• 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.

• 한국콘텐츠학회논문지
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• 제13권11호
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• pp.249-260
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• 2013

본 연구의 주된 목적은 의사의 환자중심 커뮤니케이션(경청요인, 배려요인, 금지요인)이 환자만족과 치료성과에 미치는 영향, 그리고 의사의 환자중심 커뮤니케이션과 환자만족, 치료성과 간 환자참여(행동적 참여, 감정적 참여, 정보적 참여)의 매개효과 여부를 검증하는데 있다. 이러한 연구목적 달성을 위해 C지역의 종합병원에서 진료를 한 339명의 외래환자를 중심으로 실증분석을 수행하였다. 연구결과 첫째, 경청요인과 배려요인은 환자만족과 치료성과에 유의한 정(+)의 영향을 보였으나 금지요인은 그렇지 않았다. 둘째, 경청요인과 배려요인은 감정적 요인과 정보적 요인에 유의한 정(+)의 관계를 보였으나, 금지요인은 환자참여의 3개 요인에 유의한 영향을 보이지 않았다. 셋째, 의사의 환자중심 커뮤니케이션과 환자만족, 치료성과 간의 관계에서 환자참여의 부분 매개효과가 존재하는 것을 확인하였다. 마지막으로 이러한 연구결과를 중심으로 환자만족과 치료성과를 높이기 위한 방안들을 제시하였다.

• Journal of Hospice and Palliative Care
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• 제24권4호
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• pp.199-203
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• 2021

This paper provides practical suggestions for how palliative care clinicians can address the expressions of spiritual struggle voiced by patients and their loved ones. In addition to practical tips for listening and responding, ethical guidance and opportunities for self-reflection related to spiritual care are briefly discussed. Principles to guide practice when the clinician is listening and responding to a patient expressing spiritual struggle include being non-directive, honoring (vs. judging) the patient's spiritual or religious experience, keeping the conversation patient-centered, focusing on the core theme of what the patient is expressing presently, using the patient's terminology and framing, and responding "heart to heart" or "head to head" to align with the patient. Ultimately, the goal of a healing response from a spiritual care generalist is to allow the patient to "hear" or "see" themselves, to gain self-awareness. To converse with patients about spirituality in an ethical manner, the clinician must first assess the patient's spiritual needs and preferences and then honor these.

• Journal of Hospice and Palliative Care
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• 제24권3호
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• pp.135-143
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• 2021

End-of-life patients experience physical, mental, social, and existential distress. While medical personnel provide medication and care to alleviate patients' distress, listening to and interacting with patients remains essential for understanding their psychological condition. The most important tool, though difficult to implement in practice, is end-of-life discussion (EOLD). EOLD has been shown to have positive effects on end-of-life treatment choices, achievement of patients' life goals, improvements in the quality of life of patients and their families, and the prevention of depression and complicated grief among bereaved family members. EOLD is not often undertaken in clinical practice, however, due to hesitancy among medical personnel and patients for various reasons. In order to conduct an EOLD, the patient's judgment, psychiatric illnesses such as delirium and depression, and psychological issues such as the side effects of psychotropic drugs, denial, and collusion must be evaluated. Open and honest conversation, treatment goal setting, the doctor's familiarity with the patient's background, and attentiveness when providing information are important elements for any dialogue. Meaning-centered psychotherapy was developed to alleviate the existential distress of cancer patients, and its application may promote EOLD. The future development of meaning-centered psychotherapy in practice and in research is expected to further promote EOLD.

• 근관절건강학회지
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• 제26권1호
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• pp.1-14
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• 2019

Purpose: This concept analysis was done to clarify therapeutic intervention in nursing. Methods: For this study the process of Walker & Avant's concept analysis was used. Twenty-nine studies from electronic data bases met criteria for selection. Results: Therapeutic intervention can be defined by the following attributes: 1) goal-oriented, 2) forming a therapeutic relationship, 3) reinforcement of coping ability, 4) patient-centered, 5) a holistic integrated approach. The consequences of therapeutic intervention were improvement of quality of life, coping skills, self-care. Conclusion: Attributes of therapeutic intervention identified in this study can be applied to develop tools for measuring therapeutic nursing behaviors or to develop therapeutic nursing intervention programs for patient or family.

