• Title/Summary/Keyword: Medical consultation

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Development and Analysis of System Dynamics Model for Predicting on the Effect of Patient Transfer Counseling with Nurses (간호사의 전원상담 효과 예측을 위한 시스템다이내믹스 모델 개발 및 분석)

  • Byun, Hye Min;Yun, Eun Kyoung
    • Journal of Korean Academy of Nursing
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    • v.48 no.5
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    • pp.554-564
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    • 2018
  • Purpose: This study aimed to construct a management model for patient transfer in a multilevel healthcare system and to predict the effect of counseling with nurses on the patient transfer process. Methods: Data were collected from the electronic medical records of 20,400 patients using the referral system in a tertiary hospital in Seoul from May 2015 to April 2017. The data were analyzed using system dynamics methodology. Results: The rates of patients who were referred to a tertiary hospital, continued treatment, and were terminated treatment at a tertiary hospital were affected by the management fee and nursing staffing in a referral center that provided patient transfer counseling. Nursing staffing in a referral center had direct influence on the range of increase or decrease in the rates, whereas the management fee had direct influence on time. They were nonlinear relations that converged the value within a certain period. Conclusion: The management fee and nursing staffing in a referral center affect patient transfer counseling, and can improve the patient transfer process. Our findings suggest that nurses play an important role in ensuring smooth transitions between clinics and hospitals.

Incidental occurrence of an unusually large mastoid foramen on cone-beam computed tomography and review of the literature

  • Syed, Ali Z.;Sin, Cleo;Rios, Raquel;Mupparapu, Mel
    • Imaging Science in Dentistry
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    • v.46 no.1
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    • pp.39-45
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    • 2016
  • The incidental finding of an enlarged mastoid foramen on the right posterior mastoid region of temporal bone is reported, together with a discussion of its clinical significance. A 67-year-old female underwent the pre-implant assessment of a maxillary left edentulous region. A cone-beam computed tomographic (CBCT) image was acquired and referred for consultation. Axial CBCT slices revealed a unilateral, well-defined, noncorticated, low-attenuation, transosseous defect posterior to the mastoid air cells in the right temporal bone. The borders of the osseous defect were smooth and continuous. No other radiographic signs suggestive of erosion or sclerosis were noted in the vicinity. The density within the defect was homogenous and consistent with a foramen and/or soft tissue. The patient's history and physical examination revealed no significant medical issues, and she was referred to a neuroradiologist for a second opinion. The diagnosis of an enlarged mastoid foramen was made and the patient was reassured.

A Study of Validity and Reliability about Parent's Satisfaction in Korean Medicine Hospital - Introducing Korean Medicine Satisfaction Questionnaire - (환자 보호자 만족도 조사에 대한 신뢰도 및 타당성 연구 - Korean Medicine Satisfaction Questionnaire(KMSQ)를 도입하여 -)

  • Jeong, Sang Gyo;Kim, Ki Bong
    • The Journal of Pediatrics of Korean Medicine
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    • v.27 no.2
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    • pp.31-47
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    • 2013
  • Objectives This study was done to confirm reliability, validity and the internal structure of the Korean Medicine Satisfaction Questionnaire(KMSQ). Methods 154 parents who visited in Department of Pediatrics of Korean Medicine, University Hospital participated in this study. They were statistically analyzed by using PASW Statistics 20.0K for Windows. Results Factor analyses were largely divided into six categories such as Hospital, Waiting & Consultation Time, Doctor, Medicine, Therapy, and Cost. The validity and reliability of KMSQ were favorable. The highest average score of satisfaction was Doctor category as $4.20{\pm}0.51$ and the lowest one was Cost as $3.33{\pm}0.71$. The six factors showed highly positive relationship from correlation analysis. The result of comparative study on parent's demographic characteristics showed only one significant difference in satisfaction of Doctor within occupation. The result of comparative study on child's demographic characteristics showed significantly different in satisfaction of Therapy within gender, and of Medicine within age. Every average score of satisfaction showed somewhat difference within each section, and only 5.6% of them showed significantly difference in T-test. Conclusions Uses and research with the KMSQ as subjective tool in various department or medical institution are suggested.

