• Title/Summary/Keyword: 상급종합병원

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A Qualitative Research on the Evaluation of Healthcare and Welfare Network for Vulnerable Populations : Focusing on the Dalgubeol Health Doctor Services (취약계층 대상 보건의료·복지 네트워크 사업 성과에 대한 질적연구 : 달구벌건강주치의사업을 중심으로)

  • Su-Jin Lee;Jong-Yeon Kim;Jae-Wook Kang;Hye-Jin Lee
    • Journal of agricultural medicine and community health
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    • v.48 no.4
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    • pp.262-274
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    • 2023
  • Objectives: This study examined the evaluation and potential improvements of 'Integrated Healthcare and Social Welfare service model' based on the experiences of practitioners from institutions participating in the 'Dalgubeol Health Doctor Services' and the service recipients. Methods: Qualitative research was conducted from September to November 2022 in this study, focusing on 4 providers from the dedicated Dalgubeol Health Doctor Services Team, 5 contact partners from affiliated organizations, and 6 service beneficiaries. The data gathered underwent thematic analysis. Results: The evaluation indicated that Dalgubeol Health Doctor Services has proven to be effective in addressing the complex needs of vulnerable populations. By providing integrated services through quick and simple beneficiary selection and resource linkage, it has contributed to the resolution of complex demands, recovery of positive attitudes towards life, and improvement in quality of life for users who have fear the use of medical and welfare services. Dalgubeol Health Doctor Services has established an integrated health care system involving not only public but also private organizations, from the referral agency to the service provider. Centered around Daegu Medical Center and involving five tertiary hospitals, it has established a model that supports treatment appropriate to the severity of the patient, from mild to severe. Conclusions: These findings indicate an enhancement in health equity, achieved through the active identification and subsequent health and welfare issue resolution of individuals marginalized from medical benefits.

A Study on the Quality of Healthcare Services for Four Critical Illnesses and the Maintenance of Right to Protection and Dignity in a Senior General Hospital (상급종합병원의 4대 중증질환 의료 서비스 품질과 보호받을 권리 및 존엄성 유지에 관한 연구)

  • Woojin Lee;Minsuk Shin
    • Journal of Korean Society for Quality Management
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    • v.51 no.4
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    • pp.531-550
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    • 2023
  • Purpose: The unique nature of life-and-death healthcare services sets them apart from other service industries. While many studies exist on the relationship between healthcare services and customer satisfaction, most of them focus on mildly ill patients, ignoring the differences between critically ill and non-seriously ill patients. This study discusses the actual quality of healthcare services for patients who are facing life-threatening illnesses and are on life support, as well as their right to protection and dignity. Methods: The survey conducted to 149 patients with the four major illnesses: cancer, heart disease, brain disease and rare and incurable disease, those who have experiences with senior general hospitals. Results: The basic statistics of this study are adequate to represent the four major critical illnesses, and the reliability and validity of this study's hypotheses, which were measured by multiple items, were analyzed, and the internal consistency was judged to be high. In addition, it was found that the convergent validity was good and the discriminant validity was also secured. When examining the goodness of fit of the hypotheses, the SRMR, which is the standardized root mean square of residuals that measures the difference between the covariance matrix of the data variables and the theoretical covariance matrix structure of the model, met the optimal criteria. Conclusion: The academic implications of this study are differentiated from other studies by moving away from evaluating the quality of healthcare services for mildly ill patients and focusing on the rights and dignity of patients with life-threatening illnesses in four senior general hospitals. In terms of academic implications, this study enriches the depth of related studies by demonstrating the right to protection and dignity as a factor of patient-centeredness based on physical environment quality, interaction quality, and outcome quality, which are presented as sub-factors of healthcare quality. We found that the three quality factors classified by Brady and Cronin (2001) are optimized for healthcare quality assessment and management, and that the results of patients' interaction quality assessment can be used to provide a comprehensive quality rating for hospitals. Health and human rights are inextricably linked, so assessing the degree to which rights and dignity are protected can be a superior and more comprehensive measurement tool than traditional health level measures for healthcare organizations. Practical implications: Improving the quality of the physical environment and the quality of outcomes is an important challenge for hospital managers who attract patients with life and death conditions, but given the scale and economics of time, money, and human inputs, improving the quality of interactions and defining them as performance indicators in hospital quality management is an efficient way to create maximum value in the short term.

