Journal of the Korean Society of Physical Medicine
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v.13
no.2
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pp.147-156
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2018
PURPOSE: The law pertaining to medical service technologists does not discuss the scope and limits of doctors' guidelines. My paper aims to discuss these topics. METHODS: This study was based on a review of literature and an analysis of judicial precedents. RESULTS: Physical therapists have often noted the need for independent practitioners in their articles on health care. Their continued discussions on professional and educational differences have centered round this issue, but their ideas have not been accepted. Practitioners have continued to interpret doctors' guidelines in hospitals without discussing their scope. However, the Supreme Court presented a meaningful decision outlining the conceptual limits and the scope of medical practice. The court suggested, basing its interpretation in the goal of clarifying the concept of medical activities smoothly, was to follow a specific judgment on the levels of education, testing, and professionalism. CONCLUSION: The role of physical therapists is expanding in this country, in order to meet the needs of the ultra-aged society. Education is already responding to rising training needs. By dividing the doctors' guidelines into indirect and direct types, if there's no medical risk near or around the health center or hospital, it is a good idea to allow the management of physical therapy partially, while understanding the scope and limitations of these guidelines clearly. A teleological interpretation of the law is especially relevant, and can be implemented immediately by the authoritative interpretation on part of the health authorities without any legal amendments.
Cohidon, Christine;Imhof, Fabienne;Bovy, Laure;Birrer, Priska;Cornuz, Jacques;Senn, Nicolas
Journal of Preventive Medicine and Public Health
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v.52
no.5
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pp.323-332
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2019
Objectives: The aim of this study was to describe general practitioners (GPs)' opinions and practices of preventive care and patients' opinions, attitudes, and behaviors towards prevention. Methods: The data stemmed from a cross-sectional national survey on prevention conducted in Switzerland from 2015 to 2016. In total, 170 randomly drawn GPs and 1154 of their patients participated. The GPs answered an online questionnaire and the patients answered a questionnaire administrated by fieldworkers present at their practices. Results: Both patients and GPs agreed that delivering preventive care is the dedicated role of a GP. It appeared that beyond classical topics of prevention such as cardiovascular risk factors, other prevention areas (e.g., cannabis consumption, immunization, occupational risks) were scarcely covered by GPs and reported as little-known by patients. In addition, GPs seemed to use a selective approach to prevention, responding to the clinical context, rather than a systematic approach to health promotion. The results also highlight possibilities to improve prevention in family medicine through options such as more supportive tools and public advertising, more time and more delegated tasks and, finally, a more recognized role. Conclusions: Despite an unfavorable context of prevention within the healthcare system, preventive care in family medicine is reasonably good in Switzerland. However, some limitations appear regarding the topics and the circumstances of preventive care delivery. A global effort is needed to implement necessary changes, and the responsibility should be broadened to other stakeholders.
The code of the International Classification of Disease(ICD) is seriously questioned on its effectiveness in identifing an independent disease entity from similar conditions at general practitioner's offices. This study has attempted to show individual coding variations in ICD for similar ambulatory care conditions. It has been assumed that a following outpatient visit is regarded as the sane kind of visit owing to the same disease if a visit to the different source of care would be mad within an interval of less than two days. The 'D' health insurance association was selected for this analysis. The 'D' association had 153,298 members and made claims of 642,605 outpatient care in 1990. Out of the total outpatient claims, 8.6%(55,102 claims) were counted as the same disease which could meet the above assumption. Percent of conditions classified as the 10 leading causes of frequent visits which were matched accurately to the subsequent ICD diagnostic code found to be 15.8% on the average. The URI was noted for the highest concurrence rate of 20.4%. This proportion was even decreased to 11.6% on the case of chronic disease. Despite the fact that the assumption underlying the definition of the above same disease is rather rough and inappropriate, this study reveals that the code of ICD currently in use has weaknesses in seperating a certain independent disease from similar conditions at the outpatient setting. Thus, efforts need to be elaborated to meet the need of a new system of classification for conditions and diseases encountering at ambulatory care.
