• The Korean Society of Law and Medicine
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• v.13 no.1
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• pp.249-293
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• 2012

Inter-hospital transfer, depending on its medical and legal appropriateness, affect the prognosis of patients and can even lead to legal disputes. As Emergency Medical Service Act, any physician shall, in case where deemed that pertinent medical service is unavailable for such patient with the capacities of the relevant medical institution, transfer without delay such patient to another medical institution where a pertinent medical service is available. For medico-legally appropriate inter-hospital transfer, the head of a medical institution shall, in case where he transfers an emergency patient provide medical instruments and manpower required for a safe transfer of the emergency patient, and furnish the medical records necessary for a medical examination at the medical institution in receipt of such patient. And transfer process must comply with the requirements prescribed by executive rule such as attachment of the referral, provision of ambulance, fellow riders and informed consent of transfer. Those engaged in emergency medical service shall explain an emergency medical service to an emergency patient and secure his consent. In addition to the duty to inform about emergency medical service to the patient and his or her legally representative, there is also a duty for doctors to sufficiently explain to the patient and his or her legally representative during inter-hospital transfer that the need for the transfer, the medical conditions of the patient to be transferred and emergency treatment that will be provided by the hospital from which the patient is going to transferred. Likewise, the hospital to which the patient is transferred must be thoroughly informed about matters such as the patient's conditions, the treatment the patient was given and reasons for transfer by transferring doctors.

• Journal of Korean Clinical Nursing Research
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• v.27 no.2
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• pp.210-219
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• 2021

Purpose: The study was conducted to investigate the correlation between perception of patient safety risk factors, patient safety competency, and safety nursing activities of nurses in hemodialysis units and identify factors affecting patient safety activities. Methods: The participants were 146 nurses from 16 hemodialysis units located in Gyeongsangnam-do. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson correlation coefficient, and multiple regression analysis using the SPSS, version 24.0. Results: The mean safety nursing activity score was 3.47±0.38. safety nursing activities of the participants were significantly correlated with patient safety competency. The characteristics showing significant differences in safety nursing activities were educational level, hospital type, hospital work experience, number of hemodialysis treatment per day, number of hemodialysis treatment per nurse, educational experience of patient safety, presence of a patient safety incident report registration system, and direct registration of patient safety incident report. The multiple regression analysis revealed that the factors influencing safety nursing activities were patient safety incident report, patient safety competency, and number of daily hemodialysis treatment (<5~7 times/day) per nurse (R²=.34). Conclusion: The results of this study suggest that the safety nursing activities of hemodialysis unit nurses should be intensified. In addition, the registration system of patient safety incident report and nurses' competency on patient safety should be improved, and the number of hemodialysis per nurse should be fewer than 7 times per day.

• Journal of Korean Academy of Nursing Administration
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• v.7 no.1
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• pp.5-14
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• 2001

To estimate total burden of hospital admission over patient of gamily, we need to know the unofficial private expenses in addition to explicit hospital admission fees. This study was conducted from June 29, 2,000 to August 10, 2,000. Subjects were 104 patient at university hospital located at chungnam province. After thorough explanation of purpose and procedures, notebooks are given to each patient or guardian. They are requested to recorded all relevant expenditures occurred during hospital stay. Incomplete records were filled-up by direct personal contact or phones. Datas were summarized and analyzed using SAS statistical package. P-value less than 0.05 was considered significant. The results of the study are as follows: 1. In 96.1% of the patient, guardians stayed at hospital to take care of patients. In 38,8% one of the family members get work-leave or temporary resting from job. Average date of leave was 7.5days. 2. Average informal cost burden per patient was 204,467 won (14,330 won${\sim}$1,594,870 won). Average hospital cost paid by the patient was 1,061,807 won. The ratio of informal cost burden to hospital cost paid by the patient was 0.327. 3. According to the regression analysis, the relevant factors affection informal cost burdens were distance from home to hospital(p=0.018), and duration of hospitalization(p=0.0001). 4. Informal cost burden was composed of expenses for personal expense of care giver (126, 720 won/patient), meal (86,924 won/patient), transportation (77,648 won/patient), necessaries of life (18,789 won/patient), tests and treatments not covered by insurance (17,289 won/patient), medical supplies not covered by insurance (15,280 won/patient), treat for visitors (14,757 won/patient), TV coin (8,247 won/patient), and others (7,582 won/patient). In addition to the hospital cost paid by the patient for hospital admission, the informal cost burdens should be recognised explicitly because it is not small. Significant proportion of informal cost burden is composed of care-giver's personal expense, transportation, meal. It is suggested that some polices are to be devised and implemented enabling that this portion of informal expenses be directed to formal professional nursing care. Thus we can improve the quality of care and decrease discomfort of patient's relatives.

