• 제목/요약/키워드: Team medical care

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Response of ordinary person/medical team after using of rapid oral HIV screening test (신속 구강 점막 도말 HIV 항체 검사에 대한 일반인/의료진의 사용 후 반응도 연구)

  • Hwang, Ji-Wan;Park, Jung-Chul;Choi, Seong-Ho;Kim, Sun-Jong;Kang, Hee-Jung;Lee, Jong-Ho;Shin, Seung-Chul;Cha, Young-Joo
    • The Journal of the Korean dental association
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    • v.49 no.1
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    • pp.38-44
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    • 2011
  • The aim of this study is to evaluate the patient's and clinician's response to rapid oral HIV screening test. Attitude assessment survey was carried out on patients test with rapid oral HIV screening test and clinicians who conducted the test. The patients and clinicians were present at the dental hospital and clinics which were participating in the research project, between March and May 2010. Rapid oral HIV screening test is safe and efficient to the patients. It also demonstrated reliability to accuracy and confidentiality, and high recommendation to rapid oral HIV screening test. The clinician survey revealed high test convenience and high appraisal to patient satisfaction. In conclusion, if rapid oral HIV screening test becomes more common, patients will receive safe and convenient and high reliable HIV infection test, while clinicians will be able to create safe dental care environment.

The Experience of Miners Relocated to Alternative Positions due to Silicosis in the Andean of CODELCO, Chile, 2010

  • Delgado, Diemen;Aguilera, Maria De Los Angeles;Delgado, Fabian;Rug, Ani
    • Safety and Health at Work
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    • v.3 no.2
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    • pp.140-145
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    • 2012
  • Objectives: To understand the personal experiences of mine workers that have experienced job relocation due to silicosis at the Andina Division of Corporaci$\acute{o}$n Nacional del Cobre (CODELCO), Chile. The purpose of the study was to provide useful information for the development of new local, business and public policies for the care of workers with silicosis. Methods: A qualitative study based on a practical case study of 5 workers. The information was collected by means of structured individual interviews. The method of analysis was phenomenology. Results: The corporal axis was the most commented upon. It included awareness of the illness, body pains, fatigue, and antagonistic mood disorders (sadness, or the difficulty in finding meaning in life). As far as personal relationships, there was evidence of strong relationships with family, coworkers and friends, as well as extended family. Over all, the experience of relocation was positive with periods of impatience and uncertainty. The job reassignment provided a new and pleasant context for the relocated workers and in the process improved their perception of their quality of life. Conclusions: A multidisciplinary team should attend mine workers relocated because of silicosis by addressing the mental and physical aspects of their disease, along with the integral participation of close family members. It is suggested that this investigation be maintain over time to record the personal experiences in the medium-term, adding new cases with the intention of shedding more light on the phenomenon being studied. As a preventive measure, continual workshops are needed on the proper use of respiratory protection in addition, a group of monitors is required.

Patterns of Over-the-Counter Drug Use and Interactions between Over-the-Counter Drugs and Prescription Drugs in Adults Visiting a Community Pharmacy (지역약국 방문 성인의 일반의약품 복용실태 및 일반의약품과 처방의약품과의 상호작용 연구)

