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종이의무기록과 전자의무기록의 기재 충실도 및 일치도 비교 연구: 의사의 입원,퇴원기록지와 간호사의 입원,퇴원간호정보기록지를 중심으로
신아미 ( A Mi Shin ),정선주 ( Sun Ju Jung ),이인희 ( In Hee Lee ),손창식 ( Chang Sic Son ),박희준 ( Hee Joon Park ),김윤년 ( Yoon Nyun Kim ),윤경일 ( Kyung Il Youn ) 한국병원경영학회 2010 병원경영학회지 Vol.15 No.1
This study was tried to evaluate the level of completeness and the accordance in electronic medical records by comparing paper-based medical record in doctor`s admission records, discharge summary, and nursing information records. Medical records of inpatients of neurology department that the 100 paper-based medical records in 2004 and 100 electronic medical records in 2006 were targeted. Existence of record items and doctor-nurse record accordance were evaluated in doctor`s admission record, discharge summary, admission nursing information record, and discharge nursing information record. There were not any differences between electronic medical records and paper-based medical records in doctor`s admission record and discharge summary. Electronic medical records had less missing records than paper-based medical records in admission and discharge nursing information records. Electronic medical records showed higher accordance than the paper-based medical record in doctor-nurse record generally, but there were statistically differences in only medication, allergy, smoking, and drinking(p<0.05). In this study, it was verified that the quality of electronic medical records are better than paper-based records in nursing information record and doctor-nurse record agreement.
신아미(A. M. Shin),박희준(H. J. Park),이인희(I. H. Lee),김윤년(Y. N. Kim) 한국재활복지공학회 2009 재활복지공학회논문지 Vol.2 No.1
본 연구는 데이터 마이닝 기법 중 하나인 순차규칙 모델링을 활용해 뇌경색증 환자의 진단을 분석함으로써 뇌경색증의 선행질환과 합병증을 파악하고 이를 최소화할 수 있는 중재 개발에 기초자료를 제공하고자 시도되었다. 뇌경색증 환자의 진단 관련 데이터는 대구에 위치한 A 의료원에서 2000년에서 2007년 사이 뇌경색증으로 진단받은 환자의 관련 데이터를 추출하여 일괄분석을 위해 데이터마트를 구축하였다. 대상 의료 기관에서 총 2,267명이 뇌경색증을 진단 받았고 추출된 진단 데이터는 총 32,692건이었다. 데이터 분석은 Clementine 12.0의 순차규칙 모델링을 이용하였고 8개의 의미 있는 규칙이 발견되었다. 본 연구 결과는 2차 뇌경색 발생 예방 프로그램 개발 및 뇌경색증 환자의 합병증 예방 중재 개발의 기초자료로 활용할 수 있을 것으로 기대된다. This study was tried to analyze the diagnosis of patients with cerebral infarction by sequence modeling that was one of data mining analysis method and find out previous disease or complication of patients with cerebral infarction. Mass data that the diagnosis code of cerebral infarction was 163 in 2000 to 2007 were extracted from A hospital"s database and then the data mart was constructed for analysis. Total 2,267 patients illnesses were diagnosed as cerebral infarction and 32,692 cases related diagnosis were extracted. Sequence modeling in Clementine 12.0 program was used to analyze diagnosis of patients with cerebral infarction and 8 meaningful rules were found in this paper. This result could be used as a basic data to make secondary cerebral infarction prevention program and to prevent complication of cerebral infarction.
신아미 ( A Mi Shin ),이인희 ( In Hee Lee ),이경호 ( Kyung Ho Lee ),윤경일 ( Kyung Il Youn ) 한국병원경영학회 2010 병원경영학회지 Vol.15 No.2
Ensuring the confidentiality of patient records is critical requirement for quality of care and in fulfilling legal obligation of healthcare organizations. This study analyzed the behavior of hospital employees who are dealing with confidential patient information in a hospital. Theory of Planned Behavior(TPB) model and TPB expanded models that add habit concept to TPB are tested for the validity in explaining the predisposing factors that affect the behavior of hospital employee in ensuring the confidentiality of patient records. Data were collected by administrating a survey to the 350 employee of a tertiary care hospital. Of the 350 questionaries distributed, 321 were responded resulting 92% of response rate. The mean differences among the groups classified by age, years of experience, gender, and occupation were analysis using ANOVA. The relationships among the concepts suggested in the models were analysed by applying the Structural Equations Modeling method. The results of ANOVA indicated significant mean differences in the frequency of confidentiality ensuing behavior. Administrative staff and medical technicians show higher frequency of ensuing behavior compared to the physicians and the nurses. And more experienced employee show more confidentiality ensuring behavior. The results of Structural Equations analysis showed that the strong effect of habit and attitude in predicting the behavior. However, the effect of perceived behavioral control was not significant. Based on the results the theoretical and practical implications are discussed.
