• 제목/요약/키워드: Health providers

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한.양방 협진에 대한 의사들의 인식변화 - 국내 문헌에 대한 체계적 고찰 - (Changes in the Attitudes of Doctors toward Cooperative Practices between Western Medicine and Traditional Korean Medicine - A Systematic Review in Korean Literature -)

  • 민현주;류지선;윤영주
    • 대한예방한의학회지
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    • 제16권1호
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    • pp.15-29
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    • 2012
  • Background : With the increase of cooperative practices (CP) between conventional western medicine and traditional Korean medicine, there have been lots of researches on the status of CP and the attitude of doctors. Objective : Since most of the research is cross-sectional, this study aims to figure out the changes in the attitude of doctors toward CP through systematic review. Method : Systematic literature searches were performed on several databases in Korea. They were categorized according to the respondents and question items and analyzed by the context of questions, similarity of respondents and measurement scale. And we analyzed the changes of response regarding to doctors' awareness and attitude to CP. Results : Thirteen survey studies including attitude of doctors toward CP were selected. These studies were conducted between 1997 and 2009 and the number of respondents of each study ranged from 20 to 702. There has been increasing awareness of CP among doctors ; however the positive responses on the necessity of CP has decreased. Regarding the type of illness effectively treated employing CP, there was a shift from neurovascular to musculoskeletal and immune diseases. Most of the studies listed different approaches to disease, prejudice of health care providers and inadequate legal system as major obstacles against CP. Conclusion : In spite of the increase of CP in the last 20 years, there has not been marked positive change in the doctors' attitude toward CP. To promote CP, it is required to confirm the effectiveness of CP through disease models and change the medical legislation policies on CP.

Does Clinical Experience Help Oncology Nursing Staff to Deal with Patient Pain Better than Nurses from other Displines? Knowledge and Attitudes Survey Amongst Nurses in a Tertiary Care in Malaysia

  • Yaakup, Hayati;Eng, Tan Chai;Shah, Shamsul Azhar
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권12호
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    • pp.4885-4891
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    • 2014
  • Background: Successful implementation of pain management procedures and guidelines in an institution depends very much on the acceptance of many levels of healthcare providers. Aim: The main purpose of this study was to determine the level of knowledge and attitudes regarding pain among nurses working in tertiary care in a local setting and the factors that may be associated with this. Materials and Methods: This cross-sectional research study used a modified version of the Nurses' Knowledge and Attitudes Survey (NKAS) regarding pain. Basic demographic data were obtained for further correlation with the level of pain knowledge. Results: A total of 566 nurses, 34 male and 532 female, volunteered to participate in this study. The response rate (RR) was 76%, with an overall mean percentage score of $42.7{\pm}10.9$ (range: 5-92.5). The majority of participants were younger nurses below 40 years of age and more than 70% had worked for less than 10 years ($6.6{\pm}4.45$). Up to 92% had never had any formal education in pain management in general. The total mean score of correct answers was $58.6{\pm}9.58$, with oncology nursing staff scoring a higher percentage when compared with nurses from other general and critical care wards ($63.52{\pm}9.27$, p<0.045). Only 2.5% out of all participants obtained a score of 80% or greater. The majority of the oncology nurses achieved the expected competency level (p<0.03). Conclusions: The present findings give further support for the universal concern about poor knowledge and attitudes among nurses' related to the optimal management of pain. The results reflected that neither number of years working nor age influenced the level of knowledge or attitudes of the practising nurses. Oncology nursing staff consistently scored better than the rest of the cohort. This reflects that clinical experience helped to improve attitudes and knowledge concerning better pain management.

Low doses of amitriptyline, pregabalin, and gabapentin are preferred for management of neuropathic pain in India: is there a need for revisiting dosing recommendations?

