• Quality Improvement in Health Care
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• v.25 no.1
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• pp.11-28
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• 2019

Purpose: The purpose of this paper is to derive implication on the adoption of PROMs (Patient-Reported Outcome Measures) to improve quality of care in South Korea. With this purpose, the paper examines the status of PROMs in South Korea and other countries including OECD's PaRIS (Patient Reported Indicators Survey) initiative, and reviews policy cases that have adopted PROMs to improve performance of healthcare system. Methods: We conducted literature review on OECD reports on PaRIS, peer-reviewed journals, and information from the websites of relevant institutions such as ICHOM, NQF and OECD. Results: To identify healthcare services of best values and support patient-centered health system, OECD has initiated PaRIS which develops, collects and analyzes patient-reported indicators for cross-countries comparison. PaRIS is implemented on two work streams: 1) collect, validate and standardize PROMs in the areas where patient-reported indicators already exist such as breast cancers, hip and knee replacement, and mental conditions, 2) develop a new international survey on multiple chronic conditions. Countries like England, U.S., Sweden and Netherlands use PROMs for measuring performance of hospitals and performance evaluation at the national level, and provide the financial incentives for reporting PROMs. Conclusions: The use of PROMs can support the current policy agenda that is the patient-centered healthcare system which has been emphasized to reinforce the primary and the community-based care. For the use of PROMs, it is recommended to actively participate in PaRIS initiative by OECD, select appropriate instruments for PROMs, and continue on standardization of them. This will assure patients' involvement in improving health system performance, systemize information generated in the process of adopting PROMs, and develop a system to evaluate performance.

• Journal of Industrial Convergence
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• v.21 no.6
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• pp.61-71
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• 2023

The objective of this research is to examine the mediating roles of nursing professional values and occupational stress in the relationship between self-leadership and patient-centered nursing among nurses employed at COVID-19 designated hospitals. This study were 160 nurses at a COVID-19 designated hospitals, and the data were collected from January 10 to February 30, 2022. The collected data were analyzed by independent t-test, one-way ANOVA, correlation analysis, multiple linear regression analysis, and SPSS PROCESS Macro model No 4 bootstrapping method. The average score for self-leadership was 61.3±8.55, nursing professional values was 95.5±11.66, occupational stress was 51.3±4.76, and patient-centered nursing was 59.3±7.63. The mediating effect of nursing professional values and occupational stress was confirmed in the influence relationship between self-leadership and patient-centered nursing of nurses at COVID-19 designated hospitals. This result suggests that the content related to improve nursing professional values and reduce occupational stress should be considered when applying the patient-centered nursing enhancement program.

• Journal of Korean Critical Care Nursing
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• v.11 no.2
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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.

• KSII Transactions on Internet and Information Systems (TIIS)
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• v.17 no.4
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• pp.1049-1065
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• 2023

Recently, with the development of IoT, AI, and mobile terminals, medical information platforms are expanding. The medical information platform can determine a patient's emergency situation, and medical staff can easily access patient information through a mobile terminal. However, in the existing platform, emergency situation decision is delayed, and faster and stronger authentication is required in emergency situations. Therefore, we propose an edge computing-based medical information platform for automatic authentication using patient situations. We design an edge computing-based medical information platform architecture capable of rapid transmission of biometric data of IoT and quick emergency situation decision, and implement the platform data flow in emergency situations. Relying on this platform, we propose the automatic authentication using patient situations. The automatic authentication protects patient information through patient-centered authentication by using the patient's situation as an authentication factor, and enables quick authentication by automatically proceeding with mobile terminal authentication after user authentication in emergencies without user intervention. We compared the proposed platform with existing platforms to show that it can make quick and stable emergency decisions. In addition, comparing the automatic authentication with existing authentication showed that it is fast and protects medical information centered on patient situations in emergency situations.

• Journal of Preventive Medicine and Public Health
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• v.50 no.4
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• pp.217-227
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• 2017

In terms of years of life lost to premature mortality, cancer imposes the highest burden in Korea. In order to reduce the burden of cancer, the Korean government has implemented cancer control programs aiming to reduce cancer incidence, to increase survival rates, and to decrease cancer mortality. However, these programs may paradoxically increase the cost burden. For examples, a cancer screening program for early detection could bring about over-diagnosis and over-treatment, and supplying medical services in a paternalistic manner could lead to defensive medicine or futile care. As a practical measure to reduce the cost burden of cancer, appropriate cancer care should be established. Ensuring appropriateness requires patient-doctor communication to ensure that utility values are shared and that autonomous decisions are made regarding medical services. Thus, strategies for reducing the cost burden of cancer through ensuring appropriate patient-centered care include introducing value-based medicine, conducting cost-utility studies, and developing patient decision aids.

