가정용 총정맥영양의 경제성 평가

민자경 ( Ja Kyung Min ) 한국정맥경장영양학회 2016 한국정맥경장영양학회지 Vol.8 No.1

The restricted resources on healthcare highlights the importance of clinical and cost effectiveness. The social and economic costs of chronic diseases are increasing. Home total parenteral nutrition (home TPN) for the patients with intestinal failure is a life-sustaining therapy until intestinal transplantation. An economic evaluation of home TPN has not been conducted in Korea. Three types of economic evaluations for home TPN are cost benefit analysis, cost effectiveness analysis, and cost utility analysis. Korea``s medical market is competitive due to the limited health care resources. A health care delivery system from hospital to home needs to be established under the supervision of professional Nutrition Support Team staff including the systematic policies and social recognition.

케네디병(Kennedy Disease) 환자의 가정 내 영양지원에 대한 증례 보고

민자경 ( Ja Kyung Min ),오수정 ( Soo Joung Oh ),김현정 ( Hyun Jung Kim ),박효정 ( Hyo Jung Park ),라미용 ( Mi Young Rha ),장동경 ( Dong Kyung Chang ) 한국정맥경장영양학회 2014 한국정맥경장영양학회지 Vol.6 No.3

A 69-year-old man was consulted to our Home Health Care department for home parenteral enteral nutrition. He was diagnosed with Kennedy disease. He had swallowing difficulty and bowel ischemia. We provided nutritional support in a variety of ways in order to suit his condition. The role of the home care nurse involves training methods depending on changes in the nutritional support to patient and care giver. However, in the case of Kennedy disease, increasing the target patient’s nutritional requirements as calculated was difficult.

단장증후군 소아의 가정 내 경정맥 영양지원

민자경 ( Ja Kyung Min ),박효정 ( Hyo Jung Park ),서정민 ( Jung Meen Seo ) 한국정맥경장영양학회 2013 한국정맥경장영양학회지 Vol.5 No.3

Many pediatric patients, particularly those with short bowel syndrome (SBS), will eventually require long-term parenteral nutrition in order to provide adequate nutritional support. This requires an extended hospital stay. We report on the case of a four-year-old boy with SBS who was administered home parenteral nutrition (HPN) during a period of 14 months. The goal of HPN therapy is to maintain the patient`s nutrition status while concurrently making all efforts to minimize complications associated with HPN. Central catheter infection did not occur during this period. Despite cyclic PN, liver function test (LFT) value was sometimes increasing. After PN calorie was decreased, LFT values were normalized. When evaluated according to the corrected age, he belonged to 5%∼25% for weight status, which was considered normal weight compared to height. For all patients requiring prolonged PN support, HPN is the only alternative to long-term hospitalization and may be the best option for improvement of patients` quality of life. However, significant benefit can be gained through collaboration between healthcare providers within the institution. Family training and education are important. Using this case, we evaluate the clinical experiences and considerations of HPN in Korea. (J Korean Soc Parenter Enter Nutr 2013;5(3):130-132)

사용자의 길찾기 인지적 난이도에 따른 가상환경과 실제환경에서의 시각적 집중도 차이 비교

민자경 ( Min Ja Kyoung ),최진경 ( Choi Jin Kyung ),김주연 ( Kim Ju Yeon ) 한국상품문화디자인학회 2021 상품문화디자인학연구 Vol.66 No.-

