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한국보건정보통계학회> 보건정보통계학회지> 검사정보의 이해를 통한 철결핍빈혈과 만성질환빈혈의 감별진단

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검사정보의 이해를 통한 철결핍빈혈과 만성질환빈혈의 감별진단

Differential Diagnosis between Iron Deficiency Anemia and Anemia of Chronic Disease by Understanding Laboratory Results

이석준 ( Suk Jun Lee )
  • : 한국보건정보통계학회
  • : 보건정보통계학회지 44권4호
  • : 연속간행물
  • : 2019년 11월
  • : 331-338(8pages)
보건정보통계학회지

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Objectives: The purpose of this study is to provide availability of laboratory results in differential diagnosis of iron deficiency anemia (IDA) and anemia of chronic disease (ACD). Methods: This study was based on a systematic review of related to iron metabolism, IDA and ACD. We searched the published articles from 1992 to 2019 in Earticle, KISS, NDSL, RISS, DBpia and PubMed. Results: IDA accounts for more than 50% of all anemia patients, followed by ACD. Differential diagnosis is needed between IDA and ACD, which usually shows microcytic, hypochromic anemia. The standard for differential diagnosis is the bone marrow iron stain. However, bone marrow study is invasive, expensive so that it cannot be routinely performed. Consequently, the measurement of serum ferritin is the first level test for differential diagnosis. Serum ferritin level is good indicators of storage iron; decreased levels in IDA and normal to increased levels in ACD. However, serum ferritin level may increase irrespective of iron stores in cases of chronic disease. Therefore, it is difficult to diagnose IDA coexisting with ACD. Another available biomarker is soluble transferrin receptor (sTfR). The sTfR level is not affected by chronic disease; it is elevated in IDA but not in ACD. Additionally, the sTfR/log ferritin index is suggested as a good biomarker for identifying coexisting IDA and CAD. Conclusions: This review introduces the etiology and differential diagnosis of IDA and ACD based on an understanding of iron metabolism. Understanding the interrelationship of the various laboratory results may be helpful in the accurate diagnosis and treatment of IDA and ACD.

UCI(KEPA)

I410-ECN-0102-2021-500-000641182

간행물정보

  • : 의약학분야  > 예방의학및보건학
  • : KCI등재
  • :
  • : 계간
  • : 2465-8014
  • : 2465-8022
  • : 학술지
  • : 연속간행물
  • : 1976-2022
  • : 771


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47권2호(2022년 05월) 수록논문
최근 권호 논문
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KCI등재

1전자의무기록 데이터 분석 접근법

저자 : 한창호 ( Changho Han ) , 박찬민 ( Chan Min Park ) , 김유정 ( Yujeong Kim ) , 강소라 ( Sora Kang ) , 박태준 ( Tae Jun Park ) , 윤덕용 ( Dukyong Yoon )

발행기관 : 한국보건정보통계학회 간행물 : 보건정보통계학회지 47권 2호 발행 연도 : 2022 페이지 : pp. 51-58 (8 pages)

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As the healthcare environment is being digitalized and changed rapidly, research using medical big data is increasing. One of the most applicable data is electronic medical records which can provide a large amount of clinically practical meaning. Electronic medical data include patient's demographic information, laboratory test results, imaging and biosignal data. In this article, we provide support for a wide variety of researchers in their efforts to use electronic medical record data accurately and usefully in their work. From the basic concept of the research using electronic medical records to challenging aspects like data integration between multiple institutions are described. Also, examples of each type of data are covered; structured such as numeric data and unstructured such as images, biosignals and narrative text. Using these kinds of electronic medical records, analyses are processed by data cleansing, transforming, and reducing in order. Many kinds of variables such as the exposure and outcome of interest, covariate and the research design can be chosen during the preprocessing. As many machine-learning-based studies as well as epidemiologic-based studies have been conducted using electronic medical records, various research frameworks have been proposed. However, data quality management and data standardization for multi-center data analysis are still remaining as challenging tasks.

