The Journal of Korean Academic Society of Nursing Education
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v.4
no.1
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pp.107-119
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1998
This study tried to answer the question : 'How does the human communication happen at the oriental medicine hospital between nurse and patient?' To answer that, a micro-ethnographic research method was used. Researcher visited T university hospital of oriental medicine and observed nurse-patient communication from September 1997 to December 1997. The data was obtained through participant observation, interview, audio-tape recording, home video camera, field note-taking, and related documents. After reviewing the whole data and deliberate analysis, first, I learned that most oriental medicine nurses communicate with their patients for their routine nursing job like recording, hand-over to the next duty, report to doctor, etc. I named this type of communication as 'ritual communication'. Second, I can define major argument as follow : Human communication of oriental medicine between nurse and patient is performed more frequently and variously when nurse contacts the patient for the routine nursing activities than for the incidental activities. As a result of these understandings, I suggest that oriental nursing need to develop the body of knowledge and expand its role and independent nursing activity. Also the bureaucratic hospital management centered doctors must be changed reasonalbly.
Kim, Doehyung;Kim, Min-Jeong;Lee, Haeyoung;Kim, Hyunseuk;Kim, Youngmi;Lee, Sang-Shin
Korean Journal of Psychosomatic Medicine
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v.29
no.1
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pp.49-57
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2021
Objectives : This study evaluated the medical communication skills of trainee doctors and analyzed the relationship between medical communication skills, self-efficacy on clinical performance (SECP) and empathy. Methods : A total of 106 trainee doctors from a university hospital participated. The questionnaire comprised self-evaluated medical communication skills, modified SECP and the Korean version of the Jefferson Scale of Empathy-Health Professionals version. The mean difference in medical communication skills scores according to gender, age, division (intern, internal medicine group or surgery group) and position (intern, first-/second- and third-/fourth-year residents) were analyzed. Pearson correlation coefficients were determined between medical communication skills, modified SECP and empathy. The effects of each variable on medical communication skills were verified using the structural equation model. Results : There were no statistically significant mean differences in self-evaluated medical communication skills according to gender, age, division or position. Medical communication skills had a significant positive correlation with modified SECP (r=0.782, p<0.001) and empathy (r=0.210, p=0.038). Empathy had a direct effect on modified SECP (β=0.30, p<0.01) and modified SECP had a direct effect on medical communication skills (β=0.80, p<0.001). Empathy indirectly influenced medical communication skills, mediating modified SECP (β=0.26, p<0.05). Conclusions : Medical communication skills are an important core curriculum of residency programs, as they have a direct correlation with SECP, which is needed for successful treatment. Moreover, the medical communication needs a new understanding that is out of empathy.
One way for phatic communication to be linguistically realized involves ritual activities, such as greetings and leave-takings. These conventionalized acts in medical contexts can significantly influence both transactional and interpersonal goals. The analysis in this paper confirms that exchanging rituals such as greeting and leave-taking between doctors and patients is not a simple exchange of conventionalized linguistic symbols. In addition, the use of discursive strategies means that to determine whether an expression is phatic or not, it is necessary to analyze it from the multidimensional perspective. The phaticity is established based on the negotiation between the participants during the interaction. We have found that the interrogative form of greeting like "¿Qué tal?" (How are you?) becomes a versatile resource in the medical context. Thus, professionals need to be attentive to the discourse progress, because the phaticity of the interrogative greetings (illocutionary force) is linked, in the vast majority, with the reaction of the patients. Also, the data confirms that when participants coordinate closings, the exchange of turns lengthens and the intervention of various discursive strategies for phatic communion becomes more prominent.
