• 의료법학
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• 제10권2호
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• pp.309-341
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• 2009

According to a case of Supreme Court's Sentence No. 2009DA17417 (May 21, 2009), the Supreme Court judges that 'the right to life is the ultimate one of basic human rights stipulated in the Constitution, so it is required to very limitedly and conservatively determine whether to discontinue any medical practice on which patient's life depends directly.' In addition, the Supreme Court admits that 'only if a patient who comes to a fatal phase before death due to attack of any irreversible disease may execute his or her right of self-determination based on human respect and values and human right to pursue happiness, it is permissible to discontinue life-sustaining treatment for him or her, unless there is any special circumstance.' Furthermore, the Supreme Court finds that 'if a patient who is attacked by any irreversible disease informs medical personnel of his or her intention to agree on the refusal or discontinuance of life-sustaining treatment in advance of his or her potential irreversible loss of consciousness, it is justifiable that he or she already executes the right of self-determination according to prior medical instructions, unless there is any special circumstance where it is reasonably concluded that his or her physician is changed after prior medical instructions for him or her.' The Supreme Court also finds that 'if a patient remains at irreversible loss of consciousness without any prior medical instruction, he or she cannot express his or her intentions at all, so it is rational and complying with social norms to admit possibility of estimating his or her own intentions on withdrawal of life-sustaining treatment, provided that such a withdrawal of life-sustaining treatment meets his or her interests in view of his or her usual sense of values or beliefs and it is reasonably concluded that he or she could likely choose to discontinue life-sustaining treatment, even if he or she were given any chance to execute his or her right of self-determination.' This judgment is very significant in a sense that it suggests the reasonable orientation of solutions for issues posed concerning withdrawal of meaningless life-sustaining medical efforts. The issues concerning removal of medical instruments for meaningless life-sustaining treatment and discontinuance of such treatment in regard to medical treatment for terminal cases don't seem to be so much big deal when a patient has clear consciousness enough to express his or her intentions, but it counts that there is any issue regarding a patient who comes to irreversible loss of consciousness and cannot express his or her intentions. Therefore, it is required to develop an institutional instrument that allows relevant authority to estimate the scope of physician's medical duties for terminal patients as well as a patient's intentions to withdraw any meaningless treatment during his or her terminal phase involving loss of consciousness. However, Korean judicial authority has yet to clarify detailed cases where it is permissible to discontinue any life-sustaining treatment for a patient in accordance with his or her right of self-determination. In this context, it is inevitable and challenging to make better legislation to improve relevant systems concerning withdrawal of life-sustaining treatment. The State must assure the human basic rights for its citizens and needs to prepare a system to assure such basic rights through legislative efforts. In this sense, simply entrusting physician, patient or his or her family with any critical issue like the withdrawal of meaningless life-sustaining treatment, even without any reasonable standard established for such entrustment, means the neglect of official duties by the State. Nevertheless, this issue is not a matter that can be resolved simply by legislative efforts. In order for our society to accept judicial system for withdrawal of life-sustaining treatment, it is important to form a social consensus about this issue and also make proactive discussions on it from a variety of standpoints.

• 한국의류산업학회지
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• 제16권6호
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• pp.849-859
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• 2014

This study developed adaptive clothing to increase psychological comfort and protection for dementia patients. Our research method and data collection were as follows. The author selected and interviewed 10 caregivers and nurses to understand dementia patient behavior. The author collected eight pieces of clothing designed for dementia patients that are sold in Korean and overseas markets. We then analyzed garment details, open systems, close systems, and expected functions. Adaptive clothing for dementia patients were developed based upon our research. The results are as follows. First, dementia patients' behavior differed by dementia patient symptoms. Second, all items sold in Korean and overseas markets were jump suits designed to prevent behavior characteristic of dementia patients. Third, the author designed and manufactured five pieces of adaptive clothing for dementia patients that included two for mild dementia patients and three for moderate dementia patients. A panel of 50 caregivers gave high marks to developed clothing in regards to functionality, hygiene, patient human rights and aesthetics. The adaptive clothing of dementia patients from this research will increase the psychological and emotional satisfaction of dementia patients.

