Objective : Due to the implementation of vaccinations and the development of therapeutic agents, the coronavirus disease 2019 (COVID-19) pandemic that started at the end of 2019 has entered a new phase. As a result, neurosurgeons should reconsider the way they treat their patients. As the COVID-19 situation prolongs, the change in neurosurgical emergency patients according to the number of confirmed cases is no longer clear. Outpatient treatment by telephone was permitted according to government policy. In addition, visits to caregivers in the intensive care unit were limited. Methods : The electronic medical records of patients who had been treated over the phone for a month (during April 2020, while the hospital was closing) were reviewed. Meanwhile, according to the limited visits to the intensive care unit, a video meeting was held with the caregivers. After the video meeting, satisfaction was evaluated using a questionnaire. Results : During April 2020, 1021 patients received non-face-to-face care over the telephone. Among the patients, no critical medical problem occurred due to non-face-to-face care. From July 2021 to December 2021, 321 patients were admitted to the neurosurgical intensive care unit and 107 patients (33.3%) including their caregivers agreed to video visits. Twice a week, advance notice was given that access would be made through a mobile device and the nurse explained to caregivers how to use the mobile device. The time for the video meeting was approximately 20 minutes per patient. Based on the questionnaire, 81 respondents (75.7%) answered that they agreed, and 26 respondents (24.3%) answered that they strongly agreed that was easy to communicate through video meetings. Fifty-two (48.6%) agreed and 55 (51.4%) strongly agreed that they were easy to understand the doctor's explanation. For overall satisfaction with this video meeting, three respondents (2.8%) gave 4/5 points and 95 respondents (88.8%) gave 5/5 points, and nine (8.4%) gave 3/5 points. Their reason was that there was not enough time. Conclusion : In situations where patient visits are limited, video meetings through a mobile device can provide sufficient satisfaction to caregivers. Telemedicine will likely become common in the near future. Health care professionals should prepare and respond to these needs and changes. Therefore, establishing a system with institutional support is necessary.
Journal of Korean Academy of Nursing Administration
/
v.2
no.1
/
pp.115-124
/
1996
This study was to analyze role conception and job satisfaction of clinical nurses by using questionnaire as designed by Corwin and Paula. For this study questionnaires from 422 nurses working at three university hospitals in Seoul were collected during September 11 to 24, 1995. Statistical analyses were done by the SPSS. The techniques used in this study inclued Chi-square test, Pearson correlation coefficients, t-test, ANOVA. For the reliability of the questionnaire, the Cronbach's alpha coefficient was calculated. The results of this study are as follows: 1. Role conception of the subjects Five Likert scale variables were used to measure role conception including professional aspect, task aspect, and bureaucratic aspect. The variables measured and their means are as follows; Total mean score for role conception was 4.2. Role conception from professional aspect(4.29); task aspect(4.18): bureaucratic aspect(4.09). 2. Job satisfaction of the subjects Five Likert scale variables were used to measure job satisfaction. The variables measured and their means are as follows; Total mean score for job satisfaction was 2.98. Job satisfaction from interaction (3.49): professinal status(3.19): autonomy(3.17): nurse-doctor relationship(2.90): task requirement(2.82): administration(2.32): salary (2.12). 3. The relationship between general characteristics and role conception. There were statistically significant differences in age(F=5.465, p<.000). merrital status(t=-2.70, p<.007), education(F=3.252, p<.022), work department(F=4.186, p<.003), work experience(F=4.457, p<.001), job position(F=8.141, p<.000). 4. The relationship between general characteristics and job satisfaction There were statistically significant difference In education(F=4.043, p<.003), work department(F=4.218, p<.002). job position(F=8.141, p<.000). 5. The correlation between role conception and job satisfaction It showed positive correlation that there was increased role conception, there was increased job satisfaction(r=.3092, p<.001). There were positive correlation in bureaucratic aspect, task aspect, and professional aspect in order.
Han Dong-Wook;Moon Tae-Ho;Lee Eun-mi;Jeon Sung-mi;Jung Won-Suck
The Journal of Korean Physical Therapy
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v.17
no.1
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pp.1-26
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2005
The most of patients and protectors point that the Home Visting Physical Therapy is necessary and compulsive. A Public Health Center and a Welfare Center have to help a home visiter for treatment cure to ask for professional medical services in general hospital. On getting a name lists of patients a treatment of doctors, they must remark the conditions of the patients to keep the mutual relation general hospital. A home visiting physical therapists in the welfare center and public health center need to discuss a main doctors in a same center for revaluation of patients. The system in a general hospital consists of the medical department and the administration with the doctor of hospital as the central figure. A department of home visiting physical therapy has a physical therapy team closely connected with various medical office in hospital. The system in a public health center is composed of the health executive office, health direction medicine office, and the community health office. Department of home visiting physical therapy belongs to community health office. Home visiting physical therapy in a welfare center belongs to home visiting service office. The qualifications of a physical therapist is intended for people who have received clinic experience of three years and regular education. The theory (352 hours) and practice (248 hours) total to 600 hours. They can develop professional skills through these education courses. The frequency of home visiting is proper third a week after talking with a medical attendant about the state of patient. The care time is proper from 30 to 60 minutes.
