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Recognition of Advance Directives by Advanced Cancer Patients and Medical Doctors in Hospice Care Ward (호스피스병동 말기 암 환자 및 내과의사의 사전의료지시(서)에 대한 인식)

  • Sun, Der-Sheng;Chun, Yeon-Joo;Lee, Jeong-Hwa;Gil, Sang-Hyun;Shim, Byoung-Yong;Lee, Ok-Kyung;Jung, In-Soon;Kim, Hoon-Kyo
    • Journal of Hospice and Palliative Care
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    • v.12 no.1
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    • pp.20-26
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    • 2009
  • Purpose: We undertook this study to find out the recognitions of terminal cancer patients and doctors about advance directives (ADs), of how they would do in non-response medical conditions and whether ADs could be one of medical options for their dying with dignity. Methods: One hundred thirty four cancer patients in the Hospice Unit, St. Vincent's Hospital, and 97 medical doctors in the Department of Internal Medicine, Catholic Medical Center, were asked about ADs, including Do-Not-Resuscitate (DNR), medical power of attorney, living will and medical options. Results: One hundred thirty patients (97%) and 38 doctors (39.2%) were unfamiliar with ADs, however, 128 patients (95.5%), 95 doctors (97.9%) agreed with it. Seventy nine patients (59.0%) and 96 doctors (99.0%) wanted DNR rather then intensive treatments if they were in non-response medical conditions. Eighty four patients (62.7%) and 75 doctors (77.3%) were agreeable to medical power of attorney. One hundred Thirty four patients (100.0%) and 94 doctors (96.9%) did not want medical options to be in terminal conditions, and hoped to die in peace. Conclusion: Most of patients did not know about ADs and how to make it. However, they showed positive attitudes about it. If we advertise it properly, it is highly likely that a large number of cancer patients would make their living wills easily by ADs. Nevertheless, many legal and ethical problems have to be solved. Doctors should engage their patients in an ongoing communication about the end-of-life. Therefore, let the patients have opportunities to plan their own deaths.

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Survey on the undergraduate curriculum in clinical pharmacology and interns' prescribing ability in South Korea

  • Gu, Namyi;Kim, Kyong-Jee;Lim, Chi-Yeon;Lee, Jun Kyu;Rhee, Moo-Yong;Shin, Kwang-Hee;Lee, Seung-Hwan;Ahn, Sangzin
    • Translational and Clinical Pharmacology
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    • v.26 no.3
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    • pp.128-133
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    • 2018
  • Appropriate prescription writing is one of the critical medical processes affecting the quality of public health care. However, this is a complex task for newly qualified intern doctors because of its complex characteristics requiring sufficient knowledge of medications and principles of clinical pharmacology, skills of diagnosis and communication, and critical judgment. This study aims to gather data on the current status of undergraduate prescribing education in South Korea. Two surveys were administered in this study: survey A to 26 medical schools in South Korea to gather information on the status of undergraduate education in clinical pharmacology; and survey B to 244 intern doctors in large hospitals to gather their opinions regarding prescribing education and ability. In survey A, half of the responding institutions provided prescribing education via various formats of classes over two curriculums including lecture, applied practice, group discussions, computer-utilized training, and workshops. In survey B, we found that intern doctors have the least confidence when prescribing drugs for special patient populations, especially pregnant women. These intern doctors believed that a case-based practical training or group discussion class would be an effective approach to supplement their prescribing education concurrently or after the clerkship in medical schools or right before starting intern training with a core drug list. The results of the present study may help instructors in charge of prescribing education when communicating and cooperating with each other to improve undergraduate prescribing education and the quality of national medical care.

Survey of Demand for Medical Devices in Korean Medicine (한방의료기기 개발 수요에 대한 조사연구)

  • Kim, Ji Hye;Kim, Keun Ho;Kim, Jaeuk U.
    • The Journal of Korean Medicine
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    • v.35 no.3
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    • pp.103-115
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    • 2014
  • Objectives: The purpose of this survey was to investigate the need for new medical devices based on opinions of members of the Korean medical society. Methods: We distributed two independent questionnaires sequentially over two-week intervals to 16,510 doctors via the Korean Medical Society, and received replies from 888 and 928 doctors, respectively. The survey was carried out through a web-based questionnaire system. The first questionnaire focused on demand for new diagnostic and therapeutic medical devices that are specific for Korean medicine (KM). In contrast, the second questionnaire focused on demand for new hybrid medical devices which are useful both in Western medicine (WM) and KM. Results: In purchase intention of Korean medical devices (KMDs), demand for diagnostic devices was greater than for therapeutic ones. Among diagnostic devices, the purchase intention of 'imaging devices' ranked the highest and was followed by 'musculoskeletal diagnostic devices'. Among therapeutic KMDs, the purchase intention of 'musculoskeletal treatment devices' ranked the highest, followed by 'cranial nerve rehabilitation devices'. In the purchase intention of hybrid medical devices that can be used both in WM and KM, 'ultrasonic-based medical device' ranked the highest, followed by 'MRI-based medical device'. Conclusions: There is increasing demand for clinically useful medical devices among Korean medical doctors. Within demand for new devices, hybrid devices that can be used in both WM and KM were most strongly desired. This survey will be useful in establishing strategic plans for the development of medical devices in KM. Keywords: Korean medicine, medical device, demand survey, questionnaire.

