• Title/Summary/Keyword: Patient-doctor relationships

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Effects of Perceived Control upon Role Performances among Healthcare Service Customers

  • Lee, Jung-Ki
    • Asia-Pacific Journal of Business
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    • v.13 no.3
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    • pp.19-34
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    • 2022
  • Purpose - The purpose of this study is to examine whether a psychological concept enhances healthcare users' service experience. Specifically, the study proposes and empirically examines a model of perceived control in which the user's sense of control is postulated as exerting positive influences upon his/her motivation, self-efficacy associated with his/her role as a patient, and satisfaction with his/her medical service experience. Methodology - Data were collected by a professional research company, using an online survey method. Participants of the study included adults nineteen years or older who had visited a medical service institute at least once during the previous one-year period. For the test of the research hypotheses, structural equation modeling using AMOS was used. Findings - Findings of this study denote a unique insight into the users' comprehension of medical service experiences and their behaviors. First, the concept of perceived control is identified as a factor that enhances the quality of individuals' medical service experiences. A sense of control directly influences medical users' self-efficacy to comply with doctor's recommendations, their motivation to comply with doctor's recommendations, and their satisfaction with the medical service experience. Second, one's perceived self-efficacy is found to exert positive influences upon both motivation and satisfaction. Third, one's motivation to comply with the doctor's recommendation is found to exert a positive influence upon one's satisfaction. Additionally, perceived control is found to exert an indirect influence upon medical service users' satisfaction through the mediation of both self-efficacy and motivation. Research Implications - The findings of the study support the notion that perception of control among medial service users enhances their service experience as patients. The main thrust of this study suggests that it is necessary for healthcare practitioners to consider implementing service encounter strategies that purposefully enhance the sense of control among their patients. The identification of significant inter-relationships among perceived control, motivation, self-efficacy, and satisfaction among medical service customers should also serve as a meaningful seed for further research pursuits.

A Study on the Factors affecting the Implementation of HCRM (병원고객관계관리 시스템 도입에 영향을 미치는 요인 연구)

  • Chun, Je-Ran
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.10 no.1
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    • pp.209-214
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    • 2009
  • Due to the high level of information supportive function of Internet, the management environment change is accelerating. The Patients are able to have the chances of Hospital- and Doctor-shopping. So the Customer Relationship Management skill or Patient -oriented management is becoming one of the important management method of Hospital. To adapt these trend, many Hospital invest the money and efforts for the implementation of Hospital CRM system. But the Performance of HCRM is not satisfactory for the investor from many reasons. In this paper we try to find out which kinds of factors have the Influences on the Implementation of HCRM, and how is the relation between these factors. We use the Structural Equation Model to clarify these relationships. The result of this paper will contribute in the decision making of the implementation of HCRM in the field, and in providing the knowledge base.

A Content Analysis of the Advocacy Concept Perceived by Nurses at Nursery Room (옹호개념에 관한 신생아실 간호사의 인지 내용 분석)

  • Cho Kap Chul
    • Child Health Nursing Research
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    • v.2 no.1
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    • pp.13-26
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    • 1996
  • This descriptive study was done to detect the possibilities of the development of the advocacy concept in nursing. The subjects consisted of 3 nurses who had agreed to participate to the study, working at nursery room in a general hospital. Data was collected from May 22 to June 13 in 1995 through tape recorded intensive-interview, and written down, then content analyzed qualitatively related to the infant advocacy. 1. Derivation fo the meaning about advocacy concept 1) The situations in need of infant advocacy were 12 categories : malpractice, overcharing, negligence, unnecessary services, and services without consent, and so on. 2) Fourteen categories of advocacy activities percived by nurses were derived from participants' statements. Protesting infant or his /her families against their counterpart, providing informations to families, cooperating with medical staffs for her patient, then calling medical staff not so as to be maleficient to her patient in its rank. 3) The expected result of advocacy activities perceived by nurses was respectively positive to her patient or families, but negative to nurse. 4) The feelings of nurses in the sitution of advocacy were expressed in to concern, comprehension, regret, powerlessness, charity, desire, and so on. 5) Nurses perceived that advocacy activities could be influenced positively by factors related to nurses' qualification and negatively by factors related to doctor's overdo and nurse's underdo. 2. Categorization of the meaning and their relationships In case of antecedental situation in need of infant advocacy, nurse perceives her patients need the advocacy to get a benefit through nurse's information, intervention speaking, building cooperations. The expected factors to influence advocacy activities perceived by nurses, are the power imbalance between medical staffs, the nurse's qualification, and the nurse's feeling from the situation. The above results suggest that the infant care situation will be recommendable field work place for concept development of advocacy with hybride model when it involves infant's families.

