• Title/Summary/Keyword: 완화의료

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The Changing Patterns and Predisposing Factors of Delirium at End of Life in Palliative Care Unit (완화 병동에서 임종기 섬망의 변화 양상과 선행 요인)

  • Rim, Mi-Roo;Kang, Sang-Gu;Choi, Seo-Hyeon;Cho, Jinhyun;Lee, Moon-Hee;Kim, Hye-Young;Bae, Jae-Nam;Lee, Jeong-Seop;Kim, Won-Hyoung
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.2
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    • pp.94-101
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    • 2018
  • Objectives : The purpose of this study is to investigate the change pattern and the leading factors of delirium in the palliative ward from 2 weeks before to the end of life. Methods : From October 2015 to August 2017, a retrospective chart review was conducted on the final 180 patients of 207 patients with terminal cancer patients at the Inha University Hospital. Clinical records were collected during palliative care hospitalization. Patients were diagnosed with three subtypes of delirium through the Richmond Agitation Sedation Scale and the Nursing Delirium Screening Scale, which were evaluated daily. Results : The prevalence of delirium 13 days before death was 46%, of which 18.3% were hyperactive subtypes, 13.8% were hypoactive subtypes, and mixed subtypes were 13.8%. And hyperactive delirium gradually decreased with the approach to the end of the day, and the mixed subtype gradually increased until 4 days before the end of life. Of the patients, the day before death, 86.9% were diagnosed with delirium. In multivariate analysis, hematologic malignancy was associated with a lower rate of delirium at the end of life than gastrointestinal cancer. Overweight was associated with hyperactive, mixed, and hypoactive delirium. Conclusions : Most palliative care patients experienced delirium at the end of life. Overweight was considered as a protective factor that reduced the all subtypes of delirium at the end of life. Further prospective studies are needed to reveal the prevalence of terminal delirium, and their risk factors.

Impact of a Palliative Care Education Program on Korean Hospice Volunteers: Motivation, Death Anxiety, and Communication with the Dying

  • Woo, Hee Young;Yeun, Young Ran
    • Journal of Hospice and Palliative Care
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    • v.21 no.2
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    • pp.58-64
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    • 2018
  • Purpose: This study was conducted to evaluate the impact of a two-week palliative care education program on Korean Hospice volunteers. Methods: A total of 71 volunteers were assigned to two groups: Group A (intervention, n=34) and Group B (usual care, n=37). Group A received six sessions of palliative care education for two weeks. The level of volunteers' motivation, death anxiety, and communication with the dying were measured at baseline and after the program ended. Results: The palliative care education program had positive influence on the volunteers' motivation (t=2.341, P=0.022), death anxiety (t=-2.166, P=0.034), and communication with the dying (t=-2.808, P=0.006). Conclusion: The findings of this study suggest that a palliative care education program may be an effective way to boost hospice volunteers' motivation, ease their death anxiety and improve their communication with the dying.

A Study on the Establishment and Operation of a Regulatory Response Framework in connection with the Regulatory Strength of the Licensing Policy for New Medical Devices -Focusing on the Application of FMEA- (의료기기 신제품의 인허가정책 규제강도에 연계한 규제대응 프레임워크 수립 및 운영에 관한 연구 - FMEA 적용을 중심으로 -)

  • Kim, Gyosu;Ru, Gyuha;Kim, Yeonhee
    • Journal of Technology Innovation
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    • v.28 no.4
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    • pp.1-26
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    • 2020
  • Due to the spread of Corona 19 around the world, Infectious Disease Medicine and New Medical Devices such as Diagnostic Agent are being rapidly developed and launched, and for the fast supply and demand of these, each country has eased import regulations or has implemented policies for fast approval(NIDS, 2020). On the other hand, New Developed Medical Devices that are not related to New Infectious Diseases, they are still entering the market through strict licensing and licensing regulations, such as delay and cancellation in the test inspection process, etc. Therefore, This Study specialized in the government-managed laws encountered when New Medical Devices enter the market, derive Factors influencing the Strength of Regulations, analyzes the Strength of Regulations, and proposes a Regulatory Response Framework. The Research Method was conducted by Literature Research, was applied by Failure Mode and Effects Analysis(FMEA) Method, Expert Interview(1st): Idea Collection, Expert Interview(2nd): Validation, and Priority through the Application Process of FMEA Method. A Method of Quantifying the Intensity of Regulation was proposed by multiplying the Impact of the Influencing Factors for each stage of regulation and the Burden Impact for each type of Regulatory Affairs to find the Importance of the Regulatory Factors and multiplying the Severity of the Regulatory Impact. The Implications are that major overseas countries and the Korean government are actively responding with Special Regulatory Policies and Mitigation Policies for fast licensing of New Developed Medical Devices in accordance with Corona 19. It is expected that the direction for improvement of regulations and measures to respond to regulations will be implemented so that a more proactive and preemptive response to the regulatory process of the licensing policy for New Devices can be achieved.

