Purpose: Physician's occupational burnout has been a very important issue that can cause negative consequences not only for individual's physical and mental health, but also for patient's health and the overall national healthcare system. For the reason, this study confirmed how consultation length and the number of outpatients affect physician's occupational burnout in the medical environment. Methodology: In the study, the data of '2020 Korean Physician Survey' conducted by Korean Medical Association(KMA) was used for the analysis, and a total of 4,215 physicians were selected as study samples. The differences in the degree of occupational burnout according to the physicians' general characteristics were confirmed through uni-variate analysis, and also a regression analysis was conducted to confirm the effects of consultation length and the number of outpatients on physician's occupational burnout. Findings: As a result. the overall degree of physician's occupational burnout decreased(𝛽=-0.051, p<0.01) as the consultation length increased. Specifically, the physician's emotional exhaustion increased(𝛽=0.051, p<0.01), while the reduction of accomplishment decreased(𝛽=-0.131, p<0.001). Furthermore, the overall occupational burnout decreased(𝛽=-0.047, p<0.01) as a proportion of advice and education during the consultation increased, and it had an effect on the decrease in depersonalization(𝛽=-0.045, p<0.01) and the reduction of accomplishment(𝛽=-0.065, p<0.001). At last, as the number of outpatients increased, the overall occupational burnout increased(𝛽=0.041, p<0.05) with more emotional exhaustion(𝛽=0.095, p<0.001), depersonalization(𝛽=0.065, p<0.001), and less reduction of personal achievement(𝛽=-0.081, p<0.001). Practical implication: Consequently, it is necessary to prevent physician's occupational burnout by ensuring sufficient consultation length and providing a medical environment to treat an appropriate number of patients. Therefore, national policies should expand health insurance coverage and compensate medical fees for sufficient consultation length that both patients and physicians can satisfy. It will ultimately contribute to ensuring the patients' health and improving the quality of national healthcare services.
All pharmacists must provide the drug consultation whenever dispense drugs to patients by the Korean Pharmacy Law. Drug consultation is very important procedure for increasing pharmacotherapy. Because it maximizes the therapeutic effects or/and minimizes adverse drug reaction during the drug therapy. However, it is not easy to do because of the dynamic and hectic pharmacy environment. Especially, if someone has a disabling body function, they required more time and efforts to perform consultation by pharmacist. Currently several auxiliary labels for helping drug consultation are using in pharmacy practice but not for disabling patients. Therefore we developed the total 53 auxiliary labels with size of 0.7 cm (width) and 1 cm (length) by Braillewriter letters for blind patients. This research has been performed for total 12 months (Mar. 15ts, 2007$\sim$Feb. 25th, 2008) and the developing methods are consisted of 4 steps: 1) selection of essential informations, 2) simplification of information, 3) changing for Braillewriter letters, 4) application and revising by blindness patients. Also the labels are consisted of 12 for adverse reactions and precautions, 8 for directions, 2 for storages, 9 for duration, 9 for dosage forms, and 12 for common names. After developed those labels, we revised those labels by discussion with 2 blind people. In conclusion, the new auxiliary labels for blind patients can increase therapeutic effects and decrease risks from pharmacotherapy besides decreasing of pharmacist's work load in the future.
This study action drama TV drama 'Ya-ha'(夜叉) the actual work practices of the pre-consultation stage through the Writers, Producer, Art directors and in consultation with the opinion of the character set the record of the contents and character changes over time in accordance with characters makeup the design elements were analyzed. The methods of study was used local and abroad related books, studies, publications and cases and the subjects were limited to be four male make up characters in drama 'Ya-cha'. As a result, TV action drama 'Ya-cha' make up design elements and representation techniques were classified as description of skin tone, wound, the shape of eyebrows, hair type, shape of beard and materials and carried out an important role in the character representation. First, presentation techniques changed skin tones depending on character and position and described wound shape as expression technique and materials were analyzed. Second, the shape of eyebrows was based on the physiognomy of the form. And hair type changed volume, thickness, length and texture depending on character. Third, shape of beard is expressed different kinds of volume, thickness, length and texture depending on character. There fore, that systematization of the make-up design elements is useful to express stable characters and make drama for make up in various image genres.
