• 제목/요약/키워드: medical advice

검색결과 138건 처리시간 0.027초

에이전트를 활용한 응급의료지도 지원시스템 설계에 관한 연구 (A Study on Design of Medical Advice Support System in Emergency using Agent System)

  • 김경환
    • 한국정보시스템학회지:정보시스템연구
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    • 제19권3호
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    • pp.263-278
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    • 2010
  • Emergency Medical Service(EMS) requires a system that supports the communication between emergency medical technicians (EMT)s and the doctor in the emergency department. Because the rapid triage and on-site treatment of patients need doctor's medical advice. However, a system to assist the doctor assign for medical advice does not exist in Korea. This paper suggests a medical advice support system that focuses on appropriate doctor assign and real-time communication among the ambulance, the Emergency Medical Information Center (EMIC), and the doctor using an agent system. We expect that the system can help to solve the problems affecting prehospital EMS and improve its general quality.

모아 애착과 회복이 어려운 환아의 치료 포기와의 관계 (A Study about the Relationship between Maternal Attachment and Discharge Against Advice in High Risk Infants)

  • 김태임
    • 대한간호학회지
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    • 제12권2호
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    • pp.31-44
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    • 1982
  • The purpose of this study was to analyze the relationship between maternal attachment and discharge against advice in high risk infants and determine the factors which affect discharge against advice. Data of this study were collected by means of reviewing the medical records of 127 in-patients who were diagnosed as high risk infants in admission and interviewing of the mothers of these patients was done by telephone. The high risk categories were neonatal hyperbilirubinemia, congenital anomaly, congenital heart disease, blood disorder, neonatal infection and birth injury. Maternal attachment was measured by deviding the subjects into 2 groups, the one the continuing treatment group and the other the discharge against advice group. Maternal attachment is determined by an interplay of maternal attitude and specific infant behaviors. Maternal attachment developes through continuous physical and psychological contact between mother and infants. Later it developes into maternal love. The results were as follows: 1. There was a significant association between maternal attachment and discharge against advice, that is, the attachment score was higher in the continuing treatment group. 2. Inspite of controlling medical insurance, severity of disease and the length of stay, it was found that there continued to be either a partially significant or fully significant relationship between maternal attachment and discharge against advice. Stepwise multiple regression revealed that maternal attachment was second in importance as a predictor of discharge against advice, which indicates that maternal attachment was a significant predictor of discharge against advice. 3. Stepwise multiple regression revealed that in 32.3% of these cases the significant predictors of discharge against advice were length of stay, maternal attachment, delivery type, feeding type and income.

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한 대학병원 자의퇴원 환자의 특성 연구 - 퇴원환자 지료정보 DB를 이용하여 - (A Study on the Characteristics of the Patients Discharged Against Medical Advice)

  • 홍준현;최귀숙;이정화;이은미
    • 한국의료질향상학회지
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    • 제8권2호
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    • pp.208-217
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    • 2001
  • Background : The objective of this study is proving the basic data for developing a management system for the discharges against medical advice(AMA) by identifying the characteristics of the AMA patients of an university hospital for 10 years. Methods : By using discharge abstract data base, we divided the total discharges(435,254) into two groups, discharge against medical advice and discharge with discharge order. We confirmed the characteristics of AMA group by analyzing discharge abstract data of the both groups by SAS software V6.12 and $x^2$ test. Medical records of AMA patients in the year 2000 were reviewed to identify the reasons for AMA which we couldn't extract from discharge abstract DB. Result : The total number of AMA for 10 years were 9,358(2.15%) and the AMA rate has been continuously decreased for 10 years. Male, admission through emergency room, discharges admission via other hospital, patients without operation during hospitalization, discharges in hopeless or not improved condition showed higher AMA rate. The AMA rate was higher as the age of the patients was higher, and the average length of stay was longer in AMA patients than in those with discharge order. The AMA rate in psychiatry was highest(14.3%) and it was higher in surgery departments than those of medical or other sections. The AMA rate varied by attending physicians even in the same department and it was statistically significant. Patients with the principal diagnosis of "medical observation and evaluation for suspected diseases" showed the highest AMA rate(15.5%), and that of schizophrenia or psychosis was the nest. One hundred twenty-one patients(19.5%) out of 622 AMA in 2000 discharged against medical advice for transfer to order health care facilities. Among them 71 patients(58.7%) discharged with their medical care information, such as copies of medical record, medical certificates, summaries, etc. Written oath of the patients discharged AMA was filed in their medical records in 466 cases(74.9%) although some of them were incomplete. Conclusion : Characteristics of AMA discharge could be used as the basic data in developing a system to manage the patients who have risk factors to leave the hospital against medical advice. By reducing number of patients leaving the hospital against medical advice we can increase satisfaction of medical providers and consumers.

