• Child Health Nursing Research
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• v.6 no.3
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• pp.411-422
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• 2000

Considering the rapid change of modern nursing knowledge, it is necessary to make changes in the curriculum of nursing education periodically according to the patient-nursing needs and the students' needs. This means that nursing education has to provide opportunities for the development of knowledge, skills, and attitudes. Also, as the students of the RN-BSN program being all registered nurses, the education program for them is planned differently from the general undergraduate program. This study was conducted to establish the scope of educational contents of pediatric nursing in RN-BSN program. The contents of the pediatric nursing curriculum and its necessity was identified and reviewed. From June 5 to June 30 2000, data were collected from 309 RN-BSN students in 5 nursing schools. The questionnaire used for this study was developed by their researchers and the Korean Nursing Association and consisted of items according to the curriculum contents of pediatric nursing. The data were analyzed through frequency and percentages and was analyzed using SPSSWIN 10.0 programs. The results were as follows: 1.In the section surveying on the credits of pediatric theory and clinical practice, 3 out of 5 schools had 2 credits in theory (60.0%), and 2 credits for clinical practice in 2 schools, and 2 credits were given to the elective practice in 2 other schools. 2. In analyzing the degree of demand for lecture and clinical practice, 52.1% of students preferred lectures to be given by professors and 53.7% preferred their level of undergraduate knowledge updated and finally most of the students (81.9%) didn't want to do the clinical practice. 3.The students weighted the importance of current curriculum contents as follows : sex education of adolescence(60.8%), high-risk infant(59.5%), sex education of school age children(59.2%), the handicapped children (55.7%), health assessment(52.4%), children with pneumonia(51.5%), children with asthma (47.1%), children with burns(41.1%). In conclusion, there is a need for research to measure the degree of education satisfaction and needs in RN-BSN students and to improve the curriculum contents in pediatric nursing.

• Clinics in Shoulder and Elbow
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• v.26 no.4
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• pp.343-350
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• 2023

Background: Our purpose was to evaluate a custom reverse total shoulder arthroplasty glenoid baseplate for severe glenoid deficiency, emphasizing the challenges with this approach, including short-term clinical and radiographic outcomes and complications. Methods: This was a single-institution, retrospective series of 29 patients between January 2017 and December 2022 for whom a custom glenoid component was created for extensive glenoid bone loss. Patients were evaluated preoperatively and at intervals for up to 5 years. All received preoperative physical examinations, plain radiographs, and computed tomography (CT). Intra- and postoperative complications are reported. Results: Of 29 patients, delays resulted in only undergoing surgery, and in three of those, the implant did not match the glenoid. For those three, the time from CT scan to implantation averaged 7.6 months (range, 6.1-10.7 months), compared with 5.5 months (range, 2-8.6 months) for those whose implants fit. In patients with at least 2-year follow-up (n=9), no failures occurred. Significant improvements were observed in all patient-reported outcome measures in those nine patients (American Shoulder and Elbow Score, P<0.01; Simple Shoulder Test, P=0.02; Single Assessment Numeric Evaluation, P<0.01; Western Ontario Osteoarthritis of the Shoulder Index, P<0.01). Range of motion improved for forward flexion and abduction (P=0.03 for both) and internal rotation up the back (P=0.02). Pain and satisfaction also improved (P<0.01 for both). Conclusions: Prolonged time (>6 months) from CT scan to device implantation resulted in bone loss that rendered the implants unusable. Satisfactory short-term radiographic and clinical follow-up can be achieved with a well-fitting device. Level of evidence: III.

