Earticle

Purpose: The purposes of this research were to study the validity of the National Examination based on smart based test(SBT) by 7 types of healthcare occupation. Methods: We conducted a questionnaires survey among 1,219 people including 210 professors for all 7 types of healthcare occupation and 573 clinical specialists ; 436 students from random sampling participated and the reliability of the questionnaire was tested using Cronbach’s alpha. Results: Professors from 7 types of healthcare occupation were investigated for their opinions on the introduction of the SBT system ; 65.9% of the professors answered positively on the introduction of the SBT National Examination System, while 40.1% of the clinical experts answered likewise. In particular, professors and the clinical experts recognized altogether that the multimedia questionnaire, being effective for the evaluation of clinical and practical competence of the subjects, enabling the evaluation of various areas and strengthening the school education in clinical practices, the 42.0% of the students from 7 departments answered that the future direction of the national test is in the SBT test system with significant difference (p=.000) found in students majoring in order of Emergency Medical Services, Radiology and Physical therapy, compared to students from other majors, showing the positive response to the SBT system. Conclusion: The results of this study comprehensively evaluated the positive recognition of development of multimedia items and SBT system in national examination of 7 types of healthcare occupation in professors, field specialists and students.

Purpose: The purpose of this study was to compare laryngoscopic views and ease of use and success of intubation, via the percentage of glottic opening (POGO) scale when using the Miller blade and Macintosh blade in paraglossal approach. Methods: Forty intern doctors were randomized for laryngoscopy to be performed in a crossover manner. They performed endotracheal intubation with Miller blade and Macintosh blade in two airway scenarios: normal airway and difficult airway with edema. We observed the rate of successful intubation, time required for visualizing the glottis, time to complete endotracheal intubation, ease of intubation, and the POGO scale. Results: In the normal airway, there was no difference in intubation between the two endoscopes. In the difficult airway, the time for visualizing the glottis (7.80 versus 10.24 sec; p=.006), the time to tube passage (19.38 versus 23.03 sec; p=.038) and the time to complete endotracheal intubation (21.84 versus 28.54 sec; p=.022) with Miller blade was shorter than with Macintosh blade. The POGO scale(%) of the Miller blade was higher than that of the Macintosh blade’s (62.25 versus 56.32; p=.030). Conclusion: Compared to the Macintosh blade, Miller blade provided better visualization of the glottis and POGO scale, and faster time to completion of endotracheal intubation.

Purpose: The purpose of this study was to present evidence for quality management based on analysis of patient transportation and response intervals among emergency medical squads. Methods: The chi-square test was used to determine whether mental status and patient assessment affected direct medical control and hospital destination. One way analysis of variance was used to compare response intervals depending on mental status and patient assessment using data drawn from 1172 prehospital care reports. Results: There was a statistically significant relationship between mental status and direct medical control (p<.001); there was a statistically significant relationship between patient assessment and hospital destination (p=.011). However, there was no statistically significant relationship between mental status and hospital destination. The interval from arrival at the patient’s side to departure from the scene showed a statistically significant difference (p<.001, p<.001), however, it took the longest time (16.8 minutes) in unresponsive patients. It showed a statistically significant difference (p<.001) in the interval from arrival at patient’s side to departure from the scene depending on patient assessment; however, it took the longest time (9.6 minutes) in emergency patients. Conclusion: There was call for direct medical control based on patient assessment; however, patient transportation and response intervals were not appropriate.

Purpose: This study was conducted to investigate the disaster response competencies of 119 emergency medical technicians (EMTs). Methods: The subjects of this study were 226 119 EMT’s at the fire station located in G province. The questionnaire consisted of 5 sub-factors and 29 items for measuring disaster response competencies and the collected data were analyzed using SPSS program. Results: Disaster response competency comprising immediate response, patient triage, patient treatment, patient transport, and collaboration support were 3.48, 3.64, 3.52, 3.64, and 3.16, respectively. Advanced EMTs scored significantly higher in patient triage (p<.001), treatment (p<.001), and transport (p=.022) competency than basic EMTs. Conclusion: In order to improve disaster response competency, it is necessary not only to enhance individual ability but also to continue disaster management training with related organizations.

Purpose: The purpose of this study was to evaluate the quality of chest compressions and ventilation when using an mechanical device(LUCAS) and 2-men manual cardiopulmonary resuscitation(CPR) performed on a minikin, as well as to propose a more effective CPR method during transit. Methods: Data were collected by LUCAS and manual virtual reality based ambulance simulation. Analysis was performed using SPSS software 12.0. The average and standard deviation of chest compression depth and ventilation were analyzed using descriptive statistics and t-test. Results: In the virtual reality based LUCAS and manual CPR results, LUCAS showed better chest compression and lower incomplete chest release than manual CPR. During CPR with a chest compression-ventilation ratio of 30:2 in virtual reality ventilation with bag-valve mask was able to deliver an adequate volume of breathing. Conclusion: It is suggested that rescuers on ambulance may consider using LUCAS as an alternative to high-quality chest compression during transit.

