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A Study on the Perception Changes of Physicians toward Duty to Inform - Focusing on the Influence of the Revised Medical Law - (설명의무에 대한 의사의 인식 변화 조사 연구 -의료법 개정의 영향을 중심으로-)

  • Kim, Rosa
    • The Korean Society of Law and Medicine
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    • v.19 no.2
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    • pp.235-261
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    • 2018
  • The Medical law stipulates regulations about the physician's duty to inform to contribute to patient's self-determination. This law was most recently revised on December 20, 2016, and came into effect on June 21, 2017. There has been much controversy about this, and it has been questioned whether or not it will be effective for physicians to comply with the duty to inform. Therefore, this study investigated perceptions of physicians of whether they observed the duty to inform and their legal judgment about that duty, and analyzed how the revision of the medical law may have affected the legal cognition of physician's duty to inform. This study was conducted through an online questionnaire survey involving 109 physicians over 2 weeks from March 29 to April 12, 2018, and 108 of the collected data were used for analysis. The questionnaire was developed by revising and supplementing the previous research (Lee, 2004). It consisted of 41 items, including 26 items related to the experience of and legal judgment about the duty to inform, 6 items related to awareness of revised medical law, and 9 items on general characteristics. The data were analyzed using SAS 9.4 program and descriptive statistics, Chi-square test, Fisher's exact test and Binary logistic regression were performed. The results are as follows. • Out of eight situations, the median number of situations that did not fulfill the duty to inform was 5 (IQR, 4-6). In addition, 12 respondents (11%) answered that they did not fulfill the duty to inform in all eight cases, while only one (1%) responded that he/she performed explanation obligations in all cases. • The median number of the legal judgment score on the duty to inform was 8 out of 13 (IQR, 7-9), and the scores ranged from a minimum of 4 (4 respondents) to a maximum of 11 (3 respondents). • More than half of the respondents (n=26, 52%) were unaware of the revision of the medical law, 27 (25%) were aware of the fact that the medical law had been revised, 20(18%) had a rough knowledge of the contents of the law, and only 5(5%) said they knew the contents of the law in detail. The level of awareness of the revised medical law was statistically significant difference according to respondents' sex (p<.49), age (p<.0001), career (p<.0001), working type (p<.024), and department (p<.049). • There was no statistically significant relationship between the level of awareness of the revised medical law and the level of legal judgment on the duty to inform. These results suggest that efforts to improve the implementation and cognition of physician's duty to inform are needed, and it is difficult to expect a direct positive effect from the legal regulations per se. Considering the distinct characteristics of medical institutions and hierarchical organizational culture of physicians, it is necessary to develop a credible guideline on the duty to inform within the medical system, and to strengthen the education of physicians about their duty to inform and its purpose.

The Prevalence and Associated Factors of Constipation in the School-aged Children (학동기 아동에서 변비의 실태와 관련요인에 대한 연구)

  • Cho, Sung-Jong;Ahn, Young-Jun;Kim, Eun-Young;Rho, Young-Ill;Yang, Eun-Suk;Park, Young-Bong;Moon, Kyung-Rye
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.5 no.1
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    • pp.26-32
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    • 2002
  • Purpose: Constipation in childhood is a significant problem, however, understanding of its epidemiology has been limited in Korea. The aim of this study was to investigate the prevalence and risk factors of constipation in school-aged children, helping to manage and prevent it. Methods: This cross-sectional, descripsive observational prevalence study included children (2grade, 1st and 6th grade) who were attending two elementary schools in Gwangju. The prevalence of constipation, associated symptoms, and risk factors were evaluated by questionnaire. A child was considered to be constipated when he or she defecated two or less times per week. Results: The prevalence of constipation was 15.4%. There is no significant difference between both sexes and grades. Of the causes of constipation, there was statistically significant difference in exercise deficiency, frequent intake of convenience food, long-time watching TV, unbalanced diet and enuresis history between constipation and normal group. Especially, long-time watching TV, exercise deficiency, and enuresis history were risk factors for development of constipation. Only 27.1% of children with constipation were treated by laxative and enema. Conclusion: Even though the prevalence of constipation was high, more than half of them was not treated at all. We should endeavor to educate the children and their parents to prevent constipation by evaluating the feeding and behavioral habit completely, and treating them properly.

