• Title/Summary/Keyword: Patient Expectation

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The Hope of the Stroke Patients (뇌졸중환자의 희망)

  • 김이순
    • Journal of Korean Academy of Nursing
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    • v.27 no.1
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    • pp.212-227
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    • 1997
  • Cerebrovascular diseases in Korea is an important health problem since mortality and mobidity have been increased rapidly. It marked the 2nd cause of specific death rates in 1993. The stroke causes physical function disorder due to hemiparalysis and emotional disorder, and stroke patients experience helplessness, powerlessness. sense of alienation and loss of hope. These feelings make the rehabilitation difficult because they lose the will of life. The subjects of the study were seven citizens who live in Pusan, are over 50 years old and belong to low income-level. The data were collected from Jan. to Sep. 1995. The researcher as a caregiver and volunteer made confidence of them and asked for their agreement on the purpose of the study. The subjects expressed their experience as openheartedly as possible. The analysis of the data was made through the phenomenological analytic method suggested by Giorgi, which is as follows ; as an unit of description which include the subject' expressions and the researcher's observation, it is examined the theme that express the hope experience with the subject's language(underlining), and the focal meanings are identified. The focal meaning is the crystalization of the theme, which is written in the language of the researcher. After intergrating the focal meaning and make the situated structural description as the meaning of the hope experience identified on each subject's point. After intergrating the situated structural description and make the general structural description as the meaning of the hope experience identified on total subject's point then the systemizing of the structure of the hope experienced phenomena and the flowing of the conciousness was researched. The conclusions of this study was as follows : The ten sources of hope which the subjects experienced were sorted as under 〈mutual relations to others : spouse, children, relatives, fellow believer. health professioner. associate patient group〉, 〈spiritual dependence〉. 〈recovery of physical function〉. 〈rumination of the past life〉, 〈expectation of the future〉. 〈economic power〉, 〈belief〉, 〈ability〉. 〈spontaneous participation〉 and 〈recovery of roles〉. Their hope was spoken out by the following two kinds of linguistics. First. the hope was expressed in the affirmative expression as follows : 〈 to be dependable〉, 〈to make efforts〉, 〈to keep under control〉, 〈to desire〉, 〈to be pleasant〉, 〈to be peaceful〉, 〈to be grateful〉, 〈to give help〉, 〈self-confidence. Courage〉, 〈to be happy〉, 〈to satisfy oneself〉, 〈to share with others〉, 〈to understand〉 and 〈to be affected, be impressed〉 Second, the hope was expressed in the negative on pression as under : 〈to be distressed〉, 〈to be uneasy〉, 〈to be sorry, be unsatisfied〉 〈despair〉, 〈to abandon〉, 〈to be fearful〉, 〈to suffer〉, 〈to bear a burden〉 〈to be confused〉, 〈to be solitary〉, 〈chest trouble〉, 〈to feel heavy〉 〈grief〉, 〈to be daunted〉, 〈to get angry〉, 〈to be uncomfortable〉, 〈to have something regretable〉 and 〈to feel guilty〉. And their hope was expressed by the following four behavioral expressions : 〈physical sphere〉, 〈psychological sphere〉, 〈social support sphere〉 and 〈spiritual sphere〉. The reaction patterns of their hope experience appeared in the following 4 coping method : 〈conquest type〉, 〈dependence type〉, 〈adaptation type〉 and 〈fate type〉. Finally, in the hope structure the sense of certainty don't always coexict with the sense of uncertainty, When the stroke patients try to search for the best quality of life, the senses of certainty and uncertainty make a continual cyclic system in the hope structure.

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THE FORCED ERUPTION OF IMPACTED MAXILLARY INCISOR: CASE REPORT (매복된 상악 중절치의 교정적 견인을 이용한 치험례)

  • Kim, Jong-Sik;Kim, Eun-Jung;Kim, Hyun-Jung;Nam, Soon-Hyeun;Kim, Young-Jin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.1
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    • pp.26-32
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    • 2005
  • A tooth impaction means a state that a tooth does not erupt out of oral mucosa or alveolar bone for many reasons. The reasons for an impaction of the Maxillary central incisor are an odontoma, supernumerary tooth, space loss, prolonged remaining or early loss of a preceding deciduous tooth, abnormalities of crown or root caused by trauma of a deciduous tooth and an ectopic position of a tooth germ. In the case of the impacted maxillary incisor, a rapid mesial movement of a lateral incisor leads a space loss and a midline deviation can be happened. Furthermore, it can cause a cyst. When we treated a patient with an impacted central incisor early, we could see a better prognosis. It means an early diagnosis and an exact treatment are very important. Generally if the impaction is not severe or it is caused by a keratinized covering tissue, a surgical exposure can induce an eruption easily but an orthodontic force is recommended when an eruption does not happen after a surgical method, when the eruption path is too transpositioned to be corrected spontaneously and when an impacted tooth is located so deeply. In the treatment using an orthodontic force, careful considerations about a root length, pulp, and a periodontal tissue can improve the periodontal and esthetic prognosis for the long follow-up results. This case is using an orthodontic traction following a periodic observation and in no expectation of spontaneous eruption. After treatment of this case, I have got some knowledges, so I report this case.