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Comparison of Root Images between Post-Myelographic Computed Tomography and Magnetic Resonance Imaging in Patients with Lumbar Radiculopathy

  • Park, Chun-Kun;Lee, Hong-Jae;Ryu, Kyeong-Sik
    • Journal of Korean Neurosurgical Society
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    • v.60 no.5
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    • pp.540-549
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    • 2017
  • Objective : To evaluate the diagnostic value of computed tomography-myelography (CTM) compared to that of magnetic resonance imaging (MRI) in patients with lumbar radiculopathy. Methods : The study included 91 patients presenting with radicular leg pain caused by herniated nucleus pulposus or lateral recess stenosis in the lumbar spine. The degree of nerve root compression on MRI and CTM was classified into four grades. The results of each imaging modality as assessed by two different observers were compared. Visual analog scale score for pain and electromyography result were the clinical parameters used to evaluate the relationships between clinical features and nerve root compression grades on both MRI and CTM. These relationships were quantified by calculating the receiver-operating characteristic curves, and the degree of relationship was compared between MRI and CTM. Results : McNemar's test revealed that the two diagnostic modalities did not show diagnostic concurrence (p<0.0001). Electromyography results did not correlate with grades on either MRI or CTM. The visual analog pain scale score results were correlated better with changes of the grades on CTM than those on MRI (p=0.0007). Conclusion : The present study demonstrates that CTM could better define the pathology of degenerative lumbar spine diseases with radiculopathy than MRI. CTM can be considered as a useful confirmative diagnostic tool when the exact cause of radicular pain in a patient with lumbar radiculopathy cannot be identified by using MRI. However, the invasiveness and potential complications of CTM are still considered to be pending questions to settle.

A Study of the Factors Affecting Expected Benefits of Medical Services via Telemedicine (원격의료서비스에 대한 기대 편익 인식에 영향을 미치는 요인에 관한 연구)

  • Kim, Seong-eun;Noh, Ghee-Young;Choi, Jounghwa
    • Journal of Digital Convergence
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    • v.15 no.11
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    • pp.471-484
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    • 2017
  • The present study explored factors that influence consumers' benefit expectancy about telemedicine service. Responses from a national online survey of 927 adults (aged 19-59), collected in January 2016, were analyzed with multiple regression analysis. The results revealed: (1) Health consciousness positively influenced all three benefit expectancies (all ps < .05); (2) Doctor-patient communication efficacy positively influenced expectancy for convenience improvement (${\beta}=.107$, p < .01) and service quality improvement (${\beta}=.086$, p < .05); (3) Use of health-related smart applications contributed to positive expectancy for service quality improvement (${\beta}=.081$, p < .05) and cost-saving (${\beta}=.067$, p < .05). Some of the relationships were moderated by gender and residence. This convergence study, which examined public's perception about telemedicine from the perspectives of consumer psychology, media, and public health, provides practical implications to promote telemedicine service and educate consumers about it.