• Journal of Korean Society for Quality Management
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• v.51 no.4
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• pp.531-550
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• 2023

Purpose: The unique nature of life-and-death healthcare services sets them apart from other service industries. While many studies exist on the relationship between healthcare services and customer satisfaction, most of them focus on mildly ill patients, ignoring the differences between critically ill and non-seriously ill patients. This study discusses the actual quality of healthcare services for patients who are facing life-threatening illnesses and are on life support, as well as their right to protection and dignity. Methods: The survey conducted to 149 patients with the four major illnesses: cancer, heart disease, brain disease and rare and incurable disease, those who have experiences with senior general hospitals. Results: The basic statistics of this study are adequate to represent the four major critical illnesses, and the reliability and validity of this study's hypotheses, which were measured by multiple items, were analyzed, and the internal consistency was judged to be high. In addition, it was found that the convergent validity was good and the discriminant validity was also secured. When examining the goodness of fit of the hypotheses, the SRMR, which is the standardized root mean square of residuals that measures the difference between the covariance matrix of the data variables and the theoretical covariance matrix structure of the model, met the optimal criteria. Conclusion: The academic implications of this study are differentiated from other studies by moving away from evaluating the quality of healthcare services for mildly ill patients and focusing on the rights and dignity of patients with life-threatening illnesses in four senior general hospitals. In terms of academic implications, this study enriches the depth of related studies by demonstrating the right to protection and dignity as a factor of patient-centeredness based on physical environment quality, interaction quality, and outcome quality, which are presented as sub-factors of healthcare quality. We found that the three quality factors classified by Brady and Cronin (2001) are optimized for healthcare quality assessment and management, and that the results of patients' interaction quality assessment can be used to provide a comprehensive quality rating for hospitals. Health and human rights are inextricably linked, so assessing the degree to which rights and dignity are protected can be a superior and more comprehensive measurement tool than traditional health level measures for healthcare organizations. Practical implications: Improving the quality of the physical environment and the quality of outcomes is an important challenge for hospital managers who attract patients with life and death conditions, but given the scale and economics of time, money, and human inputs, improving the quality of interactions and defining them as performance indicators in hospital quality management is an efficient way to create maximum value in the short term.

• Journal of Oral Medicine and Pain
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• v.31 no.4
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• pp.283-296
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• 2006

Along with the development of scientific technologies, health care has been growing remarkably, and as the social life quality improves with increasing interest in health, the demand for medical service is rapidly increasing. However, medical accident and medical dispute also are rapidly increasing due to various factors such as, increasing sense of people's right, lack of understanding in the nature of medical practice, over expectation on medical technique, commercialize medical supply system, moral degeneracy and unawareness of medical jurisprudence by doctors, widespread trend of mutual distrust, and lack of systematized device for solution of medical dispute. This study analysed 30 cases of civil suit in the year between 1994 to 2004, which were selected among the medical dispute cases in dental field with the judgement collected from organizations related to dentistry and department of oral medicine, Yonsei university dental hospital. The following results were drawn from the analyses: 1. The distribution of year showed rapid increase of medical dispute after the year 2000. 2. In the types of medical dispute, suit associated with tooth extraction took 36.7% of all. 3. As for the cause of medical dispute, uncomfortable feeling and dissatisfaction with the treatment showed 36.7%, death and permanent damage showed 16.7% each. 4. Winning the suit, compulsory mediation and recommendation for settlement took 60.0% of judgement result for the plaintiff. 5. For the type of medical organization in relation to medical dispute, 60.0% was found to be the private dental clinics, and 30.0% was university dental hospitals. 6. For the level of trial, dispute that progressed above 2 or 3 trials was of 30.0%. 7. For the amount of claim for damage, the claim amounting between 50 million to 100 million won was of 36.7%, and that of more than 100 million won was 13.3%, and in case of the judgement amount, the amount ranging from 10 million to 30 million won was of 40.0%, and that of more than 100 million won was of 6.7%. 8. For the number of dentist involved in the suit, 26.7% was of 2 or more dentists. 9. For the amount of time spent until the judgement, 46.7% took 11 to 20 months, and 36.7% took 21 to 30 months. 10. For medical malpractice, 46.7% was judged to be guilty, and 70% of the cases had undergone medical judgement or verification of the case by specialists during the process of the suit. 11. In the lost cases of doctors(18 cases), 72.2% was due to violence of carefulness in practice and 16.7% was due to missing of explanation to patient. Medical disputes occurring in the field of dentistry are usually of relatively less risky cases. Hence, the importance of explanation to patient is emphasized, and since the levels of patient satisfaction are subjective, improvement of the relationship between the patient and the dentist and recovery of autonomy within the group dentist are essential in addition to the reduction of technical malpractice. Moreover, management measure against the medical dispute should be set up through complement of the current doctors and hospitals medical malpractice insurance which is being conducted irrationally, and establishment of system in which education as well as consultation for medical disputes lead by the group of dental clinicians and academic scholars are accessible.