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원격의료 서비스의 규제개선에 관한 연구 (A Study on Legal and Regulatory Improvement of Telemedicine Service)

  • 권준철;최용전;정용규
    • 서비스연구
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    • 제4권1호
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    • pp.83-93
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    • 2014
  • 원격의료란 의사와 환자가 멀리 떨어져 있는 장소에서 행하는 의료행위로, 통신 수단에 의해 환자의 상태를 파악하여 적절한 진료를 하는 것이다. 일반적으로 상호작용하는 정보통신 기술을 이용하여 원거리에 의료정보와 의료서비스를 전달하는 모든 활동으로 정의된다. 즉 텔레비전, 통신, 컴퓨터, 공학들의 정보통신의 다양한 기술과 의료서비스가 융합된 응용 분야라고 할 수 있다. 환자 및 정보가 먼 거리로 떨어져 있거나 시간적으로 많은 차이가 발생하는 등 여러 가지 문제로 인해 도달할 수 없는 경우 의료정보 및 전문적 조언을 원격으로 제공하는 시스템으로, 환자 진료뿐만 아니라 의료행정, 의학교육, 자문과 의뢰 등을 포함하는 포괄적인 개념으로 쓰인다. 이에 본 논문에서는 원격의료의 법적인 규제를 살펴보고, 현행법에서 규제개선의 쟁점사항을 분석한다.

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진료과목 관련성을 중심으로 분석한 의학적클레임검토 유형론에 관한 연구 (A study on the typology of the medical claims review in terms of hospital department)

  • 이신형
    • 보험의학회지
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    • 제27권1호
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    • pp.33-36
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    • 2008
  • BACKGROUND : The medical claims review(MCR) is unique methodology of medical consultation in terms of insurance claim administration in Korean insurance market. The most important practical matter in the MCR is formatted question. In Korea, medical specialty is composed of 26 legally defined hospital departments. It is worth of studying to investigate type of MCR by hospital departments. METHODS : Fifty Cases of the MCR were selected randomly by statistical program SPSS among 1,032 cases which were performed between April 1, 2006 and March 31 2007. All of selected cases were evaluated one insurance doctor and made a score points from 0 to 10 in terms of hospital department. RESULTS : Multidimensional scaling was performed. The MCR types - diagnosis, malignancy and cause of death are located in the same 2-dimensional configuration area. It can be called as verification of benefit. Others are advice. - such as causality, interpretation, translation, independent medical examination, and so on. DISCUSSION : We can conclude the classification of MCR typology are two main subjects, verification and advice. Theses results are same as previous article which was based on experience.

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몽고증과 미국 사회의 '오리엔트적 상상'(Oriental Imaginary) (Mongolism and the "Oriental Imaginary" of Modern America)

  • 신지혜
    • 미국학
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    • 제44권1호
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    • pp.39-79
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    • 2021
  • This paper examines professional and popular medical discourse on "mongolism" (Down syndrome) in the early twentieth century to delve into the history of mongolism and the "Oriental imaginary" of modern America. The Oriental imaginary is a concept to explore the ways in which Americans, who had heard of mongolism or seen a "Mongol" themselves, imagined and conceptualized the defect in terms of the contemporary race relations. Moving beyond the interests of medical professionals discussed in the previous scholarship, this paper aims to include views and perceptions of the American public. The second section reviews the existing studies of the history of mongolism in the West. The third section discusses the mongolism of Asians and African Americans, among whom it had long been believed not to occur. Lastly, an analysis of American newspaper health advice columns on mongolism sheds light on the public reception and transmission of medical knowledge.

