• 한국융합학회논문지
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• 제10권11호
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• pp.543-555
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• 2019

본 연구의 목적은 만성질환자의 공유의사결정에 대한 개념의 속성을 명확히 정의하기 위함이다. 개념분석의 절차는 Walker and Avant의 방법에 근거하여 학제간 융합적 분석을 시도하였다. 분석결과, 만성질환자의 공유의사결정의 속성은 자기돌봄 전문가로서 인정, 자기 결정권, 번복 가능한 협상, 환자중심 돌봄으로 정의되었다. 선행요인은 비슷한 치료방법 중 선택해야 할 필요성이 있는 상황, 의사결정 갈등, 환자, 가족, 의료제공자의 참여 의지, 충분한 시간과 기회이다. 만성질환자의 공유의사결정의 결과는 의사결정 갈등 감소, 환자결과와 만족도 및 삶의 질의 향상, 장기적인 환자의 자기관리 및 자기 효능감 향상, 질병을 수용하는 삶의 태도이다. 본 연구는 만성질환자의 공유의사결정에 대한 명확한 개념을 제공하고, 관련 간호중재 개발을 위한 이론적 근거 형성에 기여할 수 있을 것이며 만성질환자를 위한 공유의사결정 측정도구 개발 연구의 수행을 제언한다.

• 한국의료질향상학회지
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• 제24권1호
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• pp.40-52
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• 2018

Purpose: This study aimed to identify the factors influencing on patients' participation in their treatment decision making, and influences of patients' experience on their health status. Methods: Data from the 2015 Korea National Health and Nutrition Examination Survey were used for the analysis. Multivariate logistic regression analysis was conducted to identify the factors influencing on patients' participation in their treatment decision making. The influences of patients' experience on their health status were analyzed using multiple linear regression analysis. Results: Of the 4,497 respondents, 3,698 (82.2%) respondents mostly participated in their treatment decision making. Those who experienced enough visit duration, physicians' explanation easy enough to understand, or more opportunities to ask were more likely to participate in their treatment decision making. After controlling for their sociodemographic factors and health status, those who had better experience during the outpatient visits were more likely to have better self-rated health or quality of life. Conclusion: To improve patients' health outcomes and satisfaction of health care uses, it is necessary to provide better experiences and expand the opportunities for participation in treatment decision making during their hospital visits.

• 한국경영과학회지
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• 제33권3호
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• pp.29-42
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• 2008

Semantic Web society initially focused only on data but has gradually moved toward knowledge. Recently rule beyond ontology has emerged as a key element of the Semantic Web. All of these activities are obviously aiming at making data and knowledge on the Web sharable and reusable between various entities around the world. If one of ultimate visions of the Semantic Web is to increase human's decision making quality assisted by machines, there is a missing but important part to be shared and reused. It is knowledge about constraints on data and concepts represented by ontology which should be emphasized more. In this paper, we propose Semantic Web Constraint Language (SWCL) based on OWL and show how effective SWCL can be in representing and solving an internet shopper's decision making problem by an implementation of a shopping agent in the Semantic Web environment.

• 성인간호학회지
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• 제22권5호
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• pp.488-498
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• 2010

Purpose: The purpose of this study was to explore clinical nurse's reported conflict experience toward end-of-life medical decision making. Methods: Data were collected by in-depth interviews with eight nurses from three different wards of university hospital in D city of Korea. Conventional qualitative analysis was used to analyze the data. Results: Results were three major themes and twelve categories from the analysis. The three major themes were prioritization of treatment, non-disclosure of diagnosis, and hierarchical and power relations. Conclusion: The results of this study suggest that shared decision making in end of life among patient, family members, physician, and nurse may contribute to improve end-of-life care performance as well as dignified dying of patient in end of life.

• 정보관리학회지
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• 제21권1호
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• pp.209-230
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• 2004

본 연구에서는 지식관리 및 지식관리구성요소의 개념적 정의에 대해 살펴보고 지식관리를 효율적으로 수행하기 위한 요인을 신뢰, 의사소통의 개방성, 의사결정의 참여정도, 혁신성, 공유된 가치, 최고경영자의 지원으로 구분해서 조사. 분석하였다. 이러한 연구결과는 조직구성원들의 원활한 지식관리역할을 수행하기 위한 기초 자료로써 활용할 수 있을 것이다.