Purpose: This study aimed to assess and improve the work scope of emergency medical technicians (EMT)-paramedics in emergency medical centers. Methods: Data were collected from February 1 to 14, 2018. The questionnaire comprised a total of 56 questions: eight general questions, six questions about the recognition of EMT-paramedics in emergency medical centers, and 42 questions about their work. Data were analyzed via frequency and correlation analysis using SPSS version 18.0. Results: Regarding the work of EMTs in emergency medical centers, positive opinions were found in 23 items, negative opinions in 4 items, and both positive and negative opinions in 9 items. Regarding the questions about the necessity, work importance, professionalism, and the need for an increase4 in EMR-paramedics, depending on respondents' career, there was no statistically significant difference between the group of beginners and the group comprising beginners and that of experienced workers (p>.200). Conclusion: The expert survey revealed that the work performance of EMT-paramedics in regional emergency medical centers was trusted and showed positive results of improvement and expansion.

Purpose: This study aimed to assess the attitude toward cadaver donation and change of intention toward cadaver donation after participation in cadaver dissection among paramedical students, and then to provide basic data to extend wholesome culture toward cadaver donation. Methods: This study was conducted among 298 freshmen via questionnaire survey. The attitude toward the cadaver donation questionnaire consisted of 12 items on a 5 Likert scale. Data were collected before and after participation in cadaver dissection with the agreement of subjects. The data were analyzed using SPSS version 24.0. Results: This study showed that attitude toward cadaver donation was significantly different according to gender (p=.027) and major (p=.035). The attitude score toward cadaver donation was 3.45 points. The rate of positive intention toward cadaver donation before participation in cadaver dissection was 46.5%. The rate of change of intention toward cadaver donation after participation in cadaver dissection was 25.9%. Among 25.9% of subjects, the intention of 56.3% was changed from positive to negative, and the intentions of 42.1% changed from negative to positive. Conclusion: The results of this study the need to provide an educational program to improve the understanding and knowledge toward cadaver donation before participation in cadaver dissection among paramedical students.

Purpose: This study aimed to provide fundamental data for the development of a human management strategy depending on the followership type in 119 EMTs. Methods: The subjects were thirty eight 119 EMTs working out of hospital in Y, D, S, G city. Data were collected from June 25 to August 10, 2017. The Q sample was selected as 40 statements in total and analyzed using the PC QUANL program. Results: As a result of the study, three followership types explained 67.59% of all the variables. Three different types were identified from the examination. The types were labeled as ‘Responsible helper type’, ‘Quick response type’, and ‘Enterprising self-development type’. Conclusion: For each type, a leader and follower should develop a team management strategy for 119 EMTs to provide high-quality emergency medical services.

Purpose: The purpose of this study was to assess empathy and resilience among healthcare college students. Methods: A self-reported questionnaire was filled out by healthcare college students from August 13 to October 13, 2018. Mean and standard deviation, t-test, analysis of variance, Pearson’s correlation coefficients, and linear regression were used to analyze the data. Results: The average score for perspective taking was 3.57(±0.48), fantasy 3.39(±0.59), empathic concern 3.57(±0.39), personal distress(3.02±0.48), and resilience 3.37±(0.41). There was a significant positive correlation between perspective taking (r=.388, p<.001) and resilience. Factors influencing resilience were perspective taking fantasy(β=.219, p<.001), empathic concern(β=.207, p=.004), and personal distress(β=-.303, p<.001). Conclusion: More studies are needed to develop the empathy improvement program for healthcare college students.

Purpose: This study examined the associations of job stress and burnout with the quality of life (QOL) among 119 emergency medical technicians (EMTs). Methods: Using a descriptive correlational design, 260 EMTs working in D City or S City completed the questionnaires. Hierarchical multiple regression analysis was conducted to determine the predictors of QOL among 119 EMTs. Results: Overall, there was relatively low job stress among 119 EMTs. There were significant differences in job stress and burnout by general characteristics, especially regarding those of gender, service career, job rank, and self-reported health. In a hierarchical multiple regression, general characteristics explained 29% of QOL (Model I, F=16.369, p<.001). The explanatory power for QOL increased to 49% upon adding job stress (Model II, F=18.737, p<.001), and 59% upon adding burnout (Model III, F=22.621, p<.001). In the last model, self-reported health (β =.316, p<.001), job demand (β=-.130, p=.009), job insecurity (β=-.136, p=.010), lack of reward (β=-.189, p=.001), emotional exhaustion (β=-.196, p=.004) and lack of personal accomplishment (β=-.334, p<.001) were significant predictors of QOL among 119 EMTs. Conclusion: Based on the results, it is necessary to assess and manage job stress and burnout systematically among EMTs, and to develop health improvement programs for better QOL.