  • Chae, Min Kyoung;Bang, Joon Seok;Lee, Yu Jeung
    • Korean Journal of Clinical Pharmacy
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    • v.23 no.1
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    • pp.49-56
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    • 2013
  • Objective: The purpose of this study was to evaluate the patterns of Over-the-Counter (OTC) drugs and their interactions with prescription drugs in adults visiting a community pharmacy. Method: The subjects were 151 adults aged over 20 years visiting a community pharmacy in Asan-si from December 16th 2011 to February 1st 2012. We used a survey questionnaire. The survey inquired about the prevalence and the details of any OTC drug use and the characteristics of the study subjects. The drug interaction classification system from Lexicomp's Lexi-interact data fields was used to identify OTC drugs likely to have clinically significant interactions with prescription drugs. Results: The patterns of OTC drug use were related to thirties (from 30 to 40 years old), female gender, higher education, non-smoking, sometimes use of alcohol, and self-perceived normal health status. The most commonly used OTC drug category was antipyretic-analgesics (n=104, 53.3%), and the most commonly used ingredient was acetaminophen (n=67, 64.4%). The biggest motivation for taking OTC drugs was suggestion by pharmacists, reported by 55.6%. After reviewing each patient's prescription drugs and OTC drugs, 14 patients (36.8%) of 38 patients using prescription drugs were taking drug combinations with potential for clinically significant interactions. The concomitant use of OTC drugs with prescription drugs may lead to increased potentially harmful interactions. Conclusion: It is suggested that health-care professionals should be more aware of the potential and possible interactions and take into better account their patients' OTC drug use.

Effects of a Tailored Education and Coaching Program to Enhance Care of Cancer-related Pain (맞춤형 암성통증관리 개별교육 및 코칭의 효과)

  • Kim, Hye Jin;Kim, Young Mee;Kim, Hee Jin
    • Journal of muscle and joint health
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    • v.27 no.1
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    • pp.12-21
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    • 2020
  • Purpose: The study was to develop a tailored education and coaching program (TECP) for cancer patients, and to identify the effects of TECP on pain severity, daily living impairment, barriers on pain management, self-efficacy, and pain management satisfaction. Methods: A randomized controlled trial was used. Patients referred to an oncology nurse specialist from oncologists for pain management were randomly assigned to TECP (25) or usual education program (UEP, 22). The intervention was offered by educating the method of taking opioid medication, managing opioid-induced side effects, reducing pain misconceptions and enhancing self-efficacy for communicating with a medical team on cancer pain severity, and pain-related impairment. Patients completed questionnaires before the education program and on the next visit 3~4 weeks later. Data were analyzed by SPSS 19.0 program using percentage, frequency, mean, standard deviation, x2 test and independent t-test. Results: At all levels, pain severity improved significantly in the experimental group-worst pain (8.16 to 3.80, p<.001), average pain (6.16 to 2.52 p=.008), and least pain (3.32 to 0.96, p=.038)-but not in the control group. Pain management satisfaction also showed significant differences (t=2.93, p=.005) between experimental (4.70±0.49) and control (4.17±0.73) groups. Interference with daily living, barriers to managing cancer pain, and self-efficacy for managing pain improved in both groups but there were no significant differences. Conclusion: The findings suggest that TECP should be considered for outpatients who need cancer pain management.

The socioeconomic impact of Korean dental health insurance policy on the elderly: a nationwide cohort study in South Korea

  • Seo, Hyewon;Lee, Bo-Ah;Lim, Hyunsun;Yoon, Joon-Ho;Kim, Young-Taek
    • Journal of Periodontal and Implant Science
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    • v.49 no.4
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    • pp.248-257
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    • 2019
  • Purpose: The purpose of this retrospective study was to investigate the relationships of types of dental insurance coverage in Korea with sociodemographic characteristics and the prevalence of systemic and oral diseases, as well as to evaluate the socioeconomic impact of Korean dental insurance policies. Methods: Sample cohort data from 2006 to 2015 were obtained from the National Health Insurance Service. Patients were divided into 2 groups. The exposed group comprised patients who received insurance benefits for complete dentures, removable partial dentures, and implant care, while the control group comprised patients who did not receive these benefits. The type of insurance coverage and the prevalence of systemic and oral diseases were compared between the 2 groups. Results: Patients who received benefits in the form of complete dentures, removable partial dentures, and implants had similar sociodemographic characteristics in terms of sex, age, income quintile, and type of insurance coverage to the control group. The prevalence of hypertension, anemia, renal disease, rheumatoid arthritis, osteoporosis, asthma, and cerebral infarction was higher in the exposed group than in the control group (P<0.05). The prevalence of periodontal diseases and dental caries was also higher in the exposed group. Conclusions: Korean dental health insurance policy has been beneficial for the medical expenses of low-income and elderly people suffering from a cost burden due to systemic diseases. However, since there is a tendency to avoid invasive interventions in older patients due to the high risk of systemic diseases, insurance coverage of dentures may be more helpful from a socioeconomic perspective than coverage of dental implant treatments.

