내과계 중환자들의 예후 판정에 었어서 제 7병일 APACHE III 점수의 임상적 유용성

김미옥,윤수미,박은주,손장원,양석철,윤호주,신동호,박성수,Kim, Mi-Ok,Yun, Soo-Mi,Park, Eun-Joo,Sohn, Jang-Won,Yang, Seok-Chul,Yoon, Ho-Joo,Shin, Dong-Ho,Park, Sung-Soo 대한결핵및호흡기학회 2001 Tuberculosis and Respiratory Diseases Vol.50 No.2

연구배경 : 중환자의 예후를 계량화 하려는 채점 체계 중 APACHE III 체계는 중환자실 제1병일 접수는 물론 일 갱선점수도 중환자의 예후를 예측할 수 있는 것으로 알려져 왔다. 평균 재원일이 외국과 비교하여 3-4배의 차이가 나는 점을 감안하면, 일 갱신점수는 예후를 판정하는 지표로서 경제적 효율성이 떨어진다. 이에 제7병일(평균 중간 재원일)의 APACHE III 점수의 임상적 유용성에 관해 알아 보고자 하였다. 방 법 : 1997년 6월부터 1998년 4월까지 한양대학교 구리병원 내파계 중환자실에 입원한 241명의 제1병일과 7병일 APACHE III 점수를 조사하여 생존군과 비생존군 간의 차이를 분석하였다. 결 과 : 전체 환자 수는 241명으로 이 중 사망자가 65명으로 26.6%의 사망률을 나타내었으며 평균 재원일 수는 $10.3{\pm}13.8$일이였다. 제1병일 APACHE III 점수는 $59.7{\pm}30.9$, 제7병일 APACHE III 점수는, $37.9{\pm}27.7$점이였다. 제1병일과 제7병일 APACHE III 점수는 생존군과 비생존군에서 $49.9{\pm}23.8$, $86.3{\pm}32.3$점, $30.1{\pm}18.5$, $81.1{\pm}30.4$점으로 유의한 차이를 보였다(P<0.0001, P<0.0001). APACHE III 점수가 사망률에 미치는 영향을 알아보기 위하여 로지스틱 회귀분석을 시행한 결과 제1병일과 제7병영일의 비차비(odds ratio)는 각각 1.0507, 1.0779로 유의한 결과를 나타내었다(P<0.0001). 결 론 : 이상의 결과로서 제1병일 APACHE III 점수 뿐 아니라 제7병일 점수 또한 사망률 예측과 입원 후 치료 경과에 의해 변화된 예후를 평가하기에 유용한 척도임을 알 수 있었다. 평균 중간 재원일인 제7병일 APACHE III 점수는 일 갱선점수가 경제적으로 물적, 인적 비용이 많이 드는 상황에서 비용효과면에서 임상의에게 도움을 줄 수 있다고 판단된다. Background : Most current research using prognostic scoring systems in critically ill patients have focused on prediction using the first intensive care unit (ICU) day data or daily updated data. Usually the mean ICU length of stay in Korea is longer than in the western world. Consequently, a more cost-effective and practical prognostic parameter is required. The principal aim of this study was to assess the prognostic value of the seventh day(7th day : the average mean ICU length of stay) APACHE III score in a medical intensive care unit. Methods : 241 medical ICU patients from July 1997 to April 1998 were enrolled. The 1st and 7th scores were measured by using the APACHE III scoring system and compared between survivors and non-survivors. Logistic regression analysis was performed to determine the relationship between the $1^{st}$ and $7^{th}$ APACHE III scores and the mortality risk. Results : 1 )The mean length of stay in the ICU was $10.3{\pm}13.8$ days. 2)The mean $1^{st}$ and $7^{th}$ day APACHE III scores were $59.7{\pm}30.9$ and $37.9{\pm}27.7$. 3) The mean $1^{st}$ day APACHE III score was significantly lower in survivors than in non- survivors($49.9{\pm}23.8$ vs $86.3{\pm}32.3$, P<0.0001). 4)The mean $7^{th}$ day APACHE III score was significantly lower in survivors than in non- survivors($30.1{\pm}18.5$ vs $80.1{\pm}30.4$, P<0.0001). 5)The odds ratios among the $1^{st}$ and $7^{th}$ day APACHE III scores and the mortality rate were 1.0507 and 1.0779 respectively. Conclusion : These results suggest that the seventh day APACHE III score is as useful in predicting the outcome as is such like the first day APACHE III score. Therefore, in comparison to the daily APACHE III score, measuring the $1^{st}$ and $7^{th}$ day APACHE III scores are also useful for predicting the prognosis of critically ill patients in terms of cost-effectiveness. It is suggested that the $7^{th}$ day APACHE III score is useful for predicting the clinical outcome.

