• 제목/요약/키워드: Patient-centered assessment

검색결과 37건 처리시간 0.029초

Preliminary Findings on the Effectiveness of Meaning-Centered Psychotherapy in Patients with Pancreatobiliary Cancer

  • Ryu, Jin Sun;Choi, Sun Woo;Yun, Sung Su;Koo, Bon Hoon;Choi, In Seok;Kim, Seung Jun;Park, Joon Seong;Seok, Jeong-Ho;Yoon, Dong-Sup
    • Yonsei Medical Journal
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    • 제59권9호
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    • pp.1107-1114
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    • 2018
  • Purpose: This study investigated the effectiveness of meaning-centered psychotherapy (MCP), which is known to be a helpful psychotherapeutic intervention in distressing conditions, for patients with pancreatobiliary cancer. Materials and Methods: We recruited 37 patients with pancreatobiliary cancer from three university general hospitals and assessed their psychological characteristics. Patients who reported clinically significant emotional distress were recommended to undergo MCP. Patients who consented to MCP were provided four sessions of the therapy. Patient psychological characteristics were assessed again 2 months after MCP. For statistical comparison, outcome variables included anxiety, depression, mental adjustment to cancer, and quality of life (QoL), as well as the degree of stress and physical symptoms. Results: Sixteen patients completed the MCP and the final assessment 2 months later. In the initial assessment, the patients receiving MCP showed higher levels of anxiety and depression than those not receiving MCP, and QoL was also lower in terms of role function, emotional function, social function, and global QoL. At the 2-month follow-up, the MCP group showed a significant improvement in anxiety (p=0.007), depression (p=0.010), and anxious preoccupation (p<0.001). In addition, QoL significantly improved in the MCP group, while there was no significant change in the non-MCP group. Conclusion: In this study, MCP showed potential therapeutic benefits against emotional distress in patients with pancreatobiliary cancer, improving their QoL.

한국의 환자 중심 의사 역량 프레임 타당화를 위한 델파이 연구 (A Delphi Study to Validate the Patient-Centered Doctor's Competency Framework in Korea)

  • 임선주;김영전;김찬웅;이건호;이선우;전우택;정한나;윤소정
    • 의학교육논단
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    • 제25권2호
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    • pp.139-158
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    • 2023
  • Defining a competent doctor is important for educating and training doctors. However, competency frameworks have rarely been validated during the process of their development in Korea. The purpose of this study was to validate the patient-centered doctor's competency framework, which had been developed by our expert working group (EWG). Two rounds of Delphi questionnaire surveys were conducted among a panel of experts on medicine and medical education. The panel members were provided with six core competencies, 17 sub-competencies, and 53 enabling competencies, and were asked to rate the importance of these competencies on a 5-point Likert scale. Between April and July 2021, a total of 28 experts completed both rounds. The data of the Delphi study were analyzed for the mean, standard deviation, median, inter-rater agreement (IRA), and content validity ratio (CVR). A CVR >0.36 and IRA ≥0.75 were deemed to indicate validity and agreement. This study found that five enabling competencies were not valid, and agreement was not reached for three sub-competencies and two enabling competencies. In consideration of CVR and the individual opinions of panel members at each session, the final competencies were extracted through consensus meetings of the EWG. The competencies were modified into six core competencies, 16 sub-competencies, and 47 enabling competencies. This study is meaningful in that it proposes patient-centered doctor's competencies enabling the development of residents' milestone competencies, an assessment system, and educational programs.

사용자 중심의 어린이전문병원 계획을 위한 사용자 평가 - 어린이 환자의 보호자와 간호사를 중심으로 - (User Evaluation for User-Oriented Children's Hospital Design - Focused on the Mothers of Child Inpatients and the Nurses -)

