• Title/Summary/Keyword: Patient Expectation

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Factors that affect Chronic Illness Anticipated Stigma(CIAS) in patients with Parkinson's disease (파킨슨병에 대한 낙인에 영향을 미치는 요인)

  • Kim, Mi-Jung;Bae, Eun-Sook
    • Korean Journal of Health Education and Promotion
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    • v.32 no.3
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    • pp.121-133
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    • 2015
  • Objectives: This study aimed to examine factors that affect chronic illness anticipated stigma among patient living with Parkinson's disease. The attributes of stigma measured in this study were labeling, expectation of prejudice, negative stereotyping, and discrimination. Chronic illness anticipated stigma was correlated with measures of mental and physical health as well as certain health behaviors. Methods: The sample included 250 adults with idiopathic Parkinson's disease that attended D university hospital in B metropolitan city from June to August 2014. Results: The chronic illness anticipated stigma were significantly correlated to depression, anxiety, Schwab & England ADL, Hoehn & Yahr stage, and age. The significant predictors of chronic illness anticipated stigma were anxiety, depression, and age. These factors accounted for 47% of variance in chronic illness anticipated stigma. Conclusions: In order to reduce the chronic illness anticipated stigma, nurse involved in the treatment and care of patients with Parkinson's disease should encourage patients to attend programs of depression and anxiety management in Parkinson's disease and systemic education programs on stigma.

Inflammatory Pseudotumor of the Entire Left Lung -1 operative case report (좌측 전폐에 발생한 염증성 가성 종양 -수술치험 1례 보고-)

  • 전양빈;이재훈
    • Journal of Chest Surgery
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    • v.30 no.4
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    • pp.437-440
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    • 1997
  • A case of inflammatory pseudotumor of the entire lung In a 61-ycar-old man is prcscntcd. The respiratory symptoms developed 2 months ago and progressed rapidly and the diagnosis of chronic pneumonia with ateletectasis of the entire lung, destroyed lung by tuberculosis and sepsis hAd to be ruled out The operative finding was different from our expectation. This case suggests that the Inflammatory pseudotumor can manifest as a whole lung-involving ass. Inflammatory pseudotumor is a nonneoplastic reactive pulmonary mass lesion that resembles tumor but shows little or no growth. Thc inflammatory pseudotufor usually present as a solitary round lung mass but in this casts progressed rapidly and destroyed the whole lung, which is rare. The patient was discharged with no problem and with outpatient followup.

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Guarantee of Safety for the Patient: Subjectivity of unsafe clinical practice in Nursing Students (임상실습 안전에 대한 간호대학생의 주관성)

  • PARK, Euna
    • Journal of Fisheries and Marine Sciences Education
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    • v.29 no.2
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    • pp.343-353
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    • 2017
  • Nursing students who are in clinical practices under the complicated medical environment to become competent practitioners can be exposed to a variety of dangerous situations. In particular, nursing students can experience stress and compromised safety because they have difficulty in prioritizing their tasks and lack confidence in clinical and interpersonal skills. The purpose of this study is to investigate the types and characteristics of nursing students' attitudes toward the safety of clinical practices, and improve their safety related to clinical practices. A total of 40 statements about the safety of clinical practices were applied to 37 nursing students. Collected data were analyzed with the PC QUANL program. The Perception of nursing students to the safety of clinical practices was categorized into three types: 'Pursuit of perfection in overwhelming state type', 'Perseverance Patience type' and 'Cover up-meeting expectation type'. The subjects related to the safety of clinical practices need to be developed within the curriculum of nursing departments by examining the Perception of nursing students to the safety of clinical practices. In addition, a sense of responsibility shared by nursing students, educators and practitioners needs to be enhanced to improve the safety of clinical practices.