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The Mediating Role of Perceived Risk in the Relationships Between Enduring Product Involvement and Trust Expectation (지속적 제품관여도와 소비자 요구신뢰수준 간의 영향관계: 인지된 위험의 매개 역할에 대한 실증분석을 중심으로)

  • Hong, Ilyoo B.;Kim, Taeha;Cha, Hoon S.
    • Asia pacific journal of information systems
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    • v.23 no.4
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    • pp.103-128
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    • 2013
  • When a consumer needs a product or service and multiple sellers are available online, the process of selecting a seller to buy online from is complex since the process involves many behavioral dimensions that have to be taken into account. As a part of this selection process, consumers may set minimum trust expectation that can be used to screen out less trustworthy sellers. In the previous research, the level of consumers' trust expectation has been anchored on two important factors: product involvement and perceived risk. Product involvement refers to the extent to which a consumer perceives a specific product important. Thus, the higher product involvement may result in the higher trust expectation in sellers. On the other hand, other related studies found that when consumers perceived a higher level of risk (e.g., credit card fraud risk), they set higher trust expectation as well. While abundant research exists addressing the relationship between product involvement and perceived risk, little attention has been paid to the integrative view of the link between the two constructs and their impacts on the trust expectation. The present paper is a step toward filling this research gap. The purpose of this paper is to understand the process by which a consumer chooses an online merchant by examining the relationships among product involvement, perceived risk, trust expectation, and intention to buy from an e-tailer. We specifically focus on the mediating role of perceived risk in the relationships between enduring product involvement and the trust expectation. That is, we question whether product involvement affects the trust expectation directly without mediation or indirectly mediated by perceived risk. The research model with four hypotheses was initially tested using data gathered from 635 respondents through an online survey method. The structural equation modeling technique with partial least square was used to validate the instrument and the proposed model. The results showed that three out of the four hypotheses formulated were supported. First, we found that the intention to buy from a digital storefront is positively and significantly influenced by the trust expectation, providing support for H4 (trust expectation ${\rightarrow}$ purchase intention). Second, perceived risk was found to be a strong predictor of trust expectation, supporting H2 as well (perceived risk ${\rightarrow}$ trust expectation). Third, we did not find any evidence of direct influence of product involvement, which caused H3 to be rejected (product involvement ${\rightarrow}$ trust expectation). Finally, we found significant positive relationship between product involvement and perceived risk (H1: product involvement ${\rightarrow}$ perceived risk), which suggests that the possibility of complete mediation of perceived risk in the relationship between enduring product involvement and the trust expectation. As a result, we conducted an additional test for the mediation effect by comparing the original model with the revised model without the mediator variable of perceived risk. Indeed, we found that there exists a strong influence of product involvement on the trust expectation (by intentionally eliminating the variable of perceived risk) that was suppressed (i.e., mediated) by the perceived risk in the original model. The Sobel test statistically confirmed the complete mediation effect. Results of this study offer the following key findings. First, enduring product involvement is positively related to perceived risk, implying that the higher a consumer is enduringly involved with a given product, the greater risk he or she is likely to perceive with regards to the online purchase of the product. Second, perceived risk is positively related to trust expectation. A consumer with great risk perceptions concerning the online purchase is likely to buy from a highly trustworthy online merchant, thereby mitigating potential risks. Finally, product involvement was found to have no direct influence on trust expectation, but the relationship between the two constructs was indirect and mediated by the perceived risk. This is perhaps an important theoretical integration of two separate streams of literature on product involvement and perceived risk. The present research also provides useful implications for practitioners as well as academicians. First, one implication for practicing managers in online retail stores is that they should invest in reducing the perceived risk of consumers in order to lower down the trust expectation and thus increasing the consumer's intention to purchase products or services. Second, an academic implication is that perceived risk mediates the relationship between enduring product involvement and trust expectation. Further research is needed to elaborate the theoretical relationships among the constructs under consideration.