안양천 생태계의 회복과 주민의식

김미옥,Kim, Mi-Ok 한국하천협회 2007 하천과 문화 Vol.3 No.3

미국 버지니아주 거주 한국인과 미국인의 건강상태 인식도 및 짠맛 기호도 비교

김미옥,Kim, Mi-Ok 한국식품영양학회 2014 韓國食品營養學會誌 Vol.27 No.4

This study was conducted as a comparative analysis, using the SPSS 17.0 program for a survey conducted from March to July 2013, on the level of perception and preference factors of Koreans and Americans residing in Virginia, USA(89 male and female adults of 20 years of age or above). For the information on the degree of obesity, a survey was used and the subjects provided with their heights and weights. The researcher used this data to calculated their BMI and distinguished the degrees of obesity. For the BMI, the obesity diagnosis of Korean Society for the Study of Obesity was used for Koreans, and the WHO's obesity diagnosis on adults were employed for Americans. First, regarding the Korean participants, the level of obesity appeared in the order of normal (79.6%), overweight (14.3%), and underweight (6.1%). Also, the level of perceptions of their health conditions appeared in the order of average (51.7%) and good (34.7%). No one perceived their health to be in poor condition. Meanwhile, for the American participants, the order was as follows: overweight at about 45%, normal weight at about 35%, obesity at about 12.5%, and underweight at about 7.5%. In terms of the level of perception of health during ordinary times, about 55% of the American participants answered that they are in good health. Therefore, the Americans were found to perceive their health to be in relatively better condition than the Koreans residing in the USA. Also, concerning the level of interest in health while eating food at ordinary times, the American participants were discovered to be more interested (about 62.5%) than the Korean participants. The research on their preference for salty taste was conducted as a survey, and the subjects were asked to choose an item according to their subjective feeling. Regarding the preference for salty taste, both Koreans and Americans residing in the USA responded as moderate. However, a higher proportion of Americans than Koreans responded to favor salty taste. Concerning the reason for their preference for salty taste, Koreans responded with various reasons whereas Americans mostly responded that it is because they eat salty food frequently. For any changes in dietary behavior related to eating salty food, both Korean and American respondents thought that the amount of their daily intake of salt is appropriate and that they consider taste as most important in selecting a snack. Based on the above data, the results of this research indicate a need for actual improvement in the diet with regard to salty food along with diverse policies for promoting life with a low salt diet in future.

장애아동의 가족탄력성에 영향을 미치는 요인에 관한 연구

김미옥,Kim, Mi-Ok 한국사회복지학회 2001 한국사회복지학 Vol.47 No.-

Little empirical study has been conducted concerning family resilience of family of children with disabilities. The purpose of this study is to examine the variables that may influence the level of family resilience and family resilience level of family of children with disabilities. This study used the sampled of 363 family of children with disabilities selected from 17 community rehabilitation centers. The measurement of family resilience composed of the base of Walsh(1998)'s theory. And using confirmatory factor analysis, it was confirmed that the scale has three factor such as belief system, organizational pattern and communication process. This study showed that using 5 points scale, mean of belief system is 3.62. And mean of organizational pattern is 3.38 and mean of communication process is 3.73. In identifying predictor of the family resilience, this study used variables from the following aspects: perspective of disability of children, intra-aspect of family, extra-aspect of family. Using Regression analysis, it was found that attitude of family of disability and spouse relationship influenced all sub-aspect of family resilience. Specially, helping of professional influenced belief system, accept of disability influenced organizational pattern. And positive expectation of family of disability influenced communication process. This finding give us significant practical implications for social work intervention & the direction of future research in family resilience.

