• Title/Summary/Keyword: Patient Participation

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A Study on the Sufficiency of Anticipated Effect of Order Communication System Introduced to Medium-Sized Hospitals (Focused on the case of S Hospital) (중소병원의 처방전달시스템 도입효과분석에 관한 연구 (S병원의 사례를 중심으로))

  • Hong, Suk-Won;Jung, Key-Sun;Choi, Sung-Woo
    • Korea Journal of Hospital Management
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    • v.7 no.4
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    • pp.172-192
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    • 2002
  • The purpose of this study is to ascertain whether the effect of introduction of OCS(Order Communication System) to the hospital is satisfied or not comparing the anticipated effect with the actual effect. For this purpose, a domestic hospital which has introduced and has been operating OCS for several years was chosen. Based on the internal data of S Hospital prepared before introducing OCS, researcher has analyzed the basic direction, design standard and status of operation after the introduction of OCS, etc. After analyzing the status of operations of several departments using OCS and interviewing with the chiefs of pertinent departments, a survey form was designed. Actual survey and interviews were conducted by the researcher for weeks to know whether doctors, nurses, medical technicians and clerks of the patient management dept. were satisfied with OCS and to find if they have any recommendations to improve OCS. Based on the analysis of survey, the effect of OCS was evaluated whether it has satisfied the anticipated effectiveness. For the question if they feel convenient in using OCS, doctors, nursing staffs in charge of ward and the staffs of billing dept. has answered that they were all satisfied(100%). The answers for the same question were relatively high in the case of nurses in charge of outpatient and staffs of radiography. Of course, there have been some nurses and staffs who complained for the inconvenience. However, overall satisfaction was high on the average. Some common problems occurred after the introduction of OCS were frequent errors due to instability of OCS system, paralysis of function of hardware on data back-up system and redundant investment due to erroneous choice of DB program in setting DB. It was also pointed out that lack of computer education and low participation of medical staffs has resulted in failure of developing effective software. As a result, it has lowered the efficiency of OCS. For example, some works have to be done by hands even after OCS. Based on the result of this research, recommendations to maximize the effect of OCS were presented as follows. First, strong leadership of CEO and active cooperation of doctors are mandatory. Second, all the process of hospital work should be analyzed and be redesigned in more efficient ways. Third, OCS should be designed to be user-based system which can be used efficiently by all staffs of the hospital. Forth, prior to the operation of OCS, proper tests of the program and trainings of the pertinent staff are required. Fifth, prior to the selection of hardware, BMT(Bench Marking Test) should be conducted. Sixth, before introducing OCS, staffs in charge of OCS should visit many hospitals operating the OCS system and take their cases into account.

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Effect of Self-help Tai Chi for Arthritis on the Quality of Life, Health Perception, Joint Flexibility, Grasping Power, and Balance (자조타이치 프로그램이 삶의 질, 건강지각, 관절 유연성, 악력 및 균형감에 미치는 효과)

  • Lee, Eun-Hee;Lee, Kyung-Sook;So, Ae-Young;Choi, Jung-Sook;Lee, In-Oak;Lee, Jun-Dong
    • Journal of muscle and joint health
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    • v.14 no.2
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    • pp.127-136
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    • 2007
  • Purpose: There has been a need to integrating the self-help program for arthritis with the TaiChi for arthritis patient. The purpose of this study was to develop and to examine the effect of the Self-help and Tai Chi for arthritis (SHTCA) program for arthritis. Method: This study was designed non equivalent control group pre-post test, quasi-experimental design. A total 40 participants were recruited in W-city, 29 participants(14-experimental group and 15-control group) completed post test. The experimental group participated in the SHTCA once a week for 8 weeks. SHTCA program was consisted of understanding of the arthritis, contracting of the promise, exercise for muscle strength and joint flexibility and 8 movements of Tai Chi exercise. Coloring plus program to cellular phone was used to encourage the exercise and participation by the KT-SHUT twice a week. Measures used to examine the effect of the SHTCA were EQ-5D standardized five dimensions(mobility, self-care, usual activities, pain & discomfort, and anxiety & depression), and health perception, joint flexibility, grasping power, and balance. Collected data was analyzed by SPSS WIN 14.0. Results: The experimental group had significantly increased the EQ-mobility(p=.033), health perception(p=.000), right shoulder flexibility(p=.007), and left shoulder flexibility(p=.002) compared to the control group. In addition, pain was decreased(p=.052) and right grip was increased(p=.052) after 8 weeks program in the experimental group. Conclusion: This SHTCA using coloring plus program was found partially effective and satisfactory. We recommended further research on the effect of this SHTCA effects.

