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Purpose: We analyzed the characteristics and differences in patients' medical benefits and health insurance based on disease severity classification. Methods: We examined 29,139 patients who visited the emergency medical center of K Hospital from January 1,2016 to December 31, 2016. Survey items included the Korean Triage and Acuity Scale (KTAS) classification of emergency and non-emergency situations ratio and type of insurance. Results: According to KTAS classification, 76.2% of patients exhibited an emergency condition and 23.8% exhibited a non-emergency condition. Emergency patients exhibited more trauma than non-emergency patients. According to the type of insurance coverage, the duration of stay in the emergency room was longer for patients with medical care than for patients with health insurance. Additionally, 119 ambulances use was significantly higher among patients with medical care. Conclusion: Policy discussions should address alternative ways to replace the 119 ambulances used by patients in this study. Additionally, health care administrators should identify alternative care agencies as potential alternatives to emergency room visits.
Purpose: This study aimed to investigate the awareness and direction of paramedics work and image in hospitals. Methods: From April 16 to May 5, 2015, data were collected through structured questionnaires from 45 paramedics and 81 nurses working in emergency medical institutions. The data were analyzed using SPSS version 18.0. Results: The work of paramedics is evaluated to be highly worthy at the in-hospital level rather than at the injury first-aid treatment level. It appears that paramedics are often forced to do what their hospitals tell them to do concerning matters related to conflicts with them and nurses. Paramedics stated that they experienced greater mental stress than those engaging in other professions, a finding similar to those of other studies. There was no statistically significant difference in opinions between the two groups about a desirable direction for the development of first-aid services at hospitals. More than two thirds of the respondents said that paramedics should be given the right to enter acting check for patients. Conclusion: Paramedics work is shown to differ in the opinions of paramedics themselves and nurses. Paramedics need for reform is associated with expanding the work of the law.
연구 목적: 본 연구는 우수한 1급 응급구조사 인력 양성 및 배출을 위해 응급구조사의 역량을 도출하여 교육제도 를 재정립하고 국가시험 및 자격제도를 개선하기 위한 정책 제안을 하고자 하였다. 연구 방법: 본 연구는 전문가 회의 및 설문지를 이용하였다. 설문 자료는 교육 전문가(응급구조학과 대학교수)와 현장 전문가(소방 119구급대원 및 병원에 근무하는 1급 응급구조사) 총 277명으로부터 수집되었으며, 자료수집 기 간은 2016년 9월 7일부터 9월 20일까지였다. 수집된 자료는 SPSS 22.0을 이용하여 분석하였다. 연구 결과: 1급 응급구조사 교육과정 강화를 위해 표준교육과정안으로 총 27과목 94학점을 제안하였고 1급 응급구 조사의 핵심역량 9가지를 도출하였다. 국가 자격시험은 필기시험 과목을 통합하는 방안과, 실기시험에 시나리오형 의 문제를 추가하고, 실기를 절차대로 수행하는 단순실기시험에 낙제기준(critical criteria)를 적용하며, 실기시험 은 통과/실패만 결정하는 것을 제안하였다. 또한 1급 응급구조사의 보건의료적 업무특성을 반영하여 자격은 면허 로 바꾸는 것을 제안하였다. 결 론: 본 연구 결과를 토대로 표준교육과정 운영으로 핵심역량을 갖추고 배출된 인력들이 신뢰성 있는 국가시 험제도를 통해 자격을 취득하고 1급 응급구조사로서 전문성을 강화할 수 있는 자격관리제도가 선순환을 이룰 때 우리나라 응급의료서비스의 질적 수준이 향상될 것이다. Purpose: With the purpose of educating and producing outstanding paramedics by enhancing their competencies, this study aimed to make policy suggestions to re-establish the education system and improve the national examination and the certification scheme. Methods: This study used focus group interviews and questionnaires to collect data. Totally, there were 277 subjects, including experts from the education and field. Data were collected from September 9 to 20, 2016, and analyzed using SPSS 22.0. Results: To strengthen the curriculum of paramedics, this study suggested 27 courses with 94 credits as the standardized curriculum and derived 9 core competencies of paramedics. For the national examination, this study suggested consolidating written test subjects, adding scenario questions to practical tests, and applying critical criteria to simple practical tests that performs a procedure, grading these tests on a pass/fail basis. In addition, this study suggested converting certification into license, reflecting paramedics' healthcare job characteristics. Conclusion: The quality of emergency medical services in Korea will improve when those with core competencies that originated from the standardized curriculum based on the results of this study acquire their certification through the national test scheme, and the certification management system creates a virtuous cycle to further enhance paramedics' professionalism.
