• Title/Summary/Keyword: 완화의료

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Comparison of Hazard Analysis for Medical Device System (의료기기 시스템의 해저드 분석 기법 비교)

  • Choi, Bo-yoon;Lee, Byong-gul;Han, Hyuk-soo
    • Journal of Internet Computing and Services
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    • v.19 no.6
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    • pp.133-145
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    • 2018
  • Medical systems incurred accidents may result in significant damage for human being. Therefore, performing hazard analysis is important for medical system which is to identify hazard for preventing the accidents and minimizing the potential harm. Hazard analysis that is applied medical systems are difficult to apposite selected, because difference of analysis methods and applied development lifecycle is caused by objective of hazard analysis. It is required to select appropriate hazard analysis at concept phase during development lifecycle, owing to basic requirement elicitation to mitigate or prevent hazard based on identified hazard at concept phase. In this paper, hazard analysis methods, PHA and STPA, are compared at concept phase in which both methods have been applied on the medical system. As a result of compared methods, hazard analyst can be selected optimized hazard analysis methods for concept phase of the medical systems.

History of the National Health Insurance Cost for Radiological Examinations and Value of the Radiological Report Fee (영상의학과 보험수가 역사와 판독료의 가치)

  • Choong Wook Lee
    • Journal of the Korean Society of Radiology
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    • v.81 no.5
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    • pp.1038-1052
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    • 2020
  • Advancements of medical care with the use of new medical technologies have been promoting public health, but they can also place a financial burden on individuals and the country. Since the introduction of the health insurance system in 1977, the South Korean government has been attempting to control medical expenses. Radiological examinations have been a major target for cost reduction. Meanwhile, the radiological report fee has been combined with the technical fee for a long time; hence, its value has not been independently evaluated, and was also decreased proportionally with examination cost reduction. However, in the revised medical fee estimation system for MRI, the report fee has begun to be calculated separately from the technical fee, significantly contributing to the evaluation of the radiologists' work value. In conclusion, radiologists need to know and actively participate in the process of determining the insurance cost of radiological examinations and reports to get a proper value of their professionalism.

A Coexistence Mitigation Scheme in IEEE 802.15.4-based WBAN (IEEE 802.15.4 기반 WBAN의 공존 문제 완화 기법)

  • Choi, Jong-hyeon;Kim, Byoung-seon;Cho, Jin-sung
    • Journal of Internet Computing and Services
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    • v.16 no.3
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    • pp.1-11
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    • 2015
  • WBAN(Wireless Body Area Network) operating around the human body aims at medical and non-medical service at the same time. and it is the short-range communication technology requiring low-power, various data rate and high reliability. Various studies is performing for IEEE 802.15.4, because IEEE 802.15.4 can provide high compatibility for operate WBAN among communication standard satisfiable these requirements. Meanwhile, in the case of coexisting many IEEE 802.15.4-based WBAN, signal interference and collision are the main cause that is decreasing data reliability. but IEEE 802.15.4 Standard does not consider about coexistence of many networks. so it needs improvement. In this paper, To solve about this problem, identify coexistence problem of IEEE 802.15.4-based WBAN by preliminary experiments. and propose a scheme to mitigate the reliability decrease at multiple coexistence WBAN. The proposed scheme can be classified in two steps. The first step is avoidance to collision on the CFP through improving data transmission. The second step is mitigation collision through converting channel access method. Proposed scheme is verified the performance by performing comparison experiment with Standard-based WBAN.

Scoping Review of Occupational Therapy in Hospice and Palliative Care (호스피스 작업치료에 관한 범위 고찰)

  • Kim, Ji-yoon;Kim, Hwan
    • The Journal of Korean society of community based occupational therapy
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    • v.7 no.2
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    • pp.33-45
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    • 2017
  • Objective : This study is to provide basic data for hospice occupational therapy and to develop hospice occupational therapy curriculum in Korea. Methods : 45 articles were selected from CINAHL, MEDLINE, and Scopus, which were published from 1980 to 2013. The selected articles were analyzed in term of study year, study source, author's characteristics, study subjects, and study designs. Results : The number of studies have increased steadily since the 1980's. A total of 21 research journals was published, and the most highest published journals were American Journal of Occupational Therapy. Qualitative research methodology was employed four times more than quantitative research methodology. Interventions included various formats such as crafts, ADLs trainings, relaxation techniques, care giver educations and applications of spirituality. The doing-being-becoming theoretical framework and the model of human occupation applied to hospice or palliative patients as a theoretical foundation. Conclusion : Hospice occupational therapy has been developed along with hospice and palliative medicine. There also appeared to be a balance on both clinical trials and researches The hospce occupational therapy care has being studied deeply with various topic. More efforts on curriculum developments as well as clinical advances pertinent to the palliative care should be proceed to warrant making the start of the hospice and palliative occupational therapy in Korea.