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Effect of Diet and Exercise Recommendations Provided by Medical Staff to Patients, and Exercise Self Efficacy with Coronary Artery Disease on Adherence to Regular Exercise (관상동맥질환자에게 제공한 의료인의 식이 및 운동권고, 운동자기효능감이 규칙적인 운동이행에 미치는 영향)

  • Mi-Soo Kweon;Suk-Jeong Lee;Du-Ri Kim
    • Journal of Industrial Convergence
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    • v.22 no.3
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    • pp.91-100
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    • 2024
  • Coronary artery disease(CAD) is associated with a high risk of recurrence and an increased mortality rate upon recurrence. Consequently, there is a need for continuous health behavior recommendations from medical staff. Therefore, a study was conducted on 219 patients hospitalized for coronary angiography. The study aimed to investigate the influence of medical staff recommendations on exercise adherence among CAD patients. In conclusion, regular exercise(RE) recommendation(OR 3.52, p=.036) and dietary advice from medical staff(OR 6.48, p=.022), having high exercise self-efficacy(OR 1.36, p=.001) positively affected RE adherence. Therefore, medical staff should strengthen personalized recommendations for RE and healthy diets, as well as develop exercise self-efficacy enhancement programs to encourage patient participation. Future research is recommended to explore the impact of the degree and method of medical staff recommendations on self-management practices among CAD patients.

A Study Concerning Health Needs in Rural Korea (농촌(農村) 주민(住民)들의 의료필요도(醫療必要度)에 관(關)한 연구(硏究))