제9회 산업보건학술제 포스터 - 충북 일부지역의 소음노출 근로자 5년간 청력검사결과 분석

김미옥,Kim, Mi-Ok 대한산업보건협회 2017 산업보건 Vol.345 No.-

제오급와동(第五級窩洞) 수복(修復)에 사용(使用)되는 수종(數種) 충전재(充塡材)의 변연누출(邊緣漏出) 비교(比較)

김미옥,조규징,Kim, Mi-Ok,Cho, Kyew-Zeung 대한치과보존학회 1989 Restorative Dentistry & Endodontics Vol.14 No.2

발거된 소구치 80개의 협, 설면에 교합면쪽의 법량질변연과 치은쪽의 상아질변연을 부여한 제 5급와동을 형성한 후, 각 20개씩 4개의 군으로 나누었다. 각 군별로 초미세입자형 광중합 복합레진과 법랑질접착체인 Durafill$^{(R)}$-Durafill bond$^{(R)}$, Bisfil M$^{(R)}$-Resin bond$^{(R)}$, 초미세입자형 복합레진과 상아질 접착제인 Silux$^{(R)}$-Scotchbond$^{(R)}$ 그리고 글라스 아이오노머 시멘트인 Fuji ionomer$^{(R)}$로 충전하였다. 온도변화는 $40^{\circ}C$와 $60^{\circ}C$의 2% methylene blue 용액에 각각 30초간 침척을 반복시킨 후 $37^{\circ}C$ 동용액에 24시간 경과시켜 법랑질변연부와 상아질변연부에서의 색소침투를 관찰하므로써 변연누출의 정도률 비교한 바 다움과 같은 결과를 얻었다. 1. 법랑질변연부에서 Durafill$^{(R)}$-Durafill bond$^{(R)}$, Bisfil M$^{(R)}$-Resin bond$^{(R)}$ 및 Silux$^{(R)}$-Scotchbond$^{(R)}$군 상호간에는 대차가 없었으나(P>0.05), 3군 공히 Fuji ionomer$^{(R)}$군보다는 변연누출이 적었다(P<0.01). 2. 상아질변연부에서는 Silux$^{(R)}$-Scotchbond$^{(R)}$군과 Fuji ionomer$^{(R)}$군이 각각 Durafill$^{(R)}$-Durafill bond$^{(R)}$군 및 Bisfil M$^{(R)}$-Resin bond$^{(R)}$군에 비해 변연누출이 적었다(P<0.01). 3. 충전한 모든군의 5급 와동에서 법랑질변연부가 상아질변연부보다 변연누출이 적었다(P<0.01). The purpose of the study is to evaluate the degree of the marginal leakage of class V cavities with 4 brands of esthetic filling materials by means of the dye penetration at the enamel & dentinal margins. 160 cavities of class V were prepared on the buccal & lingual surfaces of 80 extracted premolar teeth, which divided into 4 groups. The four groups of cavities were filled with Durafill$^{(R)}$-Durafill bond$^{(R)}$(KuIzer & Co GmbH), Bisfil M$^{(R)}$-Resin bond$^{(R)}$(BISCO Inc.), Silux$^{(R)}$-Scotchbond$^{(R)}$(3M Co.) and Fuji ionomer$^{(R)}$(type II, G-C Co.) each. All specimens were immersed in 2% methylene blue dye solution for 24 hours at $37^{\circ}C$ after a 30-second thermocycling at $4^{\circ}C$ and $60^{\circ}C$ and longitudinally sectioned with diamond disk into two parts. The results were as follows : 1. At enamel margins, the group filled with Durafill$^{(R)}$-Durafill bond$^{(R)}$, Bisfil M$^{(R)}$-Resin bond$^{(R)}$ and Silux$^{(R)}$-Scotchbond$^{(R)}$ show no significant difference each other(p>0.05), and the above groups show less marginal leakage comparing with the group filled with Fuji ionomer$^{(R)}$(p<0.01). 2. At dentinal margins, the group filled with Silux$^{(R)}$-Scotchbond$^{(R)}$ or Fuji ionomer$^{(R)}$ show less marginal leakage than that with Durafill$^{(R)}$-Durafill bond$^{(R)}$ or Bisfil M$^{(R)}$-Resin bond$^{(R)}$(p<0.01). 3. The enamel margins show less marginal leakage than dentinal margins in all the class V cavities(p<0.01).