A study for the relationship between the cognition difference and satisfaction for the medical service and the revisiting (의료서비스의 인식차이와 만족이 재방문에 미치는 영향에 관한 연구)

  • Lee, Kyoung-Woo
    • Korea Journal of Hospital Management
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    • v.8 no.3
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    • pp.143-160
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    • 2003
  • Due to the dramatic and situational change in medical industry, it has became very important to keep existing patients and to attract new patients by monitoring the medical consumer's expectation and various needs and ensuring the patients' satisfaction. This study regards the patients' satisfaction as the final object of medical service. So the object of this study is to provide useful data for the decision making and medical service marketing by exploring the problems generated by the cognition difference for the medical service between inpatients and outpatients, by responding for the problems and by examining the relationship between the satisfaction with the medical service and revisiting. To achieve the object of this study, literature research and empirical analysis were used. I establish the research model based on the existing service marketing and some hypotheses were chosen for the empirical analysis. As a result of empirical analysis for the five hypotheses, two hypotheses were chosen. First, there was cognition difference about accessibility and convenience between inpatient and outpatient. I guess that the satisfaction degree of inpatient is higher than the outpatient because the inpatient has the reliability for the hospital and determines the hospitalization or emergent coming to hospital. Second, the fifth hypothesis, "the satisfaction of patient will influence the revisiting." was chosen. The hypothesis is not only coincident with existing scholars and studies but also it provides the meaningful points for medical service marketing. The result shows that the parties concerned with hospital management should endeavor for the patient satisfaction in medical service, and that hospital management should be medical consumer centered. To measure the quality of medical service, the cognition differences for accessibility, convenience, physical environment, and human service were evaluated and the result shows that the cognition difference for the accessibility and convenience was outstanding. The analysis shows that there was cognition difference in the four categories among six subcategories in the human service -- the attitude of medical technologist, the attitude of doctor, the length of time for doctor's diagnosis for the patient and doctor's explanation. Therefore, I think that further study is required for the cause analysis for service categories which have cognition difference between inpatient and outpatient. I think the result will be very useful. Through this study, the relationship between patient satisfaction with the medical service and revisiting was verified. And it suggests that, to face the changing medical environment actively and to improve the quality of medical service, marketing strategy should be focused not on medical service providers but on medical service consumers and that the further studies for the medical consumer should be continued.

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A Study on Experiences of Total Knee Replacement in Patients with Osteoarthritis (골관절염 환자의 슬관절 전치환술 경험)

  • Park, Hyun-Ok;Park, Kyung-Sook
    • Journal of muscle and joint health
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    • v.3 no.2
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    • pp.135-150
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    • 1996
  • This study was performed to analyze the patient's experience during the progress of disease in the patients with osteoarthritis, who are taken the replacement surgery of knee Joint. The examine was consisted of five patients with osteoarthritis, who are taken the replacement surgery of knee joint from Dec. 4. 1995 to May, 20, 1996 at C university hospital. After hospitalization, the physical and psycho-logical status of the patients during preoperation, postoperation and discharge was examined. The data were examined according to the ethnographic method. The results are as follows. The patients experienced the periods of embarrasment, conflict, before surgery suffering, acceptance period after surgery. In the embarrasment period, the patients take a multiple medication therapy including hospital treatment, oriental medication and folk medication to ameliorate joint pain after first diagnosis on arthritis. The embarrasment period includes compulsive drug medication, oriental medication, folk medication, trouble some, sadness and survey of hospitals. In the conflict period, the patients consider the operation of knee because of working difficulty and severe Joint Pain, while they feel anxiety about the surgery. They condemn their physical situations. They have the conflict and anxiety on surgical operation. they consider the quality of life. They hope the surgery makes patients to improve walking ability. This period includes self-condemned, sorry, tiresomeness, expectation, worrisomeness, anxiety and hesitance. In the suffering period, the patients experience post operation physical discomfort after the total knee replacement. They do physical exercise, including extension and straight leg raising to maintain walking ability, while they endure to wait approximately 6 months for normal walking movements and they are also unstable to environmental people's sight. This period includes postoperative pain, continuous discomfort, inability and communication difficulty to other's people. In the acceptance period, the patients consider longerity of artificial Joint and also endure mild remaining joint pain. Some of them have religions for their wellbeing of life. This period include a self-protesting policy, abandonment, self-consolation, dependence on religions. According to the result from this study I suggested these shown below. 1) After replacement surgery of knee joint, continuous investigation on outcome patient is necessary. 2) It is also necessary to analyze on patient's experiences, who are taken the replacement surgery of hip Joint. 3) Study on disease experiences of patients with rhematoid arthritis, who take drug medication and physical therapy alone without surgery, is necessary. 4) Investigation on patient's favorable folk medication may be helpful to analyze disease experience of patients with osteoarthritis.

