• Title/Summary/Keyword: Doctor-doctor Relationship

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A Study on the categorization of acupuncture points of the Lung Meridian based on Huangdineijingmingtang ("황제내경명당(黃帝內經明堂)"을 중심으로 살펴본 폐경(肺經) 수혈(腧穴) 배열법에 관한 고찰)

  • Ahn, Jin-Hee;Baik, You-Sang;Jang, Woo-Chang;Jeong, Chang-Hyun
    • Journal of Korean Medical classics
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    • v.25 no.2
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    • pp.141-168
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    • 2012
  • Objective : The objective of this paper is to study the characteristics of the categorization of acupuncure points of the Lung Meridian(肺經) based on Hwangdineijingmingtang(黃帝內經明堂). Method : This paper examines several texts regarding the Lung Meridian. Result and Conclusion : Out of Yang Shangshan(楊上善)'s work, the theoretical aspects are presented in Hwangdineijingmingtang, whereas contents regarding acupuncture points are presented in Hwangdineijingmingtang. This is due to Yang's position as an imperial doctor(太醫侍御). In Hwangdineijingmingtang, Yang explains the characteristics of Metal(金) based on Hwangdineijingmingtang followed by an explanation of the acupuncture points of the Lung Meridian, which shows his emphasis on the relationship between the meridian as the main branch and the viscera. Along this medical logic, Yang must have included LU1(中府) into the Lung Meridian. This is Yang's unique point of view, distinguishing itself from other texts regarding the Lung Meridian. Apart from the means of explanation of the Lung Meridian by Yang, the verse 'made a volume for each 12 meridian' in the introduction of Hwangdineijingmingtang, discussion of the main treatable diseases of Hwangdineijingmingtang, contents on pathways of Lingshu Jingmai(靈樞 經脈), the start and end points of the meridians in Lingshu Maidu(靈樞 脈度) points to the assumption that each acupuncture point's belonging meridian known to us today was fixated by Yang.

Probability of Early Retirement Among Emergency Physicians

  • Shin, Jaemyeong;Kim, Yun Jeong;Kim, Jong Kun;Lee, Dong Eun;Moon, Sungbae;Choe, Jae Young;Lee, Won Kee;Lee, Hyung Min;Cho, Kwang Hyun
    • Journal of Preventive Medicine and Public Health
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    • v.51 no.3
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    • pp.154-162
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    • 2018
  • Objectives: Early retirement occurs when one's job satisfaction suffers due to employment mismatch resulting from factors such as inadequate compensation. Medical doctors report high levels of job stress and burnout relative to other professionals. These levels are highest among emergency physicians (EPs), and despite general improvements in their working conditions, early retirement continues to become more common in this population. The purpose of this study was to identify the factors influencing EPs intention to retire early and to develop a probability equation for its prediction. Methods: A secondary analysis of data from the 2015 Korean Society of Emergency Physicians Survey was performed. The variables potentially influencing early retirement were organized into personal characteristics, extrinsic factors, and intrinsic factors. Logistic regression analysis was performed to identify risk factors and to develop a probability equation; these findings were then arranged in a nomogram. Results: Of the 377 survey respondents included in the analysis, 48.0% intended to retire early. Risk factors for early retirement included level of satisfaction with the specialty and its outlook, slanderous reviews, emergency room safety, health status, workload intensity, age, and hospital type. Intrinsic factors (i.e., slanderous reviews and satisfaction with the specialty and its outlook) had a stronger influence on early retirement than did extrinsic factors. Conclusions: To promote career longevity among EPs, it is vital to improve emergency room safety and workload intensity, to enhance medical professionalism through a stronger vision of emergency medicine, and to strengthen the patient-doctor relationship.