Determinants of Adherence to Diabetes Screening in Iranian Adults With a Positive Family History of Diabetes

  • Malih, Narges;Sohrabi, Mohammad-Reza;Abadi, Alireza;Arshi, Shahnam
    • Journal of Preventive Medicine and Public Health
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    • 제54권3호
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    • pp.190-198
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    • 2021
  • Objectives: Insufficient evidence exists regarding factors that affect screening adherence among people with a family history of diabetes, who comprise roughly half of all patients with diabetes. Therefore, we aimed to identify the determinants of diabetes screening adherence in adults with a family history of diabetes who had not yet been diagnosed with diabetes. Methods: This cross-sectional study was conducted at selected urban primary healthcare facilities in Tehran, Iran. The study population was clinically non-diabetic adults above 20 years of age with a family history of diabetes in at least 1 first-degree relative. All eligible people identified on randomly-selected days of the month were invited to join the study. Results: Among 408 participants, 128 (31.4%) had received a fasting blood glucose check during the last year. Using binary logistic regression, the independent predictors of screening adherence were knowledge of adverse effects of diabetes such as sexual disorders (odds ratio [OR], 3.05) and renal failure (OR, 2.73), the impact of family members' advice on receiving diabetes screening (OR, 2.03), recommendation from a healthcare provider to have a fasting blood glucose check (OR, 2.61), and intention to have a fasting blood glucose check within the next 6 months (OR, 2.85). Other variables that predicted screening adherence were age (OR, 1.05), job (being a housekeeper; OR, 3.39), and having a college degree (OR, 3.55). Conclusions: Knowledge of the adverse effects of diabetes, physicians' and healthcare providers' advice about the benefits of early disease detection, and family members' advice were independent predictors of screening adherence.

간호사의 업무수행상의 권한과 행사전략 (Nurse's Power and Tactics in Nursing Practice)

  • 한혜자
    • 간호행정학회지
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    • 제5권1호
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    • pp.23-37
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    • 1999
  • This study is to understand and to describe the power that a nurse experiences on nursing practice and then. to present a basic data for nurse's power-development, power improving and empowering. Ethnography was used to understand and to describe experience on exercising various powers occurred on nursing practice. and to analyze and to understand the meaning of a nurse's power. The objects was nurses. Ten nurses who have more than three year's experience were selected as objects from Cuniversity's hospital in Seoul from May of 1996 to August of 1997 through in-depth interview. participant observation, and phone interview. Instruments werw a portable recorder and field notes. I described a case appeared in a data using Agar's 'Pencil and scissors' method right after collecting materials. Then, Idescribed a theme discovered commonly. Followings are the results of the study. 1. There were three categories of relationships with main objects when nurses exercised their power on their practices: a therapeutic caring relationship with patients, a relationship of companion, vertical cooperation, and a constituent person with a doctor, and a relationship of cooperation, and a constituent person with administrative workers and medical technicians. 2. There were many types of nurse's power, tactics and various patient's responses about them. 1) Types of nurse's power to patients were giving information, controling environment, helping for cure, emotional support, and performing discretion. 2) Nurse's tatics for performing power were positive tactics neutral tactics, and negative tactics. 3) Patient's responses were appeared as compliance and noncompliance. Compliance were agreeing. taking nurse's advice, trusting, understanding, being admitted, exposuring himself, and appreciating. 3. There were types of nurse's power and performing tactics. 1) Types of power to a doctor were advice, informing, demanding and mediation. 2) Performings of tactics to a doctor were positive tactics, neutral tactics, and negative tactics. 3) Doctor's responses were appeared as accepting and unaccepting. Acceptings were taking in and appreciating, and unacceptings were denying nurse's advice and authoritative. 4. There were types of nurse's power and tactics about administrative workers and medical technicians and responses about them. 1) Types of power about administrative workers and medical technicians were suggestions and demands. 2) Power performings tactics were positive tactics.neutral tactics, and negative tactics. 3) Responses of administrative workers and medical technicians about nurse's power performing were appeared appeared as accepting and unacce pting. Acceptings were taking in, and unacceptings were denying. Therefore, it can be said that types of nurse's power and performing tactics on nursing practice and nurse's power based on responses of a patient, a doctor, an administrative worker, and a medical technicians are power or influence for agreeing, taking advice, trusting, understanding, exposuring himself, appreciating, and taking in to objects. The results of this study helped to understand nurse's power. I expect that this study will improve nure's power by using expert power, referent power, and legitimate power effectively among powers acmpanied with the origin and that nurses make ef-ort to improve professional knowledge and human nature so that they use this study as a chance to develope expert nursing practice.