Anxiety, Depression and their Correlates in Rectal Cancer Patients Without Ileostomy (장루미보유 직장암 환자의 불안과 우울 및 관련요인)

  • Lim, Semi;Kang, Younhee
    • Journal of Korean Clinical Nursing Research
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    • v.21 no.1
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    • pp.80-91
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    • 2015
  • Purpose: This study aimed to identify the relationships among bowel function, health locus of control, anxiety, and depression in patient with rectal cancer. Methods: This study utilized a descriptive correlational design. Subjects were 200 rectal cancer patients who attended out-patient clinic in a colorectal cancer center. The study instruments included the scales for bowel function, health locus of control, anxiety, and depression. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, and Pearson's correlation coefficient. Results: The mean score of bowel function was $34.44{\pm}5.73$. The mean scores of internal HLOC, chance HLOC, doctor HLOC, and powerful others HLOC were $29.06{\pm}6.81$, $22.41{\pm}6.96$, $15.88{\pm}2.85$, and $10.72{\pm}4.68$ respectively. The mean scores of anxiety and depression were $4.49{\pm}3.95$ and $6.25{\pm}3.98$, respectively. There were significant negative correlations between bowel function and anxiety (r=-.180, p=.011); between bowel function and depression (r=-.267, p<.001); and between internal health locus of control and depression (r=-.149, p=.035). There were significant positive correlations between chance health locus of control and depression (r=.146, p=.039), and between anxiety and depression (r=.651, p<.001). Conclusion: It is suggested that anxiety and depression for the patients with low bowel function after colorectal cancer surgery should be evaluated and nursing interventions to enhance internal health locus of control need to be developed.

Frequency and Severity of the Nurses' Role Conflict in the Hospital Nurses (병원간호사 역할갈등의 빈도와 심각성)

  • Lee, Eun Hee;Cho, Kyung Sook;Son, Haeng Mi;Yi, Yeo Jin;Yoo, Cheong Suk
    • Journal of Korean Clinical Nursing Research
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    • v.19 no.1
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    • pp.81-95
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    • 2013
  • Purpose: The purpose of this study was to identify the frequency and severity of role conflict experienced by nurses in the hospital. Methods: For this survey a self-report questionnaire on nurses' role conflict was used for data collection. Participants were 472 nurses in hospitals with over 500 beds. The questionnaire had 82 items classified into five categories (role activity, relationships between: nurse-nurse, nurse-patient/caregiver, nurse-doctor, and nurse-other department staff). The questionnaire was developed through focus group interviews with nurses according on their work experiences and literature reviews that were validated by the researchers. Data were analyzed using descriptive statistics for frequency and severity of nurses' role conflict. Cronbach's ${\alpha}$ for the questionnaire was .95 (frequency), .97 (severity). Results: Mean score for nurses' role conflict was 1.64. The highest frequency for nurses' role conflict was in the category, relationship between nurse and patients or their families ($2.00{\pm}0.46$). The highest severity for nurses' role conflict was in the category; relationship between nurses and doctors ($1.96{\pm}0.56$). Conflict about nurses' role activity showed both high frequency ($1.99{\pm}0.39$) and severity ($1.95{\pm}0.43$). Conclusion: Results indicate a need to develop programs to improve interpersonal relationship so as to reduce role conflict and encourage nurses' professional satisfaction and achievement.

A Study on Sexual Concern and Sexual Satisfaction in Diabetic Patients (당뇨병환자의 성생활 관심과 성생활 만족정도)

  • Lee, Kang Yi;Kim, Keum Sook
    • Journal of Haehwa Medicine
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    • v.8 no.1
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    • pp.853-863
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    • 1999
  • This study was designed and undertaken to examine the sexual concern and sexual satisfaction in diabetic patients. The data were collected from September to November, 1997. The subjects in this study were 77 diabetic patients who visited to check their blood glucose level to the outpatient department of internal medicine in one of hospitals located in Taejon city. The questionnaires developed by Derogatis L. R. were used. Data were analysed using percentages, means, F-test, done with the SAS program. The results of this study were as follows ; 1) In the question that If the patients want to be counselled about sexual need or not, male and female diabetic patients answered "moderate"(37 patients(48.1%). 2) In the question that if the patients are worry for their sexual life or not because of present illness, male and female diabetic patients answered "moderate"(27 patients (35.1%). 3) In the question that If the patients worried about sexual life, they wish to counsell for who, the majority of patients answered that want to counsell the medical doctor(49 patients(64.5%). 4) In the question that if a medical team is concerned about patient's sexual need or not, the patients usually answered negatively. 5) In the question of attitude about masturbation, male and female answered that they think it doesn't matter if they maintain privacy. 6) In the question that if they use professional therapeutic method for sexual act or not, it is highly appeared not using(72 patients(93.5%). 7) In the relationships between the sexual satisfaction and the sex, age, the period of disease, want to counselling about sexual need, the concern of the medical team about sexual need of the Patients showed statistically significant differences.

