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Bereavement Care of Hospice Services in Korea (국내 호스피스 기관의 사별 관리 실태)

  • Ro, You-Ja;An, Young-Lan
    • Journal of Hospice and Palliative Care
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    • v.3 no.2
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    • pp.126-135
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    • 2000
  • Purpose : To evaluate the present status of bereavement care in Korean hospice service as a basic database for the effective bereavement care. Method : The data were collected two sets from September to October, 1999 and from November to December, 2000, 55 hospice institutions identified by the Hospice Education Institution, College of Nursing, Catholic University were contacted for a telephone survey. The researchers conducted telephone interviews with hospice administrators for 10 to 30 minutes. Result : 1) Among the 55 Korean Hospice institutions, 38 institutions(69.1%) provided bereavement services. 2) The contents of bereavement services consisted of telephone call 28 institutions(74.5%), bereaved family meeting 26 institutions(69.4%), home visiting 22 institutions(57.9%), mail 16 institutions(42.1%), personal counselling 7 institutions(18.4%). 3) The 26 hospice institutions(68.4%) which provided meetings for bereaved families met with the following frequency : Annually is 11 institutions(42.3%), biannually 6 institutions(23.1%), monthly 6 institutions(23.1%) and bimonthly 3 institutions(11.5%). 4) Only 4 hospice institutions(10.5%) used the assessment tool to screen for high risk of bereaved. 5) The major difficulties of current bereavement services were low attendance for the bereaved family meeting, shortage of professional managers and volunteers, limited accessibility to hospice institutions, little social awareness for the bereaved, and financial difficulties. 6) The hospice administrators expressed the need for the development of bereavement program, the education program for the bereavement services, trained professionals, the sufficient provision of human resource and financial support for more effective bereavement services. Conclusion : Although many hospice institutions(69.1%) provided bereavement services, they generally lacked capable bereavement professionals and various individualized bereavement services. In conclusion, it is required to develop the specified bereavement program and the training program for the staff and volunteers, so as to provide customized bereavement services based on individual needs. Further research will be necessary to evaluate the effects of customized bereavement services in Korea before applying to practice.

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Performance of Occupational Health Services by Type of Service : Cost Benefit Analysis (사업장 보건관리 사업의 형태별 수행성과 분석 -비용편익 분석을 중심으로-)

  • Cho, Tong Ran;Kim, Hwa Joong
    • Korean Journal of Occupational Health Nursing
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    • v.4
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    • pp.5-29
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    • 1995
  • Occupational health services in Korea have been operated as dual types : one is operated by occupational health care manager and the other is health care agency without their own personnel. The performance of occupational health service should be different due to the variety of characteristics of health care manager and workplace, qualification of health care manager. This study is to analyze performance of occupational health care services with a particular consideration of job performance shape and efficiency, based on comparing those two types of health care management to show on the basic data for the settlement of more qualitative health care management system at workplace. For this study, total 391 places in Seoul and Inchon city area ; 154 places (39.4%) managed by designated health care manager and 237 places (60.6%) by the agency with their commission are selected as research samples. Tools for data collection are questionnares that have been investigated during the period of 20 September 1993-20 December 1993. Those data are compared with percentiles, mean, standard deviation and B/C ratio using SPSS PC program. Conclusions observed from the tests and each comparison could be summerized as follows : 1. Occupational health care have been accomplished at workplaces with designated people than with agencies people, and coverage rate of the occupational health care services has differences, due to management types. The reason of these results is due to visit only one or two times monthly by the agencies, while their own health care manager obsess, at the workplaces all the times. 2. Most of the expense for environmental control of all health care services expenditures shows that there is almost no fundamental improvement because more expenses are needed for procuring personal protective equipment and measuring work environment instead of environmental improvement. 3. It is investigated how much the cost of occupational health care services needs per worker, and calculated how much the cost needs per service hour per worker. The results from this show that the cost of occupational health services at workplaces with their own managers used less than the cost of health care agencies, eventually the former gives better services with less cost than the latter. 4. Benefit/Cost ratio is also produced by total benefit/total cost. The result from the above way reads 4.57 as a whole, while their own manager having workplaces reads 4.82 and the agencies do l.56. Even if their own manager performing workplaces spent more cost, this system produces more benefit than the agencies management. 5. The B/C ratio for medical organization such as local clinic, health care center and pharmacy shows more than or equal to at the workplaces controlled by the agencies. It is inferred that benefit would be much less than the cost used, with so being inefficient. 6. It is assumed that the efficiency ratio of health education is equal to reduction rate of workers medical organization visit. Estimated reduction rate 5%, 10%, 15%, show that the efficiency ratio of health education have an effect on producing benefits. It is estimated that more benefit can be produced if more qualitative education will be provided for enhancing health care efficiency. 7. Results of this study cannot be generalized because there are large scale of deviation in case of workplaces with less than 300 full time workers, but B/C ratio reads 2.69 as a whole and 3.25 at workplaces with their own health care manager are higher than 1.63 at the workplaces manged by the agencies. Finally, all the benefit concerning health care services could not be quantified, measured and shown on the value of money. This is a reason that a considerable part of benefits are so underestimated. This is also thought that measurement tools should be developed for measuring benefits of health care services with a comprehensive quantification. in the future. It is also expected that efficiency of occupational health care services should be investigated using cost-effectiveness analysis.

