• 대한유전성대사질환학회지
• /
• 제14권1호
• /
• pp.1-9
• /
• 2014

Many inborn errors of metabolism can be completely cured with early detection and early treatment. This is why neonatal screening on inborn errors of metabolism is implemented worldwide. In 1991, the Ministry of Health & Social affairs adopted a nationwide service program for neonatal screening of phenylketonuria, galactosemia, maple syrup urine disease, homocystinuria, histidinemia and congenital hypothyroidism for newborns delivered from low class pregnant women registered in health centers. Government decreased the test items from six to two, PKU and congenital hypothyroidism to increase test numbers with same budget from 1995. 78 laboratories wanted to participate for neonatal screening test in 1999. Government decided to screen six items of PKU, congenital hypothyroidism, maple syrup urine disease, homocystinuria, galactosemia and congenital adrenal hyperplasia from 2006. In 2014, thirteen laboratories are participating. Inter laboratory quality control was started 6 times a year from 1994. In case a patient with an inherited metabolic disease is diagnosed by screening of government program, special milk is provided at government's expense. According to the government project, from 1997 to 2013, 7,080,569 newborns were screened. 144 PKU, 2.451 congenital hypothyroidism were detected. So incidence of PKU is 1/49,170 and congenital hypothyroidism is 1/2,888. The cost benefit of performing screening procedures coupled with treatment has been estimated to be as high as 1.77 times in PKU, 11.11 times in congenital hypothyroidism than cost without screening. By January 2007, many European countries had expanded of their newborn screening programs by inclusion of Tandem mass spectrometry. We are trying to increase the budget to test all newborns for Tandem mass spectrometry from 2016. We are considering four to five central laboratories which cover all newborns and are equipped with tandem mass spectrometer & enzyme immunoassay for TSH, 17OHP & enzyme colorimetric assay for galactose. And I hope to expand test including Wilson disease screening test and lysosomal storage diseases.

• 한국IT서비스학회지
• /
• 제16권3호
• /
• pp.17-45
• /
• 2017

Health Information Exchange (HIE) is expected to improve the quality and efficiency of care by allowing providers online access to healthcare information generated by other providers at the point of care. However, the adoption of the technology in Korea has been slow since its pilot program in 2007~2010 at Seoul National University Bundang Hospital. The objective of this study was to survey stakeholders on the incentive program for the facilitation of HIE adoption. We surveyed 39 experts representing 6 categories of stakeholders-provider, insurer, government, information service firms, customers, and medical informatics experts for the interviews. Interview questions included program objectives, program participation requirements, incentive payment method, and administrative burden for program participation. Experts indicated that the quality of care was the most important value the program should aim to achieve through the HIE adoption. They suggested that the requirements and administrative burden for participation should be kept at minimum to recruit a large number of providers to the program, which is an indicator of program success. Experts were divided on the payment method whether the incentive should be paid as a part of the fee payment scheme operated by the National Health Insurance (NHI) or should be a payment made independent of the NHI. The source of the divide was conflict of interest among stakeholders as to who pays for the program, and the insurer and consumer groups were against the NHI taking the financial burden. It appeared to be the most significant factor for the successful program launching to resolve the gap in perceptions about benefits of the technology among stakeholders and to win the willingness to pay for the program.

• 대한간호학회지
• /
• 제43권3호
• /
• pp.420-430
• /
• 2013

Purpose: The aim of this study was to review the literature to determine whether intensive pelvic floor muscle training during pregnancy and after delivery could prevent urinary and fecal incontinence. Methods: Randomized controlled trials (RCT) of low-risk obstetric populations who had done Kegel exercise during pregnancy and after delivery met the inclusion criteria. Articles published between 1966 and 2012 from periodicals indexed in Ovid Medline, Embase, Scopus, KoreaMed, NDSL and other databases were selected, using the following keywords: 'Kegel, pelvic floor exercise'. The Cochrane's Risk of Bias was applied to assess the internal validity of the RCT. Fourteen selected studies were analyzed by meta-analysis using RevMan 5.1. Results: Fourteen RCTs with high methodological quality, involving 6,454 women were included. They indicated that Kegel exercise significantly reduced the development of urinary and fecal incontinence from pregnancy to postpartum. Also, there was low clinical heterogeneity. Conclusion: There is some evidence that for antenatal and postnatal women, Kegel exercise can prevent urinary and fecal incontinence. Therefore, a priority task is to develop standardized Kegel exercise programs for Korean pregnant and postpartum women and make efficient use of these programs.

