• Journal of Korean Clinical Nursing Research
• /
• v.16 no.3
• /
• pp.73-84
• /
• 2010

Purpose: The purpose of this study was to investigate the ethical awareness and attitude of patients' families towards Do-Not-Resuscitate(DNR), and thus provide basic information required to develop Korean appropriate DNR instructions and practice informed consent for DNR. Methods: During April 2010, 219 patient family members visiting the hospital were surveyed using a questionnaire. Results: Most of the participants preferred DNR to meaningless treatment for incurable patients. They recognized the necessity of explaining DNR to the patient with a terminal disease. They also requested DNR orders for themselves if they were in the same medical condition. In making a DNR decision, the patient's family agreed and preferred that it reflect the opinion of the patient and the doctor in charge. They also agreed that treatment should be given with the best efforts even if a DNR decision had been made for the patient. Conclusion: To make a decision on DNR for a patient who is terminally ill or for whom survival is not possible, a practice of informed consent and guidelines for executing the DNR reflecting the patient's opinion are required.

• Journal of Korean Academy of Rural Health Nursing
• /
• v.18 no.1
• /
• pp.40-48
• /
• 2023

Purpose: This study is a descriptive research that analyzes the current status of education for COVID-19 response tasks and factors affecting work fatigue of primary health care practitioners who have experience in dispatching to respond to COVID-19. Methods: This study collected data through an online survey from September 21 to 29, 2022, targeting 193 primary health care practitioners. The data were analyzed by frequency, percentage, mean, standard deviation, and logistic regression analysis using the SPSS 25.0 program. Results: 74.1% of the study subjects were dispatched without receiving disaster medical training to respond to COVID-19. 59.6% of the study subjects' work fatigue was above the level of being very tired. The factors that affect the work fatigue of the subjects were disaster participation experience, work intensity, compensation regulations, compensation satisfaction, and understanding of COVID-19 guidelines. Conclusion: Based on the results of this study, an educational program for systematic disaster response and preparation for primary health care practitioners in charge of public health care should be developed to efficiently cope with the occurrence of new infectious diseases in the future.

• Journal of Physiology & Pathology in Korean Medicine
• /
• v.21 no.1
• /
• pp.347-351
• /
• 2007

This study was done to report the improvement of second case report form(CRF) and standard operating procedure(SOP) of Tentative Korean Standard Differentiation of the Symptoms and Signs for Stroke. We were in charge of developing case report form(CRF) and educating the investigators. In the process of this project, we needed to develop standard operating procedure(SOP) for this CRF. So we made Tentative Korean Standard Differentiation of the Symptoms and Signs for Stroke and tried clinical application at Department of Oriental Internal Medicine of Wonkwang University and Daejeon University in 2005. And in this pilot study we can find out some problems and need to improve it. We strengthen the incision and exclusion criteria of CRF We canceled the Chief complains entry for efficiency. We reflected the decision of Stroke standard committee. We reduced the differentiation index of CRF to promote efficiency and accuracy. We rearranged the order of the differentiation index to promote rationality and practicality. We regulated detail item belonging to Differentiation index. We used a colloquialism in question. We inserted flow chart in SOP. We inserted picture of diagnostic index.

• Journal of Korean Academy of Nursing
• /
• v.30 no.5
• /
• pp.1156-1169
• /
• 2000