연구장비 Grid

김미옥,Kim, Mi-Ok 한국과학기술정보연구원 2002 지식정보인프라 Vol.8 No.-

연구장비 Grid는 고속의 네트웍으로 첨단연구장비를 연결하여 연구장비 전용망을 구성하고, 연구장비 망에 접속 가능한 모든 연구자들에게 이용이 편리한 표준화된 미들웨어를 제공하여 장비와 연구자 간의 거리와 상관없이 연구자가 원격지의 장비를 제어하고, 실시간으로 데이터를 처리함과 동시에 화상 대화를 통해 다른 연구자들과 실험 과정 및 결과에 대한 토론을 수행할 수 있다. 이러한 기능을 제공하는 연구장비 Grid가 구축되면 국내 연구장비 공동활용 활성화는 물론 해외 첨단연구장비를 사용할 수 있고, 또한 해외연구자 및 북한연구자와도 공동연구를 수행할 수 있을 것이다.

일 대학병원 중환자실 간호사의 음독자살시도 환자 간호 경험: 포커스 그룹 연구

김미옥,조흥돈,봉은경,손연정,박영수,Kim, Mi Ok,Cho, Heung Don,Bong, Eun Kyung,Son, Youn-Jung,Park, Young-Su 한국중환자간호학회 2013 중환자간호학회지 Vol.6 No.1

Purpose: This study to describe experiences of nurses who work in intensive care units (ICUs) where they frequently encounter patients with attempted suicide by drug ingestion. Methods: Data were collected by 2 focus group interviews with 9 ICU nurses. The interview were recorded and transcribed, and data were analyzed using qualitative content analysis. Results: The results of data analysis, five themes were drawn: 'Confusion about for the attempted suicidal patient care', 'Helplessness for dying with attempted suicidal patients', 'Guilty for insufficient care', 'Ambivalence for the attempted suicidal patients', 'Recognition of need for professional approach'. Conclusion: The results of this study help us to understand patients who attempted suicide through the ICU nurses' experience. It would be useful to develop effective education programs for ICU nurses to preventive strategies for patients who are high risk of recurrence of suicidal crisis situation.

고령여성장애인의 삶에 관한 탐색적 연구

김미옥 ( Mi Ok Kim ),김고은 ( Go Eun Kim ),최수연 ( Soo Yeun Choi ) 한국가족사회복지학회 2013 한국가족복지학 Vol.42 No.-

