• 한국임상약학회지
• /
• 제31권4호
• /
• pp.285-292
• /
• 2021

Background: Recently, the Korean Association of Pharmacy Education has been focusing on competency-based education (CBE) and has established required areas of competencies to improve the graduation competency. However, competency-based assessment (CBA) tools for implementing CBE have not yet been developed for faculty members and students to successfully access the assessment tests. Moreover, the faculty members in charge in pharmacy schools have encountered various barriers in recruiting individuals with integrated clinical experience to act as virtual patients. Therefore, this study aimed to identify the advantages and limitations of applying CBA tool and faculty assessors in the development of CBE to ensure the reliability of this assessment. Methods: Utilizing CBA tool, the students' communication skills and styles were assessed. students and faculty assessors were surveyed to evaluate the advantages and limitations of the CBA tool. Results: 8 assessors and 96 students participated in this study. 100% (8/8) of the faculty assessors and 77.4% (65/84) of the students reported that CBA tool is valuable to assess and improve student's ability. 90.5% (76/84) of the students felt confident in applying knowledge to patient-centered care. CBA tool can be a valuable for the instructors in identifying the competency level of students but can also be associated with limitations in implementation to ensure the objectivity and reliability of the CBA. Conclusions: The CBA tool can be valuable in assessing the level of students' competency. Faculty assessors have the advantage of well-prepared themselves for patient roles, so that the time and cost required may be minimized.

• Clinical and Experimental Pediatrics
• /
• 제61권1호
• /
• pp.1-5
• /
• 2018

We often overlook the importance of several safety issues such as identification of patients, timeout procedure, hand hygiene, handoff communication, and many others. This ignorance, along with many other issues, leads to medical error being ranked as a third leading cause of death in the U.S. Consequently, quality improvement (QI) has become one of the major subjects in healthcare despite a relatively short history. Improving quality is about making healthcare safe, effective, patient-centered, timely, efficient, and equitable. Understanding the need and methodology of QI as well as participation is now essential for physicians. Although basic QI methodology has not changed, one of the most fascinating changes in recent QI is conducting large-scale QI projects through multicenter networks. Prospective multicenter QI projects utilizing the Korean Neonatal Network are a substantial initiation of pediatric QI in Korea. The Korean Pediatric Society should set ambitious goals for QI activities for every primary care pediatrician and pediatric subspecialist.

• 대한물리치료과학회지
• /
• 제2권2호
• /
• pp.533-544
• /
• 1995

Multiple sclerosis is a chronic, pregressive, demyelinating, disease of the central nervous system. It is named for the formation of disseminated scarlike lesions primarily in the central white mattrer of the brain and spinal cord. These plaques are commonly found in the regions of the optic tracts, third and fourth ventricles, basal ganglia, midbrain, pons, and spinal cord. Multiple sclerosis is an unpredictable disease, typically presenting with an exacerbating-remitting course, although other clinical courses have been recognized. Common clinical findings include disturbances in sensation, muscle strength, tone, fatigue, coordination, vision, communication, bladder and bowel function, and cognitive and behavioral function. Physical therapy of the patient with multiple sclerosis is centered around decreasing symptoms, improving function, prevention secondary complications, and promoting successful psychological adjustment. It requires the comprehensive efforts of a health care team to provide coordinated and continuing care.

• 대한치과의사협회지
• /
• 제53권11호
• /
• pp.770-778
• /
• 2015

This article discusses how to conduct treatment planning and decision making in special needs dentistry. Special needs patients often lack cooperative ability during dental treatment and have a deteriorated oral health status. To overcome the limitation in communication with special needs patients and solve their complicated dental problems, dentists need to have extensive preoperative information about the patients and their caregivers. Treatment procedures should be organized in a patient-centered and cost-effective manner. Additionally, clinical outcomes need to be predicted taking into consideration of the patients' condition. The clinical experience of committed dentists is another factor that enhances the benefits of extensive treatment in special needs patients with many limitations. The insightful treatment decision-making of dentists will contribute to improving the oral health of special needs patients despite the various obstacles.

