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홍차넷
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Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/outlogin_toby.php on line 45
Warning: Use of undefined constant r - assumed 'r' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/outlogin_toby.php on line 47
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Warning: Use of undefined constant memo - assumed 'memo' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/lib.php on line 237
Warning: Use of undefined constant level - assumed 'level' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/outlogin_toby.php on line 34
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/outlogin_toby.php on line 45
Warning: Use of undefined constant r - assumed 'r' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/outlogin_toby.php on line 47
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Warning: Use of undefined constant memo - assumed 'memo' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/lib.php on line 237
Warning: Use of undefined constant is_admin - assumed 'is_admin' (this will throw an Error in a future version of PHP) in /home/redtea/html/zero_header.php on line 269
Warning: Use of undefined constant level - assumed 'level' (this will throw an Error in a future version of PHP) in /home/redtea/html/zero_header.php on line 300
Warning: Use of undefined constant title - assumed 'title' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/bbs_title.php on line 16
티타임
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/bbs_title.php on line 21
Warning: Use of undefined constant header - assumed 'header' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/bbs_title.php on line 31
- 다양한 주제에 대해 자유롭게 글을 작성하는 게시판입니다.
Warning: Use of undefined constant use_formmail - assumed 'use_formmail' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/lib.php on line 519
Warning: Use of undefined constant use_category - assumed 'use_category' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/include/print_category.php on line 9
전체기타일상/생각꿀팁/강좌방송/연예도서/문학영화의료/건강문화/예술경제생활체육과학/기술철학/종교정치요리/음식역사여행육아/가정IT/컴퓨터음악창작게임스포츠사회오프모임
Warning: Use of undefined constant level - assumed 'level' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/setup.php on line 29
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/setup.php on line 41
Warning: Use of undefined constant memo - assumed 'memo' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 389
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Warning: Use of undefined constant x - assumed 'x' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 398
Warning: Use of undefined constant subject - assumed 'subject' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 402
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Warning: Use of undefined constant total_comment - assumed 'total_comment' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 406
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Warning: Use of undefined constant reg_date - assumed 'reg_date' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 405
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Warning: Use of undefined constant x - assumed 'x' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 403
Warning: Use of undefined constant reg_date - assumed 'reg_date' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 405
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Warning: Use of undefined constant subject - assumed 'subject' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 402
Warning: Use of undefined constant x - assumed 'x' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 403
Warning: Use of undefined constant reg_date - assumed 'reg_date' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 405
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Warning: Use of undefined constant x - assumed 'x' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 403
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Warning: Use of undefined constant reg_date - assumed 'reg_date' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 405
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Warning: Use of undefined constant name - assumed 'name' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view.php on line 2
Warning: Use of undefined constant HTTP_HOST - assumed 'HTTP_HOST' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/memo_replace.php on line 3
Warning: Use of undefined constant x - assumed 'x' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view.php on line 10
Warning: Use of undefined constant use_category - assumed 'use_category' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view.php on line 40
| Date |
Warning: Use of undefined constant reg_date - assumed 'reg_date' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view.php on line 53 18/04/04 16:42:07 Warning: Use of undefined constant mod_date - assumed 'mod_date' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view.php on line 56 |
| Name | 세상의빛 |
| Subject | 환자의 순응도 |
|
