• 제목/요약/키워드: Patient Acceptance of Health Care

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환자의 눈을 통한 간호의 질(QUOTE) 평가의 통합적 고찰 (An Integrative Review of the 'QUality Of care Through patient's Eyes')

  • 오진아;김예영;김현경;박현정;조해련
    • Child Health Nursing Research
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    • 제20권4호
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    • pp.283-293
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    • 2014
  • 목적 간호의 질을 평가함에 있어 환자의 측면에서 평가하는 것의 중요성이 점점 증가되고 있다. 본 연구의 목적은 환자의 눈을 통해 간호의 질을 평가하는 QUOTE 평가의 속성을 발견하고 제시하는 것이다. 방법 본 연구에서는 1997년부터 2013년까지 이루어진 QUOTE 평가 관련 국외 연구논문을 통합적 고찰 방법으로 분석하였고 Whittemore와 Kanfl (2005)이 제시한 4단계에 따라 연구를 진행하였다. 결과 본 연구에서 분석한 QUOTE 관련 연구는 총 32편이었으며, 분석을 통해 QUOTE 평가는 환자와 가족의 개별성을 인정함, 간호사의 다양한 역량을 평가함, 간호환경의 질을 평가함, 모든 평가과정에 대상자가 참여함의 4가지 주요한 속성을 가지는 것으로 밝혀졌다. 결론 본 연구는 임상현장에서 환자와 가족중심 간호를 제공하고 그 간호의 질을 평가할 때 유용하게 사용할 수 있는 평가 개념을 소개하고 그 핵심 속성에 대한 이해를 돕기 위해 시도되었다. QUOTE 평가에 대한 통합적 고찰이 국내 간호 현장에 맞는 다양한 도구개발로 이어진다면, 아동 간호현장에서 대상자와 가족에게 제공되는 간호에 대한 적합한 질 평가와 지속적 질 향상에 기여할 수 있을 것이다.

Risk Acceptance and Expectations of Scalp Allotransplantation

  • Choi, Jun Ho;Kim, Kwang Seog;Shin, Jun Ho;Hwang, Jae Ha;Lee, Sam Yong
    • 대한두개안면성형외과학회지
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    • 제17권2호
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    • pp.68-76
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    • 2016
  • Background: In scalp allotransplantation, the scalp from a brain-dead donor, including hair, is transferred to a recipient with scalp defects. Opinions differ on the appropriateness of scalp allotransplantation. In order to maintain graft function and cosmetic outcomes, scalp transplantation recipients would need to receive lifelong immunosuppression treatments. The risks of this immunosuppression have to be balanced against the fact that receiving a scalp allotransplant does not extend lifespan or restore a physical function. Therefore, the present study aimed to investigate risk acceptance and expectations regarding scalp allotransplantation in different populations. Methods: A questionnaire survey study was conducted. A total of 300 subjects participated; survey was conducted amongst the general public (n=100), kidney transplantation recipients (n=50), a group of patient who required scalp reconstruction due to tumor or trauma (n=50), and physicians (n=100). The survey was modified by using the Korean version of the Louisville instrument for transplantation questionnaire. Results: Risk acceptance and expectations for scalp transplantation varied widely across the groups. Kidney transplantation recipients revealed the highest risk acceptance and expectations, whereas the physicians were most resistant to the risks of scalp transplantation. Conclusion: Our study demonstrates that, in specific groups, scalp allotransplantation and the need for immunosuppression carries an acceptable risk despite the lack of lifeextending benefits. Our results suggest that scalp allotransplantation can be an acceptable alternative to existing scalp reconstruction surgeries in patients with pre-existing need for immunosuppression.

Psychometric Properties of the Persian Version of Satisfaction with Care EORTC-in-patsat32 Questionnaire among Iranian Cancer Patients