Spirituality and Stress in Mental Health Social Workers (정신보건사회복지사의 영성과 스트레스)

  • Kim, Chang-Gon
    • Journal of Hospice and Palliative Care
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    • v.16 no.4
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    • pp.253-263
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    • 2013
  • Purpose: This study was conducted to analyze the association between spirituality and stress of mental health social workers, which could be used in development of a program to help them manage stress and offer spiritual support. Methods: Participants were 154 mental health social workers in Korea. Data were collected from November 1 through November 30, 2011. The study employed the Korean version of the Spirituality Scale and Psychosocial Well-being Index-Short Form (PWI-SF). Data were analyzed using SPSS/Windows 17.0. Results: The mean score for the Spirituality Scale was 3.63 and for PWI-SF 18.78. Spirituality scores showed a significant difference among participants by age, education, religion and marital status. Psychosocial stress scores also significantly differed by marital status. Spirituality scores were negatively correlated with psychosocial stress scores (r=-0.548, P<0.001). Conclusion: In this study, a significant negative association was found between spirituality and stress in mental health social workers in Korea. A follow-up study with a larger sample of participants is needed to confirm these findings.

Quality Indicators of End-of-Life Cancer Care from the Family Members' Perspective in Korea (호스피스 임상 질 지표에 대한 보호자의 동의정도와 이와 관련된 인자)

  • Kim, Hyo-Min;Youn, Chang-Ho;Ko, Hae-Jin
    • Journal of Hospice and Palliative Care
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    • v.14 no.2
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    • pp.101-109
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    • 2011
  • Purpose: The Assessing Care Of Vulnerable Elders project has developed indicators for the quality of the end-of-life (EOL) care. However, family members of cancer patients may have a different view on the quality indicators (QIs) established by health care experts. We evaluated the QIs from the family members' perspective. Methods: The information used in this study was gathered by surveying family members of cancer patients who were admitted to the inpatient hospice ward in Korea. A cross-sectional anonymous questionnaire was distributed to 120 potential respondents from July to October 2009. We included 69 responses in this study (effective response rate, 57.5%). Statistical analysis was performed by using SPSS for Win ver. 14.0, with independent t-test and Pearson's chi-square test. Results: Among QIs for good hospice care, families agreed the most on "Medical examination by the palliative care team or specialist" (88.4%) and "Dying in the family's presence" (88.4%). They agreed the least on "Discussing cardiopulmonary resuscitation with patients" (15.9%). Among QIs for bad hospice care, "Occurrence of fall or pressure ulcer are undesirable" showed the highest agreement rate (94.2%). The lowest agreement rate was 11.6% on "Dying in the hospital is undesirable." In addition, women, patients who were aware of their prognoses, and people with a high socioeconomic status tended to agree more on the QIs. Conclusion: Patients' families did not agree on some of the QIs recommended by previous studies. Family members' characteristics were related to their opinions on QIs.

Factors That Affect the Level of Emotional Labor in Dental Hygienists (치과위생사의 감정노동 영향요인 연구)

  • Choi, Hye-Jeong;Bang, Hyo-Jung;Chung, Eun-Young;Seo, Young-Jun
    • Journal of dental hygiene science
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    • v.14 no.3
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    • pp.295-301
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    • 2014
  • This research purports to find out the factors that affect the level of emotional labor in dental hygienists. Data were collected from 204 dental hygienists working at 5 university hospitals and 55 dental clinics through self-administered questionnaire, and analyzed by statistical analysis using t-test, ANOVA, and regression analysis. The main findings of the study are as follows: First, the higher the educational level of dental hygienists, and the bigger the size of dental institutions they work, the higher the level of emotional labor of dental hygienists. Second, patient and environmental factors were found to have significant effects on the level of emotional labor. The above results imply that managers should try to make the workplace better environment which can secure appropriate workload and rewards, and support for work related education programs etc. It is also needed to educate the patients in order to prevent unnecessary conflicts between the patients and dental hygienists.