대구일 종합병원 전자간호기록 시스템에 대한 사용자 만족도 조사
신아미 ( A Mi Shin ),박희준 ( Hee Joon Park ),정선주 ( Sun Ju Jung ),박명화 ( Myong Hwa Park ),윤경일 ( Kyung Il Yoon ),김윤년 ( Yoon Nyun Kim ) 한국보건통계학회 2009 보건정보통계학회지 Vol.34 No.1
Objective: This study was tried to survey nurse`s satisfaction on the ENR(electronic nursing record) system in general hospital in Daegu. Methods: 250 nurses who were working in the A general hospital in Daegu participated to survey through Questionnaire for User Interaction Satisfaction about satisfaction of electronic nursing record system. Results: Mean score of Questionnaire for User Interaction Satisfaction was 3.18 and this result was statistically higher than middle score of 3. Score of terminology & message was the highest and score of capabilities was lowest in all categories of Questionnaire for User Interaction Satisfaction. Results of stepwise multiple regression between overall evaluation and other categories were that categories of learning, capabilities, screen influenced category of overall evaluation and category of learning was the biggest influence variable. Conclusion: Users seem to be satisfied with the electronic nursing record system and this results could help to modify better electronic nursing record system in A hospital.
데이터 마이닝을 활용한 뇌경색증과 동반되는 질환의 연관성 분석
이인희,신아미,손창식,박희준,김중휘,박상영,최진호,김윤년,Lee, In-Hee,Shin, A-Mi,Son, Chang-Sik,Park, Hee-Joon,Kim, Joong-Hwi,Park, Sang-Young,Choi, Jin-Ho,Kim, Yoon-Nyun 대한물리치료학회 2010 대한물리치료학회지 Vol.22 No.1
Purpose: The purpose of this study was to apply association rule mining to explore the labyrinthine network of cerebral infarction comorbidity and basic data supply to develop cutting-edge physical therapy protocols for cerebral infarction with comorbidity Methods: From clinic records of enrollees of A Hospital in D city, patients over 18 years of age with cerebral infarction and cerebral infarction comorbidity were recruited as a case group. All diagnoses of that hospital were categorized according to the "International Classification of Disease (ICD)" diagnosis system. We extracted code I63 from the "Korea Classification of Disease (KCD)-4". Associated rule mining was done with a priori modeling and Web nodes to examine the strengths of associations among those diagnoses. The support and confidence values of associated rule mining results were examined. Results: The subjects of this study were 2,267 cerebral infarction patients. E11 (Non-insulin-dependent diabetes mellitus), E78 (Disorders of lipoprotein metabolism and other lipidaemias), G81 (Hemiplegia), I10 (Essential hypertension), and K29 (Gastritis and duodenitis) were high frequency diagnoses, being found in 10% or more of total diagnoses of cerebral infarction from frequency analysis results. The highest frequency diagnosis was 1,042 (46.0%) for I10. The second most frequent diagnosis was for E11(21.5%) while the third most frequent diagnosis was E78 (20.2%). Results from a priori modeling and Web nodes indicated that cerebral infarction has a strong association withessential hypertension, non-insulin-dependent diabetes mellitus, disorders of lipoprotein metabolism and other lipidaemias. Conclusion: Cerebral infarction is associated with hypertension, diabetes mellitus, and disorders of lipoprotein metabolism and other lipidaemias. The result of this study will be helpful to clinicians treating patients with cerebral infarction.