This study was made in order to evaluate the effectiveness on the activities of Community Welfare Association through the inter-agencies, carried out in 14 regions in our country as the examples. I'd like to emphasize the two main points in this study. One is whether the community practitioners have positive thoughts or not, about the evaluation on the activities through the inter-agencies. The other is how the receivers react to the inter-agency services. In order to find the solutions for two questions, the survey data of Korea Institute for Health and Social Affairs were reanalyzed. First, the attitudes of the practitioners are as follows; that is, the directors of the organizations have negative opinions about the communication, while practitioners have positive evaluations. About the performance of its roles, 68.2 percent of practitioners showed positive reactions, and 77.8 percent answered it's necessary to manage the community association continuously. The receivers have positive evaluations in general about the inter-agency services. In the comparison of the community activities between before and after, domiciliary services were improved because there was a meaningful statistical difference, however, other services such as medical care service were not bettered. And there was no difference between before and after in the CSQ.
Kim, Hong Sung;Kang, Ji-Hyuk;Yang, Man-Gil;Park, Chang-Eun;Shin, Kyung-A;Kwon, Pil Seung
Korean Journal of Clinical Laboratory Science
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v.50
no.3
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pp.289-296
/
2018
Opinions regarding interdisciplinary unification of medical laboratory science were analyzed by an online questionnaire distributed to 255 professors and 4,000 hospital practitioners in January of 2018. The recovery rate was 79 (30.9%) for professors and 1,368 (34.2%) for hospital practitioners. In the perception survey on the duality of interdisciplinary, both the professors and the hospital practitioners reported that they felt interdisciplinary integration is necessary. The prerequisite of four-year integration was the establishment of institute of accreditation and standardization of curriculum, and the requirements for the four-year integration were considered important for adjustment of student quota and standardization of curriculum. In the four-year integrated approach, the opinion that only universities that passed the accreditation evaluation should operate a four-year system was highest among professors and hospital practitioners. The optimum capacity of university students was less than 40 in cases of 4-year integration. In conclusion, the above results suggest that the professors and hospital practitioners realize 4-year interdisciplinary integration is necessary to produce a competent medical technologist, and the institute of accreditation, standardization of curriculum, and student quota adjustment should be presupposed for 4-year integration.
Purpose: The purpose of this study was to develop parent coaching domains for the health management of childhood leukemia survivors. Methods: In this study, we conducted a literature review and in-depth interviews with 6 parents of childhood leukemia survivors who were identified using convenience sampling. We identified areas of parent coaching through the 4 stages of the GROW model, which are: goal setting, realistic grasp, confirmation of realization, and search for alternatives. Results: Nine domains and 27 subcategories emerged from the study. The 9 parent coaching domains for the health management of childhood leukemia survivors were routine life management, education and information provision, emotional support for the surviving children, social support for the surviving children, follow-up management, family support, school life management, symptom management, and improvement of growth and development. Conclusion: This research developed 9 parent coaching domains for the health management of children surviving leukemia. The results of this study are expected to contribute to the efficient health management of childhood leukemia survivors by enabling practitioners to continuously identify new coaching domains as needed for their health management. Researchers should improve the health management of childhood leukemia survivors by developing nursing interventions for these new coaching areas.
Purpose: This study was to develop an effective evaluation tool for evaluation of hypertension prevention and management program(HPMP) in community health posts (CHPs). Method: Evaluation tool composed from the literature review, the field visiting, and the in-depth interviews with the community health practitioners. Result: The evaluation tool had four domains, each with different maximum points:, hypertension prevention (35), hypertension management (40), environment of the CHPs(10), and evaluation system of the HPMP(15). The first domain was hypertension prevention with sub-domains of health education, and early detection of patients with hypertension. The second domain was hypertension management with sub-domains of management of health records of patients, education and counseling, and treatment and follow-up of patients. The third domain was the environment of the CHPs with subdomains of accessibility of CHPs to residents, accessibility of general health data to the public, and availability of health information to the public by multimedia. The fourth domain was the evaluation system of the HPMP with the subdomains of planning of program, formative evaluation, process evaluation, and summative evaluation. Conclusion: The newly developed evaluation tool will contribute not only to plan and set goals for evaluation of HPMP in CHPs.
