• Journal of Korean Academy of Nursing
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• v.42 no.4
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• pp.453-465
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• 2012

Purpose: The study was done to develop a shared decision-making scale for end-of-life patients in Korea. Methods: The process included construction of a conceptual framework, generation of initial items, verification of content validity, selection of secondary items, preliminary study, and extraction of final items. The participants were 388 adults who lived in one of 3 Korean metropolitan cities: Seoul, Daegu, or Busan. Item analysis, factor analysis, criterion related validity, and internal consistency were used to analyze the data. Data collection was done from July to October 2011. Results: Thirty-four items were selected for the final scale, and categorized into 7 factors explaining 61.9% of the total variance. The factors were labeled as sharing information (9 items), constructing system (7 items), explanation as a duty (5 items), autonomy (4 items), capturing time (3 items), participation of family (3 items), and human respect (3 items). The scores for the scale were significantly correlated among shared decision-making scale, terminating life support scale, and dignified dying scale. Cronbach's alpha coefficient for the 34 items was .94. Conclusion: The above findings indicate that the shared decision-making scale has a good validity and reliability when used for end-of-life patients in Korea.

• Journal of Korean Clinical Nursing Research
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• v.14 no.2
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• pp.59-70
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• 2008

Purpose: Purposes of this study were to promote understanding on mutually informed consent by comparing and analyzing the perception and experience of informed consent among physicians, nurses, and patients. Method: Participants in the study were 145 physicians, 300 nurses, and 178 patients from eight hospitals in Busan. To examine their understanding and experience with informed consent, all participants responded to a questionnaire. The collected data were analyzed using SPSS/PC 12.0 program. Results: On the necessity of informed consent, the affirmative percentages were 95.9% for physicians, 99.0% for nurses and 84.8% for patients. As to the most important reason for informed consent 47.6% of the physicians and 64.3% of the nurses answered 'because it is an occupational and ethical duty', while 46.6% of the patients answered 'because it is protection for physicians'. Regarding the legal decision maker for informed consent, 33.1% of the physicians, 27% of the nurses, and 42.1% of the patients answered that the legal decision-making right belonged to the 'patient'. The agreement rate on the necessity of providing a comprehensive explanation about informed consent was 89.0% for physicians, 98.3% for nurses, and 96.1% for patients. Conclusion: Most physicians, nurses, and even patients have inaccurate perceptions and inappropriate experience with informed consent.

• The Korean Journal of Health Service Management
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• v.7 no.4
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• pp.243-257
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• 2013

This study was conducted in order to survey in healthcare worker's recognition of diagnosis related group(below; DRG) effect from July 1, 2012, to examine their recognition, expectation of the DRG system, and to provide the basic data necessary for the enforcement of the settlement. The subjects of this study were workers at clinics and hospitals sampled from hospital with DRG applying 7 diseases in Busan and Kyung-nam. A questionnaire of survey was conducted with the subjects working at clinics and hospitals from July, 25, 2012 to September 7, 2012, and the subjects were limited to doctors, officers, nurses, medical technicians and nurse assistants, and a total of 618 subjects were enrolled in this study. In the result of this study, generally, the healthcare workers recognized the DRG system. But their knowledge about that was not clear. Expanding enforcement DRG system at the present time, to provide accurate information to the healthcare consumer, workers need to know about DRG system clearly. To this end, for national health policy and medical institutions, workers should be educated constantly about providing medical service as well as the duty of enough explanation about the healthcare consumer's right to know.

• The Korean Society of Law and Medicine
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• v.19 no.1
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• pp.207-254
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• 2018

The major court rulings delivered in 2017 include the ruling that separated the legal character of denture production agreement signed together with medical care agreement and found a subcontracting dimension in the former, and the ruling that overcame the limitations of the theory of entire appearance of a fetus as discussed in civil law by using the legal principle of insurance which suggests that unborn child insurance takes effect after the contract is signed and the first installment of the premium is paid in. As more court rulings find the medical specialists responsible for accidents and injuries from drugs, some argue that medication counseling by the druggist who makes and dispenses drugs should be upgraded. And with respect to a court ruling that denied the hospital's responsibility for an infection-involving accident even if there were no records on specific measures taken in infection management, some criticized the court for being too conservative in recognizing responsibilities. And with respect to infectious disease management, some criticized the court for its interpretation and application of the facts in the direction of denying the negligence. In addition, some claimed that it is necessary to establish institutional system for hospital infection control and its aid for victims, and to improve the system including the reversal of the burden of proof given the special nature of hospital infections. A number of rulings on the duty to disclose included the one which stated that the specific matter did not require a doctor's explanation as it was explained or the specific medical service would have been performed even if no explanation had been given. There was a greatly controversial ruling over the scope of indemnification, which accepted the occurrence of multiple scars and deformation as disorders while regarding breast as a thoracic organ. And a Supreme Court ruling over interpreting Medical Service Act was criticized as overstepping the boundary allowed in the law.

