위절제술 환자의 표준진료지침 개발 및 적용 효과

김은희,김철규,이순교,김순덕,이혜옥,권정순,이경미,이민미,심순미,유용만,신종식,강은희,이상일,김병식,오성태,육정환,박수길 한국의료QA학회 2003 한국의료질향상학회지 Vol.10 No.2

Background : Gastric cancer is the most common malignant tumor in Korea. surgical operation is one of the major treatment modalities for gastric cancer patients. Therefore, gastrectomy is one of the most common procedures in General Surgery. There were variation in length of hospital stay and medical treatment for gastrectomy between three surgeons at Asan Medical Center. Clinical pathways have received considerable attention as a tool for recucing the medical practice variation, increasing the efficiency of care process, and improving the quality of care. The aim of this study was to evaluate the effect of a clinical pathway for gastrectomy in gastric cancer patients. Methods : The clinical pathway for gastrectomy was developed and implemented by a multidisciplinary group in Asan Medical Center. A computerized clinical pathway program was developed and revised after a pilot test. A total of 145 patients underwent gastrectomy by three surgeons at Asan Medical Center. We compared the length of hospital stay, patient satisfaction, and unplanned readmission rate between the pre-pathway group(n=67) and the post-pathway group(n=78). We also investigated the degree of satisfaction among the physicians and nurses who were main end-users of the clinical pathway. Results : The clinical pathway was applied to all target patients. The average length of hospital stay was shortened from 12.7days to 10.6days(p<0.01). The degree of patient satisfaction with the care process changed from 90.3% to 89.2% after the implementation of the clinical pathway, but the difference was of satistically significant(p=0.761). Unplanned readmission rate was 2.9% in the pre-pathway group. More than 90% of physicians and nurses answered that the clinical pathway had been a useful tool in their medical practice. Conclusions : The findings of the study demonstrated that implementation of the clinical pathway for gastrectomy produced substantial reduction in the length of hospital stay while improving the quality of patient outcomes. The computerized clinical pathway program can be used as one of the powerful patient management tools for reducing the practice variations and increasing the efficiency of care process in Korea hospital settings.

분자역학적 방법을 이용한 부산시내 대형건물 냉각탑수의 레지오넬라균의 형별 분류

김정만,정석훈,서대영,박은희,송은주,최재철,이은엽,장철훈 대한임상미샐물학회 2004 Annals of clinical microbiology Vol.7 No.1

