• 한국전문물리치료학회지
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• 제25권1호
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• pp.31-38
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• 2018

Background: Patient-centered care has recently become highly recommended, because it can improve health outcomes more effectively than problem-oriented care. The goal attainment scale (GAS) is one of the methods used for patient-centered care. It was originally developed as an outcome measurement tool, but it can also be used as a therapeutic intervention when setting quantifiable patient-centered goals. Objects: We sought to identify the effect of setting patient-centered goals on rehabilitation outcomes in patients with subacute stoke using GAS. Methods: Overall, 46 subjects with subacute stroke were divided into experimental ($n_1=23$) and control ($n_2=23$) groups. Subjects in both groups attended physical therapy sessions five times a week for four weeks. Those in the experimental group set goals using goal-attainment scaling. The mobility of each subject was evaluated using the Rivermead mobility index (RMI); daily-living activities, using the K-modified Barthel index (K-MBI); participation, using the Hopkins rehabilitation-engagement rating scale (HRERS); satisfaction, using the patient-satisfaction scale (PSS). Results: Subjects in the experimental group experienced more significant increases in RMI, HRERS, and PSS than those in the control group (p<.05, p<.05 and p<.01, respectively). After four weeks, GAS scores of the experimental group had increased more significantly than those of baseline (p<.01). Conclusion: Setting patient-centered goals is effective in improving the mobility and satisfaction of patients with subacute stoke. Setting patient-centered goals needs to be performed more frequently in clinical settings.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제21권3호
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• pp.37-45
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• 2015

Purpose: The main objective of this paper is, to evaluate the unit design for patient-centered care and to draw lessons-learned for further improvement. Methods: This study conducted a case study of the intensive care unit, designed to fulfill patient-centered care in the US. It evaluated the effectiveness of the unit by incorporating several study methods such as plan analyses, direct observations through nursing tracking and behavior mapping, and focus group interviews. Results: The major design decision made in this patient-centered unit was the use of patient rooms with designated family areas and distributed nursing stations. Both design features appeared to be a success on a variety of research metrics and outcomes. The study identified that the patient rooms ultimately help family members to spent more time with their loved ones, which leads to increased satisfaction of family members and nurses also report that they generally enjoy the distributed nurses' stations, which provide a comfortable environment to complete their regular lines of work such as charting, monitoring patients, and collaborating with their colleagues. Implications: Certain design features in intensive care units such as patient rooms with designated family areas and distributed nursing stations could appropriately support hospitals to fulfill patient-centered care.

• 한국콘텐츠학회논문지
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• 제13권3호
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• pp.278-286
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• 2013

본 연구는 의사의 환자중심 커뮤니케이션(촉진요인, 금지요인)이 환자 참여(행동적 참여, 감정적 참여, 정보적 참여)에 미치는 영향을 분석하기 위한 것이다. 구체적인 연구목적으로는 첫째, 환자중심 커뮤니케이션이 환자참여에 미치는 영향, 둘째, 환자중심의 커뮤니케이션과 환자참여간의 관계에서 신뢰의 조절효과 확인이며, 이를 위하여 국내 종합병원의 환자 301명을 대상으로 SPSS 19.0을 통계패키지를 사용하여 요인분석과 조절회귀분석을 수행하였다. 연구결과, 커뮤니케이션 촉진요인은 행동적 참여, 감정적 참여, 정보적 참여 모두에 유의한 정(+)의 영향을 미치는 것으로 확인되었으나, 금지요인은 영향을 미치지 않는 것으로 나타났다. 또한 신뢰의 조절효과는 촉진요인과 감정적 참여간, 촉진요인과 정보적 참여간에서 발견되었으며, 신뢰의 수준이 높은 집단에서 촉진요인은 감정적 참여와 정보적 참여에 더 큰 영향을 미치는 것으로 확인되었다. 마지막으로 이러한 연구결과를 토대로 환자중심의 커뮤니케이션과 성공적인 의료서비스 제공에 필요한 이론적이고 실무적인 시사점을 제공하였다.

