• 제목/요약/키워드: Medical practice management

검색결과 654건 처리시간 0.023초

Medical Data Base Controlled By Medical Knowledge Base

  • Chernyakhovskaya, Mery Y.;Gribova, Valeriya V.;Kleshchev, Alexander S.
    • 한국지능정보시스템학회:학술대회논문집
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    • 한국지능정보시스템학회 2001년도 The Pacific Aisan Confrence On Intelligent Systems 2001
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    • pp.343-351
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    • 2001
  • World practice is evidence of that computer systems of an intellectual support of medical activities bound up with examination of patients, their diagnosis, therapy and so on are the most effective means for attainment of a high level of physician\`s qualification. Such systems must contain large knowledge bases consistent with the modern level of science and practice. To from large knowledge bases for such systems it is necessary to have a medical ontology model reflecting contemporary notions of medicine. This paper presents a description of an observation ontology, knowledge base for the physician of general tipe, architecture, functions and implementation of problem independent shell of the system for intellectual supporting patient examination and mathematical model of the dialog. The system can be used by the following specialist: therapeutist, surgeon, gynecologist, urologist, otolaryngologist, ophthalmologist, endocrinologist, neuropathologist and immunologist. The system supports a high level of examination of patients, delivers doctors from routine work upon filling in case records and also automatically forms a computer archives of case records. The archives can be used for any statistical data processing, for producing accounts and also for debugging of knowledge bases of expert systems. Besides that, the system can be used for rise of medical education level of students, doctors in internship, staff physicians and postgraduate students.

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상충관계이론과 자본조달순위이론에 기초한 병원 자본조달행태 분석 (Hospital's Financing Behaviors Based on Comparative Analysis of Trade-off Theory and Pecking Order Theory)

  • 김재명;함유상;안영창
    • 한국병원경영학회지
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    • 제11권2호
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    • pp.61-86
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    • 2006
  • Based on a previous literature about hospital capital structure(Shyam- Sunder & Myers, 1999), this study attempted comparison and analysis on whether the forecast of trade-off and pecking order theory could be validated in hospital's capital structure. First, this study analyzed whether hospitals follow the priority for each capital source as suggested by pecking order theory under lack of capital running in hospital. Next, it analyzed whether debt level is regressed on the average to target debt level so as to verify the validity of trade-off theory. Finally, it also analyzed possible associations between debt level and determinants of capital structure as adopted in static trade-off theory, so as to verify relative advantages of these two theories about hospital capital structure. The analysis over whole period showed that both trade-off theory and pecking order theory isn't supported particularly. This mean that each hospital's financing behaviors is different and that has not dominant financing behaviors. In the midst of separation of dispensary from medical practice, medical institutions in Korea first finances funds required using retained earnings and then use liabilities. however pecking order theory is supported, the preference of long-term liabilities and short-term liabilities is not clear. In addition, considering that debt level is in no average regression to target debt ratio, it is found that hospital capital structure following trade-off theory turns into that subject to pecking order theory via the separation of dispensary from medical practice.

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문신시술의 비범죄화에 대한 비판적 검토와 대안 (Critical Review and Alternatives to the Decriminalization of Tattooing)

  • 심영주;이상한
    • 의료법학
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    • 제23권1호
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    • pp.149-176
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    • 2022
  • 우리나라 법제는 비의료인에 의한 의료행위를 엄격히 금지하고 있는데, 문신시술의 경우 의료행위로 분류되어 비의료인이 문신시술시 무면허의료행위로 처벌받게 된다. 그런데, 현실적으로 문신시술을 의료인에게 받는 경우가 매우 드물고, 문신시술을 업으로 하고 있는 비의료인들은 직업선택의 자유 침해 등을 주장하며 비의료인에 의한 문신시술의 의료행위성을 부정하고 비범죄화할 것을 요구하고 있다. 그런데 문신시술은 바늘 등을 사용하여 이루어지기 때문에 신체에 대한 침습이 있어 의료인이 행하지 않으면 보건위생상 위해가 발생할 수 있는 행위로 볼 수 있고 감염 예방 등을 위해 엄격한 관리가 필요하다. 그러나 이러한 현실적인 부분과 법제와의 괴리를 고려할 때, 보건의료적 관점에서 안전성을 고려하면서도, 사실상 의료인에 의해 행해지는 문신시술이 많지 않은 현실을 고려하여 비의료인에 의한 문신시술을 제도화하는 방안 등에 대해 전향적으로 생각을 해 볼 필요가 있다. 본고는 이러한 관점에서 문신시술이 의료행위에 해당하는지 법제를 검토하고, 보건의료적 관점에서 문제가 된다면 이를 해결하기 위한 방안을 모색하여 현실을 반영하면서도 안전성을 도모할 수 있는 대안으로 3단계로 나누어 단계화된 접근을 제시하였다.