• 중환자간호학회지
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• 제11권2호
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• pp.21-33
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• 2018

Purpose : To explore the person-centered care (PCC) experienced by critical patients. Method : This qualitative study deductively examined the attributes of the PCC model proposed by Jakimowicz and Perry. The participants were 16 patients who were recently discharged from intensive care units at a university hospital. Data were collected through in-depth interviews and were analyzed using the deductive method of content analysis. Results : A total of 4 categories, 16 subcategories, and 33 codes were generated from 171 meaningful statements. The final 4 categories were "compassionate presence," "professional interaction," "outstanding competency," and "patient identity." These were consistent with the main attributes of Jakimowicz and Perry's model. However, most of the codes belonged to the "compassionate presence" and "patient identity" categories. Among the attributes of the model, "continuity of nursing," "therapeutic relationship," "expert knowledge," "clinical knowledge," "evidence-based intervention," and "patient's rights" were not derived as codes. Conclusion : These findings deepen the understanding of the PCC model from the patient's point of view. The main attributes of PCC identified in the current study can be applied to the development of practical guidelines for intensive care nursing. In addition, we recommend the development of a PCC measurement tool for critical care patients.

• 디지털융복합연구
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• 제13권1호
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• pp.275-281
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• 2015

최근 헬스케어는 다양한 의료 서비스를 제공받으려는 사용자가 급격하게 증가하고 있으며, 환자의 정보가 제3자에게 쉽게 노출되어 악용될 수 있어 환자에 따라 병원 관계자(의사, 간호사, 약사 등)의 역할이 명확하게 분류될 필요가 있다. 본 논문에서는 헬스케어 환경에서 환자의 정보가 제3자로부터 안전하게 사용하기 위해서 환자의 속성정보를 분류하고, 병원 관계자는 역할에 따라 권한을 분류하여 계층적 다중 속성을 이용한 환자의 프라이버시 보호기법을 제안한다. 제안 기법은 환자의 프라이버시 속성정보(데이터 소비자, 시간, 센서, 목적, 의무, 위임 그리고 상황 등)를 수학적 모델로 표현하고, 제 3자로부터 환자 정보가 불법적으로 악용되는 것을 예방하기 위해서 환자와 병원관계자 사이의 속성정보를 동기화하여 환자의 프라이버시 정보의 유출을 예방한다.

• The Journal of Korean Physical Therapy
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• 제14권3호
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• pp.116-128
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• 2002

Physical therapy record what the therapist dose to manage the individual patients case. The rights of the therapist and patients are protected should any question occur in the future regarding the care provided to the patient. Physical therapy note is a method of communicating with the patient's physician, other health care professionals and including other therapists. Abbreviations and symbols are used as a time and space saver while writing physical therapy Progress note. In order to ensure that everyone in the hospital need understand what has been written in the chart by others. Therefore, we need a enactment of physical therapy abbreviations and symbols in Korea. There are 468 abbreviations and symbols. It will be change with development of medical science, physical therapy and culture.

• The Journal of Korean Physical Therapy
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• 제14권4호
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• pp.234-259
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• 2002

Physical therapy record what the therapist dose to manage the individual patients case. The rights of the therapist and patients are protected should any question occur in the future regarding the care provided to the patient. Physical therapy note is a method of communicating with the patient's physician, other health care professionals and including other therapists. Abbreviations and symbols are used as a time and space saver while writing physical therapy progress note. In order to ensure that everyone in the hospital need understand what has been written in the chart by others. Therefore, we need a enactment of physical therapy abbreviations and symbols in Korea. There are 468 abbreviations and symbols. It will be change with development of medical science, physical therapy and culture.

• 한국치위생학회지
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• 제11권3호
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• pp.353-361
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• 2011

Objectives : This study was to examine the social value of dental hygienists, their values about the health system and the relationship of all the related variables. Methods : The subjects in this study were 205 dental hygienists who worked in dental clinics and hospitals on Seoul. A survey was conducted from August 12 to October 15, 2010. The questionnaire consisted of nine items about general characteristics, two items about social values and 11 about values of the health system. The items related to social values and values of the health system were prepared by translating the items used in David et al's study, and the Cronbach alpha coefficient of those items respectively 0.80 and 0.76. Results : The dental hygienists got 3.94 in social values, which was above the average. In terms of values about the health care system, their values of the treatment delivery system(3.92) rated highest, followed by values of patient rights(3.79) and values of institutional restrictions(3.25). Their socal values had a closest positive correlation to their values of the treatment delivery system, and their values of patient rights had a strong positive correlation to those of the treatment delivery system and was positively correlated to those of institutional regulations as well. And there was a positive correlation between their values of the treatment delivery system and institutional regulations(r=.276). Conclusions : The above-mentioned findings illustrated that the social values of the dental hygienists had a positive correlation to their values of the health system. Therefore the kinds of educational programs that help dental hygienists to build their social values and values of the health system should be developed to improve their job efficiency as oral health experts.