대학생 흡연자의 금연경험에 따른 건강신념차이

구정일,김민정,김동희,백정희,안현실,은가희,우혜령,이명희,이수현,김수지 이화여자대학교 간호과학대학 2003 이화간호학회지 Vol.- No.37

It has been generally known that smoking is one of the worst factor increasing disease and mortality in human health since in 1950's and nowadays. But regardless of various proofs about social or economical problems due to smoking, current smoking rate has not been decreased in our country. Until now, most of tobacco use and its addiction researches have been focused on the adolescent or adult women smokers not on the university students. Therefore, the purpose of this study was to investigate smoking cessation of university smokers and analyze the health belief-perceived sensitivity, severity, benefits and barriers- difference, then to provide basic data for effective smoking cessation strategy for university smokers. The subjects were comprised of 181 university smokers from 15 universities in Seoul. The data were collected by structured questionaires. The questionaires were designed to measure general characteristics, smoking cessation and health belief, based on Ahn(2003)'s result on the Study of Smoking attitude, Behavior and Smoking Cessation of Adult Male and Lee(1987)'s result on Relationships Between the Health Belief Model and Smoking Habits. The data were collected from May 5 to 16. The collected data were analyzed by SPSS program. The actual number, percentiles, means, standard deviation, t-test and ANOVA were done. The result of this study were as follows; 1. The general characteristics of the subjects of this study The range of age was from 18 to 34 and the averaging age was 23. The subjects of this study were 141 males and 40 females. The religions were Christianity 25.4%(46), Buddhism 12.7%(23), Catholic 23.2%(42), no religion 37.0%(67). The residential forms were living with family 59.1%(107), cooking food for oneself 28.7%(52), dormitory 5.0%(9), boarding house 1.7%(3). Smoking starting age were university 43.1 %(78), high school 29.8%(54), middle school 14.9%(27), in the army 6.1 %(11), elementary school 1.1 %(2). 2. The smoking cessation of the subjects 80% of current smokers showed quitting smoking decision and 20% have not tried. The frequency of quitting smoking decision were from 1 to above 8 and mean was 3.06. As for smoking cessation plan, 54.7%(99) current smokers answered yes, 3.9%(7) said no, 35.4%(64) had no idea and 6.1 %(11) didn't answer. As for the reason of never quitting smoking decision, 71.42%(25 among total 35) have no need to quit smoking and the others said difficulty of smoking cessation. As for the main reason of smoking cessation decision, 54.7%(99) answered for the health, 7.2%(13) family advice, 15.5%(28) girl/boy friend's advice, 1.7%(3) to save money. As for the reason to fail smoking cessation, 56.7%(68) were will-lack, 17.5%(21) stress, 15%(18) smoking mood, 10%(12) withdrawl symptom. As for the smoking cessation method, 85.0%(125) were oneself-will, 2.7%(4) way acquired by mass-media, 2%(3) doctor's prescription, 2%(3) religion's help, 0.7%(1) smoking cessation school. As for the difficulty in smoking cessation, 42.2%(62) were drinking meeting, 23.1 %(34) no alternative of stress release, 12.2%(18) withdrawl symptom, 11.6%(17) having nothing to do, 7.5%(11) friend's encouragement. As for the most difficult cigarette to quit, 67.8%(99) were all-day smoking except the first smoking in the morning, 32.2%(47) the first smoking in the morning. 3. Health belief as for general characteristics Gender - The total point in benefits showed higher in male(28.5177) than female(26.6750). There was significant difference(t=.778, p<.05). The total point in health belief showed higher in male (105.8298) than female(l00.5000). So there was significant difference(t=.345, p<.05). Age - There was significant difference in benefits between age(10's-25.83, 20's-28.39, 30's-32.00)(F=3.73, p<.05). Smoking starting age - There was significant difference in total point of sensitivity and health belief(sensitivity F=4.00, p<.Ol, health belief F=2.843, p<.05). As for sensitivity, subjects who started smoking in the army showed the highest(33.36) and ones in high school showed the lowest(26.96). The total point in health belief showed the highest in elementary school(l19.00) and the lowest in high school(100.98). 4. Health belief as for smoking cessation There was significant difference in health belief as for smoking cessation(t=0.189, p=0.OO2). Sensitivity point showed higher in smoking quitting trial smokers(29.2) than non-trial smoker (26.9). Severity point showed higher in trial smokers (30.7) than non-trial smokers(28.9). Benefit point showed higher in trial smokers(28.6) than non-trial smokers(26.2). There was no significant difference in barriers point.

지적장애 학생의 창의ㆍ인성교육에 대한특수교사의 관심 및 운영 실태

배지은ㆍ정은희(Bae Ji EunㆍJeong Eun Hee) 한국특수교육학회 2016 특수교육학연구 Vol.50 No.4

일 전문대학 간호과 학생들이 인지하는 강의평가 기준에 대한 조사연구

김정애,이애경,주미경,정안순,장은정,김정수,강정희,이정애 경복대학 2004 京福論叢 Vol.8 No.-

일개 전문대학 간호과 학생들을 대상으로 강의평가 기준을 파악하고자 하였다. 개방형 질문지를 이용하였으며 7개의 교수관련 강의평가 문항 각각에 대해 좋은 점수 및 나쁜 점수를 부여하는 기준을 조사하였다. 각 문항별로 다양한 기준이 확인되었으며, 간호과 학생들의 강의 만족도를 높일 수 있는 교수설계를 위한 기초 자료로 활용할 수 있을 것이다. We aimed to set standards for the student evaluation of instruction for college students of Nursing. We used an open questionaire and surveyed the standards for how students judge the instruction good of bad by using seven questions related to the instructor. Various standards set from each question could be used as basic materials to meet the students' needs in the classroom when the instructors try to find out new instructional design.

