• 제목/요약/키워드: Medical autonomy

검색결과 176건 처리시간 0.023초

우리나라 전문간호사제도 개선방안에 관한 연구 (A Study on the Establishment of Clinical Nurse Specialist)

  • 변영순;김영임;송미숙
    • 지역사회간호학회지
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    • 제5권2호
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    • pp.130-146
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    • 1994
  • Our medical care system is trying to diversify in order to meet the client's needs, and to adjust to a medical environment which is changing very rapidly. Because current nursing theory and practice focus on holistic care, health care management, education, and research, contrary to the traditional emphasis on only assisting a physician, more autonomy and specialization for the implementation of nursing are required. Considering these trends and actual needs, the category of clinical nurse specialist should be established as soon as possible. In order to develop strategies for implementing this new professional specialty, the authors conducted a field survey and literature review of the current system in Korea. As a result, various obstacles and constraints were discovered as follows : 1) There are few accredited educational programs for the training of CNS's. 2) Several hospitals already have staff designated as clinical nurse specialist (CNS) even though the term CNS is not yet standardized or adopted in nationwide. 3) The role of the CNS is not clearly understood by the medical societies, or even nursing societies. A nurse who works in specific nursing areas such as central supply, kidney dialysis, intensive care, coronary care, etc. for a long time, considers herself /himself a CNS. Based upon the above findings, the following alternatives are recommended. 1) The role of the CNS should be defined according to specified functions and authority : professional autonomy ; counselling and educating patients and their familes, nurses, and even other medical personnel ; research on improvement of nursing ; and management of the nursing environment including medical resources, information, and cases. 2) the qualification of CNS should be attained only by a nurse who has an RN license and clinical experience of more than 3 years in a specific nursing field: passes a qualifying examination; and contributes to the professional development of peers, colleagues, and others. A master's degree should only be optional, because of the insufficient of graduate programs which are well designed for the CNS. 3) The CNS should initially be a head nurse rather than line staff in order to deal with as wide an experience base as possible. 4) The nursing specialty could be divided into two areas such as a clinical field and a community field. The clinical field could then be categorized by the Styles' classification such as diseases and pathogenics, systems, ages, acuity, skills/techniques, and function/role ; the community field could be classified according to work site.

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보건의료영역 사회복지사의 전문직 공동체의식과 참여의식에 대해 조직 관리적 요인이 미치는 영향 (Managerial Factors Affecting the Community Spirit and Participation of Medical and Psychiatric Social Workers)

  • 김동원;조남신
    • 한국병원경영학회지
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    • 제18권2호
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    • pp.104-126
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    • 2013
  • The goal of the study is to find what managerial characteristics affect the community spirit and participation of medical and psychiatric social workers. To do this, managerial characteristics were divided into organizational structure and culture as well as job satisfaction. As a result of an empirical study, while Herzberg's motivators or mental rewards, such as autonomy, sense of accomplishment, and sense of respect, improved the levels of community spirit and participation, Herzberg's hygiene factors or economic rewards did not have any relationship with them statistically. This means that mental rewards equivalent to those of other professions in hospitals will improve the professional identity and activities of social workers, who are working with diverse professions in hospitals. On the other hand, organizational structure and culture were not significant statistically.

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충북지역 물리치료사의 직무만족도에 관한 연구 (A Study on the Job Satisfaction of Physical Therapist's in Chungbuk)

  • 박성하;정한신;최원호
    • The Journal of Korean Physical Therapy
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    • 제14권4호
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    • pp.214-223
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    • 2002
  • The purpose of this study was practiced to investigate factors affecting physical therapist's job satisfaction. The data were collected from September 15, 2002 and 113 valid questionnaires were obtained and analyzed. They were analyzed by the percent, frequency, T-test, one-way ANOVA and Pearson correlation coefficiency The results of the study were as follows: The average marks by their job satisfaction factors indicated 3.09 for professional status, 3.22 for task requirement, 3.62 for pay, 2.96 for physical therapist-doctor relationship, 2.96 for administration, 2.89 for autonomy. There were statistically a difference of the professional status, pay, administration, in their age. There were statistically a difference of the professional status in total career, marriage presence. There were statistically a difference of the professional status, task requirement in total career.

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군진의학 연구에서 인간대상 연구윤리 (Ethics Involving Human Subject Research in Military Medicine)

  • 권복규
    • 대한기관윤리심의기구협의회지
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    • 제4권2호
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    • pp.23-29
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    • 2022
  • The goal of the military medicine is not as same as that of the civil medical practice, and consequently the characteristics of military biomedical researches have their own uniqueness. In front of the prerogative of national defense, some of the human rights ordinarily ensured in normal researches with human subjects are not to be fully guaranteed. The hierarchic system of the military would complicate the issue when the soldiers are enrolled as human subject for the research. Some researches could be classified as a military secret, therefore, the confidentiality issues need to be well addressed. Institutional Review Board and review procedure should be modified for the military purposes. So, it is necessary to establish the appropriate regulatory system for the military biomedical researches with human subject to manage the complicated issues involved in them.