KCI등재

2인과성 추론에서 성향점수 매칭에 대한 비판적 고찰

저자 : 유지웅 ( Jiwoong Yu ) , 이우주 ( Woojoo Lee )

발행기관 : 한국보건정보통계학회 간행물 : 보건정보통계학회지 47권 2호 발행 연도 : 2022 페이지 : pp. 59-69 (11 pages)

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Propensity score matching (PSM) is one of the most widely-used causal inference methods to estimate the causal estimands such as average treatment effect or average treatment effect on the treated from observational studies. To implement PSM, a researcher first selects an appropriate set of confounders, estimates the propensity score, and matches the treated group with the control group using a matching algorithm such as nearest neighborhood or optimal matching. In this paper, we highlight the importance of investigating the assumptions employed in the PSM procedure thoroughly because they strongly affect the analysis result, but are not testable using observational data. We explain how to exploit the domain knowledge to avoid the potential risks from the violation of the untestable assumptions, and show how the research purpose is linked to selecting the matching algorithm and downstream analysis after PSM. In addition, to examine the vulnerability of the causal result, we highlight the use of sensitivity analysis for the analysis after PSM. These points are demonstrated in detail using National Supported Work data.

KCI등재

3간호대학생의 셀프리더십, 감성지능, 사회적 지지가 문제해결능력에 미치는 영향

저자 : 김민서 ( Min-seo Kim ) , 배한주 ( Han-ju Bea ) , 이정숙 ( Jung-suk Lee )

발행기관 : 한국보건정보통계학회 간행물 : 보건정보통계학회지 47권 2호 발행 연도 : 2022 페이지 : pp. 79-85 (7 pages)

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Objectives: The purpose of this study was to identify the relationship of self-leadership, emotional intelligence, social support, and problem-solving ability of nursing college students, and to understand the factors that affect problem-solving ability. Methods: Participants were in 2nd and 3rd grade of nursing students. The collected data were analyzed by SPSS 22.0 program using descriptive statistics, t-test, ANOVA, correlation, and multiple regression analysis. Results: The significant influencing factors of problem-solving ability were self-leadership. β=0.36 (p=0.001), emotional intelligence β=0.15 (p<0.04), social support β=0.29 (p<0.001) and club activity β=0.14 (p<0.02). These factors explained 45.5% of the variance (R2=0.46, p<0.001). Conclusions: This study showed that problem-solving ability were influencing factors on self-leadership and it is necessary to develop various strategies to improve self leadership in nursing college students.

KCI등재

4한국 성인의 우울증과 심혈관질환 위험요인의 관련성: 2014년, 2016년 국민건강영양조사

저자 : 조은영 ( Eunyoung Cho ) , 송영숙 ( Yeoungsuk Song )

발행기관 : 한국보건정보통계학회 간행물 : 보건정보통계학회지 47권 2호 발행 연도 : 2022 페이지 : pp. 86-94 (9 pages)

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Objectives: This study was to investigate the relationship between depression and cardiovascular disease (CVD) risk factors among Korean adults. Methods: A total of subjects from the Korean National Health and Nutrition Examination Survey (VI-2, VIII-1) were 7,417 (men 3,023, women 4,394). The relationship between depression and CVD risk factors of the study subjects were analyzed using descriptive analysis, chi-square test, and multiple logistic regression. Results: The prevalence of diabetes mellitus and hyperlipidemia was 14.9% and 43.5% in depression group and there were stastically signficant. However there was not significantly associated between depression and hypertension, diabetes mellitus, and hyperlipidemia. Conclusions: Although this study showed that depression was not associated with cardiovascular factors such as hypertension, diabetes mellitus, and hyperlipidemia, the prevalence of diabetes and hyperlipidemia in depression group was significant. Therefore, further study is needed to find relationship with depression and CVD risk factors, and develop the intervention program to control depression and CVD risk factors.

KCI등재

5중환자실 간호사의 요통 및 요통 영향요인

저자 : 엄현주 ( Hyun Ju Uhm ) , 박혜자 ( Hye-ja Park )

발행기관 : 한국보건정보통계학회 간행물 : 보건정보통계학회지 47권 2호 발행 연도 : 2022 페이지 : pp. 95-102 (8 pages)

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Objectives: This study determined the associated factors with low back pain in intensive care unit nurses. Methods: In this cross-sectional correlational study, 85 nurses working at five intensive care units completed questionnaires on the low back pain using visual analogue scale (VAS), use of body mechanics, work-related factors, the Oswestry disability index (%), the FACIT-fatigue, and the mini-sleep questionnaire. A back pain score of ≥4 was considered significant. Data were analyzed with χ2 test, unpaired t-test, Pearson correlation analysis and logistic regression. Results: Forty-five nurses (52.9%) had a significant low back pain score of ≥4 (VAS). Higher low back pain was associated with greater use of body mechanics (r=0.37, p=0.001), higher disability index (r=0.72, p<0.001), greater fatigue (r=0.59, p<0.001), and poorer sleep quality (r=0.36, p=0.001). Low back pain was associated with heavy workload (odds ratio, OR: 4.20, 95% confidence interval, CI: 1.40-12.58) and long standing to work (OR: 3.54, 95% CI: 1.20-10.48). Low back pain was associated with fatigue (OR: 1.18, 95% CI: 1.08-1.30) after adjusting covariates. Conclusions: Low back pain is associated with a heavy workload, long-standing to work, and greater fatigue among intensive care unit nurses.