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The Effects of Discrepancy in Reconstruction Algorithm between Patient Data and Normal Database in AutoQuant Evaluation: Focusing on Half-Time Scan Algorithm in Myocardial SPECT (심근 관류 스펙트에서 Half-Time Scan과 새로운 재구성법이 적용된 정상군 데이터를 기반으로 한 정량적 분석 결과의 차이 비교)

  • Lee, Hyung-Jin;Do, Yong-Ho;Cho, Seong-Wook;Kim, Jin-Eui
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.1
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    • pp.122-126
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    • 2014
  • Purpose: The new reconstruction algorithms (NRA) provided by vendor aim to shorten the acquisition scan time. Whereas depending on the installed version AutoQuant program used for myocardial SPECT quantitative analysis did not contain the normal data that NRA is applied. Thus, the purpose of this paper is to compare the results according to AutoQuant versions in myocardial SPECT applied NRA and half-time scan (HT). Materials and Methods: Rest Tl and stress MIBI data of total 80 (40 men, 40 women) patients were gathered. Data were applied HT acquisition and ASTONISH (Philips) software which is NRA. Modified autoquant of SNUH and old version of AutoQuant (full-time scan) provided by company were compared. Comparison groups were classified as coronary artery disease (CAD), 24 hrs delay and almost normal patients who have a simple pain patient. Perfusion distribution aspect, summed stress score (SSS), summed rest score (SRS), extent and total perfusion deficit (TPD) of each 25 patient who have above diseases were compared and evaluated. Results: The case of CAD, when using re-edited AutoQuant (HT) SSS and SRS showed about 30% reduction (P<0.0001), Extent showed about 38% reduction and TPD showed about 30% reduction in the tendency (P<0.0001). In the score of the perfusion, especially on the part of infero-medium, infero-apical, lateral-medium and lateral-apical regions were the biggest change. The case of the 24 hrs delay patient SRS (P=0.042), Extent (P=0.018) and TPD (P=0.0024) showed about 13-18% reduction. And the case of simple pain patient, comparison of 4 results showed about 5-7% reduction. Conclusion: This study was started based on expectation that results could be affected by normal patient data. Normal patient data is possible to change by race and gender. It was proved that combination of new reconstruction algorithm for reducing scan time and analysis program according to scan protocol with NRA could also be affected to results. Clinical usefulness of gated myocardial SPECT is possibly increased if each hospital properly collects normal patient data for their scan acquisition protocol.

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A study on the actual condition of dental clinic use of the out patient (일부 외래환자의 치과의원 이용실태에 관한 연구)