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An Experimental Study on the Excellences of Nurses′ Communication Method upon Psychiatric Patient′s Response. (간호원의 의사소통방법이 정신병환자 반응에 미치는 영향에 대한 실험적 연구)

  • 이평숙
    • Journal of Korean Academy of Nursing
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    • v.4 no.2
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    • pp.78-92
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    • 1974
  • It is the purpose of this study to make clear the way in which people can lead a more desirable human life, that is, to ascertain the method of achieving therapeutic change through transaction between nurses and psychiatric patients. The various problems proposed by th9 above-stated aims of study can be shown, such as: What kind of influences does the method of a nurse′s communication have upon the response of psychiatric patients? 1) What are the general methods of communication used by the nurses? 2) Are there any differences between the control group and experimental group in the patients′ "Child" response? 3) Are there any differences between the control group and experimental group in the Patients "Adult" response? 4) What is the most desirable method of communication for therapeutic change in the patients? In an effort to solve the above questions this study attempted and managed to draw a random sampling of 200 patients being accommodated in the National Mental Hospital by dividing them into two groups, experimental groups and control groups, and recording the transactions between nurses and patients. In the course of carrying,: out this study, the experimental group was interviewed by the nurses specially trained In the P.A.C theory. and the control group interviewed at random by the nurses with no special training in communication. Further, the communication between nurses and patients in a free, relaxed atmosphere was allowed only for 15 minutes, whereupon the nurses were requested to make process-recording according to her memory of nurse patient transaction. The process-recording which recorded a series ol transactions between the nurses and the patients was analyzed according to Berne and Harris′transactional Analysis Standard. Through this standard, the writer of this study examined the significance of difference to compare the transactions brought forth between the experimental group and the control group. The following is a summary of the study which the writer of this thesis undertook. Hypothesis to The method of communication which the nurses usually apply to the patients will be higher in "Parent" than in "Adult". The communication which the nurses carried out in the control group turned out to be not significant between "Adult" and "Parent" Accordingly hypothesis 1. carne to be rejected. Hypothesis 2. The patients "Adult" response will be higher in the experimental group than in the control group. According to the result of a CR examination, as the communication showed a significant difference on P〈.01 level′ hypothesis 2 became affirmative. Hypothesis 3. The patients′"Child" response will be higher in the control group than in the experimental group. Hypothesis 3 proved affirmative since it showed an significant degree on P〈.01 level according to the result of a CR examination. Hypothesis 4 "Adult" response of the patient will be higher in frequency by nurses′"Adult" stimulus than nurse′s "Parent" stimulus Chi-square examination revealed significant difference on P〈.05 level. Hypo. 4 is affirmed. The following conclusions are drawn out based on the result of this study. 1) The generally used method of communication stimulus used by nurses for patients proved to be "Adult" and "Parent" in similar proportion. 2) The group in which the nurses could increase the patients "Adult" response proved to be higher in the experimental group than in the control group. Therefore, the communication (or stimulus) which has been applied in the experimental group can be said to be possible method of achieving therapeutic change. 3) Since the patients′"Child" response were higher in the control group than in the experimental group the communication method used In the control group was suggested as the less agreeable method of achieving therapeutic change than that used in the experimental Group. 4) "Adult" response of patient was elicited in significantly greater percentage when the "Adult" stimulus was used by the nurse. Therefore the most desirable method of-communication to give therapeutic change definitely was shown to be the "Adult" stimulus. Recommendations for further studies are as follows: 1) Studies on nurses′role perception in nurse-patient relationships. 2) Studies on patients′response to the method of communication used by nurses according to variables such as sex, social status, educational background, state of health. 3) Application of T.A, method to various groups of patients. 4) Study of various methods to improve student skill in use of process recording.

