• 보건행정학회지
• /
• 제32권1호
• /
• pp.94-106
• /
• 2022

Background: The efforts to build more "people centered," "patient centered" health system has been emerging all over the world. Aligning with it, the Korean government is conducing the survey called "Medical Service Experience Survey (MSES)." There are critics, however, that MSES is not scrutinizing the medical experiences of patients in various healthcare settings. For this reason, this study aims to perform an empirical analysis of the differences in answers of patients responding to various healthcare settings. Methods: There are two steps in this study. First, explanatory analysis is conducted to compare the tendency of statistical concentration on questionnaires by divided healthcare settings. Second, confirmative analysis is carried out to evaluate the construct validity, reliability, and discriminant validity of the questionnaire in each healthcare setting. The raw data of MSES, which was conducted in 2020 by the Ministry of Health and Welfare in Korea and the Korean Institute for Health and Social Affairs is used. Results: As a result of exploratory factor analysis for all outpatients, the items were classified into four factors statistically: "doctor experience," "nurse experience," "outpatient service experience," and "patient satisfaction." It was confirmed that the reliability of all factors extracted was secured. However, for patients who visited hospitals, questionnaires related to personal privacy, such as "experiences on medical staffs considering physical exposure" or "experiences related to personal information exposure," were answered in conjunction with items of "nurse experience." Besides, patients responded that administrative elements of medical services, such as "experiences of comfort in medical institutions" and "experiences of satisfactory administrative services," were related to the items of "nurse experience." The answers of patients who visited traditional medical hospitals and clinics about "doctor experience" and "nurse experience" were not discerned statistically, and the answers to "doctor experience," "nurse experience," and "medical institution experience" were entangled with the responses of patients who visited dental hospitals and clinics. On the other hand, as a result of the confirmatory factor analysis, it was found that the inquiries of MSES generally had intensive validity. Conclusion: The collection of objective and scientific data is the prominent component to enlighten the patient-centered healthcare system alongside with change of the worldwide paradigm of measuring the healthcare system performance as follows the transition of perspective of health care from provider-centered to patient-centered. This study empirically shows that the patient experience can vary as the healthcare settings. Furthermore, to make an advance in measuring the experience of patients with medical services, this article proposes the deliberate consideration of the different kinds of healthcare settings and articulate design of the survey.

• 대한간호학회지
• /
• 제28권2호
• /
• pp.479-489
• /
• 1998

This work was done for 9 patients having experience of a herb medical treatment after being diagnosed as CVA during a year from January, 1996 to December, 1996 by using an ethnographic research method. The summarized results of this research are following. Ⅰ. THE EXPERIENCE OF THE ILLNESS First, the falling-ill phase is the time that they have the first stroke of paralysis and the decision pattern of medical institution' comes out. The emotional experience in the period is something like 'flustration', 'anxiety', 'despair', and 'expectation'. Second, the active-treatment phase is the time that the patients as well as their family or care giver not only show the positive attitude and actively participate in the illness treatment but also show a lot of interest in medical institutions and activities of health recovery. There is a primary factor of the continuation of treatment as an experience of treatment and being crushed and sensitivity as an experience of the illness. Third, the rehabilitation phase is the time that the patients or their family become tired and insensitive to the treatment and recuperation, and then reduce the treatment activity. There is a primary influence factor of the discontinuance of treatment as an experience of treatment and physical experience and emotional experience as an experience of the illness. The physical experience is divided into 'personal-hygiene care', and 'the sphere of activity' The emotional experiences are 'blaming someone', 'contempt' and 'despair' as a negative experience and 'hope' as a positive experience. Ⅱ. COPING STRATEGY There are a physical coping, an emotional and mental coping, a social coping, and a spiritual coping as a coping strategy used for the patients to overcome their illness and adjust themselves to their altered life. First, the physical coping comes out as 8 categories, 'using an auxiliary tool', 'doing exercise', 'protecting', 'improving their diet', 'taking care of something', 'using subsidiary medicines', 'trying a folk remedy', and 'having interest in their health'. Second, for the emotional and mental coping, there are 'accepting' and 'trying' as a positive coping and a failure of control as a negative coping. Third, the social coping is appeared as 'being supported'. Fourth, the spiritual coping is recognized as' recourse to God' and 'preparation of death'. After all, the elderly CVA patients in an agricultural area choose the act of treatment based on the traditional belief and the relationship with a caretaker. A personal health can be maintained by taking care of themselves and controling their mind, and the overcome of the illness is decided on the basis of traditional concepts and cultural principles in which the patients as well as the family, neigbors and take carers should work out together and cooperate with each other in order to achieve that.