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Analysis of Role Modeling Experiences and Reflection Level of Fourth-Year Medical Students at a Single Medical College: A Focus on the Clinical Clerkship (일개 의과대학 본과 4학년의 롤 모델링 경험과 성찰수준 분석: 임상실습을 중심으로)

  • Lee, Sangmi Teresa;Park, Kyung Hye;Park, Yon Chul;Yeh, Byung-il
    • Korean Medical Education Review
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    • v.24 no.1
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    • pp.46-55
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    • 2022
  • This study aimed to analyze the subjects, situations, and reflection levels related to role modeling experienced by medical students during their clinical clerkship and their own reflections. This study intends to suggest ways of improving how residents and clinical faculty should treat and teach medical students. Written interviews were conducted regarding senior medical students' role modeling experiences during their clinical clerkships in 2018 and 2019. Content analysis was conducted for a total of 224 cases from 196 students. Content analysis revealed three types of role modeling content: subjects (faculty, residents, nurses, peer students), situations (clinical competence, personal qualities, teaching skills), and the level of reflection (critical reflection, reflection, thoughtful action, and habitual action) in each case. As role model subjects, faculty were found to be the paramount role model (n=142, 62.83%). Role modeling was the most frequently performed for clinical competence (n=103, 45.98%). Clinical competence was frequently shown in communication and empathic listening during rounds and outpatient relationships between the patient and doctor. Regarding the level of reflection for role modeling, the number of critical reflections was 86 (38.39%) and that of reflections was 80 (35.71%). In particular, negative role modeling showed a high level of critical reflection in relation to faculty (64.44%) and nurses (8.89%). In conclusion, role modeling of medical students participating in clinical clerkships occurs in situations that the role models are not aware of, with positive or negative effects on the formation of professional identity among medical students.

Childhood Trauma and Pharmacotherapy Retention among Outpatients with Panic Disorder (공황장애 외래 환자의 아동기 외상과 약물치료 유지)

  • Kim, Dong Joo;Kim, Daeho;Lee, Jinbok;Kim, Yaeseul;Sohn, Sujin
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.1
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    • pp.53-62
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    • 2020
  • Objectives : This study investigated lifetime experiences of trauma, treatment retention, and psychiatric symptoms among outpatients with panic disorder after initiation of pharmacotherapy. Our research hypothesis was that panic patients with childhood trauma would display more severe symptoms and less treatment retention compared to those without such history. Methods : A total of 135 first-visit outpatients with DSM-IV panic disorder were approached during the period from March 2012 to August 2016. Fifty-three patients (39%) either refused or returned incomplete questionnaires, leading to a final sample size of 82. Participants completed the Trauma History Screen, the Beck Depression Inventory, the Beck Anxiety Inventory, and the Abbreviated PTSD checklist. Results : The number of lifetime trauma was significantly correlated with treatment retention (rho=-0.269, p=0.015). Among subtypes of trauma, only childhood physical abuse was significantly correlated with treatment retention (rho=-0.298, p=0.007). Conclusions : Our results indicated that psychological trauma, particularly of an interpersonal nature from childhood, can affect pharmacotherapy treatment retention in panic disorder. This may be mediated by poor patient-doctor relationships originating from trust issues among childhood trauma survivors or lack of perceived improvement due to the more severe symptoms and unfavorable course experienced by those with childhood trauma. Further studies are needed to explore the reasons for poor treatment adherence in this population.