The pediatrics has other diagnosis and treatment compared with an adult. It is therefore, the children have different pathogenesis, pathology from adult's. The special feature of the children is two. Firstly, children are the body of the pure Yang[純陽之體], which means the growth and development of them are very fast. Secondly, they have weak muscle, skeletal and digestive function. So we must consider health-preserving method in different physiology and pathology aspects of the children. The children have weak digestive functions, so they should be careful to avoid eating greasy food and overeating. They must eat the nourishing Eum[滋陰] food. The children should wear thin clothes as possible. If the children wear clothes so thick, it promote the Yang (陽), so the Eum(陰) is hurted. The children are to be lack of Eum[陰不足], so they need to grow and raise the Eum(陰) in this way which the lower body is cool. Sleep is important ways to generate Eum Essence[陰精]. So the children should take a bed as change of the season. Children's muscles and skeleton are growing so incomplete that they are hard to handle Wind-Cold pathogen[風寒邪]. Therefore, the children should be training vital Essence and Gi(氣) with appropriate exercise. We should be careful treatment the Hwayeoljeung(火熱證) with purgation[瀉下] - bitter in taste and cold in nature[苦寒藥], aromatic herb[芳香性藥物], sudorific herb[發汗藥] In addition, child has weak digestive function, so doctor should not use a lot of nourishment[滋補].
The Journal of Korean Academic Society of Nursing Education
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v.14
no.1
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pp.98-107
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2008
Purpose: The purpose of this study was to provide basic data which is necessary for educating nursing and medical students for establishing a desirable sense of ethics values Method: In this descriptive research, a total of 140 nursing students and 124 medical students were selected. The tools used for data analysis were descriptive statistics, t-test, one-way ANOVA, and Scheffe test by using SPSS/WIN 12.0 version. Result: When the differences in the consciousness of biomedical ethics of nursing and medical students were compared, statistically significant differences were found in the category of brain death (t=-3.26, p=.001). Statistically significant differences were found in the general characteristics of religion (F=3.05, p=.018), and participation in religious activity (F=3.34, p=.006). Statistically significant differences were found in the characteristics related to the subjects' ethical values such as satisfaction level of a nurse/doctor (F=7.39, p=.000) occupation, the experience of A Patient's Bill of Rights (F=2.97, p=.020), the intention to attend biomedical ethics (F=5.61, p=.000), and the possibility of increasing ethical problems according to the development in the field of medical science (F=7.92, p=.000). Conclusion: An effort should be made to overcome the differences in the perception of biomedical ethics between nursing students and medical students. Moreover, when investigating the course of an integrated education for the establishment of a desirable sense of biomedical ethics, an alternative plan that could promote ethical values must be considered so that the significant variables can promote bioethical perception.
Health insurance fees are set by relative value scales and conversion factors. Since 2008 the conversion factor has been classified into 7 according to the provider type, and a separate contract has been made respectively. As such classification of the conversion factor reflects only the different characteristics of providers, however, further classification to reflect the different cost structures of providers is proposed. Cost varies according to the type of not only providers but also services each provider supply. In fact different cost structures of providers are the result of their different services. This study analyzed the cost structure of medical services to propose a new approach to the classification of the conversion factor. This study analyzed the cost structure of medical services using cost data constructed in the revision study of relative value scales. The cost data consist of doctor's fee, support staff's fee, cost of medical equipments, cost of medical supplies and indirect cost. The proportion of each cost component to the total cost was analyzed in terms of service department and service type. 72 service groups are defined in terms of the combination of service department and service type. Through cluster analysis, 72 service groups were reduced into 7 clusters each of which has a similar cost structure. Conversion factor is contracted annually to reflect the change in the cost of providing medical services. So the classification of conversion factor has to be based on the cost structures of medical services, not the characteristics of providers. Service clusters derived in this study can be used as a new classification for health insurance fee contract.
