• 한국직업건강간호학회지
• /
• 제27권3호
• /
• pp.180-189
• /
• 2018

Purpose: The aim of this study was to investigate the influence of nurses' awareness of healthcare accreditation on their job stress and turnover intention. Methods: Across-sectional correlation study design was used. Participants consisted of 143 nurses from two tertiary hospitals in Seoul and Gyunggido, South Korea. Data were collected in October 2016 using self-report questionnaires and analyzed using descriptive statistics, t-test, an ANOVA, Pearson's correlation coefficient, and multiple regression in SPSS/WIN 21.0. Results: Awareness of health care accreditation correlated negatively with job stress (r=-.63, p<.001) and turn over intention (r=-.50, p<.001). Awareness of health care accreditation was the factor that most influenced job stress, explaining 38% of the variance (F=23.10, p<.001). Awareness of health care accreditation and duty pattern were the factors that most influenced intention to leave, explaining 32% of the variance (F=10.35, p<.001). Conclusion: These findings suggest raising nurses' awareness of certification systems to reduce their job stress and turnover intentions. It will be necessary to provide support for the aggressive work nurses do and improve their work structure, highlighting the need for both manpower and institutional support. Accordingly, providing regular education programs and appropriate compensation schemes, by raising nurses' awareness of medical institutions' certification systems, is necessary.

• 보건행정학회지
• /
• 제13권2호
• /
• pp.1-22
• /
• 2003

Since 1990s, the use of Complementary and Alternative Medicine(CAM) has been rising rapidly all of the world. In 1983, WHO recommended that the traditional medicine actively be utilized. At the end of 20th century, as chronic and intractable diseases increased in western countries, traditional medicine has attracted considerable attention. COWM shows possibilities of new approaches for these intractable diseases. Thus, we try to show our proper approach of COWM through the international comparative study. In order to fulfill the objectives, we applied the following methodology: 1) Literature review on previous study, 2) Local survey using self-administered questionnaire, and 3) FGI(Focus Group Interview) with local experts. The results were as follows : Three Asian countries, China, Korea and Taiwan, are very active in implementing COWM policy. Japan, however, has independent system of unified medicine. In regards to the combined care policy and system, China has the most advanced COWM system among four countries. In respect to combined care education, it is needed to increase the COWM education contents and the amount of cross educational curriculum. Based on the current COWM system, Chinese, Japanese and Taiwanese doctors can prescribe both oriental and western drugs. But, Korean medical law prohibits western doctors and oriental doctors from prescribing the counterpart´s medicine. So, the revision of current medical law is urgent for COWM in Korea. And when it comes to patient satisfaction, more than fifty percent responded positively in China, Korea and Taiwan. To achieve the goal of COWM ; 1) mutual understanding and recognition of COWM is essential. 2) institutional and legal support system for COWM is desperately urgent. 3) possible international collaboration and cooperation should be sought to untangle these complex cultural dilemmas.

• 대한치과마취과학회지
• /
• 제2권2호
• /
• pp.101-106
• /
• 2002

Background: The management of the behavior of handicapped children when providing required dental care is often a problem, whether in the dental office or in a hospital setting. Because of the high incidence of poor cooperation, many of these patients are scheduled for dental care under general anesthesia with preoperative medical assessment. The purpose of this study was to carry out a clinico-statistical survey on dental treatment for handicapped children under general anesthesia. Methods: After approval from the institutional review board, the medical records of 64 handicapped children between 1997 and 2002 were reviewed to determine the patient profiles, anesthesia management, and complications. The charts of these patients, who underwent dental examination, scaling and prophylaxis, and restoration and extraction of teeth under general anesthesia, were reviewed. Results: The mean age was 12.8 years old, and males (53%) predominated females (47%). Twenty-four patients had mental retardation, twelve had autism, six had cerebral palsy, 4 had behavior disorder, others had heart disease, convulsive disorder, etc. Sixty-two had intravenous thiopental with neuromuscular blocker, 2 had intravenous ketamine induction. Nasotracheal intubation was uneventful in 55 patients, nine had orotracheal intubation because of difficult visualization of the larynx. Twenty-one patients experienced postoperative complications in the recovery room, including epistaxis, nasal obstruction, vomiting, airway obstruction, respiratory depression. Conclusions: General anesthesia is a very effective way of completing the dental treatments for disabled children. We emphasize the need to train anesthesiologists in the care of disabled patients.

