병원 근로자들의 고용형태에 따른 직무 스트레스와 삶의 질의 관계

전은숙,이강숙,이선영,유재희,홍아름 大韓産業醫學會 2009 대한직업환경의학회지 Vol.21 No.1

목적 본 연구는 병원에 종사하는 정규직 비정규직 근로자의 직무스트레스와 삶의 질 수준을 파악하고 직무스트레스와 삶의 질과의 관련성 및 삶의 질에 영향을 미치는 요인을 규명하기위해 수행되었다 방법 자기기입형 설문조사를 실시하였으며 정규직 172명 비정규직 189명이 최종 분석하였다 일반적 특성과 한국인 직무스트레스 측정도구-단축형 (Korean occupational stress scale short form) 삶의 질 측정을 위한 도구 WHOQOL-BREF를 사용하였다 결과 정규직에 비해 비정규직에서 직무스트레스 수준이 높았다 정규직은 직무요구도와 직장문화의 항목에서 비정규직은 직무자율성 직무불안정성 보상부적절의 항목에서 직무스트레스 요인이 유의하게 많았다 삶의 질수준은 정규직 근로자에서 유의하게 높았으며 심리적 영역 사회적 영역 생활환경 영역에서 비정규직보다 유의하게 높은 수준을 보였다 결론 정규직과 비정규직 근로자의 직무스트레스 요인과 삶의 질 수준은 달랐다 고용형태를 막론하고 직무스트레스는 삶의 질에 부정적인 영향을 미치고 있었으며 비정규직은 직장문화로 인한 스트레스 요인이 많을수록 삶의 질이 낮았다 따라서 병원근로자의 삶의 질 향상을 위하여 적절한 관리 혹은 프로그램이 제공되어야 할 것이며 특히 비정규직 근로자의 직무스트레스를 일으키는 요인들에 대한 적절한 관리가 필요할 것이다 Objective This study was conducted to evaluate the relationship between job stress and quality of life for hospital workers by type of employment Methods Data were obtained for 361 workers in a large hospital 172 of whom were categorized as typical workers defined by permanent employee and 189 of whom were categorized as atypical workers defined by fixed term contraction Job stress was assessed using the Korean Occupational Stress Scale Short Form and the World Health Organization Quality of Life-BREF Questionnaire Results Atypical workers had significantly higher scores for job related stress in the domains Of insufficient control over work job insecurity and lack of reward in the workplace compared with typical workers who had higher scores for stress in the domains of job demands and occupational climate Test scores also indicated that typical workers had a significantly better quality of life than atypical workers especially in terms of mental health social relationships and environment Conclusion These findings suggested that factors contributing to job-related stress were different between typical and atypical hospital and typical workers are likely to have a better quality of life

만성 신장질환자의 혈액투석 중 부작용에 대한 일반투석과 profiling 투석법의 비교

강해숙,강현주,강의정,유난영,김아름,공진화,양영옥 병원간호사회 2007 임상간호연구 Vol.13 No.1

Purpose: The purpose of this study was to evaluate adverse reactions during hemodialysis with gradient ultrafiltration and high sodium dialysate could be reduced as compared to conventional hemodialysis. Method: Thirteen outpatients who had been on hemodialysis three times in a week for more than 6 months were recruited. he data were collected for 8 weeks from July 3 through August 26, 2006. Patients received conventional hemodialysis for the first four weeks, and then received profiling dialysis of gradient ultrafiltration & high sodium dialysate for the second four weeks. The collected data were analyzed with mean, standard deviation, paired t-test at significant level of .05. Result: The incident frequency of hypotension during sodium profiling hemodialysis was reduced, compared to conventional hemodialysis(t=1.210, p=.020). At the same time, the number of nursing interventions during sodium profiling hemodialysis was reduced significantly. Although systolic and diastolic blood pressure measured after profiling hemodialysis and conventional hemodialysis were not significantly different, the levels of systolic and diastolic BP were increased and concentration level of sodium was increased from 138.0±2.2mEq/L in conventional hemodialysis(the first four weeks) to 140±2.9mEq/L in profiling hemodialysis(the second four weeks) with t=-1.627, p=.114. Conclusion: Due to the reduced number of adverse reactions and nursing interventions in profiling hemodialysis, we can expect an increase in patient's compliance toward hemodialysis. This study suggest that profiling hemodialysis would be more efficient hemodialysis and more effective nursing interventions in occurrence of adverse reactions. However, because of the limited number of cases of this study, the effectiveness of profiling hemodialysis is yet to be determined.