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Measurement of Ambulatory Patients' Satisfaction and Its Influencing Factors in a Tertiary Hospital (병원 외래 방문 환자의 만족도 평가 및 관련 요인에 대한 연구 - 한 3차 병원 방문 환자를 중심으로 -)

  • Lee, Sang-Il
    • Journal of Preventive Medicine and Public Health
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    • v.27 no.2 s.46
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    • pp.366-376
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    • 1994
  • Patients' evaluation of hospital care is one of the most important aspects of quality assessment. Survey allows patients to judge sujectively the events that occur during their hospital visit if performed properly. This study describes the result of a research effort to develop outpatient questionnaire that has sufficient validity and reliability to be used to measure patients' perception of satisfaction in Korea and to investigate influencing factors on patients' satisfaction. Self-administered questionnaire was developed for outpatient and the survey was conducted covering 827 outpatients in a tertiary hospital. It was confirmed by factor analysis that patients evaluate several components of ambulatory care distinctly ; hospital environment, administration and ancillary services, and medical care. We found strong evidence of construct validity and internal consistency for the above three dimensions of hospital process. On the contrary, reliability of overall outcome measures was low. It suggests that three items concerning overall outcome measures have some different meanings in patients' perception. Using logistic regression analysis it was found that previous health status, cost evaluation, and improvement in health status have significant influences on the level of patients' overall satisfaction and that patient's sex, experience of previous visit, expectation for improvement, cost evaluation, and improvement in health status are strongly related with intention to recommend hospital. In spite of some limitations the results of this study can be used helpfully as baseline informations for developing self-administered questionnaire and for exploring the influencing factors on patients' satisfaction. Further comprehensive research efforts should be made on the measurement of ambulatory patients' satisfaction and its related factors in current Korean situation.

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The Pregnancy Rate following Myomectomy in Infertile Women (불임여성에서 자궁근종절제술 후 임신율에 관한 연구)

  • Won, J.G.;Bai, S.W.;Kim, J.Y.;Yi, J.W.;Lee, B.S.;Kim, J.S.;Lee, K.S.;Park, K.H.;Cho, D.J.;Song, C.H.
    • Clinical and Experimental Reproductive Medicine
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    • v.24 no.2
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    • pp.193-198
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    • 1997
  • To evaluate the efficacy of transabdominal myomectomy in the management of infertile patients, and to analyze on the results of abdominal myomectomy in 38 infertile patients with no other detectable cause except myomas were undertaken at the Department of Obstetrics and Gynecology in Yonsei University Hospital from 1990 to 1996. The results are as follows; 1. Average age of patients was 31.1 years. The infertility duration ranged 12 months to 144 months, and average infertility period of patients was 29.4 months. 2. Fourteen of the 38 patients (8 of 23 patients with primary infertility, 6 of 15 patients with secondary infertility) conceived following myomectomy, with a pregnancy rate of 36.8%. 3. Patients with less than 4 years of infertility showed a higher pregnancy rate after myomectomy than those with more than 4 years of infertility (42.4% vs 0%, p<0.05). 4. Patients younger than 35 years showed significantly higher pregnancy rate than those older than 35 years (46.4% vs 9.0%, p<0.05). 5. The removal of a solitary myoma produced a significantly higher pregnancy rate than that of multiple myomas (47.8% vs 20.0%, p<0.05), and the size of the myomas did not influenced the pregnancy rate after myomectomy (p>0.1). 6. The average time period from operation to conception was 12.1 months. Eight of the 14 patients (57.1%) conceived in the first year after operation and 12 patients (85.7%) condeived within two years. In conclusion myomas are a possible cause of infertility and myomectomy can be strongly recommended with good success expectation for the infertile women if uterine myoma be considered as the main cause of infertility. And factors affecting the pregnancy rate after myomectomy in these patients are the age of the patient, the duration of infertiluty, and the number of myoma.