KCI등재

6한국의 고령자에서 교육과 인지기능 관련성에 미치는 성별의 조절효과: 한국고령화연구패널조사자료의 분석

저자 : 송인명 ( Inmyung Song )

발행기관 : 한국보건정보통계학회 간행물 : 보건정보통계학회지 47권 2호 발행 연도 : 2022 페이지 : pp. 103-110 (8 pages)

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목적: 전통적인 개발국의 연구결과에 따르면, 인지장애의 위험으로부터 보호하는 교육의 효과가 남녀 간 차이가 있었다. 이에 본 연구에서는 과거 교육기회에 대한 접근성에 있어 남녀 간 차별을 겪었던 고령 한국인들을 대상으로 인지기능과 교육수준 간의 관계에 미치는 성별의 조절효과를 조사하고자 한다.
방법: 본 연구는 전국적인 조사자료인 2018년 고령화연구패널조사자료를 사용하였다. 인지장애는 Mini-Mental State Exam (MMSE) 점수 24점 이하로 정의하였다. 단변량분석에서는 MMSE 점수와 각각의 사회경제학적 변수 또는 행위 변수들 간의 관계를 확인하기 위하여 카이제곱검정을 사용하였다. 공변량을 통제한 상태에서 MMSE 점수와 교육수준 간의 관련성을 확인하기 위해서는 다변량로지스틱 회귀분석을 사용하였으며, 교차비(OR)와 95% 신뢰구간(CI)을 구하였다.
결과: 분석에 포함된 총 5,793명의 대상자 중 31.53%은 교육을 전혀 받지 못하였거나 초등교육만 이수하였다. 이처럼 무교육/초등교육을 받은 대상자는 대학 이상의 교육을 받은 사람에 비해서 인지장애를 겪을 위험이 유의하게 높았다(OR=3.31, 95% CI=3.29-3.34, p<0.001). 낮은 교육수준과 인지장애의 관련성은 남성에 비해서 여성에게서 더 높았다. 교차비는 여성에서 4.58 (95% CI= 4.52-4.65) 남성에서 2.98 (95% CI=2.95-3.00)이었다.
결론: 낮은 교육수준은 인지장애의 위험도 증가와 관련성이 있었으며 그 관련성이 남성보다는 여성에게서 더 높았다. 전통적으로 교육 기회에 대한 차별을 겪었던 여성고령자에게서 교육의 인지기능 보호효과가 클 가능성을 시사한다.


Objectives: In traditionally developed countries, the protective role of higher education on cognitive impairment differed between men and women. This study investigated the moderating impact of sex on the relationship between cognitive function and educational level in older Koreans, who may have experienced inequality in access to educational opportunities in the past. Methods: This study used data from the 2018 Korean Longitudinal Study on Aging (KLoSA), a nationwide panel survey of community-dwelling older adults. Cognitive impairment was defined as a Mini-Mental State Exam (MMSE) score below 24. In univariate analyses, the χ2 test was used to examine the relationship between MMSE and each of sociodemographic and behavioral variables. Multiple logistic regression models were implemented to examine the association between MMSE score and educational level controlling for covariates. Multivariate-adjusted odds ratios (OR) and 95% confidence intervals (CI) were calculated. Results: A total of 5,793 respondents were analyzed; 31.53% received no or only primary education. Individuals with up to primary education were more likely than those with college or higher education to have cognitive impairment (OR=3.31, 95% CI=3.29-3.34, p<0.001). The association between lower educational level and cognitive impairment was stronger for women than for men; OR was 4.58 for women (95% CI=4.52-4.65) and 2.98 for men (95% CI=2.95-3.00). Conclusions: Lower education was associated with increased risk of cognitive impairment and the protective role of education in cognitive function was stronger in women than in men.

