가정간호 시범사업 간호진단 및 간호중재 분석 연구

서미혜,이혜원,정춘영 대한간호협회 1995 대한간호 Vol.34 No.5

Prevalence of Obesity and Incidence of Obesity-Related Comorbidities in Koreans Based on National Health Insurance Service Health Checkup Data 2006-2015 (J Obes Metab Syndr 2018;27:46-52)

서미혜,김양현,한경도,이원영,유순집 대한비만학회 2018 The Korean journal of obesity Vol.27 No.3

2018 Korean Society for the Study of Obesity Guideline for the Management of Obesity in Korea

서미혜,이원영,김성수,강재헌,강지현,김경곤,김보연,김양현,김원준,김은미,김현수,신윤아,신혜정,이규래,이기영,이상엽,이성규,이주호,이창범,정소정,조영혜,최경묵,한정순,유순집,대한비만학회 진료지침위원회 대한비만학회 2019 The Korean journal of obesity Vol.28 No.1

Obesity increases the risks of diabetes, hypertension, and cardiovascular diseases, ultimately contributing to mortality. Korean Society for the Study of Obesity (KSSO) was established to improve the management of obesity through research and education; to that end, the Committee of Clinical Practice Guidelines of KSSO reviews systemic evidence using expert panels to develop clinical guidelines. The clinical practice guidelines for obesity were revised in 2018 using National Health Insurance Service Health checkup data from 2006 to 2015. Following these guidelines, we added a category, class III obesity, which includes individuals with body mass index (BMI) ≥35 kg/m2. Agreeing with the International Federation for the Surgery of Obesity and Metabolic Disorders, Asian Pacific Chapter consensus, we determined that bariatric surgery is indicated for Korean patients with BMI ≥35 kg/m2 and for Korean patients with BMI ≥30 kg/m2 who have comorbidities. The new guidelines focus on guiding clinicians and patients to manage obesity more effectively. Our recommendations and treatment algorithms can serve as a guide for the evaluation, prevention, and management of overweight and obesity.

노지고추에 발생하는 주요 해충 발생 현황

서미혜,김동환,김형환,양창열,윤정범 한국응용곤충학회 2017 한국응용곤충학회 학술대회논문집 Vol.2017 No.10

기후변화에 따른 노지고추의 해충 발생 추이를 비교해 보고자, 3 지역의 주산지를 중심으로 조사를 수행하였다.6월 상순부터 9월 중순까지 총채벌레, 담배나방, 진딧물, 노린재류가 주로 발생하였으며 총채벌레는 6월 하순부터증가하기 시작하여 7월 상순과 중순에 밀도가 가장 높았다. 시기별로 총채 벌레를 채집하여 동정을 한 결과 대만총채벌레, 꽃노랑총채벌레, 파총채벌레가 주로 발생하고 있었다. 연도별에 따른 발생양상에서는 2016년은 대만총채벌레가많았던 것에 비해 2017년은 대만총채벌레와 꽃노랑총채벌레가 많이 발생하였으며 두 종간에는 유사한 밀도를나타내었다. 노린재류는 톱다리개미허리노린재, 알락수염노린재, 썩덩나무노린재가 주로 발생하였는데 특히, 톱다리개미허리노린재의 경우 노지고추의 주위작으로 콩과작물을 재배하고 있던 농가에서 그 발생 비율이 매우 높게나타났다.

Metabolic and Cardiovascular Implications of a Metabolically Healthy Obesity Phenotype

서미혜,이은정 대한내분비학회 2014 Endocrinology and metabolism Vol.29 No.4

Metabolically healthy obesity (MHO) is a new concept in which an individual may exhibit an obese phenotype in the absence of any metabolic abnormalities. There are a number of definitions of MHO that utilize a variety of components. The findings of clinical and basic studies indicate that subjects with MHO do not exhibit an increased mortality, an increased risk of cardiovascular disease, or an increased risk of type 2 diabetes mellitus, as compared to normal-weight controls. Although these findings imply that metabolic health is a more important factor than obesity, several studies have shown that subjects with MHO have a similar risk of metabolic or cardiovascular diseases as those with metabolically unhealthy obesity. Thus, there is still debate regarding not only the implications of the MHO phenotype but its very existence. Accordingly, future studies should focus on developing a unified definition of MHO and distinguishing subjects who will be at a high risk for metabolic and cardiovascular diseases.

