• 의료법학
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• 제7권2호
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• pp.9-74
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• 2006

Due to the awareness of their rights for medical liability and the advancement of legal principles, it becomes also not hard to find those who seek damages against hospitals, doctors and nurses for the suicide committed under the protection of psychiatric institute in Korea these days. Judgements on these kinds of cases are not enough yet, so that it may be too early to try to find principles used in these cases, however it is hardly wrong to read following things from above cases. That is, to gain the case, plaintiffs should show (1) there exists an obligation of "due care"(there is a special relation between patients and hospitals), (2) the duty is violated on the basis of the applicable standard of care, (3) whatever injures or damages are sustained are proximately caused by the breach of duty and (4) the plaintiff suffers compensable damages. To specific, whether a psychiatric institute was liable for wrong death or not depends upon the patients conditions, circumstances and the extent of the danger the patients poses to himself or herself; in short, the foreseeability of self-inflicted harm(the doctor should have or could reasonably have foreseen the patient's suicide and the doctor's negligence actually caused the suicide). In this context if a patient exhibit strong suicidal tendencies, constant observation should be required. Negligence has been found not exist, however, when a patient abruptly and unexpectedly dashes from an attendant and jumps out a window or otherwise attempts to injure himself or herself. And the standard of conduct that is required to meet the obligation of "due care" is based on what the "reasonable practitioner" would do in like circumstances. The standard is not one of excellence or superior practice; it only re quires that the physician exercise that degree of skill and care that would be expected of the average qualified practitioner practicing under like circumstances. Most of these principles have been established at cases of the U.S.A and Japan. In this article you can also find the legal organizations of medical liability and medical contacts on the suicide of patients who have psychiatric diseases under Korean negligence law.

• 대한방사선기술학회지:방사선기술과학
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• 제43권5호
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• pp.343-351
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• 2020

This study analyzed dose reduction and quality of images through dose reduction tools and shielding board to protect sensitive eye lens in radiation during orbit CT examinations for clinical data use. During CT scans of the phantom, surface dose (CT scanner dosimetry phantom, ion chamber-3 times) and quality of image (radiosurgery head phantom, visual assessment-2 times, HU standard deviation) were evaluated using X-care which is dose reduction tools and bismuth shielding board. The results of experiments of eight conditions showed a relatively reduced dose in all other conditions compared to when no conditions were set. In particular, the area corresponding to the ophthalmic part reduced the surface dose by up to 45.7 %. The visual evaluation of images by specialists and the quality evaluation of images analyzed by HU standard deviation were clinically closest to the use of X-care and shielding board (1 cm in height). Therefore, it is believed that the use of shielding board in a suitable location with dose reduction tools while investigating the optimal radiation dose will reduce the exposure dose of sensitive lens at radiation while maintaining the quality of the images with high diagnostic value.

• 대한약침학회지
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• 제21권2호
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• pp.126-131
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• 2018

This study investigates the effect of a combination of homeopathic medicine and electro- acupuncture in two patients with breast cancer and severe liver disease who could not receive standard anaesthesia therapy due to liver problems. Specifically, measurable and quantifiable parameters were used to evaluate whether an integrated approach-consisting of electro- acupuncture and a homeopathic medicine diluted above Avogadro's limit (that is, above a potency of 12CH) during the pre-surgical, surgical and post-surgical phases -can improve general well-being of a patient undergoing breast cancer surgery. In breast cancer surgery, we employed an integrated approach consisting of induction with hypnotics and muscle relaxants, followed by maintenance with anaesthetic gas, combined with a homeopathic treatment (Arnica montana 15CH and Apis mellifica 15CH) before and after surgery and an electro- acupuncture treatment performed in the pre- and post-surgical phases without any analgesic/pain relieving medications. Both of the patients treated with the integrated approach improved their overall condition without need for other common pain relieving medicines. Additionally, thanks to their rapid awakening, the patients were not relocated to a protected area and the hospitalization was shorter. A multidisciplinary approach incorporating homeopathic medicine and electro-acupuncture can be a solution for patients who need or ask about a different and/or safer alternative to the standard treatment. This approach can offer a safe, much less expensive, non-invasive and viable alternative for such cases. Moreover it can be useful for an opioids free anesthesia.