KCI등재

7직장 여성 흡연자의 흡연 유형, 금연 관련 심리적 요인 그리고 니코틴 의존도가 금연에 미치는 영향

저자 : 김현민 ( Hyun-min Kim ) , 박기수 ( Ki-soo Park )

발행기관 : 한국보건정보통계학회 간행물 : 보건정보통계학회지 47권 2호 발행 연도 : 2022 페이지 : pp. 111-117 (7 pages)

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Objectives: Recently, female smokers are increasing in Korea. This study aims to report the dependence of nicotine and the type of smoking as a factor influencing the success of smoking cessation among female smokers. Methods: Data were collected from the Comprehensive information system for smoking cessation service, and data from 862 women who used the smoking cessation service by Gyeongnam Tobacco Control Center between June 2015, and December, 2018, were used. After controlling demographic and smoking-related variables, a multiple logistic regression analysis was performed on the relationship between nicotine dependence, smoking type, smoking cessation related psychological factors and smoking cessation. Results: The smoking cessation rate of female smokers was 7.8%. Smoking type and nicotine dependence were low in stimulus-seeking type, and high in addiction, habit type, and complex type. After controlling demographic, health behavior and disease variables, the factors affecting female smokers' smoking cessation were nicotine dependence (odds ratio, OR=0.49, p=0.020), preparation (OR=7.14, p=0.015), confidence (OR=7.14, p=0.015) of smoking cessation. In other words, smoking cessation among women who smoked was higher in the high group than in the group with low anti-smoking preparation and confidence and smoking cessation was higher in the low group than in the high group of nicotine dependence. Conclusions: The actual smoking cessation strategy for women considering related factors of smoking cessation is to reconsider the content of counseling interventions according to the type of smoking and to reduce the dependence of nicotine through a treatment approach for each type, resulting in a higher smoking cessation rate.

KCI등재

8가상현실을 활용한 디지털 역량증진 교원연수 프로그램이 보건교사의 디지털 미디어 리터러시, 교사 효능감, 문제해결 능력에 미치는 효과

저자 : 하영선 ( Young-sun Ha ) , 박용경 ( Yong-kyung Park ) , 김은휘 ( Eun-hwi Kim ) , 김경진 ( Kyeng-jin Kim )

발행기관 : 한국보건정보통계학회 간행물 : 보건정보통계학회지 47권 2호 발행 연도 : 2022 페이지 : pp. 118-125 (8 pages)

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Objectives: This study was conducted to examine the effects of digital empowerment teacher training program applying virtual reality on digital media literacy, teacher efficacy, and problem-solving ability of school nurse. Methods: A quasi -experimental study of pre- and post-experimental design was performed on 47 school nurse located in K city and the developed digital empowerment teacher training program was implemented. The data collection period is July 27, 2021, and the collected data is collected using the SPSS 18.0 program. Paired t-test were analyzed. Results: According to the results of the effect, it was found that there was a significant difference in digital media literacy and problem-solving ability. Conclusions: The digital empowerment teacher training program developed in this study can be used as an effective program to enhance the digital media literacy and problem-solving ability of school nurse.

KCI등재

9간호대학생의 그릿과 문제해결능력의 관계에서 고통감내력과 자기주도성의 매개효과

저자 : 김수진 ( Su Jin Kim ) , 장군자 ( Gun Ja Jang )

발행기관 : 한국보건정보통계학회 간행물 : 보건정보통계학회지 47권 2호 발행 연도 : 2022 페이지 : pp. 126-132 (7 pages)

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목적: 본 연구는 간호대학생의 그릿과 문제해결능력과의 관계에서 고통감내력과 자기주도성의 매개효과를 규명하기 위함이다.
방법: 간호대학생 335명을 대상으로 일반적 특성과 측정변수들은 기술통계를 이용하였고, 변수 간 상관관계는 Pearson 상관계수로, 그 릿과 문제해결능력의 매개효과는 Baron and Kenny가 제안한 3단계 회귀분석 매개효과 검정방법을 이용하였다.
결과: 그릿, 고통감내력, 자기주도성, 문제해결능력은 서로 양의 상관관계를 보였고, 간호대학생의 그릿과 문제해결능력의 관계에 고통 감내력과 자기주도성의 매개효과가 있는 것으로 나타났다.
결론: 간호대학생의 문제해결능력 향상을 위해 고통감내력과 자기주도성을 향상시킬 수 있는 프로그램 개발이 필요함을 밝히는 바이다.