임상실습 교육개선을 위한 간호학생의 간호활동시간 분석

이애경,김정애,주미경,정안순,장은정,김정수,강정희,이정애 경복대학 2001 京福論叢 Vol.5 No.-

신규간호사의 능력은 간호학생 때의 다양한 임상경험에 기초를 둔다. 따라서, 간호대학의 교수, 병원 지도자, 임상지도자는 간호학생들이 다양한 지식을 획득하고 간호기술을 경험할 수 있도록 도와주는 중요한 역할을 한다. 이 연구의 목적은 이러한 간호학생들의 임상실습에서 수행하는 간호활동과 간호활동 시간을 분석하고자 하는데 있다. 연구결과 간호학생 1인당 직접간호활동 시간은 185.5분(직접간호비율은 56.7%)으로 141.65분(간접간호 비율은 43.3%)인 간접간호활동 시간보다 많았다. 직접간호활동 시간 중 활력징후 측정이 51.9분으로 가장 많은 시간을 차지하였고, 간접간호활동 시간 중에는 차트보기가 22.98분으로 가장 많은 시간을 차지하였다. 전반적으로 기본적인 임상간호 수행기술에 소요되는 시간이 고도의 숙련된 간호기술을 수행하는데 드는 시간보다 많은 것으로 나타났다. 따라서, 본 연구결과를 토대로 간호대학의 지도자와 병원의 지도자 및 임상지도자가 함께 임상실습 교육과정의 지침서와 평가서를 평가할 필요가 있다고 제언하는 바이다. The competence of newly graduated nurses is based on various clinical experiences gained when they were students. Therefore, professors in nursing schools, directors in hospitals or preceptors must play a critical role in assisting them to obtain various knowledge and experienced nursing skills. The purpose of this study is to investigate nursing care activities and nursing care hours practiced by nursing students in clinical experience. The results of this study showed that the direct nursing care hours per each nursing student are 185.5 mins(direct nursing care rate 56.7%) and it is higher than indirect nursing care hours, 141.65 mins(indirect nursing care rate 43.3%). The hours of checking vital signs are the longest(51.9mins) among the direct nursing care activities, and the hours of reviewing chart are the longest(22.98mins) among the indirect nursing care activities. In general, the time of performing basic clinical nursing technique was higher than that of performing high skilled nursing technique. And nursing observation was higher than that of directly performing task. So, we suggest based on the results of this study as follows. It is needed for nursing instructors in nursing schools and hospitals together to evaluate the guidelines and check-list of clinical practice courses.

부산시 일개구 지역주민의 위암선별검사 수검 및 반복수검 실태 및 관련요인조사

정인숙,배은숙,천동환,전진호,이화자,박남희 韓國保健敎育.健康增進學會 2003 보건교육건강증진학회지 Vol.20 No.1

The importance of repeat screening for stomach cancer is well known to decrease deaths from stomach cancer. This study was aimed at assessing practice behaviors and to identify related factors in the aspects of demographic factors, health status and cancer risk recognition, attitude to cancer screening, health behaviors, and inhibiting or facilitating factors to stomach cancer screening in an urban area. Data was collected through self-administered questionnaires from 403 people aged 40 to 69 years from April 23th to May 15th, 2002. Practice behaviors were classified as :"ver"r "ver"and "peat"r "t repeat"rouped based on a recent 5 year screening history. The results were as follows: 1. Among the 403 subjects: "e ever group"as 23.8% and "e repeat group"as 4.0%. The rates of screening were 20.5% for men, 27.8% for those women, and 27.3% for aged 40-49, 24.5% for those aged 50-59, 19.0% for those aged 60-69. The rates of repeat screening were 4.0% for men, 4.1% for women, and 2.9% for those aged 40-49, 6.3% for aged 50-59, 2.5% for those aged 60-69. 2. The main factors associated with adherence to gastric cancer screening were education(post high school vs below : OR=2.44), previous cancer screening(yes vs no : OR=2.61), belief in personal health(no vs yes : OR=2.72), health status(unhealthy vs healthy : OR=3.40), possibility of cancer compared to others(low vs not low : OR=2.56), and regular exercise(yes vs no : OR=2.94). The main factor associated with adherence to gastric cancer repeat screening was other cancer screening (yes vs no : OR=6.33). Consequently, there is a need to change the recognition of the importance and necessity of stomach cancer screening in healthy conditions through health education, and to perform multiple screening tests each visit.

