• The Korean Journal of Pain
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• 제24권2호
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• pp.74-80
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• 2011

Background: Lidocaine patch (L5P) has demonstrated short-term efficacy in treating both acute surgical pain and chronic neuropathic pain with tolerable side effects. Percutaneous endoscopic lumbar discectomy (PELD) is the mainstay of minimally invasive spine surgery (MISS). Sufficient analgesia during PELD surgery makes the patient consider it real MISS. This study was performed to evaluate the efficacy and adverse effects of lidocaine patch in patients who underwent PELD under local anesthesia. Methods: L5P (L group) or placebo (P group) was randomly applied on the skin of the back covering the anticipated path of the working channel before 1 hour of surgery in 100 patients who underwent a single level PELD at L4-L5. Efficacy of the lidocaine patch was assessed by patient's numeric rating scale (NRS) of pain at each stage during the surgery and by a 5-scale grading of the satisfaction with the anesthesia of the operator and patients after surgery. Results: Mean NRS scores at the stages of needle insertion, skin incision, serial dilation and insertion of working channel, and subcutaneous suture were significantly lower in the L group than the P group. Postoperative operator's and patients' satisfaction scores were also significantly higher in L group than in the P group. There were subtle adverse effects in both groups. Conclusions: L5P provided better pain relief during PELD, especially at the stage of needle insertion, skin incision, serial dilation and insertion of working channel, and subcutaneous suture. It also provided higher patient and operator postoperative satisfaction, with only subtle adverse effects.

• 한국병원경영학회지
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• 제13권1호
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• pp.42-64
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• 2008

This study was conducted to evaluate the quality in medical records by analyzing its completeness through setting up the level of record on the patient's past history and through examining the actual medial records. Targeting the information on the patient's past history in interns' records, residents' records and nurses' records toward 403 inpatients who were admitted first in 2004 at an university hospital due to stomach cancer. We analyzed whether the charts were recorded or not, recording level, the satisfaction with the expectant level of the records in the hospital targeted for a research and the level of agreement. The results were as follows; first, as for the rate of recording those each items, they were high in the chief complaint & present illness and the past illness history. Depending on the group of recorders, the recording rate showed big difference by items. Second, as a result of measuring the level after dividing the recording level of items for the patient's past history from Level 1 to Level 4 by each item, the admission history, the past illness history, and the family history were about Level 3, and the smoking history, the medication history, the chief complaint & present illness, the drinking history and allergy were about Level 2. In the admission department, it was excellent in the interns' records for the medical department. Third, as a result of its satisfactory level by comparing the expect level of a record and the actual record by item in information on the patient's past history, which was expected by the medical-record committee members of the hospital targeted for a study. And forth, we analyzed the level of agreement with Kappa score in the level of 'Yes' or 'None' related to the corresponding matter in Level 1, in terms of information on the past history in the intern's record, the resident's record, and the nurse's record. The level of agreement in the resident's record & the nurse's record, and in the intern's record & the resident's record was from "excellent" to "a little good". There were differences in the level of completeness and in reliability for the information on the past history by the recorder group or by the admission department. The encounter process that was performed by the admission department or the recorder group, indicated the result that was directly reflected on the quality of medical records, thus it was required further study about the medical record documentation process and quality of care. The items that showed the high recording rate quantitatively were rather low, consequently we'd should develop the tool for the qualitative inspection and evaluate the medical records further. And the items were needed to be detailed in the record level were rather low, and hence there needed to be a documentation guideline and education by the clinical departments.