  • Lee, Sung-Kwan;Kim, Doo-Hie;Jung, Jong-Hak;Chunge, Keuk-Soo;Park, Sang-Bin;Choy, Chung-Hun;Heng, Sun-Ho;Rah, Jin-Hoon
    • Journal of Preventive Medicine and Public Health
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    • v.7 no.1
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    • pp.29-94
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    • 1974
  • Today most developed countries provide modern medical care for most of the population. The rural area is the more neglected area in the medical and health field. In public health, the philosophy is that medical care for in maintenance of health is a basic right of man; it should not be discriminated against racial, environmental or financial situations. The deficiency of the medical care system, cultural bias, economic development, and ignorance of the residents about health care brought about the shortage of medical personnel and facilities on the rural areas. Moreover, medical students and physicians have been taught less about rural health care than about urban health care. Medical care, therefore, is insufficient in terms of health care personnel/and facilities in rural areas. Under such a situation, there is growing concern about the health problems among the rural population. The findings presented in this report are useful measures of the major health problems and even more important, as a guide to planning for improved medical care systems. It is hoped that findings from this study will be useful to those responsible for improving the delivery of health service for the rural population. Objectives: -to determine the health status of the residents in the rural areas. -to assess the rural population's needs in terms of health and medical care. -to make recommendations concerning improvement in the delivery of health and medical care for the rural population. Procedures: For the sampling design, the ideal would be to sample according to the proportion of the composition age-groups. As the health problems would be different by group, the sample was divided into 10 different age-groups. If the sample were allocated by proportion of composition of each age group, some age groups would be too small to estimate the health problem. The sample size of each age-group population was 100 people/age-groups. Personal interviews were conducted by specially trained medical students. The interviews dealt at length with current health status, medical care problems, utilization of medical services, medical cost paid for medical care and attitudes toward health. In addition, more information was gained from the public health field, including environmental sanitation, maternal and child health, family planning, tuberculosis control, and dental health. The sample Sample size was one fourth of total population: 1,438 The aged 10-14 years showed the largest number of 254 and the aged under one year was the smallest number of 81. Participation in examination Examination sessions usually were held in the morning every Tuesday, Wenesday, and Thursday for 3 hours at each session at the Namchun Health station. In general, the rate of participation in medical examination was low especially in ages between 10-19 years old. The highest rate of participation among are groups was the under one year age-group by 100 percent. The lowest use rate as low as 3% of those in the age-groups 10-19 years who are attending junior and senior high school in Taegu city so the time was not convenient for them to recieve examinations. Among the over 20 years old group, the rate of participation of female was higher than that of males. The results are as follows: A. Publie health problems Population: The number of pre-school age group who required child health was 724, among them infants numbered 96. Number of eligible women aged 15-44 years was 1,279, and women with husband who need maternal health numbered 700. The age-group of 65 years or older was 201 needed more health care and 65 of them had disabilities. (Table 2). Environmental sanitation: Seventy-nine percent of the residents relied upon well water as a primary source of dringking water. Ninety-three percent of the drinking water supply was rated as unfited quality for drinking. More than 90% of latrines were unhygienic, in structure design and sanitation (Table 15). Maternal and child health: Maternal health Average number of pregnancies of eligible women was 4 times. There was almost no pre- and post-natal care. Pregnancy wastage Still births was 33 per 1,000 live births. Spontaneous abortion was 156 per 1,000 live births. Induced abortion was 137 per 1,000 live births. Delivery condition More than 90 percent of deliveries were conducted at home. Attendants at last delivery were laymen by 76% and delivery without attendants was 14%. The rate of non-sterilized scissors as an instrument used to cut the umbilical cord was as high as 54% and of sickles was 14%. The rate of difficult delivery counted for 3%. Maternal death rate estimates about 35 per 10,000 live births. Child health Consultation rate for child health was almost non existant. In general, vaccination rate of children was low; vaccination rates for children aged 0-5 years with BCG and small pox were 34 and 28 percent respectively. The rate of vaccination with DPT and Polio were 23 and 25% respectively but the rate of the complete three injections were as low as 5 and 3% respectively. The number of dead children was 280 per 1,000 living children. Infants death rate was 45 per 1,000 live births (Table 16), Family planning: Approval rate of married women for family planning was as high as 86%. The rate of experiences of contraception in the past was 51%. The current rate of contraception was 37%. Willingness to use contraception in the future was as high as 86% (Table 17). Tuberculosis control: Number of registration patients at the health center currently was 25. The number indicates one eighth of estimate number of tuberculosis in the area. Number of discharged cases in the past accounted for 79 which showed 50% of active cases when discharged time. Rate of complete treatment among reasons of discharge in the past as low as 28%. There needs to be a follow up observation of the discharged cases (Table 18). Dental problems: More than 50% of the total population have at least one or more dental problems. (Table 19) B. Medical care problems Incidence rate: 1. In one month Incidence rate of medical care problems during one month was 19.6 percent. Among these health problems which required rest at home were 11.8 percent. The estimated number of patients in the total population is 1,206. The health problems reported most frequently in interviews during one month are: GI trouble, respiratory disease, neuralgia, skin disease, and communicable disease-in that order, The rate of health problems by age groups was highest in the 1-4 age group and in the 60 years or over age group, the lowest rate was the 10-14 year age group. In general, 0-29 year age group except the 1-4 year age group was low incidence rate. After 30 years old the rate of health problems increases gradually with aging. Eighty-three percent of health problems that occured during one month were solved by primary medical care procedures. Seventeen percent of health problems needed secondary care. Days rested at home because of illness during one month were 0.7 days per interviewee and 8days per patient and it accounts for 2,161 days for the total productive population in the area. (Table 20) 2. In a year The incidence rate of medical care problems during a year was 74.8%, among them health problems which required rest at home was 37 percent. Estimated number of patients in the total population during a year was 4,600. The health problems that occured most frequently among the interviewees during a year were: Cold (30%), GI trouble (18), respiratory disease (11), anemia (10), diarrhea (10), neuralgia (10), parasite disease (9), ENT (7), skin (7), headache (7), trauma (4), communicable disease (3), and circulatory disease (3) -in that order. The rate of health problems by age groups was highest in the infants group, thereafter the rate decreased gradually until the age 15-19 year age group which showed the lowest, and then the rate increased gradually with aging. Eighty-seven percent of health problems during a year were solved by primary medical care. Thirteen percent of them needed secondary medical care procedures. Days rested at home because of illness during a year were 16 days per interviewee and 44 days per patient and it accounted for 57,335 days lost among productive age group in the area (Table 21). Among those given medical examination, the conditions observed most frequently were respiratory disease, GI trouble, parasite disease, neuralgia, skin disease, trauma, tuberculosis, anemia, chronic obstructive lung disease, eye disorders-in that order (Table 22). The main health problems required secondary medical care are as fellows: (previous page). Utilization of medical care (treatment) The rate of treatment by various medical facilities for all health problems during one month was 73 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 52% while the rate of those who have health problems which did not required rest was 61 percent (Table 23). The rate of receiving of medical care for all health problems during a year was 67 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 82 percent while the rate of those who have health problems which did not required rest was as low as 53 percent (Table 24). Types of medical facilitied used were as follows: Hospital and clinics: 32-35% Herb clinics: 9-10% Drugstore: 53-58% Hospitalization Rate of hospitalization was 1.7% and the estimate number of hospitalizations among the total population during a year will be 107 persons (Table 25). Medical cost: Average medical cost per person during one month and a year were 171 and 2,800 won respectively. Average medical cost per patient during one month and a year were 1,109 and 3,740 won respectively. Average cost per household during a year was 15,800 won (Table 26, 27). Solution measures for health and medical care problems in rural area: A. Health problems which could be solved by paramedical workers such as nurses, midwives and aid nurses etc. are as follows: 1. Improvement of environmental sanitation 2. MCH except medical care problems 3. Family planning except surgical intervention 4. Tuberculosis control except diagnosis and prescription 5. Dental care except operational intervention 6. Health education for residents for improvement of utilization of medical facilities and early diagnosis etc. B. Medical care problems 1. Eighty-five percent of health problems could be solved by primary care procedures by general practitioners. 2. Fifteen percent of health problems need secondary medical procedures by a specialist. C. Medical cost Concidering the economic situation in rural area the amount of 2,062 won per residents during a year will be burdensome, so financial assistance is needed gorvernment to solve health and medical care problems for rural people.