통증관리 근거중심 가이드라인의 국내 타당성 검증 - 복부수술 환자를 대상으로 - (Validation of a Translated Guideline on Pain Assessment and Management: Focused on Abdominal Surgery Patients)

  • 홍성정;이은주
    • 임상간호연구
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    • 제18권1호
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    • pp.159-170
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    • 2012
  • Purpose: This study was designed to examine the validity of the evidence-based guideline on pain developed by Registered Nurses Association of Ontario(RNAO) translated into Korean based on the experts' opinions. Methods: The panel consisted of experts of 60 registered nurses in surgical units, medical doctors and nursing managers who were experts in pain assessment and management. The validity of translated RNAO guideline was evaluated in terms of appropriateness, applicability, and utilization in current practice. Appropriateness and applicability of each recommendation were measured with 9 point scale, whereas utilization was measured by yes/no question. Data were analyzed by mean, standard deviation, and percent. The experts' opinions were analyzed by content analysis method. Results: In general, most of the recommendations in the guideline received above 7 point in appropriateness and applicability. However, above 20% of recommendations showed less than 50% of utilization rates in current practice. Conclusion: The reasons for low utilization of recommendations in current practice are in need for investigation. This study can be used for the development of guideline more acceptable in Korean health care settings and improve the quality of care for the abdominal surgery patients suffering from pain in Korea.

중학생들의 학교안전교육 실태와 안전분야 지식 및 실천 :「재난안전, 응급처치, 교통안전, 생활안전」 (School safety education status and the awareness and practice of safety among middle school students: 「First aid, disaster safety, traffic safety, and daily life safety」)

  • 이효철;장푸름이;김정환
    • 한국응급구조학회지
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    • 제25권2호
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    • pp.129-143
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    • 2021
  • Purpose: This study aimed to identify the current status of school safety education and the differences in knowledge and practice of middle school students. Methods: A structured questionnaire was distributed to 418 middle school students in J province. The questionnaires consisted of 35 questions on the status of school safety education as well as the four school safety education domains of first aid, disaster safety, traffic safety, and daily life. Data were analyzed using frequency analysis, cross-tabulation analysis, a t-test, analysis of variance, and Pearson's correlations. Results: Awareness regarding the top seven standards for school safety and interest in school safety education were both relatively low. Among all the different kinds of safety accidents, those related to school violence(33.8%) and life safety(24.9%) were experienced the most in school. A more pleasant school life and better peer relationships led to interest in school safety(p=.000)(p=.000), awareness regarding the top seven standards for school safety(p=.022)(p=.009), adoption of coping measures(p=.000)(p=.000), and practice(p=.000)(p=.000) in case of safety accidents(p=.000)(p=.000). Conclusion: To increase awareness regarding the seven standards for school safety education and raise interest in safety education, it is necessary to cultivate experts and actively utilize them and to prepare systematic and continuous school safety education programs.

The Value and Limitations of Guidelines, Expert Consensus, and Registries on the Management of Patients with Thoracic Aortic Disease

  • Pacini, Davide;Murana, Giacomo;Leone, Alessandro;Marco, Luca Di;Pantaleo, Antonio
    • Journal of Chest Surgery
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    • 제49권6호
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    • pp.413-420
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    • 2016
  • Doctors are often faced with difficult decisions and uncertainty when patients need a certain treatment. They routinely rely on the scientific literature, in addition to their knowledge, experience, and patient preferences. Clinical practice guidelines are created with the intention of facilitating decision-making. They may offer concise instructions for the diagnosis, management (medical or surgical treatments), and prevention of specific diseases or conditions. All information included in the final version are the result of a systematic review of scientific articles and an assessment of the benefits and costs of alternative care options. The final document attempts to meet the needs of most patients in most circumstances and clinicians, aware of these recommendations, should always make individualized treatment decisions. In this review, we attempted to define the intent and applicability of clinical practice guidelines, expert consensus documents, and registry studies, focusing on the management of patients with thoracic aortic disease.

간호분야 실무지침의 수용개작 방법론에 따른 경장영양 실무지침의 개발 (Development of Nursing Practice Guidelines on Enteral Tube Feeding using the Guideline Adaptation Process)

  • 조용애;은영;구미옥;조명숙;박명화;김경숙;김정연
    • 임상간호연구
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    • 제20권2호
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    • pp.147-161
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    • 2014
  • Purpose: This study was aimed to modify and adapt the previously developed, high-quality enteral tube feeding guidelines for the usage in clinical settings in Korea. Methods: Guideline adaptation process was undertaken according to the guideline adaptation manual version 2.0 developed by NECA (Kim, et al., 2011) and the standardized methodology for nursing practice guideline adaptation (Gu, et al. 2012). Results: The modified and adapted enteral tube feeding guidelines were consisted of 11 domains and 95 recommendations. The domains and numbers of recommendations in each domain were: 4 on general issues, 2 on enteral nutrition indication and discontinue, 6 on enteral nutrition device selection, 12 on enteral tube feeding device insertions, 3 on enteral nutrition formular and choices, 16 on enteral tube feeding start and progress, 20 on enteral tube feeding maintenance and management, 15 on monitoring enteral tube feeding administration, 10 on prevention of error, 5 on medication administration, and 2 on documentation and report. There were 16.1% of the recommendations marked as A grade, 17.8% of B grade, and 66.1% of C grade. Conclusion: The adapted enteral tube feeding nursing practice guideline is to be added to the evidence-based practice guidelines for fundamentals of nursing practice. The guideline is hoped to be disseminated to nurses nationwide in order to improve the efficiency of enteral tube feeding practice.

