향을 주는 영향변수들을 알아보고자 하였다. 2009년 4~5월까지 중앙소방학교에서 교육 중인 전국과 C도에서 근무하는 구급대원들을 편의표집하여 총143부가 SPSS WIN 14.0 program을 이용하여 분석되었다. 외상성스트레스 검사는 Weiss(1997)가 다시 제작한 IES-R 도구를 사용하였고 최은숙(2000)이 수정, 개발한 업무부담감 측정도구와 오진환(2006)의 연구에서 수정 보완한 사회적 지지 측정도구와 이장호(1988)등의 연구에서 총 62문항으로 구성된 대처방식을 측정도구를 사용하여 분석하였다. 외상성스트레스 고위험군은 74명(51.7%)로 나타났고 일반적 특성에 따른 외상성스트레스 정도는 나이, 결혼, 학력, 직급에서 유의한 차이를 보였다. 유의수준 p=0.000에서 고위험군이 외상성 스트레스의 모든 세 하위영역(t=20.25), 업무부담감(t=5.75), 소극적 대처(t=4.19)와 적극적 대처방법(t=5.61)에서 높은 것으로 나타났다. 외상성스트레스와 주요변인간 상관관계는 유의수준 p=0.000에서 사회적 지지를 제외한 업무부담감(r=0.508), 적극적 대처(r=0.375), 소극적 대처(r=0.505)와 상관관계가 있는 것으로 나타났다. 구급대원들의 외상성스트레스에 가장 큰 영향을 미치는 요인으로는 업무 부담감(0.371)과 소극적 대처(0.366)로 나타났고 또한 외상성 스트레스 고위험군에 가장 영향을 주는 변수로도 업무 부담감(odds ratio=1.064, 95% 신뢰구간:1.031-1.103)과 소극적 대처(odds ratio=1.050, 95% confidence interval:1.022-1.080)로 나타나 일치하였다. 적극적 대처에 가장 큰 영향을 미치는 요인으로는 외상성 스트레스(0.392)와 사회적지지(0.158)로 나타났다. 따라서 구급대원의 외상성 스트레스를 감소하기 위해 업무부담감을 줄이고 소극적 대처를 감소시키고 대신 사회적 지지를 높여 적극적 대처를 할 수 있는 정책적 대안이 필요하다. This study not only investigates emergency medical personnel`s posttraumatic stress(PTS), social support, work burden, and coping style but also identifies related factors which were exerted influence on PTS and active coping method of emergency medical personnels among the firefighters. The data were gathered from 143 emergency medical personnels who were receiving training. The data were collected by IES-R, consisting of twenty-two questions that determine the level of PTS, method used in Cho`s research(2000) that deal with work burden, method used in Oh`s article (2006) relating to social support, and sixty-two questions that deals with coping methods. Then the data gathered were analyzed using SPSSWIN 14.0 program. PTS of general characteristics showed significant difference in age, marriage status, education, and position. High risk group of PTS was 74(51.7%). Work burden, active and passive coping method, and three symptoms in PTS are significantly high(p=0.000) in high risk group. PTS was correlated with work burden(r=0.508, p=0.000), active coping method(r=0.375, p=0.000), and passive coping method(r=0.505, p=0.000) but not with social support. Related factors of PTS were work burden(0.371) and passive coping method(0.366). Also related factors of high risk group of PTS were work burden(odds ratio=1.064, 95% confidence interval:1.031-1.103) and passive coping(odds ratio=1.050, 95% confidence interval:1.022-1.080). Related factors of active coping method were PTS(0.392) and social support(0.158). To minimize the PTS of emergency medical personnels, the new policy should decrease their work burden and passive coping method and strengthen the social support to encourage active coping method.

대구지하철 참사를 경험한 소방관의 외상 후 스트레스유형에 따른 대처방식

백미례,Baek, Mi-Lye 한국응급구조학회 2007 한국응급구조학회지 Vol.11 No.3

The purpose of this study was to identity the distribution of post-traumatic stress types and coping methods and to find the relationship between the post-traumatic stress types and the coping methods, for firefighters who experienced in Dea-Gu Subway Fire Disaster. The Subjects of this study were 126 firefighters who experienced Deagu Subway Disaster. Q questionnaire developed by Q-study and coping methods instrument based on that of Folkman & Lazaruswas revised and complemented by Kim Jung Hee was used. Data were analyzed by t-test, ANOVA using SPSS. The results of this study were as follows : 1. The distribution of post-traumatic stress types were 52.4% of Emotional arousal trauma, 34.1% of Trauma experience persistence and 13.5% of Physiological symptom experience. 2. The difference of post-traumatic stress types according to the general characteristics were significantly related to the physical injury(p = .010). 3. The minimum score of coping with post-traumatic stress types was 0.07, the maximum was 2.96 and the mean score was 1.27. 4. The coping methods according to the general characteristics were significantly different at active coping method according to educational level(p = .001), passive coping method according to educational level(p = .003) and passive coping method according to diagnosis(p = 0.20). 5. The mean score of active coping method according types were Emotional arousal trauma(1.505), trauma experience persistance(1.322) and Physiological symptom experience(1.276). The mean score of passive coping method related with types were Emotional arousal trauma(1.328), trauma experience persistance(1.254) and Physiological symptom experience(1.219).

