• 대한족부족관절학회지
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• 제23권2호
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• pp.67-70
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• 2019

Septic arthritis is a serious medical condition that can lead to significant complications if misdiagnosed or mismanaged. A rare case of a 1st metatarso-phalangeal joint septic arthritis in a native joint is presented in a patient with no significant risk factors. A 41-year-old patient was referred by his general practitioner owing to ongoing pain and swelling over his native 1st metatarso-phalangeal joint with difficulty on weightbearing for three months. After a series of investigations, including blood tests and a foot magnetic resonance imaging, which were inconclusive, the patient was led to the operating theatre for sampling and washout of his joint. The samples taken in the theatres revealed septic arthritis with Streptococcus mitis as the causative microorganism. The patient was treated with six weeks of oral antibiotics with a good functional outcome. This case report illuminates this rare condition and makes foot and ankle surgeons aware of its existence. A high suspicion for this condition can prevent misdiagnosis and mismanagement.

• 한국병원경영학회지
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• 제7권4호
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• pp.57-101
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• 2002

These days, the environment of hospital marketing is changing rapidly. The level of expectation and demand of patients have become greater and more diversified, and patients have more alternatives in selecting hospitals. The standard of hospital selection and the type of using hospital have been changed, and competition among hospitals has been accelerated due to the opening of the medical market through globalization. Accordingly, differentiation strategies are critical in hospital marketing. The quality of medical service oriented toward patient satisfaction becomes a strong strategic weapon to secure a hospital's competitive advantage. Therefore, marketing and communication strategies should be focused on patient-oriented, rather than hospital-oriented. Considering the changes in the hospital environment and the increase in the patients' expectation level, this study categorizes doctors' communication styles into four different ones: trust-type, professional-type, cooperation-type, and control-type. The effects of these communication styles on patient satisfaction were empirically examined. The moderating roles of the patient's characteristics and clinical characteristics between the doctors' communication styles and patient satisfaction were also investigated to find out managerial implications for hospital management. To achieve such goals, data were collected from patients of 12 general hospitals in Busan. The data were analyzed to test research hypotheses that examine 1) the relationships between doctors' communication styles and patient satisfaction, 2) the moderating roles of the patient characteristics and clinical characteristics in the research model, and 3) the impact of patient satisfaction on positive word-of-mouth and repurchase. The following summarizes the major results of this research. First, the data showed that patient satisfaction varied across doctors' communication styles. Trust-type style had the strongest impact on patient satisfaction while control-type style had the weakest influence on patient satisfaction. Professional-type style and cooperation-type style also had positive effects on patient satisfaction but the impact of the two are not statistically different. Second, significant differences in terms of patient satisfaction were found depending upon demographic variables such as gender, marital status, age, occupation, and education. Patient satisfaction, however, was consistent across varying income groups. Third, patients' medical insurance types were also related to patient satisfaction. It implies that a doctor may need to use different communication styles depending on a patient's medical insurance type. Fourth, out-patient and in-patient showed a different level of satisfaction with varying communication styles. Fifth, highly professional knowledge and strong control can influence patient satisfaction depending on the characteristics of the patient treatment field. Sixth, patient satisfaction were proved to have significantly positive effects on word-of-mouth and repurchase. The implications drawn from this study must be tempered by its limitations. First of all, the subjects used in this study were patients in Busan and small- and medium-size hospitals were excluded from the research. Therefore, future research should examine the research model by using a variety of hospitals and clinics throughout Korea. Another research agenda has to do with finding more determinant and moderating variables which will increase an explanatory power of the model. In short, this study may be the first empirical research that investigates the effects of doctors' communication styles on patient satisfaction. Interestingly enough, the results showed that each communication style had a unique impact on patient satisfaction. The findings from this research can be very useful in developing hospital marketing strategies.

• 한국콘텐츠학회논문지
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• 제17권2호
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• pp.467-475
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• 2017

본 연구의 목적은 환자가 경험하는 의사소통 장애가 환자 만족도와 장기적 관계지향성에 미치는 영향을 알아보는데 있다. 치과 병 의원을 방문한 환자 214명을 대상으로 설문조사를 실시하였다. 분석은 PASW Statistics 18.0과 IBM SPSS AMOS 21을 이용하였다. 의사소통 장애 요인분석결과 '일방적소통', '신뢰배려부족', '환자영역', '환경영역'의 요인으로 나뉘었다. 분석 결과, 환자가 느끼는 의사소통 장애요인은 환자 만족도와 장기적 관계지향성에 영향을 미치며, 환자 만족도는 장기적 관계지향성에 영향을 미치는 것으로 나타났다. 이 같은 결과를 바탕으로 치과종사자는 환자와 신뢰를 구축할 수 있는 의사소통 능력을 지니는 동시에 환자 만족도를 높여 계속적인 관계를 유지할 수 있도록 해야 한다.