  • Han, Se-Young;Han, Soo-Youn
    • Journal of Korean society of Dental Hygiene
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    • v.10 no.4
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    • pp.635-644
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    • 2010
  • Objectives : The purpose of this study was to analyze and investigate the effecting factors on the actual condition of dental clinic use of the out patient. Methods : In oder to achieve this purpose, A survey for 302 patients in 6 participating dental clinics located in Daejeon metropolitan city from May 01 to May 30, 2010. The result of this study was as follows. Results : 1. The duration of dental clinic use was reflected in 36.1% of the under 1 year, 34.1% of over 2 years, and 29.8% of over 1 ~ under 2 years in order. Especially, the higher the duration of over 2 years the higher the age was, on married group had a significance. 2. The type of medical examination for samples was 27.6% of periodontal, 26.5% of conservative, 17.2% of prosthodontics, 10.9% of implant, and 7.9% of preventive in order. Especially, the male group the more the prosthodontics, implant had a significance. the higher the monthly income, on married group, the more the periodontal, prosthodontics and implant had a significance. 3. The motive of dental clinic selection was 38.4% of acquaintances' inducement, 33.4% of the superb treatment, 15.6% of easy convenience, and 7.0% of friendliness staff in order. Especially, male group the more the easy convenience, superb treatment, friendliness staff had a significance. 4. The mean of transportation in order to visit a dental clinic was 38.7% of public transportation, 37.5% of the own car, 23.8% of others in order. Especially, there was a highly significant difference on the public transportation in female, the lower education level, lower monthly income, and medical protection group. 5. The duration of time required of dental clinic reflected in 80.1% of the under 30 minute, 16.3% of over 30 minute~under 1 hour, and 3.6% of over 1 hour in order. Especially, the higher the treatment satisfaction, the dissatisfaction the higher the duration of time required under 30 minute had a significance. Conclusions : These results indicate that as medical services upgrade and get more varied, the expectation of medical quality also increases. It is thus considered that the revitalization of this hospital's management strategy can be achieved by providing highly developed medical services, and, more importantly, by better understanding the actual conditions of dental clinic use by the patients themselves.

A Study on the Activities of IV Team In the Children's Hospital (소아병원의 정맥주사팀 활동에 대한 조사연구)

  • Hwang, Jeong Hae;Hwang, Jee In;Kim, Mi Ran;Shin, Hee Young;Ahn, Hyo Seop
    • Quality Improvement in Health Care
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    • v.6 no.1_2
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    • pp.92-106
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    • 1999
  • Background : In many university hospitals, intravenous(IV) therapies and samplings had been one of the most important works of doctors who are in training. However, recently as patient oriented care is becoming more weighted for qualified health service IV therapies should be the works of specialized personnels. This study was conducted to investigate the medical staff's perception on IV team, to survey patient or parent's expectation on IV team, and to assess the frequency of IV therapy related complications and the characteristics of phlebitis among the hospitalized children. Methods : We collected data prospectively before the start of IV team from February 22 to February 29. 1999 and from September 27 to October 3, 1999, 6 months after beginning of IV team at Seoul National University Children's Hospital. IV team started their activities from March 1, 1999. General pediatric wards were not included for the IV and sampling team and oncology ward and surgical units were all included for the IV and sampling team's work. IV specialist was the well trained nurse who had been working in the field of pediatrics especially for the oncology patients. The subjects of this study were medical staffs who were working in children's hospital as doctors in training and patients who were treated with IV therapies in children's hospital during the same period. Results : Doctors responded that IV team need to be organized for IV care and expected IV team could reduce their work load. Parents of patients also responded IV team was very improtant to perform high quality IV care. They had willingness to pay extra charge for IV team care. In the wards where IV team did not work, they used various kinds and sizes of catheters, but in the wards where IV team worked, they needed just one or two types of catheters. As the exact role of IV team is not still established, job description is needed between the IV team and medical doctors. In the aspects of medical costs. it could save the materials for the IV also. Conclusion : This study showed that IV team could increase patient's satisfaction with decrease of medical doctors work load and concomitantly could save the costs of IV materials. And for the expansion of the IV team, job description is needed and for the total care of the children IV specialist and sampling team should expand their roles.

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Three-year Analysis of Patients and Treatment Experiences in the Regional Trauma Center of Gachon University Gil Hospital between 2011 and 2013 (가천대학교 길병원 권역외상센터 3개년 내원 환자 및 치료 경험 분석(2011~2013))

