• The Journal of Korean Physical Therapy
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• v.24 no.3
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• pp.171-180
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• 2012

Purpose: The purpose of this study was to investigate the clinical decision making (CDM) development process throughout the comparison between novice and expert physical therapist as well as develop a CDM model for physical therapists under the fee-for-service (FFS) and physicians' prescriptions. Methods: Purposive sampling techniques were used to select 10 clinical physical therapists paired into five groups (each pair consisted of 1 novice and 1 expert physical therapist). The coding schemes were extracted from interviews and through within- and across-case analyses, cases were summarized. The reliability of coding schemes was confirmed by checking of case summaries by the participants. Results: Novice and expert physical therapists were influenced by two themes, internalized theme and external forces or information. Novice clinicians depended more on external forces or information. Although clinicians should care patients under the FFS and physician's prescription, expert clinicians were more likely to rely on internalized knowledge. Conclusion: The findings of the present study may be used by educators or association officials enhance CDM abilities and knowledge pools of student or novices as well as develop a guide to suitable novices or students under the specific context limiting the development of their CDM.

• Journal of Digital Convergence
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• v.16 no.12
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• pp.511-521
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• 2018

The purpose of this study was to investigate the effect of critical thinking, clinical decision making ability, patient safety knowledge and attitude ability to perform patient safety activities during clinical practice on nursing student's. Data were analyzed using t-tests and one-way ANOVA using the SPSS 21.0 program. As a result, the subjects' safety nursing activities was positively correlated critical thinking disposition(r=.278, p=.001), clinical decision making ability(r=.202, p=.014), patient safety attitude(r=.421, p<.001).The significant predictors of perform safety nursing activities were gender(${\beta}=.175$, p=.031), patient safety education(${\beta}=-2.266$, p=.025), critical thinking disposition(${\beta}=3.354$, p=.001), patient safety attitude(${\beta}=.368$, p<.001). These factors explained 31.5% of the variance(R2=.561, F=4.56 p<.001). It is necessary to establish a curriculum for critical thinking disposition, clinical decision making ability, and patient safety education in order to improve patient safety performance necessary for clinical practice education of nursing college students.

• The Journal of the Korean dental association
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• v.53 no.11
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• pp.770-778
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• 2015

This article discusses how to conduct treatment planning and decision making in special needs dentistry. Special needs patients often lack cooperative ability during dental treatment and have a deteriorated oral health status. To overcome the limitation in communication with special needs patients and solve their complicated dental problems, dentists need to have extensive preoperative information about the patients and their caregivers. Treatment procedures should be organized in a patient-centered and cost-effective manner. Additionally, clinical outcomes need to be predicted taking into consideration of the patients' condition. The clinical experience of committed dentists is another factor that enhances the benefits of extensive treatment in special needs patients with many limitations. The insightful treatment decision-making of dentists will contribute to improving the oral health of special needs patients despite the various obstacles.

• Journal of the Korean Applied Science and Technology
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• v.38 no.1
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• pp.88-98
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• 2021

This study was conducted to identify the factors affecting the self-confidence in performing patient safety management in nursing students. As a result of the analysis, 7.0 points in knowledge of patient safety management, 3.86 points in attitude of patient safety management, 3.47 points in clinical decision making ability, and 4.15 points in self-confidence in performing patient safety management. Self-confidence in performing patient safety management was positively correlated with knowledge of patient safety management(r=.216, p<.01) and attitude of patient safety management(r=.375, p<.01), clinical decision making ability(r=.467, p<.01). The self-confidence in performing patient safety management was influenced by clinical decision making ability(β=.409, p<.001) and attitude of patient safety management(β=.198, p=.011), explanatory power was 26.3%.

• Korean Journal of Adult Nursing
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• v.22 no.5
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• pp.488-498
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• 2010

Purpose: The purpose of this study was to explore clinical nurse's reported conflict experience toward end-of-life medical decision making. Methods: Data were collected by in-depth interviews with eight nurses from three different wards of university hospital in D city of Korea. Conventional qualitative analysis was used to analyze the data. Results: Results were three major themes and twelve categories from the analysis. The three major themes were prioritization of treatment, non-disclosure of diagnosis, and hierarchical and power relations. Conclusion: The results of this study suggest that shared decision making in end of life among patient, family members, physician, and nurse may contribute to improve end-of-life care performance as well as dignified dying of patient in end of life.

• Journal of Sasang Constitutional Medicine
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• v.27 no.2
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• pp.222-230
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• 2015

Objectives The purpose of this study is to design a research to find clinical factors involved in the decision-making process for determining the constitutional prescription based on prospective clinical data. Methods We have created a draft of the case report form. Therefore, seven constitutional experts was interviewed for additional items to be important used to determine the constitutional prescription in clinic. Interviews were done from December 2012 to March 2014, experts per person 2-3 times, took time of about 120 minutes per interview. Since then, we developed the final case report form through the expert meeting. At the same time, the developing the electronic case report form (eCRF) and the protocol to collect constitutional treatment cases was also discussed. Results & Conclusions The items of the case report form were subject general, lifestyle, health measurement, record of expert, prescription and evaluation after medication. The part of the clinical symptoms of the record of expert allowed to be recorded in the 5-point scale for the collection of quantitative data as much as possible. Assuming a re-visit of the patient, if necessary, twice the recording were to be possible. At the same time, the eCRF and the protocol to collect constitutional treatment cases were also developed. In this study, it will be able to more objectively standardize the medical decision making process that the experts of constitutional prescription decision. As a result, it will be possible to provide the standardized constitutional medical services.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.18
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• pp.8595-8598
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• 2016