• 대한예방한의학회지
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• 제18권3호
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• pp.11-21
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• 2014

The rapid development and distribution of information communication industry facilitates the changes of hospital administration, introducing EMR(Electronic Medical Record) instead of paper-based medical record in the medical field. The developed countries such as U.S. have established EMR system after in the middle of 1970s because the primary advantages of EMR is to store and handle vast amounts of records efficiently and increase the quality of health care. Most of health organizations in Korea also apply medical record system to their administration. As the result, they have accomplished a scientific administration system through the use of medical record to handle a variety of patient's information including patient's confidentiality and privacy such as family history, social status, income level, and so on. However, access to and the misuse of EMR causes illegal infringement of patient's information and finally it becomes a very serious medical issue. Potential leakage and misuse of records may seriously infringe patient's privacy rights. In this respect, the related agencies in the public and private sector have been making efforts to prevent patient's records leakages. Especially, the revision bill of Medical Law in 2002 establishes the ways on the security and standards of electronic records. However, it does not provide the proper guidelines which is applied to the rapid changes of the medical environment. One of the most priorities in the hospital administration is the production and maintenance of an accurate medical records fulfilled by medical recorders. Therefore, it is very important for health care providers to hire ethical-based medical recorders. But, unfortunately most of hospitals overlook the importance of their roles. All parts including government, physician and patient must have more concerns on the problems related to EMR. Therefore, this study aims to propose the proper ways to resolve the problems coming from EMR.

• 한국임상약학회지
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• 제26권1호
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• pp.33-39
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• 2016

Background: Elements of informed consent including capacity, disclosure, understanding, voluntariness, and permission of the participant, are all crucial for clinical trials to be legally and ethically valid. During the informed consent process, the patient information leaflet is an important information source which prospective research subjects can utilize in their decision-making. In the adequate provision of information, KGCP guideline necessitate 20 specific items, as well as the use language that individuals can understand. This study measures the vocabulary level of patient information leaflets in an effort to provide an objective evaluation on the readability of such material. Methods: The word difficulty of 13 leaflets was quantitatively evaluated using Kim kwang Hae's vocabulary grading framework, which was compared to the difficulty level of words found in the $6^{th}$ grade Korean textbook. The quantitative outcomes were statistically analyzed using chi-squared tests and linear by linear association for ordinal data. Results: There was a statistically significant difference between the vocabulary level and frequency of words in leaflets and the 6th Korean textbook. The leaflets were on average 260 sentences and about roughly 15 pages long, including lay language (easier or equal to language used in primary school) of around 12% less; technical language of around 4.5% more. As the vocabulary grades increase, there was a distinct difference in vocabulary level between Korean textbook and each information leaflet (p < 0.001). Conclusion: Patient information leaflets may fail to provide appropriate information for self-determination by clinical trial subject through the difficulty level of its wording. Improvements in the degree of patients' understanding and appropriate use of information leaflets are collaboratively equipped to strengthen patient's autonomy and therefore guaranteeing participant's rights.

• 디지털융복합연구
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• 제11권3호
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• pp.305-310
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• 2013

최근 병원에서는 불치병을 갖고 있는 환자에게 의료서비스를 제공하기 위해서 체내에 장치를 부착하여 환자상태를 모니터링하는 체내삽입장치를 사용하고 있다. 그러나, 유헬스케어 환경을 구성하고 있는 병원관계자가 무분별하게 환자의 생체정보를 악용하여 환자의 생명에 위협을 줄 수 있는 문제점들이 나타나고 있다. 본 논문에서는 병원 관계자의 권한레벨에 따라 환자의 생체정보를 사용하기 위한 연합 ID 기반의 인증 모델을 제안한다. 제안 모델은 서로 다른 인증 식별 체계가 사용되고 있는 병원에서 다양한 형태로 존재하는 다수의 ID 정보를 연합하여 병원 간 건강/의료 정보 공유시 불필요한 개인 정보 노출 없이 익명성을 보장받을 수 있다. 특히, 환자 정보에 쉽게 접근할 수 있는 병원관계자의 악의적 행위에 대해서 환자 정보를 안전하게 보호하기 위해서 접근권한에 대한 레벨을 부여함으로써 제 3자가 쉽게 접근하지 못하도록 한다.