Comparison of Inpatient Medical Use between Non-specialty and Specialty Hospitals: A Study Focused on Knee Replacement Arthroplasty (전문병원과 비전문병원 입원환자의 의료이용 비교 분석: 인공관절치환술(슬관절)을 대상으로)

  • Mi-Sung Kim;Hyoung-Sun Jeong;Ki-Bong Yoo;Je-Gu Kang;Han-Sol Jang;Kwang-Soo Lee
    • Health Policy and Management
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    • v.34 no.1
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    • pp.78-86
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    • 2024
  • Background: The purpose of this study was to determine the effectiveness of the specialty hospital system by comparing the medical use of inpatients who had artificial joint replacement surgery in specialty hospitals and non-specialty hospitals. Methods: This study utilized 2021-2022 healthcare benefit claims data provided by the Health Insurance Review and Assessment Service. The dependent variable is inpatient medical use which is measured in terms of charges per case and length of stay. The independent variable was whether the hospital was designated as a specialty hospital, and the control variables were patient-level variables (age, gender, insurer type, surgery type, and Charlson comorbidity index) and medical institution-level variables (establishment type, classification, location, number of orthopedic surgeons, and number of nurses). Results: The results of the multiple regression analysis between charges per case and whether a hospital is designated as a specialty hospital showed a statistically significant negative relationship between charges per case and whether a hospital is designated as a specialty hospital. This suggests a significant low in charges per case when a hospital is designated as a specialty hospital compared to a non-specialty hospital, indicating that there is a difference in medical use outcomes between specialty hospitals and non-specialty hospitals inpatients. Conclusion: The practical implications of this study are as follows. First, the criteria for designating specialty hospitals should be alleviated. In our study, the results show that specialty hospitals have significantly lower per-case costs than non-specialty hospitals. Despite the cost-effectiveness of specialty hospitals, the high barriers to be designated for specialty hospitals have gathered the specialty hospitals in metropolitan and major cities. To address the regional imbalance of specialty hospitals, it is believed that ease the criteria for designating specialty hospitals in non-metropolitan areas, such as introducing "semi-specialty hospitals (tentative name)," will lead to a reduction in health disparities between regions and reduce medical costs. Second, it is necessary to determine the appropriateness of the size of hospitals' medical staff. The study found that the number of orthopedic surgeons and nurses varied in charges per case. Therefore, it is believed that appropriately allocating hospital medical staff can maximize the cost-effectiveness of medical services and ultimately reduce medical costs.

Medical Information Privacy Concerns in the Use of the EHR System: A Grounded Theory Approach (의료정보 프라이버시 염려에 대한 근거이론적 연구: 전자건강기록(EHR) 시스템을 중심으로)

  • Eom, Doyoung;Lee, Heejin;Zoo, Hanah
    • Journal of Digital Convergence
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    • v.16 no.1
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    • pp.217-229
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    • 2018
  • Electronic Health Record (EHR) systems are widely adopted worldwide in hospitals for generating and exchanging records of patient information. Recent developments are moving towards implementing interoperable EHR systems that enable information to be shared seamlessly across healthcare organizations. In this context, this paper explores the factors that cause medical information privacy concerns, identifies how people react to privacy invasion and what their perceptions are towards the acceptance of the EHR system. Interviews were conducted to draw a grounded theory on medical information privacy concerns in the use of EHRs. Medical information privacy concerns are caused by perceived sensitivity of medical information and the weaknesses in security technologies. Trust in medical professionals, medical institutions and technologies plays an important role in determining people's reaction to privacy invasion and their perceptions on the use of EHRs.

A Study on the Ageism and Age-integrated Perception of Healthcare Professional Groups with experience in treating elderly patients (노인의료전문가 집단의 연령주의 및 연령통합 인식에 관한 연구)

  • Oh, Hye In;Ju, Kyong Hee;Kim, Ju Hyun
    • Korean Journal of Family Social Work
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    • no.61
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    • pp.59-91
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    • 2018
  • Using a Consensus Qualitative Research approach, this study aimed to identify the ageism and explore age-integration as a solution of age discrimination that occurs during the delivery of medical services by nine healthcare professionals who have experience in treating elderly patients. There were two-sided confession has shown by health care professionals about the Ageism. They reported that they don't discriminate by age. However, They also appealed an inconvenience due to the elderly. There were real Ageism in the Healthcare Professional site as a way of Unsuitable care, elderly alienation and dependence on caregivers, polarization of medical service and double discrimination against poor elderly. They found it difficult to offer age integrated health care as a means to mitigate or solve. However they have sought to break barriers to communication, provided a comfortable environment not only for senior citizens but also for all others, and have diversified institutional and service standards. To ensure the healthy life and proper medical service of the rapidly increasing elderly patients, we proposed to do critical review of the factors in the Korean medical system that accelerate the Ageism, reorganization of the health care system for the poor elderly, including the curriculum associated with age-integrating within the health care professional education system, raising the Geriatric Medical Service and the relating professionals and improvements in perception of the health care domains for the elderly and older adults.