Park, Ji-Min;Yoon, Young-Hoon;Horeczko, Timothy;Kaji, Amy Hideko;Lewis, Roger J
Journal of Trauma and Injury
/
v.30
no.2
/
pp.25-32
/
2017
Purpose: The use of computed tomography (CT) to evaluate acute abdominal complaints has increased over the past two decades. We investigated how the clinical practice of patients with intestinal perforation has changed with the increasing use of abdominal CT in the emergency department (ED). Methods: We compared ED arrival to CT time, ED arrival to surgical consultation time, and ED arrival to operation time according to the method of diagnosis from 2003-2004 and 2013-2014. Results: In patients with gastrointestinal perforation, time from ED arrival to CT was shorter ($111.4{\pm}66.2min$ vs. $199.0{\pm}97.5min$, p=0.001) but time to surgical consultation was longer ($135.1{\pm}78.8$ vs. $77.9{\pm}123.7$, p=0.006) in 2013-2014 than in 2003-2004. There was no statistically significant difference in time to operation for perforation confirmed either by plain film or CT between the two time periods. There was no statistically significant difference in length of hospital or ICU stay or mortality between the two groups. Conclusion: With the increasing use of abdominal CT in ED, ED arrival to CT time has decreased and ED arrival to surgical consultation time has increased in gastrointestinal perforation. These changes of clinical performance do not delay ED arrival to operation time or adversely influence patient outcome.
Kim, Hyon-Chul;Lee, Sang-Chul;Kim, Do-Hoon;Lee, Sang-Kyu;Hong, Seung-Gwan;Son, Bong-Ki
Korean Journal of Psychosomatic Medicine
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v.12
no.1
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pp.15-22
/
2004
Objectives: Delirium after head trauma results in various cognitive and behavioral dysfunction. This study aimed at developing and validating a predicitive model for clinical improvement after delirium based on precipitating factors during hospitalization Method: Data were collected on 45 patients who developed delirium after head trauma using 5 year retrospective design, based on reviews of medical charts including psychiatric consultation reports. The differences of the group who sustained residual symptoms of delirium(The RS group) and the group of full recovery(The FR group) at 4 week follow-up visits were compared by motoric type of delirium, socio-demographic variables, neuroimaging variables and clinical variables of interest. Result: There was significant difference in reason for initial consultation between two groups, in terms of hyperactivity(p<.01). The presence of compensation claim, subcortical gray matter lesion was significantly associated with the RS group(p<.05). Total length of intensive care unit(ICU) admission and of hospital stay were significantly longer in RS group than FR group(p<.01). Conclusion: This study shows that hyperactivity on initial consultation, compensation claims, specific brain lesion were altogether significant factors in explaining prolonged duration of delirium after head trauma. A simple predictive model based on the presence of precipitating factors might be used to identify delirious patients at high risk for prolonged cognitive dysfunction. Early psychiatric intervention would be required for evaluating efficacious management and shortening admission period.
Journal of Korean Academy of Fundamentals of Nursing
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v.4
no.2
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pp.245-265
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1997
The purpose of this study was to promote the effectiveness in managing disease or injury, by examining the length of stay in hospital according to characteristics concerned before and after operation, and by serving as a basis for reducing that length. As a result of investigating the length of stay in hospital according to inpatient's personal characteristics, clinical features and other characteristics concerned, the following characteristics appeared significant. The characteristics that showed a significant difference about the length of stay in hospital before and after operation were the age and the fact whether one was married or not among inpatient's personal characteristics. The significant ones among clinical features were the route to be taken to hospital, the form of insurance, the experience of re-hospitalization, whether another disease coexisted, the experiment of changing department, whether a diagnosis was determined by consultation, whether an intensive care unit was used, whether re-operation was performed, the total number of case of the experience of re-hospitalization, inpatient who were again sent to hospital under the same diagnosis was not included in the investigation, which was pointed out as a limit in this study. The significant ones among other characteristics concerned were the date and season when the patients were taken to hospital and the doctor in attendance. The doctor in attendance appeared to give a significant impact on the length of stay in hospital before operation, but no significant difference was noted in the mean among the doctors in attendance. And those characteristics were not found regularly among the selected departments. As stated above, one way to reduce the length of stay In hospital was to diminish the length of stay in hospital before operation. The term of hospitalization before operation shall be reduced by grasping the factors that affected that length before operation and by conducting examination as many as possible in the out-patient department. Also, the efforts should be put on that length after operation. The management of hospital seemed to be successfully carried out if those factors affected that length were effectively controlled.