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Effective Customer Risk Management at the Nuclear Medicine Department: Risk Managemont MOT Development Application and Producing Public Relations Film (핵의학과 내에서의 효과적인 고객위험관리: 위험관리 응대 MOT 개발적용 및 홍보동영상 제작)

  • Ham, Jong-Hum;Hwang, Jae-Bong;Kim, Joon-Ho;Lee, Gui-Won
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.110-122
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    • 2009
  • Purpose: Nowadays, A medical institution assesment could get more interest about a quality of medical services from many hospitals that developed the active activities for improving medical services. Also, there is an other additional issue which is the patients risk management. Uijeongbu ST. Mary's hospital Nuclear Medicine department has been changed many work process after PET-CT introduction and renovation of its place since 2008. Therefore, modified structure and the way of existing work process have contained risk factors. The purpose of this study would be the appropriate risk management process while imaging examination process, the removal risk factors and improved activities through the analysis risk factors. Materials and Methods: Nuclear Medicine department new process should analysis through many-sided, Firstly, make and trained risk management manual after then apply an actual work. Result analysis showed the number of risk accident occurrence that comparing the last year and after the improved activities. Secondly, producing risk management public relations film has been showed an applicable patient after then the customer service measurement checked for a hundred patient by questionnaire. Lastly, Risk factors were eliminated through the facilities participation improving activities which could change for the better risk factors. Results: The number of safety accident occurrence(medication error, fall and collision) were checked as zero after the improving activities both PET-CT and gamma camera examination. The results of questionnaire showed as follows; 74% marked as understanding of the test process and 81% checked "satisfaction" after the public relations film showing. The question "Did you consider about the risk factors?", both PET-CT and gamma camera checked as 94% and 89% respectively. Customer risk management could be accomplished effectively through the improving activities at the nuclear medicine department. Conclusions: The study would be an opportunity that spread risk factors were systematically showed and analyzied. Also, It showed the possibility of the minimized safety accident and its feedback, if application of the response manuel that could be a standard of radiology technician's work method to react safety accident. It was the more effective that visual material could be easy to approach as a methodology of risk factors. As far as I have concerned that It could help the safety and convenience through continuous and detailed activities that offer to patients.