• Journal of Chest Surgery
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• v.40 no.11
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• pp.752-758
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• 2007

Background: Thoracic sympathetic block surgery is a safe and effective procedure for palmar hyperhydrosis, and this maintains sufficient moisture and prevents compensatory hyperhidrosis. To avoid compensatory hyperhidrosis, the authors performed sympathetic block surgery just above the R4 level to maintain sympathetic tone affecting the caudal area. Material and Method: A total of 71 subjects (45 males and 26 females) were categorized into two groups. Group 1 (31 patients, mean age: 25.5 years) had clips placed both on the upper and lower part of R4 sympathetic ganglion, and group 2 (40 patients, mean age: 25.9 years) underwent clipping of the upper part of R4. Telephone surveys were done to collect data on 8 categories, and the average follow up interval was 24.9 months (group 1) and 18.9 months (group 2). Result: For group 1, 41.9% experienced no sweating and 48.4% re-plied they experienced some sweating depending on the surrounding conditions. Group 2 showed that 60% experienced no sweating and 35% replied they experienced some sweating depending on the surrounding conditions, 58.1% in group 1 experienced sweating right after the surgery, and 40.0% in group 2 experienced the same. Group 1 (38.1%) and group 2 (37.5%) replied they experienced no hand dryness and more patients in group 2 than in group 1 had hand dryness, but without uncomfortable symptoms. 71.0% (group 1) and 62.5% (group 2) replied they had no compensatory hyperhidrosis or related symptoms. One patient in group 1 and two in group 2 reported they regretted undergoing the procedure. The regions of compensatory hyperhidrosis were the back, thigh and chest in group 1 and the group 2 reported the back, chest, and abdomen in the order of frequency. Fewer incidences of the gustatory hyperhidrosis were noted in group 2. Most of the patients were satisfied with their treatment. Conclusion: Clipping the upper part of the R4 ganglion or R4 sympathetic block are both effective for treating palmar hyperhidrosis and these treatments decrease the occurrence or symptoms of compensatory hyperhidrosis. The upper R4 sympathetic block procedure is easier and safer with fewer incidences of gustatory hyperhidrosis and a higher percentage of patient satisfaction.

• Tuberculosis and Respiratory Diseases
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• v.53 no.6
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• pp.612-618
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• 2002

Background : Bronchoscopy is an important diagnostic and a therapeutic tool in chest medicine. However, most patients feel that a bronchoscopy is an unpleasant procedure, and it is important to sedate the patients appropriately, particularly where repetitive examinations are required. Midazolam is a sedative drug with amnestic qualities and a rapid 2 hour half-life. This study have attempted to determine the safety, appropriate dosage, and the effect of midazolam premedication in patients who underwent a bronchoscopy. Methods : One hundred and eighty consecutive patients undergoing bronchoscopy were enrolled in this study. The patients received a midzolam doses of 0.03 mg/kg, 0.06 mg/kg, or a placebo. An additional dose of lidocaine, the total number of coughs, and the duration of the procedures were recorded with monitoring the the blood pressure, heart rate, and oxygen saturation. The level of satisfaction was assessed by the patient, bronchoscopist, and the nurse. Results : The blood pressure, pulse rates, oxygen saturation, number of coughs, lidocaine dose, and procedure time in the 3 groups were similar. There was a trend for the midazolam 0.03 mg/kg group to satisfy bronchoscopists more than the other two groups. The nurses' acceptability was lower in the midazolam 0.06 mg/kg group than the other groups. The patients' acceptablity was greater in both the midazolam 0.03 mg/kg and 0.06 mg/kg groups than in the control group. Conclusion : Sedation with low doses of intravenous midazolam is a safe technique for fiberoptic bronchoscopy with a low morbidity and high acceptable to patients and bronchoscopists.

