• 제목/요약/키워드: Patient-centered Care

검색결과 221건 처리시간 0.027초

혈액투석환자의 이행과 건강관련 삶의 질 간의 관계 (Relationships between compliance and health-related quality of life in patients with hemodialysis)

  • 차지은
    • 한국산학기술학회논문지
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    • 제16권10호
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    • pp.6495-6503
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    • 2015
  • 본 연구는 혈액투석환자의 이행 수준을 파악하고 이행과 생리적 지표, 건강관련 삶의 질 간의 관계를 조사하였다. 지역 투석의원 27곳에서 220명의 혈액투석환자로부터 자료를 수집하였다. 이행은 투석 간 체중증가, 혈중 칼륨과 인과 함께 환자역할행위이행 도구로 측정하였고 건강관련 삶의 질은 MOS-SF 12로 측정하였다. 자료는 서술통계, t-test, ANOVA, 피어슨 상관계수로 분석하였다. 이행의 평균 점수는 4점을 기준으로 2.92점이었고, 전체 15개 이행 항목 중 투석스케줄 지키기에서 가장 높은 점수를 보였다. 이행 수준은 연령, 결혼상태, 투석기간에 따라 유의한 차이가 있었으며, 이행 항목 중에서 복약, 감염관리, 수면, 야채와 과일섭취가 건강관련 삶의 질과 유의한 상관관계를 보였다. 본 연구결과는 혈액투석환자의 삶의 질을 향상시키기 위해 환자중심 접근이 도움이 될 것임을 시사한다. 건강돌봄제공자들은 환자에게 중요한 이행을 확인하고 환자의 가치와 우선순위를 고려함으로써 환자들의 입장을 이해할 필요가 있다.

재미 한국 간호사들이 경험한 한국과 미국 병원의 간호실무의 차이 (A Comparison of Hospital Nursing Practice in Korea and the U.S. as Experienced by Korean Nurses)

  • 이명선
    • 대한간호학회지
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    • 제28권1호
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    • pp.60-69
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    • 1998
  • Since the introduction of Western concept of nursing to Korea in late 1880s, Korean nursing practice has evolved into Korean culture. The purpose of this study was to explore and identify similarities and differences in hospital nursing practice between Korea and the United States using the grounded theory method. The data were gathered from 15 Korean nurses working in U.S. hospitals using semi-structured, in-depth interview method. Major similarities in nursing practice between Korea and U.S. existed in the 7 domains that Benner indicated in 1984. The nursing administration system was also similar in both countries. On the other hand, differences existed in how nurses execute these domains of nursing practice. These are the roles of nurses. nurse aides and family members. and the interpersonal relationships, and problem presentation and problem-solving strategies. American family members rarely participated in the patient's bedside nursing care, while Korean family members actively participated. American nurse aide participated in direct patient care, while Korean nurse aides did not. Also Korean nurses were participated more in administering and managiang the patient's diagnostic and treatment modalities, while American nurses foucused on the needs and demands of the patient. In terms of interpersonal relationships, American patients were more self-centered and demanding than Korean. American nurses focused more on the right of individuals while Korean nurses were more oriented to harmony with the coworkers. With inferiors and superiors, American members were more egalitarian, while Koreans tended to be hierachical. In ways of suggesting problems, American nurses tended to pick out the problems more frequently than Korean nurses did.. As to ways to solve the problems, American nurses relied heavily on explicit verbal explanations, while Korean nurses relied more on bodily action and behaviors. The results of this comparative study contribute to nursing by adding knowledge on the theory of culture care by describing the similarities and differences in nursing practice between Korea and the United States.

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국내·외 의료 환경 내 가족 참여 음악 중재 연구 고찰 (Review of Music Interventions for Family Caregivers of Patients in Medical Settings)

  • 최다인
    • 인간행동과 음악연구
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    • 제14권1호
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    • pp.17-39
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    • 2017
  • 본 연구에서는 국내 외에서 실시된 의료 환경 내 가족 보호자 대상 음악 중재 연구를 고찰하고 가족 보호자의 참여 유형에 따라 중재 목표, 음악 중재 내용 등이 어떻게 달라지는지 분석하였다. 본 연구를 위해 국내외 학술지 전자데이터베이스를 사용하여 음악 중재와 가족 보호자, 호스피스, 중환자, 소아병동, 재활 등의 세부 의료 환경 등을 검색어로 하여 2016년까지 게재된 논문을 검색하였다. 검색 과정을 통해 국내 연구 5편, 국외 연구 38편의 총 43편을 최종 선정, 분석하였다. 연구 분석 결과, 가족 보호자만 중재에 참여한 논문이 5편, 환자와 가족이 동반 참여한 논문이 38편이었다. 국외에서는 다양화된 형태의 가족 참여 연구가 1980년대 후반부터 시행된 반면, 국내에서는 가족 보호자만을 대상으로 하는 중재 연구는 미비하고 환자와 가족이 함께 참여하는 형태의 연구만 시행된 것으로 나타났다. 가족 단독 참여 연구는 주로 완화의료 병동에서 진행되었으며, 환자의 배우자가 참여하는 비율이 높았다. 가족 동반참여 연구는 신생아 중환자실, 암병동 등에서 실시되는 비중이 높고, 부모의 참여 비율이 가장 높았다. 가족 단독 참여 연구에서는 수동적인 음악 중재가 시행된 경우가 많은 반면, 환자와 보호자가 동반 참여한 연구에서는 적극적인 음악 중재가 사용되는 비중이 보다 많았다. 본 연구 결과는 의료 환경 내에서 중요하게 고려되고 있는 가족 중심 돌봄의 개념이 국내 의료 환경 내 음악 중재에 어떻게 적용될 수 있는지에 대한 기초 자료를 제시했다는 데 그 의의가 있다.