아동의 잠재된 영재성 개발 프로그램

  • Lee, Sun-Ju
    • Journal of Gifted/Talented Education
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    • v.10 no.2
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    • pp.71-86
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    • 2000
  • According to Torrance, it is said that about 30% of feeble-headed children are bearing potential brilliant quality. Such potential gifted children exist really much more than children who appear to show their own brilliant quality. Nevertheless, research activity to reveal children's potential giftedness has not been relatively actively progressed. Renzulli, Smith and so on progresses research activity to reveal children's potential giftedness and strategies developed by them are being used widely all over the world, but these strategies show the defect that children can not overcome by themselves the interfered factors influenced negatively on their gift revelation. Russian scholar Babaeva made the effective education program to develop children's potential giftedness. Her program includes various activity methods or mental correct activity and psychological training activity and such training activity is realized through some steps and each step has it's own purpose and realization method. With the result that children discriminated as common children by the experimental study which is progressed by the present program participate, their standard of intelligence and originality showed the improved effect of the similar standard to children factors not a little influencing on children's giftedness development process but she also developed the leading concrete study method for the children to overcome this by themselves. In this paper, the present writer will examine potential giftedness development program researched in Russia and discuss their theoretic background and concrete activity course, activity result. Through this, children's have the excellent abilities in various spheres, this writer will obtain significant suggestions to educate the potential gifted children who do not display their own potentialities and do not receive a favor from gifted children program.

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The Clinical Applicability of Transoral Transpharyngeal Approach to the Craniovertebral Junction Lesions (두개 경추 이행부의 병소에 대한 경구적 접근법의 유용성)

  • Cho, Tae Goo;Park, Kwan;Cho, Yang-Sun;Baek, Chung-Hwan;Nam, Do Hyun;Kim, Jong Soo;Hong, Seung-Chyul;Shin, Hyung Jin;Eoh, Whan;Kim, Jong Hyun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.3
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    • pp.379-388
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    • 2000
  • Objective : Although transoral transpharyngeal approach is a very useful method for the lesions of craniovertebral junction, it is not frequently used because of anatomical unfamilarity, risk of cerebrospinal fluid(CSF) leakage, and resultant postoperative meningitis. To evaluate the usefulness of transoral transpharyngeal approach for various lesions of craniovertebral junction, clinical characteristics and the results of this approach are investigated. Methods : Transoral transpharyngeal approaches were performed in eight cases between 1996 and 1999. Among them, there were three basilar invaginations due to congenital anomalies, two odontoid type I fractures, two atlantoaxial dislocations, and one pseudotumor. Surgical methods included five cases of anterior decompression and posterior fusion, two anterior approaches for decompression and one transoral approach for biopsy. Results : This procedure allowed immediate clinical improvement in all cases. In seven patients with preoperative motor deficit showed a progressive neurological improvement. The follow-up plain x-rays demonstrated successful bony fusion in all patients. Only one patient suffered from postoperative wound dehiscence, but she completely recovered after wound revision. There was no complication of postoperative CSF leakages. Conclusions : Transoral transpharyngeal approach for the ventral lesions of craniovertebral junction, can be used as a relatively simple and effective method.

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The influence of perceived usefulness and perceived ease of use of experience store on satisfaction and loyalty (체험매장의 지각된 용이성과 유용성이 만족과 충성도에 미치는 영향)

