• Title/Summary/Keyword: 환자중심의료

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A Preliminary Study on the Signifiant-Politics in the Case of 'Personalized Medicine' Discourse ('맞춤의학' 담론에서 발견되는 기표-정치(signifiant-politics)에 관한 연구)

  • Lee, June-Seok;Hyun, Jaehwan
    • Journal of Science and Technology Studies
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    • v.14 no.1
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    • pp.139-175
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    • 2014
  • For the past 20 years, expert groups and citizens in Korea have debated on the usefulness of personalized medicine. These debates were mainly focussed on the possibility of the promise - people mainly discussed whether it was a probable future or if it was just a hype. Following Hedgecoe and Tutton(2002) who argue that it is only a 'rhetorial device', we will analyze about 9,000 news media coverages that deal with personalized medicine. With these data, we will show that the same terminology of personalized medicine have been used very differently according to the time and people who use it. Our research will show that this term has both diachronic heterogeneity and synchronic equivocality. This has happened because of the innate lack that exists in our symbolic system. Policy and governance regarding new technology is important because they provide quilting point to those slippery term/signifiant. Also we would like to carefully suggest that we might be able to call this phenomena as signifiant-politics.

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A Study on the Causes of Injury Codes by Case-Based Injury Code of External Causes Frequency Analysis (사례 중심의 손상코드 별 손상외인코드 빈도수 분석에 따른 손상코드 발생 원인에 관한 연구)

  • Eun-Mee Choi;Hye-Eun Jin;Jin-Hyoung Jeong
    • The Journal of Korea Institute of Information, Electronics, and Communication Technology
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    • v.16 no.1
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    • pp.50-59
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    • 2023
  • The purpose of this study was to analyze the patients hospitalized with damage by injury code based on data for two years in 2020 and 2021 of A institution located in Gangneung, Gangwon-do. Analyzed the injury codes with a large number of occurrences per year, and analyzed the injury codes of external causes accordingly. The cause of the injury code was analyzed by analyzing the frequency of the injury code of external causes. Injury code S0650 had the highest frequency of injury code of external causes W189 and X5999, which was judged to be the cause of traumatic subdural hemorrhage without open intracranial wounds when falling in an unspecified place or toilet. Injury code S72120 had the highest frequency of injury code of external causes W010 and W180, and it was judged to be the cause of obstructive femoral intertrochanteric fracture that occurs when falling in the residence. The injury code S32090 had a high frequency of X5999, and it was analyzed that it caused the obstructive fracture of the lumbar region due to an accident caused by exposure in an unspecified place, and the injury code S72.090 had a high frequency of W010 and W180. It was confirmed that the cause of the obstructive fracture of the femoral neck was mainly caused by slipping or slipping in the residence, and the injury code S0220 had a high frequency of the injury code of external causes Y049, and it was confirmed that the fibula was fractured mainly by the force or fist. As such, the cause of the injury code was analyzed by analyzing the frequency of the injury code for each injury code of external causes.

Effects of Modified Ultrafiltration in Pediatric Open Heart Surgery (소아 개심술에 있어서 변형초여과법의 효과)