Needs assessment for maternal health care in Ermera, Timor-Leste (동티모르 에르메라 지역의 모성보건사업 요구 분석)

  • Kim, Soo Jeong;Kim, Seong Min;Cho, Kyoung Won
    • The Journal of Korean Society for School & Community Health Education
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    • v.20 no.2
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    • pp.53-67
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    • 2019
  • Objectives: The purpose of this study is to obtain the basic data for the development of maternal health care by analyzing the status and needs of service target persons in Timor-Leste. Methods: The subjects were selected through the non-probability sampling method applying the FGI. Researchers interviewed 3 maternal health service managers, 6 midwives at Gleno and Railaco Health Centers and 2 women between 15 and 45 years of age. Results: In the results of on-site visit of the delivery facility and the FGI, we found poor sanitation in delivery room, lack of medical equipment related to antenatal consultation and delivery. In the case of the health center manager, the public health center provides various maternity health services, but the lack of the staff has difficulty in providing the service and managing the subjects. Midwives asked for regular maintenance education. Women in child bearing age living in mountainous areas had poor access to delivery facilities and lack of awareness of delivery services. Conclusions: It is necessary to increase the maternity management rate through regular maternity and maternal health check service and application to maternal management database, to improve the sanitation of the maternity clinic in the public health center, to strengthen the midwife competency program.

The Space Characteristics of Senior Welfare Centers in Eastern Cities of Jeonnam Province (전남 동부도시 노인복지관의 공간적 특성)

  • Chung, Kumho;Kim, Juntaek
    • Journal of the Korean Institute of Rural Architecture
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    • v.23 no.1
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    • pp.27-34
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    • 2021
  • The senior welfare centers should provide integrated welfare services to the elderly whose needs are in change. So this paper tried to find a direction for improvement by identifying the spatial organization of the centers which are in Yeosu, Suncheon and Gwangyang. Classification of spaces of senior welfare center followed the guidelines 2020 for senior welfare center from Ministry of Health and Welfare which are consultation, medical rehabilitation, day or short-term protection, social education, home welfare, employment, welfare and public relations and PR planning and by adding management and public space. The above factors are invested and analyzed. The results of the survey and analysis of seven senior welfare centers are as follows. First, in the survey, the spatial organization of the senior welfare centers surveyed showed that the larger the size is, the dominantly lager the social education space is. Second, the space for day or short-term care, and employment is less than 1% of the total area, and most senior welfare centers do not have a basic space for this. Third, the space related to home welfare and counseling is very small, and more than half of the senior welfare centers do not have space related to it.

Frequency and time of actual duties of some dental hygienists (일부지역 치과위생사의 실제 업무의 빈도와 소요시간)

  • Hwang, Soo-Jeong;Han, Yang-Keum
    • Journal of Korean Academy of Dental Administration
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    • v.7 no.1
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    • pp.10-20
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    • 2019
  • Korean dental hygienists perform more tasks in dental clinics than are described in the law. The purpose of this study was to investigate the actual work of Korean dental hygienists in dental clinics using an observational study design. Two dental hygienists observed and recorded the work performed in 1 day from the time of commencement to the time of leaving work by 18 dental hygienists working in the dental clinic in a single area. Data management, prevention of infection, counseling, calculus removal, radiography, assistance of fixed orthodontic treatment, assistance of fixed prosthetic treatment, and preparation for implant surgery were recorded. Among the tasks that take more than 1 min, the most time-consuming tasks were document management, infection control, consultation, calculus removal, preparation for implant surgery, assistance of orthodontic treatment, and assistance of fixed prosthetic treatment. Korean dental hygienists are performing various tasks, such as infection control, dental hospital/clinic management, oral disease prevention, and dental treatment assistants.

Full mouth rehabilitation of an asthma patient with severe tooth wear and occlusion disharmony (심한 마모 및 교합 부조화를 가진 천식 환자의 전악 수복 증례)

  • Jo, Yu-Jin
    • Journal of Korean society of Dental Hygiene
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    • v.22 no.4
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    • pp.225-230
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    • 2022
  • Objectives: Patients with excessive tooth wear should first be diagnosed for the etiology of the tooth wear. Causes of tooth wear include bruxism, clenching, and taking medications for systemic diseases. After identifying the cause of tooth attrition, the final prosthesis should be restored with an appropriate vertical dimension. Methods: A 79-year-old man with worn out teeth desired a whole dental treatment. He was on medications for high blood pressure and asthma. The treatment proceeded with a consultation with a medical doctor. The medications for asthma evoked multiple teeth wear and a loss of the vertical dimension. After recovery of 3 mm of vertical dimension, 2 months of evaluation was followed by an interim prosthesis. Results: The increased vertical dimension caused no problem in function and esthetics, and the final restoration was performed with a full monolithic zirconia crown. Group function, adequate anterior guidance, and the occlusal plane were determined. Conclusions: After the final restoration, the patient was both esthetically and functionally satisfied, and a night guard splint was delivered to prevent prosthesis fracture. The patient was informed about the potential tooth wear associated with asthma drugs and educated to visit the clinic regularly.