가정간호에서 사용된 간호진단과 간호중재 분류

서미혜,허혜경,Suh, Mi-Hae,Hur, Hae-Kung 한국가정간호학회 1998 가정간호학회지 Vol.5 No.-

This study was done to identify basic information in classifying nursing diagnoses and nursing interventions needed for the further development of computerized nursing care plans. Data were collected by reviewing charts of 123 home care clients who had active disease, for whom at least one nursing diagnosis was on the chart, and who had been discharged. Data included demographics, medical orders, nursing diagnoses and nursing interventions. The results of the study, which found the most frequent medical diagnoses to be cancer (40.7%) and brain injury (26.8%), showed that 'Impaired Skin Integrity'(18.3%), 'Risk for Infection'(15.0%), 'Altered Nutrition, Less than Body Requirements'(13.8%), and 'Risk for Impaired Skin Integ rity'(9.9%) were the most frequent nursing diagnoses. 'Pressure Ulcer Care'(28.4%) was the most frequent intervention for 'Impaired Skin Integrity', 'Infection Protection'(16.0%) for 'Risk of Infection', 'Nutrition Counseling'(26.8%) for 'Altered Nutrition' and 'Positioning'(22.0%) for 'Risk for Skin Integrity Impairment', Comparison of interventions with the Nursing Intervention Classification(NIC) showed that the most frequent interventions were in the domain 'Basic Physiological' (33.94%), followed by 'Behavioral'(27.8%), and 'Complex Physiological' (22.6%). Interventions related to teaching family to give care at home could not be classified in the NIC scheme. Examination of the frequency of NIC interventions showed that for the domain 'Activity & Exercise Management', 75% of the interventions were used, but for seven domains, none were used. For the domain 'Immobility Management', 93% of the times that an intervention was used, it was 'Positioning', for the domain 'Tissue Perfusion Management', 'IV Therapy' (59.1%) and for the domain 'Elimination Management', 'Tube Care: Urinary'(54.0%). The nursing diagnoses 'Altered Urinary Elimination' and 'Im paired Physical Mobility' were both used with these clients, but neither 'Fluid Volume Deficit' nor 'Risk of Fluid Volume Deficit' were used rather 'IV Therapy' was an intervention for 'Altered Nutrition, Less than Body Requirements', A comparison of clients with cancer and those with brain injury showed that interventions for the nursing diagnosis 'Impaired Skin Integrity' were more frequent for the clients with cancer, interventions for 'Risk of Infection' were similar for the two groups but for clients with cancer there were more interventions for' Altered Nutrition'. Examination of the nursing diagnoses leading to the intervention 'Positioning' showed that for both groups, it was either 'Impaired Skin Integrity' or 'Risk for Skin Integrity Impairment'. This study identified a need for further refinement in the classification of nursing interventions to include those unique to home care and that for the purposes of computerization identification of the nursing activities to be included in each intervention needs to be done.

Management of Blood Pressure in Patients with Type 2 Diabetes Mellitus: A Nationwide Survey in Korean

서미혜,이우제,박철영,김성래,박중열,윤건호,이문규,박성우 대한당뇨병학회 2011 Diabetes and Metabolism Journal Vol.35 No.4

Background: Hypertension is common in patients with type 2 diabetes, affecting up to 60% of patients. The Korean Diabetes Association performed a nationwide survey about prevalence, awareness and control of hypertension among diabetic Koreans. Methods: The current survey included 3,859 diabetic patients recruited from 43 hospitals in Korea. Age, gender, height, weight and blood pressure (BP) were measured by standard methods. Data on fasting plasma glucose, glycosylated hemoglobin (HbA1c), awareness of hypertension, and compliance of antihypertensive medication were collected via interview and reviewed using patient medical records. Results: A total of 57.5% of all patients were >60 years old. Their mean HbA1c was 7.6±1.5%. Among antihypertensive medication users, 39.9% had <130 mm Hg and <80 mm Hg, whereas 60.1% had ≥130 mm Hg or ≥80 mm Hg. The answer “BP is under good control” was given by 75.1% of the antihypertensive medication users. Out of these patients, 26.4% had <130 mm Hg and <80 mm Hg, whereas 73.6% had ≥130 mm Hg or ≥80 mm Hg. A total of 75.5% of antihypertensive medication users answered that they had taken their antihypertensive medication every day for the past 2 weeks. “Forgetfulness” was most frequently the reason of non-compliance for patients that did not take their antihypertensive medication regularly. Conclusion: Approximately one third of the patients with diabetes were found to reach target blood pressure control in the 43 hospitals across Korea. Stricter control is needed to reduce severe complications of diabetes in Korea.