  • 전태국;박표원
    • Journal of Chest Surgery
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    • v.30 no.6
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    • pp.591-597
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    • 1997
  • Cardiopulmonary bypass in children is associated with capillary leak which results in an increase in total body water after open heart surgery The purpose of these studies was to assess the cardiopulmonary effects of modified ultrafiltration after pediatric open heart surgery Study h: Twenty-six consecutive children aged 0.1 ~ 10 years(median 7 months) underwent cardiac operation inc rporating modified ultrafiltration. After completion of cardiopulmonary bypass, modified ultrafiltration was commenced at the flow rate of 100~ 15011min for 3 ~ 14 min. After modified ultrafiltration, elevation of hematocrit(28.3% $\pm$ 3.6% vs. 33.8olo $\pm$ 4.Ooloi p < 0.001), increased systolic 1)loots Pressure(66.7 $\pm$ 11.2mmHg vs. 76.2$\pm$ 11.BmmHg, p < 0.02), and decreased central venous pressure(7.8 $\pm$ 3.7mmHg vs. 6.9$\pm$ 2.gmmHg, p<0.001) were observed. Study B: Twenty-six children who underwent cardiac operation with the diagnosis of VSD under 2 years were assigned to control(n= 14) or modified ultrafiltration(n= 12). Peak inspiratory pressure checked immediately after operation was significantly lower in modified ultrafiltration group than in control group(20.0$\pm$ 2.4 cmH20 vs.22.4$\pm$ 2.3cmH20, p < 0.03). Modified ultrafiltration after cardiopillmonary bypass in children improves early homodynamics and pulmonary mechanics, and represents an excellent option for perioperative managemen of accumulation of fluid in the tissues. We will continually employ the modified ultrafiltration technique in pediatric cardiac operations.

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Actual Condition of Quality Control of X-ray Imaging System in Primary Care Institution: focused on Gwangju Metropolitan City (1차 의료기관의 엑스선 발생장치 정도관리에 관한 현황조사:광주광역시 지역을 중심으로)

  • Dong, Kyung-Rae;Lee, Seun-Joo;Kweon, Dae-Cheol;Goo, Eun-Hoe;Jung, Jae-Eun;Lee, Kyu-Su
    • Journal of Radiation Protection and Research
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    • v.35 no.1
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    • pp.34-42
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    • 2010
  • With the expanded use of radiation in modern medical practices, the most important issue in regards to efforts to reduce individual exposure dose is quality assurance. Therefore in order to study the present condition of quality assurance, the Gwangju Metropolitan City area was divided into five districts each containing ten hospitals. Four experiments were conducted: a reproducibility experiment for kVp, mA, and examination time (sec) intensity of illumination; half-value layer (HVL) measurement; and beam perpendicularity test matching experiment. The tube voltage reproducibility experiment for all fifty hospitals resulted in a 95.33% passing rate and mA and examination time both resulted in a 77.0% passing rate. The passing rate for intensity of illumination was 86.0% and 52.0% for HVL, which was the lowest passing rate of all four factors. For the beam perpendicularity test matching experiment, generally the central flux is matched to within $1.5^{\circ}$. Of all fifty hospitals 30.0% were beyond $3^{\circ}$. The results of the survey showed that 58% responded that they knew about quality assurance cycle. All fifty respondents stated that they have not received any training in regards to quality assurance at their current place of employment. Although quality assurance is making relative progress, the most urgent issue is awareness of the importance of quality assurance. Therefore, the implementation of professional training focusing on safety management and accurate quality assurance of radiation will reduce the exposure to radiation for radiologists and patients and higher quality imaging using less dosage will also be possible.

The Use and its Affecting Factors of patients aged 30 and over with single and multiple chronic diseases and their usage outpatient Korean medicine clinics - Based on the Ministry of Health and Welfare's 2011 Report on usage of Korean medicine - (30세 이상 한방의료기관 외래환자 중 비복합 및 복합만성질환자의 의료이용과 결정요인 - 2011년 한방의료이용 및 한약소비실태조사보고서(보건복지부)자료를 중심으로 -)