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Innovative approaches to the health problems of rural Korea (한국농촌보건(韓國農村保健)의 문제점(問題點)과 개선방안(改善方案))

  • Loh, In-Kyu
    • Journal of agricultural medicine and community health
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    • v.1 no.1
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    • pp.5-9
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    • 1976
  • The categories of national health problems may be mainly divided into health promotion, problems of diseases, and population-economic problems which are indirectly related to health. Of them, the problems of diseases will be exclusively dealt with this speech. Rurality and Disease Problems There are many differences between rural and urban areas. In general, indicators of rurality are small size of towns, dispersion of the population, remoteness from urban centers, inadequacy of public transportation, poor communication, inadequate sanitation, poor housing, poverty, little education lack of health personnels and facilities, and in-accessibility to health services. The influence of such conditions creates, directly or indirectly, many problems of diseases in the rural areas. Those art the occurrence of preventable diseases, deterioration and prolongation of illness due to loss of chance to get early treatment, decreased or prolonged labour force loss, unnecessary death, doubling of medical cost, and economic loss. Some Considerations of Innovative Approach The followings art some considerations of innovative approaches to the problems of diseases in the rural Korea. 1. It would be essential goal of the innovative approaches that the damage and economic loss due to diseases will be maintained to minimum level by minimizing the absolute amount of the diseases, and by moderating the fee for medical cares. The goal of the minimization of the disease amount may be achieved by preventive services and early treatment, and the goal of moderating the medical fee may be achieved by lowering the prime cost and by adjusting the medical fees to reasonable level. 2. Community health service or community medicine will be adopted as a innovative means to disease problems. In this case, a community is defined as an unit area where supply and utilization of primary service activities can be accomplished within a day. The essential nature o the community health service should be such activities as health promotion, preventive measures, medical care, and rehabilitation performing efficiently through the organized efforts of the residents in a community. Each service activity should cover all members of the residents in a community in its plan and performance. The cooperation of the community peoples in one of the essential elements for success of the service program, The motivations of their cooperative mood may be activated through several ways: when the participation of the residents in service program of especially the direct participation of organized cooperation of the area leaders art achieved through a means of health education: when the residents get actual experience of having received the benefit of good quality services; and when the health personnels being armed with an idealism that they art working in the areas to help health problems of the residents, maintain good human relationships with them. For the success of a community health service program, a personnel who is in charge of leadership and has an able, a sincere and a steady characters seems to be required in a community. The government should lead and support the community health service programs of the nation under the basis of results appeared in the demonstrative programs so as to be carried out the programs efficiently. Moss of the health problems may be treated properly in the community levels through suitable community health service programs but there might be some problems which art beyond their abilities to be dealt with. To solve such problems each community health service program should be under the referral systems which are connected with health centers, hospitals, and so forth. 3. An approach should be intensively groped to have a physician in each community. The shortage of physicians in rural areas is world-wide problem and so is the Korean situation. In the past the government has initiated a system of area-limited physician, coercion, and a small scale of scholarship program with unsatisfactory results. But there might be ways of achieving the goal by intervice, broadened, and continuous approaches. There will be several ways of approach to motivate the physicians to be settled in a rural community. They are, for examples, to expos the students to the community health service programs during training, to be run community health service programs by every health or medical schools and other main medical facilities, communication activities and advertisement, desire of community peoples to invite a physician, scholarship program, payment of satisfactory level, fulfilment of military obligation in case of a future draft, economic growth and development of rural communities, sufficiency of health and medical facilities, provision of proper medical care system, coercion, and so forth. And, hopefully, more useful reference data on the motivations may be available when a survey be conducted to the physicians who are presently engaging in the rural community levels. 4. In communities where the availability of a physician is difficult, a trial to use physician extenders, under certain conditions, may be considered. The reason is that it would be beneficial for the health of the residents to give them the remedies of primary medical care through the extenders rather than to leave their medical problems out of management. The followings are the conditions to be considered when the physician extenders are used: their positions will be prescribed as a temporary one instead of permanent one so as to allow easy replacement of the position with a physician applicant; the extender will be under periodic direction and supervision of a physician, and also referral channel will be provided: legal constraints will be placed upon the extenders primary care practice, and the physician extenders will used only under the public medical care system. 5. For the balanced health care delivery, a greater investment to the rural areas is needed to compensate weak points of a rurality. The characteristics of a rurality has been already mentioned. The objective of balanced service for rural communities to level up that of urban areas will be hard to achieve without greater efforts and supports. For example, rural communities need mobile powers more than urban areas, communication network is extremely necessary at health delivery facilities in rural areas as well as the need of urban areas, health and medical facilities in rural areas should be provided more substantially than those of urban areas to minimize, in a sense, the amount of patient consultation and request of laboratory specimens through referral system of which procedures are more troublesome in rural areas, and more intensive control measures against communicable diseases are needed in rural areas where greater numbers of cases are occurred under the poor sanitary conditions.