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대학병원 간호사들의 직무스트레스와 피로수준과의 관련성 (Relationship Between Job Stress and Fatigue Symptoms Among Nurses in a University Hospital)

  • 김순영;권인선;조영채
    • 한국산학기술학회논문지
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    • 제13권4호
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    • pp.1759-1768
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    • 2012
  • 본 연구는 한 대학병원에 근무하고 있는 간호사들의 피로수준을 파악하고, 인구사회학적 특성, 건강관련행위 특성, 직업관련 특성 및 직무스트레스 내용과 피로수준과의 관련성을 규명하고자 하였다. 조사대상은 대전광역시의 한 대학병원에 근무하고 있는 전체 간호사 726명을 대상으로 계통추출법에 의해 추출한 450명으로 하였으며, 조사는 2010년 10월 1일부터 10월 31일까지의 기간 동안에 구조화된 무기명 자기기입식 설문지를 이용한 설문조사에 의하였다. 연구 결과, 조사대상자의 피로수준의 분포는 정상 군이 75.1%, 고위험 피로 군이 24.9%이었으며, 직무스트레스 내용별 고위험피로수준의 분포는 업무요구도가 높을수록, 업무의 자율성이 낮을수록, 상사의 지지도가 낮을수록 유의하게 높았다. 또한 피로수준은 업무요구도와 유의한 양의 상관관계를 보인 반면, 업무의 자율성, 상사의 지지도와는 유의한 음의 상관관계를 보였다. 로지스틱 회귀분석 결과, 다른 변수를 통제한 다변량 모델에서 업무요구도는 가장 낮은 군(Q1)에 비해 높은 군(Q3, Q4)에서, 고위험 피로 군에 속할 위험도가 유의하게 증가한 반면, 업무의 자율성은 가장 낮은 군(Q1)에 비해 높은 군(Q3, Q4)에서 고위험 피로 군에 속할 위험도가 유의하게 감소하였다. 결론적으로 조사대상 간호사들이 경험하는 직무스트레스 내용은 독립적으로 피로수준에 영향을 미치는 요인임이 확인되었다.

지방의료원장의 의사결정 유형, 공공 기업가정신 및 경영성과 (The Decision-Making Types, Public Entrepreneurship and Performance Management of Local Public Hospital Directors)

  • 이정우;김노사
    • 보건의료산업학회지
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    • 제12권1호
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    • pp.1-11
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    • 2018
  • Objectives : The purpose of this study was to identify the relationship between decision-making types, public entrepreneurship, and performance management of local public hospital directors. Methods : A questionnaire survey was carried out to assess the dependent variables of directors' decision-making types and public entrepreneurship. The analysis of management performance was carried out through a comparison between 2016 results of, data of variation rate on medical revenue and change rate on medical profit and results in 2015. Results : Results indicated that local public hospital directors who used rational decision-making showed better performance management. The analysis showed that enterprise had a greater positive effect (+) on variation rate of medical revenue than that of innovation. However, innovation had a higher positive effect (+) on change rate of medical profit than that of enterprise. These results suggest that innovation and enterprise have a major influence on performance management. Conclusions : The survey used for this study suggests that an education and training program is needed to improve public hospital directors' ability for rational decision-making, public entrepreneurship and performance management. Additionally, the policy change guaranteeing autonomy within the proper range is demanded that Local Public Hospital Director having spirit of innovation and enterprise achieves peak capacity and have responsibility for management.

Overcoming Barriers to Research Competency: a nationwide mixed-method study on residency training in the field of Korean medicine

  • Min-jung Lee;Myung-Ho Kim
    • 대한약침학회지
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    • 제27권2호
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    • pp.142-153
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    • 2024
  • Objectives: This study aimed to analyze the educational needs of interns and residents in Korean medicine as the first step in developing an education program to improve their research competencies. Methods: A mixed-method design, incorporating both quantitative and qualitative data collection methods, was used to investigate the educational needs for research competencies among interns and residents working in Korean medicine hospitals nationwide. Data were collected through online surveys and online focus group discussions (FGDs), and processed using descriptive statistical analysis and thematic analysis. The study results were derived by integrating survey data and FGD outcomes. Results: In total, 209 interns and residents participated in the survey, and 11 individuals participated in two rounds of FGDs. The majority of participants felt a lack of systematic education in research and academic writing in postgraduate medical education and highlighted the need for nationally accessible education due to significant disparities in the educational environment across hospitals and specialties. The primary barrier to learning research and academic writing identified by learners was the lack of knowledge, leading to time constraints. Improving learners' research competencies, relationship building, autonomy, and motivation through a support system was deemed crucial. The study also identified diverse learner types and preferred educational topics, indicating a demand for learner-centered education and coaching. Conclusion: This study provides foundational data for designing and developing a program on education on research competencies for interns and residents in Korean medicine and suggests the need for initiatives to strengthen these competencies.