Objectives: This study aimed to identify the mediating effects of distress tolerance and self-directedness on the relationship between grit and problem-solving ability in nursing students. Methods: Participants were 335 nursing students in two universities between September to December 2018. The data were analyzed using a t-test, one-way ANOVA, and Person's correlation coefficients. In addition, Baron and Kenny's method was used to analyze mediating effects of distress tolerance and self-directedness between grit and problem-solving ability. Results: Significant correlations were found between grit and problem-solving ability (r=0.57, p<0.001), between grit and distress tolerance (r=0.38, p<0.001), and grit and self-directedness (r=0.46, p<0.001). There were the mediating effects of distress tolerance (z=5.37, p<0.001) and self-directedness (z=7.25, p<0.001) on the relationship between grit and problem-solving ability. Conclusions: It is necessary to develop and apply the programs that strengthen distress tolerance and self-directedness to improve nursing students' problem-solving ability.

KCI등재

10최근 9년간의 1급 응급구조사 국가자격시험 결과 추이 분석

저자 : 김영화 ( Young Hwa Kim ) , 강민주 ( Min Ju Kang )

발행기관 : 한국보건정보통계학회 간행물 : 보건정보통계학회지 47권 2호 발행 연도 : 2022 페이지 : pp. 133-138 (6 pages)

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Objectives: The study was to analyze the trend of the result of the national examination for EMT-paramedics. Methods: This study was to find the result of published on the website of Korea Health Personnel Licensing Examination Institute for the past 9 years. Results: Although there was no significant change in the pass rate, difficulty, and discrimination of the national examination, the average score of the total score showed a tendency to decrease every year. Unlike the average scores of other subjects, the basic medicine subjects showed a steady decline. The number of those who failed the written test were higher than those who failed the practical test. As a result of analyzing those who failed the written test, the majority of those who failed basic medicine and emergency medical service-related legislation. Conclusions: The steady decline in basic medicine scores and the steady increase in the number of people who failed has raised the need to reinforce basic medicine in universities or institutions that are nurturing EMT-paramedics in order to improve the quality of the national examination. In addition, the subjects of emergency medical service-related legislation was considered as subjects to be strengthened along with basic medicine.

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1외국의 백신 능동적 감시 시스템 소개

저자 : 정나영 ( Na-young Jeong ) , 박상신 ( Sangshin Park ) , 임은선 ( Eunsun Lim ) , 최남경 ( Nam-kyong Choi )

발행기관 : 한국보건정보통계학회 간행물 : 보건정보통계학회지 44권 4호 발행 연도 : 2019 페이지 : pp. 317-330 (14 pages)

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Vaccines require higher safety standards than most other medicinal products because they are given to healthy individuals, including infants, children, and elderly. Despite various activities by national agencies, public concern about vaccine safety often arises. Post-marketing activities for vaccine safety can be broadly classified into passive and active surveillances. Many countries as well as Korea operate passive vaccine safety surveillance systems that report adverse events related to vaccines. However, the active surveillance systems operate only in several countries, such as the United States of America (USA), Europe, Canada and Australia. In the US, Vaccine Safety Datalink (VSD) and Post-Licensure Rapid Immunization Safety Monitoring (PRISM) were developed in 1990 and 2009 respectively for monitoring vaccine actively. In the case of Europe, the Vaccine Adverse Event Surveillance and Communication (VAESCO) consortium was launched in 2008. After the end of VAESCO, the Accelerated Development of VAccine beNefit-risk Collaboration in Europe (ADVANCE) was organized to establish a vaccine benefit-risk monitoring framework in 2013. Canada has been operating a vaccine active monitoring system known as the Canadian Immunization Monitoring Program, ACTive (IMPACT) since 1991. The objective of this review was to describe and compare background, databases, and analysis systems of various vaccine active surveillance systems in the US, Europe, and Canada. We described the examples of studies on the safety of influenza A (H1N1) vaccines carried out in each system. This review could help provide directions for the future development of the ideal active vaccine safety surveillance system in Korea.