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A Study on Perception and Attitudes of Health Workers Towards the Organization and Activities of Urban Health Centers (도시보건소 직원의 보건소 업무에 대한 인식 및 견해)

  • Lee, Jae-Mu;Kang, Pock-Soo;Lee, Kyeong-Soo;Kim, Cheon-Tae
    • Journal of Yeungnam Medical Science
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    • v.12 no.2
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    • pp.347-365
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    • 1995
  • A survey was conducted to study perception and attitudes of health workers towards health center's activities and organization of health services, from August 15 to September 30, 1994. The study population was 310 health workers engaged in seven urban health centers in Taegu City area. A questionnaire method was used to collect data and response rate was 81.3 percent or 252 respondents. The following are summaries of findings: Profiles of study population: Health workers were predominantly female(62.3%); had college education(60.3%); and held medical and nursing positions(39.6%), technicians(30.6%) and public health/administrative positions(29.8%). Perceptions on health center's resources: Slightly more than a half(51.1%) of respondents expressed that physical facilities of the centers are inadequate; equipments needed are short(39.0%); human resource is inadequate(44.8%); and health budget allocated is insufficient(38.5%) to support the performance of health center's activities. Decentralization and health services: The majority revealed that the decentralization of government system would affect the future activities of health centers(51.9%) which may have to change. However, only one quarter of respondents(25.4%) seemed to view the decentralization positively as they expect that it would help perform health activities more effectively. The majority of the respondents(78.6%) insisted that the function and organization of the urban health centers should be changed. Target workload and job satisfaction: A large proportion (43.3%) of respondents felt that present target setting systems for various health activities are unrealistic in terms of community needs and health center's situation while only 11.1 percent responded it positively; the majority(57.5%) revealed that they need further training in professional fields to perform their job more effectively; more than one third(35.7%) expressed that they enjoy their professional autonomy in their job performance; and a considerable proportion (39.3%) said they are satisfied with their present work. Regarding the personnel management, more worker(47.3%) perceived it negatively than positive(11.5%) as most of workers seemed to think the personnel management practiced at the health centers is not fair or justly done. Health services rendered: Among health services rendered, health workers perceived the following services are most successfully delivered; they are, in order of importance, Tb control, curative services, and maternal and child health care. Such areas as health education, oral health, environmental sanitation, and integrated health services are needed to be strengthening. Regarding the community attitudes towards health workers, 41.3 percent of respondents think they are trusted by the community they serve. New areas of concern identified which must be included in future activities of health centers are, in order of priority, health care of elderly population, home health care, rehabilitation services, and such chronic diseases control programs as diabetes, hypertension, school health and mental health care. In conclusion, the study revealed that health workers seemed to have more negative perceptions and attitudes than positive ones towards organization and management of health services and activities performed by the urban health centers where they are engaged. More specifically, the majority of health workers studied revealed to have the following areas of health center's organization and management inadequate or insufficient to support effective performance of their health activities: Namely, physical facilities and equipments required are inadequate; human and financial resources are insufficient; personnel management is unsatisfactory; setting of service target system is unrealistic in terms of the community needs. However, respondents displayed a number of positive perceptions, particularly to those areas as further training needs and implementation of decentralization of government system which will bring more autonomy of local government as they perceived these change would bring the necessary changes to future activities of the health center. They also displayed positive perceptions in their job autonomy and have job satisfactions.