안녕하세요. 주제 넘게 '의료/건강' 탭으로 글을 쓰게 되었습니다. 이 글을 쓰게된 동기는 1) 오늘 환자 내원이 적어서 심심. 2) 이 주제로 얼마 전에 강의를 해서 입니다. ㅋㅋㅋ 환자의 순응도에 대해서 말씀드려볼까 합니다. 순응도는 환자 순응도, 치료 순응도, 복약 순응도 등 여러 용어가 있지만 기본적으로 순응도란 의사의 처방이나 충고에 대해 환자의 행동이 얼마나 일치하는가에 대한 개념입니다. 순응도가 높을수록 긍정적인 치료 결과를 기대해 볼 수 있기 때문에 진료에 임하는 모든 의사들이 갖는 고민이라고 해도 과장은 아닙니다. 순응도에 포함되는 요소들은 여러가지가 있지만 이들 중 중요하다고 판단한 것은 다음과 같습니다. 1) 예약 시간을 지키는 것 2) 용법대로 약을 복용하는 것 3) 생활 습관의 변화를 위해 노력하는 것 그렇다면 환자의 순응도에 영향을 미치는 요인들은 어떤 것이 있을까요? 관련 교과서는 1) 환자 요인 2) 질병 요인 3) 처방 요인 4) 의사 요인 등을 언급하고 있습니다. 1) 환자 요인 환자 자신의 질병에 대한 인식(병식이라고도 하죠), 치료 동기 등 질병과 관련된 환자의 인지적 요소들이 순응도와 관련이 있습니다. 환자 자신의 생활 습관 중 본인의 병을 악화시키는 것이 무엇인지를 뚜렷하고 명확하게 인식할 수록 순응도도 높고, 생활 습관의 교정도 용이해지는 면이 있습니다. 건강검진 결과 고중성지방혈증, 비만, 허리둘레 이상, 지방간 등이 확인된 40대 남자의 경우 저는 보통 술을 줄이거나 간식을 줄이거나 둘 중 하나를 명확히 하시기를 조언합니다. 둘 다 하면 좋겠지만 현실적으로 쉽지 않기 때문에 타겟을 단순하고 명확하게 해주는 것이죠. 2) 질병 요인 만성 질환이나 일부 정신건강의학과 질환은 순응도가 떨어집니다. 장기 치료가 요구되는 질환이면서 생활습관 교정이 강하게 필요한 질환은 환자의 순응도가 매우 낮습니다. 대표적인 예로 당뇨병을 들 수 있겠군요. 반대로 신속한 처치가 필요한 질환 후유 장애의 빈도나 정도가 심한 질환의 순응도는 상대적으로 높은 편입니다. 급성 심근경색이나 뇌졸중, 다발성 외상 등을 예로 들 수 있겠군요. 3) 처방 요인 작용 시간이 긴 주사제는 경구약제보다 순응도가 좋은 편입니다. 그리고 투약하는 약의 갯수가 적을 수록 복용 횟수가 적을수록 순응도가 높습니다. 여러 성분의 약을 한 알로 만든 병합제제의 출시가 많아지는 이유가 복약 순응도가 높기 때문이죠. 복용 횟수도 중요합니다. 대상포진의 치료로 쓰이는 항바이러스제 중 acyclovir는 800mg 씩 하루 다섯번을 복용해야 하지만, famciclovir는 500mg 씩 하루 세번 복용이면 됩니다. 당연히 famciclovir 쪽이 순응도가 높지요. 4) 의사 요인 진료에 대한 기대치가 만족되고 양질의 진료를 받았다고 환자가 느끼면 당연히 순응도가 좋습니다. 의사에 대한 개인적인 친밀감을 느끼는 경우에도 순응도가 좋습니다. 제 은사님은 환자 분의 개인사를 잘 기억해두셨다가 진료시 인사로 잘 활용하십니다. "다현(환자분의 따님) 양이 이제 중학생인가요?" 이런 말씀을 진료 시작 시 짧게 하시는데 환자 분들의 친밀감이 커지는 것을 밝아진 표정으로 알 수 있었습니다. 마치며... 환자의 순응도는 환자-의사 간 커뮤니케이션을 반영합니다. 그러나 제한된 진료 시간에 만족스런 커뮤니케이션을 하는 것은 쉽지 않은 일입니다. 최근 커뮤니케이션에 대해 공부를 하면서 알게된 커뮤니케이션 기법들을 진료에 어떻게 녹여볼까 고민을 많이 했는데 아직 만족스런 방법을 찾지는 못했습니다. 아마 계속 고민하지 않을까 하네요. 부족한 글 읽어주셔서 감사드립니다. Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view.php on line 133 Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view.php on line 146 Warning: Use of undefined constant vote - assumed 'vote' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view.php on line 161 5 |
|
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Warning: Use of undefined constant name - assumed 'name' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 542
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Warning: Use of undefined constant grant_delete - assumed 'grant_delete' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 577
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Warning: Use of undefined constant is_admin - assumed 'is_admin' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/lib.php on line 605
Warning: Use of undefined constant is_admin - assumed 'is_admin' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/lib.php on line 605
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Warning: Use of undefined constant ismember - assumed 'ismember' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/lib.php on line 616
Warning: Use of undefined constant x - assumed 'x' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/lib.php on line 618
Warning: Use of undefined constant name - assumed 'name' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/lib.php on line 618
Warning: Use of undefined constant x - assumed 'x' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 612
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Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 646
Warning: Use of undefined constant HTTP_HOST - assumed 'HTTP_HOST' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/cmt_replace.php on line 3
Warning: Use of undefined constant ismember - assumed 'ismember' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 6
Warning: Use of undefined constant file_name - assumed 'file_name' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 28
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 65
102232 class="iamcmt" style="display:none;"> Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 66
102232 class='vcm '>
Warning: Use of undefined constant x - assumed 'x' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 70
Warning: Use of undefined constant x - assumed 'x' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 71
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 76
Warning: Use of undefined constant ismember - assumed 'ismember' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 117
Warning: Use of undefined constant ismember - assumed 'ismember' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 118
Warning: Use of undefined constant ismember - assumed 'ismember' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 119
Warning: Use of undefined constant ismember - assumed 'ismember' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 120
Warning: Use of undefined constant ismember - assumed 'ismember' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 121
102232'> 지겐
Warning: Use of undefined constant mod_date - assumed 'mod_date' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 133
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 140
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 140
Warning: Use of undefined constant reg_date - assumed 'reg_date' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 142
18/04/04 16:49
102232>삭제 주소복사
Warning: Use of undefined constant level - assumed 'level' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 150
제가 어릴 때 가던 내과 의사 선생님께서도 진료 차트에 아무도 못 알아볼 글씨로 가정사를 적어놓고 물어보시곤 하셨었죠 ㅎㅎ
Warning: Use of undefined constant level - assumed 'level' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 158
Warning: Use of undefined constant password - assumed 'password' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 166
Warning: Use of undefined constant vote - assumed 'vote' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 171
Warning: Use of undefined constant vote - assumed 'vote' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 172
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 173
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 173
Warning: Use of undefined constant vote - assumed 'vote' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 173
1
Warning: Use of undefined constant level - assumed 'level' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 158
Warning: Use of undefined constant password - assumed 'password' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 166
Warning: Use of undefined constant vote - assumed 'vote' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 171
Warning: Use of undefined constant vote - assumed 'vote' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 172
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 173
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 173
Warning: Use of undefined constant vote - assumed 'vote' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 173
1
102232>
102232>