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Recognition and Request for Medical Direction by 119 Emergency Medical Technicians (119 구급대원들이 지각하는 의료지도의 필요성 인식과 요구도)

  • Park, Joo-Ho
    • The Korean Journal of Emergency Medical Services
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    • v.15 no.3
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    • pp.31-44
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    • 2011
  • Purpose : The purpose of emergency medical services(EMS) is to save human lives and assure the completeness of the body in emergency situations. Those who have been qualified on medical practice to perform such treatment as there is the risk of human life and possibility of major physical and mental injuries that could result from the urgency of time and invasiveness inflicted upon the body. In the emergency medical activities, 119 emergency medical technicians mainly perform the task but they are not able to perform such task independently and they are mandatory to receive medical direction. The purpose of this study is to examine the recognition and request for medical direction by 119 emergency medical technicians in order to provide basic information on the development of medical direction program suitable to the characteristics of EMS as well as for the studies on EMS for the sake of efficient operation of pre-hospital EMS. Method : Questionnaire via e-mail was conducted during July 1-31, 2010 for 675 participants who are emergency medical technicians, nurses and other emergency crews in Gyeongbuk. The effective 171 responses were used for the final analysis. In regards to the emergency medical technicians' scope of responsibilities defined in Attached Form 14, Enforcement regulations of EMS, t-test analysis was conducted by using the means and standard deviation of the level of request for medical direction on the scope of responsibilities of Level 1 & Level 2 emergency medical technicians as the scale of medical direction request. The general characteristics, experience result, the reason for necessity, emergency medical technicians & medical director request level, medical direction method, the place of work of the medical director, feedback content and improvement plan request level were analyzed through frequency and percentage. The level of experience in medical direction and necessity were analyzed through ${\chi}^2$ test. Results : In regards to the medical direction experience per qualification, the experience was the highest with 53.3% for Level 1 emergency medical technicians and 80.3% responded that experience was helpful. As for the recognition on the necessity of medical direction, 71.3% responded as "necessary" and it turned out to be the highest of 76.9% in nurses. As for the reason for responding "necessary", the reason for reducing the risk and side-effects from EMS for patients was the largest(75.4%), and the reason of EMS delay due to the request of medical direction was the highest(71.4%) for the reason for responding "not necessary". In regards to the request level of the task scope of emergency medical technicians, injection of certain amount of solution during a state of shock was the highest($3.10{\pm}.96$) for Level 1 emergency rescuers, and the endotracheal intubation was the highest($3.12{\pm}1.03$) for nurses, and the sublingual administration of nitroglycerine(NTG) during chest pain was the highest($2.62{\pm}1.02$) for Level 2 emergency medical technicians, and regulation of heartbeat using AED was the highest($2.76{\pm}.99$) for other emergency crews. For the revitalization of medical direction, the improvement in the capability of EMS(78.9%) was requested from emergency crew, and the ability to evaluate the medical state of patient was the highest(80.1%) in the level of request for medical director. The prehospital and direct medical direction was the highest(60.8%) for medical direction method, and the emergency medical facility was the highest(52.0%) for the placement of medical director, and the evaluation of appropriateness of EMS was the highest(66.1%) for the feedback content, and the reinforcement of emergency crew(emergency medical technicians) personnel was the highest(69.0%) for the improvement plan. Conclusion : The medical direction is an important policy in the prehospital EMS activity because 119 emergency medical technicians agreed the necessity of medical direction and over 80% of those who experienced medical direction said it was helpful. In addition, the simulation training program using algorithm and case study through feedback are necessary in order to enhance the technical capability of ambulance teams on the item of professional EMS with high level of request in the task scope of emergency medical technicians, and recognition of medical direction is the essence of the EMS field. In regards to revitalizing medical direction, the improvement of the task performance capability of 119 emergency medical technicians and medical directors, reinforcement of emergency medical activity personnel, assurance of trust between emergency medical technicians and the emergency physician, and search for professional operation plan of medical direction center are needed to expand the direct medical direction method for possible treatment beforehand through the participation by medical director even at the step in which emergency situation report is received.