A Study of the New Positioning Guide Based on the Correlation between the Orbit Meatus Line and Mandibular Body Angle in Paranasal Sinus Parietoacanthial Projection(Water's Method) (코곁굴 두정비극방향 검사 시 안와이공선과 아래턱뼈 몸통각도의 상관관계를 이용한 새로운 자세잡이 기준에 관한 연구)

  • Yong-Min Son;Han-Yong Kim;Young-Cheol Joo
    • Journal of the Korean Society of Radiology
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    • v.18 no.4
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    • pp.335-344
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    • 2024
  • In this study, we aim to investigate the correlation between the lateral images of Korean skulls and the angle between the OML and the Body of the Mandible. Additionally, we seek to provide criteria for the ease of positioning in clinical settings and establish standardized imaging procedures for the PNS Water's view examination. This study was conducted on a total of 202 patients who visited the radiology department of a general hospital and examined the skull lateral radiography. In addition to the patient images, skull phantoms were also utilized, and images were obtained using GC85A and EOS equipment. In this research, abbreviations related to the angle of the Body of Mandible were defined using PACS on lateral images. Measurements were taken for various angles, including ramus of mandible angle(RIA), accurate OML angle(TIA), OML and IR Angle(OIA), total mandibular length(TML), ramus height(RH), the angle between the pogonion, gonion, and condylion(MA). The validity of these measurements was confirmed using the skull phantom in the study. The age-specific average range for RIA was 22.67° to 26.04°, with measurements of 23.14° for males and 24.78° for females. The age-related mean ranges for TIA and OIA were 35.98° to 38.31° and 72.27° to 75.25°, respectively. For males, TIA was 36.74° and OIA was 72.73°, while for females, TIA was 36.43° and OIA was 73.38°. The age-dependent measurements for TML and RH ranged from 85.73 mm to 89.60 mm and 62.60 mm to 70.87 mm, respectively. Male values were 90.54 mm and 70.78 mm, while female values were 85.13 mm and 61.54 mm for TML and RH, respectively. The age-specific average range for MA was 55.95° to 58.63°, with measurements of 57.96° for males and 57.76° for females. Correlation analysis revealed a positive correlation between RIA and OIA, as well as between RIA and TIA. Based on the results of this study, which indicate a positive correlation between the angle of the Body of Mandible and the OML, it can be inferred that adjusting the mandible vertically to align with the imaging receptor may contribute to more accurate image acquisition during PNS Water's view examination. Therefore, it is believed that there is value in utilizing this relationship as a criterion for establishing new positioning standards, which could enhance the utility of a new positioning guide.

Length of stay in PACU among surgical patients using data mining technique (데이터 마이닝을 활용한 외과수술환자의 회복실 체류시간 분석)

  • Yoo, Je-Bog;Jang, Hee Jung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.7
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    • pp.3400-3411
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    • 2013
  • The data mining is a new approach to extract useful information through effective analysis of huge data in numerous fields. This study was analyzed by decision making tree model using Clementine C&RT(Classification & Regression Tree, CART) as data mining technique. We utilized this data mining technique to analyze medical record of 1,500 people. Whole data were assorted by length of stay in PACU and divided into 3 groups. The result extracted by C5.0 decision tree method showed that important related factors for lengh of stay in PACU are type of operation, preoperative EKG abnormality, anesthetics, operative duration, age.