The Relationship between Pulse Pattern and NIHSS Score in Early Stroke Patient;Multi Center Trials (초기 중풍 환자에 있어서 맥상(脈象)과 NIHSS과의 상관성 연구;다기관 임상연구)

  • Ma, Mi-Jin;Gang, A-Mi;Choi, Dong-Jun;Han, Chang-Ho;Lee, Won-Chul;Jun, Chan-Yong;Cho, Ki-Ho;Choi, Sun-Mi
    • The Journal of Internal Korean Medicine
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    • v.28 no.4
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    • pp.727-732
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    • 2007
  • Objectives : This study investigated using National Institutes of Health Strokes Scale in acute and subacute stroke patients and evaluated relativity of pulse pattern to NIHSS. Methods : 104 acute and subacute stroke patients were selected from 4 oriental medical hospitals from April 2007 to May 2007. The patients were admitted to hospital within 1 month after stroke. Pulse feeling diagnosis was done by oriental medical doctor and classified into 7 subtypes. Results : There were significant results statistically between slow/rapid pulse and NIHSS score in the male group; in the female group, there were no significant results statistically but the results showed that slow pulse has lower NIHSS score than rapid pulse. Patients with surging pulse had lower NIHSS score than the other patients. Another pulse pattern had no relativity to NIHSS score.

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Determinants of Quality in Outpatient Medical Service (외래 의료서비스 질적 수준의 결정요소)

  • Park, Sook-Hee;Kim, Seok-Beom;Kang, Pock-Soo
    • Quality Improvement in Health Care
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    • v.5 no.2
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    • pp.176-189
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    • 1998
  • This study was conducted to evaluate the subjective ideas about the determinants of quality in ambulatory care unit among outpatients and medical staff of a university hospital, and to compare the differences of the ideas, between patients themselves and hospital staff. A self-administered questionnaire survey was conducted covering 799 outpatients and 190 hospital staff in March, 1998. The questionnaire included general characteristics and 26 determinants of ambulatory care quality. The following are summaries of the findings: 1. Both of outpatients and hospital staff perceived, "Physician's knowledge" as the most important determinant of medical care quality. 2. In respect of 7 determinants related to physician's knowledge and skill, both outpatients and hospital staff perceived "physician's knowledge and skill" as important determinants. The scores of determinants such as, "Not doing unnecessary examinations", and "Assignment of adequate number of patients and duty schedule for the physician" were significantly different between outpatients and hospital staff. 3. In respect of 4 determinants related to doctor-patient relationship, both outpatients and hospital staff perceived "attention to patient's complaints" as the most important determinant. The scores related to the determinants such as "kindness of physician" and "explanation of treatment outcome" were significantly different between outpatients and hospital staff. 4. Among the amenities related determinants, "Modern facilities and equipments" were perceived as the most important determinant in both group. 5. In respect of 8 determinants related to non-financial accommodation, outpatients perceived, "Waiting hours for treatment" as the most important determinant, and hospital staff perceived, "Kindness of hospital staff". 6. In respect of 4 determinants related to financial accommodation, outpatients perceived, "Fare account of medical cost" as the most important determinant, and hospital staff perceived, "Increasing reimbursements". Further comprehensive research should be made on the evaluation of perceptions of medical care quality, both of outpatient and inpatient care, among patients and hospital staff. So good quality in medical care will be achieved based on clients' needs.

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Difference in Results according to Scorer and Test Date in Clinical Practice Test (진료수행 시험에서 채점자 및 시험 일자에 따른 결과 차이)

  • Kwon, So-Hee;Kim, Young-Jon
    • The Journal of the Korea Contents Association
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    • v.18 no.8
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    • pp.345-352
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    • 2018
  • The purpose of this study is to clarify the difference between the scoring results by scorer(doctors and standardization patients) and examination dates. A total of 101 students in the fourth grade of medical school participated in four clinical practice test. Students were randomly assigned to either day-1 or day-2, which was consisted of a standardized patient scoring set or a physician scoring set. Station checklists consisted of history taking, physical examination, patient education, physician-patient relationship and clinical courtesy. The achievement scores of each case and each domain were converted to the standard score, and the differences between groups were compared. Female students' achievement scores were significantly higher than male students' achievement scores in all domains. There was no significant difference between means by the standardized patients' group and doctors group. Day-2 group was significantly higher than day-1 group in both of history taking and physical examination domains. If the principles of checklist are clearly defined, the scorer status (either physician or standardized patients) does not determine the difference of students' practice test scores.