• 대한인간공학회지
• /
• 제31권1호
• /
• pp.109-116
• /
• 2012

Objective: The aim of this study is to present a solution to problems in the services provided by the general hospitals by creating a user-centric environment through analyzing the User Journey Map and the User Context. Background: The rapid growth in aging population and the monopolization of superior medical staffs by the general hospitals increased demand for the general hospitals in Korea. But, often services provided by the general hospitals are provider-centric and low quality. Method: This study examines problems in the services provided by the general hospitals by analyzing the User Journey Map through stakeholder interviews(contextual interviews) and on-site observation. Based on the contextual analysis of the user(i.e. the patient), this study proposes new and improved user-centric services to be provided by the general hospitals. Results: Ten new user-centric services proposed by this study are: (1) "Booklet on Success Story", (2) "FAQs by Doctor", (3) "Designated Nurse", (4) "Patient Interview Record Card", (5) "Close relationship between doctor & patient", (6) "Thank You Notice Board", (7) "Step by Step", (8) "Green Cap", (9) "Patient Kit", (10) "RFID Direction Display System". Conclusion: The service design for the general hospitals proposed by this study is an important case-study on improving the environment of the general hospitals from provider(medical staffs)-centric to user(patents and its family)-centric. Application: This study is expected to be used in various areas to improve existing system(products and/or services) to be more user-centric.

• Journal of Oral Medicine and Pain
• /
• 제35권4호
• /
• pp.265-273
• /
• 2010

환자가 진료실에 들어설 때 어떤 기대와 목표를 가지고 있는 지 파악하여 치료에 적절히 반영한다면 환자의 치료만족도를 향상시키고 보다 나은 치료효과를 얻을 수 있을 것이다. 본 연구는 TMD 환자의 첫 내원 시 면담과 치료에 대한 기대감을 조사하고, 이러한 내원 목표가 과거치료의 유무나 통증 정도 및 통증으로 인한 일상생활의 제한 정도 같은 요소들에 따라 달라지는지를 조사하고자 하였다. 지난 3개월(2010년 8월부터 11월) 동안 단국대학교 치과대학 부속병원 구강내과에 내원하여 TMD로 진단된 18세 이상의 성인 환자를 대상으로 담당의사와의 첫 면담 전 대기실에서 환자기대조사 설문지와 간이통증목록(Brief Pain Inventory, BPI)을 작성하게 하여 분석하였다. 322명의 TMD 환자들의 남녀 비는 1:1.5 이었고 평균연령은 약 36세이었다. 본 연구 결과 TMD 환자들이 병원을 찾을 때 가장 중요한 Top 3의 기대목표는, '통증이 완전히 나았으면 좋겠다(cure of pain)', '왜 아픈지 이유를 알고 싶다(understanding)', '자신의 증상에 대해서 의사와 충분히 상의하고 싶다(doctor-patient communication)'로 조사되었다. 성별이나 병력기간, 과거치료 경험에 따른 환자 내원 목표의 차이는 관찰되지 않았다. TMD를 세분하였을 때, 근육장애, 특히 복합(관절-근육)장애 환자군에서 통증조절을 가장 중요하게 생각하는 비율이 상대적으로 높았고, 자신이 아픈 이유를 알고자 기대가 큰 반면, 관절장애군은 의사소통과 검사에 대한 기대가 상대적으로 더 컸다(p<0.005). 또한 통증과 통증으로 인한 일상생활 제한이 심할수록 통증조절을 가장 중요하게 생각하는 환자의 비율이 증가하였으며, 통증 강도가 낮은 환자들의 경우 의사-환자간 communication에 대한 기대가 상대적으로 컸다(p<0.05). 이러한 결과로 볼 때 TMD 환자의 치료에서 효과적인 통증조절은 가장 우선되어야 할 치료목표이지만, 질병의 원인과 기전에 대한 충분한 설명과 진단과 치료에 대한 의사-환자 간의 충분한 의사소통을 통하여 환자의 진료 만족도를 더욱 향상 시킬 수 있을 것으로 판단된다. 질병에 대한 환자이해를 돕고 의사소통을 충분히 하기 위해 환자중심의 상담과 자료의 적극적인 활용이 필요하겠다.