• The Journal of the Korea Contents Association
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• v.17 no.10
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• pp.268-279
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• 2017

The purpose of this study was to investigate the relationship between recognition about patient safety culture, patient safety competence, and safety nursing activities for emergency room nurses. The subjects of this study were 121 nurses working in the emergency room among the nurses with more than one year working in 9 general hospitals. The research tools were structured questionnaires of patient safety culture, patient safety competence, and safety nursing activities. As a result of this study, the perception of the patient safety culture was 3.51 out of 5, and the patient safety knowledge / attitude at the individual level was the highest. Patient safety competence was 3.60 points out of 5, and sub-domain showed 3.91 for attitude, 3.47 for skill, 3.24 for knowledge. Safety nursing activities showed 3.85 points out of 5 points and sub-area showed the highest level of medication. There was a positive correlation between safety nursing activities and patient safety culture(r=.40, p<.001), patient safety competence, and safety nursing activities(r=.70, p<.001), patient safety competence and patient safety culture(r=.40, p<.001). Especially, it was found that among the characteristics showing differences in the perception of the safety culture, patient safety competence, and safety nursing activities, the safety education within the last one year was influential. The lowest score in the knowledge domain was found to be the lowest among sub-scales of patient safety competence, and it was found that efforts to increase the knowledge level of patient safety were needed.

• Journal of The Korea Institute of Healthcare Architecture
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• v.24 no.1
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• pp.33-40
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• 2018

Purpose: The main objective of this paper is, to assess environment, care process, and patient-related factors associated with patient falls. The study also aims at identifying various factors that would affect inpatient falls and, therefore, helping both caregivers and designers contribute to better prevent inpatient falls in their own areas of expertise. Methods: A retrospective analysis of inpatient falls that occurred in the unit of General Medicine in the United States has been conducted and environment, care process, patient-related factors associated with those falls have been analyzed at the same time. Results: The study identified several factors associated with inpatient falls. They range from environmental factors to care process- and patient-related factors. Patient visibility and patient accessibility can matter to patient falls and where those falls occur, along with patient days per room, the percentage of patient days with high fall risk patients per room, the percentage of high fall risk patients per room. Implications: The findings of the study can provide design implications that can be incorporated into design process and design decisions to promote fall prevention in inpatient care units. Inpatient falls can be effectively reduced when caregivers and designers work together to understand the complex nature of inpatient falls and the importance of multidisplinary efforts among various experts in the areas of healthcare.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.17 no.1
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• pp.89-106
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• 1987

The author obtained individualized lateral cephalometric tomograms from 23 young adults (46 of left and right normal TMJ) with normal occlusion and 20 patients (14 of patient asymptomatic TMJ and 26 of patient symptomatic TMJ) with clicking and painful TMJ after the analysis of submental vertex view. Individualized lateral cephlometric tomogram analysis and TMJ space analysis were performed after tracing each film. All data from these analysis was recorded and statistically processed with CYBER computer system. 1. The results were obtained as follows. In submental vertex view, the mean condylar angulation of Rt. side in normal group was 20.348°±6.358°, Lt. side was 18.870°±7.777° and Rt. side in patient group was 19.350°±7.576° Lt. side was 17.750°±6.146° respectively. The mean condylar angulation of Rt. side was larger than Lt. side in normal and patient group. 2. When the mandible was moved from centric occlusion to centric relation, condylar position relating to the glenoid fossa was placed posteriorly and superiorly in normal TMJ group and patient symptomatic TMJ group. 3. In centric relation position, the proportion of anterior space to posterior space was 1.593 for normal TMJ group, 1.604 for patient asymptomatic TMJ group and 1.671 for patient symptomatic TMJ group. In centric occlusion position, 1.390 for normal TMJ group, 1.539 for patient asymptomatic TMJ group and 1.196 for patient symptomatic group. Normal TMJ group, patient asymptomatic TMJ group and patient symptomatic TMJ group and patient symptomatic TMJ group revealed significant difference in ∠C₂ measurement. (ANOVA-test, p<0.05) 5. Normal group and patient group revealed significant difference in Fh, ∠C₁and ∠C₂ measurement. (T-test, p<0.05) 6. There were strong positive correlation (0.8771) between Fp and Fm, and strong negative correlation (-0.9039) between ∠C₂ and ∠C₁ from the lateral cephalometric tomogram analysis.