병원과 종합병원의 환자중심 의료서비스 제공 수준 평가- 환자경험평가를 중심으로 (Evaluation of Patient-Centered Healthcare Provision in Hospitals and General Hospitals- Based on Patient Experience Assessment)

  • 황병덕;김윤정
    • 보건의료산업학회지
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    • 제12권3호
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    • pp.1-11
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    • 2018
  • Objectives: The purpose of this study is to evaluate patient experience assessment of inpatients, and to prepare measures to improve the quality level of medical services and guarante patient rights. Methods: The study was conducted among 199 patients admitted to hospitals and general hospitals in the metropolitan area. The analysis method used was crossover analysis, including a comparison of means, and logistic regression analysis. Results: The overall average score of satisfaction with healthcare service was 3.39 for nurses, 3.35 for hospitals and 3.42 for general hospitals. Age at the time of hospitalization affected satisfaction. The overall average score of healthcare service satisfaction was 3.09 for doctors, 3.14 for hospitals, and 3.04 for general hospitals. The factors affecting hospital satisfaction were gender and subjective health status. The factors affecting satisfaction in general hospitals were education, medical department, and hospitalization route. Conclusions: Hospitals should also introduce a systematic management system of general hospitals and strengthen the guarantee of the rights of patients who can improve the quality of medical care through positive communication between medical personnel and patients.

치과위생사의 정보활용역량이 의사소통능력에 미치는 영향 : 잡크래프팅의 매개효과 (The effect of information literacy the communication ability of dental hygienist: mediating effect of job crafting)

  • 박진아;김선영;문상은;김윤정;조혜은;강현주
    • 한국치위생학회지
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    • 제22권3호
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    • pp.217-224
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    • 2022
  • Objectives: This study aimed to establish the basic data for the performance of patient-centered care, perception of core competencies, and self-development of dental hygienists by verifying the effects of information literacy on the communication ability of dental hygienists, and the mediating effects of job crafting. Methods: Collected and analyzed data by conducting a survey targeting total 222 dental hygienists working for dental hospitals/clinics located in Seoul and Gyeonggi region. Verify the mediating effects of job crafting on the effects of information literacy on the communication ability, this study conducted the correlation analysis and simple regression analysis and multiple regression analysis. Results: In the effects of information literacy on the communication ability of dental hygienists, the cognitive crafting of job crafting (β=0.209, p<0.001) and relational crafting of job crafting (β=0.318, p<0.001) showed the partially mediating effects. Conclusions: In order to increase the educational accessibility for dental hygienists to perceive the importance of information literacy and communication ability, to improve the expertise as healthcare personnel who perform the patient-centered care by developing it, and also to develop the information literacy and job crafting, it would be necessary to develop various educational programs and contents.

간호사의 임상판단 측정도구 개발 (Development of Nursing Clinical Judgment Scale)

  • 권시내;박효정
    • 대한간호학회지
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    • 제53권6호
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    • pp.652-665
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    • 2023
  • Purpose: This study aimed to develop a nursing clinical judgment scale (NCJS) and verify its validity and reliability in assessing the clinical judgment of nurses. Methods: A preliminary instrument of the NCJS comprising 38 items was first developed from attributes and indicators derived from a literature review and an in-depth/focus interview with 12 clinical nurses. The preliminary tool was finalized after 7 experts conducted a content validity test based on a data from a preliminary survey of 30 hospital nurses in Korea. Data were collected from 443 ward, intensive care unit, emergency room nurses who voluntarily participated in the survey through offline and online for the verification of the construct validity and reliability of the scale. Results: The final scale comprised 23 items scored on a 5-point Likert scale. Six factors - integrated data analysis, evaluation and reflection on interventions, evidence on interventions, collaboration among health professionals, patient-centered nursing, and collaboration among nurse colleagues - accounted for 64.9% of the total variance. Confirmatory factor analysis supported the fit of the measurement model, comprising six factors (root mean square error of approximation = .07, standardized root mean square residual = .04, comparative fit index = .90). Cronbach's α for all the items was .92. Conclusion: The NCJS is a valid and reliable tool that fully reflects the characteristics of clinical practice, and it can be used effectively to evaluate the clinical judgment of Korean nurses. Future research should reflect the variables influencing clinical judgment and develop an action plan to improve it.