장기공여를 위한 사전동의의 생의윤리학적 고찰 (A Bioethical Study of the Informed Consent for Organ Donor)

  • 엄영란;한성숙
    • 간호행정학회지
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    • 제4권2호
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    • pp.475-487
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    • 1998
  • This is a study to search for the ethical basis for valid informed consent of organ donors. It is an admirable action that a person give his own body part or organ as a gift to another person. The organ for transplantation can be removed only when the donor consents voluntarily to donation. It is recently proposed as the need for organ transplantation is increased that organs can be harvested although the consent of deceased cannot be obtained. This may raise many moral issues because human beings all have an unalienable right to control their own bodies. The principle of autonomy is usually regarded as an ethical basis for informed consent. However, some people criticize that the principle of autonomy requires a person and his decision to be autonomous (but there are many patients who aren't autonomous due to their confusion or unconscious condition in a clinical situation). or this principle can foster indifference to patients needing help: thus respect for principles of care and beneficence is necessary. When we consider the complexity of making a decision about organ donation. the principle of autonomy should be replaced by the principle of respect for individual autonomy. as expressed by Childress (1990). This principle requires the care givers to respect the client's individual decisions. The elements of informed consent are threshold elements: competence to understand and decide. voluntariness in deciding: information elements: disclosure of material information. recommendation of a plan. understanding of disclosure and recommendation: and consent elements: decision in favor of a plan. authorization of the chosen plan. In cases of living donors. the elements of competence and voluntariness are more important than the others. So only an adult can give a recipient his own body part. but it should be forbidden to harvest from minors or protected adults (i.e. developmentally disabled person However. when organs are removed from a cadaver donor. we ought to respect the donor's decision. So we ought to try to seek donor cards or any documents expressing the donor's opinion about organ transplant. All health care givers ought to disclose donor information about organ transplantation clearly enough for the donor to understand it and to be able to weigh the harms and benefits. We are going to propose 'the subjective standard' as the ethical standard of disclosure. This standard will assure that patients have enough information to be able to decide autonomously from their own position. Care givers have to consider the method of disclosure because donors can be influenced by it positively or negatively, Establishment of the Hospital Committee is recommended. because medical professionals will have a chance to discuss the procedure of decision and the validity of harvesting a organ from a person.

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의대생의 전문직 사회화 과정에 대한 고찰 (Professional Socialization of Medical Students)

  • 한달선;조병희;배상수;김창엽;이상일;이영조
    • Journal of Preventive Medicine and Public Health
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    • 제29권2호
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    • pp.265-278
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    • 1996
  • This paper concerns professional socialization of medical students. Professional socialization, in the context of this paper, means the process through which a layperson becomes a doctor equipped with professional identity and values. While medical education does not include such process in the curriculum, medical students obtain certain values and identity informally. The dependent variables were professional values and professionalism. The former means the desirable attributes required to conducting professional works such as humane attitudes, science-oriented mind, capability for organizational management. The latter means socio-political reasoning with which doctors can rationalize their privileges such as autonomy. A specially designed questionnaire was developed. The data were collected from five medical schools for 1,318 students in 1994. A total of 1,070 cases were finally included in the statistical analysis. The students emphasized the human factor in the professional values. Their attitude did not change with the grade. Other independent variables such as motives for entering a medical school, socioeconomic status, satisfaction with medical education, etc. also did not influence professinal values. It implies that professional values were not consolidated among the students. However, the factors of professionalism change significantly with the grade. It implies that the students paid more attention to socio-political issues related to doctor's interests as the grade went up. And the factor scores for professionalism were higher for those students who had more positive attitude towards doing medical practice for profit, expected higher income, and were more conservative about social reform. Other independent variables did not influence professionalism. It seems that the students also give emphasis on professionalism, like current medical doctors, mainly because of their concern with recent unfavorable changes in economic conditions of medical care providers.

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의료시장 변화에 의한 의료기사의 법률적 정의와 시대적 요구에 관한 연구 (A Study on the legal definition and the demands of the times of a medical technician according to changes in the medical market)

  • 김정호;한만석;김창규;서선열;김갑중;배석환;김용균
    • 디지털융복합연구
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    • 제19권11호
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    • pp.397-406
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    • 2021
  • 국내 의료기사 등에 관한 법률에서 의료기사는 의사 또는 치과의사의 지도 아래 업무를 행하는 것으로 되어있다. 하지만 실제 업무행태 및 국내외적 경향, 그리고 의료기사의 교육 수준을 고려한다면 전문성을 인정해주어야 한다. 이러한 전문적이고 독립적인 운영시스템은 의료기사의 자율성을 보장해주어야 하며, 법률적으로도 변화가 필요하다고 할 수 있다. 즉, 우수한 교육과정과 많은 나라에서 "요청", "협조" 등의 개념을 적용하는 시대적 요구에 따라 "지도" 보다는 "의뢰 및 처방"으로 변경이 필요하다. 이러한 변화는 시대적 요구라 할 수 있고 의료서비스의 향상, 그리고 사회적 기여를 위한 변화라고 할 수 있다.