  • Kamble, Sanjay Vasant;Motlekar, Salman Abdulrehman;D'souza, Lyndon Lincoln;Kudrigikar, Vinay Nanda;Rao, Sameer Eknath
    • The Korean Journal of Pain
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    • 제30권3호
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    • pp.183-191
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    • 2017
  • Background: Current therapy for the treatment of neuropathic pain is often unsatisfactory. Considerable variation in treatment pattern still exists in spite of availability of sufficient literature from various guidelines. Recent Indian market data suggested that the utilization (sale) of drugs such as amitriptyline, pregabalin, and gabapentin was more for low-dose unit packs than that of the high-dose unit packs, raising the belief that these drugs are prescribed at a lower dose than is actually recommended in the guidelines. To test this hypothesis, a survey was conducted across speciality throughout the country to observe the prescription pattern of these drugs amongst the health care providers in India. Methods: Three hundred fifty survey forms were distributed of which 281 forms were included for analysis. Results: It was observed that the commonly used initiation and maintenance dose for amitriptyline, pregabalin, and gabapentin was 5-10 mg/day, 50-75 mg/day, and 100-300 mg/day, respectively. The reason to select the lower dosages was to have a balancing effect to achieve good efficacy with minimum side effects. Care-givers reported no side effects/not many side effects as a reason in 22.2%, 16.88%, and 23.86% patients with amitriptyline, pregabalin, and gabapentin, respectively. Sedation and giddiness were commonly reported with all three drugs. Conclusions: Commonly prescribed drugs for management of neuropathic pain, such as amitriptyline, pregabalin, and gabapentin are preferred at lower doses in Indian clinical settings. Acceptable efficacy and low tolerance to the standard dosage is believed to be the reason behind the prescribed dose.

"의림(醫林)"지(誌)를 통해 살펴본 1950년대 동서의학 논쟁 (The Medical Dispute between Korean and Western Medicine in 1950s Examined through "EE LIM")

  • 이태형;김태우;김남일
    • 대한한의학원전학회지
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    • 제25권3호
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    • pp.57-78
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    • 2012
  • Objective: Although the government acknowledged Korean Medical Doctors as official health care providers since 1951, criticism regarding its modernity persisted. This paper focuses on the medical dispute between Korean and Western Medicine in 1950s risen from the problem of modernization of Korean Medicine. Method: This paper looked into the medical dispute between Korean and Western Medicine in 1950s through "EE LIM". "EE LIM" is a scholarly journal published by Korean Medical doctor Bae Won-Sik. Articles regarding the medical dispute between Korean and Western Medicine were selected, categorized and analyzed. Result: The main questions against Korean Medicine were: whether it was scientific or not, and whether there was a possibility of systematization. Several opinions were brought up on these issues. 1) Some people criticized Korean Medicine as being unscientific based on modern science. 2) Others emphasized the identity of Korean Medicine against the critics. 3) Another group of people wanted to study Korean Medicine using modern methods and obtain merits from both sides. Conclusion: The different understanding of the term 'science' led to diverse discussions on the direction of Korean Medicine's progression. The narrow meaning of science only considers Korean Medicine as an object of modern scientific and medical study. But if the meaning is broadened, containing empirical aspects, Korean Medicine can be included as a category of science based on its clinical utility.

국외 간호학술지에서의 의료기관 내 실행연구 동향분석 (Action Research in Hospital Settings: A Literature Review of International Nursing Journals)

  • 문정은;송미옥;김희영;박현영;김은아;김윤민;장금성
    • 간호행정학회지
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    • 제22권1호
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    • pp.46-56
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    • 2016
  • Purpose: Purpose of this study was to identify major trends of action research from 2006 to 2013 and suggest directions for activating and advancing domestic action research in nursing. Methods: A review was made of 118 action research studies in hospital settings reported in international journals. Search from PubMed, Ovid, and CINHAL was done using analysis criteria developed by the researchers. General and methodological characteristics and focus on changing outcomes of action research were analyzed. Results: The major group of researchers belonged to colleges/universities (40.7%). Methods included use of qualitative methods (61.0%), research questions (24.6%), and use of theoretical models (35.6%). Prevalent data collection methods were interviews (20.2%), and 48.3% showed more than a 1-cycle process including spiral circulation structure. Focus of changing outcomes of the 56 papers including more than 1-cycle were practice (66.1%), environment (8.9%), client-nurse (7.1%). Conclusion: Trends in action research in nursing were identified providing necessary reasons to increase action research in nursing as follows: needs of various researchers including stakeholders as well as healthcare providers, various research designs including unconstrained reflection and writing, specific presentation of adapted theoretical models and action strategies, and quality assurance for validity and reliability of research processes and outcomes.