• 대한간호학회지
• /
• 제6권1호
• /
• pp.72-79
• /
• 1976

Contemper nursing literature place much importance on human- centered and individualized care. Nursing research has related stress during hospitalization of adolescent patients to adaptation to a new environment, isolation from friends, limitation due to illness, over protection of parents and communication with member of the medical team. The investigator conducted this study in the hope that an understanding of adolescents responses to hospitalization, their perceptions, the kinds and levels of stress, and the relationships between stressors and individual characteristics would contribute to the improvement of adolescent patient care. The objective of the study was to obtain informations related to the adolescents psychological stress experience during hospitalization, specifically stress from interpersonal relationships and communication, isolation from the family, social or economic problems, illness and from the treatment environment and nursing care. An interview schedule adopted from Holmes and Rahe's Social Readjustment Rating Scale and selected items from Voicer's instrument on stress-producing events was used with 120 adolescent inpatients aged 13 to 18 years three general hospitals in Seoul during Aug. 10, to Sep. 30, 1975. 1. The sample consisted of 66 male and 54 female patients. Sixty-six percent were late adolescents, aged 16 to 18 years: 4% were early adolescents, aged 13 to 15 years. The primary cause for hospitalization was for orthopedic problems (35.8%). More than half of these (54.4%) were due to injury or accident. 2. Stress eclated to illness revealed the highest score (4.97), followed by stress related to treatment environment and nursing care (4.34) , isolation from family and social or economic problems (4.01) and interpersonal relationships and communication (3.96). 3. The perceived indifference of doctors and nurses was a serious cause of stress (mean=4.83). Fellow patients and visitors caused least stress (mean=2.06). 4. Discontinuation of education or unemployment were major stressful events (mean=4.71). Least stressful was isolation from the family (mean=3.47). 5. More than 94% of the respondents expressed fears related to body image (mean=4.97) 6. Within the category of treatment environment and nursing care, items related to restrictions because of treatment, discomfort because of treatment, inadequate explanation from nurses about procedures were rated as severe stress events (mean=4.6). Items related to the ward environment and to having a relative stay with them were seen by the group as less serious events (mean=3.7). 7. Stress related to interpersonal relationships and communication was correlated positively with female patients and those preferring passive activities. (P〈0.05) 8. Stress related to family problems was positively related to female and early adolescent patients (P< 0.05). Stress related to social problems was positively , elated to students and those preferring active pursuits (P< 0.05). 9. There were no correlation between the high stress related to disease and any of the characteristic items. (P> 0.05) 10. Stress related to treatment environment and nursing care was positively related of early adolescent and female and student patients. (P< 0.05) This group of hospitalized adolescents reported high level of stress related to treatment environment and nursing care, due to lack of consideration of normal growth and development and individual characteristics. The findings have important implications for the planning of effective, individualized, comprehensive nursing care of adolescents during hospitalization.

• 한국정보통신학회논문지
• /
• 제10권11호
• /
• pp.2026-2031
• /
• 2006

최근 U-Korea 구축을 위한 다양한 연구가 진행되고 있다. 특히, USN기술을 응용한 U-Learning, U-캠퍼스와 같은 교육적 활용분야에도 많은 연구 결과들이 나오고 있다. 그러나 초 중등학교와 관련된 학생관리 분야에서의 연구는 미흡한 실정이. 따라서 본 논문에서는 유비쿼터스 상에서의 RFID 기술과 NEIS 시스템을 접목한 사용자 중심환경의 응용서비스 중의 하나인 효율적인 학생관리 애플리케이션을 제안하고 한다. 제안된 시스템은 RFID 태그와 NEIS시스템의 학생정보를 이용하여, 학생의 위치 정보 및 상담내역(진로, 건강, 기타)에 대한 데이터 정보를 효율적으로 전송 및 관리 할 수 있는 시스템이다.