  • Lee, Ji-Hyun
    • Journal of Distribution Science
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    • v.9 no.3
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    • pp.5-14
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    • 2011
  • One of the new roles of modern retail stores is to supply consumers with a memorable experience. In Korea, enhancing a store's environment so that customers remember a unique shopping experience is recognized as a sound strategy for strengthening the store's competitiveness. Motivated by this incentive, awareness of the experience-store concept is starting to increase in various categories of the retail industry. However, many experience stores, except in a few cases, have yet to derive a significant profit, explaining why Korean consumers are somewhat unfamiliar with, yet fascinated by, the experience stores that now exist in the country. Consumer satisfaction directly, and indirectly, affects a company's future profit and potential financial gain; customer satisfaction also affects loyalty. Therefore, knowing the significant factors that increase satisfaction and loyalty is essential for any company, in any field, to be able to effectively differentiate itself from the competition. Intrigued by increased competition opportunities, most Korean companies have adopted experience-store marketing strategies. When establishing the most effective processes for increasing sales and achieving a sustainable competitive advantage of a new concept, companies should consider certain factors that influence consumers' ability to accept new concepts and ideas. The Technology Acceptance Model (TAM) is a theory that models how people accept new concepts. TAM proposes the following two factors that influence a person's decisions about how, and when, he or she will use a new product: "perceived usefulness" and "perceived ease of use." Much of the existing research has suggested that a person's character also affects the process for accepting new ideas. Such personal character attributes as individual preferences, self-confidence, and a person's values, traits, and/or skills affect the process for willingly consenting to try something new. It will be meaningful to establish how the TAM theory's components, as well as personal character, affect individuals accepting the experience-store concept. To that end, as it pertains to an experience store, the first goal of the study is to examine the influence of innovative factors (perceived usefulness and perceived ease of use) on satisfaction and loyalty. The second objective is to define the moderate effect of consumers' personal characteristics on the model. The proposed model was tested on 149 respondents who were engaged in leisure sports activities and bought sports outdoor garments and equipment. According to the study's findings, the satisfaction and loyalty of an experience store can be explained by perceived usefulness and perceived ease of use, with the study's results demonstrating the stronger of the two factors being "perceived ease of use." The study failed to explain the effects of a person's character on the model. In conclusion, when the companies that operate the experience stores execute their marketing and promotion strategies, they should stress the stores' "ease of use" product components. Additionally, it can be extrapolated from the study data that since the experience-store idea is still relatively unfamiliar to Korean consumers, most customers are not yet able to evaluate, nor take a position regarding, their respective attitudes toward experience stores.

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Womans experience of Risk Situation on the High-Risk Pregnancy (여성의 고위험 임신에 대한 경험)

  • Kim, Kyung-Won;Lee, Kyung-Hye
    • Women's Health Nursing
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    • v.4 no.1
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    • pp.161-178
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    • 1998
  • In spite of the great progress of the theory and skill of the Nursing Care & Medical area in relation to pregnancy, nurses in clinics face up to many challenges in maternity nursing care areas. The reason is that the mobility and mortality of mothers was sharply decreased and the unknown high-risk diseases of pregnancy woman in the past is made public. That's why it is difficult to meet the pregnancy woman in natural process from pregnancy to delivery in recently. Admission rooms are filled with high-risk pregnancy women. As a matter of fact, we have done nursing care into the surface symptoms and diseases of high-risk pregnancy women so far. We have been indifferent to a long period hospitalization, separation from family, and conflict of repeated examination. Therefore, it is widely spread to understand the emotional conflict experienced by high-risk pregnancy women and to need for nursing intervention to bring up about emotional support and the ability of perception in psychological crisis. Although the pregnancy woman judged in high-risk should carry out normal task of pregnancy, she have to be confronted with secondary risk situation. The health of self & fetus threatened by the risk situation could be decreased through care plan, but psychological stress increases. Therefore, the pregnancy brings into non-control state. It is important to ask that what the hospitalized pregnancy women in high-risk think of themselves status. Because misunderstanding or serious anxiety of themselves status put into mother and fetus in danger. And adaptation mode makes all the difference. I would like to consider how nurses could deal with this high-risk circumstances in the position of pregnancy woman on the basis of the above fact. This study uses phenomenological method to suggest the basis material for nurses to do nursing intervention in view of pregnancy woman. Because this method understands the nature of true life of pregnancy woman throughly. The phenomenological method is the sources to describe or explain affluently the process generated in confirmation areas and environment and is the application for readers to understand and recognize clinic reality and then apply this method to reasoning study place or other places. Specifically, the phenomenon study method, one of the phenomenological method, is applied. The use of that method is to describe and generalize the experience in environment exactly. The study of this study is as follows : Among 187 descriptive stamens from 8 study participants are classified into 42 theme cluster at the stage of the first analysis. Those theme is categorized into 8 sub-subjects such as anxiety of uncertainty, foreknowledge about risk circumstance, will power about overcome, unsettled feeling about hospital, relief, optimistic thought, family support, and indifferences. At the last stage of analysis, those things are categorized into 3 subjects. When high-risk pregnancy woman foretell the situation, they feel unsettlement about uncertainty and untrust feeling about hospital. But they are ease with family support and hospital support. On the other hand, they express indifferent 3-way structure response to the situation having will of overcome and exceeding optimistic thought. In those statements, the experience by pregnancy woman shows 3 respect subjects. 1. They are anxious of this situation and are in desperation and don't recognize their role to be carried out 2. They think of this situation as normal process of pregnancy and are not concerned that this can give themselves and fetus fatal damage. 3. The pregnancy women will never confront this situation. This study shows the pregnancy woman has anxiety and optimistic relief about the situation, and ignores and optimistic relief about the situation, and ignores many things. Therefore, nurses in clinic should give pregnancy woman knowledge and information about the high-risk and help them to deal with the situation spontaneously. High-risk pregnancy woman should have the care plan in respect of the right perception. And the nurse know that their support help out pregnancy woman overcome the crisis in this respect of the special nursing intervention.