생명과학기술의 또 다른 그늘: 유전자차별 (Genetic discrimination as another shadow of biotechnology)

  • 김상현
    • 과학기술학연구
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    • 제14권1호
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    • pp.59-85
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    • 2014
  • 이 글은 생명과학기술의 또 다른 그늘로서 유전자차별의 사회학적 함의를 조명하기 위한 것이다. 이를 위해 유전자차별과 관련된 주요개념과 세 가지 시각(예외주의, 표현주의, 인권적 담론)을 검토하고, 미국의 "유전자차별금지법(GINA)"과 우리나라 "생명윤리 및 안전에 관한 법"에 나타난 사회적 함의와 한계를 분석하였다. 또한 기존의 유전자차별에 대한 인식결과(차별인식, 차별경험, 차별의 두려움, 차별에 대한 대응)에 기반하여 향후 유전자차별의 연구 및 정책을 위한 몇 가지 함의를 제시하였다. 우선, 유전자차별에 대한 개념적 합의와 함께 인권주의 시각의 중요성이 요구된다. 둘째, 공적 영역뿐만 아니라 사적 영역에서의 차별에 대한 관심과 유전소인을 가진 인구집단의 시각을 반영한 연구가 필요하다. 셋째, 법제도적 장치뿐만 아니라 국민과 의료인들에게 유전자차별 의식을 고양하고, 유전소인을 가진 사람들을 위해 유전자차별의 두려움을 낮출 수 있는 심리사회적 대응방안이 개발되어야 한다.

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여성의 요실금 빈도와 관련 요인에 대한 조사 연구 (Incidence and Correlates of Urinary Incontinence in Women)

  • 윤혜상;노유자
    • 대한간호학회지
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    • 제27권3호
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    • pp.683-693
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    • 1997
  • Urinary incontinence is defined as the involuntary and inappropriate loss of urine to failure to emit normal responses as the bladder fills, or inability to reach the bathroom in sufficient time. This study was undertaken to estimate the incidence of urinary incontinence and to determine the correlates of urinary incontinence among women. Subjects of this survey consisted of 408 women, 26 to 83 years old in Incheon. The results of this study are as follows. 1. Of the subjects 50.7% reported urine loss once or twice per year and 28.5% reported incontinence on a regular basis at least once per month. 2. 40.5% of women reported small volume accidents of only 1 to 2 drops, 31.4% ; 1 t-spoon, 16.9% : 1 T-spoon, while 10.1% of women couldn't estimate the volume of urine loss. 3. The volume of urine loss was great enough to require a change of garment (undergarments or outer garments) in 73%. But only 3.8% of those used some type of pads. 4. 56.5% of incontinent women didn't talk about their urinary incontinence with other persons because they felt that urinary incontinence was shameful(38.4%), was not a disease(31.6%), was incurable in spite of treatment(27.4%) and was fearful of being uncured (2.6%). 5. Only 15.5% of urinary incontinent women had sought treatment. 6. The incidence of urinary incontinence was significantly higher in women who had more pariety and uterine-ovarian disease, older age, worrying about where toilets were when they visited new places or voiding anxiety, nocturia and frequency, but was significantly lower in women who had coffee intake. The incidence of urinary incontinence was not related to smoking and enuresis. The results indicate that urinary incontinence is common among young and middle-aged women. That few seek treatment for urinary incontinence suggests a need for more information about women's attitudes toward urinary incontinence and more attention to this problem by health care providers.

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Presence련와 관련된 요인 분석 (Factor analysis of Presence)