소아 5세 표준촬영 가이드라인과 임상 촬영조건의 입사표면선량과 주요 장기흡수선량 비교

강아름(Kang, A-Rum),이인자(Lee, In-Ja),안성민(Ahn Sung-Min) 대한방사선과학회(구 대한방사선기술학회) 2017 방사선기술과학 Vol.40 No.3

소아는 성인보다 장기의 방사선에 대한 감수성이 크고 성장 중이기 때문에 더 민감하다. 피폭으로 인한 부작용을 겪는 기대수명이 길기 때문에 피폭선량의 관리가 어른의 경우보다 중요하게 다뤄진다. 본 연구는 10세 팬텀을 사용하여 현재 우리나라에 권고되어 있는 5세 소아의 촬영기준과 입사표면선량의 적합성을 확인하고 추가적으로 제시된 촬영기준으로 장기흡수선량을 측정해보았다. 임상에서 사용 중인 5세와 10세의 촬영조건과 장기흡수선량, 입사표면선량을 비교하였다. 임상 5세 촬영조건이 권고촬영조건보다 약간 높으며 임상 10세 촬영조건은 많이 높게 나타났다. 또한 권고 촬영조건으로 ESD를 측정한 결과 임상 촬영조건의 ESD가 43% 높게 나타났으며 10세의 ESD 는 5세의 권고 촬영조건의 ESD 보다 126% 증가를 나타냈다. 5세의 권고된 ESD와 임상 촬영조건에 의한 ESD를 비교한 결과 31.6%의 차이를 나타냈다. 5세의 권고 촬영조건과 임상 촬영조건에 의한 장기흡수선량은 큰 차이는 없으나 흉부와 골반검사에서는 차이가 컸다. 그러나 10세의 임상 촬영조건에 의한 장기흡수선량을 비교하면 월등한 차이가 있었음을 알 수 있었다. 따라서 소아의 권고 선량에 대한 더욱 세분화된 기준안이 연구되어야 할 것으로 사료된다. Pediatrics are more sensibility to radiation than adults and because they are organs that are not com-pletely grown, they have a life expectancy that can be adversely affected by exposure. Therefore, the management of exposure dose is more important than the case of adult. The purpose of this study was to determine the suitability of the 10 year old phantom for the 5 year old pediatric s recommendation and the incident surface dose, and to measure the organ absorbed dose. This study is compared the organ absorbed dose and the entrance surface dose in the clinical conditions at 5 and 10 years old pediatric. Clinical 5 year old condition was slightly higher than recommendation condition and 10 year old condition was very high. In addition, recommendation condition ESD was found to be 43% higher than the ESD of the 5 year old group and the ESD of the 10 year old group was 126% higher than that of the 5 year old group. The recommended ESD at 5 years old and the ESD according to clinical imaging conditions were 31.6%. There was no significant difference between the 5 year old recommended exposure con-ditions and the organ absorbed dose due to clinical exposure conditions, but there was a large difference between the Chest and Pelvic. However, it was found that there was a remarkable difference when com-paring the organ absorbed dose by 10 year clinical exposure conditions. Therefore, more detailed standard exposure dose for the recommended dose of pediatric should be studied.

Routing to Endovascular Treatment of Ischemic Stroke in Korea: Recognition of Need for Process Improvement

Jihoon Kang,김성은,박홍균,조용진,김준엽,이건주,박종무,박광열,이경복,이수주,Ji-Sung Lee,이준영,Ki Hwa Yang,Ah Rum Choi,Mi Yeon Kang,최낙천,Philip B. Gorelick,배희준 대한의학회 2020 Journal of Korean medical science Vol.35 No.41