• 디지털융복합연구
• /
• 제13권5호
• /
• pp.111-118
• /
• 2015

컴퓨터에 전자적 형태로 저장된 의무기록인 EMR의 표준화에 대한 논의가 활발하다. 이는 EMR 표준화를 통해 의료 서비스의 향상을 기대할 수 있을 뿐만 아니라, 의료와 IT의 융합영역인 의료 빅데이터의 가치가 점차 높아지고 있기 때문이다. EMR 표준화와 관련한 주요 이슈 중 하나는 EMR 표준화의 필요성과 효과성을 이해관계자들에게 설득시키는 일이다. 연구자는 EMR 표준화에 대한 의사들의 인식을 기술 관점과 경제적 관점에서 살펴보고자 설문조사를 실시한 후 이에 대해 통계분석을 실시하였다. 실증분석 결과, EMR 시스템의 기능 품질과 경제적 가치는 EMR 표준화에 대한 유용성 인식과 수용 의도에 정(+)의 영향을 미치는 반면, 상호운용성은 유용성 인식에만 영향을 미치는 것으로 나타났다. 또한, 경제적 가치가 EMR 표준화 필요성에 대한 공감대 형성에 가장 중요한 변수로 확인되었다.

• 대한물리치료과학회지
• /
• 제9권4호
• /
• pp.63-72
• /
• 2002

Patient satisfaction is an important factor in evaluating the quality of care. Patient satisfaction may be used to evaluate provider services and facilities, and used to predict the patient returns to a facility. The patients d whether the patient returns to a facility or whether the patient recommends the facility to other people may be affected by a variety of factors of patient satisfaction. Low satisfaction may result in poor compliance with the potential of waste of resources and suboptimal clinical outcome. This study is to identify factors of patient satisfaction that will affect patients decision whether the patient returns or not. A self-administered questionnaire survey was conducted in Seoul, Chung-Joo and Bu-Cheon cities, Survey data was obtained from 743 patients who visited the physical therapy practice at university hospitals, general hospitals and clinics. Response rate was 94.4%. The instrument developed by Goldstein et al. (2000) was used and translated into Korean. Several items were added to the instrument. Patient's opinions of service in each domain measured using 5-point Likert-type scales that ranged from strongly disagree to strongly agree. A multiple-regression analytic approach was used to predict overall satisfaction of physical therapy. Age, kindness, scheduling, convenience of parking, privacy, and waiting time predicted the overall satisfaction of physical therapy. The older patients had higher level of satisfaction with physical therapy compared with the younger patients. Patient satisfaction were more affected by access (scheduling and waiting time), administrative technical management (convenience of parking), and interpersonal management (kindness of physical therapists and other staffs) than clinical technical management (physical therapists' skills).

• 대한물리의학회지
• /
• 제5권2호
• /
• pp.165-172
• /
• 2010

Purpose : The purpose of this study was to investigate curriculums of physical therapy education. Methods : We identified the curriculums of physical therapy education by internet. Results : In Korea, education on physical therapy started as a two-year program in 1963, and recently reorganized as three or four years programs. Currently some ten schools offer physical therapy programs for master's and doctor's degrees. The member countries of the World Confederation for Physical Therapy (WCPT) provide approximately ten types of education programs that take two to six years. In Korea, the same programs have three or four years of education periods. The American Physical Therapist Association (APTA) launched on the doctor of physical therapy (DPT) course in the late 1990s, encouraging physical therapists to acquire a doctorate degree. In addition, the U.S. Vision 2020 envisions that all physical therapists acquire DPT by the year 2020. As the medical field becomes more professional and specialized, physical therapists are expected to supplement and even replace works of doctors, instead of merely assisting them. It is necessary to reinforce education programs and improve related school systems to enhance status of physical therapist in accordance with the changing social needs and to provide quality service to patients. Conclusion : We suggest to change the curriculum of Korea. It is more accurately reflected the scope, depth, breadth, and rigor of the high-quality education preparation needed for current and future practice.

• 한국의료질향상학회지
• /
• 제27권1호
• /
• pp.10-19
• /
• 2021

Purpose: This study was designed to investigate that the prevalence of Post-traumatic stress disorder (PTSD) and occupational environmental factors that contribute to the developing of PTSD in workers who worked in emergency room in Korea. Methods: This study is a multicenter cross-sectional study that was conducted in three emergency rooms. Data was collected by self-response method through questionnaire. The Impact Event Scale-Revised was used to screen the high-risk group of PTSD. Univariate and multivariate regression analysis was used to identify the factors associated with the developing of high-risk group of PTSD. Results: Total 211 subjects responded to the questionnaire. Of these, 170 subjects experienced psychological trauma event (PTE) in the working environment. And 60 subjects classified as high risk group of PTSD, so a prevalence of high risk group for PTSD was 28.4%. Factors related to the high risk group of PTSD were the frequency of psychological trauma events experienced over the past 1 year and the high score of QIDS-SR16. Conclusion: The prevalence of high risk group for PTSD among emergency room workers in Korea is very high. This may adversely affect the safety of patients, so early screening and intervention are necessary.