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A Study on the Actual Conditions of Smoking in Middle and High School Students in One Region (일 지역 중·고등학생의 흡연실태)

  • Kim, Hyeon-Ok
    • Journal of the Korean Society of School Health
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    • v.12 no.1
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    • pp.149-167
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    • 1999
  • To investigate the actual conditions of smoking in middle and high school students in Chinan County, I used a sturctured questionnaire for 1,579 students attending twelve middle-high schools from December 1, 1998 to December 20, 1998. I collected and data correlated the using an $SPSS-PC^+$ 1. The smoking rate of middle-high schoo1 students in Chinan County was 17.9%, relatively high. This smoking rate was different according to the gender, grade, religion, and economic situation. In mals, high school students, non-religious, students low income family students, the smoking rate was higher. The smoking rate of high school students was almost the same as the smoking rate of adults, generally higher than that of foreign teenagers. Because the smoking rat of studinets in the third grade of middle school and in the first grade of high School was six times higher, increased education should be conducted during this time in an attempt to curb the sudden increase of the smoking rate. The smoking rate of girl students was 5.0%; this has increased mor than three times from ten years ago. Consequently, counter measures should be taken against the smoking of female students as well as juvenile smoking in general. In addition, the smoking rate of middle-high school students showed interesting differences when correnated with enviornmental factors. Students with low grades, who are not satisfied with school life, who don't have both parents, who have uncaring parents who nare too strict or too arbitary, who have smoking parents, or who have experienced smoking commonly smoked. Therefore, to lower the smoking rate we should improve the school environment, improve a student's interest in school life. And parents or siblings should lead by example and quit smoking at home. Schools should educate students more effectively concerning the harmful effects of smoking and create an accurate understanding of its dancers. From the beginning, we should teach students never ever to touch cigaretts. 2. The surve discovered that most students started out of curiosity, or solicitantion from friends or elders at middle school, and had been smoking one to five cigarettes for more than a year. They obtained cigarettes at stores and most of them have friends who smoke. As a result anti-smoking education should be conducted at elementary schools prior to middle school. More than 95% of the teenagers who smoke had friends who smote and smoked out of curiosity or the recommendation of elders. Thus, we must focus on teenagers who smoke in group, rather than individually. Fuyrthermore, the strict application of the regulation of tobacco sales as well as tobacco cooperation from retailers are needed. While students did not show any mood or academic achievement difference after beginning smoking, 58.1% of the students a health situdation that was worse. Juvenile smoking is more harmful to the juvenile than adult smoking is to the adult. This should be focused on in an anti-smoking campaign. 3. Students who smoke hada more positive attitude toward smoking than students who don't smoke. Students who smoke had a tendency to have a nuetral position and are not concerned about smoking compared to non-smoking students. The survey showed that the great number of students had a nuetral position. Because this nuetrality may increase Juvenile smoking, education that provides an exact understanding of smoking should be performed to build the correct attidude toward smoking. 4. Middle school students smoke when angry, gloomy, anxious, a lone and when they have some problems to solve, on when they feel inconveniened in other wores, they smoke to reliver stress. They also smok due to addiction. Because smoking is not a praetical method to relieve stress, a program which helps to acquire positive relief stress should be provided to help reduce smoking. 5. About 65% of students who smoke want to quit smoking because of health problem, 78% of them have tried mor than once to quit but failed due to weak will power and peer pressure from friends who smoke. Juvenile smoking is group, oriented. Thus, the program that advances less smoking will be the one that focuseds on groups. 6. As for advice to students who want to quit smoking, "persuasion" was used most commonly, followed by a "presentation on how to quit smoking". Another method were severe punishment. About 70% of the students wanted the anti-smoking guide at school. 7. Most students (73.5%) had a position that more anti-smoking education at school is needed. Obriously, then, anti-smoking education at middle-high schools should be reinfoced. Although the education which explains the harmful influence of tobacco is known as an efficient way prevent smoking; it does not influence students who already smoke. Therefore, for students who smoke, multi-dimensional approaches must be attempted that include physical training, phychokogical approache, consultation and discussion, medical chek-ups, audio-visual education technigues, and professonal instructors, in addition, because smoking students have more negative on lukewarm attitude to anti-smoking education anti-smoking education should be conducted through a communicative style by dedicated teachers who care about students. In order to increase the effectiveness of this program.

