• 간호행정학회지
• /
• 제9권3호
• /
• pp.337-352
• /
• 2003

Purpose: The purpose of this study is to analyse research trends related to the evaluation of quality of nursing, thereby obtaining basic data relating to the identification of current situation of instrument development of quality of nursing, and of future research orientation and to the development of performance index of nursing organization. Method: The data were collected from June to December, 2002 through the review of total of 32 research papers which had evaluated quality of nursing among published papers in Korea from 1976 to August 2002. The analysis was done in terms of research period, the periodicals in which research papers were published, domains and the approaches of evaluation of nursing quality. The content analysis of lowest-level items amounting was performed using NIC developed by McCloskey & Bulecheck(1998) and consequential indices of quality of nursing developed by Chi(1995). Results: Twenty-three of 32 papers(71.8%) turned out to be published after 1995, indicating surging interest in the evaluation of quality of nursing from the mid 1990s. Also, ten of 12 research papers dealing with subjects' diseases were published after 1995. In content analysis of lowest-level items of the process-oriented evaluation of quality of nursing, the highest nursing intervention was patient education about procedure and treatment; followed in descending order by patient education about disease process, strengthening of communication, managing environment, infection control, admission care, defecation and urination care. In content analysis of lowest-level items of the outcome-oriented evaluation of quality of nursing, items of physical and psychological state, of patient and family satisfaction, of knowledge and home care, of change of patients' state, of addressing nursing issues, and of patient recovery were the outcome indicators in more than 60 percent research papers. Conclusion: The findings provided the foundation for their effective use in nursing practice with comparing and presenting various core evaluation items representing process and outcome domains.

• 정보교육학회논문지
• /
• 제17권4호
• /
• pp.475-486
• /
• 2013

환자의 입원전후, 입원생활, 수술전후, 퇴원후 정보교육 및 식사 영양지도 등 의료 기관에서의 적재 적시적 환자교육 정보의 부재, 지연과 오류는 임상적 예후는 물론 의료의 질 저하와 의료분쟁 등 심각한 문제를 야기시키고 있다. 따라서 최근 의료선진국을 중심으로 의료의 질 관리, 상호소통 및 의료분쟁의 화두와 함께 맞춤형 환자교육 체계의 중요성이 크게 부각되고 있다. 의료진, 원무행정 및 임상 실험실들을 중심으로 환자교육이 네트워크기반으로 활발하게 이뤄질 때 의료 질이 향상되고, 궁극적으로 병원의 경영이익창출에도 도움이 되는 것으로 S병원 사례에서 유의미하게 나타났다. 이러한 동기에서 본 논문에서는 CPES 개념의 연구를 바탕으로 웹기반 맞춤형 환자교육 시스템을 제안하고 S 병원을 대상으로 설계와 구현을 진행하였다. 더불어 S병원에서의 실증적 계량분석을 통해 ?춤형 환자 중심 교육 시스템의 도입 효율성과 효과성을 분석하였다.

• Physical Therapy Rehabilitation Science
• /
• 제9권4호
• /
• pp.318-323
• /
• 2020

Objective: Reacquisition of motor functions following stroke depends on interhemispheric neural connections. The intervention highlighted in the present case is an insight for augmenting motor recovery by stimulating the lesioned area and adjacent areas governing the motor behaviour of an individual. The purpose of this study was to determine the changes in the motor and cognitive outcomes through multi target stimulation of cortical areas by application of multichannel transcranial direct current stimulation (M-tDCS) in a stroke survivor. Design: A case report. Methods: The patient was a participant of a trial registered with the clinical trial registry of India (CTRI/2020/01/022998). The patient was intervened with M-tDCS over the left primary motor cortex i.e. C3 point and left dorsolateral prefrontal cortex i.e. F3 point with 0.5-2 mA intensity for the period of 20 minutes. SaeboFlex-assisted task-oriented training, functional electrical stimulation over the lower extremity (LE) to elicit dorsiflexion at the ankle and eversion of the foot, and conventional physiotherapy rehabilitation including a tailored exercise program were performed. Outcome assessment was done using the Fugl-Meyer assessment scale (FMA) for the upper and lower extremity (UE and LE), Montreal Cognitive Assessment (MOCA), Wisconsin Gait Scale (WGS) and the Stroke Specific Quality of Life (SSQOL) measures. Assessment was taken at Day 0, 15 and 30 post intervention. Results: Improvement was observed in all the outcome measures i.e FMA (UE and LE), MOCA, SSQOL and WGS across the span of 4 weeks. Conclusions: M-tDCS induced improvement in motor functions of the UE and LE, gait parameters and cognitive functions of the patient.

