The concept of expectation rights considers 'the expectation' that the patient should be given proper medical treatment as the benefit and protection of the law, so it would be the benefit and protection of the law due to personal rights different from 'the legal principle that has the possibility to a considerable extent' being in an extension of life and body. However, the problem how the patient's expectation of medical service sets up in order to make it the benefit and protection of the law would be still left in the vague concept of the patient's 'expectation', thus, in the first place, the medical practice following formed medical standard in every particular medical institutes should be the standard because these medical services are normally within a range of the patients' expectations. In addition, it should be naturally constituted as mental profit to get the subjective circumstances such as 'the patient's expectation' to be an object, and also, different from the profit and protection of the law such as life and body that should be absolutely protected, the origin of violation behavior should be regarded simultaneously to define the denotation of expectation rights. Therefore, the expectation rights violations would be problematic in case it fails to reach the medical standard that is expected for common doctors to practice properly. This is the concept of expectation rights that gets subjective matters such as the patient's expectation to be objectivity as medical practices that can be expected by generalized abstract doctors. This standard should be defined as the minimum standard that is naturally expected for doctors to practice, different from medical standard that decides the level of doctors.
As the number of medical disputes regarding nurses has increased after medical disputes have increase, there is a need for a study on it. However, the legal relationship between nurses and patients has not yet been analyzed. Recently, the role and function of nurses are expanded according to the development of the science of nursing; moreover their activity and limitation of responsibility are also expanded. For this reason, the medical disputes regarding nurses have been increasing. However, the majority of these kind of dispute are just passed over because their practice is usually considered to be a mere action to assist doctor's role. In addition, nurse practice is not a secondary action of doctor's role, but forms part of a medical treatment. Of course, nurses handle many secondary tasks after doctors finish their medical treatment. But this is only part of the whole tasks of nurses. Furthermore, the general details of their medical treatment are not different from those of doctors because they also belong to the medical service personnel. Considering these features of nurse and the medical condition in South Korea, their task is becoming increasingly developed and specialized and they are also establishing their own field. With this stream of times, there is a growing interest in enacting a Nursing Practice Act, in other words, the independent law on nurse for the sake of patient safety and national health promotion. Then, their responsibility will distinctly be expanded as much more. That is, the time that nurses practice their medical care by following doctors' order and also pass over their responsibility to doctors is closed. Thus, this study examines the features and responsibilities of nursing practice, and discusses an institutional framework to efficiently cope with the legal disputes between nurses and patients. It aims to throw light on the decision making on nurse-patient disputes in future.
The rapid change of the health and medical environment and the globalization of medicine has driven doctors to converge and analyse of new and up-to-date medical information and decide to what to make decision for diagnosis and treatments in clinical practice. Medical environment goes with the changes with social environment such as rapid increase of aging population, changes of disease pattern, formation of new area of experts except doctors, government intervention for the medical system, medical insurance of the charges of medical treatment, a increased desire for human rights. These trends should be adopted rapidly to the education system for the students of medical school. The learning objectives of the preventive medicine was developed in 1995 and underwent necessary revision of the contents to create the first revision in 2006. However, the required educational contents of health promotion and disease prevention have been changed by the new trends of medical education such as PBL and integrated curriculum and the 2006 revision does not satisfy these needs. We formed a task force which surveyed all the Western and Traditional Korean medical colleges to describe the state of preventive medicine education in Korea, analyzed the changing education demand according to the change of health environment and quantitatively measured the validity and usefulness of each learning objective in the previous curriculum. With these results, for the good education for preventive medicine, each Traditional Korean medicine schools need more preventive medicine faculties and teaching assistants and opening of some required subjects such as Yangsaeng and Qigong. And future studies of the learning process and ongoing development of teaching materials according to the new learning objectives should be undertaken with persistence in order to ensure the progress of preventive medicine education.