• Journal of Yeungnam Medical Science
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• 제40권4호
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• pp.364-372
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• 2023

Background: Growing evidence suggests that beta-hydroxy-beta-methylbutyrate (HMB), arginine (Arg), and glutamine (Gln) positively affect wound recovery. This study investigated the effects of long-term administration of HMB/Arg/Gln on pressure ulcer (PU) healing in sedentary older adults admitted to geriatric and rehabilitation care facilities. Methods: This was a pilot retrospective case (standard of care and HMB/Arg/Gln)-control (standard of care alone) clinical study. Outcome measures were relative healing rates and Pressure Ulcer Scale for Healing (PUSH) scores (calculated after 4, 8, 12, 16, and 20 weeks) and time to healing. Results: The study subpopulation was comprised of 14 participants (four males, 28.6%) with the median age of 85.5 years (interquartile range [IQR], 82.0-90.2 years). The control subpopulation was comprised of 31 participants (18 males, 58.1%) with the median age of 84.0 years (IQR, 78.0-90.0 years). At the beginning of follow-up, there were no statistically significant demographic (sex and age) and clinical (main diagnosis, baseline area, and PU perimeter) differences between the groups. During the study period, there were no significant differences in the relative healing rates and PUSH scores between the subpopulations. The median time to complete healing in the study and control populations was 170.0 days (95% confidence interval [CI], 85.7-254.3) and 218.0 days (95% CI, 149.2- 286.7) (log-rank, chi-square=3.99; p<0.046), respectively. Conclusion: More than 20 weeks of HMB/Arg/Gln supplementation had a positive effect on difficult PU healing in older adults with multiple comorbidities.

• 여성건강간호학회지
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• 제8권2호
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• pp.301-313
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• 2002

The purpose of this study was to develop the frame for standardized manual for Sanhujoriwon by finding out the status of the management of women & newborn in Sanhujoriwon, like postpartum care center. The subjects were 95 staffs of 22 Sanhujoriwon agreed on oral consent, in Seoul and Bundang, Korea. Data were collected from Sep. 15 to Oct. 24, 2001. The instrument used for this study was a structured questionnaire consisted of 16 items of general characteristics & educational characteristics about postpartum care, 31 items of degree of management of women's postpartum care (Cronbach's $\alpha$.93 ), 24 items of degree of management of newborn's care(Cronbach's $\alpha$.94 ), 10 items of methods of management of women's postpartum care, 8 items of methods management of newborn's care. The data were analyzed by the SPSS/PC+ program using frequency, percentage, mean, standard deviation, t-test, ANOVA and Pearson correlation coefficient. The results of the study were as follows ; 1. The mean of the degree of management for postpartum women was 4.1. The mean score for the degree of management of general postpartum care for women was 4.00 & traditional postpartum care(Sanhujori) was 4.20. The degree of management of traditional postpartum care was higher than general postpartum care for women. 2. The degree of management for newborn : The mean score for the degree of management of newborn was 4.37. 3.There was a strong positive correlation between general postpartum care and traditional postpartum care($r=.744^{**}$), and postpartum mother care and newborn care($r=.798^{**}$). 4.The basic frame for the management of the women and newborn in Sanhujoriwon. 1) For women: Integrated postpartal care Physical management : Vital sign & BP check, contraction of uterus, form and amount of lochia, management of personal hygiene, management of breast & breast-feeding, management of postpartum exercise, prevention of infection, symptom & sign of high risk and prevention & management of high risk condition; Emotional-psychological management: assessment and management of mother-baby attachment, emotional state; Educational management : education of vaccination schedule, urinary incontinence, rearing infant, breast-feeding ; and Environmental management : temperature, humidity, disinfection, cleaning, light, infection control integrated with 6 principles of Sanhujori. 2) For newborn Physical management : check of vital sign, management of umbilical cord, jaundice, prevention of infection, management of diaper rash; Emotional-psychological management : assessment of sleep, crying, activity, response of mother-baby attachment; and Environmental management : temperature, humidity, disinfection, cleaning, light, infection control integrated with 6 principles of Sanhujori. In conclusion Sanhujoriwon must be health care center for the postpartum women and newborn. Therefore, the establishment of various laws and regulations in such a way to meet the realistic needs of Sanhujoriwon as a health care center for women and infants future health should be done. The standardized management manual based on the results is absolutely required above all.