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Investigation of the Current Clinical Result of Korean Medical Treatment of Infertility -In Major University Korean Medicine Hospitals and Local Korean Medicine Clinics Participated in the Research- (한방 난임 치료의 특성과 결과에 대한 분석 -2011년 주요 한의과대학 부속한방병원 및 연구 참여 한의원을 중심으로-)

  • Lee, Dong-Nyung;Choi, Min-Sun;Kim, Dong-Il
    • The Journal of Korean Obstetrics and Gynecology
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    • v.27 no.4
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    • pp.69-87
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    • 2014
  • Objectives: We analyzed retrospective clinical data of Korean medical institutes for infertility care and investigated current status and outcome of the Korean medical treatment of infertility as a part of foundational research for verifying validity of constructing national support system and developing appropriate policy on Korean medical treatment of infertility. Methods: We investigated data uploaded on the homepage of The Society of Korean Medicine for Subfertility (http://www.okinfertility.org) by Korean medical institutes for infertility care to get informations such as patients' age, body height, weight, methods of Korean medical treatment, cost and duration of treatment, success or failure of pregnancy and result of treatment. Results: The average age of patients was $33.1{\pm}3.8$ and the average body height was $161.2{\pm}5.3cm$ and the average body weight was $55.2{\pm}8.5kg$. The method of Korean medical treatment was Herbal medicine (97.5%), acupuncture (80.4%), moxibustion (57.7%), cupping (32.7%). The average cost of treatment was $1,160,625{\pm}882,499$ won, and the average medical cost per visit was $357,845{\pm}241,602$ won. The average duration of treatment was $11.26{\pm}10.58$ weeks, and the average number of visits per patient was $4.78{\pm}6.10$ times. The average duration of treatment was the longest in the group of infertile patients with the highest average medical cost per visit. The average pregnancy success rate was 30.9% overall, and that of the group of infertile patients was 25.8%. Conclusions: When we develop the standard project model with expectation for about 25% success rate of pregnancy and delivery in the group of patients who have idiopathic and ovulatory factors, it is desirable to perform acupuncture and moxibustion treatment 1-2 times a week with herbal medicine. The treatment period is set to at least 12 weeks. Average treatment fee maybe calculated by converting the averaged treatment cost of clinic's one month worth of daily treatment fee and medical hospital's ten day treatment fee into weekly treatment cost.

Perception and Attitude on Augmented Reality Smart Glass for Healthcare Convergence Simulation (증강현실(AR) 스마트글라스 보건의료 융합 시뮬레이션에 대한 인식 및 태도)

  • Lee, Youngho;Choi, Jongmyung;Yoon, Hyoseok;Kim, Sun Kyung
    • Journal of the Korea Convergence Society
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    • v.12 no.1
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    • pp.369-377
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    • 2021
  • Augmented reality smart-glass enables healthcare providers to use patient and their care related information without interference of workflow. In addition, augmented reality smart-glass simulation had advantages in improving competency via remote collaboration and real-time information sharing. This study investigated perception and attitude regarding augmented reality smart glass based healthcare simulation on three different groups of healthcare major students, computer major students, developers and faculties. Using convenience sampling method, data were obtained from 95 participants and statistical analysis were performed using SPSS 25.0. Developer and faculty group showed the highest scores, followed by healthcare major students. There was the high expectation on augmented reality smart-glass for skill acquisition and the high performance and big screen were essential features of device. The findings of this study revealed that differences between healthcare and computer major students exist and strategies to reduce those gaps are required to adopt augmented reality smart glass in healthcare settings.

The Jurisdictional Precedent Analysis of Medical Dispute in Dental Field (치과임상영역에서 발생된 의료분쟁의 판례분석)