Purpose: We undertook this study to find out the recognitions of terminal cancer patients and doctors about advance directives (ADs), of how they would do in non-response medical conditions and whether ADs could be one of medical options for their dying with dignity. Methods: One hundred thirty four cancer patients in the Hospice Unit, St. Vincent's Hospital, and 97 medical doctors in the Department of Internal Medicine, Catholic Medical Center, were asked about ADs, including Do-Not-Resuscitate (DNR), medical power of attorney, living will and medical options. Results: One hundred thirty patients (97%) and 38 doctors (39.2%) were unfamiliar with ADs, however, 128 patients (95.5%), 95 doctors (97.9%) agreed with it. Seventy nine patients (59.0%) and 96 doctors (99.0%) wanted DNR rather then intensive treatments if they were in non-response medical conditions. Eighty four patients (62.7%) and 75 doctors (77.3%) were agreeable to medical power of attorney. One hundred Thirty four patients (100.0%) and 94 doctors (96.9%) did not want medical options to be in terminal conditions, and hoped to die in peace. Conclusion: Most of patients did not know about ADs and how to make it. However, they showed positive attitudes about it. If we advertise it properly, it is highly likely that a large number of cancer patients would make their living wills easily by ADs. Nevertheless, many legal and ethical problems have to be solved. Doctors should engage their patients in an ongoing communication about the end-of-life. Therefore, let the patients have opportunities to plan their own deaths.
Objectives: The purpose of this study was to develop a competency model for the Korean medicine doctors and find application plans for the future education in Korean medicine. Methods: Based on literature review, we drafted a competency model framework for modeling and defined competencies using generic model overlay method. Also we conducted a FGI with 20 extension specialists in Korean medicine to validate competency model. Results: Findings are 5 domains and 15 competencies. 5 domains have optimal patient care, reasonable communication skill, professionalism enhancement, performing social accountability, and efficient clinical management. 3 competencies are included in 5 domains each. With this model, 4 ways of application plans are shown to apply for the future competency-based education in Korean medicine. Conclusion: Developed 2016 competency model for the Korean medicine doctors can be a first huge step to innovate education in Korean medicine toward competency-based educational system.
Kim, Kyung Ho;Park, Ji Ho;Park, Young Sik;Hwang, Yu Min;Kim, Jin Young
Journal of Satellite, Information and Communications
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v.9
no.2
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pp.80-84
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2014
As an integrated technology with IT and biomedical sciences, U-health offers various healthcare services without time and space limit. In order to make a proper diagnosis, doctors need two key technologies: biosignal measurement and high reliability communication technologies. In this paper, we introduce an implementation process of a bio signal system with using an electrocardiography(ECG) sensor, video, global positioning system(GPS), communication module and micro controller unit(MCU).
The purpose of this study is to find out the successful way of the hospital management focusing on the OCS. More than 40 educational hospitals have OCS. However, only five of them were chosen for the research. Questionnaires are collected from more than 750 persons working in five educational hospitals and some of them were interviewed. The major conclusions of the study can be summarized as follows: o The OCS has simplified the treatment procedure for outpatients, and the outpatients' waiting time has been shortened. o Higher rate of satisfaction was found among the personnel in general. o The number of patients who visited outpatients clinics has increased, so as the hospital profits: the personnel are rescheduled or sent to other departments the number of employees in hospitals have decreased. o The system has the positive effect on large hospitals with over 1000 beds, highly invested hospitals, well computerized hospitals and where the personnel are much interested in the system. o The managers' and the doctors' intention to utilize the OCS is the most important factor influencing the patients' convenience, the simplification of the work and the rate of the employees' satisfaction about their duties. The suggestions for more efficient hospital management through the OCS are as follows ; o The managers and the doctors are need to decide to make active use of the OCS. o The hospital can be run more effective under the clear management purpose. o The work in the hospital must be standardized based on patients' needs. o The OCS must be built and developed mainly for the users' utility. o The education of the personnel and the inspection of the program are necessary before the OCS is introduced. o The hardware should be thoroughly benchmarked before the purchase.