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2검사정보의 이해를 통한 철결핍빈혈과 만성질환빈혈의 감별진단

저자 : 이석준 ( Suk Jun Lee )

발행기관 : 한국보건정보통계학회 간행물 : 보건정보통계학회지 44권 4호 발행 연도 : 2019 페이지 : pp. 331-338 (8 pages)

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Objectives: The purpose of this study is to provide availability of laboratory results in differential diagnosis of iron deficiency anemia (IDA) and anemia of chronic disease (ACD). Methods: This study was based on a systematic review of related to iron metabolism, IDA and ACD. We searched the published articles from 1992 to 2019 in Earticle, KISS, NDSL, RISS, DBpia and PubMed. Results: IDA accounts for more than 50% of all anemia patients, followed by ACD. Differential diagnosis is needed between IDA and ACD, which usually shows microcytic, hypochromic anemia. The standard for differential diagnosis is the bone marrow iron stain. However, bone marrow study is invasive, expensive so that it cannot be routinely performed. Consequently, the measurement of serum ferritin is the first level test for differential diagnosis. Serum ferritin level is good indicators of storage iron; decreased levels in IDA and normal to increased levels in ACD. However, serum ferritin level may increase irrespective of iron stores in cases of chronic disease. Therefore, it is difficult to diagnose IDA coexisting with ACD. Another available biomarker is soluble transferrin receptor (sTfR). The sTfR level is not affected by chronic disease; it is elevated in IDA but not in ACD. Additionally, the sTfR/log ferritin index is suggested as a good biomarker for identifying coexisting IDA and CAD. Conclusions: This review introduces the etiology and differential diagnosis of IDA and ACD based on an understanding of iron metabolism. Understanding the interrelationship of the various laboratory results may be helpful in the accurate diagnosis and treatment of IDA and ACD.

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3외과계 전담간호사의 전문직 정체성과 직무만족도와의 관계에서 조직몰입의 매개효과

저자 : 유성현 ( Seonghyun Yoo ) , 김명수 ( Myoung Soo Kim ) , 박형숙 ( Hyoung Sook Park )

발행기관 : 한국보건정보통계학회 간행물 : 보건정보통계학회지 44권 4호 발행 연도 : 2019 페이지 : pp. 339-348 (10 pages)

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Objectives: Professional identity, which is a subjective evaluation of self-determination, has been studied as an important factor in determining job satisfaction. Organizational commitment can be expected to play an important role in the relationship between professional identity and job satisfaction. The study was aimed to examine mediating effect of organizational commitment of physician assistants in the relationship between professional identity and job satisfaction. Methods: The participants of this study were 124 nurses who agreed to participate in the study among physician assistants working at two university hospitals located in B metropolitan city and Y city. The measurement tools included a questionnaire on professional identity, organizational commitment, and job satisfaction. Descriptive statistics, t-test, ANOVA, Kruskal-Wallis test, partial correlation coefficients, and multiple regression were used to analyze results. Results: The mean score of professional identity was 3.36±0.42, organizational commitment was 3.28±0.54, and job satisfaction was 3.12±0.38. There were significant positive partial correlations between professional identity and organizational commitment (r=0.56, p<0.001), professional identity and job satisfaction (r=0.65, p<0.001), and organizational commitment and job satisfaction (r=0.61, p<0.001). Organizational commitment was a mediator between professional identity and job satisfaction. Conclusions: Based on this study, organizational commitment promotion strategies to improve job satisfaction are needed. These results will contribute to development of education program of a physician assistant and promotion of quality of medical services.

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4의료서비스 이용경험이 환자 만족도와 병원 추천의사에 미치는 영향

저자 : 조명선 ( Myong Sun Cho )

발행기관 : 한국보건정보통계학회 간행물 : 보건정보통계학회지 44권 4호 발행 연도 : 2019 페이지 : pp. 349-358 (10 pages)

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Objectives: This study examined to identify the factors influencing on patients' satisfaction with treatment outcome and willingness to recommend hospital to others. Methods: Data from the 2017 National Patient Experience Survey were used for the analysis. Logistic regression analysis was conducted to explore the factors such as sociodemographic, health related factors and perceived quality of healthcare services which patience had experienced. The influence of patients' satisfaction on willingness to recommend hospital was analyzed using logistic analysis. Results: Of the 7,488 patients experiencing outpatient services, 6,676 (89.2%) and 6,383 (85.2%) respondents showed satisfied with treatment outcome and willingness to recommend hospital, respectively. Those who experienced involvement in care decision, ample opportunities to questions, enough time to talk and being treated with respect by physician were more likely to satisfy with treatment outcome. Even after controlling for their socio-demographic and health related factors, outpatients with better quality of healthcare services were more likely to show higher satisfaction and willingness to recommend hospital. Conclusions: The result revealed that experiences of positive physician-patient relationship and better hospital facility and effective administrative service affected the patients' satisfaction with treatment outcome and willingness to recommend hospital. To improve patients' satisfaction of health care uses, it is necessary to improve non-medical service as well as patient-health care provider interaction from the patients' perspectives.