Clinical Dilemmas for the Diagnosis and Treatment of Helicobacter pylori Infection in Children: From Guideline to Practice

  • Susanne Jenneke Van Veen;Elvira Ingrid Levy;Koen Huysentruyt;Yvan Vandenplas
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제27권5호
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    • pp.267-273
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    • 2024
  • Helicobacter pylori infection is often acquired in early childhood. While most infected children remain asymptomatic, H. pylori can cause chronic gastritis, gastric ulceration, and, in the long term, gastric cancer. This article aimed to review different diagnostic and treatment options and discuss the challenges associated with applying the current guidelines in the real world. Relevant articles published from 2015 to August 2023 in the English language in PubMed and Medline electronic databases were extracted using subject headings and keywords of interest to the topic. References of interest in the selected articles were also considered. Invasive and noninvasive diagnostic tests have advantages but also disadvantages and limitations according to the clinical setting and age of the child. Guidelines recommend not performing diagnostic testing in children with long-lasting or recurrent abdominal complaints or cases of a family history of severe disease caused by H. pylori. However, parents regularly consult with the explicit demand to test for H. pylori because of them or a close family member experiencing severe gastric disease caused by H. pylori. In some situations, it may be challenging for the healthcare professional to stick to evidence-based guidelines and not consider "patient-centered care," with the risk of putting a trustful relationship in danger. Physicians may find it challenging not to perform diagnostic tests for H. pylori and prescribe eradication treatment in specific clinical settings when maintaining a trusting patientphysician relationship by applying this "patient-centered care" method when evidence-based guidelines recommend differently.

간호·간병통합서비스로 인한 간호대학생 임상실습환경의 변화 (Changes in Clinical Practice Environment of Nursing Students due to Comprehensive Nursing Care Services)

  • 김정현;신수진;이민경
    • 한국보건간호학회지
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    • 제32권2호
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    • pp.221-234
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    • 2018
  • Purpose: This mixed method study was conducted to analyze the changes in nursing students' practice environment due to comprehensive nursing care services. Methods: For the quantitative study, a checklist and practicum evaluation surveys completed by 85 students were analyzed using SPSS utilizing a Mann-Whitney U test. For the qualitative study, 13 students with experience of practice in comprehensive nursing care service units participated in focus group interviews. The data were analyzed using a content analysis method. Results: From the qualitative findings, four themes and eight sub-themes were identified. The four themes were , , , and . The quantitative findings found that students could observe and perform fewer nursing tasks and the students' satisfaction with practice was lower in the comprehensive nursing care service unit. Conclusion: This study was meaningful in that it analyzed the experiences of nursing students in comprehensive nursing care services.

일 대도시 보건소 이용자의 보건의료서비스 만족도 (User's satisfaction of health care service in public health centers ­-in a metropolitan area­-)

  • 이가언
    • 보건행정학회지
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    • 제13권4호
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    • pp.28-47
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    • 2003
  • The purpose of this study was to assess the user's satisfaction of health care service in public health centers in Busan. The study respondents were 212, those who visited health centers for health care service. Data were collected in July 2002 by using SERVQUAL(comprehensive service quality measurement scale) and 3 open questions for more details about service satisfaction and the needs for health care service. SERVQUAL has 5 dimensions; tangibles, reliability, responsiveness, assurance and empathy. The results were as follows : 1. The users reported more satisfaction at 'just service cost', 'convenient service procedure' and 'clean physical environment' at SERVQUAL. Among them the highest rated item was 'service cost'. And the less satisfaction items were 'understanding and individual concerns about service users', 'medical equipment' and 'health center facilities'. 2. There were no statistical differences by general characteristics except for the kind of services rendered. Those who visited for physical examinations and laboratory tests reported lower satisfaction than any other groups. 3. At the open questions, the respondents expressed that they were satisfied with the low service cost, kindness of employee and clean environment. But they criticized the old facilities and worn medical equipment, in addition to the less than kind attitudes. These strengths and weaknesses of health center's service could be applied for planning of customer­centered health care service.

부산광역시 정신의료기관 적정성 평가지표 실태 (Status of Medical Care Psychiatric Quality Assesment in Busan)

  • 김수정;박재홍;김성민;조경원
    • 보건의료산업학회지
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    • 제12권4호
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    • pp.103-113
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    • 2018
  • Objectives: The study aimed to compare the indicators of infrastructure of the whole country with those of Busan through National Medical Care Psychiatric (hospital level) Quality Assesment and to provide the basic evidence for presenting vision and strategies of mental health policy. Methods: National Medical Care Psychiatric (hospital level) Quality Assesment Data was used from 2011 to 2015. A total of 8 indicators were analyzed including facility and workforce. Results: The median value of the capacity per ward was decreasing with years both whole country and Busan. The number of beds out of total inpatient occupancy was improved over the years. There was no clear change in the number of inpatients per toilet in the hospitalized ward, but the indicator was decreasing obviously. Therefore, the median value of whole country and Busan was same with 10.2 in 2015. Conclusions: We confirmed that indicators for infrastructure were improving in a generally positive change over the years. The infrastructure is related to the patient-centered treatment environment, and the workforce is related to the quality of care. Therefore, the structural area should be continuously evaluated and improved.