• The Korean Journal of Nuclear Medicine Technology
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• v.17 no.1
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• pp.30-35
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• 2013

Purpose: One of the current services, providing information to the patients and their guardians by using promotion materials induces positive responses and contributes to the improvement of the hospital reliability. Therefore, the objective of this study is to evaluate the effectiveness of audio visual materials, one of the means of promotion, as a way to give accurate medical information to resolve patient's curiosity about purpose and procedure of their examination and deplete complains about waiting which attributes negative effect to service quality assessment. Materials and Methods: 60 patients(mean age $53.97{\pm}12.24$, male : female = 26 : 34) who had $^{18}F-FDG PET/CT$ scan from July 2012 to August 2012 in Seoul Asan Medical Center were referred to the study. All of the patients having PET/CT scan were asked to watch an informative video material before the injection of radiopharmaceutical ($^{18}F-FDG$) and to fill in a questionnaire. Results: As a result of analyzing the contents of questionnaire, 52% of 60 patients had PET/CT scan for the first time and 72.4% of the patients read the PET/CT guidebook offered from their outpatient department or inpatient wards before their scan. After we searched the level of previous knowledge of the purpose and method of PET/CT scan, the patients answered 25.1% "know well", 34% "not sure", 40.9% "don't know" respectively. And 84.7% of the patients answered that watching the PET/CT guide video before the injection helps understanding what exam they were having and 15.3% of the patients did not. For the question asking ever the patients have experienced using our homepage or smart phone QR code to see the guide video before they visit out PET center, only 3.3% of them answered "yes". Lastly, the patients answered 60.1% "yes", 31.4% "so so" and 8.5% "no" respectively for the question asking whether watching the video makes the patients to fill the waiting time short. Conclusion: It is found that understanding of objective and method of the PET/CT scan and level of satisfaction was improved after the patients watched the guide video whether they had PET/CT scan before and read the PET/CT guidebook or not. Also, watching the video was effective for the reduction of perceptible waiting time. But while displaying the PET/CT guide video is useful for providing information about the scan and shortening the waiting time as one of the medical service, utilization of service was actually very poor because of the passive promotion and indifference of the patients about their examination. Therefore, from now on, it is necessary to construct the healthcare system which can be offered to more patients through the active promotion.

• Journal of Korean Physical Therapy Science
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• v.5 no.3
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• pp.659-674
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• 1998