• 의학교육논단
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• 제24권2호
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• pp.79-92
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• 2022

With increasing demands for medical care by society, the medical system, and general citizens and rapid changes in doctor's awareness, the competencies required of doctors are also changing. The goal of this study was to develop a doctor's competency framework from the patient's perspective, and to make it the basis for the development of milestones and entrustable professional activities for each period of medical student education and resident training. To this end, a big data analysis using topic modeling was performed on domestic and international research papers (2011-2020), domestic newspaper articles (2016-2020), and domestic social networking service data (2016-2020) related to doctor's competencies. Delphi surveys were conducted twice with 28 medical education experts. In addition, a survey was conducted on doctor's competencies among 1,000 citizens, 407 nurses, 237 medical students, 361 majors, and 200 specialists. Through the above process, six core competencies, 16 sub-competencies, and 47 competencies were derived as subject-oriented doctor's competencies. The core competencies were: (1) competency related to disease and health as an expert; (2) competency related to patients as a communicator; (3) competency related to colleagues as a collaborator; (4) competency related to society as a health care leader (5) competency related to oneself as a professional, and (6) competency related to academics as a scholar who contributes to the development of medicine.

• 대한간호학회지
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• 제4권1호
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• pp.1-21
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• 1974

A considerable change of the Korean nursing system has been made during the last decade not only in its philosophy but also in its function and structure to meet political and scientific need of the modern society. The main purpose of this study is to develope the new concept of comprehensive nursing care, both its Philosophy and ethics, as the basic of modern clinical nursing theory and practice. Comprehensive nursing care is the concept of human centered nursing care, and it helps a man to meet the basic physical, psychological, environmental, socioeconomic and teaching needs. It also helps him to help himself to meet these needs. This concept starts from the individualized nursing care and its ultimate goal is to improve a man to have a better position in his own community so that he may able to have a meaningful life. To accomplish this goal, an individualized nursing care plan as a nursing diagnosis and problem solving method should be set up for different patients with similar diagnosis to meet their needs, because each patient has a different social background. from this viewpoint, nursing is a science as well as abstruse humanity. The performance of comprehensive nursing care is a goal and issue of modern clinical nursing care. If nursing is a science and a profession for man, it should have ethics which recognize the dignity of man and offers infinite service voluntarily, and should be able to show leadership in carrying out the nursing responsibility. This leadership finds a person's potential and encourages him to utilize it. Such concepts should develop into a nursing ideology and this ideology should become a priority in comprehensive nursing care. The following statements are the conclusion of this study. 1) Modern nursing has been developed from disease centered nursing care to comprehensive nursing care based on humanity. The primary principle of nursing was to assist in the treatment of disease, but it has been changed to the professional nursing system independently. 2) The concept of nursing is one of continuous or endless scope of dispersion. It proves that nursing is grasping the professional responsibility to be able to coordinate scientific principles Patient health problems are according to scientific principles rather than adhering to nursing technical discipline as a daily work. 3) In chapter I and Ⅱ, the philosophy and ideology of nursing have been discussed and the flow of concept of clinical nursing and the rate of progress which emerges from naturalizing performance of the concept of comprehensive nursing in clinical nursing studied. The discussion developed the theory that a nurse should be to embody nursing ideas and objectives by establishing definite conviction of professions and study. 4) In chapter lil, nursing planning based on nursing diagnosis as a method to attain ideal nursing care for humanity with a definite idea of establishing philosophy of nursing was presented. 5) From the result of survey on patient needs about treatment and nursing, it was observed that all patient had emotional stress from unknown factors. Therefore it was concluded that nurses should not only educate the patient but also give them the opportunity to communicate freely their needs and anxieties. Furthermore complaints and doubts of the patient should be carefully noted and must be considered to meet these needs. 6) Patient teaching is the most important part of comprehensive nursing care. In chapter, Ⅲ, the important of patient teaching was emphasized by demonstrating the effect of patient teaching for diabetic patient. 7) In Chapter Ⅳ, from the result of the study on nurses attitudes to comprehensive nursing care, it was pointed that the evolution of nursing education and the establishment of a complete concept and value of comprehensive nursing was necessary.