A Study on the Nurse's Response for the Clinical Application of Nursing Diagnosis (간호진단 임상적용을 위한 교육프로그램의 효과 및 간호사의 반응조사 연구)

  • Chun, C.Y.;Lim, Y.S.;Kim, Y.S.;Park, J.W.;Cho, K.S.
    • The Korean Nurse
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    • v.29 no.1
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    • pp.59-71
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    • 1990
  • Although the usefulness and importance of clinical application of nursing diagnosis are well recognized by the academic circle, it is not yet generally practiced. In order to provide data for establishing a policy for clinical nursing diagnosis; a study was made at a seminar, sponsored by the Department of nursing, Severance Hospital, with participation of 190 nurses from 33 hospitals. The objective of the study was to find out; 1) if the nurses agree with the academic community in recognizing the benefits and problems of clinical application of nursing diagnosis; 2) how the nurses evaluate their ability to carry out nursing diagnosis; and 3) if educational programs would help enhance ability of nursing diagnosis among nurses. The summary of findings by the study is as follows; 1. While all nurses responded positively on the question of benefits improving science and quality of nursing, thus elevating credibility and position of nurses, some expressed concern on the practicality of the system in setting up nursing objectiveness, confirming the nursing problems and utilizing patient information. For the 20 questions and the scale of 1~5, the lowest average score was 3.223 and the highest 4.066. 2. The study attempted to find out the opinion of the nurses on the problems that 'would make difficult to adopt the nursing diagnosis in clinics. The result of the study indicates the nurses believe the major problems are the fact that the subject of nursing diagnosis are not well defined and that the form sheets do not match with the ones that are currently being used. However, comparing it with the result of the previous study on the same question (inadequate manpower and insufficienf time allocated for the job were two major problems pointed out then.), it can be said that the opinion of the nurses studied this time was much more positive and it suggests that they believe the system can be adopted without increasing manpower and only by giving additional training and by adjusting the format of nursing record sheets. It suggests that the future for adopting a clinical nursing diagnosis is very bright. 3. As the most urgent problem to be solved for adopting clinical nursing diagnosis, 38. 5% responded that it was "education of nurses, "and 34.2% responded that it was "staffing adequate number of nurses". 4. For the 10 questions asked for self-evaluation of ability to adopt the system, with the scale of 1~5, average score was lower than 3. This indicate that they evaluate their ability to adopt the system is low. 5. The results of study taken before and after the educational programs for clinical nursing diagnosis were compared with overall score in order to determine if such program would cause changes in the response to the effect of clinical application of nursing diagnosis, and it was found that there was statistically significant changes suggesting that the education contributed to positive change in the response. 6. The results of study taken before and after the educational programs for clinical nursing diagnosis were compared with overall score in order to determine how the proble~ ms for adopting nursing system would be effected by such educational programs, and it was found that those problems be not soived with a short course of training. 7. The results of study taken before and after the educational programs for clinical nursing diagnosis were compared with overall score in order to determine if such programs would bring changes in the self-evaluation of nurses on the ability of nursing diagno sis, and it was found that program improve score of self-evaluation their ability of the nursing diagnosis. As seen in the above reports, it was found that the nu'rses are very positive about the clinical nursing diagnosis, that educational program for the clinical nursing diagnosis helps nurses for positively changing their attitude for ,the nursing diagnosis, for their self-confidence on their ability to perform nursing diagnosis. With improved know-how and self"confictence of nurses gained through educational and .training programs, the future of clinical application of nursing diagnosis is very bright.diagnosis is very bright.