This Study was to investigate elaborated research themes and direction through specifying the problems of clinical practice education and looking for the direction of improvement. It was in the basis of the viewpoint of the educators that professors and therapists who were the subjects of this study. Perform this study, the 15 colleges' professors and the 55 hospitals' therapists was made up questionnaire, and the data was analysing by Chi-square test and percentage. The results were as follow : ${\cdot}$ In a personal history among the general qualities, professors have little clinical practice history(l-5 years, 53.3%), and therapists have little lecture career(1-5 years, 43.6%, have no 49.0%), ${\cdot}$ The 78.6% subjects were unsatisfied of clinical practice systems. ${\cdot}$ The correlation between clinical history, school career and lecture career and the satisfaction level of clinical practice systems has no(P<.005), ${\cdot}$ The subjects were agreed to that clinical practice curriculum should be changed(67.1%), reinforced(82.9%), and specified(90.0%). ${\cdot}$ The clinical practice credits are 11 points averagely. ${\cdot}$ In the clinical practice curriculum, it made no difference in the practicum of diseases, modality, and the therapeutic techniques between professors and therapists. ${\cdot}$ The 100% professors said that the practicum of the patients' assessment is necessary, and the 63.6% therapists were training for that. ${\cdot}$ The 66.7% professors said that the practicum of the clinical psychology is necessary, and only the 20.0% therapists were training for that. ${\cdot}$ The 93.3% professors said that the practicum of the patients' management is necessary, and the 50.9% therapists were training for that. ${\cdot}$ The 66.7% professors said that the practicum of the medical ethics is necessary, and the 34.5% therapists were training for that. ${\cdot}$ The 46.7% professors said that the practicum of the hospital administration is necessary, but the 54.5% therapists have not training. ${\cdot}$ The 33.3% professors said that the practicum of the pharmacology is necessary, but the 81.8% therapists have not training. ${\cdot}$ The 86.7% professors said that the practicum of the patient's education is necessary, and the 43.6% therapists have training. ${\cdot}$ The 66.7% professors said that the practicum of the prosthesis and brace is necessary, but the 14.5% therapists have not training. ${\cdot}$ The 60.0% professors said that the practicum of the exercise prescription is necessary, but the 25.5% therapists have not training. ${\cdot}$ The 53.5% professors said that the practicum of the emergency treatment is necessary, but the 52.7% therapists have not training. ${\cdot}$ Drawing up the plan about the curriculum of clinical practice, the professors (46.7%) were agreed to national master plan framing by an expert advisor, but the therapists (58.2%) said that the plan that make the most of hospitals' characteristics should be specified. ${\cdot}$ It was found that a clinical special therapists(54.5%) was good as a person in charge of clinical practice education, in that each therapist's own good time (34.5%) was. ${\cdot}$ It made use of the form framing by college(40.0%) as the clinical practice textbook, the form framing by hospital (42.9%) and each therapist(22.9%) as the plan, and the form framing by college (74.3%) as the measurement. ${\cdot}$ The most difficult point in clinical practice education was the lacks of the theory-praciticum linkage(78.2%). ${\cdot}$ It was found that the period of clinical practice was in the second semester-third grade (40.0%) and the desirable period was in the first semester-third grade(50.0%). ${\cdot}$ Professors (53.3%) were agreed that the desirable clinical practice duration was from four months to six months(60.0%), and the therapists (60.0%) were agreed that from one month to three months. ${\cdot}$ This study presented the lacks of rearing the experts, the lacks of cultural education, and the lacks of the theory-clinical practice linkage. There were need to develop the systematic programs, clinical practice textbooks, the measurements and the special hospital for clinical practice. And it was need to reduce the gab between of the hospitals for clinical practice, to cut down the costs. and to improve the labour conditions of leaders. In view of this findings, it takes notice of that both professor and therapist were dissatisfied at the present clinical practice systems. These results point out the problems of clinical practice systems, and do not make expect to us the successive and positive clinical practice. The general, specific and intensive plan about the problems and the direction of improvement that establishing the level of hospital for clinical practice and physiotherapy can be elaborated.

• Journal of agricultural medicine and community health
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• v.17 no.1
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• pp.34-45
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• 1992

In this county, the gap between the urban 'haves' and the rural 'have-nots' continues to be an increasing problem. WHO and UNICEF see primary health care(PHC) as the key to achieving an acceptable level of health throughout the world as a community development. PHC is essential health care made accessible to individuals and families in the community by means acceptable to them. It is the first level of contact of individual, the family, and community with the national health system. It includes at least education on health system. It includes at least education on health problems, promotion of food supply, MCH including family planning, immunization against infectious diseases, control of endemic diseases, treatment of common diseases and injuries, promotion of mental health, and provision of essential drugs. However, of the aboves, education concerning of mental health problems and the methods to identify, prevent, and control them is the principal step of establishment. In Korea, the category of PHC worker includes the physician as public doctor and nurse as primary health care practitioner and community health leader as village health worker. PHC workers of the aboves will thus function best if they are appropriately trained to respond to the health needs of the community. However in this country, since the national PHC service project launched in 1980, the government has not developed and performed appropriate and enough education and training activities. In light of above reasons, several categories of health education activities had been planned and performed being aimed at above specific target groups and the main focus was on the village health workers for about one year from July 1991 to July 1992 in Yeoju Kun of Kyonki Province. At the end of the period, evaluation of education input was carried out to measure the improvement of healthful life of people in terms of awareness, attitude, and practice. At the end of the period, evaluation of education input was carried out to measure the improvement of healthful life of people in terms of awareness, attitude, and practice. The totals of 80 village health workers, 13 public health practitioners and 9 public docters took in the course of health education for a few hours at every month and the evaluation works of educational effect were taken. The results the study were as follows. 1) Number of persons who realized the maxim "health care of the people is a duty of the government" increased after the education course, On the other hand, the rate of satisfaction on the effort of government for health promotion of the people decreased. 2) Public doctors and primary health care practitioners(nurses) liked and enjoyed the education schedule as a meeting of peer group. It provided chances of communication with staffs of Korea University Hospital. It was said that lectures covered great deal of knowledge and technic they urgently needed in the field. 3) After finishing the education course, more of village health workers(VHW) thought they adapted themselves to their roles and functions showing increased number of home visit and contact with primary health care practitioners by month. 4) In case of patient refer, VHW preferred primary health care practitioners to public doctors. 5) Capability of VHWs in most of their functions increased dramatically after when the education course finished except tuberculosis control.