Background: To track triage, routing, and treatment status regarding access to endovascular treatment (EVT) after acute ischemic stroke (AIS) at a national level. Methods: From national stroke audit data, potential candidates for EVT arriving within 6 hours with National Institute of Health Stroke Scale score of ≥ 7 were identified. Acute care hospitals were classified as thrombectomy-capable hospitals (TCHs, ≥ 15 EVT cases/year) or primary stroke hospital (PSH, < 15 cases/year), and patients' initial routes and subsequent inter-hospital transfer were described. Impact of initial routing to TCHs vs. PSHs on EVT and clinical outcomes were analyzed using multilevel generalized mixed effect models. Results: Out of 14,902 AIS patients, 2,180 (14.6%) were EVT candidates. Eighty-one percent of EVT candidates were transported by ambulance, but only one-third were taken initially to TCHs. Initial routing to TCHs was associated with greater chances of receiving EVT compared to initial routing to PSHs (33.3% vs 12.1%, P < 0.001; adjusted odds ratio [aOR], 2.21; 95% confidence interval [CI], 1.59–2.92) and favorable outcome (38.5% vs. 28.2%, P < 0.001; aOR, 1.52; 95% CI, 1.16–2.00). Inter-hospital transfers to TCHs occurred in 17.4% of those initially routed to a PSH and was associated with the greater chance of EVT compared to remaining at PSHs (34.8% vs. 7.5%, P < 0.001), but not with better outcomes. Conclusion: Two-thirds of EVT candidates were initially routed to PSHs despite greater chance of receiving EVT and having favorable outcomes if routed to a TCH in Korea. Process improvement is needed to direct appropriate patients to TCHs.

청소년의 코로나19 감염예방행위 관련 요인: 건강신념모델을 바탕으로

강푸름(Pu-Rum Kang),이현주(Hyun-Ju Lee),김지혜(Ji-Hye Kim) 한국보건복지학회 2023 보건과 복지 Vol.25 No.4

The purpose of this study is to determine the extent to which adolescents perform COVID-19 preventive behaviors and identify related factors based on the health belief model. The subjects were students enrolled in high schools located in J Province, and data were collected from 221 students. Using SPSS 24.0, the data were analyzed with descriptive statistics, independent t-test, one-way analysis of variance, Pearson correlation coefficient, and multiple regression analyses. As a result of the study, the average level of COVID-19 preventive behaviors was 3.96±0.65. Among the factors of the Health Belief Model, the self-efficacy (β=.578 p<.001) and perceived severity (β=.108, p=.038) were related factors in the performance of COVID-19 preventive behaviors. Therefore, it suggests that differentiated strategies are needed to increase adolescents performance of infection preventive behaviors in the context of a new infectious disease epidemic, and in particular, it is necessary to develop strategies that emphasize perceived severity and self-efficacy of preventive behaviors among health beliefs.

Characterization and Identification of Distinct Mycobacterium massiliense Extracellular Proteins from Those of Mycobacterium abscessus

A-Rum Shin,Hosung Sohn,Choul Jae Won,Byungsoo Lee,Woo Sik Kim,Hyun Bae Kang,김화중,신성재,조상래 한국미생물학회 2010 The journal of microbiology Vol.48 No.4

Mycobacterium massiliense is an emerging pathogen and very similar to Mycobacterium abscessus of rapidly growing mycobacteria in the phenotype and genotype. Pathogenic bacteria secrete a diversity of factors into extracellular medium which contribute to the bacterial pathogenicity. In the present study, we performed the comparative proteome analysis of culture filtrate proteins from a clinical isolate of M. massiliense and M. abscessus strains using two-dimensional gel electrophoresis and liquid chromatography-electrospray ionization mass spectrometry (LC-ESI-MS). Interestingly, 9 proteins of M. massiliense were distinctly expressed from those of M. abscessus. Bioinformatic analysis of the identified proteins revealed that 3 unique proteins corresponded to serine/arginine rich protein, membrane protein from Streptomyces coelicolor, and one hypothetical protein from Corynebacterium efficiens YS-314, respectively. Culture filtrate proteins from M. massiliense induced the release of pro-inflammatory cytokines from macrophages in a dose-dependent manner but not that from M. abscessus. Taken together, the functional study on the identified proteins uniquely produced from M. massiliense may provide not only the clues for the different pathogensis, but also help develop the diagnostic tools for the differentiation between two mycobacterial species.

Noonan 증후군 환아의 마취경험

최보름 ( Bo Rum Choi ),허협 ( Hyub Huh ),강화자 ( Wha Ja Kang ),신옥영 ( Ok Young Shin ) 경희대학교 경희의료원 2010 慶熙醫學 Vol.26 No.1

Noonan syndrome (NS) is an autosomal dominant disorder characterized by dysmorphic facial features in association with short stature and heart disease. A webbed neck, chest deformities, mental retardation, and bleeding disorders are also frequently associated with this pathology. The syndrome is named after Dr. Jacqueline Noonan. Patients with Noonan`s syndrome present a multiplicity of challenges to the anaesthetist, particularly with regard to spinal and airway abnormalities. Alternative methods of management should be discussed fully with patients. Careful preoperative consultation and determination of the degree of associated anomalies will help to prepare the anesthesiologist for potential problems. We describe the anesthetic management of a eight-year-old girl with Noonan syndrome for dental management under general anesthesia. We report successful management of a patient with Noonan syndrome, suspected the difficult airway, undergoing dental surgery using the induction agent with propofol and remifentanil, the muscle relaxant used after the intubation.