  • Pishkuhi, Mahin Ahmadi;Salmaniyan, Soraya;Nedjat, Saharnaz;Zendedel, Kazem;Lari, Mohsen Asadi
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권23호
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    • pp.10121-10128
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    • 2015
  • Background: Cancers impose an increasing burden on health of the populations and individuals, but little is known about cancer patient satisfaction with care. The aim of this study was to assess the psychometric properties of the Persian version of European Organisation for Research and Treatment of Cancer (EORTC) In-Patsat32, as a recently developed questionnaire to assess cancer patient satisfaction with care and information provided during hospital admission. Materials and Methods: Complying with EORTC protocols, the Persian version of Inpatsat32 was translated and piloted in a small group of patients, then applied to 380 cancer patients admitted to different oncology wards in Tehran. Validity (convergent, discriminant, and divergent) and reliability of the tool was assessed through using multitrait analysis, factor analysis, intraclass correlations, Chronbach's alpha and test-retest (on a sample of 70 patients). Results: Good acceptance and high sensitivity of the questionnaire with low floor and ceiling effects were recognized, indicating power of the instrument to detect differences between groups with heterogeneous levels of satisfaction. Multitrait scaling analyses supported the convergent validity of the majority of scales (correlation coefficient >0.4) and favorable discriminant validity (item own scale correlation >0.8). There was no correlation between In-patsat32 scales and the EORTC-C30, which measures different concepts, confirming divergent validity of the tool. Internal consistency for all domains was high (${\alpha}$ >0.70) except for the hospital access score and the test-retest reliability was excellent (r=0.86-0.96). There was a weak responsiveness to change except for nurses technical skills. Principle component analysis confirmed five domains with much improved internal consistency (${\alpha}$ >0.9). Conclusions: The Persian version of the EORTC-in-patsat32 module is a reliable and valid instrument to measure cancer patient satisfaction with care received during their hospitalization period and can be utilized in clinical cancer research.

간호업무개선에 대한 간호사의 변화수용도 (Nurse호s Adoption on a Planned Organizational Change)

  • 이태화;김조자;박정숙;김소선
    • 대한간호학회지
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    • 제32권2호
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    • pp.155-164
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    • 2002
  • With the dynamically changing environment of society, managing change is the vital element of organizations's survival and growth. Health care organizations have expended enormous resources to restructure patient care delivery. Despite the growing literature describing these organizational innovations, there is a paucity of credible data that reflects systematic measurement and evaluation of such changes. This study examined the nurses' psychological response toward the work process redesign, newly introduced by the nursing department in a acute care hospital. The aim of the study was to figure out how nurses's general perception of change and perceived attributes of change affected their acceptance of change during the organizational transition. This was descriptive- correlational. The sample for the study included 50 head nurses and 135 staff nurses. Data was analyzed using SPSS PC+, version 10.0. The major findings of the study were as follows: First, the mean score of the perception of change was 71.2(SD=13.8) with the range of 0-100, which means nurses generally perceived change positively. There were significant differences in perception of change by gender and education level. Head nurses perceived change more positively than staff nurses. The higher education level showed the more positive view of change. Second, among the perceived attributes of change, trialability had the highest mean score, which means nurses perceived the change more positively if it is testable on a limited basis. Relative advantage was perceived the most negatively. Finally, factors influencing the acceptability of the work-process redesign were perceived comparability, complexity, relative advantage, and observability, which accounted for 43.7% of the variance in the acceptability of change. This study evaluated the preliminary effects of the nursing process for reengineering, focusing on nurses' acceptability towards change. The usefulness of this research study was to determine the factors influencing acceptance of organizational members during transitional periods of change and to suggest effective strategies for increasing adoption as well as for decreasing resistance to change.

한국형 호스피스 케어 개발을 위한 기초 조사 연구 (The National Hospice Care Service Development in Korea)