• 대한간호학회지
• /
• 제25권4호
• /
• pp.641-652
• /
• 1995

Working as nurses, authors found that some patients were not content with their hospital life. Some patients wanted to move to another ward, and others complained about their ward atmosphere. In spite of patients' discomfort, nurses didn't know what made some patients complain about their ward. So, authors tried to find factors that influence atmosphere of hospital wards of the neurosurgery patients. To know the atmosphere of wards, authors selected five neurosurgery ward of a university hospital in Seoul. Observation took a month. An author observed using molar approach, in the morning, in the day time, and in evening time. Authors used concealment /no intervention technique. An author checked condition of people in the wards, and observed their verbal and nonverbal communication behavior their activities and environmental characteristics, and interpreted their meaning through ethnographic research methodology by Spradly. Authors found there was an important factors that influence the atmosphere of ward. It was a human and his attitude. At least one person who was willing to help others made ward atmosphere better. Helping others physically whenever needed, sup-porting the depressed emotionally, offering foods, or talking to others friendly brought good atmosphere. On the contrary, if everyone was indiffernt to others, the atmosphere became cold. Self-centered or selfish behaviors such as occupying too much area, using the toilet too long, covering other's suction bottle without permission and seeing others delicate or urinate were hurtful. In addition to the attitude of patients and their families, unkindness of medical teams including nurses and doctors and tasteless meal caused bad ward atmosphere. Based on this research finding, authors suggest the followings. A For the better atmosphere of ward 1. Nurses should try to make the ward atmosphere better by introducing new patient to older ones. 2. Every ward should have dividing curtains to keep patient's privacy. 3. All hospital personnel should be kind enough to make patients feel that they are repected. 4. Hospital should serve high quality meals to patients. 5. Patients had better stay with those in the similar condition. B. For the future studies 1. Repeated researches are necessary to check reliability of this results. 2. Researches for patients in different area such as ICU, or hemodialysis unit are necessary.

• 디지털콘텐츠학회 논문지
• /
• 제19권9호
• /
• pp.1751-1758
• /
• 2018

통합 의료 정보 시스템은 의료 서비스의 질과 고객 만족도 향상, 환자의 안전을 우선으로 하는 시스템으로 다른 환경으로 구성된 단위 시스템을 통합하는 기능이 제공되어야 한다. RBAC 기반 의료 정보 시스템은 직종과 직책, 규칙에 따라 사용자는 접근 권한을 부여 받게 된다. 본 논문에서는 CRM 상담 서비스를 중심으로 한 멀티 채널 IPCC 컨택 센터의 플랫폼을 구현 하였다. 이를 통해 SMS MO, 진료 예약 및 취소, 상황별 통계, CRM/EMR 연동 서비스가 멀티 채널을 사용하여 상담원의 도움없이 통신 서비스가 가능하며 예약 환자의 부도율을 감소 시킬 수 있으며, 시스템 내부적으로는 RBAC 기반 CRM 상담 서비스는 권한 관리가 미리 생성되어 되어 있는 정보 테이블의 column을 조사하여 해당 테이블을 호출하는 procedure 및 object를 생성하고, 환자 정보를 나타나게 하여 개인 정보 보호를 전제 조건으로 접근 권한의 rule에 따라 환자별 상담 이력정보에 접근할 수 있으며, 의료 정보 사용 현황별 통계화면을 통해 추출된 정보들을 중심으로 상황별 운영 관리에 필요한 중요 지표를 관제 할 수 있어서 통합 의료 정보시스템의 운영 개선 서비스로의 확대 뿐만 아니라 환자에게 중요한 의사 결정시 의료진과 환자 및 가족에게 도움 줄 수 있다.