Clinical Report of Various Postpartium Symptoms (산후질환에 관한 임상보고)

  • Koo, Jin Suk;Lee, Young Jun;Seo, Bu Il
    • The Journal of Korean Medicine
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    • v.38 no.1
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    • pp.112-124
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    • 2017
  • Objectives: The purpose of this study is to investigate the various postpartum symptoms and the relevant factors. So it can provide fundamental data about postpartum health care. In conclusion, we can prevent and manage the postpartum disease by using this data. Methods: The subject of the present study was 94 women (63 women who completed vaginal delivery and 31 women who delivered by cesarean section) who completed labor between November 1, 2013 and January 31, 2016, at the clinic of OB&GYN. They have been taking good care of their health at postpartum clinic in Andong Woori Women Hospital. We investigated the various symptoms and situation which occurred from the moment of hospital to postnatal admission health care period, and Korean medical doctor examined the patients through the four examination methods. We classified the symptoms by maternal age, the frequency of maternal childbirth, the method of delivery, the delivery season, the term of pregnancy, the body weight of infant, the weight change of mother and the way of feeding. Results: There were no remarkable corelation in the frequency of symptoms according to maternal age, the way of delivery, the delivery season, the change of weight before and after of delivery, gestational weeks at delivery, the manner of feeding and the body weight of infants except for the frequency of maternal childbirth. Conclusion: The symptoms of hemorrhoids, the feeling of coldness and chilliness increased with increasing the frequency of maternal childbirth. Other circumstances, there was no relationship with symptoms of postpartum.

Effects of Stress and Obesity on the Prevalence of Metabolic Syndrome to the Sasang Constitution (체질에 따른 스트레스와 비만도가 대사증후군 유병률에 미치는 영향)

  • Yu, Ha-Na;Kim, Ho-Seok;Lee, Si-Woo;Seo, Bok-Nam;Baek, Young-Hwa
    • Journal of Sasang Constitutional Medicine
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    • v.30 no.1
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    • pp.58-65
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    • 2018
  • Objectives This study is to identify the relationship between stress, obesity and metabolic syndrome (MetS) by Sasang constitution (SC) and to use it as a basic data for the customized healthcare system of chronic disease management. Methods In a cross-sectional study conducted in a rural area of the Gyeongju area in 2014, we extracted data on 1,847 people using data from Korean medicine Data Center (KDC). The SC types diagnosed by Sasang constitutional medicine doctor. The stress was measured by the psychosocial well-being index questionnaire, and the obesity was defined by the body mass index. Results In all SC type, the stress and obesity was associated with MetS. There was a significant difference in the prevalence and trend of MetS according to presence of stress and obesity. The prevalence of MetS was the highest in Taeumin with all the stress and obesity, in order of Soeumin and Soyangin. Regardless SC types, the stress was associated with higher risk of MetS in the obese but not in the nonobese. Conclusion The results of this study indicate that further research is necessary to the SC types for the management of the Metabolic syndrome according to stress and obesity.

Nurse의s Perception in the Homecare Needs of Cancer Patient (간호사가 지각한 암환자의 퇴원후 가정간호요구)