  • Yoon, Jinwon;Choi, Sungyong;Lee, Sundong
    • Journal of Society of Preventive Korean Medicine
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    • v.19 no.1
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    • pp.95-107
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    • 2015
  • Objective : To use and its affecting factors of patients' outpatient treatment that have single and multiple chronic illnesses Method : We used the 2011 study by the Ministry of Health and Welfare, "Report on Usage and Consumption of Korean Medicine." This report was conducted on outpatients and inpatients that visited Korean traditional medicine, from August 25th, 2011, to September 30th, 2011. Our research was based on 1729 patients with chronic diseases aged 30 and over who received outpatient treatment during the last three months. Results : There were 1365 patients with non-complex chronic diseases, while there were 364 patients with complex chronis diseases. Patients had 1 - 8 chronic diseases, and the average number (standard deviation) was 1.26 (0.59). There were statistically significant differences by sex(P<0.0001), age(p=0.0045), marriage (p=0.0060), education level(p<0.0001), income level(P=0.0063), and types of health insurance(p=0.0023). The diseases most common among patients with non-complex chronic diseases were: low back pain, arthritis, gastrointestinal disorder, frozen shoulder, side effects from motor accidents, high blood pressure, fracture, stroke, diabetes, cancer, atopic dermatitis, and asthma. The diseases most common among patients with non-complex chronic diseases were: arthritis+low back pain, low back pain+gastrointestinal disorder, low back pain+side effects from motor accidents, low back pain+frozen shoulder, arthritis+gastrointestinal disease, gastrointestinal disease+frozen shoulder, arthritis+low back pain+gastrointestinal disease, high blood pressure+arthritis, arthritis+low back pain+frozen shoulder, arthritis+fracture, and arthritis+side effects from motor accidents. There were statistically significant differences among the usage of medical clinics by: frequently used clinic (p<0.0001), number of treatment (p<0.0001), the cost of outpatient treatment (p=0.0073), the satisfaction rate (p=0.0171), whether the clinic is the preferred clinic (p=0.0040). In model 1, men than women, people who had local benefits instead of type 1 medical aid, and patients with complex chronic diseases were more likely to use Korean medical clinics. In model 2, men than women, people who had local benefits than people with types 1 and 2 medical aids, people who went to pharmacies and Korean medicine pharmacies than people who went to hospitals, people who went to get treatment 1-10 times than people who visited 11-20 times and more than 41 times, and people who spent less than ten thousand Korean won than people who spent 1 to 2 million Korean won, and people without complex chronic diseases were more likely to use Korean medical treatment. Conclusion : There were differences in sociodemographic characteristics and the usage of medical clinics between patients with non-complex chronic diseases and patients with complex chronic diseases. Among patients with complex chronic diseases, women, patients with types 1 and 2 medical aid, patients who used Korean medical clinics, patients who were treated 11-20 times and more than 41 times, and patients who spent 1 million to 2 million Korean won on outpatient treatment used less treatment than patients with non-complex chronic diseases. However, patients with complex chronic diseases used pharmacies and Korean medicine pharmacies more.

<Field Action Report> Local Governance for COVID-19 Response of Daegu Metropolitan City (<사례보고> 코로나바이러스감염증-19 유행과 로컬 거버넌스 - 2020년 대구광역시 유행에 대한 대응을 중심으로 -)

  • Kyeong-Soo Lee;Jung Jeung Lee;Keon-Yeop Kim;Jong-Yeon Kim;Tae-Yoon Hwang;Nam-Soo Hong;Jun Hyun Hwang;Jaeyoung Ha
    • Journal of agricultural medicine and community health
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    • v.49 no.1
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    • pp.13-36
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    • 2024
  • Objectives: The purpose of this field case report is 1) to analyze the community's strategy and performance in responding to infectious diseases through the case of COVID-19 infectious disease crisis response of Daegu Metropolitan City, and 2) to interpret this case using governance theory and infectious disease response governance framework. and 3) to propose a strategic model to prepare for future infectious disease outbreaks of the community. Methods: Cases of Daegu Metropolitan City's infectious disease crisis response were analyzed through researchers' participatory observations. And review of OVID-19 White Paper of Daegu Metropolitan City, Daegu Medical Association's COVID-19 White Paper, and literature review of domestic and international governance, and administrative documents. Results: Through the researcher's participatory observation and literature review, 1) establishment of leadership and response system to respond to the infectious disease crisis in Daegu Metropolitan City, 2) citizen's participation and communication strategy through the pan-citizen response committee, 3) cooperation between Daegu Metropolitan City and governance of public-private medical facilities, 4) decision-making and crisis response through participation and communication between the Daegu Metropolitan City Medical Association, Medi-City Daegu Council, and medical experts of private sector, 5) symptom monitoring and patient triage strategies and treatment response for confirmed infectious disease patients by member of Daegu Medical Association, 6) strategies and implications for establishing and utilizing a local infectious disease crisis response information system were derived. Conclusions: The results of the study empirically demonstrate that collaborative governance of the community through the participation of citizens, private sector experts, and community medical facilities is a key element for effective response to infectious disease crises.