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해양원격의료 지원제도 개선을 위한 관련 법령정비 방안 (De Lege Frenda for Improvement of Marine Telemedicine Service System)

  • 전영우;홍성화;김재호
    • 수산해양교육연구
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    • 제28권4호
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    • pp.994-1005
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    • 2016
  • Expansion and spreading of marine telemedicine is rather restricted due to the conflict of laws relating to medical service and lack of provisions in the Seafarers' Act, Medical Service Act, etc. Thus, this study is intended to reveal the current status and problems of marine emergency medical advice system for the furtherance of health care of seafarers and emergency medical assistance conditions and deduce relevant proposals for legislative improvements thereof in order to resolve underlying problems and issues. The results of this study can be summated as follows. First, in respect of directions to provide marine emergency service based on marine telemedicine system, emergency radio medical advice system needs to be strengthened to meet domestic and international instrument, marine telemedicine system needs to be provided through integrating u-Health technology and special marine medical center needs to be established. Second, regarding directions to provide health promotion service based on the marine telemedicine system, a new process of health care service for seafarers needs to be devised and provided involving seafarers' life cycle covering from prior to boarding to after leaving a ship. The conclusions of this study can be given as follows. First, the following new provisions need to be introduced in the Seafarers' Act. (1) The Minister of Oceans and Fisheries and a shipowner shall conduct matters pertaining to preventive health promotion and care for seafarers; (2) a provisions regarding establishment of seafarers' health promotion center by the Minister; (3) a special exemption permitting marine telemedicine service and qualification requirements for marine telemedicine assistant; (4) shipowner's obligation of carrying seafarers' health measuring equipment on board. Second, the relevant provisions regarding medical care persons needs to be revised in such a way that master or chief officer shall be appointed to be in charge of medical care on board. Last but not least, it is also essential to amend and update the minimum standards on drug and medicines to be carried on board and medicine chest and equipment on board.

원격의료 서비스의 쟁점사항에 관한 연구 (A Study on Telemedicine Service Issues)

  • 정용규;김장일;권준철;최영진
    • 서비스연구
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    • 제4권2호
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    • pp.57-67
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    • 2014
  • 원격의료도 의료행위이므로, 의료인이 행하지 않으면 보건위생상 위해가 생길 우려가 있기에, 의료인만이 할 수 있도록 법률로 제한되어 있다. 반면 원격의료도 존귀한 사람의 생명과 신체를 다루는 일이므로, 작은 실수를 수반하는 원격의료일지라도 그 피해가 영원히 회복할 수 없거나 회복하기 어려울 수도 있다. 그러므로 기초의학부터 시작하여 체계적으로 의학을 공부하고, 인간의 신체 및 생명에 대한 외경심을 체계적으로 교육을 받았을 뿐만 아니라 상당기간 임상실습을 한 후 국가의 검증을 거친 의료인에 한하여 원격의료행위를 허용할 수 있다. 환자 및 정보가 먼 거리로 떨어져 있거나 시간적으로 많은 차이가 발생하는 등 여러 가지 문제로 인해 도달할 수 없는 경우 의료정보 및 전문적 조언을 원격으로 제공하는 시스템으로, 환자 진료뿐만 아니라 의료행정, 의학교육, 자문과 의뢰 등을 포함하는 포괄적인 개념으로 쓰인다. 이러한 측면에서 의료산업의 발전을 위하여 규제에 대한 다양한 의견을 언급하고 쟁점사항을 정리해보았다.

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