Purpose: This study was carried out to understand the in-patients' experiences related on informed consent for examination, treatment or surgery. Method: The study was conducted with 578 patients who were admitted to the departments of internal medicine and surgery for examination, treatment or surgery requiring informed consent from November 1 to 30, 2004 at three general hospitals in Daegu, Busan and Gyeongsangbuk-do. The data was analyzed by using SPSS 11.5 for Windows. Results: Although the one who explains during the process of informed consent should be doctors, 6.6% was informed by nurses or others. In addition, the majority has been told for complications and risk while relatively fewer patients were informed for necessity, method and costs of the procedure, and no one ever heard of other alternatives or the right to terminate the procedure at any time. While 40% of patients were not the final decision-makers of examination, treatment or surgery, 11.9% of patients answered their opinions were not considered during the final decision-making process. Conclusion: The study suggest that the ethically appropriate informed consent has not been achieved in the clinical practice, and therefore it is necessary to develop the specific behavioral guidelines and nursing ethics education program for nurses in order to settle down the desirable informed consent at the dimension of nursing management.
Background: It is important to understand the perceptions of oncologists to understand the comprehensive picture of clinical presentation of breast cancer. In the absence of clear evidence, clinical practice involving patients of breast cancer in India should provide insights into stages of breast cancer with which women present to their clinics and mode of screening of breast cancer prevalent in Andhra Pradesh. Materials and Methods: A qualitative study was conducted to understand the perceptions of oncologists regarding clinical presentation of breast cancer, stages at which women present to clinics, and mode of screening of breast cancer prevalent in Andhra Pradesh. In-depth interviews (IDI) were conducted with ten practising oncologists from various public and private cancer hospitals in Hyderabad city to understand their perspectives on breast cancer and screening. The data were triangulated to draw inferences suitable for the current public Health scenario. Results: Late presentation was indicated as the most important cause of decreased survival among women. Most women present at Stage 3 and 4 when there is no opportunity for surgical intervention. The results indicate that there is a huge gap in awareness about breast cancer, especially in rural areas and among poor socioeconomic groups. Even despite knowledge, most women delay in reporting due to reasons like fear, embarrassment, cost, ignorance, negligence, and easy going attitude. Conclusions: It is important to improve awareness about breast cancer and screening methods for promoting early screening. The study inferred that it would be beneficial to establish cancer registries in rural areas. Also, the policymakers need to make key decisions which among three methods (breast self examination (BSE), clinical breast examination and mammography) can best be used as a screening tool and how to successfully implement population wide screening program to prevent mortality and morbidity from breast cancer in India.
This study focuses on the protection of trial subjects, who participate in clinical trials for new drug. It takes long time to develop new drugs and the clinical trials are required. Usually, pharmaceutical company, which develop new drug, request a research institution(usually, hospital) to investigate the examination of security and side effects of new drug. The institution recruit trial subject to participate in the trials. The contract for clinical research of investigational new drug is concluded between the pharmaceutical company and the institution. This thesis studies the legal regulations for protection of participants of clinical research for new drug. In this respect the first matter of this study is to seek which relation between pharmaceutical firm and participants of clinical trials. Especially, there is a question which the trial subject is entitled to demand the pharmaceutical company which requested clinical trials the institution to supply the investigational new drug, after the contract for clinical trials had terminated or cancelled. This study take into account the liability of the pharmaceutical company to trial subject. Secondly, it is researched the roles and authority of Institutional Review Board(IRB). IRB is Research Ethics Committee of the institution, in which clinical trials for new drug are conducted. According to the rule of Korea good clinical practice(KGCP), IRB is the mandatory organization which is authorized to approve, secure approval or disapprove the clinical trials for investigational new drug in the institution. The important roles are the review of ethical perspective of trial research and the protection of trial subject. Thirdly, this paper focuses if the participants are to be paid for the participation for clinical research. This is ethical aspect of clinical trials. It is resonable that the participant is reimbursed for expenditure such as travels, and other expenses incurred in participation in trials. It is not allowed that the benefit of clinical trials is paid to trial subject. The payment should not function as financial inducements for participations of trials. Finally, the voluntary consent of the trial subject is required. The institution ought to inform the subject, who would like to participate in trials, and it ought to received informed consent in writing for subject. In this regard, it is matter that trial subject has ability of consent. It is principle that the subject as severely psychogeriatric patient has not ability of consent. However, it is required that not only healthy people but also patients are allowed to take part in clinical trials of new drug, in order to confirm which the investigation new drug is secure. Therefore there are cases, in which the legal representative of subject consent the participation of the trials. In addition, it is very important that the regulations concerning clinical trials of new drug is to be systematically well-modified. The approach of legal and political approach is needed to achieve this purpose.