Factors Related to Substantial Pain in Terminally Ill Cancer Patients

  • Suh, Sang-Yeon;Song, Kyung-Po;Choi, Sung-Eun;Ahn, Hong-Yup;Choi, Youn-Seon;Shim, Jae-Yong
    • Journal of Hospice and Palliative Care
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    • v.14 no.4
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    • pp.197-203
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    • 2011
  • Purpose: Pain is the most common and influential symptom in cancer patients. Few studies concerning pain intensity in the terminally ill cancer patients have been done. This study aimed to identify factors related with more than moderate pain. Methods: This study used secondary data of 162 terminal cancer inpatients at the palliative ward of six training hospitals in Korea. Physician-assessed pain assessment was by 10 point numeric rating scale. Substantial pain was defined more than moderate intensity by the Korean National Guideline for cancer pain. The Korean version of the MD Anderson Symptom Inventory was self-administered to assess symptoms. Survival prediction was estimated by the attending physicians at the time of admission. Results: Less than six weeks of predicted survival and more than numeric rating of six for worst drowsiness in the previous 24 h were significantly related to substantial pain (P=0.012 and P=0.046, respectively). The dose of opioid analgesics was positively related to substantial pain (P=0.004). Conclusion: Factors positively related to substantial pain were less than six weeks of predicted survival and considerable drowsiness. Careful monitoring and active preparation for pain are required in terminal cancer patients having those factors.

End of Life Care Competencies and Terminal Care Stress of Nurses in Long Term Care Hospitals (요양병원 간호사의 생애말 환자간호 역량과 임종간호 스트레스)

  • Jeong, Young-Hee;June, Kyung Ja
    • Journal of Hospice and Palliative Care
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    • v.22 no.3
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    • pp.125-133
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    • 2019
  • Purpose: The purpose of this study was to investigate the relationship between end of life care competencies and terminal care stress of nurses in long term care hospitals. Methods: For this study, 140 nurses were sampled among those that have over 6-month end of life care experience and were working at long term care hospitals located in A city and C city of Chungcheongnam-do. Using a questionnaire, data were collected from January 2018 through March 2018. Data were analyzed using the SPSS, Windows version 21.0, according to the purpose of the study and analyzed by descriptive statistics, t-test, one way ANOVA, $Sch\acute{e}ffe^{\prime}s$ test, and Pearson's correlation coefficient. Results: The mean score on terminal care stress of nurses was above the normal level. The scores on end of life care competencies significantly varied by age, total career at hospitals, death/hospice and palliative care education, and bereavement experience. The mean score of end of life care competencies was negatively correlated with the mean score of lack of knowledge and skills among the subitems of the terminal care stress category (r=-0.260, P=0.002). Conclusion: To decrease the terminal care stress of long term care hospital nurses, it is suggested to carry out end of life care education tailored to nurses characteristics.

Reliability and Validity of an Instrument Assessing Advance Directives for Nurse (간호사의 사전의사결정 태도측정 도구의 신뢰도 및 타당도 검증)

  • Cheon, Hojung;Kim, Eunha
    • Journal of Hospice and Palliative Care
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    • v.22 no.3
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    • pp.134-143
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    • 2019
  • Purpose: This methodological study was conducted to test the reliability and validity of an instrument that measures attitudes of advance directives (ADs) among nurses. Methods: 1) Sixteen items related to attitudes in the English version of the Knowledge, Attitudinal, and Experiential Survey on Advance Directives (KAESAD) were forward/backward translated into Korean. 2) The content was validated by an expert panel (three nursing professors and eight hospice nursing specialists). 3) The preliminary 12 items were selected as a tool to assess the Korean version of Nurses' Attitudes towards Advance Directives (NAAD-K). 4) The instrument was validated by a survey (n=216). 5) It was confirmed to use the 12 items for the final version of the instrument. Results: NAAD-K was shown to be valid in terms of factors, items and content. The three factors extracted from the factor analysis were named as follows: Caring for patients with an AD (factor 1), nurses' role in informing patients (factor 2) and patient right (factor 3). The three factors explained total variance 57.796%. Factor loadings of the 12 items ranged from 0.47 to 0.93. For the 12 items, Cronbach's alpha was 0.81, and Guttman split-half coefficient was 0.78. Conclusion: This instrument was identified to be applicable with satisfactory reliability and validity for further use in measuring nurses' attitudes towards ADs in hospice and palliative care.