• Journal of Korean Neurosurgical Society
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• 제55권4호
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• pp.195-199
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• 2014

Objective : Age is a strong predictor of mortality in traumatic brain injuries. A surgical decision making is difficult especially for the elderly patients with severe head injuries. We studied so-called 'withholding a life-saving surgery' over a two year period at a university hospital. Methods : We collected data from 227 elderly patients. In 35 patients with Glasgow Coma Score 3--8, 28 patients had lesions that required operation. A life-saving surgery was withheld in 15 patients either by doctors and/or the families (Group A). Surgery was performed in 13 patients (Group B). We retrospectively examined the medical records and radiological findings of these 28 patients. We calculated the predicted probability of 6 month mortality (IPM) and 6 month unfavorable outcome (IPU) to compare the result of decision by the International Mission for Prognosis and Analysis of Clinical Trials in TBI (IMPACT) calculator. Results : Types of the mass lesion did not affect on the surgical decision making. None of the motor score 1 underwent surgery, while all patients with reactive pupils underwent surgery. Causes of injury or episodes of hypoxia/hypotension might have affected on the decision making, however, their role was not distinct. All patients in the group A died. In the group B, the outcome was unfavorable in 11 of 13 patients. Patients with high IPM or IPU were more common in group A than group B. Wrong decisions brought futile cares. Conclusion : Ethical training and developing decision-making skills are necessary including shared decision making.

• The Journal of Asian Finance, Economics and Business
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• 제7권11호
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• pp.843-851
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• 2020

This study focuses on identifying and prioritizing the broader performance measures for the service supply chains by taking the case of Majan Electricity Company, Sohar, in the Sultanate of Oman. For an examination of the uniformity of ultimate objectives and the priorities therein, two strata of respondents with a total of fourteen respondents were approached for their valuable insights. Suitable structured instruments were personally administered to elicit the insightful and worthy responses. The two multi-criteria decision-making techniques, namely, the Fuzzy Analytical Hierarchy Process and the Best-Worst Method were used to reach a meaningful prioritization of the identified and refined broader performance measurement dimensions. The results show that there exists a minor gap between the two respondents' groups in terms of their prioritizations. The major finding points to the difference in terms of the topmost priorities as revealed by the two set of respondents. For one group of respondents, the customer satisfaction matters the most, whereas for the other group, it is the overall profitability that matters the most. This gap against the utopian state assists in concluding that there is a requirement to reorient the employees so as to have a shared and common understanding of the organizational priorities.

• Tuberculosis and Respiratory Diseases
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• 제78권3호
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• pp.175-179
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• 2015

The intensive care unit (ICU) is the most common place to die. Also, ethical conflicts among stakeholders occur frequently in the ICU. Thus, ICU clinicians should be competent in all aspects for ethical decision-making. Major sources of conflicts are behavioral issues, such as verbal abuse or poor communication between physicians and nurses, and end-of-life care issues including a lack of respect for the patient's autonomy. The ethical conflicts are significantly associated with the job strain and burn-out syndrome of healthcare workers, and consequently, may threaten the quality of care. To improve the quality of care, handling ethical conflicts properly is emerging as a vital and more comprehensive area. The ICU physicians themselves need to be more sensitive to behavioral conflicts and enable shared decision making in end-of-life care. At the same time, the institutions and administrators should develop their processes to find and resolve common ethical problems in their ICUs.

• Asia pacific journal of information systems
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• 제8권3호
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• pp.21-36
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• 1998

Group collaborative systems are recently emerging to support a group of users engaged in common tasks such as group decision making, engineering design, or collaborative writing. Simultaneously, as communications networks and distributed database systems become core underlying architecture of the organization, the need of collaborative systems are gaining more attentions from industry. In such collaborative systems, as the shared objects may evolve constantly or change for operational purposes, providing the users with synchronized and consistent views of the shared object and maintaining the consistency between shared object and replicated objects are important to improve the overall productivity. This paper provides an change management framework for the group collaborative systems to facilitate managing dependency relationships between shared objects and dependents, and coordinating change and propagation activities in distributed computing environments. Specifically, the framework adopts an object-oriented database paradigm and presents several object constructs capturing dependency management and change notification mechanisms. And the proposed framework accommodates both persistent dependents such as replicated data and transient dependents such as various user views in a single formalism. A prototype system is developed on a commercial object-oriented database management system called OBJECTSTORE using the C++ programming language.

• 한국경영과학회지
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• 제20권3호
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• pp.1-16
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• 1995

Group collaborative systems are recently emerging to support a group of users engaged in common tasks such as group decision making, engineering design, group scheduling, or collaborative writing. This paper provides an change management framework for the group collaborative system to facilitate managing dependency relationship between shared objects and dependent user views, and coordinating change and propagation activities between the two in distributed computing environments. Specifically, the framework adopts an object-oriented database paradigm and presents several object constructs capturing dependency management and change notification mechanisms. First, it introduces change management mechanisms with transient shared objects and secondly, it extends them into presistent object computing environment by integrating transaction management mechanisms and change notification mechanisms. A prototype change management framework is developed on a commercial object-oriented database management system.