The Role of Guidelines on the Judgement of Medical Negligence - Referring to Debates in Japan - (의료과실판단에서의 가이드라인의 역할 -일본에서의 논의를 참고하여-)

  • Song, Young-Min
    • The Korean Society of Law and Medicine
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    • v.11 no.2
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    • pp.209-235
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    • 2010
  • According to the development of medical technology, new medical treatments have been dramatically increased as an inevitable consequence, however, it is not easy for medical workers to learn the knowledge that is necessary for new medical treatments and their additions in the medical services. Therefore, it could not be helped increasing the guidelines for applying new medical treatments, and then, the problem would come out whether to attribute the medical negligence to the doctors who did not follow the guidelines when the patient became worse because of his non-compliance. Nevertheless, there is no document to review the problem mentioned above and also no definite precedents. Thus, the civil lawful character and obligation of guidelines on the lawsuit against the medical default have been examined in this studies. The medical negligence is defined as usual doctors violate the care obligation which is demanded for them to follow when they treat patients under the proper medical standard in those days. It is resonable to assume that the matter of guidelines is to decide the level of the care obligation, that means the care which is required of the rational doctors under same circumstances, and in general, the experts' testimonies should be needed in this case. In addition, the issue comes out whether the guidelines can be the standard of the judgement of the medical negligence. Finally, I suppose, the evaluation of the issue depends on who makes the guidelines, what materials are based on, and also depends on whether there is another guidelines in the same disease, what the purpose of guidelines is to save the medical costs or to realize the appropriate medical services, in addition, it depends on how often renew the guidelines, and how wide is the usage of guidelines.

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A study on the knowledge and attitude of medical professionals about AIDS (에이즈 감염인의 인권에 대한 공중보건의사 인식 조사)

  • Lee Jin Seok;Yoon Ho Je;Kim Hyung Soo
    • Health Policy and Management
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    • v.15 no.1
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    • pp.57-77
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    • 2005
  • The purpose of this study was to assess medical professionals' knowledge and attitude about AIDS. The subjects of study were medical doctors and dentists, belonging to Korea Association of Public Health Doctors. We sent a e-mailed questionnaire to 3,059 members and received 407 replies. Questionnaire was made on the basis of former studies' results and interviews with infected people. Major findings of this study were as follow. A lot of medical professionals had incorrect and biased knowledge about AIDS. More than half of them overestimated infection probability in case of being prickled with a contaminated needle. And many has negative attitude. The more they had correct informations about AIDS, the more they had possibilities to have friendly attitude to infected people. Incorrect knowledge cause excessive fears about AIDS, which amplify the stigma and discrimination. They contribute to people's vulnerability not only to HIV infection but also to other threats to health and well-being. It is in need of medical professionals' effort to increase their knowledge and improve attitude about AIDS.

The Observation on the Five Vicera's A Study of External Treatment on the 『Chuan-Ya-Wai-Bian(串雅外編)』 -part of internal medicine- (『관아외편(串雅外編)』의 외치료법(外治療法)에 관한 연구 - 내과질환을 중심으로 -)

  • Jeong, Gil Chae;Kim, Eun Ha;Lee, Byung Wook
    • The Journal of Korean Medical History
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    • v.19 no.2
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    • pp.49-66
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    • 2006
  • 1) Objective External treatments have various curative effects. So it had been used to cure various patients. But, it has a limited sphere of application in the present South Korea. And treatments of wander doctors had been disregarded by general doctors and the public. But Zhao-Xue-Min(趙學敏) had thought that there are useful treatments in it. So, the "Chuan-Ya(串雅)" had been written by Zhao-Xue-min in 1759. The book had included treatments of wander doctors. Especially, it had included various external treatments. Therefore we would like to bring out it's external treatments theory 2) Conclusions We have researched external treatments of "Chuan-Ya", and then we have arrived at following conclusions. "Chuan-Ya" has 48 sentences that have related to external treatments in internal medicine. And it had recorded fire conducting method(引火法) to explain process of external teratment principle.