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5간호대학생의 임상실습 교육에 대한 자기효능감과 조직몰입, 조직시민행동, 임상실습만족도와의 관계

저자 : 이정숙 ( Jung Suk Lee ) , 이영옥 ( Young Ok Lee ) , 배한주 ( Han Ju Bea )

발행기관 : 한국보건정보통계학회 간행물 : 보건정보통계학회지 44권 4호 발행 연도 : 2019 페이지 : pp. 359-365 (7 pages)

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Objectives: The purpose of this study was to identify the relationship of self-efficacy, organizational commitment, organizational citizenship behavior, and satisfaction of clinical practice and investigate the influencing factors on satisfaction of clinical practice in nursing college students. Methods: Participants were in 3rd and 4th grade of nursing students with clinical experiences. Data were gathered from December 3, 2018 to December 7, 2018. Data were analyzed by descriptive statistics, t-test, ANOVA, Scheffe test, Person's correlation coefficients, multipel regression using SPSS 22.0 program. Results: The significant influencing factors of satisfaction of clinical practice were religion β=0.14 (p=0.008), major satisfaction β=0.12 (p=0.035), organizational commitment β=0.38 (p<0.001) and organizational citizenship behavior β=0.29 (p<0.001). These factors explained 43% of the variance (R2=0.43, p< 0.001). Conclusions: This study showed that organizational commitment and organizational citizenship behavior were influencing factors on satisfaction of clinical practice and it is necessary to develop various strategies to improve organizational commitment and organizational citizenship behavior in nursing college students.

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6간호사의 감정노동이 직무열의 및 이직의도에 미치는 영향

저자 : 권주영 ( Ju Young Kwon ) , 지재훈 ( Jae Hoon Ji ) , 김원중 ( Won Joong Kim )

발행기관 : 한국보건정보통계학회 간행물 : 보건정보통계학회지 44권 4호 발행 연도 : 2019 페이지 : pp. 366-374 (9 pages)

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Objectives: The purpose of this study is to analyze whether emotional labor experienced by nurses in their work affects turnover intention through job engagement. Methods: Data were collected by a self-entry method using structured questionnaire for 243 nurses who worked at hospitals in Busan. Structural equation and moderating regression model were applied for the analysis. Results: Firstly, in emotional labor, which is an independent variable, emotional disharmony had a negative (-) effect on job engagement and a positive (+) influence on turnover intention. Secondly, it was found that job engagement, which is a mediating variable, had a negative (-) influence on turnover intention. Third, job engagement had partially mediating effect on causal relation between emotional disharmony (which is a subordinate variable of emotional labor) and turnover intention. Conclusions: Based on the results of this study, it is suggested that preparation of a scheme to raise job enthusiasm and lower intention to change jobs is required by recognizing emotional disharmony experienced by nurses and paying continuous attention to their work environment.

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7국가 보건의료사업에 대한 지역주민의 인지도가 만족도에 미치는 영향

저자 : 김유호 ( You Ho Kim )

발행기관 : 한국보건정보통계학회 간행물 : 보건정보통계학회지 44권 4호 발행 연도 : 2019 페이지 : pp. 375-383 (9 pages)

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Objectives: The purpose of this study was to examine the degree of satisfaction of ordinary residents with each healthcare project and determine the extent of satisfaction of local residents by level of awareness towards each healthcare project so as to increase satisfaction of local residents with healthcare projects ultimately. Methods: The subjects of this study were 212 ordinary residents in Chungcheongbuk-do. For the analyses of simple data, the SPSS 25.0 statistics package was used to analyze the data from June 03 to 24, 2019. To determine the difference in demographic characteristics, frequency analysis, independent sample t-test and ANOVA were used. Results: First, a significant difference was observed in the satisfaction with healthcare projects by, education level, and occupation. By education level, the satisfaction increased as the education level was lower. Second, overall average score of awareness by item of health improvement projects was 3.0 points or lower. Third, overall average score of awareness by item of health management projects was 3.0 points or lower. Fourth, overall average score of awareness by item of projects for pregnant women, infants and toddlers and infectious disease prevention projects was 3.0 points or lower. Fifth, overall average score of awareness by item of medical cost support and vaccination projects was 3.0 points or lower. Conclusions: Based on overall consideration of the results, the awareness towards healthcare projects was found to be very low. Those results were considered attributable to the lack of promotion of healthcare projects led by public health centers.