Research on National Korean Medicine Policy Priorities using Delphi-AHP : Focusing on the 4th Comprehensive Plan for Korean Medicine Development (델파이-AHP 기법을 사용한 국가한의약정책 우선순위에 관한 연구 - 제4차 한의약육성발전종합계획을 중심으로 -)

  • Yi, Eunhee;Kim, Dongsu;Park, Soo-Kyung
    • Journal of Society of Preventive Korean Medicine
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    • v.26 no.2
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    • pp.1-9
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    • 2022
  • Objectives : The purpose of this study is to identify priorities for the 4th Comprehensive Plan for Korean Medicine Development using Delphi and AHP techniques. Methods : This study uses Delphi-AHP method to first, select the target priority policy based on the policy content of the 4th Comprehensive Plan. In addition, two surveys on the priorities were conducted to reach consensus between experts. The main results of the first survey were also provided to experts participating in the second survey to help form expert consensus. Finally, the final policy priority was chosen based on the second survey result. Results : Survey results showed that of the 39 policies in the 4th Comprehensive Plan, "improve the accessibility of Korean medicines," was the most important goal. This was followed by "support for Korean medicine R&D from clinical research to industrialization," "provide foundation for a pilot project that provides customized medical services" and "strengthen the public medicine function of Korean medicine by expanding the its infrastructure in national and public hospitals." Conclusion : The results showed that capacity building of Korean medicine in primary care, improvement of the health insurance system, and research centered on industrialization are relatively more important goals, while the need to enhance global competitiveness was much less important. These key points can serve as a reference when formulating the 5th Comprehensive Plan for Korean Medicine Development in the future.

Effects of Emotional Labor, Communication Competency, Emotional Intelligence and Social Support on Burnout among Nurses in Outpatient Department (외래 간호사의 감정노동, 의사소통능력, 감성지능 및 사회적 지지가 소진에 미치는 영향)

  • Kim, Ji-Hye;Chang, Ae-Kyung
    • Journal of East-West Nursing Research
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    • v.28 no.2
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    • pp.179-189
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    • 2022
  • Purpose: Based on the results of Grandey's Emotion Regulation Process Model and previous studies, this study was conducted to identify the relationship between emotional labor, communication competency, emotional intelligence, social support, and burnout, and to identify factors affecting burnout of nurses in outpatient department. Method: The participants were 190 nurses with more than six months of experience working at the outpatient department of a general hospital in Seoul. Data were collected from April 5 to May 28, 2021, and analyzed using SPSS/WIN 25.0. Results: Significant variables affecting burnout were emotional labor, communication competency, emotional intelligence, education, and total clinical experience. Social support showed a statistically significant negative correlation with burnout, but did not affect burnout. Burnout showed a statistically significant a positive correlation with emotional labor, and showed a negative correlation with communication competency, emotional intelligence and social support. We found a negative correlation between burnout and subjective health status. Emotional labor had a positive effect on burnout. Emotional intelligence, clinical experience for more than 10 years, communication competency, and education for masters or higher negatively affected burnout, respectively. They accounted for 49.2% of the total variance of burnout. Conclusion: Based on the results of this study, it is necessary to reduce emotional labor, one of the major predictors of burnout for outpatient care. In order to prevent emotional labor that results in burnout, an integrated program that improves emotional intelligence and communication competency should be developed.