• Archives of Plastic Surgery
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• 제47권6호
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• pp.567-573
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• 2020

Background Polyurethane implants have been used on and off in breast reconstruction since 1991 while prepectoral breast reconstruction has gained popularity in recent times. In this study, we present our outcomes from the use of acellular dermal matrix (ADM) complete wrap with polyurethane implants in prepectoral breast reconstruction. Methods This is a retrospective review of prospectively maintained database from 41 patients receiving complete ADM wrap with prepectoral polyurethane implants over a 3-year period. Selection criteria were adapted from a previous study (4135 Trust Clinical Audit Database) evaluating prepectoral reconstruction with Braxon matrices. Patient demographics, operative data, surgical complications, and outcomes were collected and analyzed. Results A total of 52 implant reconstructions were performed in 41 patients with a mean follow-up of 14.3 months (range, 6-36 months). The overall reported complication rates including early (less than 6 weeks) and late complications. Early complications included two patients (4.9%) with wound dehiscence. One of which had an implant loss that was salvageable. Another patient (2%) developed red-breast syndrome and two women (4.9%) developed with seroma treated conservatively. Late complications included one patient (2%) with grade II capsular contraction, 12 patients with grade I-II rippling and two patients (4.9%) with grade III rippling. Conclusions We present our experience of prepectoral polyurethane implant using complete ADM wrap. This is one of the few papers to report on the outcome of the prepectoral use of polyurethane in immediate implant-based breast reconstruction. Our early observational series show satisfactory outcome and long-term results are warranted by a large multicenter study.

• 산업경영시스템학회지
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• 제32권2호
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• pp.112-119
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• 2009

Telecare, one of the e-healthcare services with lCT, is a promising technology which aims to monitor the state of patients and then provide the medical services appropriately in remote sites. Virtual telecare team based on the concept of virtual collaborative teams which consist of a patient, a doctor, and a telecare team, operates on a temporary basis in need. Reputation, which means the degree of a patient's belief to a doctor in consideration, is the most important factor to make the virtual telecare team trustable. In this paper, we propose the fuzzy reputation model of a virtual telecare team, which is a reputation-based trust model based on fuzzy set theory. An illustrative example is also given in order to show the applicability of the model to the concept of a virtual telecare team.

• 혜화의학회지
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• 제22권2호
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• pp.119-141
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• 2014

Objective : This study was designed to health-Care services recognition comparison of patient between Korean Medicine 00 Hospital and Seoul 00 Health Center. Methods : 277 subjects were participated in this study. After a treatment, we analyzed a patient type by using a questionnaire. After all treatment, we conducted a survey about Medical Trust Scale, Medical Happiness Index Scale, Service Quality Scale. To evaluate a satisfaction degree, we analyzed results of survey statistically. Results : The results of the analysis, Korean Medicine 00 Hospital group got a higher score than Seoul 00 Health Center group statistical significantly on Medical Trust Scale, Medical Happiness Index Scale, Service Quality Scale. Conclusion : Korean Medicine 00 Hospital group got a higher score than Seoul 00 Health Center group. It was more effective in Korean Medicine 00 Hospital group than Seoul 00 Health Center group.

• Archives of Plastic Surgery
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• 제47권2호
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• pp.146-152
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• 2020

Background Preoperative computed tomography angiography (CTA) of the abdominal wall vessels is used when planning free flap breast reconstruction (FFBR) because it provides a surgical road map which facilitates flap harvest. However, there are few reports on the effect of abnormal findings on the operative plan. Methods We conducted a retrospective study of all FFBRs performed at a tertiary referral center over a 6-year period (November 2011 to June 2017). One consultant radiologist reported on the findings. Details on patient demographics, CTA reports, and intraoperative details were collected. Results Two hundred patients received preoperative CTAs. Fourteen percent of patients (n=28) had abnormal findings. Of these findings, 18% were vascular anomalies; 36% tumorrelated and 46% were "miscellaneous." In four patients, findings subsequently prevented surgery; they comprised a mesenteric artery aneurysm, absent deep inferior epigastric (DIE) vessels, bilateral occluded DIE arteries, and significant bone metastases. Another patient had no suitable vessels for a free flap and the surgical plan converted to a pedicled transverse rectus abdominis musculocutaneous flap. The remaining incidental findings had no impact on the surgical plan or appropriateness of FFBR. More than one in 10 of those with abnormal findings went on to have further imaging before their operation. Conclusions CTA in FFBR can have a wider impact than facilitating surgical planning and reducing operative times. Incidental findings can influence the surgical plan, and in some instances, avoid doomed-to-fail and unsafe surgery. It is therefore important that these scans are reported by an experienced radiologist.