• 한국전문물리치료학회지
• /
• 제25권1호
• /
• pp.31-38
• /
• 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.

• Physical Therapy Rehabilitation Science
• /
• 제6권4호
• /
• pp.202-207
• /
• 2017

Objective: The self-decisions of the client regarding the meaningful work as a therapeutic approach of client-orientation. The Cognitive Orientation to daily Occupational Performance (CO-OP) is an occupation-oriented problem-solving approach. The purpose of this study was to describe the goals and intervention protocols of CO-OP in those affected by stroke. Design: A systematic review. Methods: Using EBSCOhost, PubMed, and ProQuest databases, we searched studies published in the past decade that utilized the CO-OP intervention. An initial search revealed 71,171 potential articles. After applying our search criteria to screen the titles, abstracts, and full-text, we included 7 articles that met our inclusion and exclusion criteria. In this study, we used the patient, intervention(s), comparison, outcome method to analyze the 7 selected studies. We analyzed the frequency of goals and intervention protocols. Results: Seven articles met our selection criteria; these studies included participants with an almost normal cognitive function from inpatient and outpatient rehabilitation facilities. CO-OP was used for 237 goals; the most used goal was the instrumental activities of daily living. The training procedure used 3 types of self-selecting goals in the activities. One of the goals was not trained, but was only evaluated to determine the generation effect. The most common outcome measurements included the Canadian Occupational Performance Measure and the Performance Quality Rating Scale. Conclusions: This research provided information about the effectiveness of CO-OP and selecting the correct evaluation tool to assess the efficiency of the intervention. This study suggests that treatment with CO-OP in occupational therapy is effective and that it outlines common protocols.

• 대한물리치료과학회지
• /
• 제16권3호
• /
• pp.67-74
• /
• 2009

Background: Various functional factors should be incorporated during assessment and intervention for patient rehabilitation. Stable respiratory function is one of required factors for functional restoration. To maximize respiratory physical therapy intervention outcome, it is required to understand clinical features of respiratory diseases and physical therapy approaches. Methods: Previous studies were systematically reviewed through computerized search. Methodological qualities of selected studies were evaluated and the levels of recommendations were determined. Results: Assessment for respiratory pattern and thoracic mobility is of importance to improve cardiopulmonary fitness during physical reconditioning. Application of optimal therapeutic protocol can increase thoracic mobility and respiratory function. Interdisciplinary communication is critical during rehabilitation for respiratory patients. Health care provider should have professional knowledge and experience for cardiopulmonary fitness and obligation to endeavor for patients' respiratory rehabilitation. It is necessary to standardize therapeutic intervention, and rehabilitative respiratory exercise should be applied to confirm the effects of intervention. Conclusion: Respiratory diseases that may reduce patients' quality of life and cardiopulmonary fitness should be resolved through physical therapy approaches. Through conducting research, effect of evidence-based and patients' function-oriented intervention can be determined.

• 의학교육논단
• /
• 제17권3호
• /
• pp.110-121
• /
• 2015

Competency-based medical education (CBME) is an outcome-oriented curriculum model for medical education that organizes learning activities and assessment methods according to defined competencies as the learning outcomes of a given curriculum. CBME emerged to address the accountability of medical education in response to growing concerns about the patient safety in North America in the 1970s, and the number of medical schools adopting CBME has dramatically increased since 1990. In Korea, CBME has been under consideration as an alternative curriculum model to reform medical education since 2006. The purpose of this paper is three-fold: (1) to review the literature on CBME to identify the challenges and benefits reported in North America, (2) to summarize the process and experiences of planning and implementing CBME at Inje University College of Medicine, and finally (3) to provide recommendations for Korean medical schools to be better prepared for the successful adoption of CBME. In conclusion, one of the key factors for successful CBME implementation in Korea is how well an individual school can modify the current curriculum and rearrange the existing resources in a way that will enhance students' competencies while maximizing the strengths of the school's existing curriculum.