• 대한치과기공학회지
• /
• 제33권4호
• /
• pp.441-452
• /
• 2011

Purpose: Identify the factors that influence following up control and reuse intention of patient who used dental health care institution after dental heath care service and in order to prepare the method which improve the quality of dental health service which dental heath care institution service afford. Methods: Data were collected through random sampling from June 20th to August 20th 2010 (for 60 days). Once we explained the purpose of our survey to people who experienced the dental service within one year, we distributed the questionnaires to someone who volunteered to respond and they answered all questions by themselves based on the actual experience of dental health care organizations. Even if the survey was conducted for 610 people, only 585 properly answered questionnaires were analyzed because responses which had many unanswered questions and had errors in responsive way were excluded. Results: Result of multiple regression analysis, the value of dental clinic service, the following up control after dental treatment, the technique and kindness of dentist, the environment of treatment, type of dental service and the kindness of dental staff is significant main cause to intention of reuse dental clinic. Conclusion: In order to increase the rate of patient reuse, enhance the value of service with following up control after health treatment and the high quality of dental health service.

• 디지털산업정보학회논문지
• /
• 제17권4호
• /
• pp.161-175
• /
• 2021

This study analyzed the efficiency and influence factors according to the main research institute type of R&D Program for the local community problem-solving. This study applied data envelopment analysis (DEA) method and Tobit regression analysis by using 20 institutions that participated in R&D Program. The results are summarized as follows. First, Analysis results according to the research institute type of R&D project, Efficient DMUs showed more regional innovation institutions than social economy enterprises. But regional innovation institutions were the lowest in the CCR and BCC model. However, efficiency dose not differ between regional innovation institutions and social economy enterprises. Second, as a result of the analysis relation between efficiency and allocation characteristics of R&D input, the participation of regional innovation organizations as participating organizations has a negative effect on efficiency. It was found that the higher the proportion of government subsidies and the higher the employment rate of the vulnerable, which is a social achievement, the positive effect on efficiency. The implication of this study is that the participation of social economy enterprises as the main R&D institution and government R&D support can provide social economy enterprises with opportunities to accumulate R&D capabilities and experience successful commercialization.

• 한국학교ㆍ지역보건교육학회지
• /
• 제8권1호
• /
• pp.69-77
• /
• 2007

Background & Objectives: International radiation protection committee recognized the importance of radiation protection from medical practices because the exposure to the radiation in medical practice is higher than any other exposure. The factors on knowledge, attitude and practice of radiation safety of the medical workers engaged in radiation were analyzed in order to improve radiation safety technology. Method: Questionnaires were used for 1200 radiation workers in medical institution from July 23 through September 4 and collected for analysis. Results: Different level of safety measures were practiced by age, marital status, career, and medical facility. The difference was statistically significant. Higher levels of safety measures were practiced in the age group of 50s and married persons. The workers who have more than 20 years experience have higher level of safety measures. The workers of health centers have higher level of safety measures to compare with other workers. The factors which give more concerns on safety practice were self efficacy, practice and knowledge in order. Conclusion: Safety conscious operators should get additional education program to maintain higher level of safety. The operators who do not have much safety concern should be intensive training program for self efficacy and safety.