• 가정간호학회지
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• 제27권2호
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• pp.198-209
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• 2020

Purpose: This study sought to develop a scale to evaluate patient-centered healthcare services at hospitals and verify its reliability and validity. Methods: We conducted a literature review and interviewed medical personnel and practitioners in medical institutions. We also conducted a content validation and preliminary survey of experts, including 40 preliminary items. We conducted the main survey among 240 medical institution workers to assess the validity and reliability of the preliminary measurement tool. Results: The validity and reliability of the scale were assessed by 29 items underlying six factors: ease of communication, continuity and extension of the hospital's role, stable environment, emotional support, respect for patients' values, and offer of information. Cronbach's α of the whole tool was .91, while the value of each factor ranged from .82 to .74, thereby verifying its reliability. Conclusion: The patient-centered healthcare services scale was identified as a tool appropriate for healthcare professionals. This tool will be useful in a diverse range of research on the development of educational programs for patient-centered healthcare services and the promotion of patient-centered causes.

• 보건행정학회지
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• 제31권4호
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• pp.518-530
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• 2021

Background: This study examined the effect of having a usual source of care on the degree of patient-centered communication among persons with disability. The role of the usual source of care has been emphasized to improve patient experience, especially for patients with complex health conditions. Methods: This study used the 2017-2018 Korean Health Panel data, and the final study observations were 22,475 (20,806 people without disability and 1,669 people with disability). We applied generalized estimating equation model to show the effect of having a usual source of care on patient-centered communication, and subgroup analysis considering the types and severity of disabilities. Results: Persons who have disabilities, compared with ones without it, significantly had more usual sources of care (32.4% vs. 24.6%). By type of disability, persons with mental (51.4%), internal organ (43.8%), visual (37%), and physical disabilities (31.6%) had more usual sources of care than hearing/speech (26.6%), and developmental disabilities (18.6%). The average score of patient-centered communication was higher among who had a usual sources of care (3.2 vs. 2.7), and the regression analysis showed that having a usual sources of care was positively associated with higher patient-centered communication score (𝛽=0.476, p<0.05). However, the positive effects of usual sources of care was not observed among persons with severe hearing/speech, developmental, and mental disabilities. Conclusion: This study showed that role of patient-centered communication was limited in persons with severe hearing/speech disabilities, developmental, and mental disabilities. The education programs and supports are needed to improve communication skills between medical staff and persons with specific types of disabilities.

• 한국간호교육학회지
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• 제27권2호
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• pp.132-143
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• 2021

Purpose: The aim of this study was to identify the relationships between health literacy competencies and patient-centered care among clinical nurses. Methods: The participants of this study were 254 nurses working in two hospitals in the D region. The data were collected from July to August 2020. The health literacy competencies for registered nurses scale and individualized care scale were utilized. Descriptive statistics, independent t-test, ANOVA, Pearson's correlation coefficient and multiple regression analysis were used for data analysis. Results: The mean of health literacy competencies was 3.16±0.31 points on a four-point scale, and the average of patient-centered care was 3.69±0.50 points on a five-point scale. Regarding the nurses' general characteristics, patient-centered care showed significant differences according to age (F=4.68, p=.010), marital status (t=-2.38, p=.018), religion (F=3.03, p=.030), total clinical experience (F=2.94, p=.021) and prior health literacy knowledge (t=3.20, p=.002). As a result of a hierarchical multiple regression analysis, health literacy competencies (β=.63) were found to significantly influence patient-centered care. The explanatory power of the model was 41.0% (F=25.58, p<.001). Conclusion: The study suggests that nurse's health literacy competencies should be developed in order to improve patient-centered care. Nursing education should include an emphasis on integrating health literacy into the nursing school curriculum.