Testing of risk perception survey - Diabetes mellitus in Korea (당뇨병 위험 지각 측정 도구의 타당성 평가)

  • Kang, Soo Jin
    • Journal of the Korean Data and Information Science Society
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    • v.27 no.2
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    • pp.477-486
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    • 2016
  • This study was to evaluate of the reliability and validity of the Risk Perception Survey - Diabetes Mellitus (RPS-DM) with Korean diabetes patients. A total of 183 patients participated in this study from December 4, 2014 to January 1, 2015 with self-reported questionnaires. The data was analyzed using exploratory factor analysis, cronbach's alpha, and item to total correlation. The factor structure of the instrument showed the cumulative variance of 45.1% in the factor analysis and a four-factor structure was found to be appropriate. The comparative site risk score matched with the RPS-DM in English except item 7, 8, and 12. The RPS-DM in Korean version has been found to be reliable and valid.

The Influence of Information Retrieval Skill on Evidence Based Practice Competency in Clinical Nurses (상급 종합병원 간호사의 정보검색능력이 근거기반실무 역량에 미치는 영향)

  • Son, Youn-Jung;Kim, Sun-Hee;Park, Young-Su;Lee, Soo-Kyoung;Lee, Yun-Mi
    • Korean Journal of Adult Nursing
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    • v.24 no.6
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    • pp.635-646
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    • 2012
  • Purpose: The purpose of this study was to understand clinical nurses' level of information retrieval skill and its influence on evidence based practice (EBP). Methods: A cross-sectional design was used. Data were collected from a convenient sample of 492 nurses working at 5 university hospitals in Korea. The Data were analyzed using descriptive statistics, t-test, one-way ANOVA, and hierarchical multiple linear regression. Results: The mean score for information retrieval skill and EBP competency were respectively $2.81{\pm}0.64$ and $3.98{\pm}0.86$. Two step hierarchical regression analysis showed that attendance at academic conference (p = .036) and information retrieval skill (p<.001) were significant factors of EBP competency, information retrieval skill explained about 19% of total variance of EBP competency. Conclusion: Nurse need to increased fundamental information retrieval skill for EBP competency. Therefore, it is important to increase nurses' information retrieval skills by tailoring continuing EBP education modules. It would be also advisable to develop centralized systems for the internal dissemination of research findings for the use of nursing staff.

Families' Perception and Attitude toward Applied Physical Restraints in General Neurological Wards (신경계 병동에서 억제대를 적용 중인 환자가족의 억제대 적용에 대한 인식과 태도)

  • Ha, So-Yeon;Ha, Yi-Kyung;Kim, Myung-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.5
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    • pp.3293-3302
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    • 2015
  • This study was conducted to identify families' perception and attitude toward application of physical restraint(PR) in general neurological wards. The study is based on subjects from 70 family members who have cared patients applying PR. Data was collected using self-report questionnaires and reviewing of patients' medical records. 68.6% of subjects were female and the mean age was 47.9 years old. Family members were either sons, daughters or spouses. The questionnaires analyzed families' perceptions based on a score of 5, the results showed a mean score of 4.2, and items related to maintaining therapeutic tools scored the highest. The application of PR with two hands was perceived by families as more important than PR applied with one hand. In families' attitude toward PR, there was general agreement that families had the right to decide to apply and remove PR. Continuous education and information regarding PR is required to support families.

A Study on the Mediating Effect of Patient Activation between Trust in Healthcare Professionals and Shared Decision Making in Diabetic Patients (당뇨병 환자의 의료진 신뢰와 공유의사결정의 관계에서 환자활성화의 조절효과)

  • Jeong, Miri
    • Journal of the Korea Convergence Society
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    • v.12 no.9
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    • pp.361-371
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    • 2021
  • This study aims to identify the moderating effect of patient activation in relation between trust in healthcare professionals and shared decision making in patients with diabetes mellitus. The participants were 186 patients who received treatment for diabetes at the department of endocrinology in the tertiary hospital located in Daejeon and consented to participate in our survey. The results of this study were a significant interaction between trust in healthcare professionals(β=0.32, p=.045) and patient activation(β=0.32, p=.024) was associated with shared decision making. The patient activation had a moderating effect between trust in healthcare professionals and shared decision making in patients with diabetes mellitus(β=0.25, p=.019). Therefore, it is necessary to assess trust in healthcare professionals to improve negative awareness of healthcare professionals and strengthen trust in them. In addition, to promote participation in shared decision making, it is necessary to develop a convergent program to focus patient activation.