연구 목적: 본 연구는 소방공무원의 근무형태에 따라 수면의 질, 직무스트레스, 피로도, 직무만족 및 외상 후 스트레스 장애 차이를 알아보고, 근무형태에 맞는 심리치료의 기초자료를 제공하고자 하였다. 연구 방법: 본 연구는 온라인 설문지를 이용하였다. 소방공무원 322명을 대상으로 하였으며, 자료수 집기간은 2018년 5월 2일부터 5월 20일까지였다. 수집된 자료는 SPSS 22.0을 이용하여 분석하였다. 연구 결과: 소방공무원의 근무형태에 따라 직무스트레스, 직무만족, 외상 후 스트레스 장애는 유의 미한 차이를 보였으나, 수면의 질, 피로도 차이는 없었다. 직무스트레스, 직무만족, 외상 후 스트레 스 장애의 유의미한 차이를 나타낸 것은 화재진압과 구조·구급근무형태였다. 또한 외상 후 스트레 스 장애는 수면의 질, 직무스트레스, 직무만족, 피로도와 유의미한 차이를 보였다. 이는 외상 후 스 트레스 장애를 겪고 있는 소방공무원들은 수면의 질, 직무스트레스, 직무만족, 피로도의 어려움을 함께 경험하고 있으므로 이를 개선할 수 있는 방안을 제안하였다. 결 론: 본 연구의 결과를 토대로 소방공무원 근무형태에 따라 수면의 질, 직무스트레스, 피로 도, 직무만족 및 외상 후 스트레스 장애를 극복할 수 있는 심리치료 기초 자료를 제공할 때 소방 공무원의 정신건강이 좋아질 것이다.

Purpose: The purpose of the study was to investigate the differences in quality of sleep, job stress, fatigue, job satisfaction, and posttraumatic stress disorder (PTSD) according to the type of work in fire-fighting officers. Methods: This study used an online questionnaire. The participants were 322 fire-fighting officers. The data were collected from May 2 to 20, 2018. Data were analyzed using SPSS 22.0. Results: According to the work styles of fire fighting officers, job stress, job satisfaction, and PTSD showed significant differences. However, There were no differences in sleep quality and fatigue. There were significant differences in job stress, job satisfaction, and PTSD in those in roles of fire suppression and rescue emergency medical technicians and this result suggests a way to improve the quality of sleep, job stress, job satisfaction and fatigue for fire-fighting officers who suffer from PTSD. Conclusion: Based on the results of this study, mental health of fire-fighting officers will be improved through basic data for psychotherapy which can overcome the quality of sleep, job stress, fatigue, job satisfaction and PTSD according to the work style of fire-fighting officers.

Purpose: The purpose of this study was to determine the effectiveness of hands-only CPR education according to the American Heart Association (2015) guideline for undergraduates with severe visual impairment, to provide basic data for expanding the subject of hands-only CPR education among the visually impaired. Methods: Twenty-one students attending four universities in C Province, aged 19 years or older, were enrolled in this study. These students had severe visual impairment and no other disabilities and have never received hands-only CPR education. This study data were collected from December 1, 2017 to January 11, 2018. The accuracy of the participants’ technique was measured using Brayden Pro CPR manikin. The data were analyzed using SPSS version 24.0. Results: Hands-only CPR education was effective in increasing confidence and accuracy of chest compression among undergraduates with severe visual impairment. Conclusion: These findings suggest that individuals with severe visual impairment should be given more educational opportunities. Additionally, subsequent studies should develop equipment that helps increase accuracy by using video aids with commentary or other auditory components for the visually impaired.

Purpose: The purpose of the study was to investigate the causes of non-transport in 119 ambulance services and to describe the difference in response time according to the reason for non-transport. Methods: This study analyzed 42,415 non-transport cases out of 123,158 cases using prehospital care reports in a metropolitan city. The Kruskal-Wallis test and the Wilcoxon-Mann-Whitney test were used to 6,857 cases for which time was recorded. Results: Non-transportation in 20○○ comprised 33.1% of all ambulance services. The reason for non-transport were other reasons (25.5%), cancellation (23.8%), and moving to other vehicles (21.7%). There were differences in ambulance service times according to the reasons for non-transport. The activation interval was the longest (2.68 minutes) in the absence of the patient, and the response interval was the shortest (4.96 minutes) among the cancelled case. The total interval was the shortest time (21.97 minutes) in the cancellation cases and the longest time among the death cases (32.23 minutes). Conclusion: It is important to suggest the direction of development of emergency services by identifying the reasons for non-transport by ambulance services and describing the response time according to the reason for non-transport.