Journal of the Korea Academia-Industrial cooperation Society
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v.13
no.6
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pp.2607-2616
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2012
This study was designed to figure out patient safety culture of medical institutions and try to utilize the study results as basic data for analyzing doctor's awareness of patient safety culture. To this end, questionnaire survey was conducted from August 1st to September 5th, 2011, targeting doctors working at senior general hospitals located in G city, and 194 questionnaires were utilized for final analysis. The research results are as follows. First, there was a difference in awareness of deployment of staffs depending on gender, age, term of service in the hospital, contact with patients and working hours per week in relationship between subjects, wards and hospital safety culture, and organizational learning and teamwork in the ward turned out to be significant in accordance with working hours per week, and all sub-areas of the ward safety culture by departments. Second, feedback about the malpractice, communication, report on malpractice frequency and overall safety awareness were found to be significant by departments in relationship of subjects, medical incident reporting system, patient safety evaluation and overall level of consciousness, and the overall safety awareness showed significant results according to contact with patients and working hours per week. Third, there was a positive corelation in sub-areas of the ward and hospital safety culture awareness, overall recognition and patient safety evaluation, and a positive corelation with medical incident reporting system was found in all areas except for attitude of managers/immediate supervisors and that of hospital executives. Fourth, sub-areas of patient safety culture which has a effect on patient safety showed significant results in organizational learning, openness of communication, overall safety awareness, systematic cooperation between departments, feedback/communication and non-punitive response. In conclusion, to increase the level of the ward and hospital patient safety culture of doctors and implement medical incident reporting system faithfully, it is necessary to activate teamwork through organizational learning in the ward based on the adequate staffing and working hours, promote open communication between departments and provide feedback on medical malpractice, thereby establishing a cooperative system by departments and active support of hospital executives for patient safet.
DUR (Drug Utilization Review) originally referred to the evaluation of drug usage details: however DUR refers to the system used to support the services of prescribing and dispensing through linking from Health Insurance Review and Assessment (HIRA) Service in Korea. HIRA is going to begin the DUR enforcement for extending to nationwide coverage after pilot test. Objectives: The aims for this study were to evaluate and clarify the current opinions of the pharmacists for the recognition and acceptance rates before nationwide coverage concerning DUR system. Methods: A 16-question-questionnaire was developed and pilot tested. For 40 days of survey by both on-line and fax paper, it was carried out on 80 pharmacists working at community pharmacy in Goyang-si, Gyeonggi-do. Results: Most of answers were broadly positive and interested in begining the DUR system and kept in mind that the goal of DUR is safety guarantee for people. On the other hand, most of answerers worry that delay of patient waiting time and inharmonious communication with doctors in DUR processing can be a major obstacle to begin the DUR system. Conclusion: To solve several problems, the most important things are to make good reciprocal relationships between doctors and pharmacists, investigate intervention tool to shorten patient waiting time, and activate educational program of inspecting items for the pharmacists.
The purpose of this study is to ascertain whether the effect of introduction of OCS(Order Communication System) to the hospital is satisfied or not comparing the anticipated effect with the actual effect. For this purpose, a domestic hospital which has introduced and has been operating OCS for several years was chosen. Based on the internal data of S Hospital prepared before introducing OCS, researcher has analyzed the basic direction, design standard and status of operation after the introduction of OCS, etc. After analyzing the status of operations of several departments using OCS and interviewing with the chiefs of pertinent departments, a survey form was designed. Actual survey and interviews were conducted by the researcher for weeks to know whether doctors, nurses, medical technicians and clerks of the patient management dept. were satisfied with OCS and to find if they have any recommendations to improve OCS. Based on the analysis of survey, the effect of OCS was evaluated whether it has satisfied the anticipated effectiveness. For the question if they feel convenient in using OCS, doctors, nursing staffs in charge of ward and the staffs of billing dept. has answered that they were all satisfied(100%). The answers for the same question were relatively high in the case of nurses in charge of outpatient and staffs of radiography. Of course, there have been some nurses and staffs who complained for the inconvenience. However, overall satisfaction was high on the average. Some common problems occurred after the introduction of OCS were frequent errors due to instability of OCS system, paralysis of function of hardware on data back-up system and redundant investment due to erroneous choice of DB program in setting DB. It was also pointed out that lack of computer education and low participation of medical staffs has resulted in failure of developing effective software. As a result, it has lowered the efficiency of OCS. For example, some works have to be done by hands even after OCS. Based on the result of this research, recommendations to maximize the effect of OCS were presented as follows. First, strong leadership of CEO and active cooperation of doctors are mandatory. Second, all the process of hospital work should be analyzed and be redesigned in more efficient ways. Third, OCS should be designed to be user-based system which can be used efficiently by all staffs of the hospital. Forth, prior to the operation of OCS, proper tests of the program and trainings of the pertinent staff are required. Fifth, prior to the selection of hardware, BMT(Bench Marking Test) should be conducted. Sixth, before introducing OCS, staffs in charge of OCS should visit many hospitals operating the OCS system and take their cases into account.
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