Dental surgical procedures are potentially stress-inducing to not only patients but clinicians especially in case of medically compromised patients. The body response to dental stress involves the cardiovascular, respiratory and the endocrine system. To minimize the stress to the medically compromised patients, the stress reduction protocols should be established. The protocols include (1) Recognize the patient's degree of medical risk (2) Medical consultation before dental therapy (3) Schedule the patient's appointment in the morning (4) Monitor and record preoperative, perioperative and postoperative vital signs (5) Intra-venous sedation during surgical procedures (6) Adequate pain control during therapy (7) Short length of appointment time (8) Contact the patients on the same day. Two cases of Bisphosphonate-related osteonecrosis of the jaws were analyzed. There were 2 women, and the mean age was 70 years (range, 64~74 years). both are medically compromised, with steroids. Both patients were taking an oral bisphosphonate for several years. BRONJ is defined as an area of exposed bone of more than 8 weeks - duration in a patient taking a bisphosphonate for bone disease. Bisphosphonates have been widely prescribed over the last decade for a range of bone diseases, mainly intravenously for bone cancers and orally for osteoporosis. Although it is still controversial as to precisely how the bisphosphonates work, generally it is accepted that they prevent osteoclast action, with consequent cessation of osteoblast activity, so that the bone turnover is markedly reduced or ceased. The aim of this study is to informed the clinicians how to prepare and recognize in case of the BRONJ with medically compromised patients.
Pregnancy and puerperium are associated with significant changes in pschological and physiologic health status. Back and pelvic pain is common in pregnancy with prevalence figures in the range of $48\%-90\%$. The pain starts during pregnancy and often disappears soon after childbirth. But the prevalence of such pain four to six months post postpartum is report to be $25-40\%$. In $10-15\%$ of the case the pain become chronics, that is persisting for more than three months after childbirth. Low back pain and pelvic pain maybe caused by several factors related to changes that occur naturally during pregnancy. Changes in the center of gravity can create a strain on weight-bearing structures in bone. Pregnancy related hormones, relaxin, create general laxity of collagenous tissue. Another factor found to be a possible primary or contributing cause for law back and hip symptoms are leg length inequality, weight gain and changes in foot function. This article outlines the physiological and biomechanical changes that occur during pregnancy which have been reported to be possible causes of low back and pelvic pain And then, examination, diagnosis, evaluation and treatment of the woman during pregnancy are described. Standard treatment for low back pain and pelvic pain in pregnancy includes education in anatomy and kinesiology, back-strengthening exercise, training of the abdominal muscles and body posture correction. So, most woman during pregnancy require individual consultation and physiotherapist.
Journal of the Korean Society for Library and Information Science
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v.45
no.1
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pp.51-73
/
2011
The purpose of this study is to improve the evaluation system of school libraries in Korea. Major issues to improve the evaluation system were identified through school library evaluations and an analysis of the existing evaluation system of the Committee on Library and Information Policy. The issues include evaluation organizations, purposes of evaluation, selection of objects, evaluation period length, systems of evaluation, and ways to receive results. Alternatives for improving the evaluation system were selected through surveys and professional consultation. Finally this study proposed a more effective evaluation system which emphasizes the self-regulation and responsibility of provincial education offices in Korea.
Han, Eunah;Hwang, Hyuna;Yu, Gina;Ko, Dong Ryul;Kong, Taeyoung;You, Je Sung;Choa, Minhong;Chung, Sung Phil
Journal of The Korean Society of Clinical Toxicology
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v.19
no.1
/
pp.1-7
/
2021
Purpose: The purpose of this study was to conduct a systematic review to investigate the socio-economic benefits of the poison control center (PCC) and to assess whether telephone counseling at the poison control center affects the frequency of emergency room visits, hospitalization, and length of stay of patients with acute poisoning. Methods: The authors conducted a medical literature search of the PubMed, EMBASE, and Cochrane Library databases. Two reviewers evaluated the abstracts for eligibility, extracted the data, and assessed the study quality using a standardized tool. Key results such as the cost-benefit ratio, hospital stay days, unnecessary emergency room visits or hospitalizations, and reduced hospital charges were extracted from the studies. When meta-analysis was possible, it was performed using RevMan software (RevMan version 5.4). Results: Among 299 non-duplicated studies, 19 were relevant to the study questions. The cost-benefit ratios of PCC showed a wide range from 0.76 to 36 (average 6.8) according to the level of the medical expense of each country and whether the study included intentional poisoning. PCC reduced unnecessary visits to healthcare facilities. PCC consultation shortened the length of hospital stay by 1.82 (95% CI, 1.07-2.57) days. Conclusion: The systematic review and meta-analysis support the hypothesis that the PCC operation is cost-beneficial. However, when implementing the PCC concept in Korea in the future, it is necessary to prepare an institutional framework to ensure a costeffective model.
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