Purpose: The appropriate duration for effective hospice care is estimated about 3 months. However, the length of hospice care of many hospice patients is mostly less than 1 months. This is too short for effective hospice care. Therefore we investigated the reason by clinical considuations include the length of hospie care, duration from diagnosed as terminatlly ill to refer to hospice, the recogntion of hospice of doctors, patients and familis. Methods: This study was designed to retrospective cohot study. The data was obtaind from 50 hospice patients those who died in hospital from July to September in 2003. Results: Out of 50 patient, 30 were male(60%). The median age wes 60years in males and was 61 years in femailes. The most prevalant cancer was colorectal cancer(9 patients, 18%), followed by hepatoma(8 patients, 16%), and stomach cancer(7 patients, 14%). The most prevalent symptom was pain(37 patients 74%) and most prevalant reason of admission was also pain(30 patients, 60%). The most prevalent physician specialty was general internal medicine(21 doctors, 42%), followed by oncology(19 doctors, 38%). The median days form diagnosed terminally ill to refere to hospice was 47 days. The median lengths of hospice care was 23 days and the median admission days was 17. Conclusion: We found that lack of recognition of hospice of doctors, patients and families made the lengths of hospice care too short. If the patient and family go to hospice just after diagnosed as terminally ill, they could get more effective hospice care. To resolve these problems, it is needed education for them constantly.
Objectives : This paper analyzes the new Majinhwiseong(麻疹彙成) manuscript discovered in Jeonju. The Majinhwiseong is a medical book specializing in measles co-authored in 1798 by Lee, Won-pung and three doctors from a middle class family. Until recently, the Handok (Korean-German) Medicine Museum copy was known to be the only existing version, but a new manuscript was recently discovered. Methods : The author, bibliography, organization, cited literature, and content of the book were studied. The contents of the Handok Museum of Medicine copy and other manuscripts were compared then reviewed. Results : 1. The book shows that middle class workers in the late 19th century were able to collaborate based on the results of their craft and form strong bonds. 2. The book was being prepared for publication in Pyeongan Gamyeong in December 1798, but failed to be published due to the sudden death of the Pyeongan-do governor. 3. For a correct understanding of this book, it is necessary to study the Handok Medicine Museum edition and the newly discovered manuscript (Jeonju edition) together. Conclusions : The two editions are of a different lineage. The Jeonju edition is overall more specific, while some parts are more detailed in the Handok edition. In conclusion, the Majinhwiseong is a book that was written by middle class doctors of late 18th century whose clinical experience was combined with Chinese medical theories. The book was specifically targeted to professional medical audiences.
Basic medical education is important for developing the competencies of medical doctors, and it includes basic biomedical sciences, preventive medicine, medical ethics, and clinical science. This study aimed to reveal the current status of the Korean Medical Licensing Examination (KMLE) regarding its evaluation of competencies in basic biomedical sciences. The basic medicine-related questions were screened and selected from the test forms of the KMLE (2016-2018) by personnel conducting basic biomedical science education, and the selected questions were analyzed by three independent groups of undergraduate students at Chonnam National University Medical School in terms of the learning outcomes of basic medical education. The study scope includes the proportion of basic medicine-related questions, which consist of basic medicine questions and basic medicine-related clinical medicine questions, its annual change, discipline distribution, and associated learning outcomes. The average proportions of basic biomedical sciences, preventive medicine and medical law, and clinical sciences were 2.3%, 5.8%, and 91.9% of all questions, respectively. The proportion of basic medicine-related questions, except those on preventive medicine and medical law, was 22.0% of the total, and questions on pharmacology and microbiology accounted for 83.0% of the basic medicine-related questions. The proportion of sub-enabling learning outcomes linked with basic medicine-related questions comprised 14.0% of the total outcomes for basic biomedical sciences and 30.4% for preventive medicine and medical law. It is concluded that the KMLE questions may not sufficiently cover the essential competencies of basic medical education for medical doctors, and the KMLE may need to be improved with regard to competencies in basic biomedical sciences.