  • 이소우;이은옥;안효섭;허대석;김달숙;김현숙;이혜자
    • 대한간호
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    • 제36권3호
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    • pp.49-69
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    • 1997
  • The urgent needs to establish hospice care systems in Korea arise from the following reasons: 0) a drastic increase in chronically ill patients with the increase of aged population: (2) rapid changes in living environment from the traditional habitation (e. g., Many Koreans living in apartment complexes, which is the most popular form of modern residence in recent years, prefer to die in the hospital.): the overall increase in patients with advanced cancer: (4) recent trends in early discharge of terminally ill patients from the limited hospital facilities to accomodate other medical insurance beneficiaries; (5) easy acceptance of euthanasia owing to the recent social atmosphere that belittles the dignity of human life; (6) medical and nursing care of AIDS patient in terminal stage; (7) and the problem associated with inhumane medical care system, overtreatment, and groundless fears against narcotics. Terminally ill patients were used to be treated in the hospital in the past. In these days, however, they are forced to have home cares with little assistance from the qualified medical personnel because of insufficient hospital facilities, which are even short for the need of emergency patients and provide priority cares to medical insurance beneficiaries with other acute problems. And yet, neither are there any administrative organizations nor systematic medical studies that deal with the level of terminally ill patient's need, their family's problems and resources of hospice care systems in Korea. Thus, most patients are not able to get appropriate medical care at the terminal stage of their lives. The objective of this study is to make comprehensive database for various hospice care organization currently in operation, link them through medical information system, and develop an easily accessible hospice care model that meets the need of most Korean people. Our survey results may be summarized as follows: Nationally there are 40 organizations that provide partial or full hospice care. However, these organizations are not linked to any formal medical service network. Furthermore, the objective of hospice care, care principles, personnel with appropriate training, educational programs, standard for care, costs, consulting service to patients' family members, the extent of medical care from professional staff members, status of hospice facility, and management of those institutions are neither clearly defined nor organized compared to the international hospice care standards. The surveys on patients of terminal stage. grouped in hospice and non-hospice care patients. reveal what they want visiting nursing care to help their pain control. psychological. social and spiritual demands. While the more than 90% of hospice care patients want to reduce their pains. the non-hospice care patients. in addition to their desire for pain control. demanded more psychological. social and spiritual helps as well. The results of this research could be utilized to 0) define the standard of hospice care. (2) provide the guidance for hospice medical care costs. (3) establish the database of hospice care systems. (4) develop softwares. (5) build communication network through Medinet. and (6) provide an organized visiting home nursing care system. These information should be a valuable resource to many medical staffs who are involved in cancer therapy. nursing care. and social welfare programs.

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의료 질 관리 활동에 대한 병원종사자들의 태도와 인식 (Quality Improvement Activity in Hospitals and Its Acceptance among Hospital Personnels)

  • 황정해;조성현;김창엽;서정돈;한만청;이정예
    • 한국의료질향상학회지
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    • 제3권2호
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    • pp.86-97
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    • 1997
  • Background : It is a primary goal for hospital personnel to improve the quality of patient care. In Korea the concept of quality assurance has been spread over the last five years. Many hospitals have implemented quality assurance programs that fit their own philosophy and needs. As a result, they are supposed to have different experiences and attitudes toward quality assurance. To investigate their diversity will be helpful to have a direction to the future and to enhance the quality assurance activities in Korean hospitals. Objectives : The aim of this study is to obtain information about hospital personnel's attitude and opinion toward quality assurance in hospitals. Methods : A questionnaire was developed which consisted of five parts; the general characteristics of respondent, the concepts of quality assurance, need for quality assurance program, current status of quality improvement activities, and participation in programs. Using the registry of Korean hospitals, 102 hospitals with more than 400 beds were selected. Questionnaires were mailed to hospital staffs of each hospital; top managers, clinical department heads, registered nurses, medical recorders, and administrators. Results : Of 2038 questionnaires sent, 877 were returned, giving response rate of 44%. Most respondents(70%) regarded quality assurance as efforts to provide patient with care in highest quality and to improve effectiveness or resource utilization. Ninety-nine percent of respondents agreed to need for quality assurance in their hospitals. There were current quality improvement programs implemented in the department of 553 respondents(62%), and most of the(85%) have participated in at least one program. Lack of motivation was pointed out as a barrier to implement the programs. Conclusion : Although most respondents have known of the concept and need for quality assurance, this study suggests that education and motivation of hospital personnel be needed to activate the quality assurance programs in hospitals.

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Epidemiology of trigeminal neuralgia: an electronic population health data study in Korea

  • Lee, Cheol-Hyeong;Jang, Ho-Yeon;Won, Hyung-Sun;Kim, Ja-Sook;Kim, Yeon-Dong
    • The Korean Journal of Pain
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    • 제34권3호
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    • pp.332-338
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    • 2021
  • Background: Trigeminal neuralgia (TN) is one of the most painful disorder in the orofacial region, and many patients have suffered from this disease. For the effective management of TN, fundamental epidemiologic data related to the target population group are essential. Thus, this study was performed to clarify the epidemiological characteristics of TN in the Korean population. This is the first national study to investigate the prevalence of TN in Korean patients. Methods: From 2014 to 2018, population-based medical data for 51,276,314 subscribers to the National Health Insurance Service of Korea were used for this study. Results: The incidence of TN was 100.21 per 100,000 person-years in the year of 2018 in Korea, and the male to female ratio was 1:2.14. The age group of 51-59 years had the highest prevalence of TN. Constant increases in medical cost, regional imbalance, and differences in prescription patterns by the medical specialties were showed in the management of TN. Conclusions: The results in this study will not only help to study the characteristics of TN, but also serve as an important basis for the effective management of TN in Korea.