• 여성건강간호학회지
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• 제8권4호
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• pp.506-520
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• 2002

The purpose of this study is to research the degree of recognition & performance of traditional postpartal care for postpartal women and to provide the basic data for improvement of service in a postpartum care center. The respondents of this study were 100 women of 6 postpartum care centers within a C province from Oct. 20 to Dec. 10, 2000. The instruments of measure were used for collecting data on the degree of recognition & performance of traditional postpartal care developed by the researcher. Data analysis consisted of frequency, percentage, mean, standard deviation, paired t-test, t-test, ANOVA which are calculated by Scheffe test and Cronbach's alpha which is used as a reliance level by using a SPSS-PC+. The results of the study were as follows:1. The average score for the degree of recognition of traditional postpartal care(Sanhujori) for postpartal women was $3.09{\pm}.31$, and they recognized that it was important. The methods which were ranked were as follows; Protecting the body from a harmful state, invigorating the body by the argumentation of heat and avoidance of cold, handling with whole heart, and keeping clean, resting without working, eating well. 2. The average score for the degree of performance of traditional postpartal care (Sanhujori) for postpartal women was $2.81{\pm}.31$, and they performed that it was important, too. The methods which were ranked were as follows; Protecting the body from a harmful state, invigorating the body by the augumentation of heat and avoidance of cold, eating well, handling with whole heart, and keeping clean, resting without working. 3. There were significant differences statistically (paired-t=-8.39, p=.000) of the degree of recognition & performance of traditional postpartal care(Sanhujori) for the postpartal women. The degree of recognition was higher than the degree of performance. So, the recognition of traditional postpartal care (Sanhujori) was higher than the performance of it. 4. There were no statistical differences of the degree of recognition & performance of traditional postpartal care(Sanhujori) among the postpartal women's age, religion, job, educational background, delivery frequency, delivery method or the sex of baby. So, the Characteristics of the respondents were not influenced as far as the degree of recognition & performance of traditional postpartal care(Sanhujori). 5. There were significant differences statistically of the degree of performance of traditional postpartal care(Sanhujori) among the 5 postpartum care centers except 1 postpartum care center(p<.01). So, the recognition of traditional postpartal care(Sanhujori) was higher than the performance of traditional postpartal care(Sanhujori) in the 5 postpartum care centers. But there was performed as good as recognition in only 1 postpartum care center.

• 한국보건간호학회지
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• 제28권1호
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• pp.57-70
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• 2014

Purpose: This study is a methodological research study for development of a tool for measurement of care satisfaction of home health nursing in patients who have received care through home health nursing and to test the validity and reliability of the tool. Method: Based on Watson's theory of caring and its constituent factors, the literature related to home health nursing was reviewed, and the standard of home health nursing was compared and analyzed. For verification of the validation and reliability of the final tool which has been developed, data were collected from 166 people who were receiving home health nursing care. Result: According to results of analysis of the factors based on Kaiser and scree test, 10 factors with an eigenvalue greater than 1.0 were extracted, and they explained 72.26% of the total variance. In addition, the factor loadings of 56 questions were greater than .30. For verification of reliability, Cronbach's alpha for all 56 items was .98 and Guttman split half reliability coefficient was .90. Conclusion: This tool based on Watson's theory of caring contributed to development and application of the nursing theory through verification of the theory.