응급구조과 학생의 첫 임상 실습 경험에 대한 연구

백미례,Baek, Mi-Lye 한국응급구조학회 2003 한국응급구조학회지 Vol.7 No.1

This study was conducted to identify an initial clinical experience of EMT students, so to better understand their' experience in clinical training. The subjects were 30 EMT students of C department of Emergency Medical technology in C city, who were demonstrating at the emergency room in C, T, S, W city. This study was approached by phenomenological method, collected data were analyzed by Colaizzi's method. the results were as a follows. From the protocol, significant statements were organized into 34 formulated meanings. from the formulated meanings, 21themes were identified, organized into 8 theme clusters, and then categories. EMT students got experienced 'tension resulting from new situation', 'fear in contacting with patients', 'lack of knowledge and skill', 'confidence feeling from being adapted', 'facing up to Paramedic role', 'experience of death' and 'stress'. The results of this study are to use as basic data for students attending clinical experience for the first time.

응급구조학과 학생의 시뮬레이션 교육 경험

백미례 ( Mi Lye Baek ) 한국주관성연구학회 2011 주관성연구 Vol.- No.23

신임 소방대원의 외상 후 스트레스 영향요인

백미례 ( Mi Lye Baek ) 한국안전학회(구 한국산업안전학회) 2014 한국안전학회지 Vol.29 No.5

This study investigated a posttraumatic stress, social support, and work burden and identified related factors which exerted influence on posttraumatic stress of new firefighters. Data were gathered from total of 144 new firefighters. Also, 22 PTS items, 20 work burden items, and 8 social support items were analyzed by SPSSWIN 21.0 program. Posttraumatic stress according to general characteristics showed significant difference in gender(t=-2.57, p=0.01), experience of self danger(t=3.06, p=0.00), experience of rescuee danger(t=2.41, p=0.02), and experience of colleague danger(t=3.43, p=0.00). High risk group of PTS was 20.1%. Posttraumatic stress, social support, and work burden showed significant difference in the high and low risk group. Posttraumatic stress was correlated with work burden(r=0.34, p=0.00), social support(r=-0.29,p=0.00). Factors influencing PTS were Experience of colleague danger(β=1.274, 95% CI=0.08-0.96), social support(β=-0.090, 95% CI=0.85-0.98) and work burden(β=0.057, 95% CI=1.02- 1.10). We need to reduce the work burden caused by influencing variable of traumatic stress and create more preventive discipline of traumatic stress for the new firefighters to improve the social support at work or home. Also, posttraumatic stress has to be managed consistently with support by changing the social attitudes and we need to seek the new system that anybody can get a consultation of a specialist.

응급구조학과 시뮬레이션 교육에 참여한 강사들의 경험

백미례(Mi-Lye Baek) 한국콘텐츠학회 2011 한국콘텐츠학회논문지 Vol.11 No.7

본 연구는 응급구조과 시뮬레이션에 참여한 강사의 경험을 확인하기 위해 Colaizzi방법으로 접근하여 분석하였다. 연구결과 28개의 주제와 9개의 주제모음, 4개의 범주가 확인되었다. 즉, 강사들은 ?학습 환경 설계에 대한 불편함?, 「교수자 역할에 대한 부담감」, 「불충분한 교육 여건으로 인한 어려움」, 「새로운 교육에 대한 가능성」을 경험하는 것으로 나타났다. 더 효과적인 시뮬레이션 교육효과를 위해서는 교육 프로그램의 참여와 미리 개발된 시나리오의 적극적 사용과 전문 보조인력을 두고 실습과 연계한 시뮬레이션 교육에 대한 응급구조과 교과과정 개선안이 필요한 것으로 나타났다. This study was conducted to identify instructor's experience on simulation education. The subjects were nine instructors in simulation education of EMT students. Data were collected through documents and in-depth interview from participants. It was analyzed by phenomenological method, using Colaizzi's method. The results of this study were as a follows. From the protocol, significant statements were organized into formulated meanings. The formulated meanings were identified 28 themes, 9 theme clusters, and 4 categories. The 4 categories were as follows; discomfort of forming the learning environment; burden of instructor's role; difficulty from insufficient education condition; possibility of new education. This study suggested that improvement of simulation education can be accomplished by providing opportunities to learn the simulation technology, using the pre-programmed scenarios, having technical support from specialist or additional operator, and adjusting the current paramedic curriculum.