• 대한가정학회지
• /
• 제27권4호
• /
• pp.167-191
• /
• 1989

The present study was conducted to devlop and appropriate retirement home model for the elderly in terms of clothing and textiles; nutrition, health, and foodservice; housing and environment; and psychological adaptation. Specifically, the purposes of the study were: 1) to provide basic guidelines for clothing by comparing the clothing behavior of the elderly living in the retirement home and those living in their own homes with family, 2) to provide basic guidelines for balanced diet and effective foodservice, 3) to develop an ideal life space and facilities, and 4) to assess the psychological characteristics of the elderly. Questionnaires, observation, experimental method, and survey of literature were used for the study. Clothing behavior showed that the elderly were much concerned about clothing, and they preferred comfortable as well as fashionable designs. The elderly in the retirement homes complained of a lack of quantity and variety in clothing. They preferred natural fiber rather than blended fabrics. Flame resistance, thermal insulation, and flexibility of textile fabrics were found to be prime considerations in manufacturing and selecting clothing materials for the elderly. The health status of the surveyed elderly was generally good, but some poor eating habits were observed. Dietary nutrients intakes were generally sufficient, but several nutrients intakes were insufficient. The level of equipment in the kitchens of the institutions was low. Furthermore, the employment rate of dietitians in institutional settings was extremely low. This resulted in a lack of systematic foodservice management. Residents in the institution were generally satisfied with present life space and facilities but this was mainly because of abandonment, adaptation, and past experience. Optimal allocation of residents per bedroom and an adequate design for storage, bathroom, utility room, and dining room were recommended. The comparison of psychological status of the elderly living at home was more stable than those living in an institution. The emotional state of the elderly living in the institution was characterized by loneliness; they did not have close interpersonal relationships or future plans. An appropriate model for the elderly was developed on the basis of these findings.

• Journal of Gastric Cancer
• /
• 제16권4호
• /
• pp.240-246
• /
• 2016

Purpose: It is hypothesized that robotic gastrectomy may surpass laparoscopic gastrectomy after the operators acquire long-term experience and skills in the manipulation of robotic arms. This study aimed to evaluate the long-term learning curve of robotic distal gastrectomy (RDG) for gastric cancer compared with laparoscopic distal gastrectomy (LDG). Materials and Methods: From October 2008 to December 2015, patients who underwent LDG (n=809) were matched to patients who underwent RDG (n=232) at a 1:1 ratio, by using a propensity score matching method after stratification for the operative year. The surgical outcomes, such as trends of operative time, blood loss, and complication rate, were compared between the two groups. Results: The RDG group showed a longer operative time (171.3 minutes vs. 147.6 minutes, P<0.001) but less estimated blood loss (77.6 ml vs. 116.6 ml, P<0.001). The complication rate and postoperative recovery did not differ between the two groups. The RDG group showed a longer operative time and similar estimated blood loss compared with the LDG group after 5 years of experience (operative time: 159.2 minutes vs. 136.0 minutes in 2015, P=0.003; estimated blood loss: 72.9 ml vs. 78.1 ml in 2015, P=0.793). Conclusions: In terms of short-term surgical outcomes, RDG may not surpass LDG after a long-term experience with the technique.

• 예술인문사회 융합 멀티미디어 논문지
• /
• 제7권9호
• /
• pp.519-527
• /
• 2017

본 연구는 어린 시절 부모와 헤어져 시설에 맡겨진 채 시설보호 양육을 받으며 성장한 부부가 자녀를 낳고 부모가 되어 자녀를 양육하는 경험을 탐색해 보고자 하였다. 이를 위해 같은 시설에서 성장한 후 결혼한 부부를 연구 참여자로 선정하여 남편과 아내를 각각 심층 인터뷰하였다. 연구 방법은 질적 사례연구방법을 활용하여 분석하였다. 분석 결과는 '지독한 외로움의 보상으로 꾸린 가족', '준비 없이 시작된 출산 그리고 자녀 양육의 늪', '마주한 실체 그리고 후회와 반성', '그래도 부모라는 책임감으로 다시 얻은 용기'와 같이 도출하였다. 어린 시절 아동양육시설에서 자란 부부는 혼자라는 지독한 외로움을 벗어나기 위해 아무런 준비 없이 막연한 환상을 갖고 결혼을 하였다. 결혼이 그랬듯 자녀 출산 또한 계획 없이 생기는 대로 낳았다. 그러나 막상 어떠한 정보나 교육 없이 부딪히게 되는 자녀 양육은 어렵고 점점 지쳐만 갔다. 그러다 아이를 어린이집에 보내면서 자신의 부정적인 모습을 똑 닮은 자녀의 실체를 마주하고 뒤늦은 후회와 반성을 하게 된다. 부부는 비록 자신들은 부모의 양육을 받고 자라지 못했지만, 부모로서의 책임감을 깊게 느끼고 있었다. 이러한 결과를 바탕으로 본 연구는 시설에서 성장한 부부의 자녀양육을 돕기 위한 사회복지적 개입방안을 제언하였다.