길찾기 실험은 가상현실기법과 함께 다양하게 연구되어져 왔으며, 가상현실기법의 추이는 대중화와 상업화에 의해 비몰입형에서 몰입형으로 변화하고 있다. 이러한 측면에서 본 연구에서는 기존의 길찾기 실험연구에서 가상환경기법이 실제환경의 유사한 대체조건의 환경으로 활용된 것과는 달리 시지각의 차이가 존재함을 전제로 실제환경과 가상환경에 어떤 시지각 차이가 발생하는지를 확인하고자 하였다. 연구는 코엑스 스타필드의 전시홀로 향하는 경로 시작점을 선정하였으며, ETG와 VR실험은 각각 20명을 대상으로 길찾기 난이도로 분류하여 주어진 실험장소에서 ETG와 VR의 Attention Start Time(시선고정 시작 시간), High Attention Start Time(시각적 주의집중 시작 시간)의 시각정보를 확인하였다. 본 실험을 통하여 실제공간에서는 가상공간보다 길찾기를 위하여 시선집중의 시작 시간차이가 다르게 나타났으며, 시각적 주의집중을 하는 시간은 몰입된 가상공간에서 차이가 많은 것을 확인할 수가 있었다. 또한 시선고정의 시작은 새로운 시각적 자극이 많은 실제공간에서 차이를 많이 가지지만, 시각적 주의 집중으로 시각정보를 획득하는 것은 몰입된 가상공간에서 차이를 가져 가상공간에서의 정보획득이 실제공간보다 쉬움을 가정할 수 있었다. 가상현실기반 콘텐츠의 발전과 함께 가상환경의 정보를 어떻게 활용하는가가 중요한 시점에, 가상현실에서 실제와의 시지각 차이는 상호작용에서 경험의 차이를 발생시킬 수 있다. 따라서 본 연구는 추후 가상공간의 디자인 설계에서 가상공간에서 사용자의 시지각 정보의 이해도를 높이고 실제환경과 VR의 상호성을 극대화하기 위한 기초적인 자료로써 활용될 수 있다고 본다. Wayfinding experiments have been studied diversely along with virtual reality techniques, and the trend of virtual reality techniques is changing from non-immersive to immersive types due to popularization and commercialization. In this regard, unlike existing wayfinding experimental studies where virtual environment techniques were used as environments with similar alternate conditions for real environments, this study was conducted to identify what differences in visual perception occur between real environments and virtual environments based on the premise that there are differences in visual perception. In this study, starting points of paths to the exhibition hall of COEX Starfield were selected, and ETG and VR experiments were conducted with 20 experimental subjects each. The visual information at the attention start time and high attention start time of ETG and VR was identified at the experimental places given after being classified with difficulties in wayfinding. Through these experiments, it could be seen that the attention start time in real spaces was different from that in virtual spaces and that the time of high attention was longer in the immersed virtual spaces. In addition, although the start of attention was earlier in real spaces where there are many new visual stimuli, the acquisition of visual information with high attention was faster in virtual spaces so that it could be assumed that the acquisition of information in virtual spaces is easier than that in real spaces. With the development of virtual reality-based content, at this time when how to utilize information in virtual environments is important, the differences in visual perception between virtual reality and real environments can cause differences in experience in interactions. Therefore, it is believed that this study can be used as basic data to enhance users’ understanding of visual perception information in virtual spaces and maximize the reciprocity between real environments and VR in the design of the virtual spaces in the future.

자아탄력성, 학업 스트레스가 간호대학생의 우울에 미치는 영향

최희정(Choi, Heejung),민자경(Min, Ja Kyung),곽은주(Kwak, Eunju),심미옥(Shim, Mi-Ock) 대한근관절건강학회 2021 근관절건강학회지 Vol.28 No.3

영양지원간호사의 역할과 과제

박정윤 ( Jeong Yun Park ),송정미 ( Jung Mi Song ),민자경 ( Ja Kyung Min ) 한국정맥경장영양학회 2020 한국정맥경장영양학회지 Vol.12 No.1

Nutrition care is important for patients’ well-being. With legislation for reimbursement for nutrition support team activities from the Korea Ministry of Health and Welfare, this has increased the importance of nurses’ role in nutrition. Nutrition support nurses (NSNs) focus on the optimization of nutritional health and prevention of nutrition-related illness and injury. NSN performs as an advanced practice nurse, a core member of a nutrition support team, an educator or consultant, a policy maker in nutrition care, and a researcher or a member of quality improvement. NSNs should develop their core competency to fulfill their roles in nutrition care and the need to participate in qualified nutrition support education programs. Further, the tasks and duties of NSNs should be specifically identified so that NSNs can fulfill their roles.