이 연구는 60대에서 70대의 고령여성장애인 6명을 대상으로 그들의 삶을 내부자 관점에서 탐색적으로 살펴본 것이다. 연구결과, 고령여성장애인은 장애를 처음 인식하게 된 그 시절을 죽음 같은 절망으로 기억하고 있었다. 이후 장애에 순응과 타협의 과정을 거치며 여성장애인으로서 여성성 상실, 소극적이고 움추려듬을 통해 사회적으로 배제되는 생활을 한 것으로 나타났다. 이 과정에서 불편한 일상으로 인해 어려움을 겪으며, 아픔인 동시에 힘의 근원으로서 가족을 인식하고 있었다. 고령이 되면서 가장 큰 어려움은 약해지는 건강과 깊어가는 가난이었다. 한편으로는 생의 회한과 혼자 남겨지는 것에 대한 두려움이 있었으나, 일부 연구참여자들은 삶의 작은 일에 감사하는 모습을 보여주었다. 여성으로서 장애를 가지고 살아왔던 삶은 힘들고 고단했으나, 노년기가 되면서 장애인 보다는 노인의 특성에더 가까운 모습이 관찰되었다. 다만, 비장애노인과 달리 장애로 인하여 노년기의 취약성은 더욱 커지는 것으로 나타났다. 이러한 결과를 통해, 본 연구는 고령여성장애인에 대한 사회적 지원체계 구축의필요성을 논의하였고, 특히 장애발생시점에 따라 다른 특성을 보이는 만큼 이에 따른 차별화된 개입및 함의를 제시하였다. The aim of this study was to explore and understand the experiences of elderly women with disabilities from their own perspective. This study obtained informations through in-depth interviews with six elderly people who have disabilities. The following main themes were extracted from the practical experiences of the participants interviewed. First, dealing with disability as a woman: ``despairing unto death``, and ``accommodation and compromise``. Second, life as a woman with disabilities: ``loss of feminity``, ``passive and quailing attitude``, ``social exclusion``, ``everyday inconvenience``, and ``ambivalence towards family``. Third, life as an elderly woman with disabilities: ``weakening health``, ``overwhelming poverty``, ``regret over the past and anxiety for the future``, and ``having hope for life despite adversity``. As a result of this study, we can understand the exhausting lives of elderly women with disabilities. In addition to adversity as people with disabilities, their vulnerability increases in old age. The implication of this study`s results on policy making and actual practices are discussed focusing on the rights and well-being of elderly women with disabilities.

발달장애인의 지원의사결정에 관한 탐색적 연구 - 종사자 인식에 대한 IPA 분석을 중심으로

김미옥(Kim, Mi Ok),김고은(Kim, Go Eun),정은혜(Jung, Eun Hye) 한국장애인복지학회 2021 한국장애인복지학 Vol.54 No.54

이 연구는 장애인복지시설 종사자를 대상으로 지원의사결정에 대한 인식을 탐색해보고자 한 것이다. 이를 위해 지원의사결정의 중요도와 실행도를 확인하고, IPA분석을 통해 그 차이를 살펴보았다. 연구결과, 첫째, 장애인복지시설 종사자들은 지원의사결정 중요도 평균 4.77점, 수행도 평균 3.86점으로 나타나 중요도 인식에 비해 그 수행은 낮은 것을 알 수 있었다. 둘째, 발달장애인의 의사결정 지원에 대한 인식은 종사자 지위, 학력, 시설유형, 시설규모 등에 따라 차이가 있는 것으로 나타났다. 셋째, 지원의사결정과정의 모든 영역에서 중요도에 비해 수행도는 상대적으로 낮았다. 넷째, 영역별 인식 차이에서는 중요도와 수행도 모두 ‘최선의 이익 고려’의 ‘이용자 특성 확인’이 가장 높은 점수를 보였고, 중요도와 수행도의 대응차가 가장 크게 나타난 항목은 ‘실행’의 ‘지원’인 것으로 확인되었다. 마지막으로 지원의사결정과정에 대한 IPA 분석에서는 각 문항별 분포가 다양하게 나타났으며, 주요 쟁점을 비교 논의하였다. 이 연구는 발달장애인 지원의사결정에 관한 복지분야 연구가 부족한 국내 현실에서, 관련 연구의 기초자료로서 그 함의가 있다. This study aims to explore the perception of supported decision-making by targeting the service providers in welfare facilities for the disabled. To this end, the importance and performance of supported decision-making were identified, and the differences were examined through IPA analysis. The following are the research findings. First, the average for the importance of supported decision-making was 4.77 and the performance average was 3.86 for the service providers in the welfare facilities for the disabled, and this showed that the performance was lower than the perception of the importance. Second, there were differences in the perceptions of supported decision-making for people with developmental disabilities based on the status of the service providers, educational background, facility type, and facility size. Third, in all the domains of the supported decision-making process, performance was relatively lower than the importance. Fourth, in the perceived differences of each domain, the score was the highest for both the importance and performance in confirmation of user characteristics in consideration of the best profit and the item with the biggest difference between importance and performance was support in execution. Finally, in the IPA analysis of the supported decision-making process, the distribution varied for each item and the key issues were compared and discussed. This study is meaningful base data of relevant research to supplement the lack of domestic research about supported decision-making for the people with developmental disabilities in the field of welfare.