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8경상북도 건강새마을 조성사업에서 주민의 참여 정도와 건강행태 개선효과

저자 : 이수진 ( Su-jin Lee ) , 김건엽 ( Keon-yeop Kim ) , 이덕희 ( Duk-hee Lee ) , 홍남수 ( Nam-soo Hong )

발행기관 : 한국보건정보통계학회 간행물 : 보건정보통계학회지 44권 4호 발행 연도 : 2019 페이지 : pp. 384-393 (10 pages)

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Objectives: The purpose of this study was to determine association between participation degree and any changes in health behaviors in the Gyeongsangbuk-do Health Saemaeul Program, a community-based health promotion project. Methods: The study used surveys of the Gyeongsangbuk-do Health Saemaeul Program, in 2016, 2018 and data from KOSIS. Results: The multi-level linear regression analysis was completed with a total health behavior improvement score based on the six types of health behavior changes. People with temporal participation showed a higher total health behavior improvement score than the non-participants. Females showed a higher total health behavior improvement score than males and people with any chronic diseases showed a higher total health behavior improvement score than those without. None of the community-related variables showed any statistical significances. The results of the stratified analysis according to individual and community-related variables revealed that a group with the following community-related characteristics were more likely to have a higher total health behavior improvement score according to the participation degree; (1) a higher proportion of vulnerable subjects, (2) a higher financial self-reliance, and (3) a higher participation degree with willingness. No statistical significance was revealed with the individual characteristics. Conclusions: In order to enhance health status of its residents in a community-level, designing an integrated health promotion program in considering the community characteristics would be more effective. In order to improve the quality of the Gyeongsangbuk-do Saemaeul Health Program and to expand its effects, an establishment of strategic plans is required at the level of selecting the target community.

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9저소득층 아동의 외로움 관련 요인

저자 : 홍연란 ( Yeon Ran Hong ) , 최청숙 ( Cheung Sook Choi ) , 장군자 ( Gun Ja Jang )

발행기관 : 한국보건정보통계학회 간행물 : 보건정보통계학회지 44권 4호 발행 연도 : 2019 페이지 : pp. 394-399 (6 pages)

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Objectives: The purpose of this study was to investigate the factor contributing to loneliness of children in lower income class and to examine the relationship of the variables. Methods: The participants were 178 children in lower income class. Data were collected from April to May, 2018 by taking a self reported survey and analyzed using descriptive statistics of a mean±SD, Pearson's correlation coefficient, and hierarchical regression analysis with SPSS 25.0 program. Results: The mean score of loneliness was 37.02±8.05 out of a 3 point scale, slightly lower the half. There were negative correlations between loneliness and allowance per month, double income couple, perceived atmosphere, and both parents' supervision and positive correlation between loneliness and both parents' abuse and neglect. Variables such as allowance, double income, mother's supervision and abuse explained 36.8% of children's loneliness. Conclusions: There is a need to develop parental educational programs to evaluate the parenting attitude for decreasing the level of children's loneliness.

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10학생진로설계프로그램이 간호대학생의 진로결정 자기효능감, 진로결정 수준 및 진로탄력성에 미치는 효과

저자 : 조은정 ( Eun Jung Cho )

발행기관 : 한국보건정보통계학회 간행물 : 보건정보통계학회지 44권 4호 발행 연도 : 2019 페이지 : pp. 400-409 (10 pages)

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Objectives: The purpose of this study was to examine effects of individual career plan program (ICPP) on career decision-making self-efficacy, career decision level and career resilience in nursing students. Methods: A quasi-experimental study with non-equivalent control group posttest only design was used. Students were allocated to the experimental group (n=169) and control group (n=68). The experimental group required to fulfil course credit of ICPP template above sixty scores in the academic year 2013-2016. Collected data were analyzed using Chi-squire test and independent t-test. Results: Total mean scores of career decision-making self-efficacy, career decision level and career resilience for experimental group were significantly higher than control group. Conclusions: The ICPP is effective in empowering nursing students' career decision-making self-efficacy, career decision level and career resilience. The findings suggest a need to explore the prolonged effect of ICPP after entering professional nursing career.

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