• 한국가정과학회지
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• 제9권3호
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• pp.47-62
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• 2006

The purpose of this study is comparing parenting efficacy, knowledge of infant-care and sensitivity, The subjects of this study were 100 parents having 12-24 monthes old child in the city of Jeonju, Korea. Parenting efficacy was developed by Shin, Suk-Jae(1997) and consisting of 16 questions. The knowledge of infant-care was assessed using Knowledge of Child Development Inventory(KCDI) by Yoon Hyung Ju, which was modified by pedology Professor and 3 graduate school students in master's or doctorate courses. In addition, by using a tool made by Gwon, Mi-Gyeong(1998) centering on the literatures on infant cue in Barnard's NCAST program, the parents' sensitivity of infant cue is investigated. The statistical analysis of the collected data is done with SPSS 10.0, and frequency, percentage, average, standard deviation, t/F test and Pearson's correlation are also used. The results of this study were as following: First, mother's parenting efficacy was higher than father's. There were significant differences in parenting efficacy by eudcational level of mothers. Second, knowledge of infant-care was higher in mothers than fathers. Areas that mothers have knowledge of infant-care in the order of the lowest areas are emotional development, sociality development, physical development and cognitive development. Third, mothers reaction to infant cue is more sensitive and positive than father's. Fourth, There were positive correlations with father's parenting efficacy and knowledge of infant-care on emotional development, and paternal parenting uneasiness has negative correlations with his sociality development and emotional development.Meanwhile, There were positive correlations with mother's parenting efficacy and knowledge of infant-care on emotional development. Maternal parenting efficacy has negative correlations with her knowledge of infant-care on emotional development.

• 한국직업건강간호학회지
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• 제20권3호
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• pp.299-307
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• 2011

Purpose: The purpose of this study is to establish the standards for duty of Medical Care Client Managers and analyze the extent of accomplishment, importance, and difficulty according to the standards. Methods: The draft for duty of Medical Care Client Managers was formed by the method of developing a curriculum (DACUM) and data were collected from 185 Medical Aid Client Managers in 234 areas to evaluate the actual frequency of accomplishment, importance and difficulty in comparison with the standards for duties. Results: The standard duty draft for Medical Care Client Manager is composed of five separate groups of duties and thirty five tasks. The five duties are Case Management, Extension Approval, External Cause of Injury, Duplicate Claims and Other Administrations. Seven Tasks are allocated to each duty such as Case Management, Extension Approval and External Cause of Injury. Five tasks are allocated to 'Duplicate Claims' duty and nine tasks are allocated to 'Other Administrations' duty. Conclusion: From the results of analysis for duties, it was apprehensive about overburdened responsibilities and carelessness in professional duties. It was necessary to establish specific guidelines for duties because of redundent application or regional variation in frequency of accomplishing other administrative duties. It was necessary to relieve a regional disparity of business charge and also was necessary to propose an alternative plan to relieve the overburdened responsibilities.

• Child Health Nursing Research
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• 제9권1호
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• pp.18-27
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• 2003

The purpose of this study is to compare the educational needs and perception of mothers of normal neonates and high risk infants. This research was designed as a descriptive study. Data were collected for two months from April 2002 to March 2002. Subjects were 41 mothers of high risk infants and 60 mothers of normal neonates in one general hospital in Seoul participated in the study. Measurement tools used in this study were the educational needs scale developed by Cho Kyoul Ja et al and the neonatal perceptive inventories scale developed by Broussard. They ask mothers to rate each item on a four point Likert type scale. The collected data were analyzed using SPSS 8.0 program. The variables were listed as frequency, mean, standard deviation, X2 test, t-test, ANOVA. The results were as follows: The educational needs of the mothers of primi pregnancy was higher than the mothers of multi pregnancy. The educational needs on management of diseases such as prevention of infection, symptoms of disease, mental development, attachment promotion, congenital metabolism test, management of convulsion, care of vomiting and fever were higher than general care of infants such as immunization, measurement of temperature, hiccough care, follow up care. The informations must be included in nursing intervention program to reduce the mothers' stress level. In conclusion, in order to promote positive mother infant relationship, nurse need to give information and educate the mothers of high risk infant and normal neonate.