지역사회 건강관리담당자의 만성질환 관리실태:전라남도를 중심으로

  • Kim, Hye-Sook;Park, Jong;Jeong, Eun
    • Journal of agricultural medicine and community health
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    • v.34 no.3
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    • pp.334-345
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    • 2009
  • Objectives: This study was performed to investigate the management status of chronic disease at community health centers. Methods: The study subjects were 450 employed persons at community health centers in Jeonlanamdo. General characteristics, status of chronic disease management and health education were collected for statistical analysis. The differences on management status among working areas were assessed with chi-square test and ANOVA. Results: The mean values of work duration were 18.7 years in rural, 14.4 years in fishing village, and 17.4 years in urban-rural, respectively. The number of management registration was highest in hypertension. The ways of disease management were medication check-up, diet stopping smoking. The contents of group health education were exercise, diet and prohibition of smoking. The place of health education was town assembling hall. The fields which officials wanted to be educated were symptom, diagnosis, treatment and complication. The most important field was early detection of chronic disease patients and health education. Finally, the field requiring support was work standardization. Conclusions: Community health workers have worked positively in chronic disease management. The barriers to work were the lack of professional and preliminary data. The support system with other health organ and health education were needed for the improvement of working ability.

Guideline for Imaging Dose on Image-Guided Radiation Therapy (영상유도방사선치료에 있어 영상선량 가이드라인)

  • Cho, Byung Chul;Huh, Hyun Do;Kim, Jin Sung;Choi, Jin Ho;Kim, Seong Hoon;Cho, Kwang Hwan;Cho, Sam Ju;Min, Chul Kee;Shin, Dong Oh;Lee, Sang Hoon;Park, Dong Wook;Kim, Kum Bae;Choi, Sang Hyoun;Kim, Hye Young;Ahn, Woo-Sang;Kim, Tae Hyeong;Han, Su Cheol
    • Progress in Medical Physics
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    • v.24 no.1
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    • pp.1-24
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    • 2013
  • As image-guided radiation therapy (IGRT) has been commonly used for more accurate patient setup and monitoring tumor movement during radiation therapy, the necessity for management of imaging dose is increased. However, it has not been an interest issue to radiation therapy communities because the imaging dose is much lower than the therapeutic dose. However, since the cumulative dose from 4DCT and repeated imaging for daily setup verificationin would not be ignorable, appropriate dose management based on ALARA (As Low As Reasonably Achievable) principle is required. In this study, we aimed that (1) survey on imaging equipments and modalities used for IGRT, (2) estimation of IGRT imaging dose depending on treatment types and equipments, (3) collecting data of effective dose on treatment sites from each equipment and imaging protocol, and thus finally provide guideline for imaging dose reduction and optimization.