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Types of Perception toward End-of-Life Medical Decision-making of Clinical Nurses: Q-Methodological Approach (말기환자의 의료적 의사결정에 관한 임상간호사의 인식: Q 방법론적 접근)

  • Jo, Kae-Hwa;Kim, Yeon-Ja;Sohn, Ki-Cheul
    • Journal of Hospice and Palliative Care
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    • v.15 no.1
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    • pp.18-29
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    • 2012
  • Purpose: We analyzed how clinical nurses in Korea perceive terminally ill patients' medical decision-making. Methods: The Q-methodology which analyzes the subjectivity of each item was used. We selected 34 Q-statements among those provided by each of 37 subjects and grouped them into a shape of normal distribution using a 9 point scale. The collected data were analyzed using a QUANL PC program. Results: Four types of perception toward medical decision-making were identified. Type I focuses on patient participation, and Type II emphasizes the role of health professionals. Type III is characterized by an open-minded culture toward death, and Type IV values the role of family members. Conclusion: The results of this study indicate the need for development of a multi-disciplinary curriculum medical decision-making and death for medical and nursing students.

The Review of Environment, Food and Exercise on Allergy Anaphylaxis (환경, 음식 및 운동 알레르기 반응에 대한 고찰)

  • Kwak, Yi-Sub;Baek, Young-Ho;Kim, Seung-Hyun;Kim, Young-Il;Yoo, Byung-In
    • Journal of Life Science
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    • v.20 no.1
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    • pp.147-152
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    • 2010
  • Exercise-induced anaphylaxis (EIA) is a physical allergy, sometimes severe, triggered by exertion following specific food intake. It was defined for the first time in 1980. EIA is associated with different kinds of exercise. The clinical manifestations progress from itching, erythema and urticaria to some combination of cutaneous angioedema and vascular collapse. Mast cell participation in the pathogenesis of this syndrome has been proved by the findings of an elevated serum histamine level during exhaustive exercise. As predisposing factors of EIA, a specific or even nonspecific sensitivity to food has been reported. Food-dependent exercise-induced anaphylaxis (FDEIA) is a distinct form of food allergy induced by physical exercise. It is typified by the onset of anaphylaxis during exercise which was preceded by the ingestion of the causal food allergens. The diagnosis of FDEIA is heavily dependent on clinical history. Allergy tests may need to be performed using a broad panel of food and food additives. As with food allergies, FDEIA diagnosis is based on interview, biological test and skin test. Prophylaxis aims to prevent a recurrence; the patient should be given an emergency kit to deal with any recurrent episodes. After the food allergen has been identified, it should be avoided for at least 4 to 5 hours before any exercise. Two cases of EIA are presented (EIA to circumstances; FDEIA) in this paper, The diagnosis, pathophysiology and therapy of FDEIA are also reviewed.