• 보건행정학회지
• /
• 제26권1호
• /
• pp.39-50
• /
• 2016

Background: This study examined patient and hospital factors related to long-stay admissions in long-term care hospitals (LTCHs) among older people in Korea. Methods: We analyzed health insurance claims data, entitlement data, and institutional administrative data from the National Health Insurance Service databases between 2010 and 2012. At the patient level, we compared characteristics of patients staying in LTCHs for over 180 days (the long-stay group) with those staying in LTCHs for less than 90 days during a calendar year. At the hospital level, we examined the general characteristics and staffing levels of the top 10% of hospitals with the highest proportion of patients whose length of stay (LOS) was 180+ days (the hospitals with long-stay patients) and compared them with the top 10% of hospitals with the highest proportions of patients whose LOS was less than 90 days (hospitals with shorter-stay patients). Results: The long-stay group accounted for about 40% of all LTCH patients. People in the group were more likely to be women, aged 80+, living alone, and experiencing more than two health conditions. Compared to the hospitals with shorter-stay patients, those with long-stay patients were more likely to be occupied by patients with behavior problems and/or impaired cognition, owned by corporate or local governments, have more beds and a longer period of operation, and deliver services with lower staffing levels. Conclusion: This study found long-stay older people in LTCHs and those in LTCHs with high proportions of long-stay older patients had several distinct characteristics compared to their counterparts designated in this study. Patient and hospital characteristics need to be considered in policies aiming to resolve long-stay admissions problems in LTCHs.

• 대한치과의사협회지
• /
• 제48권1호
• /
• pp.6-11
• /
• 2010

Amid the rapid transitions in both local and international markets, the Korean dental industry is facing more challenges than at any time in its history. This paper tried to address some of the key issues faced by the industry as well as the policy issues and I direction of implementation that the Korean Dental Association (KDA) is expected to tackle. First, the direction of reforming the country's health insurance system was examined with emphasis on the expected changes in and improvement of the fee-for-service reimbursement system (FFSRS) and medical reimbursement system (MRS). With FFSRS, the most urgent issue would be ameliorating the current lop-sided, unreasonable reimbursement system that prevents suppliers from voicing their opinions. To help achieve that goal, the limited authority and responsibility of the president of National Health Insurance Corporation (NHIC) as one of the contract-making parties must be clarified. In addition, the functions of NHIC's Health Insurance Finance Committee must be restricted; at the same time, the panel organization of the Health Insurance Policy Review Committee needs to be reformed to embrace greater democracy. As with MRS, the government is considering a block budget bill to help promote efficiency in employing and managing the health insurance fund. Policymakers must understand that the implementation of such proposal could exacerbate an already dire situation. Improving MRS requires meeting the following preconditions: (a) the structurally vicious cycle of small charge-small salary needs to be resolved, and a certain percentage of fee raise must be guaranteed on a yearly basis to help adjust the fee system to a more realistic level; (b) the supply-and-demand balance in producing health care professionals must be improved including the prevention of oversupply of doctors, nurses, etc., and; (c) institutional strategies must be provided to enhance the quality of medical care and ensure academic advancement in health care disciplines.

• Asian Pacific Journal of Cancer Prevention
• /
• 제17권4호
• /
• pp.1745-1754
• /
• 2016

Background: The prime output of Hospital Based Cancer Registries is stage and treatment based survival to evaluate patient care, but because of challenges of obtaining follow-up details a separate study on Patterns of Care and Survival for selected sites was initiated under the National Cancer Registry Programme of India. The results of stage and treatment based survival for head and neck cancers by individual organ sites are presented. Materials and Methods: A standardized Patient Information Form recorded the details and entered on-line at www.hbccrindia.org to a central repository - National Centre for Disease Informatics and Research. Cases from 12 institutions diagnosed between 1 January 2006 and 31 December 2008 comprised the study subjects. The patterns of treatment were examined for 14053 and survival for 4773 patients from five institutions who reported at least 70% follow-up as of 31 December 2012. Results: Surgical treatment with radiation for cancer tongue and mouth showed five year cumulative survival (FCS) of 67.5% and 60.4% respectively for locally advanced stage. Chemo-radiation compared to radiation alone showed better survival benefit of around 15% in both oro and hypo-pharyngeal cancers and their FCS was 40.0%; Hazard Ratio (HR):1.5;CI=1.2-1.9) and 38.7%; (HR):1.7; CI=1.3-2.2). Conclusions: The awareness about the requirement of concurrent chemo-radiation in specifically cancers of the oro and hypopharynx has to be promoted in developing countries. The annual (2014) estimate number of new Head and Neck cancers with locally advanced disease in India is around 140,000 and 91,000 (65%) patients do not receive the benefit of optimal treatment with ensuing poorer survival.

• 대한예방한의학회지
• /
• 제21권3호
• /
• pp.19-28
• /
• 2017

Objectives : This study aims to investigate the recognition on Mibyeong among Korean Medicine doctors (KMDs) and to suggest institutional approaches for the active use of Mibyeong. Methods : On-line survey for KMDs who were registered in the Association of Korean Medicine was performed. The survey questionnaires included definitions and categories of Mibyeong, clinical use of Mibyeong, and the need for developing Mibyeong care packages, etc. Results : Of 18,344 KMDs who were received survey e-mail, 884 KMDs replied. As for the awareness of the Mibyeong, over 80% of the KMDs agreed the definitions based on patients' subjective symptoms and Korean Medicine theories. 36.1% of respondents used the term Mibyeong in the medical record, and 38.6% used when they explained the patients' condition to the patients. A majority of respondents agreed with the need for a developing Mibyeong care package. Developing the standard methods for Mibyeong assessment was the primary requisite on Mibyeong research. Conclusions : Currently the level of recognition and use of Mibyeong among Korean Medicine doctors was relatively low. To promote the use of Mibyeong in the clinical field, the standard methods for Mibyeong assessment and Mibyeong care package need to be developed.