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A study on the process and the historical significance of the conflict between the oriental medicine doctors and the pharmacists in Korea (90년대(年代) 한약분쟁(韓藥分爭)의 과정(過程)과 역사적(歷史的) 함의(含意) -한방의약분업(韓方醫藥分業)과 의료일원화(醫療一元化)에 미치는 영향(影響)을 중심(中心)으로-)

  • Shin, Sang-moon;Yoo, Dong-yeul
    • Journal of Haehwa Medicine
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    • v.10 no.2
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    • pp.41-71
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    • 2002
  • The purpose of this paper is to infer the effects on the separation of pharmacy and clinic in the oriental medicine, the unification of the medical system and the medical and pharmaceutical system, etc. from the conflict between the oriental medicine doctors and the pharmacists in 1990s. The results are as follows. 1. The oriental medicine doctors, the pharmacists and a private organization(Citizen's Coalition for Economic Justice) found the solution in the conflict nongovernmently as the government failure. 2. The conflict brought about directly the separation of pharmacy and clinic in the western medicine but the opposite effect in the oriental medicine. 3. The conflict brought about the continuance of the dual medical system. 4. In the part of the medicine, citizen's organizations stated to play their part in the dispute. This is a positive side in the conflict. 5. The conflict contributed to democratization in the medical market and the medical world.

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Course on Death and Dying for Medical Students (의과대학생을 위한 죽음학 수업)

  • Park, Joong Chul
    • Korean Medical Education Review
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    • v.22 no.3
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    • pp.153-162
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    • 2020
  • The aim of modern medicine is to prolong life by fighting death. Doctors have traditionally believed that this was an ethical good deed. The negative connotation surrounding death has led to the avoidance of terminally ill patients. But in a modern society where death is medicalized, doctors have to see dying patients every day and are in a state of guilt from implementing meaningless life-sustaining treatments. Therefore, medical schools should allow medical students to embrace a new perspective through death education. Yonsei University Medical College has implemented death education since 2017 as an optional class for first and second year medical students. Students watch videos related to death once a week for 6 weeks and submit their reflections by e-mail. The professor reads the students' reflections and gives them weekly feedback. Through this coursework, students realize that death is not a medical event, but rather a part of life and completion. The ultimate purpose of death education is to transform blind life-absolutist identity into narrative identity.

Knowledge and Awareness of Nurses and Doctors Regarding Cancer Pain Management in a Tertiary Hospital (일개 상급종합병원 간호사와 의사의 암성 통증관리 지식 및 인식도)

  • Kim, Hee-Jin;Park, Ihn-Sook;Kang, Kyung-Ja
    • Asian Oncology Nursing
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    • v.12 no.2
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    • pp.147-155
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    • 2012
  • Purpose: The purpose of this study was to compare and check the levels of cancer pain management knowledge and awareness between doctors and nurses in a tertiary hospital and to develop an intervention program. Methods: Participants were 725 nurses and 95 doctors working in a hospital from May 2 to 29, 2009. Data were analyzed using t-tests, ${\chi}^2$-tests, and ANOVA with SPSS WIN 18.0. Results: In a comparison of the pain management score, nurses showed significant results for age (p<.001), carrier (p<.001), education (p<.001), workplace (p<.001), and doctors showed significant results only for age (p=.032). Doctors' marks were significantly higher than nurses' in pain management scores (p<.001). Knowledge about analgesic medication (t=-5.38, p<.001) and analgesic drug effect (t=-8.59, p<.001) were significantly different in the pain management subcategory score between nurses and doctors. There were four items with different awareness levels related to analgesics between nurses and doctors. Conclusion: The findings of this study demonstrate that it is possible to develop pain education content for nurses and doctors. The findings of this study are useful when seeking to change the awareness level of a medical team regarding opioid analgesics.

Changes in the Attitudes of Doctors toward Cooperative Practices between Western Medicine and Traditional Korean Medicine - A Systematic Review in Korean Literature - (한.양방 협진에 대한 의사들의 인식변화 - 국내 문헌에 대한 체계적 고찰 -)

  • Min, Hyun-Ju;Ryu, Ji-Seon;Yun, Young-Ju
    • Journal of Society of Preventive Korean Medicine
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    • v.16 no.1
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    • pp.15-29
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    • 2012
  • Background : With the increase of cooperative practices (CP) between conventional western medicine and traditional Korean medicine, there have been lots of researches on the status of CP and the attitude of doctors. Objective : Since most of the research is cross-sectional, this study aims to figure out the changes in the attitude of doctors toward CP through systematic review. Method : Systematic literature searches were performed on several databases in Korea. They were categorized according to the respondents and question items and analyzed by the context of questions, similarity of respondents and measurement scale. And we analyzed the changes of response regarding to doctors' awareness and attitude to CP. Results : Thirteen survey studies including attitude of doctors toward CP were selected. These studies were conducted between 1997 and 2009 and the number of respondents of each study ranged from 20 to 702. There has been increasing awareness of CP among doctors ; however the positive responses on the necessity of CP has decreased. Regarding the type of illness effectively treated employing CP, there was a shift from neurovascular to musculoskeletal and immune diseases. Most of the studies listed different approaches to disease, prejudice of health care providers and inadequate legal system as major obstacles against CP. Conclusion : In spite of the increase of CP in the last 20 years, there has not been marked positive change in the doctors' attitude toward CP. To promote CP, it is required to confirm the effectiveness of CP through disease models and change the medical legislation policies on CP.