연구 목적 : 한국에서 일반인의 의한 AED의 사용 사례를 극히 드물다. 병원 전 심정지 상황에서 특히 제세동이 필요한 환자의 소생률을 높이기 위해서는 일반인에 의한 AED 사용이 요구된다. 본 연구의 목적은 AED사용에 영 향을 미치는 요인을 분석하는 것이며, 한일 비교를 통해 사회적 특성이 있는지를 확인하는 것이다. 연구 방법 : 2013년 2월 25일부터 3월 4일까지 설문 조사를 실시했다. 한국에서 517명, 일본에서 520명의 데이터 를 회수했다. 설문지를 통해 파악한 사회인구학적 요인과 AED에 관한 지식 요인이 AED사용의도에 영향을 미치는 지를 알기 위해 로지스틱 회귀분석을 실시했다. 연구 결과 : 한국의 517 명의 응답자 중 220명, 42.6%만이, 그리고 일본의 520명의 응답자 중 387 명, 74.4%가 AED를 사용해 환자를 도우려는 의사를 가지고 있었다. 한국과 일본 모두 성별은 유의한 요인이었다(한국 odd ratio[OR] = 0.419, 일본 OR = 0.582). 양국 모두에서 여성은 남성에 비해 AED를 사용해 환자를 도우려고 하지 않았다. AED에 관한 지식은 양국 모두에서 가장 큰 영향을 끼치는 요인이었다. 국가 간의 차가 있었던 요인은 우 선 연령이었다. 연령 요인이 한국에서는 유의하지 않았지만 일본에서는 젊을수록 AED 사용의사가 높았다(OR = 0.968). 또한 일본에서는 심장병력이 유의한 요인(OR=2.099)이었다. 결 론: 본 연구는 AED사용의도에 가장 큰 영향을 끼치는 요인이 AED에 관한 지식임을 밝혔다. 따라서, 병원 전 심정지 상황에서 제세동을 장려하기 위해서는 AED 설치와 함께 사회적 요인을 반영한 교육 프로그램이 필요하다.
To offer basic data about the influential factors on patient's Satisfaction level for emergency medical services the authors were performed this study in 60 patients visited to emergency room of third stage general hospital in Taejeon city. Data were collected through interview with patients by using a 15 items' questionnaire according to care subscale, teaching subscale of Likert's five stage quantitative scale and the tools developed by Barbara Davis. The data were analyzed by using the SPSS/PC computerized program for mean, standard deviation, percentage, ANOVA, t-test, and pearson correlation. The results are as followings ; 1 Satisfaction of emergency medical service were showed in care area, but not showed in teaching and total area. 2. Satisfaction of sociodemographic characteristics were a statistically significant difference only marriage, that were the higher in marriaged than single (P<0.05). 3. In the emergency situation characteristics the satisfaction accordings to the visit cause were lower in accident than disease group, the reason of hospital selection were in order trust, introduction group, distance. Traffic, kinds, and score of satisfaction were showed each of 43.47 51.27 (P<0.01), the transportation vehicle was the 119, hospital ambulance group. but were not a satistically significant difference. 4. The negative correlation was observed between satisfaction and the length of stay at ER and the longer length of stay at ER was showed the lower satisfaction. But the positive correlation was observed between satisfaction and the arrival time, patients who arrived ER from 6:00 P.M to midnight were more satisfied than patients who arrived other time. 5. The length of stay at ER was significantly different according to the reason of hospital selection, the reason of ER selection, the visitant cause and hopital decisioner. Especially the length of stay was much longer in accident group and unconscious group.
This study was analyze that they knows how to think improvement about the emergency relief squad 119. The result is following: 1. Convenience when to use an ambulance is not difference of the voluntariness by regional groups and then result get that ambulance is necessary with going out as quick as possible. 2. Improvement of the ambulance os not difference of the voluntariness by regional groups and then result get that ambulance is necessary with improvement for the ambulance and equipment. 3. First remembrance when you call the ambulance is not difference of the voluntariness by sex distinction, and then result get that they will have the public relations.
Purpose: The purpose of this study was to determine whether, in patients with acute coronary syndrome (ACS), according to the mode of arrival affect the emergency medical process. Methods: The participants of this study were 118 adult patients (46 patients admitted by emergency medical services (EMS), 48 walk-in patients, and 24 transferred from other hospitals) admitted to the emergency departments at one regional-level medical center who underwent coronary angiography between January 1, 2016 and December 31, 2017. To compare treatment courses, the median values of the following variables were compared among groups: symptom to door time; door to triage time; and door to ECG time. All data were analyzed using SPSS program. Results: Based on the initial assessment at triage, there was a significantly greater proportion of Korean Triage and Acuity Stage (KTAS) Level 1 or 2 among patients admitted by EMS than among walk-in patients. All three analyzed variables were lower in patients admitted by EMS than in the other two groups. Conclusion: Our results show that ACS patients who accessed EMS reached the emergency center faster after symptom onset, received initial triage assessment at earlier stages, and underwent sooner important examinations (i.e., the 12-lead ECG).
Purpose: This study aimed to provide basic data for clinical training program development by analyzing the operating conditions and satisfaction in a clinical training program for 119 emergency medical technicians (EMTs) in South Korea. Methods: Data from 84 EMTs were collected on June 19, 2014. We administered a 64-item questionnaire about operating conditions and satisfaction in the clinical training program, and analyzed data (SPSS v 21.0). Results: The degree of performance in the field, importance of the item in the field, and level of difficulty were 3.36, 4.23, and 3.21, respectively. In the number of times that an item was directly performed according to the subjects'general characteristics a statistically difference in sex (p = .000), duty (p =.021), and total working time of trainees (p = .002). The subjects'total satisfaction score was 3.77. The difference in satisfaction according to the subjects'characteristics was a statistically significant in terms of sex (p = .016) and clinical training area (p = .005). Conclusion: A more efficient training system for hospital clinical training courses should be developed. The operation condition analyzed in this research may contribute to the improvement of the performance of EMTs.