  • Yoon, Yong-Cheol;Lee, Jung-Nam;Chung, Min;Jeon, Yang Bin;Park, Jae Jeong;Yu, Byung Chul;Lee, Gil Jae;Cho, Hyun Jin;Ma, Dae Sung;Lee, Min A;Choi, Jung Ju;Son, Seong
    • Journal of Trauma and Injury
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    • v.27 no.4
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    • pp.170-177
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    • 2014
  • Purpose: The first regional trauma center selected in Korea was the Gachon University Gil hospital regional trauma center; expectation on its role has been high because of its location in the Seoul metropolitan region. To determine if those expectations are being met, we analyzed the patients visiting the center and their treatment experiences for the past 3 years in order to propose a standard for the operation of a trauma center. Methods: The visiting route, visiting methods, performance of emergency surgery, the ward and the length of stay, the injury mechanism, the injury severity score (ISS), the department that managed the surgery, and the cause of death were analyzed for 367 patients visiting the center from its establishment in June 2011 through December 2013. Results: The mean age of the patients was 47 years (285 male and 82 female patients). A total of 187 patients directly visited the center whereas 180 were transferred to the center. Traffic accidents comprised the majority of injury mechanisms, and 178 patients underwent emergency surgery. The mean length of stay per patient was 11 days for those in the ICU and 27 days for those in a general ward. These patients occupied 4 beds in the ICU and 10 beds in the general ward per day. A total of 1.21 surgeries were performed per patient, and the mean number of surgeries performed per day was 0.49. The mean ISS was 15.91, and 183 patients (50%) had an ISS of ${\geq}16$. Thirty-one patients died; they had a mean ISS of 28.42. The most frequent cause of death was multi-organ failure. The mean number of treatment consultations during a patient's stay was 6.32. Forty-five patients (13%) were discharged from the center, and 291 (79%) were transferred to another hospital. Conclusion: A systematic approach to establishing a treatment model for trauma patients, including injury mechanism, multidisciplinary treatment, and trauma surgeon intervention, is required for treating trauma patients.

The Concept Analysis of Hope : Among Cancer Patients Undergoing Chemotherapy (희망의 개념 분석 -항암화학요법을 받는 암환자를 대상으로-)

  • Song, Mi-Sun;Lee, Eun-Ok;Park, Yeong-Suk;Ha, Yang-Suk;Sim, Yeong-Suk;Yu, Su-Jeong
    • Journal of Korean Academy of Nursing
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    • v.30 no.5
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    • pp.1279-1291
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    • 2000
  • The main objectives of this study were to analyze the concept of hope, so to provide basic data to develop a valid instrument to measure hope, and to develop hope enhancing nursing intervention a program for cancer patients. The hybrid model approach was applied in three phases, the theoretical phase, the empirical phase, and the analytic phase. The study was developed on universal attributes explaining generalized hope and specific hope, which were revealed in a comprehensive review of the literature. In the empirical phase, eight cancer patients undergoing chemotherapy were interviewed to reveal causes, motivation, and their resource of hope according to The Hope Assessment Guide (Farren, Herth, & Popovich, 1995). In the analytical phase, the results of the two previous stages of the study were compared. The results were as follows : In the theoretical phase, six dimensions of hope emerged; affective, cognitive, behavioral, affiliative, temporal and contextual dimension. The antecedent of hope was loss, crisis, uncertainity, and stress. The consequences were renewal, development of new methods, safety, peace and transcendental competence. In the empirical phase, these six dimensions emerged as theoretical phases were verified and specified as these descriptive terms: feeling, intention, expectation, activity, relation, future- orientation, reality and goal-setting. The antecedent factor of hope was occurrence or recurrence of cancer. The consequence of hope was ability to cope with real condition, feeling of safety and comfort, peace, development of new strategy and recovery of disease. The major content of hope in this phase was related to specific hope, but it was also influenced on by general hope. In the analytic phase, general and specific hope was renamed as trait and state hope. All attributes emerged at the empirical phases, and also emerged at the theoretical phase. However, cognitive and contextual dimensions were revised and specified. In conclusion, the concept of hope is divided into trait hope and state hope, and state hope is an anticipatory expectation that occurs at the time of a stressful stimulus, such as being diagnosed with cancer. Hope is a multidimensional dynamic energized mental state which has the dimensions of affective, cognitive, behavioral, affiliative, temporal and contextual. There should be further studies to develope the state and trait hope scale according to definition and attributes of hope investigated in this study. In addition, considering results of the empirical phase, the family is very a important factor as a resource of hope, so it is necessary to consider family in implementing a nursing intervention program to enhance hope.

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