• The Korean Journal of Emergency Medical Services
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• v.13 no.1
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• pp.19-33
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• 2009

Purpose : To check the legal relation between rescue team and patient as well as legal responsibility for patient's damage intentionally or erroneously caused by rescue member, a public official, in the performance of relevant job ; to prevent legal dispute over rescue team and to present program for fair settlement of dispute and equitable and feasible burden of damage. Method : First, the legal principle of Civil Law, Criminal Law and Administrative Law related to the theme of this research will be investigated around research by literature. Second, the case of dispute related to rescue team will be introduced. Result: 1. If 119 rescue members as a public official intentionally or erroneously cause damage to patient in the performance of job, they shall bear civil, criminal and administrative responsibility. They shall bear civil responsibility for indemnity for damage due to default or tort. The typical criminal responsibility includes accidental homicide arising out of duty, preparing falsified official document, dereliction of duty, etc. In the administrative side, the state is responsible for indemnity for peculiar status of the rescue member, public official. 2. Though raising civil petition or legal dispute over unsatisfactory rescue service may be reasonable to guarantee the right of nation, such action may cause stress to rescue member as well as may lead to mental shrinking and defensive attitude only to take the basic first aid treatment which has low possibility of mistake instead of active first aid treatment so as to avoid legal responsibility. 3. The program that may prevent legal dispute over 119 rescue team includes expansion of manpower specialized in first aid treatment, enhancement of education on legal environment, development and application of standard job guideline, formation of mutual trust with patient, detailed explanation, preparing and keeping minute record, improvement of the rescue members' ability of first aid treatment and development of medical instruction mode. Conclusion : The best policy is to prevent legal dispute. If it is impossible to basically exclude the possibility of dispute, however, we need to make effort to minimize the occurrence, settle fairly and divide damage equitably and feasibly. To improve the preventible death rate of our first aid system to the level of advanced country, 119 rescue team which is in charge of the stage before hospital needs to positively enforce special first aid by improving the qualitative level of rescue service and to strive to prevent legal dispute that may occur in the process.

• Quality Improvement in Health Care
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• v.5 no.2
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• pp.176-189
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• 1998

This study was conducted to evaluate the subjective ideas about the determinants of quality in ambulatory care unit among outpatients and medical staff of a university hospital, and to compare the differences of the ideas, between patients themselves and hospital staff. A self-administered questionnaire survey was conducted covering 799 outpatients and 190 hospital staff in March, 1998. The questionnaire included general characteristics and 26 determinants of ambulatory care quality. The following are summaries of the findings: 1. Both of outpatients and hospital staff perceived, "Physician's knowledge" as the most important determinant of medical care quality. 2. In respect of 7 determinants related to physician's knowledge and skill, both outpatients and hospital staff perceived "physician's knowledge and skill" as important determinants. The scores of determinants such as, "Not doing unnecessary examinations", and "Assignment of adequate number of patients and duty schedule for the physician" were significantly different between outpatients and hospital staff. 3. In respect of 4 determinants related to doctor-patient relationship, both outpatients and hospital staff perceived "attention to patient's complaints" as the most important determinant. The scores related to the determinants such as "kindness of physician" and "explanation of treatment outcome" were significantly different between outpatients and hospital staff. 4. Among the amenities related determinants, "Modern facilities and equipments" were perceived as the most important determinant in both group. 5. In respect of 8 determinants related to non-financial accommodation, outpatients perceived, "Waiting hours for treatment" as the most important determinant, and hospital staff perceived, "Kindness of hospital staff". 6. In respect of 4 determinants related to financial accommodation, outpatients perceived, "Fare account of medical cost" as the most important determinant, and hospital staff perceived, "Increasing reimbursements". Further comprehensive research should be made on the evaluation of perceptions of medical care quality, both of outpatient and inpatient care, among patients and hospital staff. So good quality in medical care will be achieved based on clients' needs.