  • 하지민;박수빈
    • 한국실내디자인학회논문집
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    • 제25권1호
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    • pp.192-200
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    • 2016
  • This study aims to design user-oriented children's hospital by examining the user needs, especially the mothers of child inpatients and the nurses. The subjects participated in a questionnaire survey including the user's characteristics, awareness of patient's room, the preference on ward size, demands, satisfaction and hospital environment assessment. The survey was conducted of the mothers of child inpatients and the nurses in A children's hospital, and the data were analyzed by the SPSS WIN 18.0 Version software. A total of 115 copies of the questionnaire were finally analyzed. The results and conclusions are as follows. 1) The mothers' demand on family-centered space and private spaces were higher than the nurses. 2) The mothers preferred 1-bed-room to 4-bed-room due to safety and privacy. 3) The items of hospital environment assessment was categorized into four factors; 'Aesthetics', 'Accessibility', 'Comfort', and 'Lighting'. The most positive factor was 'Aesthetics', whereas 'Comfort' was the negative factor. 4) The mother's satisfaction was lower than the nurse's. The most influential factors on the satisfaction was 'Accessibility'. To improve the satisfaction of the mothers of child inpatients and the nurses, safety, privacy, accessibility should be considered.

어린이의 구강 검사를 위한 International Caries Detection and Assessment System II의 적용 (LITERATURE REVIEW OF INTERNATIONAL CARIES DETECTION AND ASSESSMENT SYSTEM II TO ORAL EXAMINATION FOR CHILDREN)

  • 김현정;노홍석;김신;정태성
    • 대한소아치과학회지
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    • 제38권2호
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    • pp.202-209
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    • 2011
  • 최근 치아우식증이 예방가능한 질환이라는 사실이 부각되면서 치료에 대한 개념이 다소 변화하게 되었다. 즉, 단순한 수복 치료가 아닌 '예방적 우식 조절(preventive caries control)'을 통한 관리가 필요하다는 것이다. 이러한 치아우식증에 대한 철학의 변화는 구강 검사의 방법이나 기준의 변화를 수반하였는데, 이미 형성된 우식 와동을 관찰하는데 그치는 것이 아니라, 와동형성이 이루어지기 전의 초기 단계에 해당하는 우식 병소를 정확하게 탐지하는 것이 필요하게 된 것이다. 최근 개발된 International Caries Detection and Assessment System II (ICDAS II)은 시진을 기반으로 한 치아우식증의 분류 기준이다. 이 분류 기준은 치아우식증의 예방 및 조기 진단과 환자 중심의 우식 관리를 지향하는 최근 경향을 바탕으로 하고 있는데, 이는 어린이의 양호한 구강 건강을 조기에 확립하여 이를 평생 유지할 수 있도록 돕는 것을 목표로 하는 소아치과학의 관점과 잘 부합한다고 볼 수 있다. 이에 저자는 어린이의 구강 검사에 ICDAS II를 적용하기 위한 기초를 제공하기 위해 이 분류 기준을 소개하고자 한다.

한국어판 '암 환자가 인식하는 간호의 질 측정도구'의 타당도와 신뢰도 (Validity and Reliability Test of the Korean Version of the Oncology Patients' Perception of the Quality of Nursing Care Scale)

  • 강지영;강혜영;김나년;이미정;김유진;김주현;여수정;서윤예;서은영
    • 성인간호학회지
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    • 제28권2호
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    • pp.191-201
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    • 2016
  • Purpose: The purpose of this methodological study was to examine the validity and reliability of a translated Korean version of The Oncology Patients' Perception of the Quality of Nursing Care Scale. Methods: The translated scale was pilot tested and then administered to 360 patients with cancer. Exploratory and confirmatory factor analyses were utilized to assess the factor structure. Internal consistency reliability was determined using coefficient ${\alpha}$. Results: Two of the 40 items were deleted with a principal component method of exploratory factor analysis because they did not meet the factor-loading criterion. The 38 items were again analyzed and, four factors were validated (KMO=.96, Bartlett ${\chi}^2=10809.81$, df=780, p<.001). The four factors accounted for 60.9% of the variance. Factor loadings of the scale on the four subscales ranged from .65 to .91. The scale showed reliable internal consistency with a Cronbach's ${\alpha}$, total 38 items (${\alpha}=.96$) in four subscales: individualization (18 items, ${\alpha}=.96$), proficiency (10, .91), responsiveness (7, .90), and coordination (3, .80). Conclusion: The findings of this study demonstrate that the scale has satisfactory construct validity and reliability to measure quality of cancer nursing care from the patient's perspective in Korea.