Background: Decision making modalities for screening for many cancer conditions and different stages have become increasingly complex. Computer-based risk assessment systems facilitate scheduling and decision making and support the delivery of cancer screening services. The aim of this article was to survey electronic risk assessment system as an appropriate tool for the prevention of cancer. Materials and Methods: A qualitative design was used involving 21 face-to-face interviews. Interviewing involved asking questions and getting answers from exclusive managers of cancer screening. Of the participants 6 were female and 15 were male, and ages ranged from 32 to 78 years. The study was based on a grounded theory approach and the tool was a semi-structured interview. Results: Researchers studied 5 dimensions, comprising electronic guideline standards of colorectal cancer screening, work flow of clinical and genetic activities, pathways of colorectal cancer screening and functionality of computer based guidelines and barriers. Electronic guideline standards of colorectal cancer screening were described in the s3 categories of content standard, telecommunications and technical standards and nomenclature and classification standards. According to the participations' views, workflow and genetic pathways of colorectal cancer screening were identified. Conclusions: The study demonstrated an effective role of computer-guided consultation for screening management. Electronic based systems facilitate real-time decision making during a clinical interaction. Electronic pathways have been applied for clinical and genetic decision support, workflow management, update recommendation and resource estimates. A suitable technical and clinical infrastructure is an integral part of clinical practice guidline of screening. As a conclusion, it is recommended to consider the necessity of architecture assessment and also integration standards.

• Journal of Korean Neurosurgical Society
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• v.55 no.4
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• pp.195-199
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• 2014

Objective : Age is a strong predictor of mortality in traumatic brain injuries. A surgical decision making is difficult especially for the elderly patients with severe head injuries. We studied so-called 'withholding a life-saving surgery' over a two year period at a university hospital. Methods : We collected data from 227 elderly patients. In 35 patients with Glasgow Coma Score 3--8, 28 patients had lesions that required operation. A life-saving surgery was withheld in 15 patients either by doctors and/or the families (Group A). Surgery was performed in 13 patients (Group B). We retrospectively examined the medical records and radiological findings of these 28 patients. We calculated the predicted probability of 6 month mortality (IPM) and 6 month unfavorable outcome (IPU) to compare the result of decision by the International Mission for Prognosis and Analysis of Clinical Trials in TBI (IMPACT) calculator. Results : Types of the mass lesion did not affect on the surgical decision making. None of the motor score 1 underwent surgery, while all patients with reactive pupils underwent surgery. Causes of injury or episodes of hypoxia/hypotension might have affected on the decision making, however, their role was not distinct. All patients in the group A died. In the group B, the outcome was unfavorable in 11 of 13 patients. Patients with high IPM or IPU were more common in group A than group B. Wrong decisions brought futile cares. Conclusion : Ethical training and developing decision-making skills are necessary including shared decision making.

• Clinical and Experimental Pediatrics
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• v.53 no.6
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• pp.669-679
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• 2010

The risk of mortality and morbidity of patients with congenital heart defects (CHDs) is highest during neonatal period and increases when diagnosis and proper management are delayed. Neonates with critical CHDs may present with severe cyanosis, respiratory distress, shock, or collapse, all of which are also frequent clinical presentations of various respiratory problems or sepsis in the newborn. Early diagnosis and stabilization and timely referral to a tertiary cardiac center are crucial to improve the outcomes in neonates with CHDs. In this review, the clinical presentation of critical and potentially life-threatening CHDs is discussed along with brief case reviews to help understand the hemodynamics of these defects and ensure proper decision-making in critically ill patients.

• Korean Journal of Occupational Health Nursing
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• v.18 no.2
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• pp.141-152
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• 2009

Purpose: The purpose of this research was to describe the decision making of nurses in a VIP ward. Method: The methodology of collecting and analyzing the data was based on the grounded theory of Strauss and Corbin (1998). The data were collected through an in-depth interview, which were audio-taped and transcribed. The data were collected from 10 nurses from July to November 2007. Results: The core category on VIP ward nurses' decision making was named as "adjusting with flexibility and deepened insight". The causal condition was established by 'the patients who wanted to be treated specially'. The contextual conditions included 'caring patients from various departments', 'differences depending on the nurses' clinical experience', and 'client-centered atmosphere in the VIP ward'. The intervening conditions included 'problem solving styles of nurses', 'attitudes of patients and family members', 'nurse-doctor relationships', and 'accessibility to information'. It was confirmed that nurses changed their action-interaction strategies depending on the intervening conditions, thus resulted in the nurses' role conflict and the need to expand their consciousness. Conclusion: The result of this study indicates that nurse's decision making depends on their experiences and the nature of social context in which nursing occurs.