• 한국의류산업학회지
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• 제16권1호
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• pp.160-166
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• 2014

Patent and utility indicate international competitiveness in the knowledge-based society of the $21^{st}$century where both the quantity and quality of the nation's scientific intelligence and innovative technology represent key criteria to evaluate its strength. Thus, discerning the trends of patents is inevitable for further development. This research is centered on apprehending the technological current of the functional clothing of Korea, through an analysis of patents and utility models. The number of patent applications in Korea was low until the mid-1990s. However, it began to grow rapidly in the 2000s and the number of patents surpassed the number of utility starting in 2006. The technological level of invention in this field has been turned into a higher level. The IPC code with the strongest application was the field related to temperature controllable clothing (A41D 13/005), followed by surgeon or patient apparel related fields (A41D 13/12), and reflective or luminous safety devices (A41D 13/01).The main technological idea was to give functionality that could protect the human body from various hazards and represents the goal of various applied techniques. About 66% of domestic patent applications belong to individuals; however, the proportion of corporate or institutional applications(including universities) remains poor. Consequently, more systematic and long-term support for research on patents is required.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제20권3호
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• pp.7-15
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• 2014

Purpose: This study is to propose direction for healing environment design in hospital architecture considering the characteristics of elderly patients. The primary goal of a public hospital is providing cheap health care and quality service chance to the underprivileged and elderly in the dead zone. Compared to the rapid increase of the aged population and chronic diseases, Ministry of Health & Welfare is currently planning model of health promotion hospital in development plans of local based public hospital. Due to the increased elderly medical expenses, elderly patients' high utilization is considered. Methods: The literature on the design factors of healing environments were investigated. based on this, analyzed drawings of surveyed hospitals ward in architectural characteristics and observe and evaluate directly healing environment design through field surveys. Results: The design of hospital environment affects patient's therapeutic effect. There is no any official formula for hospital design but environment that architect create could be a big part of the healing process. To increase the quality of the environment, apply the characteristic factors and harmonize well as a human-centered healing environment. Implications: Healing environment design for the elderly is first necessary condition due to high proportion of elderly patients.

• Nuclear Medicine and Molecular Imaging
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• 제41권2호
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• pp.91-96
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• 2007

The measurement of pathologically low levels of tissue $pO_2$ is an important diagnostic goal for determining the prognosis of many clinically important diseases including cardiovascular insufficiency, stroke and cancer. The target tissues nowaday have mostly been tumors or the myocardium, with less attention centered on the brain. Radiolabelled nitroimidazole or derivatives may be useful in identifying the hypoxic cells in cerebrovascular disease or traumatic brain injury, and hypoxic-ischemic encephalopathy. In acute stroke, the target of therapy is the severely hypoxic but salvageable tissue. $^{18}F-MISO$ PET and $^{99}mTc-EC-metronidazole$ SPECT in patients with acute ischemic stroke identified hypoxic tissues and ischemic penumbra, and predicted its outcome. A study using $^{123}I-IAZA$ in patient with closed head injury detected the hypoxic tissues after head injury. Up till now these radiopharmaceuticals have drawbacks due to its relatively low concentration with hypoxic tissues associated with/without low blood-brain barrier permeability and the necessity to wait a long time to achieve acceptable target to background ratios for imaging in acute ischemic stroke. It is needed to develop new hypoxic marker exhibiting more rapid localization in the hypoxic region in the brain. And then, the hypoxic brain imaging with imidazoles or non-imidazoles may be very useful in detecting the hypoxic tissues, determining therapeutic strategies and developing therapeutic drugs in several neurological disease, especially, in acute ischemic stroke.