치근면에 도포된 Tetracycline의 유리양상에 관한 연구

정은희,정현주 전남대학교 치과대학 1989 전남치대논문집 Vol.1 No.2

This study was performed to observe the desorption pattern of tetracycline-HCI topically applied to root surface. Periodontally diseased human teeth were extracted and root planed thoroughly. Dentin slabs were prepared from roots and applied with 50 ㎎/㎖ and 100 ㎎/㎖ tetracycline-HCI solution for 5 minutes and immersed in 1㎖ of distilled water. The aliquot of distilled water was exchanged and assayed for tetracycline by measuring the absorption peak at 276nm on UV Spectrophotometer every 12 hours. For in vivo study, two individuals diagnosed as moderate to severe periodontitis were selected and 50 ㎎/㎖ and 100 ㎎/㎖ solution of tetracycline-HCI were applied topically to root surfaces during flap surgery. Gingival fluid was sampled from 10 sites per patient using paper strip at 1, 2, 4, 8, 24, 32, 48, 56, 72, 96, 120 and 144 hours. The absorbed paper strips were placed on Mueller-Hinton agar plate containing Bacillus cereus and incubated aerobically in 37℃, 12 hrs and the inhibition diameters were measured. The results were as follows : 1. In vitro study From dentin slabs treated with 50 ㎎/㎖ and 100 ㎎/㎖ tetracycline solution, concentration of tetracycline released in distilled water was 7.32 ㎍/㎖ and 6.18 ㎍/㎖ at 48 hours and 1.3 ㎍/㎖ and 1.42 ㎍/㎖ at 7 days, respectively. The amount of desorption of tetracycline was 5.04 ㎍/㎣ and 5.49 ㎍/㎣ respectively. 2. In vivo study The concentration of tetracycline in gingival fluid was 5.79 ㎍/㎖ and 6.54 ㎍/㎖ at 4 days in 50㎎/㎖ and 100㎎/㎖ tetracycline treated sites respectively. In two sites of 50 ㎎/㎖ tetracycline treated area and three sites of 100 ㎎/㎖ tetracycline treated area, 4 ㎍/㎖ of tetracycline was desorbed still at 6 days. This study indicates that the topical application of tetracycline-HCI results in substantial binding to tooth substance and slow release of effective tetracycline concentration for several days, and the effects of tetracycline may contribute to new attachment of connective tissue.

시각적 피드백을 병행한 어깨복합운동프로그램이 어깨비대칭 청년들의 어깨 근력과 정렬에 미치는 영향

강순희, 강은지, 목미경, 박지연, 손혜림, 연우정 한국교통대학교 2016 한국교통대학교 논문집 Vol.51 No.-

The purpose of this study was to identify whether shoulder complex exercise program with visual feedback could improve the shoulder muscular strength and postural alignment in adolescents with shoulder asymmetry. Twenty eight subjects were recruited from the K university and divided into three groups: experimental 1, 2group(Each n=10) and control group(n=8). For 4 weeks, the experimental group 1 performed shoulder muscle complex exercise program and the experimental group 2 performed shoulder complex exercise program with visual feedback. The control group did not perform exercises. The shoulder muscle strength and difference between the height of left and right shoulders were assessed before, after training using the hand-held dynamometer and Global Posture System. Subordination variables, general characteristics analysis, χ² test and Kruskal Wallis H test were conducted to evaluate differences between groups and training before, after changes were checked Wilcoxon signed rank test with using the PASW 18.0 statistical program. The results of the study were as follows. 1) Both the experimental 1, 2group showed improvements in muscle strength of several muscles following training (p<.01). The control group showed significant reduction in the left posterior deltoid (p<.05), and did not show significant changes in examining other muscles (p>.05). And there were differences among three groups in shoulder muscle strength (p<.001). Muscle strength changes in several muscles were greater in the experimental 1, 2group compared with the control group (p<.001). Muscle strength changes in the several muscles were greater in the experimental group 2 compared with the experimental group 1 (p<.001) 2) Both the experimental 1, 2group showed significant decreases in the difference between the left and right shoulder heights following training (p<.01). The control group did not show change (p>.05). Changes in the difference between the left and right shoulder heights were greater in the experimental 1, 2group compared with the control group (p<.001).

어패럴 CAD 시스템에서 진동둘레 그레이딩 편차 설정

정은숙,김희은 한국의류학회 2003 한국의류학회지 Vol.27 No.6

The purpose of this study was to develop a grading increment at armhole area by apparel CAD(Computer Aided Design) system. In developing a grading increment at armhole area, we analyzed ease values of armhole area in bodice and sleeve by manual drafting patterns of five sizes. We suggested grading increments applied Pythagorean theorem to development the grading increment of the armhole of sleeve. The results and discussions of this study were as follows: 1. In drafting each size, the ease values were not identical. It was difficult to draft perfectly the same armhole line shape between sizes. 2. According to our developed grading increments applied Pythagorean theorem, the ease values were identical between sizes and difference of the armhole length between sizes was also identical. 3. The grading formulas were made out for apparel CAD system. Once grading increment or formula is set in the computer, it can be easily altered to various clothing items at any time. The efficiency of grading work will be also improved and grading time will be reduced.