• Physical Therapy Rehabilitation Science
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• 제10권2호
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• pp.217-224
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• 2021

Objective: This study is about the physical therapy facilities and environmental and service satisfaction of patients visiting in the front military hospitals and divisions. Design: Survey study Methods: Prior to this survey, 28 users of the front division and military hospital were surveyed in advance to verify the survey through reliability analysis. For this survey, 1,300 questionnaires were distributed to seven frontline divisions and three military hospitals, of which 578 military hospitals and 479 divisions were collected. Among them, 1,042 pieces of data were used for the analysis, excluding 15 questionnaires that exceeded the research period of the division. Analysis methods used Cronbach-α and multiple regression for mean comparison analysis, factor analysis for validation, and reliability verification to verify differences between groups. Results: As a result of the satisfaction analysis, the division's stage satisfaction was higher than that of military hospitals, and as a result of analyzing the satisfaction items by sector, accessibility, re-visit doctors, and professionalism accounted for a large portion in the field of physical therapy services. As a result of a regression analysis, the factors that affect the satisfaction of physical therapy had the greatest impact on facility and environmental satisfaction, and expertise in physical therapy services. Conclusions: In the future, it will be necessary to improve the comfort of the physical therapy room and the expertise of physical therapy in order to improve the satisfaction level of physical therapy at military medical facilities.

• International Journal of Quality Innovation
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• 제10권2호
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• pp.109-126
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• 2009

The purpose of this study was to examine overall customer satisfaction associated with medical service quality in Taiwan by integrated Kano's model and customer satisfaction index model. Another purpose was to confirmed nonlinear and asymmetric relationship of Customer Satisfaction and Quality Performance by the research outcome. By analyzing 1,100 patients or their family members, this study used the structural equation model (SEM) with AMOS software for data analysis. The results show that must-be attributes, one-dimensional attributes and attractive attributes had a direct effect on overall customer satisfaction, Surprisingly, overall customer satisfaction had positively influenced customer loyalty customer satisfaction had negatively influenced customer complaints. The study also found that customer complaints have direct effect on customer loyalty. Importantly, the study found out the must-be attributes, the attractive attributes and one-dimensional attributes increased, the level of overall customer satisfaction also increased. The customer satisfaction positively influences customer loyalty in medical service quality in Taiwan. The findings might reveal new insights for researchers dealing with quality of medical service and for hospital managers who devote resources exclusively to achieving highest possible levels of patient satisfaction.

• Archives of Plastic Surgery
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• 제32권5호
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• pp.573-581
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• 2005

Breast cancer is the second leading cause of death in woman. Unfortunately, the frequency of breast cancer and mastectomy are increasing in Korea. This paper introduces the breast reconstruction by use of pectoralis major muscle transfer with breast implant for small size defect after skin sparing mastectomy for more satisfaction. We reviewed 24 consecutive patients who underwent breast reconstruction by pectoralis major muscle transfer with implant and only breast implant in Dong-A University from April 2002 to March 2004. The patient's age ranged between 29 and 54 years with mean of 42.3 years. We used pectorals major muscle transfer with breast implant in 12 patients and breast implant alone in 12 patients as control. The follow-up period of patients ranged from 10 months to 3 years with mean of 18.5 months. The points of comparison with control group reconstructed by breast implant alone were doctor and patient satisfaction score, operation time, duration of admission, amount of drainage, complication and satisfaction according to mass location. In conclusion, there is no difference with control group in the point of operation time, mount of drainage, duration of admission. And there is higher level of doctor's and patient's satisfaction in group reconstructed by pectoralis major muscle transfer with breast implant than implant only group. Especially, pectoralis major muscle transfer with breast implant was especially necessary for the defect in upper lateral quadrant of the breast to get more satisfaction. The advantage of pectoralis major muscle transfer with breast implant is prevention of the protruding and palpability of implant and aesthetically satisfactory result by intraoperative modification of breast shape.