중환자실(I.C.U.)환자에 관한 임상 간호학적 관찰 -중환자실 임상 간호 교육을 위한 기초조사- (Clinical Nursing Survey of the Patients in the Intensive Care Unit)

  • 모경빈;최영희;김문실
    • 대한간호학회지
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    • 제9권2호
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    • pp.73-83
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    • 1979
  • The objectives of this study have been conducted to establish effective clinical teaching program to I.C.U in terms of proper assignment of the clients for the students, proper rotation schedule, priorities in critical nursing problems and selection of the teaching and learning. We have analyzed statistically 1,850 patients who have been admitted during a period from January 1977 to October 31 1979 in Ewha Woman's University Hospital. The results are as follows: 1. The proportion to the total inpatients number was 6.5% and mortality rate was 16.3%. 2. The average hospitalized days were 5.8 days in I.C.U and the total death was occured from 1 st hospital day to 5th hospital day. So it shows a certain difficulties for clinical experiences of the senior students in I.C.U. 3. In the age of the death, 41.3% of the patients were in the 41-60 year age group. It shows highest mortality rate in socially active and productive age groups. 4. The mortality rates of the departments of the medicine was 18.7%, general surgery 18.5%, and neurosurgery 14.7%. 5. The number of patients admitted to the department of neurosystem was 30.6%, cardiovascular system 22.6%, respiratory system 11.1 % and urinary system 2.9%. 6. On utilizing instruments and machine for diagnosis and client's assessment in I.C.U, they have utilized everything a usual. But they never utilize angiogram and cardiac catheterization in cardiovascular system, and retroperitoneal pneumography in the urologic system. Further more we would recommend as follows 1. In consideration of the average hospital days and the date of death, the rotation program for clincal experience need to be adjusted as continuing practice program in apposite to current alternative practice program for comprehensive nursing care. 2. Socioeconomic needs for the patient's families and himself should be emphasized by the students in addition to physical needs. 3. Course content for critical care might be built up in considering of core disease centered nursing problems. 4. The diagnostic procedures and client's assessment items which could not experience in our university hospital by the students might be considered and refilled as filled trips to another hospital and visual aids.

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의과대학의 학습경험 중심 전문직업성 프로그램 운영 및 평가 (The Implementation and Evaluation of Learning Experience-Based Professionalism Program in Medical School)

  • 유효현;김영전
    • 한국콘텐츠학회논문지
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    • 제18권1호
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    • pp.164-172
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    • 2018
  • 본 연구는 의과대학에서 학습자 주도의 학습경험중심의 전문직업성 프로그램을 개발하여 운영한 후 효과성과 사용성 평가를 통해 대학수준에서 학습경험 중심의 교육과정의 실제적 함의를 밝히고자 한다. 의과대학 1학년 74명의 학생들이 학생경험개발 모형에 기반하여 설계된 PDS1(Patient-Doctor-Society1): 전문직업성, 1주일 블록수업(총 30시간), 1학점 과목에 참여하였다. 학생들은 모두 6가지의 학습주제와 학습자원 및 지원도구를 제공받아 경험의 준비, 조직, 공유, 성찰, 평가로 구성된 학습활동 단계를 수행하였다. 교육의 효과성 평가는 24개 설문항목을 사전-사후 비교하였고, 사용성 평가는 학생대상의 만족도 설문 및 교수자 학생대상의 면담이 시행되었다. 전문직업성에 대한 학습자 자기평가 결과, 리더십과 자기 주도적 학습, 전문성에 대한 태도, 사회적 책무성 모두 학습 이전과 이후의 결과에 유의미한 차이가 확인되었다. 학생을 대상으로 하는 프로그램의 만족도는 항목별 3.58~3.78에 분포하였다. 교수자와 학습자 면담에서는 교육과정설계, 운영, 평가의 전 과정에서 실질적인 사용성을 확인하였다. 연구결과는 학습경험중심의 교육과정설계와 평가의 현장 적용 가능성에 대하여 실증적 타당성을 제시해주었다. 본 연구는 의과대학에서 학습자 주도의 학습경험 방식으로 전문직업성 교육프로그램을 개발하여 운영한 실증적 사례로써 함의가 있다.