성인 단장증후군 환자의 다학제 장 재활: 국내 단일 기관 다학제 장재활 클리닉의 경험

윤소정 ( Sojeong Yoon ),이상훈 ( Sanghoon Lee ),박효정 ( Hyo Jung Park ),김현정 ( Hyun-jung Kim ),윤지혜 ( Jihye Yoon ),민자경 ( Ja-kyung Min ),서정민 ( Jeong-meen Seo ) 한국정맥경장영양학회 2018 한국정맥경장영양학회지 Vol.10 No.2

Purpose: Intense multidisciplinary team effort is required for the intestinal rehabilitation of patients afflicted with the short bowel syndrome (SBS). These include enteral and parenteral nutrition (PN) support, monitoring of complications related to treatment, and considering further medical or surgical options for intestinal adaptation. Methods: In the Intestinal Rehabilitation Team (IRT) at the Samsung Medical Center, we have experienced 20 cases of adult SBS requiring multidisciplinary intestinal rehabilitation. This study is a retrospective review of the collected medical records. Results: Of the 20 subjects treated, 12 patients were male and 8 patients were female. At the time of referral to the IRT, the mean age was 51.5 years, and the mean body weight was 50.1 kg, which was 90% of the usual body weight. The diseases or operative managements preceding massive bowel resection were malignancy in 11 cases, cardiac surgery in 2 cases, trauma in 2 cases and one case, each of tuberculosis, corrosive esophagitis, atrial fibrillation, simultaneous pancreas and kidney transplantation, and perforated appendicitis. Of these, there were 14 survivals and 6 mortalities. The fatalities were attributed to progression of disease, intestinal failure-associated liver disease, and sepsis (unrelated to intestinal failure) (2 cases each). Among the 14 surviving patients, 8 patients have been weaned off PN, whereas 6 are still dependent on PN (mean PN dependence 36%). Conclusion: This paper reports the results of multidisciplinary intestinal rehabilitation of adult short bowel patients treated at the Samsung Medical Center. Further studies are required to improve survival and enteral tolerance of these patients.

장부전 환자의 장재활 시스템 구축을 위한 질 향상 활동

박효정 ( Hyo Jung Park ),이상훈 ( Sang Hoon Lee ),윤지혜 ( Ji Hye Yoon ),김현정 ( Hyun Jung Kim ),홍슬희 ( Seul Hee Hong ),김은주 ( Eun Ju Kim ),민자경 ( Ja Kyung Min ),김현정 ( Hyun Jung Kim ),정보경 ( Bo Kyung Jung ),오채연 ( Ch 한국정맥경장영양학회 2014 한국정맥경장영양학회지 Vol.6 No.3

Purpose: Intestinal failure (IF) is a complex clinical condition requiring a multi-disciplinary team approach. Our objective was to set up the treatment protocols and education documents for IF patients for development of intestinal rehabilitation programs in our hospital. Methods: We compared the number of inpatients, length of hospital stay, mode of nutrition and calorie supply at discharge, and the frequency of blood transfusions before and after quality improvement of multidisciplinary activities, in order to evaluate the indirect effects of new protocols and training materials and for development of the intestinal rehabilitation system. Results: We integrated eleven protocols for treatment and monitoring and seven educational materials for patients and caregivers. We compared indirect effects before and after the quality improvement activities. The number of IF patients hospitalized was reduced from 12 to 9. The mean days of hospital stay was decreased from 322 days to 73 days, the average number of monthly blood transfusions was also reduced from 1.8 to 0.3. In addition, the percentage of patients administered enteral nutrition and calories supplied was increased at discharge. Conclusion: By integrating IF protocols and education materials for IF patients, we found possible indirect effects of intestinal rehabilitation using a multidisciplinary team approach.