• 재활치료과학
• /
• 제12권2호
• /
• pp.55-68
• /
• 2023

목적 : 본 연구는 뇌성마비 아동에게 시지각 중재를 적용한 연구들에 대해 체계적으로 고찰하여, 시지각중재의 효과에 대해 분석하고자 한다. 연구방법 : 데이터 베이스는 PubMed, EMbase, Science Direct, ProQuest, Koreanstudies Information Service System (KISS), Research Information Sharing Service (RISS), 국회도서관을 사용하였다. 키워드는 뇌성마비, 시지각, cerebral palsy, CP, visual perception을 사용하였다. PRISMA Flowchart에 따라 2012년 1월 1일부터 2022년 3월 30일까지 게재된 연구 중에서 10편을 선정하였다. 선정된 연구들의 질적 수준, 연구 대상자의 인구학적 특성, 중재의 효과, 중재의 영역과 전략, 중재의 효과를 측정하기 위한 평가도구, 비뚤림 위험에 대해 분석하였다. 결과 : 선정된 모든 연구에서 시지각 중재가 시지각 기능 증진에 효과적임을 확인하였다. 또한 시지각중재는 시지각 기능뿐만 아니라 상지기능, 일상생활활동, 자세조절, 목표달성, 심리사회 영역에서도 긍정적인 결과를 나타냈다. 눈-손 협응 영역은 모든 연구에서 중재되었다. 결론 : 시지각 중재 시 시지각 기능을 영역별로 평가하고, 개인별 체계적으로 단계화된 맞춤 중재를 적용해야 한다.

• 대한영양사협회학술지
• /
• 제19권3호
• /
• pp.265-286
• /
• 2013

The present study was conducted to develop a standardized job description for clinical dietitians working in hospitals. A developing curriculum (DACUM) method was used for the job analysis of clinical dietitians. Based on DACUM analysis with 14 members, including clinical dietitians and professors majoring in clinical nutrition and job analysis, information on the duties, tasks, and task elements of clinical dietitians was determined. To verify the job descriptions derived from DACUM analysis, a total of 46 tertiary and general hospitals with over 500 beds were recruited for the survey. The final developed job description for clinical dietitians included 7 duties, 27 tasks, and 93 task elements. The duties consisted of nutritional assessment, nutrition diagnosis, nutrition intervention, nutrition monitoring evaluation, consultation cooperation, nutrition research, and self-development. The mean scores of perceived importance, performance, and difficulty on the clinical dietitian's task elements (out of a maximum score of 5.0) were 4.5, 3.7, and 3.5, respectively, with significant differences between the items (P<0.001). The perceived importance and performance grid of clinical dietitian's tasks showed that "construction and maintenance of collaboration" (E2) and "activity of quality improvement" (F1) received relatively low scores for performance despite their high importance scores; thus the performance of these tasks requires significant improvement. In conclusion, the job descriptions of clinical dietitians developed from this study are useful for the qualitative improvement of clinical nutrition services in hospitals.

• 한국콘텐츠학회논문지
• /
• 제16권1호
• /
• pp.708-719
• /
• 2016

본 연구는 지역 종합병원 간호사의 감정 노동과 직무만족, 그에 따른 이직의도를 파악하여 감정노동 수준을 낮추고, 직무만족을 높여 이직의도를 감소시키면서도 효율적인 인사관리를 하여 질적 간호를 제공하기 위해 시행되었다. D시에 소재하는 종합병원에 간호사 중 참여에 동의한 대상자 100명을 편의 추출하여 2015년 4월 6일부터 4월 12일까지 설문지를 이용하였으며, 분석 방법으로 t-test, ANOVA, Pearson's correlation 을 사용하였다. 본 연구의 감정노동 평균 점수는 $3.37{\pm}.85$, 직무만족 평균 $2.86{\pm}.66$, 이직의도 평균 $3.47{\pm}.87$로 측정되었고, 감정노동은 직무만족과는 음의 상관관계(r=-.56, p<.001), 이직의도와는 양의 상관관계(r=.67, p<.001)를 보였으며, 직무만족은 이직의도와 음의 상관관계(r=-.64, p<.001)를 보였다. 본 연구 결과에 따라 병원 조직에서 중요한 위치인 간호사의 감정노동 수준을 낮추고, 직무만족을 높일 수 있는 제도적 방안 검토가 요구되며, 또한 간호사 사기를 충족시켜 질 높은 간호 서비스를 제공할 수 있도록 근본적 문제해결을 위한 적극적인 노력이 필요하다.