• 대한물리의학회지
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• 제13권2호
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• pp.147-156
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• 2018

PURPOSE: The law pertaining to medical service technologists does not discuss the scope and limits of doctors' guidelines. My paper aims to discuss these topics. METHODS: This study was based on a review of literature and an analysis of judicial precedents. RESULTS: Physical therapists have often noted the need for independent practitioners in their articles on health care. Their continued discussions on professional and educational differences have centered round this issue, but their ideas have not been accepted. Practitioners have continued to interpret doctors' guidelines in hospitals without discussing their scope. However, the Supreme Court presented a meaningful decision outlining the conceptual limits and the scope of medical practice. The court suggested, basing its interpretation in the goal of clarifying the concept of medical activities smoothly, was to follow a specific judgment on the levels of education, testing, and professionalism. CONCLUSION: The role of physical therapists is expanding in this country, in order to meet the needs of the ultra-aged society. Education is already responding to rising training needs. By dividing the doctors' guidelines into indirect and direct types, if there's no medical risk near or around the health center or hospital, it is a good idea to allow the management of physical therapy partially, while understanding the scope and limitations of these guidelines clearly. A teleological interpretation of the law is especially relevant, and can be implemented immediately by the authoritative interpretation on part of the health authorities without any legal amendments.

• Journal of Preventive Medicine and Public Health
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• 제52권5호
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• pp.323-332
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• 2019

Objectives: The aim of this study was to describe general practitioners (GPs)' opinions and practices of preventive care and patients' opinions, attitudes, and behaviors towards prevention. Methods: The data stemmed from a cross-sectional national survey on prevention conducted in Switzerland from 2015 to 2016. In total, 170 randomly drawn GPs and 1154 of their patients participated. The GPs answered an online questionnaire and the patients answered a questionnaire administrated by fieldworkers present at their practices. Results: Both patients and GPs agreed that delivering preventive care is the dedicated role of a GP. It appeared that beyond classical topics of prevention such as cardiovascular risk factors, other prevention areas (e.g., cannabis consumption, immunization, occupational risks) were scarcely covered by GPs and reported as little-known by patients. In addition, GPs seemed to use a selective approach to prevention, responding to the clinical context, rather than a systematic approach to health promotion. The results also highlight possibilities to improve prevention in family medicine through options such as more supportive tools and public advertising, more time and more delegated tasks and, finally, a more recognized role. Conclusions: Despite an unfavorable context of prevention within the healthcare system, preventive care in family medicine is reasonably good in Switzerland. However, some limitations appear regarding the topics and the circumstances of preventive care delivery. A global effort is needed to implement necessary changes, and the responsibility should be broadened to other stakeholders.

• 보건행정학회지
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• 제2권1호
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• pp.66-79
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• 1992

The code of the International Classification of Disease(ICD) is seriously questioned on its effectiveness in identifing an independent disease entity from similar conditions at general practitioner's offices. This study has attempted to show individual coding variations in ICD for similar ambulatory care conditions. It has been assumed that a following outpatient visit is regarded as the sane kind of visit owing to the same disease if a visit to the different source of care would be mad within an interval of less than two days. The 'D' health insurance association was selected for this analysis. The 'D' association had 153,298 members and made claims of 642,605 outpatient care in 1990. Out of the total outpatient claims, 8.6%(55,102 claims) were counted as the same disease which could meet the above assumption. Percent of conditions classified as the 10 leading causes of frequent visits which were matched accurately to the subsequent ICD diagnostic code found to be 15.8% on the average. The URI was noted for the highest concurrence rate of 20.4%. This proportion was even decreased to 11.6% on the case of chronic disease. Despite the fact that the assumption underlying the definition of the above same disease is rather rough and inappropriate, this study reveals that the code of ICD currently in use has weaknesses in seperating a certain independent disease from similar conditions at the outpatient setting. Thus, efforts need to be elaborated to meet the need of a new system of classification for conditions and diseases encountering at ambulatory care.

• 한국사회복지학
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• 제55권
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• pp.309-339
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• 2003