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A cognitive survey on the Diversification of class year from Junior Colleges by Changing Educational Environment-Focused on Health Sciences Departments (교육환경 변화에 따른 전문대학 수업 연한 다양화에 대한 인식조사 - 보건계열학과 중심으로)

  • Park, Cheolin;Park, Su-Jin;Kwon, Soon-Mu;Kim, Won-Gi;Chang, Ki-whan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.4
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    • pp.186-196
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    • 2018
  • Junior colleges are higher education institutions that have played a major role in the economic development of Korea by providing the necessary human resources for its industrial development. Recently, however, they have experienced difficulties due to the reduction in the number of students. Therefore, it is time for junior colleges as a representative higher vocational education institution to change their role in this rapidly changing environment, and adopt a survival strategy through mutual cooperation and competition. The purpose of this study was to analyze the current state of the national health universities, to investigate the policy changes adopted by colleges and universities, and to utilize the results as data. This study analyzed the current status of health science colleges nationwide and investigated the policy changes as well as the directions presented to the colleges, in order to use the results as the basic data to promote the diversification of the class periods and degree programs. This study surveyed 636 professors from health sciences departments and industry workers from May 1 to May 30, 2017. 70.7% of the respondents supported the transition of the existing three-year systems of the health science departments to four-year systems. The reason for this is that it is possible to strengthen the field practice and personality education of the students by having a sufficient number of class periods, and to provide them with an equal educational background. The most anticipated effect of the transition to a four-year system is to improve the social status of medical personnel and to improve the educational environment of the colleges/universities. Moreover, the universities, associations of medical personnel and Ministry of Education are expected to play a leading role in the transition to the four-year system. Based on the results of this study, it was concluded that a more systematic and advanced vocational education system for the training of professional healthcare workers is needed in the upcoming fourth Industrial Revolution era. Also, this transition is expected to actively foster the education of advanced health care workers thanks to the diversification of the degree programs through the adjustment of the class periods which can be completed by general university (4-year) graduates.

Rationalizing Strategies for Children's Activity Spaces and Facilities (어린이 활동공간 및 놀이시설 제도 합리화 방안)

  • Park, Mi-Ok;Koo, Bon-Hak
    • Journal of the Korean Institute of Landscape Architecture
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    • v.40 no.4
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    • pp.36-50
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    • 2012
  • This study was carried out to find contradiction factors on laws for children's activity spaces and facilities and to suggest the rational options to control and manage those spaces and facilities by environmental and landscape planning methods. The results of this study are as follows: 1. The major laws related to the environmental safety for children's activity spaces are "Environmental Health Act (ERA)" for managing the environmental safety of children's activity spaces; "Safety Supervision Law of Children's Play Facilities(SSLCPF)" for the inspection and management for safety of children's play facilities; "Quality Management and Industrial Products Safety Management Law(QMIPSML)" for managing safety certification on children's play equipments. 2. The interior space such as "living room" by the Children's Welfare Law(CWL), "Children Park" by the Act on Urban Parks and Green Spaces(AUPGS), "classroom" on private educational institutes by the Act on Establishment and Operation Private Lesson and Training(AEOPLT) and "nursing room" of child care center smaller than $430m^2$ are needed to be managed as an activity space. 3. In order to reduce industrial burden in the production, establishment, construction, and operation and to minimize unwilling extra burden in the administration effort due to legally double regulate, it is necessary to mitigate the inspections on the equipment certificate from QMIPSML and overlapped or different factors and standards must be unified. With this study, the landscape domain could he enlarged from producing, import of play equipment and establishment, construction and operation of play facilities for a comprehensive range of activity spaces, and the landscape industry such as engineering industry, academic research, management, etc.