Practice of Breast Self-Examination Among Women in Malaysia

  • Al-Naggar, Redhwan Ahmed;Bobryshev, Yuri V.;Al-Jashamy, Karim
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권8호
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    • pp.3829-3833
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    • 2012
  • Objective: The objective of this study was to examine the practice and associated factors of breast self-examination (BSE) among Malaysian women. Methods: For this cross-sectional study 250 women were selected by a simple random sampling technique. The questionnaire was consisted of three parts: socio-demographic characteristics, knowledge about BSE, and practice of BSE. Obtained data was analyzed using SPSS version 13. T-test and ANOVA test were used to explore the relation between socio-demographic characteristics and the practice of BSE. Results: About 32% of the participants reported that they have had family history of cancer and about 20% of the participants reported that they have had family history of breast cancer. The majority of the participants (88.8%) have heard about breast cancer and 78.4% of the participants have heard about BSE. Race, marital status, residency, regular exercise, awareness about breast cancer, belief that breast cancer can be detected early, belief that early detection improves the chance of survival, family history of cancer, family history of breast cancer, awareness about BSE, and belief that BSE is necessary, significantly influenced the practice of BSE among women. Practice of BSE on monthly basis was found to be 47.2% among the study participants. Conclusions: The socio-demographic characteristics significantly influence the practice of BSA among women in Malaysia. The findings of this study might not only influence the planning of specific screening interventions and strategies in Malaysia but might also be important for the relevant international communities, interested in the peculiarities of BSE incidence in different countries.

융복합 사회에서 응급구조(학)과 학생들의 임상실습 실태조사 및 개선방안 (Survey and Improvement Scheme for Clinical Practice of Emergency Medical Technology Students in the Convergence Society)

  • 정상우
    • 디지털융복합연구
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    • 제15권1호
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    • pp.287-299
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    • 2017
  • 본 연구는 응급구조(학)과 학생들의 임상실습 현실과 실태를 조사하여 임상실습 개선방안을 제시하고자 한 연구이다. 융복합 사회에서 임상실습은 다양한 직업을 경험할 권리만큼 중요한 것으로 간주되고 있고 최근 NCS(National Competency Standards)의 등장에 의해 더욱 활기를 띠고 있다. 응급구조(학)과 학생 115명이 대상이다. 자료는 2016년 6월 16-17일까지 수집하여 SPSS v. 18.0을 사용하여 분석하였다. 응급실만을 경험한 2학년은 취업에 대한 부정적 인식을 보였다. 반면 응급실과 119 구급대를 경험한 3학년은 119 구급대 임상실습의 후광효과로 취업에 대한 인식의 변화가 거의 나타나지 않았다. 두 그룹 모두 타직종에서의 다양한 임상실습 경험을 원한다. 연구 결과를 바탕으로 다양한 임상실습기관을 제공하여 취업에 대한 인식을 긍정적으로 바꾸고 다가올 1급 응급구조사의 취업난을 해결할 것을 제안한다.

전립선증식증(Benign Prostatic Hyperplasia)의 한의 임상 진료 현황 조사를 위한 온라인 설문 조사 (Clinical Practice Patterns for Benign Prostatic Hyperplasia: An Online Survey)

  • 백지수;신선미;조충식
    • 대한한방내과학회지
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    • 제44권4호
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    • pp.703-725
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    • 2023
  • Objectives: This study investigated Korean medicine doctors' perspectives on clinical practice patterns in the process of developing Korean medicine clinical practice guidelines for benign prostatic hyperplasia. Methods: A questionnaire was developed for Korean medicine doctors. A total of 323 oriental medicine doctors participated in the survey, which was live for a total of 9 days from September 22, 2022, to September 30, 2022. Results: Regarding awareness of treatments for benign prostatic hyperplasia, 63.8% of respondents showed high awareness of Korean medical treatments. However, items such as diagnostic criteria (17.7%), evaluation methods (17.0%), and Western medical treatments (22.9%) showed low recognition rates. In clinical practice, 76.2% of respondents were found to treat five or fewer patients with benign prostatic hyperplasia per month, and the average treatment period was 1 to 3 months for most at 41.2%. Korean medicine doctors diagnosed benign prostatic hyperplasia based on clinical features. The main interventions used were acupuncture, herbal medicine (prescription medicine), and moxibustion. This study has several limitations because of the low response rate for this survey; therefore, the participants are not representative of all Korean medicine doctors. In addition, because the study was conducted broadly on various topics related to benign prostatic hyperplasia, sufficient quality management was not carried out. Further studies that include a larger sample size and more in-depth studies on benign prostatic hyperplasia are needed. Conclusions: It is necessary to develop appropriate and reasonable Korean medicine clinical practice guidelines for benign prostatic hyperplasia.