본 연구는 2002년, 우리나라 14지역에서 시범사업으로 실시되었던 지역사회복지협의체 사업을 기관간 연계로 보고, 그 효과성에 대해 평가를 한 것이다. 연구에서 밝히고자 하는 문제는 두 가지이다. 하나는 기관간 연계로서 협의체 사업의 참여자들은 이 사업에 대해 긍정적으로 평가하는가, 부정적으로 평가하는가이고, 다른 하나는 서비스 제공자들간 연계에 의한 서비스에 대해 수혜자들은 어떠한 반응을 보이는가이다. 이 두 가지 질문에 대한 답을 찾고자, 한국보건사회연구원의 조사 자료를 재분석 하였다. 먼저 참여자들의 태도를 요약하면 다음과 같다. 즉, 의사소통에 대해 기관장들은 부정적인 평가를 하고, 실무자들은 긍정적인 평가를 하고 있다. 역할 수행에 대해 참여자들은 68.2%가 긍정적으로 평가하고 있으며, 77.8%가 협의체는 상시적으로 운영될 필요가 있다고 하고 있다. 수혜자들은 기관간 연계 서비스에 대해 전반적으로 긍정적으로 평가하고 있다. 그러나, 협의체 사업 전.후 비교에서, 가사서비스는 통계적으로 유의미한 차이가 있어 개선되었지만, 의료서비스 등 기타 서비스는 개선되지 않았다. 클라이언트만족문항(CSQ)척도 점수도 사전과 사후에 차이가 없었다.

• 대한임상검사과학회지
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• 제50권3호
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• pp.289-296
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• 2018

임상병리학과 학제 단일화에 대한 의견을 교수와 병원근무자들을 대상으로 설문조사 형식으로 조사하여 분석하였다. 2018년 1월 18일부터 25일까지 웹 버전의 설문지가 255명의 대학교수들과 4,000명의 병원근무자들에게 배포되었다. 회수율은 교수들은 79명(30.9%), 병원실무자들은 1,368명(34.2%)이 응답하였다. 임상병리학의 학제 이원화에 대한 인식조사에서는 교수와 병원근무자 모두 4년제로 학제 통합이 필요하다고 조사되었다. 4년제 통합 전제조건은 임상병리 인증평가원 설립과 교육과정의 표준화가 높게 조사되었고, 4년제 통합의 필요조건은 학생정원조정과 교육과정의 표준화가 높게 조사되었다. 4년제 통합방식은 인증평가를 통과한 대학만이 4년제를 운영해야 한다는 의견이 교수와 병원근무자 모두 가장 높게 조사되었다. 4년제 통합시 대학정원 적정인원은 40명 미만이 가장 높게 조사되었다. 결론적으로 교수들과 병원실무자들은 의료환경의 급격한 변화에 부응하는 전문성을 가진 임상병리사를 배출하기 위해서는 임상병리학과 학제의 4년제 통합이 필수적이고, 이를 위해 임상병리인증평가원 설립, 교육과정의 표준화, 학생정원조정 이 전제되어야 한다고 생각하고 있음을 보여준다.

• Child Health Nursing Research
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• 제24권1호
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• pp.68-77
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• 2018

Purpose: The purpose of this study was to develop parent coaching domains for the health management of childhood leukemia survivors. Methods: In this study, we conducted a literature review and in-depth interviews with 6 parents of childhood leukemia survivors who were identified using convenience sampling. We identified areas of parent coaching through the 4 stages of the GROW model, which are: goal setting, realistic grasp, confirmation of realization, and search for alternatives. Results: Nine domains and 27 subcategories emerged from the study. The 9 parent coaching domains for the health management of childhood leukemia survivors were routine life management, education and information provision, emotional support for the surviving children, social support for the surviving children, follow-up management, family support, school life management, symptom management, and improvement of growth and development. Conclusion: This research developed 9 parent coaching domains for the health management of children surviving leukemia. The results of this study are expected to contribute to the efficient health management of childhood leukemia survivors by enabling practitioners to continuously identify new coaching domains as needed for their health management. Researchers should improve the health management of childhood leukemia survivors by developing nursing interventions for these new coaching areas.

• 지역사회간호학회지
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• 제15권2호
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• pp.197-208
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• 2004

Purpose: This study was to develop an effective evaluation tool for evaluation of hypertension prevention and management program(HPMP) in community health posts (CHPs). Method: Evaluation tool composed from the literature review, the field visiting, and the in-depth interviews with the community health practitioners. Result: The evaluation tool had four domains, each with different maximum points:, hypertension prevention (35), hypertension management (40), environment of the CHPs(10), and evaluation system of the HPMP(15). The first domain was hypertension prevention with sub-domains of health education, and early detection of patients with hypertension. The second domain was hypertension management with sub-domains of management of health records of patients, education and counseling, and treatment and follow-up of patients. The third domain was the environment of the CHPs with subdomains of accessibility of CHPs to residents, accessibility of general health data to the public, and availability of health information to the public by multimedia. The fourth domain was the evaluation system of the HPMP with the subdomains of planning of program, formative evaluation, process evaluation, and summative evaluation. Conclusion: The newly developed evaluation tool will contribute not only to plan and set goals for evaluation of HPMP in CHPs.