• 지역사회간호학회지
• /
• 제12권3호
• /
• pp.647-660
• /
• 2001

Forming health care management model in small-scale enterprises was the purpose of this study. For the purpose, we tried to investigate the characteristics of small-scale enterprises and analyzed the pattern of their health care management. The results are as follow: 1. The strength of health managing agency and technical supporting program lies in team approach by specialized manpower. However, if the liaison between each part of the organization is not smooth, the overall management will be very difficult. 2. Small scale enterprises are characterized by their short life after the establishment, use of rental building, lack of welfare facilities, weakness in sanitary management and aggregation of factories of similar type of industry. Because of these characteristics, it is very difficult to solve problem basically, such as improvement of working environment. Therefore, it is important to focus on health education and community based approach. 3. Many workers in small-scale factories are in middle and old age. They have health problems mainly related to personal habits. Implementation of an appropriate health promotion program is needed. 4. The number of workplaces, which should be managed by health managing agent. is increasing rapidly. But the number of health managing agent is limited. In the aspect of the requirement of manpower and equipment, training personal agent is more urgent than founding institutional agent. 5. The uniform method of health management hampers the choice of employer and workers. The types of provision of health management should be diversified. 6. For an efficient management, a frequent visit of personal agent and the following referral to a specialist should be done. The specialists in charge of secondary management are from the field of occupational medicine, occupational hygiene, ergonomics, etc. 7. The health management of small-scale facilities should have six components. They are community-based approach, multi-disciplinary cooperative system, program based on the need of recipient, forming partnership of employer and worker, change of lifestyle, and evidence-based program.

• 한국치위생학회지
• /
• 제15권2호
• /
• pp.325-332
• /
• 2015

Objectives: The purpose of this study was to investigate tooth whitening maintenance efficacy of several dentifrices containing effective ingredients for tooth whitening. Methods: Hydroxyapatite specimens(HAPs) staining was done by using modified Stookey's methods. HAPs were treated with 2.9% hydrogen peroxide containing strip for whitening, and were shaken with several dentifrice slurry(dentifrice 1 : artificial saliva 2) for 30 minutes. The HAPs were finally dipped in staining solution for an hour. Shaking and dipping were repeated 4 times and lightness values were measured by colorimeter at each step. In clinical test, test 4 dentifrice and control dentifrice were evaluated by 21 subjects for 2 months after receiving institutional review board(IRB) approval. Organoleptic(vita shade guide) and instrumental(SHADEEYE-NCC) evaluation were performed for whiteness change of teeth. Statistical analysis was performed using repeated measures ANOVA, Tukey's post hoc test and ${\chi}^2$-test(p<0.05). Results: All dentifrices showed statistical significance in comparison with control dentifrice containing sodium fluoride and test 4 dentifrice containing sodium pyrophosphate, sodium metaphosphate, candelilla wax, and sodium fluoride showed statistical significance in comparison with other dentifrices by inhibiting staining in vitro(p<0.05). In clinical test, test 4 dentifrice showed better effects than control dentifrice in organoleptic and instrumental evaluation in tooth whitening maintenance efficacy(p<0.05). The awareness toward tooth whitening maintenance efficacy for 2 months use showed that test 4 dentifrice was much better than control dentifrice, but did not show statistically significant(p>0.05). Conclusions: Dentifrice containing sodium pyrophosphate, sodium metaphosphate, candelilla wax and sodium fluoride was more effective in keeping teeth white.

• 한국의료질향상학회지
• /
• 제23권2호
• /
• pp.23-34
• /
• 2017

Purpose: Nurse's second victim experiences could influence organizational negative work-related outcome. The purpose of this study was to investigate the casual relationship between nurses' second victim experience and third victim experience and multiple mediation effects of second victim supports. Methods: A cross-sectional, self-report survey (the Second Victim Experience and Support Tool) was conducted with 305 nurses working in a general hospital. Data were collected from October 20 to November 25, 2016 and analyzed using SPSS Win version 23.0. Results: The nurses' perceived second victim experience was $3.24{\pm}0.61$ and the third victim experience was $3.12{\pm}0.92$. Nurses' second victim experience was found to have a direct effect on increasing third victim experience and indirect effect of colleague support as mediator (p<.05). However, institutional support and supervisor support had not a partial and indirect effect on third victim experience. Conclusion:This study is one of the first to connect second victim experience to third victim experience in South Korea. This study broadens the understanding of the negative effects of a second victim experience influence third victim experience. When involvement in patient safety events, the important role of colleague support in limiting nurse's third victim experience have been acknowledged. This study reinforces the efforts health care leaders are making to develop interventional programs to colleague support their staff as they recover from adverse event involvement.