Jo, Hyun Kyo;Park, Jang Wan;Hwang, Jae Ha;Kim, Kwang Seog;Lee, Sam Yong;Shin, Jun Ho
Archives of Plastic Surgery
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v.41
no.5
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pp.505-512
/
2014
Background Laryngeal allotransplantation (LA) is a technique involving transplantation of a deceased donor's larynx into a recipient, and it may be substituted for conventional laryngeal reconstruction. There are widely different views on LA, as the recipient is administered continuous, potentially life-threatening, immunosuppressive therapy for a functional or aesthetic result, which is not directly related to life extension. The purpose of this study was to analyze the difference in risk acceptance and expectations of LA between four population groups. Methods A survey was performed to examine patients' risk acceptance and expectations of LA. The survey included 287 subjects in total (general public, n=100; kidney transplant recipients, n=53; post-laryngectomy patients, n=34; doctors, n=100), using a Korean translated version of the louisville instrument for transplantation (LIFT) questionnaire. Results All four groups responded differently at various levels of their perception in risk acceptance and expectations. The kidney transplant recipients reported the highest risk acceptance and expectations, and the doctor group the lowest. Conclusions This study examined the disparate perception between specific population groups of the risks and benefits of using LA for the promotion of the quality of life. By addressing the information gaps about LA in the different populations that have been highlighted from this survey, we suggest that LA can become a more viable alternative to classical surgery with resultant improved quality of life for patients.
Twenty-first century coming of health care in our country is in a situation of much conflict because the relationship between nurses and doctors is seen in terms of a traditional and vertical structure. Accordingly. it is very difficult to find collaboration amongst individuals of these two professions. Now nursing is trying to find independence and autonomy by carrying out independent professional skills. This study on collaboration and the obstacles hindering its pursuit. The strategies of collaboration to give better health care quality are as follows; First, a program for professionals should be developed to enhance professional knowledge and technology and train nursing professionals so that nursing can be acknowledged as a profession with a power to carry out on independent job. Second, collaboration reduces expenses and results in satisfactory performances of duty, high productivity, low incidence of medical accident, and higher satisfaction of the patient. Therefore the leader in the higher position should take positive stance for collaboration and help create a cooperative situation through the development of practical orders for collaboration. opening cooperative wards, and meeting for collaboration. Third, a collaboration model should be introduced into the courses of the nursing and medical school curriculum, which would influence job atmosphere after graduation. Fourth, nurses should have pride in their jobs as professionals and have confidence in their professional skill, knowledge and ability. Nurses should make an effort to share responsibility and have independence and autonomy. Fifth, common people as well as doctors know little about professional practice and the role of nurses, so a publicity campaign is also required.
Kim Hyung-Bae;Kwon Man-Jun;Cha Eun-Jong;Chun Myung-Geun
Journal of the Korean Institute of Intelligent Systems
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v.15
no.3
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pp.349-354
/
2005
In this paper, we propose a mobile telemedicine system that acquires more easily and analyzes individual's bio-signal using PDA. It is not easy for modern people who live busily, disabled patients, or old people to visit hospital. The major goal of this study is to implement the mobile telemedicine systems that the captured bio-signal from remote hospital or other medical treatment device is transmitted via Bluetooth module in ubiquitous environment, PDA with built-in Bluetooth module receives its data and displays on the screen in various form. By implemented systems, it is possible to compare current bio-signal with historical bio-signal and analyze bio-signal, and it is able to make a self diagnosis and it is available to be examined and treated remote diagnosis by sending stored bio-signal to a medical doctor.
Background: In South Korea, 22.3% of women ${\geq}50years$ of age and 37% of women ${\geq}70years$ of age visit the doctor to obtain treatment for osteoporosis. According to the analysis of the National Health Insurance Services claim data between 2008 and 2012, the number and incidence of hip and vertebral fractures increased during the same period. Denosumab, a newly marketed medicine in Korea, is the first RANK inhibitor. Methods: A cost-utility analysis was conducted from a societal perspective to prove the superiority of denosumab to alendronate. A Markov cohort model was used to investigate the cost-effectiveness of denosumab. A 6-month cycle length was used in the model, and all patients were individually followed up through the model, from their age at treatment initiation to their time of death or until 100 years of age. The model consisted of eight health states: well; hip fracture; vertebral fracture; wrist fracture; other osteoporotic fracture; post-hip fracture; post-vertebral fracture; and dead. All patients began in the well-health state. In this model, 5% discounted rate, two-year maximum offset time, and persistence were adopted. Results: The total lifetime costs for alendronate and denosumab were USD 5,587 and USD 6,534, respectively. The incremental cost-effectiveness ratio (ICER) for denosumab versus alendronate was USD 20,600/QALY. Given the ICER threshold in Korea, the results indicated that denosumab was remarkably superior to alendronate. Conclusion: Denosumab is a cost-effective alternative to the oral anti-osteoporotic treatment, alendronate, in South Korea.
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