• 간호행정학회지
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• 제7권3호
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• pp.439-446
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• 2001

The purpose of this study was to identify the relationship of nursing service satisfaction and nurse's nursing activity styles in a hospital settings. The subjects of this study were 150 admitted patients in a hospital. The data was collected with Nursing Service Satisfaction Scale developed by Tomas(1996) and modified Nurse's Nursing activity styles Scale developed by Coeling(1993). The results were as follows: 1. The mean score for the level of nursing service satisfaction was 65.00(SD=14.10). The mean score for subcategories of nurse's nursing activity styles were as follow; work difficulties management 9.47(SD=2.02), effective work attitude 23.53(SD=3.14), interpersonal relationship 48.82(SD=6.18), keep regulation 23.24(SD=3.62), professional values 48.28(SD=5.27), and professional development 24.41(SD=3.07). 2. The correlations of nursing service satisfaction and subcategories of nurse's nursing activity styles were revealed a positive significant correlation; work difficulties management(r=0.17, p=0.03), effective work attitude(r=0.44, p=0.00), interpersonal relationship(r=0.51, p=0.00), keep regulation(r=0.44, p=0.00), professional values(r=0.31, p=0.00), professional development(r=0.30, p=0.00). 3. Stepwise multiple regression analysis revealed that the most powerful predictor of nursing service satisfaction was effective interpersonal relationship. A combination of effective work attitude, work difficulties management account for 38% of the variance in nursing service satisfaction of the patient in a hospital. In conclusion, this study revealed that the effective work attitude, interpersonal relationship, and work difficulties management in nursing activity were important factors to improve the level of nursing service satisfaction.

• 디지털융복합연구
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• 제15권11호
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• pp.317-327
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• 2017

본 연구는 간호대학생의 간호전문직관과 비판적 사고성향이 환자안전에 대한 태도에 미치는 융 복합적 영향을 규명하고자 시도되었다. 연구 대상자는 S지역 소재 2개 대학의 4학년 학생 172명이며 자료 수집기간은 2017년 5월 15일부터 5월 26일까지이다. 수집된 자료는 SPSS 23.0 Version을 이용하였으며 t-test, ANOVA, $Scheff{\acute{e}}$ test, Pearson's correlation coefficient와 Hierarchical regression analysis를 실시하였다. 연구 결과 연구대상자의 환자안전에 대한 태도는 3.76점으로 중간 정도이었다. 간호전문직관과 비판적 사고성향은 환자안전에 대한 태도와 양의 상관이 있는 것으로 나타났다. 환자안전에 대한 태도에 유의한 영향을 미치는 변수는 간호학과 지원동기의 '주변권유'와 학업성적, 전공만족, 간호전문직관으로 이들 변수의 설명력은 17.8%로 나타났다. 따라서, 간호대학생의 환자 안전에 대한 태도를 향상시키기 위하여 학과 지원동기, 학업성적, 전공만족도 및 간호전문직관 확립을 위한 체계적인 관리가 필요하며, 향후 환자안전에 대한 태도에 영향을 미치는 설명력 있는 변수에 대한 추가연구가 필요하다.

• 치위생과학회지
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• 제5권4호
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• pp.191-198
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• 2005