A study of relationships among tuberculosis knowledge, family support, and medication adherence in tuberculosis patients (결핵환자의 결핵관련 지식, 가족지지 및 약물복용이행과의 관계)

  • Jang, Yoo-Ri;Lee, Mi-Aie
    • The Journal of Korean Academic Society of Nursing Education
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    • v.28 no.1
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    • pp.80-90
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    • 2022
  • Purpose: This study was conducted to investigate the effect of tuberculosis-related knowledge and family support on medication adherence in tuberculosis patients. Methods: The data were collected from 175 patients diagnosed with tuberculosis at three general hospitals located in two provincial cities in South Korea from September 1 to November 31, 2020. The 160 questionnaires were analyzed using IBM SPSS WIN 25.0. Results: The patients' average score for tuberculosis-related knowledge was 15.85±5.87 (out of 25), for family support it was 22.03±9.20 (out of 35), and for medication adherence it was 5.11±2.68 (out of 8). There were significant differences in tuberculosis-related knowledge, family support, and medication adherence according to patients' general characteristics and significant positive relationships among tuberculosis-related knowledge, family support, and medication adherence. Factors affecting patients' tuberculosis medication adherence were history of stopping the medication, the importance of treatment among tuberculosis-related knowledge and family support, and these factors could explain 78% of patients' taking tuberculosis drugs. Conclusion: It could be concluded that the importance of tuberculosis treatment and family support are very important for improving patients' rates of medication adherence. Therefore, medical staffs caring for tuberculosis patients need to manage patients' medication of tuberculosis drugs with continuous consultation.

Evolving the Cybersecurity of Clinical Photography in Plastic Surgery

  • Daisy L. Spoer;Alexandra Junn;John D. Bovill;Zoe K. Haffner;Andrew I. Abadeer;Stephen B. Baker
    • Archives of Plastic Surgery
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    • v.50 no.4
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    • pp.443-444
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    • 2023
  • Point-of-care photography and photo sharing optimize patient outcomes and facilitate remote consultation imperative for resident surgeons. This literature review and external pilot survey study highlight the risks associated with current practices concerning patient privacy and biometric security. In a survey of 30 plastic surgeon residents and attendings, we found that the majority took photos of patients with their iPhones and shared them with colleagues via Apple iMessage. These findings corroborate previous reports and highlight a lack of physician user acceptance of secure photo-sharing platforms. Finally, we frame a successful example from the literature in the context of a postulated framework for institutional change. Prioritizing the privacy and safety of patients requires a strategic approach that preserves the ease and frequency of use of current practices.

Diagnosis of Abusive Head Trauma : Neurosurgical Perspective

  • Kwak, Young Ho
    • Journal of Korean Neurosurgical Society
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    • v.65 no.3
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    • pp.370-379
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    • 2022
  • Abusive head trauma (AHT) is the most severe form of physical abuse in children. Such injury involves traumatic damage to the head and/or spine of infants and young children. The term AHT was introduced to include a wider range of injury mechanisms, such as intentional direct blow, throw, and even penetrating trauma by perpetuator(s). Currently, it is recommended to replace the former term, shaken baby syndrome, which implicates shaking as the only mechanism, with AHT to include diverse clinical and radiological manifestations. The consequences of AHT cause devastating medical, social and financial burdens on families, communities, and victims. The potential harm of AHT to the developing brain and spinal cord of the victims is tremendous. Many studies have reported that the adverse effects of AHT are various and serious, such as blindness, mental retardation, physical limitation of daily activities and even psychological problems. Therefore, appropriate vigilance for the early recognition and diagnosis of AHT is highly recommended to stop and prevent further injuries. The aim of this review is to summarize the relevant evidence concerning the early recognition and diagnosis of AHT. To recognize this severe type of child abuse early, all health care providers maintain a high index of suspicion and vigilance. Such suspicion can be initiated with careful and thorough history taking and physical examinations. Previously developed clinical prediction rules can be helpful for decision-making regarding starting an investigation when considering meaningful findings. Even the combination of biochemical markers may be useful to predict AHT. For a more confirmative evaluation, neuroradiological imaging is required to find AHT-specific findings. Moreover, timely consultation with ophthalmologists is needed to find a very specific finding, retinal hemorrhage.