• Journal of agricultural medicine and community health
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• v.19 no.2
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• pp.141-158
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• 1994

To provide better health care services to the rural population, the government has made the Community Health Practitioner(CHP) a regular government official from April 1, 1992. This study was carried out to study the impact of officialization of CHP on the activities and management system of Primary Health Post(PHP). Fifty PHPs were selected by two stage sampling, cluster and simple random, from 595 PHPs in Kyungnam and Kyungpook provinces. Data were collected by a personal interview with CHPs and review of records and reports kept in the PHPs. The study was done for the periods of January 1-March 31, 1992 (before officialization) and January 1-March 31, 1993 (after officialization). Ninety-six percent of the CHPs wanted to become a regular government official in the hope of better job security and higher salary. The proportion of CHPs who were proud of their iob was increased from 24% to 46% after officialization. Those CHPs who felt insecure for their job decreased from 30% to 10%. Monthly salary was increased by 34% from 802,600 Won to 1,076,000 Won and 90% of the CHPs were satisfied with their salary, also more CHPs responded that they have autonomy in their work planning, implementation of plan, management of the post, and evaluation of their activity. There were no appreciable changes in such CHPs' activities as assessment of local health resources, drawing map for the catchment area, utilization of community organization, grasping the current population structure in the catchment area, keeping the family health records, individual and group health education, and school health service. However, the number of home visits was increased from 13.6 times on the average per month per CHP to 27.5 times. More mothers and children were referred to other medical facilities for the immunization and family planning services. Average number of patients of hypertension, cancer, and diabetes in three months period was decreased from 12.7 to 11.6, from 1.5 to 1.2, and 4.3 to 3.4, respectively. Records for the patient care, drug management, and equipment were well kept but not for other records. The level of record keeping was not changed after officialization. The proportion of PHPs which had support from the health center was increased for drug supply from 14.0% to 30.0%, for consumable commodities from 22.0% to 52.0%, for maintenance of PHP from 54.0% to 68.0%, for supply of health education materials from 34.0% to 44.0%, and supply of equipment from 54.0% to 58.0%. Total monthly revenue of a PHP was increased by about 50,000 Won; increased by 22,000 Won in patient care and 34,700 Won in the government subsidy but decreased in the membership due and donation. However, there was no remarkable changes in the expenditure. The proportion of PHPs which had received official notes from the health center for the purpose of guidance and supervision of the CHPs was increased from 20% to 38% during three months period and the average number of telephone call for supervision from the health center per PHP was increased from 1.8 to 2.1 times(p<0.01). However, the proportion of PHPs that had supervisory visit and conference was reduced from 79% to 62%, and from 88% to 74%, respectively. The proportion of CHPs who maintained a cooperative relationship with Myun Health Workers was reduced from 42% to 36%, that with the director of health center from 46% to 24%, that with the chief of public health administration section from 56% to 36%, and that with the chairman of PHP management council from 62% to 38%. Most of the CHPs (92% before and 82% after officialization) stated that the PHP management council is not helpful for the PHP. CHPs who considered the PHP management council unnecessary increased from 4% to 16%(p<0.05). Suggestions made by the CHPs for the improvement of CHP program included emphasis on health education, assurance of autonomy for PHP management, increase of the kind of drugs that can be dispensed by CHPs, and appointment of an experienced CHP in the health center as the supervisor of CHPs. The results of this study revealed that the role and function of CHPs as reflected in their activities have not been changed after officialization. However, satisfaction in job security and salary was improved as well as the autonomy. Support of health center to the PHP was improved but more official notes were sent to the PHPs which required the CHPs more paper works. Number of telephone calls for supervision was increased but there was little administrative and technical guidance for the CHP activities.