• Radiation Oncology Journal
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• v.37 no.4
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• pp.302-308
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• 2019

The abscopal effect is a term that has been used to describe the phenomenon in which localized radiation therapy treatment of a tumor lesion triggers a spontaneous regression of metastatic lesion(s) at a non-irradiated distant site(s). Radiation therapy induced abscopal effects are believed to be mediated by activation and stimulation of the immune system. However, due to the brain's distinctive immune microenvironment, extracranial abscopal responses following cranial radiation therapy have rarely been reported. In this report, we describe the case of 42-year-old female patient with metastatic melanoma who experienced an abscopal response following her cranial radiation therapy for her brain metastasis. The patient initially presented with a stage III melanoma of the right upper skin of her back. Approximately 5 years after her diagnosis, the patient developed a large metastatic lesion in her upper right pectoral region of her chest wall and axilla. Since the patient's tumor was positive for BRAF and MEK, targeted therapy with dabrafenib and trametinib was initiated. However, the patient experienced central nervous system (CNS) symptoms of headache and disequilibrium and developed brain metastases prior to the start of targeted therapy. The patient received radiation therapy to a dose of 30 Gy delivered in 15 fractions to her brain lesions while the patient was on dabrafenib and trametinib therapy. The patient's CNS metastases improved significantly within weeks of her therapy. The patient's non-irradiated large extracranial chest mass and axilla mass also shrank substantially demonstrating the abscopal effect during her CNS radiation therapy. Following radiation therapy of her residual chest lesions, the patient was disease free clinically and her CNS lesions had regressed. However, when the radiation therapy ended and the patient continued her targeted therapy alone, recurrence outside of her previously treated fields was noted. The disease recurrence could be due to the possibility of developing BRAF resistance clones to the BRAF targeted therapy. The patient died eventually due to wide spread systemic disease recurrence despite targeted therapy.

• Journal of The Korea Institute of Healthcare Architecture
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• v.20 no.4
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• pp.49-56
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• 2014

Purpose : This purpose of this study is to make a better public hospital patient room to reflect the views of the patient. Methods: Survey to examine patient experience on healing environment in public hospital have been conducted for the data collection. 229 open-ended answers have been analysed statistically by MS Excel program. Results : 1) If there is no toilet space in the six-patient room, installation of toilet in the patient room is necessary. 2) The most Frequently used patient furnitures are necessary to accomodate the patients needs. Depending on the patient condition, installation of a portable or fixed the room furniture for the convenience to the using furniture. 3) According to the flow of modern times, wireless internet access is required to install of expand the space. Also be used to establish a regulations of internet space. 4) To create healing environment infection free environment should be provided. 5) Need for improvements of patient room for relatives of patient. It is necessary to secure a comfortable space to stay. 6) Separation is needed among the patients through therapeutic classification. Implication : In order to provide a better patient room environment, it is necessary to reflect the patient's opinion.

• The Journal of the Korea Contents Association
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• v.13 no.3
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• pp.278-286
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• 2013

The main purpose of this study is to examine the effect of patient-centered communication of doctor(facilitating factor, inhibition factor) on patient participation(behavioral participation, emotional participation, informational participation). Concretely, it is confirmed where there are effects of patient-centered communication of doctor to patient participation and whether there are moderating effects of trust between patient-centered communication of doctor and patient participation. In domestic general hospital, 301 samples were for this analysis collected and tested by factor analysis and moderating regression analysis. As a result of this study is as followings. First, it is confirmed that communication facilitating factor have influences on patient participation positively and communication inhibition factor have no influences on patient participation. Second, there are moderating effects of trust between facilitating factor and emotional participation, between facilitating factor and informational participation. Especially, in higher level group of trust, it is confirmed that facilitating factor more influence on emotional participation and informational participation. On the basis of these study results, I suggested theoretical and practical implication for the patient-centered communication and successful medical service.

• Journal of Oriental Neuropsychiatry
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• v.21 no.2
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• pp.75-85
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• 2010

Objectives : This study was designed to evaluate the correlation between patterns of dyspepsia(acute dyspepsia, functional dyspepsia, dyspepsia with the organic disease) and autonomic nerve system dysfunction using HRV analysis. Methods : The patient group consisted of 88 patients diagnosed as a dyspepsia (Acute dyspepsia group-35 patients, Functional dyspepsia group-28 patients, Dyspepsia with the organic disease group-28 patients) who visited in the Oriental Medical Hospital of Dong-eui University from 2005.3.OO to 2008.8.OO. And the control group consisted of 33 patients diagnosed as a normal state of stomach during the same period. We checked HRV of the 4 groups over 5 minutes and compared the HRV index between groups. Results : 1. HF, LF, VLF and TP were significantly lower in the acute dyspepsia, functional dyspepsia and organic dyspepsia patient group than in the control group. 2. HF, LF, VLF and TP were higher in the acute dyspepsia patient group than in the organic dyspepsia patient group, but the differences were not statistically significant. 3. HF, LF, VLF and TP were higher in the acute dyspepsia patient group than in the functional dyspepsia patient group, but the differences were not statistically significant. 4. HF, LF, VLF and TP were lower in the functional dyspepsia patient group than in the organic dyspepsia patient group, but the differences were not statistically significant. Conclusions : Compared to the control group, all of the dyspepsia patient groups showed the tendency that the overall activity of the autonomic nervous system and the activity of sympathetic nerves decreased. Although there was no significant difference in the suppression of the autonomic nervous system, chronic dyspepsia patient group was lower than acute dyspepsia patient group, functional dyspepsia patient group was lower than the organic dyspepsia patient group in HRV.