DCM(Dementia Care Mapping)을 활용한 한국 요양시설에서의 사람중심케어 실천의 탐색적 연구 (Exploratory Study of Person Centered Care Practice in Korean Long-term Care Facilities using DCM(Dementia Care Mapping) as a tool)

  • 김동선
    • 한국노년학
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    • 제41권2호
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    • pp.197-215
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    • 2021
  • 본 연구는 요양시설거주 치매환자들의 삶의 질을 사정하기 위해 개발된 DCM(Dementai Care Mapping)을 활용, 국내 장기요양시설에서의 사람중심케어 실천 정도 및 특성을 탐색하는 것을 목적으로 한다. DCM은 훈련받은 매퍼가 시설거주 치매노인을 관찰 사정하는 도구이지만 본 연구에서는 장기요양 시설 종사자들의 자기보고식 평가척도로 변용하였다. DCM의 개념을 34개의 문항으로 조작화하였으며 브래포드치매팀의 검토를 거쳐 총화평정척도로 만들었다. 본 척도의 신뢰도는 .88로 신뢰할 만 하며, 이를 국내 시설 종사자 343명을 대상으로 설문조사를 실시한 결과 평균점수는 3.77점(5점 척도)으로 나왔다. DCM의 하위카테고리 별 평균 점수는 애착(4.02), 편안함(3.95), 포용(3.89), 정체성(3.67), 주체성(3.41)으로 나타났다. 국내 요양서비스가 대상자의 안전과 편안함에 초점을 맞춘 신체수발에 주력하며 종사자와 대상자간에 애착이 형성되고 있지만, 개별적 케어(정체성)부족이나 대상자의 삶에서 의미있는 활동이 부족한 점(주체성)에서 사람중심케어가 취약함이 드러났다. 한편, DCM척도에 의한 사람중심케어의 특성을 조직 및 개인 특성에 따라 살펴보면, 시설의 규모가 작을수록 사람중심케어 실천이 높으며 공립과 민간시설간의 차이는 없었다. 또한 시설장과 직접 서비스제공자의 사람중심케어 실천이 높으며 경력이 1~2년인 종사자들의 사람중심케어 점수가 높은 것으로 나타났다. 본 연구는 국내 요양서비스에서 사람중심케어의 실천이 필요하며 이를 위한 구체적인 방안으로 유니트케어의 적용, 시설에서 직접 서비스제공자뿐 아니라 간호, 사회복지사등 전 직원을 대상으로 한 사람중심케어 교육 실시를 제언한다. 국내 요양서비스의 질평가에서도 사람중심케어의 관점이 강화돼야 하며 이를 위해 DCM 또는 직접 관찰이 어려운 상황에서는 대안으로 본 연구에서 개발한 한국형DCM척도의 활용을 제언한다.

질적 간호에 대한 환자와 가족의 지각 (Perceptions of Quality Nursing care of Patients and Families)