The study was aimed at developing an independent hospice center model that would be best suited for Korea based on a literature review and the current status of local and international hospices. For the study, five local and six international hospice organizations were surveyed. Components of the hospice center model include philosophy, purpose, resources (workers, facilities, and equipment), allocation of resources, management, financial support and hospice team service. The following is a summary of the developed model: Philosophies for the hospice center were set as follows: based on the dignity of human life and humanism, help patients spend the rest of their days in a meaningful way and accept life positively. On the staff side, to pursue a team-oriented holistic approach to improve comfort and quality of life for terminally ill persons and their families. The hospice center should have 20 beds with single, two, and four bed rooms. The center should employ, either on a part-time or full-time basis, a center director, nurses, doctors, chaplains, social workers, pharmacists, dieticians, therapists, and volunteers. In addition, it will need an administrative staff, facility managers and nurses aides. The hospice should also be equipped with facilities for patients, their families, and team members, furnished with equipment and goods at the same level of a hospital. represented by a center director who reports to a board and an advisory committee. Also, the center director administers a steering committee and five departments, namely, Administration, Nursing Service, Social Welfare, Religious Services, and Medical Service. Furthermore, the center should be able to utilize a direct and support delivery systems. The direct delivery system allows the hospice center to receive requests from, or transfer patients to, hospitals, clinics, other hospice organizations (by type), public health centers, religious organizations, social welfare organizations, patients, and their guardians. On the other hand, the support delivery system provides a link to outside facilities of various medical suppliers. In terms of management, details were made with regards to personnel management, records, infection control, safety, supplies and quality management. For financial support, some form of medical insurance coverage for hospice services, ways to promote a donation system and fund raising were examined. Hospice team service to be provided by the hospice center was categorized into assessment, physical care, emotional care, spiritual care, bereavement service, medication, education and demonstrations, medical supplies rental, request service, volunteer service, and respite service. Based on the results, the study has drawn up the following suggestions: 1. The proposed model for a hospice center as presented in the study needs to be tested with a pilot project. 2. Studies on criteria for legal approval and license for a hospice center need to be conducted to develop policies. 3. Studies on developing a hospice charge system and hospice standards that meet local conditions in Korea need to be conducted.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.13 no.3
• /
• pp.1178-1185
• /
• 2012

The 4th year medical students were randomly divided and designated as group HF and LF, representing high and low fidelity simulations respectfully. Both groups performed OSCE on 2 topics(adult intubation and IV cannulation) with each composed of the same scenario. Each scenario was developed by a faculty in charge of clinical skill education with supervision from 2 other faculty members. High fidelity simulations were designed as in-situ simulations in real OR. Low fidelity simulations had the same scenarios but the environment was simulated only with a simple task trainer in the classroom. All students participated in series of survey using a Likert scale before and after the simulations. The provided data was anlayzed with paired T-test and Mann-Whiteney test(p<0.05). The post simulations self evaluation score for group HF was lower than pre-simulation self confidence score for both topics of adult intubation and IV cannulation where as for group LF, it was lower only for adult intubation(p<0.05). In group HF, the needs for clinical training on both topics increased after the simulation. In group LF, there was no significant change of needs for clinical training between pre and post simulation survey. This suggest that fidelity may be a helpful factor to improve the motivation of the students and further study on economical aspect should be addressed.

• The Journal of Korean Medicine
• /
• v.27 no.1 s.65
• /
• pp.204-219
• /
• 2006

Objectives : This study is to report the proceeding of the project sponsored by the ministry of science and technology of Korea for the stroke study titled as 'fundamental study for standardization and objectification of differentiation and pattern identification of symptoms of Oriental Medicine in stroke'. Methods and Results : We works for clinical research and molecular epidemiology center and we are in charge of the development of case report form, education of the investigators, data entry, data validation, and analysis. In the process of this project, we need to development of standard operating procedures for development and education for the case report form. Conclusions : This study is to let researchers for Traditional Korean Medicine and clinical research know how to develop of case report form and standard operating procedures in clinical researches and maintain the resource document and data.

• The Journal of the Korea institute of electronic communication sciences
• /
• v.7 no.2
• /
• pp.447-455
• /
• 2012

The present study was carried out with a view to examine the protective actions of physical and occupational therapists for patients's privacy. For this purpose, a survey was conducted with the questionnaires that were distributed to 297 physical and occupational therapists engaged in general hospitals as well as in rehabilitation clinics across the country from January 2 to 13, 2012. From the survey, it was made known that the overall extent of protective actions practiced by them was $3.54{\pm}.733$ in average. Divided by area, the average protective action in communication was $3.62{\pm}.776$, followed by $3.57{\pm}1.013$ in direct contact and $3.53{\pm}.780$ in maintenance and management, respectively. The analysis of general characteristics by each area showed that the older their age gets and the longer their career is, the more the protective action is practiced by them. Although they are well aware of the fact that the medical information of patients should be kept 100% secret and they practice it to almost excellent grade (5), the physical and occupational therapists, as key experts in charge of improving functions of patients, were found to have little concern for and little knowledge about contents of protecting medical information. It is thus required to perform public relation and instruction continuously to intensify their awareness of needs to protect patients' privacy and to implant ethical sense in this regard deep in their mind.