  • Kwon, Byung-Ki;Ahn, Hyoung-Joon;Kang, Jin-Kyu;Kim, Chong-Youl;Choi, Jong-Hoon
    • Journal of Oral Medicine and Pain
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    • v.31 no.4
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    • pp.283-296
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    • 2006
  • Along with the development of scientific technologies, health care has been growing remarkably, and as the social life quality improves with increasing interest in health, the demand for medical service is rapidly increasing. However, medical accident and medical dispute also are rapidly increasing due to various factors such as, increasing sense of people's right, lack of understanding in the nature of medical practice, over expectation on medical technique, commercialize medical supply system, moral degeneracy and unawareness of medical jurisprudence by doctors, widespread trend of mutual distrust, and lack of systematized device for solution of medical dispute. This study analysed 30 cases of civil suit in the year between 1994 to 2004, which were selected among the medical dispute cases in dental field with the judgement collected from organizations related to dentistry and department of oral medicine, Yonsei university dental hospital. The following results were drawn from the analyses: 1. The distribution of year showed rapid increase of medical dispute after the year 2000. 2. In the types of medical dispute, suit associated with tooth extraction took 36.7% of all. 3. As for the cause of medical dispute, uncomfortable feeling and dissatisfaction with the treatment showed 36.7%, death and permanent damage showed 16.7% each. 4. Winning the suit, compulsory mediation and recommendation for settlement took 60.0% of judgement result for the plaintiff. 5. For the type of medical organization in relation to medical dispute, 60.0% was found to be the private dental clinics, and 30.0% was university dental hospitals. 6. For the level of trial, dispute that progressed above 2 or 3 trials was of 30.0%. 7. For the amount of claim for damage, the claim amounting between 50 million to 100 million won was of 36.7%, and that of more than 100 million won was 13.3%, and in case of the judgement amount, the amount ranging from 10 million to 30 million won was of 40.0%, and that of more than 100 million won was of 6.7%. 8. For the number of dentist involved in the suit, 26.7% was of 2 or more dentists. 9. For the amount of time spent until the judgement, 46.7% took 11 to 20 months, and 36.7% took 21 to 30 months. 10. For medical malpractice, 46.7% was judged to be guilty, and 70% of the cases had undergone medical judgement or verification of the case by specialists during the process of the suit. 11. In the lost cases of doctors(18 cases), 72.2% was due to violence of carefulness in practice and 16.7% was due to missing of explanation to patient. Medical disputes occurring in the field of dentistry are usually of relatively less risky cases. Hence, the importance of explanation to patient is emphasized, and since the levels of patient satisfaction are subjective, improvement of the relationship between the patient and the dentist and recovery of autonomy within the group dentist are essential in addition to the reduction of technical malpractice. Moreover, management measure against the medical dispute should be set up through complement of the current doctors and hospitals medical malpractice insurance which is being conducted irrationally, and establishment of system in which education as well as consultation for medical disputes lead by the group of dental clinicians and academic scholars are accessible.

A Study on the Use of Active Protocol Using the Change of Pitch and Rotation Time in PET/CT (PET/CT에서 Pitch와 Rotation Time의 변화를 이용한 능동적인 프로토콜 사용에 대한 연구)

  • Jang, Eui Sun;Kwak, In Suk;Park, Sun Myung;Choi, Choon Ki;Lee, Hyuk;Kim, Soo Young;Choi, Sung Wook
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.2
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    • pp.67-71
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    • 2013
  • Purpose: The Change of CT exposure condition have a effect on image quality and patient exposure dose. In this study, we evaluated effect CT image quality and SUV when CT parameters (Pitch, Rotation time) were changed. Materials and Methods: Discovery Ste (GE, USA) was used as a PET/CT scanner. Using GE QA Phantom and AAPM CT Performance Phantom for evaluate Noise of CT image. Images are acquired by using 24 combinations that four stages pitch (0.562, 0.938, 1.375, 1.75:1) and six stages X-ray tube rotation time (0.5s-1.0s). PET images are acquired using 1994 NEMA PET Phantom ($^{18}F-FDG$ 5.3 kBq/mL, 2.5 min/frame). For noise test, noise are evaluated by standard deviation of each image's CT numbers. And then we used expectation noise according to change of DLP (Dose Length Product) to experimental noise ratio for index of effectiveness. For spatial resolution test, we confirmed that it is possible to identify to 1.0 mm size of the holes at the AAPM CT Performance Phantom. Finally we evaluated each 24 image's SUV. Results: Noise efficiency were 1.00, 1.03, 1.01, 0.96 and 1.00, 1.04, 1.02, 0.97 when pitch changes at the QA Phantom and AAPM Phantom. In case of X-ray tube rotation time changes, 0.99, 1.02, 1.00, 1.00, 0.99, 0.99 and 1.01, 1.01, 0.99, 1.01, 1.01, 1.01 at the QA Phantom and AAPM Phantom. We could identify 1.0 mm size of the holes all 24 images. Also, there were no significant change of SUV and all image's average SUV were 1.1. Conclusion: 1.75:1 pitch is the most effective value at the CT image evaluation according to pitch change and It doesn't affect to the spatial resolution and SUV. However, the change of rotation time doesn't affect anything. So, we recommend to use the effective pitch like 1.75:1 and adequate X-ray tube rotation time according to patient size.