• 디지털융복합연구
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• 제19권7호
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• pp.419-426
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• 2021

정보통신기술이 발달함에 따라 스마트병원은 헬스케어 산업에서 새로운 트렌드가 되고 있다. 본 논문에서는 문헌고찰을 통해 스마트병원의 개념, 주요 기술, 적용분야, 직면과제 및 사용자 중심의 스마트병원 구축 전략에 대해 살펴본다. 스마트병원에서는 상호연결된 디지털 네트워크 안에서 임상가들이 환자중심의 통합적 의료서비스를 효율적으로 제공하도록 함으로써 보다 나은 환자결과에 도달할 수 있게 될 것이다. 그러나 향후 보다 성공적인 환자중심 스마트병원을 위해서는 비용이나 기술, 보안, 표준 등과 관련된 여러 장애요소들이 극복되어야 하며, 디지털 솔루션의 최종 사용자인 환자와 의료인의 참여가 요구된다.

• 중환자간호학회지
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• 제15권1호
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• pp.13-23
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• 2022

Purpose : Life-threatening illnesses represent a crisis for individual patients and their families. Little has been made to understand the priorities or perspectives in developing a care plan. This results in poor outcomes, and patients and families return home without being satisfied with the care provided. This study aimed to address nurses' and families' care priorities on patient and family-centered care principles and compare those priorities. Methods : A quantitative comparative descriptive research was conducted. The data were part of a study that was carried out to elicit and compare nurses' and families' perceptions of complying with patient and family-centered care (PFCC) principles in intensive care units (ICU) in Ghana. The respondents were ICU nurses (n=123) and family members of hospitalized patients in the ICU (n=111). The tool for the study was a "modernized version of a hospital self-assessment inventory on PFCC," and data analyses were performed using SPSS version 20.0. Results : Nurses and families differed significantly in their priorities of care based on the principles of PFCC. The means and p-values were significantly different for the definition, pattern of care and access to information/education, and the overall total scores of the patient and family-centered care principles (PFCCP) Conclusion : To render care that aligns with the care priority of families and patients in the ICU, nurses must plan care in consultation with their families.

• 한국융합학회논문지
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• 제10권6호
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• pp.365-379
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• 2019

본 연구의 목적은 환자-가족중심 의료서비스의 특성과 성과를 체계적 문헌고찰 방법으로 분석하여 서비스의 융합적 유효성을 평가하는 것이다. 15개 전자 데이터 베이스에서 환자-가족중심 의료서비스의 성과를 연구한 RCT 문헌 검색, 선정, 자료 추출, 질 평가를 시행하였다. 선정된 21편 문헌의 환자-가족중심 의료서비스의 공통적 특성은 정보제공과 교육, 의사소통, 가족 및 친구의 참여였다. 환자-가족중심 의료서비스의 성과 측정 변수는 89개였고, 환자 성과는 사망률, 재원기간 등으로 측정되었으며 18편의 문헌에서 환자 성과가 유의하게 향상되었다. 본 연구는 환자-가족중심 의료서비스의 성과를 통합적으로 제시하여 서비스의 유효성을 증명함으로써 의료기관과 지역사회의 지속적인 의료질 향상 활동을 위한 당위성을 제공하였으며 향후 의료의 질 향상과 환자안전을 위한 환자-가족중심 의료서비스의 융합적 적용과 이에 대한 근거기반 연구가 필요함을 제언한다.

• 대한간호학회지
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• 제49권5호
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• pp.613-630
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• 2019

Purpose: This study aimed to develop a scale measuring the Patient-Centered Nursing Culture (PCNC) and provide a basic tool to improve PCNC in Korea. Methods: A conceptual framework and construct factors were extracted through extensive literature review and in-depth interviews with nursing professionals. In total, 59 items were derived based on the pilot survey. Data were collected from 357 nurses working at general hospitals and analyzed for verifying the reliability and validity of the scale. Results: Nine factors containing 54 items were extracted from the exploratory factor analysis to verify the construct validity. The nine factors were top management leadership, policy and procedure, education and training, middle management leadership, supportive teamwork, nursing workplace environment, professional competence, patient-centered nursing activity, and nurses' values. These items were verified by convergent, discriminant, and concurrent validity testing. The internal consistency reliability was acceptable (Cronbach's ${\alpha}=.96$). Conclusion: The developed PCNC scale is expected to be used as the tool for the development of theory and improvement of PCNC, the empirical testing for cause and effect of PCNC, the development of interventions, education and training programs for improving PCNC, and indicators for evaluation or accreditation of hospital service quality.