• Journal of the Korean Chemical Society
• /
• v.57 no.5
• /
• pp.634-639
• /
• 2013

The use of medical imaging has been increased for diagnosis of cancer or vessel disease. Among the medical imaging, computed tomography (CT) is one of the popular methods, however, which should need administration of contrast medium. Therefore, we developed gold coated liposomes (GCL) as a contrast medium. To coat gold on the liposomal surface, positive charged liposomes was prepared and then negative $Au^-$ can coat on the liposomal surface by electronic interaction. The size of GCL was $154.8{\pm}9.2$ nm and surface charge was $27{\pm}3.2$ mV, respectively. The morphology of GCL was confirmed by electron microscopy (SEM) and transmission electron microscopy (TEM). The coating efficiency of gold was 18%. Chemical procedure for gold coating on liposomal surface was not toxic for cell cytotoxicity by MTT assay. Finally, we demonstrated attractive CT image for GCL. Taken together, the GCL would be useful for various vessel related disease as a contrast medium.

• The Journal of Korean Philosophical History
• /
• no.27
• /
• pp.63-84
• /
• 2009

I analyzed about the Ruyi(儒醫)'s mind on this article. Ruyi led and Nei-Jing (內經)'s Xin(心)-Shen(神)-Qingzhi(情志) it developed a medical theory. Qingzhi comes true confucianism aims became the good tool. Junhuo(君火)-Xianghuo(相火) for them to apply medically. Junhuo-Xianghuo is a possibility of seeking a ground from Nei-Jing. Junhuo governs all body and Xianghuo takes charge of the role which raises the body. It is to divide huo(火)with relationship of the king and the liege man. After Yuan-dynasty(元代) Ruyi medical sciences grasped Junhuo-Xianghuo with confucianism structures. The representative scholar is Zhu zhen-heng(朱震亨). I analyzed Zhu's Junhuo-Xianghuo. Xin-huo rules over the body. For expression of active Chi, it set the dual structure-'Junhuo-Xianghuo'. And it divided Junhuo from desire and sentiment. And Zhu zhen-heng attempted Taoism and medical science and Confucianism from the process under integrating. And analyzed Junhuo-Xianghuo Confucianism meaning. With Junhuo-Xianghuo and Confucianism described a relationship in the Zhu zhen-heng's theory. Finally view of Ruyi, medical science is the method of confucianism aims comes true.

• Journal of the Korean association of regional geographers
• /
• v.3 no.2
• /
• pp.163-193
• /
• 1997