Prevalence of Obesity and Incidence of Obesity-Related Comorbidities in Koreans Based on National Health Insurance Service Health Checkup Data 2006–2015

서미혜,김양현,한경도,정진형,박용규,이성수,권혁상,이원영,유순집 대한비만학회 2018 The Korean journal of obesity Vol.27 No.1

Background: The prevalence of obesity and related comorbidities is increasing worldwide, including in Korea. The Korean Society for the Study of Obesity released the Obesity Fact Sheet 2017 to address this problem in the Korean population. Methods: Data from the National Health Insurance Service Health Checkup database from 2006 to 2015 were standardized by age and sex using the 2010 Census. The definition of obesity was a body mass index (BMI) ≥25 kg/m2, and that of abdominal obesity was a waist circumference ≥90 cm in men and ≥85 cm in women. Multivariate adjusted Cox regression analysis was conducted, and hazard ratios (HRs) with 95% confidence intervals were calculated for comorbidities. Results: From 2009 to 2015, the prevalence of obesity increased from 29.7% to 32.4%, and that of abdominal obesity increased from 18.4% to 20.8%. Obesity with abdominal obesity also increased from 15.1% to 17.7%. Between 2014 and 2015, the prevalence of obesity increased until 30–40 years of age, but decreased from 40–50 years of age in men. In women, it increased until the mid-70s, and decreased thereafter. Abdominal obesity increased from 20–30 years of age to 70–80 years of age, but decreased thereafter. The HRs for type 2 diabetes mellitus, hypertension, dyslipidemia, myocardial infarction, and ischemic stroke were elevated in subjects with abdominal obesity, and their incidence increased as the BMI increased, but slowed down at BMI ≥35 kg/m2. Conclusion: Based on the Obesity Fact Sheet 2017, strategies for reducing the prevalence of obesity and abdominal obesity are essential.

서해안 주요 고추 주산지에서 발생하는 총채벌레의 발생현황

서미혜,이성찬,양창열,윤정범,박정준 한국환경생물학회 2018 환경생물 : 환경생물학회지 Vol.36 No.4

2017년과 2018년 노지고추 재배기간인 6~8월 간 전북 고창, 충남 청양, 충북 괴산지역 노지 고추 포장에서 총채벌레의 종류와 발생현황을 조사하였다. 시기별로 총채벌레를 채집하여 동정한 결과 꽃노랑총채벌레 (Frankliniella occidentalis), 대만총채벌레 (F. intonsa), 파총채벌레 (Thrips tabaci)의 발생이 확인되었다. 이들 3종 중 대만총채벌레가 시기별로 가장 발생 밀도가 높은 것으로 보아 우점종으로 보여진다. 총채벌레의 발생은 6월 하순부터 증가하기 시작하여 7월 중순에 밀도가 가장 높았다. 따라서, 노지고추에서 총채벌레 방제전략은 6월 상순부터 모니터링하여 밀도증가 이전에 적절한 방제방법을 동원하여야 할 것이다. Thrips populations were monitored in field-cultivated pepper at Gochang, Jeonbuk province, Cheongyang, Chungnam province, and Goesan, Chungbuk province during the field growing seasons of 2017 to 2018, respectively. We classified and quantified thrips population in each plot and year. Most of the monitored thrips were composed of three species: Frankliniella intonsa, F. occidentalis, and Thrips tabaci, respectively. F. intonsa was the dominant species in all the monitoring season. The density of thrips was increased from late June in each field and year with the highest density being recorded in mid-July. Based on the results, management strategy of thrips in red peppers should be evaluated from early June with monitoring and appropriate controls.

일 종합병원의 가정간호사업 : 원주기독병원편

서미혜 연세대학교 간호정책연구소 1993 간호학탐구 Vol.2 No.1