• 대한간호학회지
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• 제7권1호
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• pp.10-19
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• 1977

Trust is an essential factor in human relations, as it enables man to accept and also disclose self. Today's health care demands nursing personnel with high level of trust . This study was designed and carried out in May through June, 1976 to measure the level of trust on nurses through the trust scale of Nurses (75- N) made by Kenneth et al. and the Parent Inventory made by Rake and to provide data for management of nursing personnel. 150 junior nursing students, 164 professional nurses from 5 universities and their medical centers and 55 nurse- educators from 8 baccalaureate nursing programs in Seoul were randomly sampled. Results are as follows : 1. The rank order of the level of trust revealed that nurse educators the highest and nursing students the lowest. 2. The level of trust revealed to be influenced by the relationship with parents at the early stages of life ; Group who appeared to have shared intimacy with their parents were the highest. 3. Factors such as ; number of siblings and birth order among them, religious affiliation, parental presence revealed to have had no influence on the level of trust in all three group. 4. No significant difference were revealed between the group who had put their names down on the questionnaire and the others. 5. Clinical specialities of practice revealed to have no signigicant influence on trust in nurses. 6. Marital status revealed to have significant influence : in nurses and nurse- educators, the mastered re vented to have significantly higher level of trust. (difference by Recommendations : 1. A study on trust level of patients and Nurses in Nurse- patient Relationship. 2. A longitudinal study to investigate the influence of Nursing education on the development of trust in Nurses are recommended. 3. A comparative study on trust level of students of Nursing & non- Nursing major.

• 의학교육논단
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• 제21권1호
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• pp.13-21
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• 2019

Patient safety and medical errors have emerged as global concerns and error disclosure has been established as standards of practice in many countries. Disclosure of medical errors to patients and their families is an important part of patient-centred medical care and is essential to maintaining trust. However, physicians still hesitate to disclose errors to patients despite their belief that errors should be disclosed. Multiple barriers such as fear of medical lawsuits and punishment, fear of damaging their professional reputation, and diminished patient trust inhibit error disclosure. These barriers as well as lack of training or education programs addressing error disclosure contribute to a low estimated disclosure rate in real situations. Nowadays, the importance of patient safety education including error disclosure is emphasized and related research is increasing. In this paper, we will discuss the background of medical error disclosure and studies on education programs related to error disclosure. In this regard, we will examine the content and methods currently being taught, discuss the effects or outcomes of such education programs and obstacles or difficulties in implementing them. Finally, the direction of future error disclosure education, support systems, and education strategies will also be covered.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제46권6호
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• pp.403-408
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• 2020

Objectives: Appropriate and accurate local anesthetic (LA) techniques are indispensable in the field of oral and maxillofacial surgery to obtain a satisfactory outcome for both the operating surgeon and the patient. When used alone, the inferior alveolar nerve block (IANB) technique requires supplemental injections like long buccal nerve block for extraction of mandibular molars leading to multiple traumatic experiences for the patient. The aim of this study was to anesthetize the inferior alveolar, lingual, and long buccal nerves with single-needle penetration requiring a minimal skillset such as administering a conventional IANB through introduction of the Benny Joseph technique for extraction of mandibular molars. Materials and Methods: This was a prospective study conducted in the Department of Oral and Maxillofacial Surgery, Kunhitharuvai Memorial Charitable Trust (KMCT) Dental College, Calicut, India. The duration of the study was 6 months, from June to November 2017, with a maximum sample size of 616 cases. The LA solution was 2% lignocaine with 1:100,000 adrenaline. The patients were selected from a population in the range of 20 to 40 years of age who reported to the outpatient department for routine dental extraction of normally positioned mandibular right or left first or second molars. Results: Of the 616 patients, 42 patients (6.8%) required re-anesthetization, a success rate of 93.2%. There were no complications such as hematoma formation, trismus, positive aspiration, and nerve injuries. None of the cases required re-anesthetization in the perioperative period. Conclusion: The Benny Joseph technique can be employed and is effective compared with conventional IANB techniques by reducing trauma to the patient and also requires less technique sensitivity.