Contamination of operator's clothing by aerosols during scaling (스케일링 시 에어로졸에 의한 술자의 의복 오염도)

  • Kang, Kyung-Hee;Kim, Ye-Jin;Min, Ji-Yeon;Park, Seul-Gi;Woo, Ju-Hee;Goong, Haw-Soo
    • Journal of Korean Academy of Dental Administration
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    • v.5 no.1
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    • pp.31-37
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    • 2017
  • Recently interest in infection control is increasing in hospitalsnfection control has become more important in the overall health care practiceental hospital also requires thorough infection control. There are various kinds of vectormedical clothing. Contaminated clothing of a hospital staff can be a vector of nosocomial infecton. actual case of nosocomial infecton caused by contaminated medical clothing, nursing students were measuring contamination levels of uniforms and pathogenic microorganism wdetected in front of the uniform and pocket. There is also a high risk of exposure to contamination in the dental hospital. We conducted a study to enhance awareness about infection and proper clothing management by comparing before and after contamination of clothing caused by aerosols produced during scaling. Subjects were scaling operators' uniforms in the department of dental hygiene, K University located in Daejeon. Before scaling, the uniform was sterilized by autoclavecaling was performed times in the same place (an average of 60 minutes per person, a total of 180 minutes). ive parts of the uniform (sleeves, chest, belly, thigh, edge of pants) contracted Rodak-plate for 15 seconds. After incubating the contacted Rodak-plate at 37℃ incubator, contamination levels by measuring the number of colonies. As a result, all parts increased number of colonies. ontamination order chestedge of pants thigh belly sleeves. Increase rate of colonies was also high in the order chest edge of pants thigh belly sleeves. This study showed seriousness of clothing contaminationcaused by aerol produced during scalingcontamination of clothing can be a path to nosocomial infecton. According to th study, infection control for clothing as well as dental instruments should be implemented and thorough infection control training needed for dental staff. In further researches, practical infection prevention supplementing clothing management method.

Current Status of Informed Consent Form for Acupotomy in Korean Medicine Hospitals and Development of a Standard Informed Consent Form Using Delphi Method (한방병원의 침도 시술 동의서의 현황 조사와 델파이 기법을 활용한 표준 시술 동의서 개발)

  • Jihun Kim;Bonhyuk Goo;Hyongjun Kim;Kyoungsuk Seo;Myungjin Oh;Myungseok Ryu;Sang-Hoon Yoon;Kwang Ho Lee;Hyun-Jong Lee;Jungtae Leem;Hyungsun Jun;Jeong Ihn Sook;Sung Woon Choi;Tae Wook Lee;Yeonhak Kim;Yoona Oh;Kunhyung Kim;Gi Young Yang;Eunseok Kim
    • The Journal of Korean Medicine
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    • v.45 no.1
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    • pp.182-201
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    • 2024
  • Objectives: This study was conducted to develop a standard acupotomy consent form that takes into account the unique characteristics of Korean Medicine. The study was motivated by the increasing importance of patient autonomy and the growing number of legal disputes related to medical malpractice in the clinical field of Korean Medicine. Methods: The analysis phase of the study involved a survey of the current status of acupotomy consent forms in Korean Medicine hospitals nationwide. The items of each form were analyzed based on the contents of the Medical law and the standard contract for medical procedures of the Fair Trade Commission (FTC). In the development and evaluation phase, the items and contents of the acupotomy consent form were evaluated using a 5-point Likert scale and content validity was assessed through two rounds of Delphi surveys. In the improvement phase, the contents of the consent form were revised based on the results of a survey of inpatient and outpatient patients in the Department of Acupuncture and Moxibustion at Pusan National University Korean Medicine Hospital, and real-time online meeting. The final version of the standard acupotomy consent form was completed after undergoing proofreading and corrections by a linguistics expert. Results: Only 30% of Korean Medicine hospitals have implemented acupotomy consent forms. The items of the consent forms did not fully include the items presented in the Medical act and the standard contract for medical procedures of the FTC. To address this issue, two rounds of Delphi surveys and a real-time discussion were conducted with a panel of 12 experts on 27 preliminary items of consent forms. The items and contents that met the criteria for content validity ratio, convergence, and consensus were derived. Based on the derived items and content, a standard acupotomy consent form was developed. Conclusions: The standard consent form for acupotomy is anticipated to ensure patient autonomy and enhance transparency and liability in acupotomy. Furthermore, it is expected to serve as evidence in case of medical disputes related to acupotomy and contribute as a reference document for the development of standard consents forms for various procedures of Korean Medicine. However, the limitations of the study include that the survey of consent forms was limited to only training hospitals of Korean Medicine, and the standard consent form is only applicable to adults in Korea. Future studies are needed to address these limitations.