  • 조계화;성기월
    • 대한간호학회지
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    • 제30권1호
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    • pp.225-239
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    • 2000
  • This study is a research of conceptual development to find the factors of presence. The concept and the definition of presence received from literary review. On the basis of these findings, we formulate the contents of presence through structured interview guide composed of open-ended questionnaire which included the frequency, attitude, and posture. We selected 104 samples who are the patients, doctors, nurses, and other health providers. And then the contents of presence were established after integrating the formulated contents and putting them in order. The categorizing of the presence was made after discussing with specialist in this field. By using the selected contents, we made 25 statements of presence which were categorized into three factors. The results were as follows: 1. The definition of presence is being with at the same time and space, making attention with openness, and the therapeutic interaction with empathy. 2. The contents of presence through personal interviews are The time required is 5 minutes(46.15%), 2-3 minutes(34.61%), and 10 minutes (15.38%) respectively. The frequency of visiting is 3 times(39.20%), every time(23.07%), and more than 5 times(20.19%) respectively. \circled2 In case of being with nurse is having pain(39.42%), suffering trouble or severe fear(9.61%), feeling discomfort(8.65%), taking care of wound(7.69%), and other unfavorable symptoms(6.73%) respectively. \circled3 The posture being with nurse is depends on the situations(63.46%), sitting(26.92%), and standing(9.61%) respectively. Eye contact with nurse is face to face(78.84%), depends on the situations(20.19%), and not face to face(0.96%) respectively. \circled4 The attitudes of comfort are explaining about disease(23.07%), holding on hands (14.42%), touching on the suffering parts (11.53%), and unconditionally being with(7.69%) respectively. \circled5 Nurses' caring actions are kindness (27.88%), replying to the question (12.50%), smiling(10.57%), bright appearances (8.65%), and right and quick treatment(8.65%) respectively. \circled6 The effects of being with are peaceful mind(58.65%), quick recovery(13.46%), and decrease in fear(12.50%) respectively. \circled7 The attitudes of being with are listening (11.53%), recognition(8.65%), talking about discomfort(8.65%), and answering kindly (7.69%) respectively. 3. From the analysis of presence factors, 25 statements and 3 categorized factors are presented.

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모바일 기반 개인 맞춤형 의료서비스 지원 시스템 설계 및 구현 (Design and Implementation of Support System for Personalized Medical Service Based on Mobile)

  • 서정석;박석천
    • 한국인터넷방송통신학회논문지
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    • 제13권6호
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    • pp.37-45
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    • 2013
  • 본 논문에서는 최근 네트워크를 이용한 온라인 원격 진료 서비스가 논의되고 있는 시점에 맞춰 환자에게 적합한 의료기관을 매칭하는 개인 맞춤형 의료서비스 지원 시스템을 제안한다. 본 시스템을 설계하기 위해 개인 맞춤형 의료서비스 지원 시스템의 요구사항을 파악하여 데이터를 표준화하였고 서버와 클라이언트 구조로 아키텍처를 설계하였다. 또한 설계한 시스템을 구현하기 위해 서버와 클라이언트, 온톨로지 저장소의 구조를 정의하고 시스템을 구현하였다. 본 논문에서 설계 및 구현한 개인 맞춤형 의료서비스 지원 시스템을 테스트하기 위해 가정 사항과 시나리오를 작성하여 테스트를 수행한 결과 환자 증상을 선택하면 선택된 증상별로 진료과가 추론이 되고 환자가 원하는 의료기관의 항목에 따라 1차 추론되 진료과에 맞는 의료기관이 추론이 되는 것을 확인하였다.

제2형 당뇨병 환자의 신체활동이 혈당조절에 미치는 영향 (Effects of Physical Activity on Glycemic Control in Type 2 Diabetics)

  • 최은진
    • 성인간호학회지
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    • 제23권3호
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    • pp.298-307
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    • 2011
  • Purpose: The purpose of this study was to examine the effects of physical activity on glycemic control among Koreans with type 2 diabetes. Methods: A total of 215 patients with type 2 diabetes (82 male and 133 female) were recruited (mean age = $59.0{\pm}9.7$ years). The amounts of physical activity was assessed using the physical activity scale for elderly (PASE). Fasting blood glucose (FBG), Hemoglobin A1c ($HbA_1c$), and 2 hours post-prandial glucose (2hrPG) were measured. Results: The highest PASE score was housework-related physical activity. However, the amounts of walking was significantly higher in good FBG level (Z = 1.39, p=.041) and the amounts of leisure-time physical activity was higher in good HbA1 and 2hrPG level than in the poor glycemic control group (Z = 2.29, p<.001; Z = 1.99, p=.001). A logistic regression analysis showed that patients with leisure-time physical activity in the top quartile more likely presented with good glycemic control in $HbA_1c$, OR=3.84 (95% Confidence Interval (CI) = 1.65~8.95) and in 2hrPG, OR=4.06 (95%CI = 1.77~9.27), compared to patients in the lowest quartile. Conclusion: Leisure-time physical activity is effective for controlling the glucose levels, especially $HbA_1c$ and 2hrPG among type 2 diabetic patients. It is suggested that health providers need to more focus on providing aggressive recommendations on physical activity considering physical activity patterns by individuals.