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Law and Love in (<춘향전>에서의 법(法)과 사랑)

  • Kim, Jong-Cheol
    • Journal of Korean Classical Literature and Education
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    • no.38
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    • pp.175-200
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    • 2018
  • From the point of view of the law and public morals in Yi-dynasty, it is possible to discover new meanings in the love of Chunhyang and Mongryong-Lee, the conflicts between Chunhyang and Hakdo-Byeon, and the rescue of Chunhyang by Mongryong-Lee as a secret royal inspector. First, although the love of Chunhyang and Mongryong-Lee was against the law and public morals of Yi-dynasty, the narrator did not call to account, but he described the love as a romantic and new one conflicting with the ruling system. And it was an unprecedented case that Chunhyang asked a written contract as a legal guarantee for marriage when Mongryong-Lee courted her. Second, Hakdo-Byeon, the Namwon county governor, accused Chunhyang, a female entertainer of the Namwon county, of disobedience to his oder and contempt of him, and interrogated her with torture when she denied his demand for bed service which was prohibited by law. Chunhyang refuted against him and regarded his demand for bed service as the rape of a married woman. In this process, narrator sharply contrasted Chunhyang's claim for human rights with Hakdo-Byeon's legal administration. Characters such as people of Namwon county and king did not call Mongryong-Lee to account for that he, as a secret royal inspector, allegedly used his power privately to rescue his sweetheart Chunhyang from Hakdo-Byeon's illegal oppression. These different judgements on legal administrations of Hakdo-Byeon and Mongryong-Lee came from the legal emotion of characters and reading publics of . Namely, people who sympathized with Chunhyang's claim for love and human rights had the legal emotion that Mongryong-Lee's administrative order suspending Hakdo-Byeon's govenor's status could be approved as an legal and exciting one. Therefore the love of Chunhyang and Mongryong-Lee implied a new legal emotion which based on the sympathy with Chunhyang's human rights consciousness, and regarded the positive law of Yi - dynasty as one behind times.

The Achievements and Limitations of Petit Bourgeois Desires in "Oksosun Story" (<옥소선 이야기> 속 소시민적 욕망의 성취와 한계)

  • Lee, Won-young
    • Journal of Korean Classical Literature and Education
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    • no.32
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    • pp.327-355
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    • 2016
  • This study aims to identify petit bourgeois desires through the characters in "Oksosun Stories" from Cheonyerok, an eighteenth-century Yadam anthology. The desires and motivations of the characters are quite secular and egocentric. Because of this, their shared characteristics are similar to those of the petit bourgeois, as neutral existence begins to emerge during the transition from feudal to modern society. The concept of petit bourgeois generally means the public and the working class of modern society. The main character's behavior in the story differs little from general petit bourgeois attitudes. An important belief in petit bourgeois is not the ruling ideology in society but the achievement and stability of realistic and ordinary desires to fulfill their lives' satisfaction. Also selfish or antisocial attitudes and boundary characteristics appear in the process, depending on whether subject having any desire. However, the character's actions are limited in the governance system of a huge reality. And It is characterized by end goal being to meet their upward mobility and stability. This corresponds with Seang's (書生) actions of turning his back on his family and country as well as promising Jaran his love; and, he redeems himself with his family and society by acquiring stability after he passed the state examination. Furthermore, the contemporary significance of this work demonstrates Seang (書生) discovering his desires for human love; therefore, in order to affirm and gratify this desire, he endures the societal state of semi-feudalism against filial duty (不孝), disloyalty (不忠), and non-chastity (不烈), and he acts independently. In addition, on the strength of his pursuit of his desires, Oksosun frees herself from the caste restraint called gisaeng (妓生) and affirms her desire to become a subject of love, but she then deviates from the social system. Moreover, the limitations and achievements of the petit bourgeois are indicated in the actions of recognizing the social threshold of their past in the process, making independent efforts using their capabilities, fulfilling success in the state examination with their intellectual capacity, and re-entering society. From the late Chosun Dynasty to modern times, there is not only the type of contemporary people who hunger for fulfillment of their personal desire and live in free will, but there is also the feudal type that is still lacking in the understanding of independent life. This is not as different as in these present times. This literature asserts the meaning of awakening one's self-existence and assigning great value to the fulfillment of self-desires against the odds that are created by socio-political, cultural, economic norms of the era. "Oksosun Story" affirms the small efforts and successes of private individuals in reality. It also validates the search for life happiness through positivity. In this sense, even the contemporary reader would derive valid meaningfulness from this literature.