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Characteristics of Patients Who Need Hypnotics on the Night before Elective Surgery (수면전일 수면제를 필요로 하는 환자들의 특성)

  • Lee, Soo-In;Yoon, Jin-Sang;Lee, Hyung-Young
    • Sleep Medicine and Psychophysiology
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    • v.4 no.2
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    • pp.172-180
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    • 1997
  • Objects : This study was carried out to investigate characteristics of patients who need hypnotics on the night before elective surgery as well as contributing variables for the necessity of hypnotics. Methods : After reviewing the clinical charts of patients who were scheduled to receive surgery by general anesthesia the following day, researchers had semi structural interviews with patients. In addition, Spielberger's State-Trait Anxiety Inventory(SSTAI), Beck Depression Inventory(BDI), Zung's Self-Rating Pain and Distress Scale(ZPDS), and Presleep and Postsleep Questionnaires were administered to patients. A total of 167 patients, who gave reliable information, were divided into two groups based on subjective judgement regarding the necessity for hypnotics on the night before surgery; 29 eligibles for hypnotics and 138 non-eligibles for hypnotics. Demographic and clinical characteristics of patients, some possible factors affecting sleep, psychological characteristics of patients and daytime status and nighttime sleep before surgery were compared between the two groups. In addition, discriminant function analysis was done to find the variables which would best discriminate among patients who differ in terms of necessity for hypnotics on the night before surgery. Results : There was no difference in demographic and clinical characteristics between the two groups; however, the satisfaction level with ward environment was significantly lower in the eligible group for hypnotics than the non-eligible group. Psychologically, the eligible group for hypnotics, compared to the non-eligible group, showed significantly more severe depression, pain, and distress; whereas anxiety level was not different between the two groups. For nighttime sleep before surgery, the eligible group for hypnotics, compared to the non-eligible group, expected poorer sleep before retiring and in fact, reported poorer sleep the following morning. In discriminant function analysis, 'expectation for sleep' and 'pain and distress' were the most potent contributors to discriminate the necessity of hypnotics. Conclusion : For the improvement of the patient's sleep on the night before elective surgery, giving hypnotics and/or analgesics should be determined by patient's opinion about the necessity of the drugs rather than by the therapist's own judgement or any other objective indices.

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An Exploratory Study on Customers' Individual Factors on Waiting Experience (고객의 개인적 요소가 대기시간 경험에 미치는 영향에 대한 탐색적 연구)

  • Kim, Juyoung;Yoo, Bomi
    • Asia Marketing Journal
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    • v.12 no.1
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    • pp.1-30
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    • 2010
  • Customers often experience waiting for buying service. Managing customers' waiting time is important for service providers since customers who are dissatisfied with waiting, secede from a service place at last. Not a few studies have been done to solve waiting time problem and improve customers' waiting experience. Hui & Tse(1996) identify evaluation factors in customers' behavioral mechanism as customers wait. That is, customers experience perceived waiting time, waiting acceptability and emotional response to the wait when they wait. Since customers evaluate the wait using these factors, service provider should manage these factors in order to minimize customers' dissatisfaction. Therefore, this study explores that evaluation factors of waiting are influenced by customers' situational and experiential characteristics, which include customer loyalty, transaction importance for customer and waiting expectation level. Those situational and experiential characteristics are usually given to service providers so they can't control these at waiting point. The major findings derived from two exploratory studies can be summarized as follows. First, according to the result from the study 1 (restaurant setting), customers' transaction importance has the greatest positive influence on waiting experience. The results show restaurant service provider could prevent customers' separation effectively through strategies which raise customers' transaction importance, like giving special coupons for important events. Second, in study 2 (amusement part setting) customer loyalty has large positive impact on waiting experience as well as transaction importance. This results show that service provider could minimize customers' dissatisfaction using strategies which raise customer loyalty continuously. This results show customer perceives waiting experience differently according to characteristics of service place and service itself. Therefore, service provider should grasp the unique customers' situational and experiential characters for each service and service place. It could provide an effective strategy for waiting time management. Third, the study finds transaction importance and waiting expectation level have direct influence customers' waiting experience as independent variables, while existing studies treated them as moderators. Customer loyalty which has not been incorporated in previous waiting time research is known to affect waiting experience. It suggests that marketing strategy which builds up customer loyalty for long period of time is also quite effective, compared to short term tactics to help customers endure waiting time. Fourth, this study reveals the importance of actual waiting time along with perceived waiting time. So far most studies only focus on customers' perceived waiting time. Especially, this study incorporates the concept of patient limit on waiting time to investigate effect of actual waiting time. The results show that there were various responses to the wait depending on how actual waiting time exceeds individual's patent limit on waiting time or not, even though customers wait about the same period of time. Finally, using structural equation model, conceptual path between behavioral responses is verified. As customer perceives waiting time, then she decides whether she can endure it or not, and then her emotional response occurs. This result are somewhat different from Hui & Tse(1996)'s study. The study also includes theoretical contributions as well as practical implications.

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