호흡곤란환자의 입-퇴원 분석을 위한 규칙가중치 기반 퍼지 분류모델
손창식,신아미,이영동,박형섭,박희준,김윤년,Son, Chang-Sik,Shin, A-Mi,Lee, Young-Dong,Park, Hyoung-Seob,Park, Hee-Joon,Kim, Yoon-Nyun 대한의용생체공학회 2010 의공학회지 Vol.31 No.1
A rule weight -based fuzzy classification model is proposed to analyze the patterns of admission-discharge of patients as a previous research for differential diagnosis of dyspnea. The proposed model is automatically generated from a labeled data set, supervised learning strategy, using three procedure methodology: i) select fuzzy partition regions from spatial distribution of data; ii) generate fuzzy membership functions from the selected partition regions; and iii) extract a set of candidate rules and resolve a conflict problem among the candidate rules. The effectiveness of the proposed fuzzy classification model was demonstrated by comparing the experimental results for the dyspnea patients' data set with 11 features selected from 55 features by clinicians with those obtained using the conventional classification methods, such as standard fuzzy classifier without rule weights, C4.5, QDA, kNN, and SVMs.
물리치료를 받은 선천성 근성 사경 환아의 최종 종괴 지름 예측 모형 개발
이인희,신아미,이경호,박희준,김윤년,Lee, In-Hee,Shin, A-Mi,Lee, Gyeong-Ho,Park, Hee-Joon,Kim, Yoon-Nyun 대한물리치료학회 2009 대한물리치료학회지 Vol.21 No.2
Purpose: The pathophysiology of congenital muscular torticollis (CMT) is that the sternoclavicularmastoid (SCM) is shortened on the involved side by fibrosis, leading to an ipsilateral tilt and contralateral rotation of the face and chin. The aim of this study was to examine the effect of physical therapy and develop a mass diameter prediction model for infants with CMT. Methods: Fifty six patients were diagnosed with CMT between April 2003 and December 2008. Infants with neurological complications, and spasmodic and ocular torticollis were excluded. Physical therapy was applied to those masses in the SCM muscles of those infants after checking their physical findings and the diameter of the mass with ultrasonography. Their physical findings and mass diameter was reevaluated when their neck tilt was under $5^{\circ}$. Results: The mean age when physical therapy was started was 35 days. After a mean 90 days of treatment, the subjects showed improvement in the neck tilt. Subjects whose neck tilted above $15^{\circ}$ showed significant improvement in neck tilt decreased their mass diameter (p<0.01). Facial symmetric infants showed a shorter recovery duration than the facial asymmetric infants (p<0.05). A mass decreasing model based on the diameter of the mass, facial symmetry or not and the physical therapy start day after birth was developed by linear regression. Conclusion: Physical therapy is an effective treatment for CMT. The change in the diameter of the mass on the SCM muscles after treatment can be predicted.
일부 물리치료사와 작업치료사의 환자 의료정보보호 행동 이해
이인희,신아미,손창식,박상영,박희준,윤경일,김윤년,Lee, In-Hee,Shin, A-Mi,Son, Chang-Sik,Park, Sang-Young,Park, Hee-Joon,Yoon, Kyung-Il,Kim, Yoon-Nyun 대한물리치료학회 2010 대한물리치료학회지 Vol.22 No.2
Purpose: The purpose of this study was to use the theory of planned behavior, past habit and moral obligation to better understand the behavior of physical therapists (PTs) and occupational therapists (OTs) in protecting the medical information of patients. Methods: We conducted a survey using self-writting questionnaires structured within the framework of the theory of planned behavior to understand to analyze information from 103 clinical PTs and OTs in their efforts to protect patient medical information. Results: The PTs and OTs' medical information protecting behavior was 2.85 mean points. That point failed to reach 1.0 points. Behavior intention was 3.83 mean points. That was judged to be improved. Behavioral intention was closely correlated with behavior, behavioral attitude, subjective norms, behavior control, and past habit. Variables related to the theory of planned behavior, attitude, subjective norms, and perceived behavior control all explained 50% of the behavioral intention of PTs and OTs regarding future divulgence of patient information. The past habits of PTs and OTs were also a significant predictor in explaining the behavioral intention to protect a patient's medical information (p<0.01). Conclusion: Revising the behavioral attitudes, subjective norms, perceived behavior control, and past habits of PTs and OTs helped improve their behavior regarding protection of the medical information of patents.