Time and Motion Study of Community Health Practitioners and Community Health Aids in Ocku Area (보건진료원 및 보건진료보조원의 근무시간활용에 대한 조사연구)

  • 황인담;기노석
    • Korea journal of population studies
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    • v.3 no.1
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    • pp.42-51
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    • 1979
  • A study on analysis of daily activities and time allocations of Community health Practitioners(CHP) and Community Health Aids(CHA) who assigned to Ocku Demonstration Health Project of the Korean Health Development Institute was conducted for one week from 3rd through 8th December 1979. The purpose of this study was to determine the efficacy including productivity of the community Health Workers developed by KHDI for rural areas. Five Community Health Practitioners and eight Community Health Aids were selected for the studies and their activities and time allocations were measured by designed format for one week. The following are the summary of the findings. 1. The mean age of the CHPs was 34.4 years with standard deviation 4.8 years, while that of CHAs was 26.9 years with standard deviation 3.1 years. 2. On educational background, all of the CHPs were graduated from Junior Nursing College, six CHAs were from high school and the rest of them from middle school. 3. On marital status, all CHPs were married, meanwhile four CHAs were married and the rest of them were single. 4. On service duration in public health fields, all of the CHPs have worked for less than three years, meanwhile five CHAs for 5 to 9 years and one CHA for more than 10 years. 5. Only one CHP lives in the myon where she works, and the rest of them live in other areas. Three CHAs live in the same myon where they work, and five live in other areas. 6. On types of work, the CHPs have worked on technical areas for 3.6 hours per day and on supportive and administrative activities for 2.7 hours and other activities for 1.8 hours on average. 7. The CHAs have spent 2.9 hours a day on technical activities, 4.2 hours on supportive and administrative activities and 1.6 hours on other activities in terms of time spent on average. 8. The average hours per day spent by CHPs on functional areas were 2.2 hours for clinic activities, 13.7 minutes for maternal health, 30.1 minutes for infant and child health, 13.4 minutes for family planning, 1.1 hours for supporting activities and 1.7 hours for administrative affairs. 9. The average hours per day spent by CHAs on functional areas were 4.1 hours for administrative affairs, 2.6 hours for supportive activities and only 2.9 for maternal health, infant and child health an family planning, and other technical works. 10. The average time spent by CHPs on clinical works were 1.0 minutes for history takings on disease, 2.6 minutes for physical examinations, 1.1 minutes for measurements, 3.8 minutes for administration of medications, 1.5 minutes for educations and 0.9 minutes for others. 11. On the average 92.8 percent of whole working hours of CHPs were spent in the substations, meanwhile 70.4 percent of CHAs were spent in the substations. 12. 17.8 percent of field working hours of CHAs were spent on the roal for their transportations. 13. The average time for unit service performance by CHPs were 10.9 minutes on clinical case, 18.1 minutes on maternal health, 14.8 minutes on infant and child health, 20.5 minutes on family planning and 29.9 minutes on tuberculosis control. 14. The average time for unit service performance by CHAs were 19.4 minutes on clinical work, 19.9 minutes on maternal health, 20.1 minutes on infant and child health, 17.2 minutes on family planning, 22.2 minutes on tuberculosis control.

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