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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    • 제50권4호
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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.

정신과 환자 퇴원시 가족들이 느끼는 불안에 관한 연구 (A Study of Anxiety of Families of Psychiatric Patients at Discharge)

  • 김기숙
    • 대한간호학회지
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    • 제7권2호
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    • pp.31-42
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    • 1977
  • This study investigated the anxiety of families of psychiatric patients at discharge. The purpose was to contribute to the improvement of psychiatric nursing care, rehabilitation and social adjustment of psychiatric patients and community mental health. The objectives of this study were to identify the acceptance of the psychiatric nurse by the families, their anxiety at the time of discharge, whether any help was wanted to reduce anxiety, the attitude toward the patient after discharge and feelings about the patients. The population studied consisted of 180 family members of patients from 10 mental hospitals (including local clinic) in Seoul and Kyung- Ki province, from March I to April 30, 1977. The date were collected by an interview schedule, and compared and analysed by Computer usings х$^2$- test. Results were as follows : 1. Many of the families(83.6%) expressed a acceptance of psychiatric nurse. 2. A little more than half of the families(51.1%) expressed happiness but a largo portion (38.9%) had "anxious" feelings at discharge. 3. Almost all families(92.6%) wanted a physician′s help to reduce discharge anxiety. Younger families tended to want the physician′s help more. 4. Many of the families(83.1%) wanted a nurse′s help. Families of parents patients admitted for the 1 st time wanted the nurse′s help more. 5. Comparing the feelings at a previous discharge with the present discharge, 49.1% of the family expressed greater happiness at tile latter than the former. 6. More than half the families responded positively toward the patient. Unmarried family members responded more positively than married Families of 1 st admission patients responded more positively than families of readmission patients. 7. Many families(78.8%)had positively feelings toward the patients. More negative responses came from women than from men, from lower education levels, lower incomes and readmission patients.

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Does Clinical Experience Help Oncology Nursing Staff to Deal with Patient Pain Better than Nurses from other Displines? Knowledge and Attitudes Survey Amongst Nurses in a Tertiary Care in Malaysia

  • Yaakup, Hayati;Eng, Tan Chai;Shah, Shamsul Azhar
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권12호
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    • pp.4885-4891
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    • 2014
  • Background: Successful implementation of pain management procedures and guidelines in an institution depends very much on the acceptance of many levels of healthcare providers. Aim: The main purpose of this study was to determine the level of knowledge and attitudes regarding pain among nurses working in tertiary care in a local setting and the factors that may be associated with this. Materials and Methods: This cross-sectional research study used a modified version of the Nurses' Knowledge and Attitudes Survey (NKAS) regarding pain. Basic demographic data were obtained for further correlation with the level of pain knowledge. Results: A total of 566 nurses, 34 male and 532 female, volunteered to participate in this study. The response rate (RR) was 76%, with an overall mean percentage score of $42.7{\pm}10.9$ (range: 5-92.5). The majority of participants were younger nurses below 40 years of age and more than 70% had worked for less than 10 years ($6.6{\pm}4.45$). Up to 92% had never had any formal education in pain management in general. The total mean score of correct answers was $58.6{\pm}9.58$, with oncology nursing staff scoring a higher percentage when compared with nurses from other general and critical care wards ($63.52{\pm}9.27$, p<0.045). Only 2.5% out of all participants obtained a score of 80% or greater. The majority of the oncology nurses achieved the expected competency level (p<0.03). Conclusions: The present findings give further support for the universal concern about poor knowledge and attitudes among nurses' related to the optimal management of pain. The results reflected that neither number of years working nor age influenced the level of knowledge or attitudes of the practising nurses. Oncology nursing staff consistently scored better than the rest of the cohort. This reflects that clinical experience helped to improve attitudes and knowledge concerning better pain management.