ICU nurses' ethical attitudes about DNR (중환자실 간호사들의 DNR에 대한 윤리적 태도)

  • Yu, Eun-Yeong;Yang, Yu-Jeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.4
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    • pp.2691-2703
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    • 2015
  • This research aims to provide basic materials for assisting DNR patient cares by understanding ICU nurses' awareness and ethical attitude regarding DNR. A total of 154 results were analyzed which were collected from Aug. 1st to Sep. 5th in 2014 by surveying nurses working in ICU (from 1 advanced general hospital in G metropolitan city and other general hospitals of more than 700 beds in Cheolla provinces). (1) For the decision attitudes of DNR, there were both consent and objection. Consent for the patient's opinion of rejecting further treatment and life extension despite of bad prognosis. And objection for no conducting DNR in the case of the patient's wish, treatment requested by the guardian, and CPR for the patient who has no chance. (2) Objection for artificial respirator and other treatment requested by the patient's family and the entrance of guardians into ICU. Consent for the passive use of artificial respirator by the doctor and the decrease of basic care to stabilize patients physically and mentally. No specific opinion for treatment not following aseptic techniques. Objection for frequent reports to primary care physician requested by the family. (3) Acknowledging less interest by the doctor, while supporting the health care team in the case of the guardian's complaint, objection for the DNR decision mede by the primary care physician. Objection for the DNR decision by the guideline. Objection or neutrality for straightforward explanation to the patient of bad prognosis. Objection for straightforward explanation of the patient's status (even near to death) to the patient him/herself or the guardian. In conclusion, the subject of DNR is the patient and the patient's opinion should be fully reflected. The conflict arising from the scope of medical practice and decision processes should be minimized. The standard and guideline for DNR decision is required for the ethical decision making for the patient along with agreements based on full explanations.

Factors Influencing Pain Intensity in Patients with Advanced Cancer (진행암 환자의 통증강도에 미치는 영향요인)

  • Lee, Sun-Hee;Chung, Bok-Yae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.1
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    • pp.506-516
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    • 2018
  • This study was conducted to identify pain intensity and factors affecting pain intensity in patients with advanced cancer. Data were collected between June 1 and September 30, 2016 using a questionnaire. The sample size was 221 patients with advanced cancer who were admitted to the oncology department or who visited the outpatient of the general hospital. Data were evaluated by descriptive and Pearson's correlation analyses, one way ANOVA, t-tests and stepwise multiple regression analysis. The mean scores of pain intensity of cancer patients were 4.23 (${\pm}1.68$) based on the average daily pain intensity. Factors influencing pain intensity were illness perception (${\beta}=.27$, p<.001), pain opioid analgesics beliefs (${\beta}=.24$, p<.001), education (middle school, ${\beta}=.24$, p=.001), economic status (${\geq_-}400$, ${\beta}=.20$, p=.001), gender (female, ${\beta}=.14$, p=.017), pain management education (${\beta}=-.14$ p=.020) and diagnosis (Pancreatic Ca, ${\beta}=.14$, p=.020). It explained 28%. Overall, the results of this study revealed that illness perception and pain opioid analgesics beliefs were important factors influencing pain intensity, but that the most important influencing factor was illness perception. Accordingly, it is necessary to develop pain management strategies that include not only pain management knowledge and pain opioid analgesics beliefs, but also illness perception.