  • Kwon, In-Soo;Eun, Young
    • Journal of Korean Academy of Nursing
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    • v.28 no.3
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    • pp.602-615
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    • 1998
  • The purpose of this descriptive study was to identify the homecare needs of the discharged patient with cancer as perceived by nurses caring hospitalized cancer patients. At two hospitals in Gyeongnam, 74 nurses responded to an open-ended questionnaire consisting of four need categories : 1) educational & informational need, 2) physical need, 3) emotional need, 4) social need. Respondents were asked to list above ten needs of cancer patient in each category. Two researchers analyzed the data by content analysis method. The findings are summarized as follows : 1) A total of 1,417 need items were generated by nurses. The largest number of needs were in the educational & informational need category(475 items, 36.3%). Physical(414 items, 31.6%), emotional (237 items, 18.1%) need were the second, third largest, and social(184 items, 14.0%) need made up the smallest category. 2) In the educational & informational need category, there were seven subcategories of prognosis, diet & exercise, medication & pain, wound care, folk remedy, personal hygiene, comfort. The need items related to prognosis of cancer accounted for almost a half(48.2%) of the total. 3) In the physical need category, there were ten subcategories of personal hygiene, skin & tissue, nutrition, side effect on treatment, exercise, pain, elimination, equipment, comfort & safety, others. The largest number of needs were in subcategory of the personal hygiene(82 items, 19.8%). 4) In the emotional need category, there were four subcategories of emotional support related to disease, emotional support related to routine life, spiritual support, maintenance of relationship with nurse & doctor. The largest number of needs were in subcatgory of the emotional support related to disease(96 items, 40.5%). 5) In the social need category, there were five subcategories of support for social life, household management, legal support, the use of volunteer service, financial support. The largest number of needs were in support for social life subcategory(58 items, 31.5%).

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Analysing of pulse wave parameter and typical pulse pattern for diagnosis in floating and sinking pulses (${\cdot}$ 침맥 진단에 유용한 맥상 파라메터 및 대표맥상 분석)

  • Lee, Yu-Jung;Lee, Jeon;Choi, Eun-Ji;Lee, Hae-Jung;Kim, Jong-Yeol
    • Korean Journal of Oriental Medicine
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    • v.12 no.2 s.17
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    • pp.93-101
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    • 2006
  • Pulse feeling is one of the most important diagnosis method in Oriental medicine. But it is not easy to make an objective and standardized diagnosis. In this study, we found how to quantify diagnosis. Specially dally the high practicality in clinic, we search some parameters especially well-related to floating and sinking pulse by statistic analysis. By extension, we find the pulse patterns of the floating and sinking pulse. We choose 15 subjects diagnosed as floating pulse and 15 subjects diagnosed as sinking pulse by oriental doctors. And their pulse signals were acquired by Pulse analyzer which has piezoresistive pressure sensor. For the quantification of the floating and sinking pulse, at first, we examined the parameters which were highly correlated with oriental doctor's diagnosis. And then we derived pulse patterns of the floating-sinking pulse from preprocessed signal and its ensemble average. We also looked trend variation (PH-Curve) between contact and pulse pressure. As a result, statistically there is the biggest difference between contact pressure, the maximum pulse pressure, diastolic area (Ad) and floating and sinking data. Through the PH-Curve, which represented the relationship between contact and pulse pressure, we could divide the floating and sinking pulse clearly. As a basic research of pulse diagnosis algorithm, we can contribute to select essential parameters in diagnosis algorithm And using these diagnosis method, we expect to find typical pulse patterns and some useful parameters about other pulses like slow/rapid, large/fine pulse and so on. We hope that this study will contribute pulse objectification.

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Wireless Digital Stethoscope Diagnosis System using Heart Rate (심박수를 이용한 무선 디지털 청진 진단시스템)

  • Park, Kee-Young;Lee, Jong-Ha;Cho, Sook-Jin;Lee, Chul-Hee;Jung, Eui-Bung
    • Journal of the Institute of Electronics and Information Engineers
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    • v.51 no.6
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    • pp.237-243
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    • 2014
  • Heart sounds of patient's chest could be heard using an analog stethoscope. However, auscultation of a heart sound can be diagnosed differently by each doctor hearing it. Therefore the condition of each patient is determined by the subjective comments based on the hearing ability of a physician who has years of experience. In this paper, through analysis of heart sound and heart rate of the patient's condition, we will define minutely how to diagnose the condition of patient using a wireless digital stethoscope diagnostic system. And it is possible to perform an objective medical diagnosis by applying LCR (Level Crossing Rate) and to show the relationship of a disease using this system.