Judicial Analysis on Supreme Court Precedents Related to Criminal Malpractice and Acceptance of Causal Relation (형사상 의료과실 및 인과관계 인정과 관련된 대법원 판례분석)

  • Park, Young-Ho
    • The Korean Society of Law and Medicine
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    • v.15 no.2
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    • pp.435-459
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    • 2014
  • Supreme Court of Korea has been mitigating the burden of proof on the malpractice and causal relation by a patient in accordance with the practical transfer of such burden of proof on causal relation as well as relieving a doctor's burden of proof on mistake in the civil damage claim suits on the malpractice. However, a prosecutor shall strictly prove the causal relation between malpractice and unfavorable results as well as a doctor's mistake in the criminal cases for making a doctor accept the professional negligence resulting in death or injury in accordance with In Dubio Pro Reo principles. Furthermore, it shall not be allowed to relieve the burden of proof on malpractice and causal relation which has been frequently applied in the civil proceedings. Nevertheless, it was widely known that the front-line courts accepted the malpractice and causal relation by quoting the legal principles on relieving the burden of proof on malpractice and causal relation applied in the civil cases even in criminal cases with no or insufficient proof on malpractice or causal relation. However, the latest precedents in Supreme Court explicitly declared the opinion that there was no reason to apply the legal principle to relieve the burden of proof on the malpractice and causal relation in the criminal cases requiring the proof 'which doesn't cause any reasonable doubt' on malpractice and causal relation in accordance with the legal principles 'favorable judgment for a defendant in case of any doubt' on the basis of the strict principle of 'nulla poena sine lege.' Accordingly, Supreme court definitely clarified that there would be no reason to relieve the burden of proof on malpractice and causal relation in criminal cases by reversing several original judgments accepting malpractice and causal relation even though there were no strict evidence.

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Spirituality and State Hope of Medical Social Workers (의료사회복지사의 영성과 상태희망)

  • Kim, Chang-Gon
    • Journal of Hospice and Palliative Care
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    • v.15 no.2
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    • pp.88-98
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    • 2012
  • Purpose: This study was designed to assess the relationship between spirituality and state hope of medical social workers in Korea and their correlation was studied to provide data in developing effective spiritual and hope intervention for medial social workers. Methods: The study surveyed 102 medical social workers in Korea from September 1, 2011 to September 30, 2011. The study employed the Korean version of the State Hope Scale (SHS) and Spirituality Scales (SS). For data analysis, descriptive statistics, t-test, ANOVA, Pearson's correlation and simple regression were performed using the SPSS WIN ver. 17.0. Results: Spirituality scores showed a significant difference according to religion. The mean score of spirituality was 3.80/5.00 and the mean score of state hope was 6.36/8.00. Spirituality scoresand state hope scoresshowed a significant positive association (P<0.001). Conclusion: This study showed a significant positive association between medical social workers' spirituality and their state hope of. Future studies would be needed to further explorespirituality and state hope.

The Influence of Moral Behavior, Biomedical Ethics Consciousness, and Death Attitudes on Hospice Awareness in Nursing Freshman (간호학과 1학년의 도덕적 행동, 생명의료윤리 의식, 죽음 태도가 호스피스 인식에 미치는 영향)

  • Kim, Jeong-Sook;Je, Nam-Joo
    • Journal of Digital Convergence
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    • v.19 no.1
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    • pp.275-284
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    • 2021
  • The purpose of this study was to provide basic data for developing hospice intervention strategies that can enhance hospice care perception plus attitude toward death of nursing students by grasping the factors affecting the perception of first grade students. Data were collected from 185 nursing students at J university in G-do. Analysis was done using t-test, ANOVA, Pearson correlation coefficient, and Multiple regression with IBM SPSS WIN/25.0. Hospice care perception was correlated to moral behavior (r=.22, p=.002) and biomedical ethics consciousness (r=.29, p<.001). The most influential factor on the subjects' hospice care perception was biomedical ethics consciousness (β=.224, p=.012), followed by high financial competence of parents (β=.187, p=.027). The explanatory power was 11.5%. Therefore, systematic programs that can enhance moral behavior and biomedical ethics consciousness are necessary to promote awareness of hospice care. Also, the following data can be utilized as basic data to help develop hospice education programs.

A Study on Radio Wave Resource Management and Industrial Technology Revitalization in The Medical and Energy Fields (의료 및 에너지 분야 전파 자원 관리 및 산업 기술 활성화 방안에 대한 연구)

  • Yoon, Sang-Ok;Seok, Gyeong-Hyu
    • The Journal of the Korea institute of electronic communication sciences
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    • v.17 no.4
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    • pp.543-554
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    • 2022
  • In this study, the government's investment, laws, regulations, and difficulties related to IoT radio technology in the energy and medical fields are mainly analyzed. Also, plans for dissemination, technology preemption, and commercialization are derived to enhance global competitiveness. Research on ways to secure and predict radio wave application technologies in energy and medical fields, and to alleviate barriers to entry for new business operators. Analyzes the efficiency of support measures using expert groups in each energy and medical field, analyzes the utilization value of accumulated data, and proposes mid- to long-term promotion systems and support measures, as well as utilization measures of data held by external agencies related to radio waves.