본 연구의 목적은 종합병원 응급실 임상실습을 경험한 간호 대학생의 경험의 의미를 이해하고 서술함으로써 간호교육에서 효과적인 임상교육 전략을 개발하고 임상실습의 질을 향상하기 위함이다. 4학년 간호 대학생 30명에게 응급실 임상실습 동안 응급실의 상황에 대한 관찰경험을 서술하도록 한 후 서술 내용을 분석하여 의미를 도출하고 실행학습을 통하여 성찰학습의 의미로 분석하였다. 간호 대학생들의 응급실 임상실습 참여관찰 경험의 내용을 분석한 결과 도출된 주제는 '역동적인 간호사', '응급상황에 맞는 의사소통', '응급실 간호사는 교통정리 담당자'라는 긍정적인 주제와 '임시방편적인 사고', '환자보호자와 간호사의 갈등', '기계적인 움직임' 등의 부정적인 주제가 도출되었다. 연구의 활용과 관련하여 간호 대학생들의 응급실 관찰경험은 간호학생 측면에서는 자신의 미래 모습을 구체적으로 생각해보고 올바른 간호중재법에 대해 생각해보는 계기를 마련할 수 있으며, 간호교육측면에서는 효과적인 임상실무교육 전략 개발에 도움이 되는 기초적인 자료가 될 것이다.
The Quality of physical therapy school system has conflicts between physical therpist, and reduces the opportunity of seguential education. So this study was investigated in order to made concrete the problems of educational duality, set up the direction of the school system's improvement, as like the four-year system and recognized the necessity. The curriculums of 13 colleges and 5 universities was analyzed. The curriculum analysis was made up the comparison and the analysis by a liberal arts point, a major point, a clinical practice point, total opening subjects, and so on. The analyzing results were as follows. 1. The average rates of a liberal arts vs. a major opening point are 17:83 in college, and are 27:73 in university. 2. It is a serious problem that college are lower than university in a liberal arts. The best method that can solve it is lengthen the number of school years. 3. There is no difference between college and university in a major subject. Rather college has the more subject's numbers than university. 4. There is no difference between college and university in a clinical practice. Above results suggests that there is not different between college and university in a major subject except for a liberal arts point. It is proper that one should be unificate the curriculum according to the sameness between a state examination and a license. Therefore, it is necessary for graduates from college that provides the opportunity of proceeding to a higher school, demands the seguential system of study cultivating and producing a bachelor, and requires the continual education in a clinical field, a bachelor admitting system of continual education, and clinical therapist's qualification. The present physical therapy educational systems should be unificated because of many right reasons. On the other hand, the follw-up study that improving the school system about the four-years and the more physical therapy should be continue from the viewpoint of education.
Shin, Yun Hee;Choi, Jihea;Storey, Margaret J.;Lee, Seul Gi
기본간호학회지
/
제24권3호
/
pp.181-188
/
2017
Purpose: Competency in physical assessment is an important component of nursing practice. However, some physical assessment skills are not being utilized within the current teacher-centered, content-heavy curriculum. This study was conducted to identify the effects of student-centered, self-directed learning in the physical assessment class. Methods: An experimental study with a post-test only control group design was used to compare an intervention group that was provided self-directed learning classes and a control group that was provided traditional lecture and practice classes. Competency in physical assessment, academic self-confidence, and learning satisfaction were evaluated. Collected data were analyzed using $x^2$-test (Fisher's exact test) and independent t-test. Results: Competency in physical assessment was significantly higher in the experimental group. However, academic self-confidence and learning satisfaction were not significantly different between the groups. Conclusion: The findings in this study indicate that self-directed learning can improve nursing students competency in physical assessment and that self-directed learning is a good education method to improve nursing students' competency in physical assessment during clinical practice and perform quality patient care by making active use of physical assessment skills.
Gastrointestinal (GI) medications have been administered to many patients without any gastrointestinal diseases. The objectives of this study were to evaluate use of GI drugs and assess related factors. Medical records of 600 outpatients were reviewed from January 1997 to December 1997 at A Hospital, Kyunggi-do, Korea. Fifty patients every month among all outpatients were randomly selected up to total 600 patients. Surgical patients, visitors for regular health examination and inpatients were excluded. GI symptoms included nausea, vomiting, diarrhea, dyspepsia, constipation, heartburn, dysphagia and abdominal pain. The prescribed gastrointestinal drugs were antacids. $H_2$-antagonist, sucralfate, cisapride, omeprazole, laxatives, digestive enzymes and antidiarrheal agents. Patients without GI symptoms were 348 out of 600 outpatients who were screened. Two hundred and eighty two of 348 patients $(81\%)$ were given GI drugs though they did not have any GI symptoms. There were no differences in regard to sex and age of patients. Most of medical departments prescribed gastrointestinal drugs for these patients. The most frequently prescribed drugs were in order of digestive enzyme, antacids and $H_2$-antagonists. In view of economic aspects, patients paid 12.28 percents of total cost per prescription for unnecessary medicines. The medical practice of prescribing GI drugs should be assessed to define appropriate subgroups to have benefits with prophylactic administration and to reduce adverse effects caused by drug interactions. Pharmacists would have a significant role to promote rational drug therapy.