• 한국엔터테인먼트산업학회논문지
• /
• 제13권4호
• /
• pp.299-309
• /
• 2019

본 연구는 작업치료과 학생들이 임상실습 동안 경험한 것을 알아보기 위해 10명의 학생들을 대상으로 포커스 그룹 인터뷰를 하였다. 연구 결과 5개의 구성요소가 도출되었으며, 구성요소는 심리적 경험, 전문적 경험, 환경적 경험, 가치관의 변화, 행동적 변화이었다. 심리적 경험으로 참여자들은 부정적 측면에서 부담감과 불안을 경험하였으며 긍정적 측면에서는 기대감과 설렘을 경험하였다. 전문적 경험으로는 이론과 임상을 연계에 대해 경험하였으며, 작업치료에 대한 전문적 지식 및 환자를 접해보는 경험을 하였다. 환경적 경험으로는 다양한 치료 접근을 경험하였고, 임상실습 지도 관리 체계 등을 경험하였다. 또한 임상실습을 통해 가치관의 변화를 경험하였으며, 행동적 변화를 경험하여 임상실습에 보다 적극적으로 참여하는 모습을 보였다. 본 연구를 바탕으로 학교에서는 전공에 대해 흥미를 가질 수 있도록 해야 하며, 이론적 지식의 적용능력 향상을 위한 교육도 필요할 것이다. 또한 임상기관에서는 효율적 임상실습을 위해 학생중심의 실습교육과정을 마련하고 최적의 실습환경 조성이 필요할 것으로 생각된다.

• Journal of Korean Neurosurgical Society
• /
• 제61권5호
• /
• pp.625-632
• /
• 2018

Objective : Because the anatomical structure of the brachial plexus is very complex, surgical treatment of tumors in this region is challenging. Therefore, a lot of clinical and surgical experience is required for successful treatment; however, many neurosurgeons have difficulty accumulating this experience owing to the rarity of brachial plexus tumors. The purpose of this report is to share our surgical experience with brachial plexus tumor with other neurosurgeons. Methods : The records of 18 consecutive patients with brachial plexus tumors who underwent surgical treatment between January 2010 and December 2017 in a single institution were retrospectively reviewed. The surgical approach was determined according to the tumor location and size, and intraoperative neurophysiological monitoring (IONM) was used in most of cases to prevent iatrogenic nerve injury during surgery. In addition, to evaluate the differences in tumor characteristics according to pathologic diagnosis, the tumors were divided twice into two groups, based on two separate classifications, and statistical analysis was performed. Results : The 18 brachial plexus tumors comprised 15 (83.3%) benign peripheral nerve sheath tumors including schwannoma and neurofibroma, one (5.6%) malignant peripheral nerve sheath tumor, one (5.6%) benign tumor of non-neural sheath origin (neurogenic cyst), and one (5.6%) metastatic tumor (papillary carcinoma). The authors analyzed relationship between tumor size/location and tumor characteristic parameters such as age, size, right-left, and pathology. There were no statistically significant differences except a tendency of bigger tumor size in young age. Conclusion : For a successful surgical outcome, an appropriate surgical approach is essential, and the appropriate surgical approach is determined by the location and size of the tumor. Furthermore, applying IONM may prevent postoperative complications and it is favorable option for brachial plexus tumors surgery.