• 대한감각통합치료학회지
• /
• 제19권1호
• /
• pp.54-68
• /
• 2021

목적 : 본 연구는 뇌성마비 아동의 신체기능과 일상생활 향상을 위해 적용된 과제 중심 훈련 방법에 대해 정리하고 효과를 제시하고자 하였다. 연구방법 : 검색 기간은 2008년 1월부터 2020년 8월까지로 하였으며, 자료 검색을 위해 CINAHL, MEDLINE, PubMed의 데이터베이스를 이용하였다. 총 18편이 선정되었으며, PICO(Patient, Intervention, Comparison, Outcome) 방법을 적용하여 체계적으로 정리하였다. 과제 중심 훈련은 선행연구를 참고하여 운동학습 및 운동조절 이론의 전략인 과제(Task), 실행(Practice), 피드백(Feedback)으로 분류하여 제시하였다. 결과 : 그 결과 13편의 연구가 운동기술 영역에서 유의한 결과를 보였으며, 그 중 2편의 연구에서 일상생활 영역에서 유의한 결과를 보였다. 과제는 개별 과제(discrete task)와 닫힌 과제(closed task) 형태가 가장 많이 사용되었다. 실행은 전체 실행(whole practice) 유형이 가장 많이 사용되었으며, 부분 실행(part practice), 차단 실행(blocked practice) 순으로 사용되었다. 마지막으로 피드백은 구체적으로 제시하지 않은 경우가 가장 많았으며, 외재적 피드백(extrinsic feedback)이 사용되었다. 결론 : 본 연구를 바탕으로 향후에는 뇌성마비 아동의 운동조절을 촉진하는 기술의 체계적인 선택과 구체적인 방법의 제시를 통하여 과제 중심 훈련이 임상에서 더욱 효과적으로 사용될 수 있을 것이라 기대한다.

• 한국의료질향상학회지
• /
• 제23권1호
• /
• pp.69-90
• /
• 2017

Purpose: The purpose of this study was to analyze the impact of healthcare accreditation and to provide empirical evidence to validate positive effectiveness. Methods:Six electronic databases (KERIS, KoreaMed, NDSL, Ovid-medline, Embase, Cochrane library) were accessed in May 2016. Keywords used were 'accreditation' and 'Joint Commission on Accreditation of Healthcare Organization (JCAHO)'. Of the initially identified 3,008 articles, 60 studies on healthcare accreditation were selected based on inclusion criteria that are hospital accreditation, accreditation by disease and clinical center accreditation. These were retrieved and analyzed. Result: The 60 study results were on the impact of healthcare accreditation. Results were classified into four perspectives of Balanced Score Card (Financial, Customer, Internal Process, Learning & Growth). In internal process perspective, results revealed that healthcare accreditation has made a positive impact on "care process and procedure". In learning & growth perspective, healthcare accreditation has made a positive influence on "leadership", "organizational cultures" and "change mechanisms". However, it revealed that healthcare accreditation does not directly affect financial performance. It is also difficult to reach a definitive conclusion that healthcare accreditation programs affect patient satisfaction of customer and clinical outcome of the internal process. Conclusion: Healthcare accreditation programs provide positive impact on change of care process and building communication-oriented hospital culture. However, more rigorous and diverse research is needed on financial effects and clinical outcomes of healthcare accreditation.

• 한국간호교육학회지
• /
• 제6권2호
• /
• pp.303-326
• /
• 2000

Only one hundred years of history in nursing education in Korea is not enough to develop the subject fully as a science. However, the development of Korean nursing education is a great historical event, because Korean nursing education has been accepted by a male-oriented Korean society and has led to a new paradigm in the new millenium. These results are largely due to the Korean people's high enthusiasm for education, as well as Korean women's diligence. I think these 100 years of history can be divided into five periods: (1) the Sunlight period (1900-1911) (2) the New born period (1912-1945) (3) the Settle-down period (1946-1960) (4) the Marked Growth period (1961-1980) (5) the Jumping Period (1981-2000) These classifications are characterized by changes in the educational system, a changed nursing curriculum, educational goals, educational outcomes, and implications. The characteristics of historical development of Korean nursing education was evaluated in three dimensions: structures, contents, and outcome. The structure of Korean nursing education consists of a 3-year program and a 4-year program. Most nursing leaders in Korea hope that these two programs will converge into one system. Secondly, the contents of nursing education in Korea underwent very active changes, according to historical development. These changes in the nursing curriculum have been developed to provide a professional education and develop nursing education as a modern science. Lastly, as to the results of nursing education in Korea, the education was needed to turn out advanced specialists in nursing. In the new millenium, knowledge and information will be the driving forces behind social development. A nation's level of development and creativity in nursing education is the most potent determinant of the future of Korean nursing. The best way to prepare for future challenges will be to create the backbone of a nursing education system. Hence, well-educated nurses in graduate programs should be turned into advanced specialists in nursing. These groups will upgrade the image of Korean nurses, and will have strong influence to improve patient care and the health situation in Korea.