Improvement of Transfusion Practice in Cardiothoracic Surgery Through Implementing a Patient Blood Management Program

  • Hee Jung Kim;Hyeon Ju Shin;Suk Woo Lee;Seonyeong Heo;Seung Hyong Lee;Ji Eon Kim;Ho Sung Son;Jae Seung Jung
    • Journal of Chest Surgery
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    • v.57 no.4
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    • pp.390-398
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    • 2024
  • Background: In this study, we examined the impact of a patient blood management (PBM) program on red blood cell (RBC) transfusion practices in cardiothoracic surgery. Methods: The PBM program had 3 components: monitoring transfusions through an order communication system checklist, educating the medical team about PBM, and providing feedback to ordering physicians on the appropriateness of transfusion. The retrospective analysis examined changes in the hemoglobin levels triggering transfusion and the proportions of appropriate RBC transfusions before, during, and after PBM implementation. Further analysis was focused on patients undergoing cardiac surgery, with outcomes including 30-day mortality, durations of intensive care unit and hospital stays, and rates of pneumonia, sepsis, and wound complications. Results: The study included 2,802 patients admitted for cardiothoracic surgery. After the implementation of PBM, a significant decrease was observed in the hemoglobin threshold for RBC transfusion. This threshold dropped from 8.7 g/dL before PBM to 8.3 g/dL during the PBM education phase and 8.0 g/dL during the PBM feedback period. Additionally, the proportion of appropriate RBC transfusions increased markedly, from 23.9% before PBM to 34.9% and 58.2% during the education and feedback phases, respectively. Among the 381 patients who underwent cardiac surgery, a significant reduction was noted in the length of hospitalization over time (p<0.001). However, other clinical outcomes displayed no significant differences. Conclusion: PBM implementation effectively reduced the hemoglobin threshold for RBC transfusion and increased the rate of appropriate transfusion in cardiothoracic surgery. Although transfusion practices improved, clinical outcomes were comparable to those observed before PBM implementation.

Development of the Information Delivery System for the Home Nursing Service (가정간호사업 운용을 위한 정보전달체계 개발 I (가정간호 데이터베이스 구축과 뇌졸중 환자의 가정간호 전산개발))

  • Park, J.H;Kim, M.J;Hong, K.J;Han, K.J;Park, S.A;Yung, S.N;Lee, I.S;Joh, H.;Bang, K.S
    • Journal of Home Health Care Nursing
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    • v.4
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    • pp.5-22
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    • 1997
  • The purpose of the study was to development an information delivery system for the home nursing service, to demonstrate and to evaluate the efficiency of it. The period of research conduct was from September 1996 to August 31, 1997. At the 1st stage to achieve the purpose, Firstly Assessment tool for the patients with cerebral vascular disease who have the first priority of HNS among the patients with various health problems at home was developed through literature review. Secondly, after identification of patient nursing problem by the home care nurse with the assessment tool, the patient's classification system developed by Park (1988) that was 128 nursing activities under 6 categories was used to identify the home care nurse's activities of the patient with CAV at home. The research team had several workshops with 5 clinical nurse experts to refine it. At last 110 nursing activities under 11 categories for the patients with CVA were derived. At the second stage, algorithms were developed to connect 110 nursing activities with the patient nursing problems identified by assessment tool. The computerizing process of the algorithms is as follows: These algorithms are realized with the computer program by use of the software engineering technique. The development is made by the prototyping method, which is the requirement analysis of the software specifications. The basic features of the usability, compatibility, adaptability and maintainability are taken into consideration. Particular emphasis is given to the efficient construction of the database. To enhance the database efficiency and to establish the structural cohesion, the data field is categorized with the weight of relevance to the particular disease. This approach permits the easy adaptability when numerous diseases are applied in the future. In paralleled with this, the expandability and maintainability is stressed through out the program development, which leads to the modular concept. However since the disease to be applied is increased in number as the project progress and since they are interrelated and coupled each other, the expand ability as well as maintainability should be considered with a big priority. Furthermore, since the system is to be synthesized with other medical systems in the future, these properties are very important. The prototype developed in this project is to be evaluated through the stage of system testing. There are various evaluation metrics such as cohesion, coupling and adaptability so on. But unfortunately, direct measurement of these metrics are very difficult, and accordingly, analytical and quantitative evaluations are almost impossible. Therefore, instead of the analytical evaluation, the experimental evaluation is to be applied through the test run by various users. This system testing will provide the viewpoint analysis of the user's level, and the detail and additional requirement specifications arising from user's real situation will be feedback into the system modeling. Also. the degree of freedom of the input and output will be improved, and the hardware limitation will be investigated. Upon the refining, the prototype system will be used as a design template. and will be used to develop the more extensive system. In detail. the relevant modules will be developed for the various diseases, and the module will be integrated by the macroscopic design process focusing on the inter modularity, generality of the database. and compatibility with other systems. The Home care Evaluation System is comprised of three main modules of : (1) General information on a patient, (2) General health status of a patient, and (3) Cerebrovascular disease patient. The general health status module has five sub modules of physical measurement, vitality, nursing, pharmaceutical description and emotional/cognition ability. The CVA patient module is divided into ten sub modules such as subjective sense, consciousness, memory and language pattern so on. The typical sub modules are described in appendix 3.