영아 담도 폐쇄증에서 카사이 수술 후 5년 생존율 및 예후인자의 분석

홍아름(A Rum Hong),정은영(Eunyoung Jung),강유나(Yu-Na Kang),최순옥(Soon-Ok Choi),박우현(Woo-Hyun Park) 대한외과학회 2010 Annals of Surgical Treatment and Research(ASRT) Vol.79 No.5

Purpose: Long-term survival of biliary atresia patients after Kasai’s portoenterostomy is being increasingly reported. Although extended survival has been achieved for many patients, factors influencing outcome have not been defined clearly. The authors investigated 5-year survival rates and prognostic factors for survival after Kasai’s portoenterostomy using univariate and multivariable methods. Methods: The authors analyzed 5-year survival rates and prognostic factors in 56 patients who underwent Kasai’s portoenterostomy during the period from 1991 to 2005 by the Kaplan-Meier model and Cox proportional hazards model, respectively. Both clinical factors and histological features of the liver and periportal fibrous mass were analyzed as prognostic factors. Results: Younger ages of less than 90 days at surgery, clearance of jaundice and absence of post-Kasai cholangitis in 6 months were predictive of a favorable outcome. A significant difference between the live and the dead was found with regard to an average of 7 or more bile ductules in periportal fibrous mass in 200 HPF (P=0.013). The external diameter of the longest bile ductule in the periportal fibrous mass is not correlated to the prognosis (P=0.49). Independent factors for good prognosis were jaundice-free in 6 months and over 7 bile ductules density in periportal fibrous mass. Conclusion: Favorable outcome after Kasai’s portoenterostomy for biliary atresia is determined by bilirubin clearance in 6 months after Kasai operation and seven or more bile ductules in periportal fibrous mass. The 5-year post-Kasai survival rate is 77.2%.

다중회귀분석 기반의 개발자 연봉 예측 실험

김아름(A Rum Kim),이기영(Ki Young Lee),이강준(Kang Jun Lee) 한국IT마케팅학회 2013 Journal of Information Technology and Management Vol.1 No.1

The sales revenue of domestic software enterprises is substantial while their spending for welfare is relatively low. Hence, it can be seen that the sales revenue of enterprises is not returning to compensate the efforts of software developers. Therefore, this paper has been prepared to make it possible for the developers to be aware of whether their annual salaries are reasonable or not. Through a questionnaire survey, annual salaries, educational background, career/retirement pensions, if any, etc. have been investigated. And after preparing a prediction model made on the basis of the multiple regression analysis with a multiple number of independent variables, an evaluation has been made by applying evaluation data to the model. Through this paper, it is aimed to make it possible for the developers of software enterprises to be compensated with reasonable annual salaries.

Gadolinium Complex of 1,4,7,10-Tetraazacyclododecane-1,4,7-trisacetic Acid (DO3A)–Ethoxybenzyl (EOB) Conjugate as a New Macrocyclic Hepatobiliary MRI Contrast Agent

Baek, Ah Rum,Kim, Hee-Kyung,Park, Subin,Lee, Gang Ho,Kang, Hyo Jeung,Jung, Jae-Chang,Park, Joon-Suk,Ryeom, Hun-Kyu,Kim, Tae-Jeong,Chang, Yongmin American Chemical Society 2017 Journal of medicinal chemistry Vol.60 No.12

<P>We report the synthesis of a macrocyclic Gd chelate based on a 1,4,7,10-tetraazacyclododecane-1,4,7-tris-acetic acid (DO3A) coordinationn cage bearing an ethoxybenzyl (EOB) moiety and discuss its use as a T-1 hepatobiliary magnetic resonance imaging (MRI) contrast agent. The new macrocyclic liver agent shows high chelation stability and high r(1) relaxivity compared with linear-type Gd chelates, Which are the current clinically approved liver agents. Our macrocyclic, liver-specific Gd chelate was evaluated in vivo through biodistribution analysis and liver MRI, which demonstrated its high tumor detection sensitivity and suggested that the new Gd complex is a promising contrast agent for liver cancer imaging.</P>