• The Korean Nurse
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• v.8 no.1 s.39
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• pp.48-50
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• 1969

• Journal of Korean Academy of Nursing
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• v.29 no.4
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• pp.790-801
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• 1999

The purpose of this study was to generate a grounded theory of how families with kidney donor or recipient coped with kidney transplantations. Interview data from twelve families involved in kidney transplants was analyzed using the grounded theory method. Data analysis revealed that “protecting the family” was the main theme that represented family member experiences. In order to maintain family function and to protect the family from breaking up, family members had to adjust the family structure from the traditional style of a husband-centered family, to one that was patient health -centered. The process of this adjustment was a very long and difficult one, taking several years from the recognition of the kidney disease to the kidney transplants. Family members, especially spouses, employed nine different strategies to deal with various problems and conflicts which occurred during the process : 1) paying attention to the patient's illness and complications ; 2) accepting the patient's illness as the family's illness as well ; 3) managing the patient's illness and complications that occured ; 4) being thrifty ; 5)supporting the kidney donor ; 6) accepting and replacing the lost roles of the patient ; 7) keeping composure and encouraging the patient ; 8) sustaining the patient's independence ; 9) self-restraining sexual desires. These findings suggest that there is a developmental process where family members adjust to a kidney transplant over time. There is also a need for increased social and psychological health services for all family members over the course of kidney transplants.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.29 no.2
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• pp.175-182
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• 2022

Purpose: The study examined the effects of ethical sensitivity and person-environment fit on person-centered care of nurses in long-term care hospitals. Methods: The participants were 111 nurses. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient, and multiple regression analysis with the SPSS program. Results: The mean of person-centered care was 2.95±0.62 out of 5. There were significant differences in person-centered care in terms of age, shift pattern, total clinical career, and educational experience of person-centered care. Person-centered care and ethical sensitivity, person-centered care and person-environment fit showed a positive correlation. Factors affecting the person-centered care were the age (20-29), shift pattern (three shift), person-environment fit. The explanatory power was 42%. Conclusion: These results can be used to increase the person-environment fit and adopt a differented approach based on age and shift pattern in order to enhance person-centered care. Therefore, it is necessary to develop and apply an person-centered care program for nurses in long-term care hospitals.

• Korean Medical Education Review
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• v.18 no.3
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• pp.132-144
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• 2016

The aim of this study is to provide the background of developing guides to clinical performance and basic clinical skills and to introduce how to teach and learn using the guide. The students' performance problems presented in an objective clinical skills examination were disease-centered tertiary hospital clinical care, incomplete performance, doing by rote, and an exam-oriented learning attitude. The problems were caused by a tertiary hospital-based educational environment as well as schools and faculty who are unfamiliar with the concept of patient-centered care. The purpose of the guide to clinical performance and basic clinical skills is to overcome these problems and address the causes. The guides show a clinical presentation approach to primary care; clinical care integrated with knowledge, skills, and attitude; a schematic approach; and a patient-centered attitude. To achieve these goals, a strategy to change the educational culture is important. Curricular reform, faculty development, and improving educational facilities and environments are suggested.

• Korean Medical Education Review
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• v.21 no.1
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• pp.1-12
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• 2019

This study is a narrative review introducing global trends in patient safety education within medical schools and exploring the status of Korean education. Core competences for patient safety include patient centeredness, teamwork, evidence- and information-based practice, quality improvement, addressing medical errors, managing human factors and system complexity, and patient safety knowledge and responsibility. According to a Korean report addressing the role of doctors, patient safety was described as a subcategory of clinical care. Doctors' roles in patient safety included taking precautions, educating patients about the side effects of drugs, and implementing rapid treatment and appropriate follow-up when patient safety is compromised. The Korean Association of Medical Colleges suggested patient safety competence as one of eight essential human and society-centered learning outcomes. They included appropriate attitude and knowledge, human factors, a systematic approach, teamwork skills, engaging with patients and carers, and dealing with common errors. Four Korean medical schools reported integration of a patient safety course in their preclinical curriculum. Studies have shown that students experience difficulty in reporting medical errors because of hierarchical culture. It seems that patient safety is considered in a narrow sense and its education is limited in Korea. Patient safety is not a topic for dealing with only adverse events, but a science to prevent and detect early system failure. Patient safety emphasizes patient perspectives, so it has a different paradigm of medical ethics and professionalism, which have doctor-centered perspectives. Medical educators in Korea should understand patient safety concepts to implement patient safety curriculum. Further research should be done on communication in hierarchical culture and patient safety education during clerkship.