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Task Analysis of Paramedics of Korea Based on DACUM Method (DACUM 기법에 의한 1급 응급구조사의 직무분석)

  • Bae, Ki-Sook;Koh, Bong-Yeun;Lee, Jung-Eun;Lee, In-Mo;Choi, Keun-Myoung;Kim, Soo-Tae
    • The Korean Journal of Emergency Medical Services
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    • v.15 no.1
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    • pp.5-23
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    • 2011
  • Objective : This study grasps specific task on paramedics who plays a great role in the emergency scene, thereby eliciting definition of job called paramedics and analyzing occupation by DACUM method. Thus, the aim is to suggest working-level guidelines on the task of paramedics. Methods : It targeted paramedics who are working at hospitals, fire stations, and industries in Seoul and Gyeonggi area from Oct. 11, 2010 to Nov. 30. A total of 608 copies of questionnaire were analyzed by DACUM method. A research tool on occupational analysis consisted of 8 pieces for duty, 43 pieces for task, and 149 pieces for task elements. In order to survey performance frequency, importance, and difficulty by element, each task was developed by this research team, and each task was analyzed and finally elicited through workshop of DACUM method. Results : The occupational definition of paramedics, which was defined through this DACUM, was elicited as 'professional job of performing emergency medical care on the scene, during transferring, or within medical institution in order to maintain life and prevent wound deterioration, targeting a person who is put in emergency situation.' Task element, whose performance frequency was indicated to be the highest, was in order of checking mental status($2.76{\pm}0.497$), checking vital signs($2.70{\pm}0.578$), and airway/c-spine immobilization($2.69{\pm}.546$). Especially, defibrillation stood at $2.23{\pm}.655$ points. Task element, whose performance frequency was low, was in order of caring sexual abuse victims($1.32{\pm}0.563$), performing cricothyrotomy($1.36{\pm}0.618$), and caring cardiac arrest victims($1.40{\pm}0.636$). Importance of task was in order of airway/c-spine immobilization ($2.88{\pm}0.338$), maintenance of respiration($2.88{\pm}0.351$), caring cardiac arrest victims($2.87{\pm}0.349$), and performing CPR($2.87{\pm}0.361$). Task element, whose importance is low, was indicated to be in order of enema($2.29{\pm}0.736$), urinary catheterization($2.35{\pm}0.664$), and nasogastric intubation($2.35{\pm}0.667$). Task element, whose difficulty was shown to be the highest, was indicated to be in order of caring cardiac arrest victims during pregnancy ($2.60{\pm}0.559$), caring cardiovascular injury($2.59{\pm}0.546$), and labor management($2.53{\pm}0.533$). Conclusion : Based on the results of this study, the job performance work table(Dacom chart) of paramedics is suggested to be used, thereby being applied to development in education and curriculum of paramedics. It is necessary to evaluate usefulness of the job performance work table by estimating effect of education for paramedics based on the job performance work table of paramedics.