• Women's Health Nursing
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• v.7 no.4
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• pp.499-507
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• 2001

The purpose of this study was to explore nursing needs during labor pain that had been suffered by women who have given birth. It is essential to identify the nursing needs in order to solve nursing problems and to provide better care for the parturients. The sample consisted of 20 women of primiparas and 17 women of multiparas. They underwent normal labor and delivered a healthy baby at term. The data had been collected through the unstructured interviews conducted 1-2 days after delivery in the admission room from March 1998 to March 1999. On average, the interviews lasted for about 30 minutes. Interviews were taken with the consent of the subjects. The data are categorized according to the similarities of their contents. Seventeen subordinate categories and six superordinate categories have been identified. Six superordinate categories are 1) physical nursing needs 2) nursing needs of medical behavior 3) emotional nursing needs 4) informational and teaching nursing needs 5) nursing needs of pain control 6) nursing needs of respect(personality). Seventeen subordinate categories include: comfortable posture, touch, professional knowledge and techniques, duty execution, support, company and talk, stable surroundings, reassurance, information on delivery, explanation of medical behavior, information on surroundings, instruction on the case of pain, arbitrary adjustment, artificial adjustment, respect, interest and reflection of opinions. The result of this research is the same as that of foreign research and the items of the questionnaire in Korea are the same as the foreign one. Despite the same result, however, this dissertation is significant in that the research identifies the parturients nursing needs and classified the data and thus the basis has been formed to develop the tools to assess the nursing needs of the Korean parturients. The findings can be used as the guide for nursing intervention of parturients.

• The Korean Society of Law and Medicine
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• v.20 no.2
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• pp.231-260
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• 2019

Following the last issue, we summarized the major medical judgments in 2018. Especially, efforts have been made to introduce as many judgments as they relate to the obligation to explain. This is because the limits of the court's judgments were so diverse that it was unknown. Regarding the extent of damages, attention should also be paid to cases where the cost of care is recognized as a large amount, and cases where the memorandum is effective for the increased cost of treatment. The rulings related to the payment and deduction of medical expenses were the most discussed, although the description was small. The case of multi-institutional operation of medical institutions is an interim decision, but it is a case of interest in the medical community, and regarding uninsured medical expenses, cases of discretionary abuse have been reduced compared to the past, but are still significant.

• The Korean Society of Law and Medicine
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• v.17 no.2
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• pp.57-81
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• 2016

It can determine the outcome of the lawsuit whether or not there is a causality between the medical malpractice of a physician and the patient's injury when the patient is filing a lawsuit against the physician in order to pursue civil liability for a medical accident. In medical malpractice lawsuits, it is not easy to judge causality between different civil cases because of the special nature of medical care. Also, information such as medical records is concentrated on doctors and the medical knowledge of the patient is relatively insufficient compared with the doctor. Therefore, it is recognized through medical malpractice lawsuits that the burden of proof of the causality burdened by the plaintiff patient is relaxed. In this paper, I examine the legal theory on how to recognize causality in medical civil liability and then concern the attitude of the case in Korea, which is divided into the types of the causality - such as the case of general medical practice, explanation duty, no causality with medical malpractice.

• Journal of the Korean Society of Safety
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• v.38 no.1
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• pp.55-61
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• 2023

Although corporate punishment-related systems are being implemented in several countries, such as South Korea's Serious Accidents Punishment Act (SAPA), related research has mainly focused on legal issues. This study aimed to compare and analyze the SAPA and Singapore's Workplace Safety and Health Act (WSHA) and Code of Practice on Chief Executives' and Board of Directors' Workplace Safety and Health Duties (WSHD). In addition, it was attempted to draw implications to enhance the effectiveness of the CEO's safety and health duties. For this study, a comparative analysis was conducted in 3 steps. In step 1, similar overseas systems were investigated. In step 2, the system contents were classified into four viewpoints (DUTY, RESOURCE, Other factors, and Main contents), and comparison items were derived from each viewpoint. In step 3, the viewpoints were compared, and implications were derived. The following three implications were derived through comparative analyses. 1) In WSHD, additional explanation and calibration of measures clarify the CEO's role, and 2) It is easy to use for the CEO's duties by providing the resources directly. 3) Penalties for violating the proposed duties are entrusted to the existing higher-level laws. Considering this, providing detailed content and related information for the CEO would possibly improve the SAPA to fulfill his/her duties through announcements from related organizations in the future.