백-밸브-마스크 환기 시 마스크 밀착방법에 따른 환기효과 비교

이남종,백미례,Lee, Nam-Jong,Baek, Mi-Lye 한국응급구조학회 2018 한국응급구조학회지 Vol.22 No.1

Purpose: The purpose of this study was to compare the tidal volumes and airway pressures of 3 mask-sealing methods (one hand C-E, two hands C-E, and one hand O-E) for ventilation treatment. Methods: The study subjects were 45 paramedic students. Tidal volume was measured for the three sealing methods by setting a ventilator, connecting it to the masks for 2 minutes, and using Respi-trainer software. Results: Regarding general characteristics, the group of men, in upper grades, and with practical training experience and experience and experience in the implementation of bag-valve-mask ventilation provided higher tidal volumes. Regarding physical characteristics, larger hands and greater grip strength correlated with higher tidal volume. Two hands C-E generated the highest tidal volume of $483.78{\pm}34.14mL$, one hand O-E generated $449.59{\pm}51.09mL$ and one hand C-E generated $394.31{\pm}68.95mL$. Conclusion: Means of tidal volumes were statistically significantly different based on mask sealing methods (p<.001). Two hand C-E was performed by the two-persons task and was suggested as the most effective method. For the one-person task, one hand O-E was the more effective method compared to the previous one hand C-E.

인공유산에 대한 응급구조학과 학생의 주관성 연구

이경숙(Lee, Kyung-Sook),백미례(Baek, Mi-Lye) 한국산학기술학회 2012 한국산학기술학회논문지 Vol.13 No.12

본 연구는 Q방법론을 적용하여 인공유산에 대한 응급구조학과 학생들의 인식에 대한 주관성을 유형화하고 각 유형별 특성을 설명함으로써 응급구조학과 학생들의 생명윤리 교육의 기초자료를 마련하고자 실시하였다. 연구기 간은 2012년 6월부터 7월까지였으며 40개의 진술문으로 된 Q표본을 응급구조학과 3학년 학생 29명에게 적용하여 QUANL프로그램을 이용하여 자료를 분석한 결과 분류된 3개의 유형은 전체 변량의 61.3%를 설명하고, 각 유형별 설 명력은 유형 1(15명)이 47.4%, 유형 2(9명)가 8.0%, 유형 3(5명)이 5.0%로 나타났다. 1유형은 ‘태아 중심 판단형’, 제 2유형은 ‘모성중심 능동적 판단형’, 제 3유형은 ‘모성 중심 수동적 판단형’으로 명명하였다. 유형 3가지 중 가장 많은 학생들이 포함된 제1유형은 태아생명을 존중하였지만 나머지 두 유형은 태아생명보다는 자신의 삶에 더 가치를 두는 자기중심적 가치관을 나타내고 있다. 이는 의료현장에서 미래에 생명체를 다루게 될 응급구조사로서 상황에 따라서는 생명체를 경시하는 행동을 할 가능성이 높다고 볼 수 있다. 따라서 응급구조학과 학생들에 대한 인공유산에 대한 가 치관 정립하고 생명을 존중할 수 있도록 생명윤리 교육이 적극적으로 이뤄져야 할 필요성을 제시해 주고 있다. The purpose of this study is to build a bioethical foundation for Paramedic students by identifying and explaining the subjective types and structures of the students’ perception on abortion using Q-methodology. Forty statements as a Q sample are selected from the literature and in-depth interview, and P-sample consists of twenty nine junior Paramedic students. The collected data is analyzed by using a QUANL program. The analysis identified three types of the paramedic students’ perception on abortion: The fetus-oriented decision type, The mother-oriented active decision type(n=15), The Type(n=9),and mother-oriented passive decision type(n=5). The three factors all had eigenvalues greater than 1.0 and explained 61.3% of the variance in responses. Based on the result of this research, type 1 focuses on the importance of life, whereas other types seem to demonstrate a self-centered mindse that puts more importance on self than the fetus. Therefore, bioethics courses, especially ones that deal with abortion, are crucial to those paramedic students who handle the lives of others.

최초 반응자를 대상으로 한 심폐소생술 교육결과의 분석

백미례 한국응급구조학회 2000 한국응급구조학회지 Vol.4 No.1

This survey is mainly focus on identifying the efficacy of CPR training for 92 first responders who participated in the first aid and emergency rescue program dated on November 22 and November 24, 2000. First responders are trained and evaluated using AHA guideline for 4 hours. Data are analyzed by Percentage, Mean, T-test, F-test using SPSS program. The results for this study are as follows: 1. An average score for CPR evaluation is high as 1.71 of total score 2.0. 2. Between adult CPR and infant CPR, an average score for adult CPR is higher than infant CPR. The highest item of adult CPR and infant CPR is checking for unresponse(1.95 and 1.93), the lowest items are checking for circulation and chest compression position in the adult CPR and location of chest compression in the infant CPR 3. There are statistically significant differences in the evaluation score of CPR according to age, education level, occupation, job experience and emergency accident situation in the past.