Background: Worldwide, over half a million women died of breast cancer in 2011 alone. Mammography screening is associated with a reduction of 20 to 35% in breast cancer mortality. The aim of this study was to determine the awareness and practice of mammography screening and predictors of its uptake in Malaysian women attending a primary care clinic. Materials and Methods: A cross-sectional study was carried out among women aged 40 to 74 years attending a primary care clinic in Selangor, Malaysia. An assisted structured questionnaire included questions on socio-demography, source of information and level of knowledge. An adapted version of the revised Champion Health Belief Model Scale plus other associated factors for mammography screening up-take were also included as part of the questionnaire. Predictors for mammography screening uptake were only determined in those who were aware about mammography screening. Significant predictors were determined by logistic regression. Results: 447 women were recruited for this study; 99.1% of them (n: 411) were aware about breast cancer. Only 50.1% (n: 206) had knowledge about mammography screening. Prevalence of clinical breast-examination (CBE) was 23.3% (n: 104) and mammography screening up-take was 13.2% (n: 59). The predictors for the latter were those who have had clinical breast-examination (aOR=17.58, 95%CI: 7.68-39.82) and those aged between 50 to 59 years (aOR=3.94, 95%CI: 1.61-9.66) as well as those aged 60 years and above (aOR=6.91, 95%CI: 2.28-20.94). Good knowledge and positive beliefs about mammography screening were not associated with mammography screening uptake. Conclusions: Half of our Malaysian women were aware about mammography screening. However, the uptake of mammography was low. Previous CBE and older age were significant predictors of mammography screening uptake. Increasing CBE services may increase compliance with guidelines.
Purpose: The purpose of this study was to seek the direction of community health nursing practice education focus on the nursing education accreditation criteria. Methods: We collected data through e-mail survey to all of 202 Korean nursing baccalaureate education institute in April, 2016. The 93 professors teaching community health nursing was responded about their affiliated institute (response rate 46.0%). Results: The Korean nursing graduates in Feb. 2016 was practiced 3.01 credits, 131.6 hours in community health nursing course. Community health nursing practice agency was public health center (98.9%), Public health center post (43.0%), Public health center branch (32.3%) in order. The possibility to achieve the course objectives up to national examination was recognised Public health center (3.4), Public health center post (3.3), Public health center branch and school (3.2) from 5 score likert scale. A lot of nursing education institute have difficulty in clinical placement in community health nursing practice agency that meet eligibility of preceptor and space gaining for only nursing students. Conclusion: The nursing education accreditation criteria in 3rd cycle have to be considered real community health nursing practice situation and newly emerging community health nursing fields.
Objectives : In order to make a proposal of a Korean standard dental hygiene curriculum, the job description of the National Health Personnel Licensing Examination Board was analyzed to prepare a job analysis matrix of dental hygienist to select required core competency. Methods : Data were analyzed to test the job validity of dental hygienist and categorize the duties of dental hygienist. A proposal of a standard dental hygiene curriculum was mapped out by making a comparative analysis of the courses necessary for American authorization of dental hygiene curriculum, existing proposals of Korean standard dental hygiene curriculum and the courses of the departments of dental hygiene offered by domestic three-year colleges and four-year universities. Results : Basic medicine courses were reinforced or newly offered to provide an opportunity for students to transfer to a domestic four-year university or to a foreign university. In the field of clinical dental hygiene and practice, preventive dentistry, prophylaxis and practice were integrated, and the names of the related courses were unified to give a chance for students to engage in comprehensive dental hygiene practice. There were different courses for dental clinical science at present. In this proposal, students should earn 125 credits in total. Conclusions : Standard dental hygiene curriculum proposal was required by three-year and four-year colleges across the nation. To make it happen, the original names of dental hygiene courses should be used, and the dental hygiene certification and evaluation institute that is under the umbrella of the Korean Dental Hygienists Association should lay out the standard of the KSDHEP to facilitate the utilization of the standard dental hygiene curriculum proposal.
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