• 한국산학기술학회논문지
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• 제11권10호
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• pp.3839-3845
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• 2010

본 연구는 치과 무면허 불법시술을 받은 사람들의 특성 및 패턴을 파악하고자 하였다. 2006년 국민구강건강 실태조사 자료를 이용하였다. 본 연구 대상자는 4,543명으로 치과 무면허 불법시술 경험 유무에 따라 그룹을 나누었다. 치과 무면허 불법시술 패턴을 기 분석에서 살아남은 변수로 조사하였다. 패턴 분석은 CHAID로 하였다. 연령은 68세 이상에 해당하는 사람들은 39%가 치과 무면허 불법시술 경험을 한 것으로 나타났으나, 33세 이하는 3%가 치과 무면허 불법시술을 경험을 한 것으로 나타났다. 연령이 55 또는 68세이면서 여성인 경우 45%가 치과 무면허 불법시술 경험을 한 것으로 나타났으나, 남성은 32%가 치과 무면허 불법시술을 경험을 한 것으로 나타났다. 최근 들어 건강에 대한 관심이 높아지고 있는 시점에서 의료비 등으로 인한 심적 부담도 많이 늘어나고 있는 실정이다. 그러나, 올바르지 못한 무면허 불법시술자에게 의술을 받고 부작용을 초래하는 경우가 종종 발생하고 있는 시점에서 무면허 불법시술에 노출될 위험이 높은 그룹의 특성 및 패턴을 사전에 파악하여 올바른 교육과 홍보를 통하여 건강을 효과적이고 효율적으로 관리할 수 있도록 하여야 할 것이다.

• 한국의료질향상학회지
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• 제21권2호
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• pp.58-72
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• 2015

Objectives: This study was conducted as descriptive correlation research in order to survey healthcare personnel(HCP)'s awareness of patient safety culture and their recognition of standard precautions, and to examine the correlation between the two factors. Methods: The subjects were 400 HCPs including 80 doctors, 240 nurses, and 80 medical technicians from two general hospitals. The questionnaire used in the survey consisted of 9 questions on general characteristics, 44 on the perception of patient safety culture, and 21 on the recognition of standard precautions. Results: According to the subjects' general characteristics, the score was significantly higher in those aged over 40 than in those aged 30-39. In addition, it was significantly higher in managers than in practitioners, in those with work experience of less than a year than in those with 5-9 years. The score was also significantly higher in those working 8 hours a day than in those working over 10 hour a day. The number of medical accident reports according to the subjects' general characteristics was significantly larger in nurses than in doctors, in managers than in practitioners, and in those with 10 years' or longer experiences than in those with less than a year. In the awareness of standard precautions according to the subjects' general characteristics, the score was significantly higher in female workers than in male workers, and in managers than in practitioners. As a whole, the subjects' awareness of patient safety culture and their recognition of standard precautions showed a significant correlation with each other. Conclusion: From the result of this study, sufficient work force and the promotion of organizational culture for safety is needed in order to guarantee patient safety. Likewise, these results suggest that experience, job skill, and adequate working hours have a positive effect on the awareness of patient safety culture and the recognition of standard precautions.

• 의료법학
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• 제23권1호
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• pp.149-176
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• 2022

우리나라 법제는 비의료인에 의한 의료행위를 엄격히 금지하고 있는데, 문신시술의 경우 의료행위로 분류되어 비의료인이 문신시술시 무면허의료행위로 처벌받게 된다. 그런데, 현실적으로 문신시술을 의료인에게 받는 경우가 매우 드물고, 문신시술을 업으로 하고 있는 비의료인들은 직업선택의 자유 침해 등을 주장하며 비의료인에 의한 문신시술의 의료행위성을 부정하고 비범죄화할 것을 요구하고 있다. 그런데 문신시술은 바늘 등을 사용하여 이루어지기 때문에 신체에 대한 침습이 있어 의료인이 행하지 않으면 보건위생상 위해가 발생할 수 있는 행위로 볼 수 있고 감염 예방 등을 위해 엄격한 관리가 필요하다. 그러나 이러한 현실적인 부분과 법제와의 괴리를 고려할 때, 보건의료적 관점에서 안전성을 고려하면서도, 사실상 의료인에 의해 행해지는 문신시술이 많지 않은 현실을 고려하여 비의료인에 의한 문신시술을 제도화하는 방안 등에 대해 전향적으로 생각을 해 볼 필요가 있다. 본고는 이러한 관점에서 문신시술이 의료행위에 해당하는지 법제를 검토하고, 보건의료적 관점에서 문제가 된다면 이를 해결하기 위한 방안을 모색하여 현실을 반영하면서도 안전성을 도모할 수 있는 대안으로 3단계로 나누어 단계화된 접근을 제시하였다.