Factors influencing health and quality of life among allergy and asthma patients: With specific focus on self-efficacy, social support and health management (건강과 삶의 질에 영향을 주는 요인에 대한 분석: 자기효능감, 사회적 지원 및 질병관리를 중심으로)

  • Uichol Kim ;Chun-soo Hong ;Jeung-Gweon Lee ;Young-Shin Park
    • Korean Journal of Culture and Social Issue
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    • v.11 no.2
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    • pp.143-181
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    • 2005
  • This article examines factors that influence health and quality of life. In addition to the symptomatology and physiological functioning, the influence of the psychological functioning and interpersonal relationship on the overall health and quality of life are also investigated. Using a case-study approach, a total of 70 patients suffering from allergy or asthma were interviewed using a semi-structured questionnaire developed by the present authors. It assessed the following six areas: Cause and onset of illness, psychological functioning, health management, trust, social support received and overall health and quality of life. Based on the transactional model (Bandura, 1997; Kim & Park, 2005), the results of the case studies have been integrated and divided into three aspects: (1) Cause and onset of illness that includes physiological and environment factors; (2) mediating influences that includes psychological functioning, health management, interpersonal relationship and social support received; and (3) outcome factor that includes symptomatology, health and quality of life. The psychological functioning includes self-efficacy (self-regulated efficacy, efficacy for enlisting social support, efficacy for managing the environment, and efficacy for overcoming difficulties), positive outlook, life goals, experience of stress, and proxy control. Interpersonal relationship includes trust of family members and the physician. Health management includes receiving proper health assessment, following the advice and prescription given by the physicians, control of the environment and maintaining a healthy lifestyle. The results indicate that physiological, psychological, relational and environment factors interact with each other and affect individual's overall health and quality of life. Self-efficacy, social support received from family members, trust of physicians, and the health care system are key factors promoting healthy lifestyle and quality of life. The results indicate the need for further interdisciplinary, indigenous and cultural psychological research.

The status quo of offering help in emergency room on pediatric patients with 119 rescuer - Focused on the Emergency Center of C National University Hospital - (119구급대를 이용한 소아환자의 응급실 내원 현황 - C대학병원 응급의료센터를 중심으로 -)

  • Yun, Jong-Geum;Lee, Jeong-Yong
    • The Korean Journal of Emergency Medical Services
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    • v.11 no.3
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    • pp.119-128
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    • 2007
  • It is happening a lot that the pediatric patients who are offering help in emergency room with background 119 rescuer require emergency care compared to adults. Our study was conducted to have a clear grasp of the status quo of pediatric patients who are offering help in emergency room with 119 rescuer. METHOD & OBJECT pediatric patients under 8 age who were offering help was conducted as objects by 119 cases from January, 2006 to January 2007, with 119 rescuer at C university hospital in Gwangju metropolitan city, which were 87 cases for a boy(73.1%), 32 cases for a girl. Based on emergency diary of emergency members and the medical treatment record of emergency room in C university hospital, a disease and a type of an external wound were analyzed according to ages of these patients, a time zone and season. RESULT In terms of an age, 25 cases(21.0%) have less than 1 age extremelymuch, in case of emergency, 61 cases(51.3%), which were more than non-emergency, in terms of happened places of patients, there were households up to 78 cases(65.5%) extremely much. In terms of happened time, 13:00 to 18:00 have highest data up to 48 cases(40.3%). According to season, there were no big differences in 4 seasons(spring : 30.3%, summer : 24.4%, fall : 29.4%, winter : 16.0%). In case of being offered help at emergency room due to diseases, 1-2 ages have highest estimate with 55.7%, in terms of a time zone, 19:00-24:00 have highest with 33.7%, in terms of season, summer(6, 7, 8) have highest with 32.8%. in case of traffic accident, 7-8 age have highest with 47.1%, according to a time zone, 13:00 to 18:00 have highest with 88.2%, according to season, fall have highest with 64.7%. In case of an external wound, 3-4 age have highest with 38.2%, according to a time zone, 13:00-18:00 have highest with 41.2%, according to season, spring have highest with 38.2%. CONCLUSION It shows that in case of pediatric patients who were offering help at emergency room with 119 rescuer, a pediatric under 1 age was due to a disease, in case of an external wound, there were 3-4 age, in case of traffic accident, 7-8 age have highest, a case for emergency have highest.

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