The Journal of Korean Academic Society of Nursing Education
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v.5
no.1
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pp.97-105
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1999
Based on literature, status and role of the NP in America was reviewed. The process of developing NP program in America suggests us many things. In America, nurse practitioners have sustained a mutually beneficial status with their patients for over thirty years. Excel fence in academic education and clinical training will enable nurse practitioners to continue to provide quality health care. The magnitude changes in the health care system of the United States, the challange of providing real access of health care continues. Lack of access to adequate primary care was the driving force in the initial 1965 Federal Involvement in developing the NP role. In 1993 President Bill Clinton's health care reform initiative provided policy support for NPs as primary care providers. The Institute of Medicine explicitly recognized NPs as an integral part of the primary care team. In addition, several national reports recognized NPs as affordable, accessible, high-quality care providers. The recent passage of direct Medicare reimbursement for NPs reflected public policy statements coincided with and likely contributed to a growth spurt in the NP workforce. From 1965 to 1977 NP programs offered traditional primary care clinical tracks(adult, family, woman's health, and pediatrics) for relatively small clusters of students in a variety of institutional settings. From 1978 to 1990 these educational programs were incorporated into graduate schools of nursing. By 1990 the majority of NPs received educational preparation in master's-level nursing programs. A new emphases was placed on postmaster's NP programs designed for master's prepared clinical nurse specialists and nurse managers. he the health care system shifted hospital nursing resources toward community-based care, these master's -level nurses sought additional NP preparation. NP educational programs are defined as the educational structure in which one or more NP clinical tracks are offered. NP clinical tracks, in turn, offer curriculum and supervised clinical experiences that match standards in specific practice areas such as family(FNP), adult(AUP), geriatrics(GNP), pediatrics(PNP), women's health (WHNP), neonatal (NNP), and acute care(ACNP). There were indications that NP practice was expanding into new clinical areas as evidenced by new types of tracks, particularly in acute care and psychiatry. The increase in acute care NP students likely reflects the increased demand from hospitals and other acute care settings. In Korea, change of nurse's role into nurse practitioner's role may have many difficulties. The need of health consumer, policy support of government, approval of medical care team are all essential component. Every nursing personnel make effort to planning the new health care delivery system.
Journal of the Korea Academia-Industrial cooperation Society
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v.11
no.10
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pp.3839-3845
/
2010
In this study, the patterns of people who get dental services from unqualified dental practitioners were identified by using "2006 National Dental Health Investigation". There were 4,543 people in total and the group was divided into two groups - those who had experience of receiving dental services from unqualified practitioners and of those who had not. The most pattern model was CHAID. It was patterned that 39% of those who are more than 68 years would experience such unqualified dental service, and it was found that 3% of those who are less than 33 years experienced such a service. It was found that 45% of those who are 55 or 68 years and woman would experience such unqualified dental service, and 32% of those who are 55 or 68 years and man experienced such a service. With the increase in health awareness, the burden of medical bills is also rising. However, cases of unqualified dental treatments that could cause extremely dangerous symptoms are also rising recently. Therefore it is most important to anticipate those groups who are most exposed to unqualified dental services, and educate them with appropriate information and publicise about the danger.
Objectives: This study was conducted as descriptive correlation research in order to survey healthcare personnel(HCP)'s awareness of patient safety culture and their recognition of standard precautions, and to examine the correlation between the two factors. Methods: The subjects were 400 HCPs including 80 doctors, 240 nurses, and 80 medical technicians from two general hospitals. The questionnaire used in the survey consisted of 9 questions on general characteristics, 44 on the perception of patient safety culture, and 21 on the recognition of standard precautions. Results: According to the subjects' general characteristics, the score was significantly higher in those aged over 40 than in those aged 30-39. In addition, it was significantly higher in managers than in practitioners, in those with work experience of less than a year than in those with 5-9 years. The score was also significantly higher in those working 8 hours a day than in those working over 10 hour a day. The number of medical accident reports according to the subjects' general characteristics was significantly larger in nurses than in doctors, in managers than in practitioners, and in those with 10 years' or longer experiences than in those with less than a year. In the awareness of standard precautions according to the subjects' general characteristics, the score was significantly higher in female workers than in male workers, and in managers than in practitioners. As a whole, the subjects' awareness of patient safety culture and their recognition of standard precautions showed a significant correlation with each other. Conclusion: From the result of this study, sufficient work force and the promotion of organizational culture for safety is needed in order to guarantee patient safety. Likewise, these results suggest that experience, job skill, and adequate working hours have a positive effect on the awareness of patient safety culture and the recognition of standard precautions.
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