치과의료기관의 치과의료서비스에 대한 만족 요인을 파악하여 치과의료기관의 환자 만족도를 향상시키고, 다른 치과의료 기관과의 경쟁력 강화를 위한 정보를 제공하고자 2003년 3월 23일부터 4월 10일까지 전라북도에 소재하고 있는 치과의원에 내원한 환자들을 대상으로 현장 설문 조사한 결과 다음과 같은 결론을 얻었다. 1. 치과의사에 대한 만족도는 남자(4.30), 50세 이상(4.41)의 연령, 중학교 졸업이하(4.30)의 학력에서 높게 나타났다. 치과위생사에 대한 만족도는 직업에서 통계적으로 유의성이 있었으며 회사원(4.38)과 자영업(4.36)에서 높게 나타났으며 공무원(3.86)에서 가장 낮게 나타났다. 2. 내부환경에 대한 만족도는 연령, 학력, 직업에서 통계적으로 유의성이 있었다. 50세 이상(4.23)의 연령, 중학교 졸업 이하(4.11)의 학력, 퇴직 또는 무직(4.31), 자영업(4.11)에서 높게 나타났다. 3. 외부환경에 대한 만족도는 직업에서 통계적으로 유의성이 있었는데 퇴직 또는 무직(3.57)에서 가장 높았으며 공무원(2.83)에서 가장 낮았다. 4. 진료절차에 대한 만족도는 직업에서 통계적으로 유의성이 있었는데 자영업(3.97), 퇴직 또는 무직(3.89)에서 높았으며, 공무원(3.34)과 전문직(3.54)에서 낮았다. 5. 진료비에 대한 만족도는 50세 이상(3.95)의 연령, 고등학교 졸업(3.80)의 학력, 자영업(3.98)과 월평균 소득 300만원 이상(3.99)에서 가장 높게 나타났다. 6. 치과의료서비스를 받은 이후 진료에 대한 전반적 만족도에 영향을 미치는 요인을 분석한 결과 치과의사, 치과위생사, 진료절차, 진료비가 통계적으로 유의성이 있었다.

• Journal of Periodontal and Implant Science
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• 제53권3호
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• pp.194-206
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• 2023

Purpose: A novel attachment system for implant-retained overdentures (IRODs) with novel material combinations for improved mechanical resilience and prosthodontic success (Novaloc) has been recently introduced as an alternative to an existing system (Locator). This study investigated whether differences between the Novaloc and Locator attachment systems translate into differences in implant survival, implant success, and patient-centered outcomes when applied in a real-world in-practice comparative setting in patients restored with mandibular IRODs supported by 2 interforaminal implants (2-IRODs). Methods: This prospective, intra-subject crossover comparison compared 20 patients who received 2 intra-foraminal bone level tapered implants restored with full acrylic overdentures using either the Locator or Novaloc attachment system. After 6 months of function, the attachment in the corresponding dentures was switched, and the definitive attachment system type was delivered based on the patient's preference after 12 months. For the definitive attachment system, implant survival was evaluated after 24 months. The primary outcomes of this study were oral health-related quality of life and patient preferences related to prosthetic and implant survival. Secondary outcomes included implant survival rate and success, prosthetic survival, perceived general health, and patient satisfaction. Results: Patient-centered outcomes and patient preferences between attachment systems were comparable, with relatively high overall patient satisfaction levels for both attachment systems. No difference in the prosthetic survival rate between study groups was detected. The implant survival rate over the follow-up period after 24 months in both groups was 100%. Conclusions: The results of this in-practice comparison indicate that both attachment systems represent comparable candidates for the prosthodontic retention of 2-IRODs. Both systems showed high rates of patient satisfaction and implant survival. The influence of material combinations of the retentive system on treatment outcomes between the tested systems remains inconclusive and requires further investigations.

• 한국병원경영학회지
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• 제26권3호
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• pp.56-67
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• 2021

There are few domestic studies on medical services in medically vulnerable areas where medical use is not met due to a lack of medical resources. The past studies on smart medicine targeting medically vulnerable areas grasp only the overall satisfaction level, or the sub-dimensions of satisfaction are not classified clearly. Also, it lacks consideration of the patient's needs. This study aims to analyze the effect of users' experience of the smart medicine pilot project conducted in medically vulnerable areas on satisfaction and demand. The user's experience was measured by variables in the dimensions of structure, process, and outcome. Among the pilot project participants, 282 subjects responded to the 2019 survey. Using the hierarchical regression method, we tried to find out the determinants of satisfaction and service demands. Experience factors affecting satisfaction were found to be accessibility, certainty, effectiveness, and efficiency. In addition, it was found that the demand in their 60s was high and that accessibility, certainty, effectiveness, and efficiency had a statistically significant effect on the demand. It is expected that the smart medicine pilot project will be effectively operated by well utilizing the factors influencing satisfaction and demand revealed in this study.