  • 지성애;권성복;박은희
    • 간호행정학회지
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    • 제4권1호
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    • pp.247-275
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    • 1998
  • The purpose of this study was to offer the results of content analysis and qualitative study that explored the perceptions about quality nursing care of patients and families as consumers and to identify the implications of this study for quality nursing care management and research. The data was collected from 12 adult patients and 9 families who were admmitted at medical and surgical nursing unit of one university hospital in Seoul from October, 1996 to January, 1997. Research participants were asked to response "what do you think quality nursing care?" and similar questions during the interviews was performed. Data were analyzed using open coding and content analysis with frequencies and percents of attributes of quality nursing care. Attributes of quality nursing care and meaning of quality nursing care that patients and families perceived were explored. 1. The attributes of quality nursing care that patient and families perceived were categorized into 56 attributes. The highest response rate among the attributes was 'one's heart at ease' (76.2%), and the next high response rates were ranked in order 'consideration' , 'care about' (each 61.9% 'expert skill' (57.1%), 'deal with problem promptly' , 'information offer' (42.9%), 'intimate feeling' (38.1%), 'smile' 'service spirit' , 'do one's best' (each 33.3%), 'frequent visit' (23.8%), 'observe the time' (23.8%), 'direct nursing care' , 'speaking warmly' , give a hope' , 'address kindly' , 'a sense of duty' , 'good facilities' (each 19.0%), 'inquire after a patient health' , 'patient-centered nursing care' , 'showing an example' , 'professional knowledge' , 'careless moraly patient' , 'give encourage to patients' , 'good answer a question' (each 14.3%), 'do not imprudently' , 'do not disregard' , 'broad knowledge' , 'emergency treatment skill' , 'dependability' ,'consolation' giving a sense of security' , 'a self sacrificing spirit' , 'a sense of responsibility' 'hard - working', 'enough disposition of nursing staff (each 9.5%), 'improve patient's pride' and the rest attributes exhibited 4.7%, respectively. 2. The attributes that were identified in patients' data only were 8 categories, 'service sprit' (58.3 %) 'expert knowledge' , 'good answer a question' (each 25.0%), 'hard working' (16.7%), 'a warm character', 'professional attainments', 'do without reserve', 'satisfaction' (each 8.3%), 3. The attributes were identified to families' data only were 31 categories, 'speaking warmly' , 'direct nursing care', 'adress kindly', 'patientcentered nursing care', 'showing an example' (each 33.3%). 'do not imprudently' , 'do not disregard' , 'consolation', 'giving a sense of security', 'broad knowledge' , 'emergency treatment skill', 'dependability' ,'a self - sacrificing spirit', 'a sense of responsibility' (each 22.2%), 'improve patient's pride' , 'without discrimination' , 'show kindness' , 'individual nursing care', 'being with patient' , 'helping' , 'accuracy' , 'without any mistake' , 'love' , 'self - confidence', 'self possession', 'a self - denying spirit' , 'a sense of duty' , 'tighten discipline' , 'disposed room with similar patient to diagnosis', 'compensatory relationship between me dical team' , 'role of connection' (each 11.1 %). 4. The attributes of quality nursing care were integrated into 11 categories that they were 'patientcentered nursing care' (25.1%), 'expertise' (22.1%), 'caring'(18.1%), 'kindness'(11.1%L 'nurse attainments(10.1%), 'sincerity' (7.5%), 'good environment' (2.0%), 'effective organizational management', 'coordination', 'enough nursing staff' ( each 1.0%), 'satisfaction' (0.5%) were showed in the order of the highest rate. 5. The concept of quality nursing care were defined as 'give a satisfaction to patients by patientcentered care based on professional skill and caring with kindness and sincerity'. The description of the meaning of quality nursing care provided by this research participants, patients and families can provide important information for quality nursing care management, medical marketing, education and researches of this field. On the basis of the above findings the following recommendations are made: to suggest to utilize this results for patient care in practice setting, development of quality assessment tool in nursing care, repeat study by the same subjects and method, and to a comparative study by the same method to nurse.

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A Survey on the Current Status of Neonatal Physical Therapy in South Korea

  • Kim, Sung Tae;Lee, Joon-Hee
    • The Journal of Korean Physical Therapy
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    • 제32권3호
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    • pp.168-175
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    • 2020
  • Purpose: This study aimed to investigate and report the current status of physical therapy (PT) performed in Korean neonatal intensive care units (NICU) to present foundational data that promotes the advances in neonatal PT in Korea. Methods: Based on the Health Insurance Review and Assessment (HIRA) data, we administered a questionnaire survey to 74 hospitals (39 tertiary and 35 general hospitals) in Korea equipped with a NICU and pediatric PT unit. We developed a 32-item questionnaire with reference to previous Korean studies. The questionnaires were distributed and retrieved via regular mail and an online system. Results: Of the 74 hospitals, 58 (78%) practiced neonatal PT and the duration of each session significantly differed according to the hospital rating. PT was given, depending on clinical symptoms, to infants who were preterm and low birth-weight (96.5%), had brain and spinal cord diseases (84.5%), had pathological tonus (94.8%), with respiratory problems (65.5%), for range of motion exercises (82.8%), for neurodevelopment approaches (72.4%), and for positioning (70.7%). Interdisciplinary meetings were held to share clinical decisionmaking in 17.2% of the hospitals surveyed and parent-participating education to ensure a family-centered approach was offered in 63.8% of the hospitals. The barriers of neonatal PT included low insurance fees, insufficient awareness of colleagues, and the severity of the patient. Conclusion: This study is the first report of the current status of neonatal PT in Korea. The findings of this study will serve as foundational data to review the current neonatal PT practice and promote further advances.