Background: The purpose of this survey study was to understand how utilization of X-rays as an adjunct to Chuna manual therapy (CT) supports treatment, as assessed by Korean medicine doctors (KMDs). Methods: A survey was emailed to all 18,289 members of the Association of Korean Oriental Medicine (AKOM)to determine the implications of X-ray use in CT. Surveys were collected from September 22, 2017 to October 15, 2017. Results: Of the 18,289 KMDs 562 completed the survey. The implications of a radiological diagnosis (X-ray) with CT was assessed using 5 items in a questionnaire: time to diagnosis, accuracy of treatment, patient comprehension and satisfaction, CT effect, and safety of CT. Survey participants identified improvement in patient comprehension and satisfaction as the most important factor for X-ray use with CT, followed by increased safety of CT. From the determinant factors for selection of CT intensity and specific techniques, severity of clinical symptoms was shown to be the most influential factor. Degenerative changes of the spine and degree of spinal malposition were also reported to be highly influential. Conclusion: The KMDs' that participated in this study indicated that utilization of X-rays in conjunction with CT administration improved patient comprehension and satisfaction, and CT safety. Installation of radiological equipment in Korean medicine clinics where CT is provided may increase safety and patients' satisfaction.
Objectives: The purpose of this study was to investigate distribution of pattern identification by age in stroke patients. Methods: From 1 April, 2007 to 29 September, 2008, 903 patients within a month after onset of stroke were included. Stroke patients were interviewed by oriental medicine doctors who used standard operation procedures for this study. A questionnaire was completed by a question-and-answer form between patients and doctors after explanation of details to patients and patients' agreement given. Results: Distributions of pattern identification in stroke patients differed by age groups. Dampness-Phlegm pattern was more common in the younger group aged under 80 years, while Yin-Deficiency pattern was more common in the older group aged over 80 years. Conclusions: In this study, we found a character of distribution of pattern identification by age in stroke patients within one month after stroke onset. We have concluded that these differences should be considered in the management and treatment of stroke patients.
Objectives: Medical personnel are professionals subject to stressful situations and psychological distress. This case series reports the results of a mindfulness meditation program combined with digital health for medical personnel at a Korean medicine (KM) hospital. Methods: An online mindfulness program was implemented in 2022 to improve the mental health of nursing staff in a KM clinic. The online mindfulness program, which was supplemented based on previous results and limitations, was applied to KM doctors and nurses working at a KM hospital in this case series. An important difference from the existing case series was the introduction of a smartphone application that promoted the daily routine of meditation. A total of 7 medical personnel, including 4 doctors and 3 nurses, participated in the program. Results: After participating in the program, an increase in deep acting and a decrease in surface acting, which are aspects of emotional labor, were consistent with the results of a previous case series. However, the patterns of change in burnout and hwa-byung symptoms differed depending on the occupation of the participants. Participants' satisfaction with this program and the smartphone application and willingness to recommend it to colleagues were high. Conclusions: As this study was only a small case series, the author plans to continue to expand and improve the program based on the findings.
Objective: To check the status of traditional Korean medical doctors' medical services amid the continual increase in the number of traditional Korean medicine clinics. Methods: A survey of traditional Korean medicine clinics based on questionnaire sheets mailed to 4,200 out of 10,895 clinics, of which 465, or 11.0%, responded, in the June 1, 2008 to December 9, 2008 period. Results: 1. 65.6% of the traditional Korean responding clinics are doing business in a rented space; 92.1%of them are one-person institutions; 24.4% of them, i.e., the largest group of those surveyed, operate in a space sized 41 (123 $m^2$)~50 pyeong (150$m^2$). The number of sick beds installed in their facilities comes to 7.9 on average. 2. Concerning support staff, 190 of them (or 40.9%), i.e., the largest group of those surveyed, employ two people in this capacity. They generally comprise assistant nurses (48.7%) and others (47.6%). 3. The size of the space used by the clinics is showing a tendency to increase. The number of sick beds and support staff, including assistant nurses, reached a peak in 2006, and has been on the decrease since then. 4. The average number of on-days comes to six days a week among 92.6% of those surveyed. Their average daily service hours come to 9 hours and 33 minutes (from 9:17 am to 6:50 pm). 5. Per-patient service time: 14 minutes on average; per-patient acupuncture time: 18.8 minutes; per-patient moxa cautery time: 10.1 minutes per-patient; boil-cupping time: 5.7 minutes; per-patient physical treatment: 28 minutes. Conclusion: Periodical studies should be carried out concerning desirable ways of developing traditional Korean medicine clinics with the focus on the facilities, doctors' service hours, and types of service.
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