Medical services are a fundamental and essential service in all urban areas. The location and accessibility of medical service facilities and institutions are critical to the diagnosis, control and prevention of illness and disease. The purpose of this paper is to present the results of a study on the location of medical facilities in Kwangju and the utilization of these facilities by the inhabitants. The following information is a summary of the findings: (1) Korea, like many countries, is now witnessing an increase in the age of its population as a result of higher living standards and better medical services. Korea is also experiencing a rapid increase in health care costs. To ensure easy access to medical consultation, diagnosis and treatment by individuals, the hierarchical efficient location of medical facilities, low medical costs, equalized medical services, preventive medical care is important. (2) In Korea, the quality of medical services has improved significantly as evident by the increased number of medical facilities and medical personnel. However, there is still a need for not only quantitative improvements but also for a more equitable distribution of and location of medical services. (3) There are 503 medical facilities in Kwangju each with a need to service 2,556 people. This is below the national average of 1,498 inhabitants per facility. The higher locational quotient and satisfactory population per medical facility showed at the civic center. On the other hand, problem regions such as the traditional residential area in Buk-Gu, Moo-deung mountain area and the outer areas of west Kwangju still maintain rural characteristics. (4) In the study area there are 86 general medicine clinics which provide basic medical services. i. e. one clinic per every 14,949 residents. As a basic service, its higher locational quotient showed in the residential area. The lower population concentration per clinic was found in the civic center and in the former town center, Songjeong-dong. In recently build residential areas and in the civic center, the lack of general medicine clinics is not a serious medical services issue because of the surplus of medical specialists in Korea. People are inclined to seek a consultation with a specialist in specific fields rather than consult a general practitioner. As a result of this phenomenon, there are 81 internal medicine facilities. Of these, 32.1% provide services to people who are not referred by a primary care physician but who self-diagnose then choose a medical facility specializing in what they believe to be their health problem. Areas in the city, called dongs, without any internal facilities make up 50% of the total 101 dongs. (5) There are 78 surgical facilities within the area, and there is little difference at the locational appearance from internal medicine facilities. There are also 71 pediatric health clinics for people under 15 years of age in this area, represents one clinic per 5,063 people. On the quantitative aspect, this is a positive situation. Accessibility is the most important facility choice factor, so it should be evenly located in proportion to demander distribution. However, 61% of 102 dongs have no pediatric clinics because of the uneven location. (6) There are 43 obstetrical and gynecological clinics in Kwangju, and the number of residents being served per clinic is 15,063. These services need to be given regularly so it should increase the numbers. There are 37 ENT clinics in the study area with the lower concentration in Dong-gu (32.4%) making no locational differences by dong. There are 23 dermatology clinics with the largest concentration in Dong-Gu. There are 17 ophthalmic clinics concentrated in the residential area because of the primary function of this type of specialization. (7) The use of general medicine clinics, internal medicine clinics, pediatric clinics, ENT clinics by the inhabitants indicate a trend toward primary or routine medical services. Obstetrics and gynecology clinics are used on a regular basis. In choosing a general medicine clinic, internal medicine clinic, pediatric clinic, and a ENT clinic, accessibility is the key factor while choice of a general hospital, surgery clinic, or an obstetrics and gynecology clinic, thes faith and trust in the medical practitioner is the priority consideration. (8) I considered the efficient use of medical facilities in the aspect of locational and management and suggest the following: First, primary care facilities should be evenly distributed in every area. In Kwangju, the number of medical facilities is the lowest among the six largest cities in Korea. Moreover, they are concentrated in Dong-gu and in newly developed areas. The desired number of medical facilities should be within 30 minutes of each person's home. For regional development there is a need to develop a plan to balance, for example, taxes and funds supporting personnel, equipment and facilities. Secondly, medical services should be co-ordinated to ensure consistent, appropriate, quality services. Primary medical facilities should take charge of out-patient activities, and every effort should be made to standardize and equalize equipment and facility resources and to ensure ongoing development and training in the primary services field. A few specialty medical facilities and general hospitals should establish a priority service for incurable and terminally ill patients. (9) The management scheme for the inhabitants' efficient use of medical service is as follows: The first task is to efficiently manage medical facilities and related services. Higher quality of medical services can be accomplished within the rapidly changing medical environment. A network of social, administrative and medical organizations within an area should be established to promote information gathering and sharing strategies to better assist the community. Statistics and trends on the rate or occurrence of diseases, births, deaths, medical and environment conditions of the poor or estranged people should be maintained and monitored. The second task is to increase resources in the area of disease prevention and health promotion. Currently the focus is on the treatment and care of individuals with illness or disease. A strong emphasis should also be placed on promoting prevention of illness and injury within the community through not only public health offices but also via medical service facilities. Home medical care should be established and medical testing centers should be located as an ordinary service level. Also, reduced medical costs for the physically handicapped, cardiac patients, and mentally ill or handicapped patients should be considered.